Hematological parameters and their predictive value for assessing disease severity in laboratory-confirmed COVID-19 patients: a retrospective study.

BACKGROUND: The coronavirus disease 19 (COVID-19) infection has spread globally and caused a substantial amount of mortality and morbidity. Early detection of severe infections will improve care and reduce deaths. The use of hematological parameters in predicting COVID-19 disease severity, patient outcomes, and early risk stratification is limited. Therefore, the study was aimed at determining hematological parameters and their predictive value for assessing disease severity in laboratory-confirmed COVID-19 patients in Northwest Ethiopia. METHODS: A retrospective cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital and Tibebe Ghion comprehensive specialized referral hospital on 253 patients diagnosed with COVID-19 and admitted between March 2021 and February 2022. Data were extracted, and entered into Epi-data 4.2.0.0, and analyzed using SPSS version 25 software. Hematological parameters were provided as the median and interquartile range (IQR). Categorical variables were represented by their frequency, and the χ2 test was applied to compare observed results with expected results. The receiver-operating curve (ROC) was used to establish the predictive value of hematological parameters for COVID-19 severity. A p-value < 0.05 was considered statistically significant. RESULTS: On a total of 253 patients, there were 43.87% severe cases, with a mortality rate of 26.9%. The ROC analysis showed the optimal cutoff values for hematological parameters were ANC (3370), lymphocyte (680), NLR (9.34), PLR (290.77), platelets (332,000), and WBCs (4390.65). The area under the curve (AUC) values for NLR (0.679) and ANC (0.631) were high, with the highest sensitivity and specificity, and could potentially be used to predict COVID-19 severity. CONCLUSION: This study proved that high NLR and high ANC have prognostic value for assessing disease severity in COVID-19. Thus, assessing and considering these hematological parameters when triaging COVID-19 patients may prevent complications and improve the patient's outcome.

Peptic ulcer disease among dyspeptic patients at endoscopy unit, University of Gondar hospital, Northwest Ethiopia.

BACKGROUND: Dyspepsia is a common complaint in upper gastrointestinal disorders. It is described as predominant epigastric pain lasting for at least one month. Globally, peptic ulcer disease occurs in 3.5-32% of patients with dyspepsia. Helicobacter pylori (H. pylori) infection and non-steroidal anti-inflammatory drugs/aspirin use are the widely known risk factors for peptic ulcer disease. There was no recent document on H. pylori infection rate among patients with peptic ulcer disease in Ethiopia. This study aimed to determine magnitude and associated factors of peptic ulcer disease among dyspeptic patients in Northwest Ethiopia. METHODS: An institutional-based cross sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia. A convenience sampling method was used to recruit 218 study subjects. A pre-designed semi-structured questionnaire was used to extract clinical information. Olympus flexible fiber-optic endoscope (Olympus, GIF-E 600, Olympus Corp., Hamburg, Germany) was used to confirm the presence of peptic ulcer disease. Diagnosis of active H. pylori infection was made using the fecal H. pylori Antigen 25 T Card Test (Anamol Lab., Pvt. Ltd., Palghar, India). The Data were entered into EPI Info version 4.6.0.2, and then exported to SPSS version 20 for analysis. Explanatory variables associated with peptic ulcer disease were analyzed by applying logistic regression model. P value < 0.05 was used to declare significant association. RESULT: A total of 218 dyspeptic patients who underwent upper gastrointestinal endoscopic evaluations were included in the study. The mean (+ SD) age of patients was 42 ± 16.4 years. Forty nine percent (95% CI 42.4-56.2) of dyspeptic patients had active H. pylori infection. Peptic ulcer disease was diagnosed in 35% (95% CI 31.4-39.2) of patients with dyspepsia. H. pylori infection (AOR = 6.298, 95% CI 2.965-13.378, P value <  0.001) and NSAIDs/ASA use (AOR = 6.252, 95% CI 2.925-13.362, P value < 0.001) were identified as risk factors for peptic ulcer disease. CONCLUSION: Medical treatment of peptic ulcer disease should target treatment of H. pylori infection and cautious use of non-steroidal anti-inflammatory drugs/aspirin.

Magnitude, outcome, and associated factors of anti-tuberculosis drug-induced hepatitis among tuberculosis patients in a tertiary hospital in North Ethiopia: A cross-sectional study.

BACKGROUND: Short-course chemotherapy comprising isoniazid, rifampicin, ethambutol, and pyrazinamide has proved to be highly effective in the treatment of tuberculosis (TB). However, the most common adverse effect of this regimen leading to interruption of therapy is hepatotoxicity. There is a paucity of evidence in Tigray region on anti-tuberculosis drug-induced hepatitis. Therefore, this study aims to determine the magnitude, outcomes, and associated factors of drug-induced hepatitis in Ayder specialized comprehensive hospital tuberculosis clinic. METHODS: An institution-based cross-sectional study was done on 188 cases of patients who took anti-tuberculosis drugs from August 4, 2015 to June 30, 2018 in tuberculosis clinic, Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Data on socio-demography, clinical characteristics and magnitude of the incidence and outcome of anti-tuberculosis drugs-induced hepatitis were collected using structured checklist from patients' records using census method. Then, we entered and analyzed the data using statistical packages for social sciences (SPSS) statistical software version 21. Descriptive statistics were done in tables, counts, proportions, median and range. Bivariate and multivariable regression analyses were done to identify factors that are associated with drug-induced hepatitis. Confidence interval was taken at 95% and p-value of less than 0.05 was used to denote significance. RESULTS: We approached a total of 226 patients' records, and we collected data from188 records (83.2%response rate). Anti-tuberculosis drug-induced hepatitis was found in 26 (13.8%) of the patients, of which 3 (11.54%) have died. Using multivariable logistic regression analyses, preexisting liver disease (AOR: 42.01, 95% CI: 4.22-417.49), taking other hepatotoxic drugs (AOR: 23.66, 95% CI: 1.77-314.79), and having lower serum albumin (AOR: 10.55, 95% CI: 2.57-43.32) were found to be significantly associated with the development of anti-tuberculosis drug-induced hepatitis. CONCLUSION AND RECOMMENDATION: The incidence of anti-tuberculosis drug-induced hepatitis was high. Patients with low baseline serum albumin, taking other hepatotoxic drugs and having preexisting liver disease should be followed with serial liver enzymes after initiation of anti-tuberculosis medications. These patients should be followed with frequent measurement of liver enzymes to assess for the development of drug-induced hepatitis.

Urinary incontinence and associated factors among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia.

BACKGROUND: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. OBJECTIVE: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. METHODOLOGY: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. RESULTS: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87-49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48-27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15-18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12-21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05-19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51-22.67), 95% confidence interval). CONCLUSION: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence.

Malaria outbreak investigation in Tanquae Abergelle district, Tigray region of Ethiopia: a case-control study.

OBJECTIVE: We investigated this outbreak to describe the magnitude and associated risk factors due to the malaria outbreak in Tanquae Abergelle district, Tigray, Ethiopia, in 2017. RESULT: Case fatality rate of this study was zero. Among the 62 cases and 124 controls, the presence of mosquito breeding sites [OR = 6.56 CI (2.09-20.58) P value = 0.001], sleeping outside a home [OR = 5.06 CI (1.75-14.61) P-value = 0.003] and having unscreened window [OR = 14.89 CI (1.87-118.25) P-value = 0.011] were associated with illness in multivariate analysis.

Determinants of teenage pregnancy in Degua Tembien District, Tigray, Northern Ethiopia: A community-based case-control study.

BACKGROUND: Approximately 16 million teenagers aged 15-19 years and 2 million teenagers under the age of 15 years give birth annually, with 95% of these births occurring in developing countries. Ethiopia has one of the highest teenage fertility rates in Sub-Saharan Africa; however determinants of teenage pregnancy are not well studied. Therefore, this study aimed to identify determinants of teenage pregnancy among female teenagers in Degua Tembien district, Tigray, Northern Ethiopia, in 2015. METHODS: A community-based case-control study was conducted in Degua' Tembien district from February 01, 2015 to March 15, 2015 with a randomly selected total sample size of 414 females (with a ratio of 1:2 case to control, 138 and 276 respectively). Data were entered in to Epi-Info and analyzed using SPSS software. Multivariable logistic regression was used to assess predictors of the outcome variable; variables with a p-value <0.25 in bivariable analysis were included in the model. Statistically significance was considered at a p-value ≤0.05 in both bivariable and multivariable logistic regression analyses. RESULT: The mean ages (plus or minus standard deviation (±SD)) of cases and controls were 18.47 (0.72) and 17.09 (1.2) years, respectively. After adjustment for other variables, predictors of teenage pregnancy included: lower monthly income below ~$25 and ~$25-50 (adjusted odds ratio (AOR) = 23.96; 95% confidence interval (95%CI) 4.89-117.29 and AOR = 4.91; 95%CI 1.64-14.66, respectively); aged 18-19 years (AOR = 16.75; 95%CI 6.45-43.47); being married (AOR = 15.91; 95%CI 7.43-34.04); not communicating with parents on reproductive health issues (AOR = 6.52; 95%CI 3.12-13.64) and having a history of maternal teenage pregnancy (AOR = 4.14; 95%CI 1.84-9.33). CONCLUSION: The factors associated with teenage pregnancy in our study were lower family monthly income, being married, being in the 18-19 year age group, not communicating with parents on reproductive health issues and having a maternal history of teenage pregnancy. Programs that encourage parent-teenage communication of reproductive health issues, starting from early adolescence, in order to build skills to prevent pregnancy in the late teenage years, are very important. In addition, multi-pronged activities across sectors that encourage delayed marriage and improve health service utilizations for girls are essential.