iHeard STL: Development and first year findings from a local surveillance and rapid response system for addressing COVID-19 and other health misinformation.

BACKGROUND: The U.S. Surgeon General and others have emphasized a critical need to address COVID-19 misinformation to protect public health. In St. Louis, MO, we created iHeard STL, a community-level misinformation surveillance and response system. This paper reports methods and findings from its first year of operation. METHODS: We assembled a panel of over 200 community members who answered brief, weekly mobile phone surveys to share information they heard in the last seven days. Based on their responses, we prioritized misinformation threats. Weekly surveillance data, misinformation priorities, and accurate responses to each misinformation threat were shared on a public dashboard and sent to community organizations in weekly alerts. We used logistic regression to estimate odds ratios (ORs) for associations between panel member characteristics and misinformation exposure and belief. RESULTS: In the first year, 214 panel members were enrolled. Weekly survey response rates were high (mean = 88.3% ± 6%). Exposure to a sample of COVID-19 misinformation items did not differ significantly by panel member age category or gender; however, African American panel members had significantly higher reported odds of exposure and belief/uncertain belief in some misinformation items (ORs from 3.4 to 17.1) compared to white panel members. CONCLUSIONS: Our first-year experience suggests that this systematic, community-based approach to assessing and addressing misinformation is feasible, sustainable, and a promising strategy for responding to the threat of health misinformation. In addition, further studies are needed to understand whether structural factors such as medical mistrust underly the observed racial differences in exposure and belief.

Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder.

Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. "High-risk" participants self-identified as "not being engaged in treatment" or "new or early in their recovery" (n = 11); "low-risk" participants self-identified as being "well-established" or "in long-term recovery" (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond.

COVID-19 Preventive Practices among Bus Station Workers in Ethiopia.

As of May 19, 2021, Ethiopia was among the five African countries most affected by COVID-19. A cross-sectional design was used to assess the level of knowledge, perceptions, and practices of bus station workers about COVID-19 between August 25 and September 17, 2020. Face-to-face interviewer-administered questionnaires were used. To identify the factors associated with the dependent variables, simple and multiple binary logistic regression analyses were used. A P value < 0.05 was considered significant. Data were analyzed using SPSS version 20 software. In this study, 427 workers from three bus stations participated. Approximately 84.5%, 84.8%, and 81.3% of the workers had good knowledge, positive perceptions, and good practices, respectively. Multivariable logistic regression analysis showed that workers with a monthly income of 3,001 to 4,000 birr were about four times more likely to have poor knowledge compared with higher income workers. Those workers with poor knowledge were 2.4 times, and security workers were 3.7 times, more likely to have poor practices compared with workers with good knowledge and drivers, respectively. In conclusion, workers used in security and those who had poor knowledge regarding COVID-19 failed to exhibit effective preventative practices against the virus.

Patient characteristics associated with different types of prison TB: an epidemiological analysis of 921 TB cases diagnosed at an Ethiopian prison.

BACKGROUND: Despite incarcerated population being at an increased risk of tuberculosis (TB) and serving as a potential source of TB transmission for the general population, prison TB remains understudied. Given its adverse impact on progress towards TB elimination, World Health Organization (WHO) has identified prison TB research as a top priority to guide TB treatment/control interventions. METHODS: We retrospectively analyzed 921 notified TB cases that were diagnosed at Kality Federal Prison, Ethiopia during 2009-2017. To assess trends of microbiologically confirmed pulmonary TB (PTB), extra-pulmonary TB (EPTB), and TB-HIV co-infection, an ecological analysis of aggregated cases was used to report trends over time. Additionally, we used multivariable log binomial regression to identify patient characteristics associated with microbiologically confirmed PTB, EPTB, and TB-HIV co-infection. RESULTS: Microbiologically confirmed PTB proportion increased over time. Young age was identified as an important risk factor for EPTB (adjusted prevalence ratio [aPR] = 1.74, 95% CI 0.97, 3.13) while HIV coinfection was negatively associated with EPTB (aPR = 0.73, 95% CI 0.55, 0.97). While previous TB history was associated with a lower likelihood of EPTB (aPR = 0.42, 95% CI 0.25, 0.70), it was associated with an increased risk of TB-HIV coinfection (aPR = 1.37, 95% CI 1.10, 1.71). Clinically diagnosed PTB patients were more likely to have TB-HIV coinfection compared to microbiologically confirmed PTB patients (aPR = 1.32, 95% CI 1.02, 1.72). CONCLUSIONS: Increasing proportion of microbiologically confirmed PTB may suggest delayed access to treatment, severe disease and increased risk of intramural transmission. Associations with clinical/demographic factors varied for different types of TB and were not always consistent with what has been previously reported for the general population, necessitating the need to refocus prison TB control/treatment strategies based on context specific epidemiological factors.

Prevalence and outcome of sepsis and septic shock in intensive care units in Addis Ababa, Ethiopia: A prospective observational study.

BACKGROUND: Sepsis and septic shock are the major causes of morbidity and mortality in Intensive care Units (ICUs) in low and middle-income countries. However, little is known about their prevalence and outcome in these settings. The study aimed to assess the prevalence and outcome of sepsis and septic shock in ICUs in Addis Ababa, Ethiopia. METHODS: A prospective observational study was conducted from March 2017 to February 2018 in four selected ICUs in Addis Ababa from a total of twelve hospitals having ICU services. There were 1145 total ICU admissions during the study period. All admissions into those ICUs with sepsis, severe sepsis, and septic shock using the Systemic Inflammatory Response Syndrome (SIRS) criteria (SEPSIS-2) during the study period were screened for sepsis or septic shock based on the new sepsis definition (SEPSIS-3). All patients with sepsis and septic shock during ICU admission were included and followed for 28 days of ICU admission. Data analysis was done using the Statistical Package for Social Sciences (SPSS) software version 20.0. RESULTS: A total of 275 patients were diagnosed with sepsis and septic shock. The overall prevalence of sepsis and septic shock was 26.5 per 100 ICU admissions. The most frequent source of sepsis was respiratory infection (53.1%). The median length of stay in the ICUs was 5 (IQR, 2-8) days. The most common bacterium isolate was Pseudomonas aeroginosa (34.5%). The ICU and 28-day mortality rate was 41.8% and 50.9% respectively. Male sex, modified Sequential Organ Failure Assessment score ≥10 on day 1 of ICU admission, and comorbidity of HIV or malignancy were the independent predictors of 28-day mortality. CONCLUSION: Sepsis and septic shock are common among our ICU admissions, and are associated with a high mortality rate.

Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018.

BACKGROUND: Pregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia. OBJECTIVE: To assess PPFP utilization and associated factors in Addis Ababa, Ethiopia. METHOD: A facility-based cross-sectional study was conducted from April to June 2018. A total of 625 women were enrolled in the study. Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Binary logistic regression model with adjusted odd ratio (AOR) and 95% confidence interval (CI) was used to identify the factors associated with PPFP use. A p-value less than 0.05 was considered as significant. RESULT: The magnitude of PPFP utilization in Addis Ababa was 71.8%. Previous family planning (FP) information (AOR = 13.2; 95% CI: (1.96, 88.07)), FP information from health facility visit (AOR = 2.23; 95% CI: (1.45, 3.43)), antenatal care (AOR = 4.96; 95% CI: (1.58, 15.64)), counseling on FP at postnatal care (AOR = 1.97; 95% CI: (1.27, 3.05)), menses resumption after birth (AOR = 1.75; 95% CI: (1.11, 2.76)), and commencing sexual activity after birth (AOR = 9.34; 95% CI: (5.39, 16.17)) were the factors associated with PPFP use. CONCLUSION AND RECOMMENDATION: Though the magnitude of PPFP use is encouraging, still three out of the ten postpartum women did not use PPFP. The determinants of PPFP use were having FP information, having FP information from health facility visit, antenatal care, counseling about FP during postnatal care, menses resumption after birth, and commencing sexual activity after birth. The health system in the City and the healthcare providers should strive to reach every woman who is not accessing the PPFP services and antenatal care services, and improve counseling services on PPFP during delivery and postnatal care services.

Determinants of severe acute malnutrition among children aged 6-59 months in the pastoral community of Liban District, Guji Zone, Oromia Regional State, Southeastern Ethiopia: a case-control study.

Malnutrition remains one of the most common causes of morbidity and mortality among children, particularly in Ethiopia. The present study aimed to assess determinants of severe acute malnutrition among children aged 6-59 months in the pastoral community of Liban District, Southeastern Ethiopia. A case-control study design was conducted on 89 cases and 177 controls from 1-30 December 2020. A simple random sampling technique was used to select study participants. Data collected using interviewer-administered structured questionnaire were used, and anthropometric measurements were done by standardised calibrated instruments to collect data. Data were entered into EPI data version 3.1 and then exported to SPSS version 25.0 software for analysis. All candidate variables with P < 0⋅25 in bivariate analysis were then entered into multivariable logistic regression. Associated factors were identified at P < 0⋅05 and 95 % CI. A total of 266 (89 cases and 177 controls) having a response rate of 96⋅6 % being underweight [adjusted odds ratio (AOR) = 11⋅8, 95 % CI 3⋅17, 43⋅89], illness previous 2 weeks (AOR = 3⋅47, 95 % confidence interval (CI) 1⋅34, 8⋅99), family member with malnutrition (AOR = 4⋅52, 95 % CI 1⋅45, 14⋅01), greater than five family size, (AOR = 5⋅33, 95 % CI 2⋅08, 13⋅66), mothers unable to read and write (AOR = 3⋅66, 95 % CI 1⋅27, 10⋅56), mothers with low decision autonomy (AOR = 5⋅67, 95 % CI 2⋅26, 14⋅27), not handwashing at all critical time (AOR = 7⋅23, 95 % CI 2⋅74, 19⋅07), not feeding child animal source (AOR = 7⋅13, 95 % CI 1⋅98, 25⋅59), bottle feeding (AOR = 7⋅06, 95 % CI 2⋅34, 21⋅28) and being married (AOR = 0⋅05, 95 % CI 0⋅02, 0⋅19) were significantly associated with acute malnutrition. The present study has confirmed the association of acute malnutrition with maternal education, underweight, family size and inappropriate infant caring practices.

Family planning awareness, utilization and associated factors among women of reproductive age attending psychiatric outpatient care, a cross- sectional study, Addis Ababa, Ethiopia.

BACKGROUND: Women with mental illness have a special need for family planning as they carry a high risk of unplanned pregnancy, sexual violence and, the poor obstetric outcomes due to their mental illness, as well as teratogenicity from exposure to psychotropic medications lower antenatal care utilization. OBJECTIVE: To assess knowledge, and utilization of family planning and associated factors among women attending psychiatric outpatient clinics in Addis Ababa. METHODS: A cross-sectional study was conducted among 423 women attending the outpatient psychiatric clinics of three general and one specialized mental hospital in Addis Ababa, the capital city of Ethiopia. A structured and pretested questionnaire were administered by psychiatric nurses. Multiple logistic regression analysis was conducted to identify factors associated with utilization of family planning methods. RESULT: Four hundred twenty-two participants who had follow up at the psychiatric outpatient departments participated in the study. Almost 88% of participants had an unintended pregnancy. Only 68% of study participant had ever heard about Family planning. Just over one third (38.6%) reported current use of at least one method of Family planning. Of those not using family planning 73.3% had no intention to have children. And 38.8% did not have any intention to use Family Planning in the future. Fear of drug-interaction with psychiatric medication was the most common reason not to use contraceptives. Having one or two children was associated with higher utilization of family planning [adjusted odds ratio (95%, confidence interval) 2.05 (1.06, 3.99)]. CONCLUSIONS: In this study, the majority of women with mental illness were not using family planning methods. The Awareness of the Family planning methods is lower than the national average. Education and counselling about family planning for women attending psychiatric outpatient departments should be strengthened.

Perinatal outcome of growth restricted fetuses with abnormal umbilical artery Doppler waveforms compared to growth restricted fetuses with normal umbilical artery Doppler waveforms at a tertiary referral hospital in urban Ethiopia.

BACKGROUND: Intrauterine growth restriction is defined as a fetal weight below the 10th percentile for a given gestational age and can be identified using umbilical artery Doppler velocimetry which is a non-invasive technique. The objective of this study was to determine the perinatal outcome of growth-restricted fetuses with abnormal umbilical artery Doppler study compared to those with normal umbilical artery Doppler waveforms at a tertiary referral hospital in Ethiopia. METHODS: A prospective cohort study was conducted among pregnant mothers with fetal growth restriction admitted for labour and delivery from September 2018-February 2019. The data were entered and analyzed using SPSS version 23. After conducting descriptive analysis, exploring the entire data, and checking for, statistical associations between abnormal umbilical artery Doppler and outcome variables, multiple logistic regression was conducted to control for confounders. RESULTS: A total of 170 pregnant mothers complicated with growth-restricted fetuses were included in the study, among which 133 were with normal umbilical artery Doppler studies and 37 were with abnormal umbilical artery Doppler studies. Four (3%) of normal and 9(24.3%) of abnormal umbilical artery Doppler studies ended in perinatal death-value = 0.001. Twenty (15%) of normal and 24(64.9%) of abnormal umbilical artery Doppler study neonates required neonatal intensive care admission-value = 0.002. Growth restricted fetuses complicated with abnormal Doppler were two times more likely to require neonatal intensive care unit admissions compared to growth-restricted fetuses with normal umbilical artery Doppler flow, P-value 0.002, (OR = 2.059,95%CI 1.449-2.926). Growth restricted fetuses complicated with abnormal Doppler were four times more likely to end in early neonatal death compared to growth-restricted fetuses with normal umbilical artery Doppler flow, P-value 0.001, (OR = 4.136, 95%CI 3.423-4.998). However, the study is unmatched and there is a possibility of gestational age confounding the result and should be seen with the context of preterm morbidity and mortality. CONCLUSION: The abnormal umbilical artery Doppler waveform is associated with cesarean section delivery, neonatal intensive care unit admission, respiratory distress syndrome, neonatal sepsis, neonatal hyperbilirubinemia, and early neonatal death compared to normal umbilical artery Doppler flow.

Factors associated with dengue fever outbreak in Dire Dawa administration city, October, 2015, Ethiopia - case control study.

BACKGROUND: Dengue Fever (DF) is underrecognized mosquito borne viral disease prevalent in tropical and subtropical regions. In 2013, Ethiopia reported the first confirmed DF outbreak in Dire Dawa city which affected 11,409 people. During the outbreak investigation, we determined factors associated with DF and implemented control measures. METHODS: We conducted a 1:2 un-matched case control study from October 7-15/2015. Case was any person with fever of 2-7 days and more than two symptoms: headache, arthralgia, myalgia, rash, or bleeding from any part of the body. We recruited participants using purposive sampling from health facilities and used structured questionnaire to collect data. Multiple logistic regression analysis was conducted to control confounders and to identify factors associated with DF. Sixty-nine serum-samples were tested by Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: We enrolled 210 participants (70 cases and 140 controls) in the study. Females accounted for 51.4% of cases and 57.1% of controls. The mean age was 23.7 ± 9.5 standard deviation (SD) for cases and 31.2 ± 13 SD for controls. Close contact with DF patient (Adjusted odds ratio [AOR] =5.36, 95% confidence interval [CI]: 2.75-10.44), nonuse of bed-nets (AOR = 2.74, 95% CI: 1.06-7.08) and stagnant water around the village (AOR = 3.61, 95% CI: 1.31-9.93) were independent risk factors. From the samples tested, 42 were confirmed positive. CONCLUSIONS: Individuals who live with DF patient, around stagnant water and do not use bed nets are at high risk of contracting the disease. Health education on DF prevention was given and mosquito breeding sites were drained. Strong vector prevention strategies are recommended by enhancing the existing malaria prevention and control program.

Glycemic Index and Load of Selected Ethiopian Foods: An Experimental Study.

BACKGROUND: Determining the glycemic index and load of foods has significant impact on meal planning for diabetes. However, there is no data on the glycemic index (GI) and glycemic load (GL) of Ethiopian foods. Therefore, the aim of this study was to analyze the glycemic index and glycemic load of Teff Injera, Corn Injera, and White Wheat Bread. METHODS: Experimental study design was conducted among selected healthy adults. Teff Injera, Corn Injera, and White Wheat Bread were selected as test foods for the study, and glucose was used as the reference food. The postprandial glucose concentrations in the blood were recorded at 0, 15, 30, 45, 90, and 120 minutes. The relative glycemic index of each food was calculated, and the presence of statistical difference in glycemic index among the three foods was analyzed. RESULTS: The mean age of the participants was 23 years (±1.6 years). The glycemic indexes of Teff Injera, White Wheat Bread, and Corn Injera were 36 (low), 46 (low), and 97 (high), respectively, and the glycemic loads were 7 (low), 14 (moderate), and 22 (high), respectively. There was a significant difference in glycemic index and load among the three food items (p < 0.001). Teff Injera had a much lower glycemic index and load compared with Corn Injera (p < 0.001) and White Wheat Bread (p = 0.03). CONCLUSIONS: Teff Injera and White Wheat Bread have low glycemic index and are recommended to be consumed by diabetic patients, whereas Corn Injera has high glycemic index and is not recommended for diabetic patients. Therefore, Teff Injera should be considered globally in the dietary modification programs for diabetes.

Predictor of multidrug resistant tuberculosis in southwestern part of Ethiopia: a case control study.

BACKGROUND: Curable disease tuberculosis is becoming incurable or difficult to treat due to drug resistance. Multi drug resistance tuberculosis is a major health problem for less developed countries. Development of drug resistance is mainly as result of man related factors and poor lifestyle. Identifying predictors of drug resistance and working on them is the important way of reducing the expansion in high burden countries. Ethiopia is one of TB, TB/HIV, and multi-drug resistant tuberculosis (MDR-TB) high burden country globally. This study was aimed to assess predictor of MDR-TB in southwest part of Ethiopia. METHODS: Unmatched case control study was conducted in case to control ratio of 1:1.2 in southwest part of Ethiopia. The cases were recruited from confirmed MDR-TB patient enrolled on second line treatment in Shenen Gibe Hospital (MDR-TB treatment center of the prefecture) and the controls were recruited from previously TB patients who cured or patient with smear negative at the end of treatment month during the study period in the same area. The data was collected by structured questionnaire by interview and logistic regression analyses were used to identify predictors of MDR-TB. Odds ratios with 95% CI were computed to determine the predictors. RESULT: From the total 132 participants about 45% of them were cases. None disclosed tuberculosis infected to relatives [AOR = 3.4, 95% CI (1.2-9.8)], insufficient instruction on how to take anti-TB drug [AOR = 4.7, 95% CI (1.4-14.6)], contact history with MDR-TB [AOR = 8.5, 95% CI (2.9-25.5)], interruption of first-line anti-TB treatment for at list 1 day [AOR = 7.9, 95% CI (2.5-24.9)], and having alcohol drinking habits [AOR = 5.1, 95% CI (1.4-18.7)] were identified predictors for MDR-TB infection in study area. CONCLUSION: TB infection disclosure status, insufficient instruction on drug usage, contact history with MDR-TB, interruption of first-line anti-TB drugs, and alcohol drinking habits were identified predictor of MDR-TB case. Therefore, early detection and proper treatment of drug susceptible TB, strengthening directly observed treatment, short-course on daily bases, community involvement, and supporting the patient to intervene identified factors is paramount.

Drug-Resistant tuberculosis in Ethiopia: Characteristics of cases in a referral hospital and the implications.

Background: Tuberculosis (TB) programs should design intervention strategies based on the sound knowledge of the existing local epidemiology and sociodemographic characteristics of drug-resistant-TB (DR-TB) cases. The aim of the study was to characterize the pulmonary multidrug-resistant (MDR) and rifampicin-resistant (RR) TB cases enrolled in a referral hospital at Addis Ababa, Ethiopia, called All Africa Leprosy, Tuberculosis, Rehabilitation and Training (ALERT) Hospital. Methods: We conducted a descriptive study based on retrospective review of medical records of 340 pulmonary MDR/RR-TB cases enrolled in ALERT Hospital from November 2011 to December 2016. To characterize the cases, we described the distribution of demographic and clinical characteristics. To compare the distribution of demographic and clinical characteristics between male and female cases, we used Pearson's Chi-squared test. Results: Males accounted for 52.9% of the 340 cases. Nine out of ten cases were in the age group of 15-44 years. Sputum acid-fast bacilli smear-positive and human immunodeficiency virus-coinfected cases constituted 63.7% and 18.1% of cases, respectively. The proportion of new cases increased through the years from nil in 2011 to 21.4% in 2016. Adult males above 24 years constituted more than three quarters (77.2%) of the total male cases, while adult females in this age group constituted 56.9%. The age distribution between male and female cases showed significant differences (P < 0.001). Conclusion: There is age disparity between male and female cases with high impact of MDR/RR-TB on productive adult male population. The transmission potential for DR-TB is also high in the community.

Diagnosis and Treatment of Human Salmonellosis in Addis Ababa City, Ethiopia.

BACKGROUND: Diagnosis using reliable tools and treatment following in vitro antimicrobial susceptibility tests are critical to proper addressing of antibiotic-resistant Salmonella infection. METHODOLOGY: A cross-sectional study was conducted to assess the practice of diagnosis and treatment of salmonellosis in Addis Ababa. Tube Widal test (for blood samples only), culture, biochemical and carbohydrate fermentation, serotyping, and antimicrobial susceptibility tests were employed for both blood and stool samples. RESULTS: Of all the diseases listed in the diagnosis, nontyphoidal (n = 72, 13.71%) and typhoidal (n = 47, 8.95%) salmonellosis were the second and third common diseases. Among the 288 blood samples, almost half were positive for O, H, or both antigens. However, only 1 (0.68%) of the positive blood samples yielded Salmonella isolate during culture. The study demonstrated low specificity (0.68%) and positive predictive value (48.78%) of Widal test. Conversely, the test showed 100% sensitivity and negative predictive values. Salmonella isolates were identified from 7 (7.07%) of 99 stool samples. Two-thirds of salmonellosis suspected patients received antibiotic treatment. However, only half of the confirmed salmonellosis patients were treated with appropriate antibiotics. All of the isolates were susceptible to ciprofloxacin and ceftriaxone but resistant to ampicillin. CONCLUSIONS: Majority of the patients who participated in this study were wrongly diagnosed using symptoms, clinical signs, and tube Widal test. Consequently, most of the patients received inappropriate treatment.

Prevalence and determinants of self-medication practice among selected households in Addis Ababa community.

BACKGROUND AND AIM: Self-medication (SM) is one part of self-care which is known to contribute to primary health care. If practiced appropriately, it has major benefits for the consumers such as self-reliance and decreased expense. However, inappropriate practice can have potential dangers such as incorrect self-diagnosis, dangerous drug-drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease, and/or risk of dependence and abuse. The main objective of this study was to assess the prevalence and determinants of the self-medication practice (SMP) in Addis Ababa. METHODOLOGY: A community based cross-sectional study was conducted among selected households in Addis Ababa from April 2016 to May 2016, with a recall period of two months before its conduction. Trained data collectors were employed to collect the data from the 604 sampled participants using pre-tested and validated questionnaires. RESULT: Among the 604 participants involved in this study, 422 (69.9%) were female and 182 (30.1%) were male and there was a mean age of 41.04 (± 13.45) years. The prevalence of SM in this study was 75.5%. The three most frequently reported ailments were headache 117 (25.7%), abdominal pain 59 (12.9%) and cough 54 (11.8%). The two main reasons for SM were mildness of illness 216 (47.4%) and previous knowledge about the drug 106 (23.2%). The two most frequently consumed medications were paracetamol 92 (20.2%) and traditional remedies 73 (16.0%), while drug retail outlets 319 (83.3%) were the main source of drugs. The two most frequently reported source of drug information were health professionals 174 (45.4%) and experience from previous treatment 82 (21.4%). Moreover, there were statistically significant differences among respondents who reported practicing SM based on income and knowledge about appropriate SMP. CONCLUSION AND RECOMMENDATION: Self-medication was practiced with a range of drugs from the conventional paracetamol and NSAIDs to antimicrobials. Being that the practice of SM is inevitable, health authorities and professionals are highly demanded to educate the public not only on the advantages and disadvantages of SM but on its proper use.

Acute poisonings during pregnancy and in other non-pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010-2015.

OBJECTIVE: To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015. METHODS: All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software. RESULTS: During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20-24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self-poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non-pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non-pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non-pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non-pregnant women was 20 and 1.87%, respectively. The pre-hospital intervention for the majority of the women was milk, in 12.0% of cases. CONCLUSION: Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non-pregnant women.

Posterior fossa tumor presenting with bilateral proptosis and blindness.

It is very unusual for a posterior fossa tumor to present with proptosis. A 24 years old female patient who had a CT Scan proven posterior fossa tumor presented with severe headache, bilateral proptosis and blindness is reported. The rarity of the cause of proptosis and blindness and also the difficulty in reaching at the clinical diagnosis is discussed.