Regional and socio-economic disparity in use of insecticide-treated nets to prevent malaria among pregnant women in Kenya.

BACKGROUND: Insecticide-treated net (ITN) use is among the most recommended strategies to prevent malaria in pregnancy. We analysed the regional and socio-economic patterns of ITN use among pregnant women in Kenya using data from the 2003, 2008 and 2014 Kenyan Demographic and Health Surveys (KDHSs). METHODS: Inequality was assessed using four dimensions: economic status, education, place of residence and region. Both relative and absolute summary measures were applied. In addition, simple and complex summary measures, i.e. difference, population attributable fraction, population attributable risk and ratio were considered based on the number of subgroups in each variable. RESULTS: There was overt inequality in the use of ITNs among pregnant women, with greater use among the better-off group in 2003 and 2014. Greater ITN use was also observed among pregnant women with a higher level of education. Pregnant women from urban settings tended to use ITNs (slept under a net the night before the survey) more than their rural counterparts in the 2003 KDHS. There were significant regional variations across the three surveys in all inequality summary measures, except ratio in the 2014 survey. CONCLUSIONS: Significant inequality in ITN use among pregnant women was observed at a macro scale.

Frequency and Factors Associated with Orthostatic Hypotension in Individuals with Parkinson's Disease: A Case-Control Observational Study.

Background: Orthostatic hypotension (OH) is a common and considered the most incapacitating non-motor symptom of Parkinson's disease (PD). Little is known about OH in Ethiopian PD patients. The objectives of the present study were to determine the frequency and factors associated with OH in individuals diagnosed with PD compared to a healthy control. Methods: A multi-center case-control observational study was conducted. A total of 53 PD cases and 53 age and sex matched healthy controls were included. Both descriptive and Chi-square proportional statistical analysis were used. Results: The mean age distribution was comparable between the two study groups (61.9 vs. 59.9 years). Distribution of male gender was comparable between PD and control groups (71.7% vs. 67.9%). Nearly all the individuals diagnosed with PD were on levodopa treatment, and close to half of them were on anticholinergic drugs. Hypertension was the commonest comorbid disorder in both groups. The prevalence of orthostatic hypotension was higher in PD patients (22.6%) compared to the control group (9.4%). The proportion of constipation (p=0.007), urinary urgency (p=0.007), and nocturia (p<0.0001) was significantly higher among Parkinson's disease patients compared to the healthy control group. Falls and excessive sweating were only reported by PD patients. Conclusion: The present study shows the frequency of orthostatic hypotension in Ethiopian Parkinson's disease patients is comparable to other regions. The presence of constipation, urinary urgency, and nocturia was associated with Parkinson's disease compared to the control group.

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia.

Background: Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. Methods: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020 and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. Conclusions: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors.

Electroencephalographic Findings, Antiepileptic Drugs and Risk Factors of 433 Individuals Referred to a Tertiary Care Hospital in Ethiopia

Little is known about the characteristics of electroencephalogram (EEG) findings in epileptic patients in Ethiopia. The objective of this study was to characterize the EEG patterns, indications, antiepileptic drugs (AEDs), and epilepsy risk factors. METHODS: A retrospective observational review of EEG test records of 433 patients referred to our electrophysiology unit between July 01, 2020, and December 31, 2021. Results: The age distribution in the study participants was right skewed unipolar age distribution for both sexes and the mean age of 33.8 (SD=15.7) years. Male accounted for 51.7%. Generalized tonic clonic seizure was the most common seizure type. The commonest indication for EEG was abnormal body movement with loss of consciousness (35.2%). Abnormal EEG findings were observed in 55.2%; more than half of them were Interictal epileptiform discharges, followed by focal/or generalized slowing. Phenobarbitone was the commonest AEDs. A quarter (20.1%) of the patients were getting a combination of two AEDs and 5.2% were on 3 different AEDs. Individuals taking the older AEDs and those on 2 or more AEDs tended to have abnormal EEG findings. A cerebrovascular disorder (27.4%) is the prevalent risk factor identified followed by brain tumor, HIV infection, and traumatic head injury respectively. CONCLUSION: High burden of abnormal EEG findings among epileptic patients referred to our unit. The proportion of abnormal EEG patterns was higher in patients taking older generation AEDs and in those on 2 or more AEDs. Stroke, brain tumor, HIV infection and traumatic head injury were the commonest identified epilepsy risk factors

Data set for demography, clinical characteristics, and risk factors of trigeminal neuralgia patients in Addis Ababa, Ethiopia.

OBJECTIVES: Pain is one of the most ignored clinical symptoms in resource limited country such as Ethiopia. Trigeminal neuralgia (TN) is one of the most painful medical illnesses known to human. Very little was reported about TN from the sub Saharan Africa (SSA), especially from Ethiopia. We aimed to study the demographic, clinical characteristics, and risk factors of TN in sixty-one patients at two public and two private health facilities in Addis Ababa Ethiopia. These data will be vital to researchers and clinicians interested in knowing the pattern of TN in SSA in order to compare and contrast with similar data from the west. DATA DESCRIPTION: The data set contains characteristics of TN patients. All the variables in the data set were coded by self-explanatory codes. The data set contains: demographic data, which contains age ranges and duration of illness; clinical characteristics data contains clinical characteristics, and risk factors includes such as structural brain abnormalities, family history, and dental extraction. Nearly 90% of the patients had Classical TN. The right side and mandibular branch of trigeminal nerve was commonly involved. Close to 40% reported previous tooth extraction history. Majority of the patients reported satisfactory pain control with carbamazepine.

Clinical characteristics and associated factors of trigeminal neuralgia: experience from Addis Ababa, Ethiopia.

BACKGROUND: Trigeminal neuralgia (TN) is considered one of the most painful illnesses known to medical practice. Little is known about TN in Ethiopia. Our study aimed to assess clinical characteristics, treatment, and associated factors of TN. METHOD: A cross-sectional study was conducted on a total of 61 patients with confirmed Trigeminal neuralgia visiting outpatient neurology clinics of two government teaching Hospitals and two private health facilities in Addis Ababa, Ethiopia between June 2019 and March 2020. RESULTS: Our participants' age range between 21 and 78 years with mean ± SD age of 50.7 ± 14.2 years. Males accounted for 50.8%. Twenty-five (41%) reported a prior history of one or more tooth extraction on the painful side. In the majority (68.9%) of the patient's right side of the face was affected. The mandibular nerve was the commonly involved branch (47.5%). Fifty-five (90.2%) of patients fulfilled criteria for classical TN and 9.8% had symptomatic TN. The majority of the participants reported mixed types of pain such as burning, lancinating, and electric shock-like. Well defined trigger zone was identified in one-third (36%) of cases. Carbamazepine was the most commonly prescribed drug with a median dose of 600 mg (IQR: 400 - 1000 mg). Two-third of the patients reported prominent satisfaction. The mean (± SD) dose of carbamazepine used to control the pain was significantly higher among those with dental extraction history as compared to those with no history of dental extraction (736 ± 478.6 mg Vs 661.1 ± 360.4 mg, respectively, T = - 2.06, p = 0.04 95% CI:-213.41 to - 2.98). A statistically significant number of patients who had single branch involvement reported prominent satisfaction with their treatment as compared to those who had more than one branch involvement. (95% CI: 1.3-3.8: p = 0.006). CONCLUSION: The majority of our patients had Classical TN in the mandibular nerve distribution on the right side of the face and well satisfied with carbamazepine only treatment. Furthermore, we observed a higher proportion of dental extraction among our patients, hinting at the scale of miss and delayed-diagnoses. Thus, we recommend conducting a well-designed prospective study to support our findings.

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study.

BACKGROUND: Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting. METHODS: A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 h of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as > 140 mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively. RESULTS: A total of 103 first-ever acute stroke patients were included (mean age = 55.5 + 15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10-19) compared to normoglycemic patients 11 (IQR 8-15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99-6.19) more likely to be functionally impaired (mRS = 3-5) at 30-days compared to normoglycemic patients (P = 0.041).Older age (≥ 65 years) (P = 0.017) and stroke severity (NIHSS > 14) (P = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association. CONCLUSIONS: Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-day of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.

Subarachnoid hemorrhage: clinical presentation, causes and outcome in 52 Ethiopian patients

Introduction: Subarachnoid hemorrhage is a devastating neurological emergency associated with high mortality and disability. Little is known about its occurrence and clinical profile in Ethiopia. We, therefore, studied the clinical presentation, causes and outcome of the condition among in a tertiary facility.Methods: A retrospective analysis of records of patients admitted with the diagnosis of subarachnoid hemorrhage to Tikur Anbassa Specialized Hospital over a period of 12 years, January 2001 to January 2012, was undertaken.Results: Of 725 patients admitted with the diagnosis of stroke 52 (7.1%) patients were diagnosed to have subarachnoid hemorrhage. Death was registered in 18(34.6%) and disability in seven (13.4%).Hypertension was the most common risk factor, observed in 36 (69.21 %) of the patients, and seizure disorder and electrolyte abnormalities-hyponatremia were the most common complications. Conclusion: The outcome of subarachnoid hemorrhage in this study is comparable with reports from elsewhere. A prospective and well-designed epidemiological study is recommended. There is a need to improve the diagnostic and interventional capacity of the hospital