Antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods in selected towns of Ethiopia.

BACKGROUND: Street foods are any foods or drinks prepared or sold by street vendors in an open space. The purpose of this study was to determine the Bacteriological safety and antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods. METHOD: A laboratory-based cross-sectional study was used from December 2022 to February 2023 on street foods of Addis Ababa, Hawassa, Dire Dawa, and Jimma towns of Ethiopia. 525 street foods and 175 water samples were taken from 175 street food vending stalls. Proportional allocation to the total town population and stratified sampling techniques were used to select vending stalls. Samples were analyzed for the presence of bacteria following the standard microbiological methods used for the isolation, enumeration, and identification of bacteria. Pour plate technique was used to transfer the suspension to MacConkey agar, Mannitol Salt Agar, and Salmonella Shigella Agar. The antibiotic susceptibility test was performed using the Kirby-Bauer disk diffusion method. SPSS software was used to analyze the data. RESULT: Out of 525 food samples, 279 (53%) were contaminated by bacteria. From 175 water samples, 95 (54.3%) were contaminated with Escherichia coli. From both samples in total, eleven bacterial species were isolated. Staphylococcus aureus was the most frequently isolated species. Shigella, Klebsiella, and Salmonella group A have statistically significant with the type of food. Erythromycin (54%), Streptomycin (17%), and Amoxicillin (14%) were the most resistant antibiotics. Least resistance was observed to Ciprofloxacin (5%). CONCLUSION: Street foods of the selected towns were highly contaminated with various antibiotic-resistant organisms. Hence, the relevant authorities ought to ensure the proper handling of street food by enforcing safety measures. Additionally, they should initiate a widespread awareness campaign promoting the prudent use of antibiotics among both street food vendors and the broader population.

Comparison of Chest Computed Tomography (CT) Imaging Patterns and Severity among COVID-19 Patients during the First and Fourth Waves in Addis Ababa, Ethiopia.

Background: Studies done globally had shown that chest imaging patterns of Corona virus disease 2019 (COVID-19) infection varied depending on the strains of the virus and the waves of the pandemic. There is no published literature done in Ethiopia to examine whether there is any difference in chest computed tomography (CT) findings of COVID-19 patients during the first and fourth waves. Thus, this study tries to fill the gap of knowledge in that regard. Objective: To describe and compare chest CT scan imaging pattern and assess the predictors of chest CT severity of the first and fourth wave of COVID-19 infection. Methods: An institution-based cross-sectional study was conducted on 200 polymerase chain reaction test confirmed COVID-19 patients who underwent chest CT scan imaging in two diagnostic centers in Addis Ababa city. Pioneer and Wudassie diagnostic centers were selected due to the high case load and availability of well-experienced cardiothoracic radiologists. Data were collected from July 1 to August 3, 2022, using a structured Google form sheet questionnaire. Binary logistic regression was performed, and statistical significance was assessed at a level of significance α = 0.05. Results: Comparatively higher proportion of patients from the first wave had positive chest CT finding than fourth wave (99% vs. 69%). Bilateral lung involvement and lower lobe predilection were seen for both waves of COVID-19. Ground glass opacity and consolidation were the most common CT features for both waves. Delayed chest CT features such as traction bronchiectasis were primarily seen among first-wave patients. Mean global CT severity score was higher for the first-wave patients (13.18 vs. 8.31), and the mean difference is statistically significant (p < 0.001). Duration of symptoms was a statistically significant predictor of CT severity during the first wave of COVID-19, and patients that presented later than 14 days had 4.12 times higher odds of being in the severe CT score category than those that presented less than 7 days (AOR = 4.12, p = 0.011). There was no statistically significant predictor of CT severity for the fourth wave in this study. Conclusion: Chest CT positivity was comparatively higher for first wave patients. Common features included bilateral involvement, lower lobe involvement, ground glass opacity, and consolidation. Mean chest CT severity was comparatively higher for the first wave than the fourth wave, and the duration of symptoms was a statistically significant predictor of the CT severity for first wave.

Introduction of "Teach and Work from Home" in Radiology during the COVID-19 Pandemic and Its Current Status: Implementation Research Done at Tikur Anbessa Specialized Hospital.

Background: The current COVID-19 pandemic is forcing the world community to change how things should be done to avoid widespread transmission and containment of infection. Some countries are promoting "Work from Home" for disciplines like radiology" to prevent infection dissemination in hospital facilities. So the aim of this study is to introduce 'work & teach and from home' during the pandemic by establishing convenient virtual platforms for faculty members and students. Methods: This implementation research introduced a model "teach and work from home" during COVID pandemic. It was evaluated using a cross-sectional design to assess the effect of attending each session on the exam score of residents during the 1st 2 months of the COVID-19 declaration in Ethiopia. Teaching and service activities that didn't require physical presence were identified and replaced with virtual activities. Additional faculty teaching activity was also introduced to compensate for the reduced radiology caseload. Results: Teach and work from home was introduced, and a total of 196 online teaching activities were conducted during the model's two-month introduction. Online attendance of teaching activities was shown to have a positive relation with exam scores for all levels of trainees. Conclusion: It was able to introduce teach and work from home model in the department of radiology at Addis Ababa university and it was shown that residents' retention of knowledge with the virtual platform was encouraging. It also brought a new experience in virtual teaching which is still practiced after the pandemic.

Bilateral Choanal Atresia in an Adolescent Female: A Rare Case Report.

Choanal atresia is a rare congenital anomaly of the nasal cavities characterized by lack of patency of the posterior ends of one or both nasal cavities (choanae). It is the most common congenital anomaly of the nasal cavity. Bilateral choanal atresia accounts for a third of the cases and is almost invariably detected in the neonatal age due to respiratory distress. Detection of bilateral choanal atresia in adulthood is extremely rare and has been reported only a few times. We report a case of a teenage girl who was diagnosed with bilateral choanal atresia after presenting with longstanding snoring and intermittent nasal discharge. She was managed with bilateral transnasal endoscopic choanoplasty to restore the choanal patency.

Evaluation of the Practice of Performing Abdominal CT Scan with Manually Administered Fixed Dose of Contrast in Achieving Adequate Hepatic Enhancement: An Institutional-Based Cross-Sectional Study.

Background: Intravenous (IV) iodine-based contrast agents are administered during computed tomography (CT) examination to enhance the density differences between lesions and surrounding parenchyma, which is important for lesion characterization, and to demonstrate vascular anatomy and vessel patency. Quality of contrast enhancement has a significant influence on diagnostic interpretation and subsequent management. In this study, we assessed the quality of portal venous phase abdominal CT scans performed with a manual injection of a fixed dose of contrast, which is the routine practice at Tikur Anbessa Specialized Hospital (TASH). The effect of age and sex was also assessed. Method: A hospital-based retrospective review was performed to identify patients who have had a precontrast and postcontrast abdominal CT scan from November 4, 2020, to September 30, 2022. All patients with abdominal CT scans having precontrast and portal venous phase scans were included in the study. All CT scans were reviewed by the principal investigator and the quality of contrast enhancement was assessed. Results: In this study, there were a total of 379 patients. The mean hepatic attenuations in precontrast and portal venous phase scans were 59.05 ± 6.69 HU and 103.73 ± 12.84 HU. The proportion of scans with less than 50 HU enhancement was 68% (n = 258). There was a significant association between age and sex with contrast enhancement. Conclusion: The hepatic contrast enhancement pattern of abdominal CT scan at the study institution reveals a concerning degree of image quality. This is evidenced by the high number of suboptimal contrast enhancement indices and the highly variable enhancement patterns across different patients. This can have a negative impact on the diagnostic performance of CT imaging and can adversely affect the management. Furthermore, both sex and age affect the pattern of enhancement.

Surviving Fetus from a Full Term Abdominal Pregnancy.

Background: Abdominal pregnancy refers to a rare form of ectopic pregnancy that has been implanted in the peritoneal cavity. Clinical suspicion combined with ultrasound is important for early diagnosis. A surviving fetus from an abdominal pregnancy is extremely rare. Case Presentation: Herein we report on a case of advanced abdominal pregnancy in a Gravida-III Abortion-II mother who presented with worsening abdominal pain of 1 week duration associated with fetal movement and managed successfully with an outcome of a live neonate and no maternal complication. Conclusion: A live neonate from term abdominal pregnancy is a rare occurrence. Early diagnosis of abdominal pregnancy is crucial to avoid potentially catastrophic maternal complications even though our patient, fortunately, has a smooth postoperative course. A high level of suspicion combined with ultrasound is helpful in reaching a diagnosis. Skill advancement for radiologists and non-radiology professionals involved in obstetric ultrasound is recommended to avoid misdiagnosis, as in our case. Careful post-operative evaluation is important to look for maternal and fetal complications.

Unmet need for long-acting and permanent contraceptives and associated factors among married women in Southern Ethiopia.

BACKGROUND: Long-acting and permanent methods (LAPMs) prevent women from having unintended pregnancies. Globally, unintended pregnancies, both mistimed and unwanted, occur every year. In developing countries, maternal mortality and unsafe abortions result from unintended pregnancies. This study aimed to assess the unmet need for LAPMs of contraceptives and associated factors among married women of the reproductive age group (15-49 years) in Hosanna Town, Southern Ethiopia, in 2019. METHODS: A community-based, cross-sectional study was conducted from March 20 to April 15, 2019. Data were collected on 672 current married women in the reproductive age group (15-49) through face-to-face interviews using a structured questionnaire. Study participants were selected using a multi-stage sampling method. Data were entered into the computer using EpiData version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were performed to identify factors associated with the unmet need for LAPMs. An odds ratio with 95% CI was used to assess the association between the independent and dependent variables. RESULTS: The unmet need for LAPMs for contraception in Hossana town was 234 (34.8%) (95% CI: 29.8, 39.8). Factors significantly associated with the unmet need for LAPMs of contraception were: women's age 35-49 [AOR = 9.01, 95% CI: 4.21, 19.32]; education of women [AOR = 8.64, 95% CI: 1.65, 45.42]; lack of discussion between partners [AOR = 4.79, 95% CI: 3.11, 7.39]; lack of proper counseling for women [AOR = 2.13, 95% CI: 1.41, 3.23]; having a daily laborer occupation [AOR = 7.08, 95% CI: 2.44, 20.51]; and attitude of women toward LAPMs of contraception [AOR = 1.62, 95% CI: 1.03, 2.56]. CONCLUSIONS: The unmet need for LAPMs was high in the study area. Age of women, discussions with partners, women ever counseled by health professionals, respondents' educational status, husband's educational status, women's attitude toward LAPMs, and respondents' occupational status were contibutes for high unmet need. High unmet need contributes to an unintended pregnancy and risky abortions. Proper counseling of women and women's discussions with their husbands is fundamental areas of intervention.

Awareness, Acceptance, and Associated Factors of Human Papillomavirus Vaccine among Parents of Daughters in Hadiya Zone, Southern Ethiopia: A Cross-Sectional Study.

INTRODUCTION: Human papillomavirus infections are the most prevalent sexually transmitted disease among women worldwide. Cervical cancer is the second-most frequent disease worldwide in terms of incidence and mortality, and it is primarily responsible for fatalities in low- to middle-income nations, including Ethiopia. OBJECTIVE: To assess awareness, acceptance, and associated factors of the human papillomavirus vaccine among parents of daughters in the Hadiya zone, southern Ethiopia. METHODS: From November to December 2021, a community-based cross-sectional study was conducted in the Hadiya zone among parents with daughters in the zone. The study respondents were chosen using a two-stage sampling technique from parents with a 9-14-year-old daughter. An interviewer-administered questionnaire was used to collect data. For analysis, the data were entered into Epidata version 3.1 and exported to SPSS version 25. Variables with a p-value less than 0.25 in the bivariate analysis were transferred to multivariable analysis. A logistic regression model was applied to forecast the association between the predictor and outcome variables. Statistical significance was considered at a 0.05 p-value. RESULTS: The study showed that the overall acceptance of parents to vaccinate their daughters with HPV vaccination was 450 (84.9%). Parents of daughters of male sex (AOR: 0.407; 95%CI: 0.221, 0.748), who had only one daughter (AOR: 2.122; 95%CI: 1.221, 3.685), whose daughter(s) attended a government school (AOR: 0.476; 95%CI: 0.263, 0.861), who had poor knowledge (AOR: 0.532; 95%CI: 0.293, 0.969) and who had a negative attitude (AOR: 0.540; 95%CI: 0.299, 0.977) were discovered to have a strong correlation. CONCLUSION: This study found that there was a high level of parental acceptance; attitudes and knowledge about the HPV vaccine are significant in determining their intentions to vaccinate their daughter. Authorities in high-risk areas for cervical cancer incidence should plan and implement strategies by providing health information regarding human papillomavirus vaccination with an emphasis on raising community awareness.

Assessment of Adult's Abdominopelvic Computed Tomography Radiation Doses in Amhara Region, Ethiopia.

Background: Computed Tomography plays a priceless role for diagnostic and therapeutic purpose; however, applying an optimized Computed Tomography Technique to produce qualified image while delivering minimum radiation dose to patients is the common challenge. The main objective of this study was to establish local diagnostic reference levels for adult patients who visited abdominopelvic Computed Tomography examination. Methods: A total of 158 patients who had taken abdominopelvic Computed Tomography examination from three selectedAmhara region hospitals were investigated. Both prospective and retrospective techniques of data collection were used while collecting the data in the entire sample. Two GE - Optima Computed Tomography 540 (16 slices) and one Phillips - Brilliance (64slices), were employed during data collections. Data for patient demographics scan protocols, Computed Tomography dose descriptors and machine specifications were collected and analyzed by using SPSS software version 26. Results: The third quartile estimated computed tomography dose index volume and dose length product, which is the local Diagnostic Reference Levels, were 12 mGy and 1904 cm.mGy respectively. The investigated local Diagnostic Reference Levels of Computed Tomography Dose index volume (mGy) was comparable to other international Diagnostic Reference Levels. However, the third quartile value of dose length product (cm.mGy) was higher than other reported international Diagnostic Reference Levels. Conclusion: The values of local Diagnostic Reference Levels presented in this work can be used as a baseline upon which future dose measurements can be compared in Amhara region.

Patterns of MRI Findings in Patients with Chronic Headache: A Retrospective Study from a Private Diagnostic Center in Addis Ababa, Ethiopia.

Background: Headache is one of the most common complaints that lead the patient to seek medical advice however only a few patients with recurrent headaches have a secondary cause like intracranial mass. The appropriate utilization of neuroimaging is important to rule-out secondary cause of headache in resource-limited regions. The objective of this study is to describe the patterns of MRI findings in the evaluation of patients with chronic headache and to determine the clinical variables helpful in identifying patients with intracranial lesions. Materials and Methods: This cross sectional study was conducted among 590 selected patients who underwent an MRI scan of the head from September 2016 to January 2018 at Wudassie Diagnostic center in Addis Ababa, Ethiopia. Siemens Magnetom 0.35T MRI was used. Results: Out of 590 patients, 372 (63.1%) were females and 218 (36.9%) were males; 300 (50.8%) patients with the mean age of 38.6 ± 0.5 years and a median of 37 ± 16.7years have normal brain MRI and 290(49.2%) have abnormal brain MRI reports. The abnormal findings further divided into non-significant findings were 166(28%) that did not alter patient management and clinically significant findings were 124 (21%) which included by decreasing order of frequency tumors, infection, hydrocephalus, hemorrhage, and vascular abnormalities. Conclusion: It was 1.3 times higher rate of positive brain MR findings in patients who had headaches plus abnormal neurologic findings as compared to patients without neurologic abnormality (P-value = 0.01). There is a high rate of significant abnormal MRI findings in this study as compared to studies from developed nations.

Linking water quality monitoring and climate-resilient water safety planning in two urban drinking water utilities in Ethiopia.

Unsafe drinking water is a recognized health threat in Ethiopia, and climate change, rapid population growth, urbanization and agricultural practices put intense pressure on availability and quality of water. Climate change-related health problems due to floods and waterborne diseases are increasing. With increasing insight into impacts of climate change and urbanization on water availability and quality and of required adaptations, a shift towards climate-resilient water safety planning was introduced into an Ethiopian strategy and guidance document to guarantee safe drinking water. Climate-resilient water safety planning was implemented in the urban water supplies of Addis Ababa and Adama, providing drinking water to 5 million and 500,000 people, respectively. Based on the risks identified with climate-resilient water safety planning, water quality monitoring can be optimized by prioritizing parameters and events which pose a higher risk for contaminating the drinking water. Water quality monitoring was improved at both drinking water utilities and at the Public Health Institute to provide relevant data used as input for climate-resilient water safety planning. By continuously linking water quality monitoring and climate-resilient water safety planning, utilization of information was optimized, and both approaches benefit from linking these activities.

Adherence to Antiretroviral Therapy and Associated Factors among People Living with HIV/AIDS in Hara Town and Its Surroundings, North-Eastern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression. Nonadherence to ART led to the human Immunodeficiency Virus (HIV) related morbidity and mortality. Moreover, it intensifies the risk of the emerging drug resistant HIV strains. This study aimed to assess the level of ART adherence and to identify its predictive associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia. METHODS: An institutional facility based cross-sectional study was conducted from April-May 2017. A total of 454 individuals were on ART follow-up in the selected ART-clinic, and only 418 patients were recruited. Bivariate and multivariate logistic regression analyses were carried out to identify associated factors. Odds ratio and 95% Confidence Interval (CI) were calculated to determine the level of significance. RESULTS: The level of ART adherence in the study setting was 300 (71.8%). Participants who had not disclosed their HIV status to their families were 88% less likely to adhere to their ART medication than those who had disclosed their HIV status ((Odds ratio (OR): 0.12, 95%CI:0.05-0.58; p<0.001). On the other hand, participants who had not encountered drug side effects were 2.69 times more likely to adhere to their ART medication than those who had ever encountered drug side effects (OR: 2.69, 95%CI:1.27-5.05; p<0.001). CONCLUSION: A very low level of ART adherence was shown in the study population. It was below the recommended good adherence standard. Therefore, patients should get adequate and comprehensive ART adherence counselling before initiation ART treatment and during the follow-up time.

Adherence to antiretroviral therapy and associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia: a cross-sectional study

BACKGROUND: Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression. Nonadherence to ART led to the human Immunodeficiency Virus (HIV) related morbidityandmortality. Moreover, it intensifies the risk of the emerging drug resistant HIV strains.This study aimed to assess the level of ART adherence and to identify its predictive associated factors among people living with HIV/AIDS in Hara Town and its surroundings, North-Eastern Ethiopia.METHODS: An institutional facility based cross-sectional study was conductedfrom April-May 2017.A total of 454 individuals were on ART follow-up in the selectedART-clinic, and only 418 patients were recruited.Bivariate and multivariate logistic regression analyseswerecarried out to identify associated factors.Odds ratio and 95% Confidence Interval (CI) were calculated to determine the level of significance.RESULTS: The level of ART adherence in the study setting was 300(71.8%).Participants who had not disclosed their HIV status totheir families were 88% less likely to adhereto their ART medicationthan those who had disclosed their HIV status((Odds ratio(OR):0.12, 95%CI:0.05-0.58; p<0.001). On the other hand, participants who had not encountered drug side effects were 2.69 times more likely to adhere to their ART medication than those who had ever encountered drug side effects(OR: 2.69,95%CI:1.27-5.05; p<0.001).CONCLUSION: A very low level of ART adherence was shown in the study population.It was below the recommended good adherence standard. Therefore, patients should get adequate and comprehensive ART adherence counselling before initiation ART treatment and during the follow-up time

High level of drug resistance by gram-negative bacteria from selected sewage polluted urban rivers in Addis Ababa, Ethiopia.

OBJECTIVE: The aim of this study was to determine the level of drug resistance by gram-negative bacteria isolated from selected sewage polluted urban rivers in Addis Ababa, Ethiopia. RESULTS: From a total of 94 river water samples, 90 medically important gram-negative bacterial isolates were recovered to the species level. The predominant bacteria isolated were E. coli. 23 (26%) followed by K. pneumoniae 18 (20%), K. oxytoca 17 (19%). E. coli showed a high level of resistance to ampicillin 21 (91.3%), cefalotin, cefuroxime, ceftriaxone and cefepime 16 (70%). Both K. pneumoniae and K. oxytoca showed high resistance to ampicillin 16 (94%) and 17 (95%) respectively. Among identified bacterial species, most of them showed a multidrug-resistant pattern. Providential retigerri showed 100% multidrug resistance followed by P. alkalificiens (90%), E. coli (78%), M. morgani (75%), and C. frundi (60%).

The safety of image-guided biopsy and its impact on patient care: the first Ethiopian experience

Background: The introduction of image-guided biopsy has revolutionized the quality of patient care by avoiding open and complications associated with it and the use anesthesia. Even though Ethiopian radiological training dates back to more than two decades, interventional radiology is a very recent introduction. This study reports the safety and significance of image guided biopsy on patient care.Patients and methods: This study was a prospective study carried out to assess the impact and safety of doing image-guided biopsy in a tertiary care teaching Hospital in Addis Ababa, Ethiopia.Results: A total of 117 patients, their age ranging from 3 to 80years and a mean age of 41 were evaluated; 6.8% of them were children below the age of 10. Around two-thirds of the cases had intra-abdominal indications for biopsy followed by mediastinal pathologies. Ultrasound was used as a guide in about 85% of the cases. Except for one case that developed massive hemoptysis following fine needle aspiration of a middle mediastinal mass and treated conservatively, there was no major complication. A few minor complications, like mild pain and minor hemorrhage, required only close observation.Conclusion: On the whole, our study indicates that image-guide biopsy improves the existing medical care.Moreover, institutions particularly those providing training in radiology should promote the establishment of interventional radiology for better patient diagnosis and improved planning of subsequent treatment