Mass Hysteria among Beneficiary Students of the School-Feeding Program in Addis Ababa, Ethiopia.

Background: Mass hysteria is described as the rapid spread of conversion disorder without organic basis among a group of people. Mass hysteria can occur in work place and commonly in schools. There are usually some factors attributable to the episode; however, the lack of a pathogen upon investigation is a fundamental characteristic. We are reporting an episode of mass hysteria from two schools in Addis Ababa, Ethiopia. Methods: Clinical record, laboratory investigation, toxicology study from the food and psychiatric evaluations. Results: On November 25, 2019 a total of 113 students were brought from two schools in Addis to Tikur Anbessa Specialized Hospital. Most were between the ages of 10 and 15 years and were female students. Their school breakfast of bread and marmalade was attributed as the cause of the episode; however only 49% of the students brought in had eaten the food. The majority complained of nausea and vomiting but most had normal physical finding; and their symptoms were resolved without treatment. The laboratory investigation on samples of blood and stool were negative for bacterial growth and food culture and toxicology were non-revealing. Most were reassured and few were given symptomatic treatment. Conclusion: This mass hysteric episode is similar to episodic reports from other school feeding programs in some Asian and African countries. The finding of this report is important for health care practitioners to consider mass psychogenic illness in case they face similar mass presentation without objective finding; and will help to avoid unnecessary costly investigations.

Qualitative Assessment of the Quality of Care for Preterm, Low Birth Weight, and Sick Newborns in Ethiopia.

This study assesses the quality of care for preterm, low birth weight (LBW), and sick newborns across the public health care system levels in 3 regions of Ethiopia. Qualitative data based on the WHO framework to assess provision and experience of care was collected using in-depth interviews and focus group discussions with women who recently delivered preterm, LBW, and sick newborns, as well as health care providers and health extension workers, and facility administrators associated with study health facilities. This qualitative approach revealed perspectives of patients, health care providers and facility administrators to assess what is actually happening in facilities. Clinical guidelines for the care of preterm, LBW, and sick newborns were not available in many facilities, and even when available, often not followed. Most providers reported little or no communication with parents following hospital discharge. Human resource challenges (shortage of skilled staff, motivation and willingness, lack of supervision, and poor leadership) inhibited quality of care. Participants reported widespread shortages of equipment and supplies, medication, physical space, water, electricity, and infrastructure. Economic insecurity was a critical factor affecting parents' experience. Acceptance by users was impacted by the perceived benefits and cost. Users reported they were less likely to accept interventions if they perceived that there would be financial costs they couldn't afford. The quality of care for preterm, LBW, and sick newborns in Ethiopia as reported by recently delivered women, health care providers and facility administrators is compromised. Improving quality of care requires attention to process of care, experience of care, and health system capacity, structure, and resources.

Introducing medical genetics services in Ethiopia using the MiGene Family History App.

PURPOSE: Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia. METHODS: A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period. RESULTS: The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward. CONCLUSION: Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.