Surgical outcome and predictors of neonates with esophageal atresia admitted at Tikur Anbesa Specialized Hospital.

BACKGROUND: Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. This anomaly continues to cause considerable morbidity and mortality in Sub-Saharan Africa, presenting various concerns about how to treat esophageal atresia. Esophageal atresia-related neonatal mortality can be reduced by evaluating the surgical outcome and identifying associated factors. OBJECTIVE: This study aimed to assess the surgical outcome and identify predictors of neonates with esophageal atresia admitted at Tikur Anbesa specialized hospital. METHODS: Retrospective crossectional study design was employed on 212 neonates with esophageal atresia who were undergone surgical intervention in Tikur Anbesa specialized hospital. Data were entered into epi data 4.6 and exported to Stata version 16 software for further analysis. A logistic regression model with Adjusted odds ratio (AOR), confidence interval (CI) and p-value <0.05 were used to identify predictors of poor surgical outcome of neonates with esophageal atresia. RESULT: In this study, 25% of newborns who underwent surgical intervention at TikurAbnbesa specialized hospital had successful surgical outcomes, compared to 75% of neonates with esophageal atresia who had poor surgical outcomes. Significant predictors of the poor surgical outcome of neonates with esophageal atresia were severe thrombocytopenia (AOR = 2.81(1.07-7.34)), timing of surgery (AOR = 3.7(1.34-10.1), aspiration pneumonia (AOR = 2.93(1.17-7.38)) and related abnormalities (AOR = 2.26(1.06-4.82)). CONCLUSION: The results of this study showed that, when compared to other studies, a substantial percentage of newborn children with esophageal atresia had poor surgical outcomes. Early surgical management, aspiration pneumonia and thrombocytopenia prevention and therapy play a big part in improving the surgical prognosis for newborns with esophageal atresia.

Prevalence and Associated Factors of Hypertension Among Adults in Gurage Zone, Southwest Ethiopia, 2022.

Introduction: Hypertension affects over a billion people worldwide, making it a major public health problem. The problem is significant in both developed and developing countries. However, studies are scarce in developing countries such as Ethiopia. Objectives: This study aimed to assess the prevalence of hypertension and its associated factors at the community level, in South Ethiopia. Methods: A cross-sectional study design was employed on a sample of 680 participants in the study from April 1 to June 30, 2022. An interview administer was conducted using a standardized and pretested questionnaire was employed. The Epi data 3.1 versions were used to enter data and then exported into SPSS version 23 for analysis. All variables in the multivariable logistic analysis were a candidate with a bi-variable at p < .25. The multivariable logistic regressions were performed to determine the predictors of hypertension, and the significance level was established with p < .05. Results: There were a total of 635 participants and the response rate was 93.4%. The prevalence of hypertension was found to be 22.0% [95% CI; 19.1-25.4]. The mean age of the participants was 40.8 ± 12.88 years. Being older age (AOR: 1.95; 95%CI; 1.13-3.36), family history [AOR: 2.65, 95%; CI (1.29-5.45)], eating animal fat [AOR: 0.21, 95%; CI (0.08-0.52)], smoking cigarettes [AOR: 4.06, 95%; CI (2.24-7.36)] and had poor knowledge about hypertension [AOR: 2.69, 95%; CI (1.61-4.49)] were significantly associated with raised blood pressure. Conclusions: Hypertension was prevalent in one out of every five study participants. Older age, family history of hypertension, animal fat intake, cigarette smoking, and lack of knowledge were found to be significant factors for hypertension. To address the burden of hypertension, health care practitioners should provide broad health education, routine screening, and promotion of recommended lifestyle measures.

Time to Death and Predictors Among Neonates with Esophageal Atresia in Ethiopia.

Background: Esophageal atresia is an upper gastrointestinal tract developmental abnormality in which the upper and lower esophagus do not connect. Esophageal atresia has a higher incidence of death in sub-Saharan Africa, ranging from 30% to 80%. In Ethiopia, infants with esophageal atresia had a higher mortality rate. The assessment of time to death and predictors of esophageal atresia can help to reduce newborn mortality. Objective: This study was aimed to investigate the time to death and predictors of neonates with esophageal atresia admitted to Tikur Anbessa Specialized Hospital, Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among 225 neonates diagnosed with esophageal atresia. The median survival time, Kaplan-Meier failure estimation curve, and Log rank test were computed. Bivariable and multivariable Cox regression hazards models were fitted to identify the predictors of time to death. Hazard ratio with a 95% confidence interval was calculated and p-values <0.05 were considered statistically significant. Results: In the study, the incidence density rate of neonates diagnosed with esophageal atresia was 5.5 (95% CI, 4.7-6.4) per 100-neonates day. The median time to death was 11 days (95% confidence interval (CI), 8.92-13.08). Birth weight <2500 g (adjusted hazard ratio (AHR)=1.49, 95% CI, 1.02 -2.21), having sepsis (AHR=1.67,95% CI, 1.15-2.44), being malnourished (AHR = 1.61, 95% CI, 1.03 -2.58), esophageal atretic neonates without surgery (AHR = 3.72, 95% CI, 1.34-10.38), diagnosis time at >48 hours of admission (AHR = 1.48, 95% CI, 1.01-2.15) and being dehydrated (AHR = 2.38, 95% CI, 1.63-3.46) were significant predictors of time to death among esophageal atretic neonates. Conclusion: The findings in this study highlighted the necessity of early diagnosis, proper comorbidity treatment, and timely surgical intervention to reduce infant deaths due to esophageal atresia.