Magnitude and associated factors of cutaneous leishmaniasis among patients visiting Nefas Mewcha primary hospital, Northern Ethiopia, 2022: An institution-based Cross-sectional study.

BACKGROUND: Cutaneous leishmaniasis (CL) is the most common neglected tropical disease, causing stigmatised skin lesions. It is an important public health concern, with 95% of cases occurring in low-income and middle-income countries. Despite its long-recognized endemicity and psychosocial impacts, it is largely overlooked. OBJECTIVE: The main aim of this study is to investigate the magnitude and associated factors of CL in north-central Ethiopia. DESIGN: An institution-based cross-sectional study was conducted. SETTING: The study was conducted in Nefas Mewcha Primary Hospital (NMPH), north-central Ethiopia. PARTICIPANTS: The study was conducted among 332 individuals visiting NMPH from June to July 2022. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was to estimate the burden of CL among patients visiting NMPH, and the secondary outcome was to identify factors associated with the presence or absence of CL. The association between predictor variables and CL was assessed using a binary logistic regression model. Statistical significance was declared at a p _value of <0.05. RESULT: Out of the 332 study participants, 63 patients sought medical care with skin lesions, and 61 (18.37%, 95% CI: 14.5% to 22.9%) were patients with CL. Localized CL was the predominant type (86.9%). Male sex (adjusted OR (AOR): 4.51; 95% CI 1.94 to 10.45), older age (AOR 0.91, 95% CI: 0.87 to 0.94), secondary and tertiary educational status (AOR: 0.18, 95% CI: 0.05 to 0.6), poor knowledge of CL (AOR: 4.02, 95% CI: 1.81 to 9.76) and living with domestic animals (AOR: 5.29, 95% CI 3.24 to 7.5) were identified as predictors of CL. CONCLUSION: In the study area, the magnitude of CL was found to be high. Being male and young, having low educational status, having poor knowledge and living with domestic animals increase the risk of acquiring CL. As a result, increasing the knowledge of the community through scaling up of health education programmes and reducing activities that increase individuals' exposure to sandflies should be prioritised.

Treatment seeking delay and associated factors in adult heart failure patients admitted to Debre Tabor comprehensive specialized hospital, North West, Ethiopia.

Objectives: This study was aimed at assessing the magnitude of treatment-seeking delay in adult heart failure patients and identifying factors that contribute to it. Design: An institution-based cross-sectional study with a consecutive sampling technique was conducted at Debre Tabor Comprehensive Specialized Hospital from February 1 to November 1, 2021. Setting: The study was conducted in the medical ward of the hospital. Participants: A total of 187 patients aged 18 and above admitted with a diagnosis of heart failure, and able to provide information were included. Results: The median delay time of adult heart failure patients admitted to the hospital was 15 days. The mean length of delay was also calculated to be 25.02 days. Urban residents and those who live at a ten or less-kilometer distance from healthcare facilities were found to be less likely to delay seeking care. Presenting with shortness of breath or paroxysmal nocturnal dyspnea, perceiving the cause to be heart-related, and getting positive responses from significant others were also associated with a relatively short delay time. Conclusion: Treatment-seeking delay was found to be a major problematic issue in heart failure patients. Therefore, patients, patient families, and the community at large must be taught about the symptoms of heart failure and the need for timely care.

Attrition rate and its predictors among adults receiving anti-retroviral therapy following the implementation of the "Universal Test and Treat strategy" at public health institutions in Northern Ethiopia. A retrospective follow-up study.

Introduction: Since 2016, the Ethiopian Federal Ministry of Health has adopted a "Universal Test and Treat" strategy to treat human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). In this test and treat era, access to anti-retroviral therapy (ART) has been rapidly expanded. On the other hand, poor retention of patients on ART remains a serious concern for reaching ART program goals. Thus, this study is targeted at investigating the attrition rate and its predictors among HIV-positive adults following the implementation of the "test and treat" strategy in Ethiopia. Methods: An institution-based retrospective follow-up study was conducted among 1048 HIV-positive adults receiving ART at public health institutions in Bahir Dar city, Northern Ethiopia. Data were extracted from randomly selected patient charts, entered into Epidata 4.6 and exported to Stata 14.2 for analysis. Kaplan-Meier curve was used to estimate individuals' attrition-free probability at each specific point in time. Both bivariable and multivariable cox regression models were fitted, and variables with a P-value of <0.05 in the multivariable model were considered as significant predictors of attrition. Results: A total of 1020 (97.3%) study participants were included in the final analysis. The attrition rate of individuals was 15 per 100 person-years of observation (95% CI: 13.5-16.9 per 100 PYO). World Health organization (WHO) stage III/IV clinical diseases (Adjusted hazard ratio/AHR/1.75 (95% CI:1.24-2.48)), Not disclosing HIV-status (AHR 1.6 (95% CI: 1.24-2.05)), rapid initiation of ART (AHR 2.05 (95%CI:1.56-7.69)), No history of ART regime change (AHR2.03 (95% CI: 1.49-2.76)), "1J (TDF_3TC-DTG)" ART regimen (AHR 0.46 (95%CI: 2.18-3.65)), and Poor ART adherence (AHR2.82 (95%CI: 2.18-3.65)) were identified as significant predictors of attrition rate of HIV positive adults. Conclusion: Following the implementation of the universal test and treat area, the attrition rate of adults living with (HIV) found to be high. Due attention shall be provided to those individuals who didn't disclose their status, were initiated into ART within seven days, had WHO stage III/IV clinical disease, had poor adherence history, had no regimen change, and are not on 1J (TDF_3TC-DTG) ART regimen type.

Time to occurrence of necrotizing enterocolitis and its predictors among low birth weight neonates admitted at neonatal intensive care unit of felege hiwot compressive specialized hospital BahirDar, Ethiopia, 2021: A retrospective follow-up study.

Background: Globally, the incidence of necrotizing enterocolitis (NEC) varies between 6 and 15% of all neonates admitted to the neonatal intensive care unit (NICU). Though necrotizing enterocolitis is a multifactorial and life-threatening disease, low birth prematurity is the single cause. Therefore, determining the time to presentation and its predictors of necrotizing enterocolitis were the main goals of this investigation. Materials and methods: An institution-based retrospective follow-up study was conducted among 747 low birth weight (LBW) neonates admitted to the neonatal intensive care unit of Felege Hiwot comprehensive specialized Hospital from 1 January 2017 to 30 December 2019. The sample size was calculated by using the STATA package. Data were entered into Epi data version 3.1 and exported to STATA version 14 for analysis. The log-rank test and the Kaplan-Meier estimator were used to display the survival probability and differences between groups. At a significance threshold of 5%, Cox proportional hazard regression was performed to determine the net independent predictors of necrotizing enterocolitis. Result: The overall incidence rate was 0.86 per 1,000 person-days (95% CI: 0.67, 1.14) with a 6.8% (95% i: 5.2, 8.9) proportion of necrotizing enterocolitis among low birth weight neonates. Preeclampsia [adjusted hazard ratio (AHR);1.92 (95% CI: 1.03-3.58)], premature rapture of membrane [AHR; 2.36 (95%, CI: 1.19-4.69)], perinatal asphyxia [AHR; 4.05 (95%, CI: 2.04-8.60)], gestational age between 28 and 32 weeks [AHR; 3.59 (95% CI: 1.01-8.83)], and birth weigh less than 1,000 g [AHR; 5.45 (95% CI: 3.84-9.12) were the independent predictors of necrotizing enterocolitis. Conclusion: Within the first 1-7 days of a newborn's life, necrotizing enterocolitis was most common. It was discovered that preeclampsia, premature rupture of membrane, perinatal asphyxia, gestational age of 28-32 weeks, and birth weight less than 1,000 g were predictors of its occurrence.

The shadow challenges to improve the state essential newborn care practices in healthcare providers: evidence from a multicentre cross-sectional study in Ethiopia.

BACKGROUND: Neonatal mortality can be reduced by providing essential newborn care. However, it is overlooked by most healthcare providers in Ethiopia. Hence, this study aims to examine immediate essential newborn care practices and associated factors among healthcare providers in Ethiopia. METHODS: Institution-based cross-sectional study was conducted among 214 healthcare providers from November 11 to December 19, 2020, at a selected South Gondar health facility. Data were entered into Epi-data 4.2 and then exported to STATA14.0 for analysis. Both bivariable and multivariable logistic regression with a 95% confidence interval were computed. The variable that had a p-value less than 0.25 in bivariable logistic regression was entered into the multivariable logistic regression. In multivariable logistic regression, variables having a p-value < 0.05 were considered a statistically significant association with the poor practice of essential newborn care practice. RESULTS: The overall essential newborn care practice among healthcare providers was found to be 74.8% (95% CI: 68.4, 80.2). Diploma educational status (AOR = 7.8, 95% CI:2.80-21.9), presence of workload (AOR = 9.7, 95% CI: 2.76-23.9), unavailability of drugs and vaccines (AOR = 9.8, 95% CI: 6.95-17.7), and having no training (AOR = 3.9, 95% CI: 1.73-8.92) were found to be predictors for poor essential newborn care practices. CONCLUSION: Essential newborn care practice among healthcare providers at South Gondar health institutions was found to be low. Being diploma educational status, presence of workload, unavailability of drugs and vaccines, and having no training were found to be independent predictors for poor practice of essential newborn care. Hence, periodic evaluation and strategies are needed for those predictor variables to address the gaps.

Survival status and predictors of mortality among traumatic brain injury patients in an Ethiopian hospital: A retrospective cohort study.

INTRODUCTION: Traumatic brain injury is a major global public health problem causing substantial mortality among the adult population. Hence, this study aimed to determine the predictors of mortality among adult traumatic brain injury patients in Felegehiwot Comprehensive Specialized Hospital in Northwest Ethiopia during 2020. METHODS: A retrospective cohort study was conducted at Felegehiwot Comprehensive Specialized Hospital using anonymized patient data obtained from chart review. Descriptive statistics were used to summarise the patient characteristics. The Kaplan-Meier survival curve and log-rank test were used to test for differences in survival status among groups. The Cox proportional hazards regression model was used at the 5% level of significance to determine the net effect of each explanatory variable on time to death. RESULTS: In total, 338 patients aged ≥15 years and diagnosed with traumatic brain injury were included in the analysis. Among these patients, 103 (30.45%) died, giving a crude death rate of 25.53 per 1000 (95% CI: 21.05-30.98) person-days of follow-up. The overall median survival time was 44 days. The independent predictors of mortality after diagnosis of traumatic brain injury were admission Glasgow coma scale score ≤ 8 (adjusted hazard ratio (AHR): 4.85; 95% confidence interval (CI): 1.73-13.62), bilateral non-reactive pupils at admission (AHR: 2.00 (95% CI: 1.10-3.71), elevated systolic blood pressure at admission (AHR: 0.31; 95% CI:0.11-0.86), elevated diastolic blood pressure at admission (AHR: 3.54; 95% CI: 1.33-9.43), and haematoma evacuation (AHR: 0.42; 95% CI: 0.16-0.90). DISCUSSION: The Survival status of traumatic brain injury patients was relatively low in this study. Glasgow coma scale score, bilateral non-reactive pupils, and elevated blood pressure were significant predictors of mortality. Further prospective follow-up studies that include residence and occupation are recommended.

Survival Status and Predictors of Mortality Among Low-Birth-Weight Neonates Admitted to the Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, 2020.

BACKGROUND: Low birth weight neonates are subjected to different comorbidities due to anatomical and physiological immaturity. Globally, 60-80% of neonatal mortality was due to low birth weight. Hence, this study aimed to assess the survival status and predictors of mortality among low birth weight neonates. METHODS: An institutional-based retrospective cohort study design was conducted among 718 low birth weight neonates admitted to the neonatal intensive care unit from January 1, 2017, to December 30, 2019, at Felege Hiwot Comprehensive Specialized Hospital. Data were entered into Epi data version 3.1 and analyzed with STATA version 14. Kaplan-Meier curves together with a Log rank test were used to estimate the survival time and showed the presence of differences among groups. Cox proportional-hazard regression was used to estimate the hazard ratio at the 5% level of significance to determine the net effect of each explanatory variable on survival status. RESULTS: The overall incidence density was 35.3 per 1000 person-day observations (CI: 30.8 -40.6) with 5715 follow-up days. Deliveries outside the health institution [AHR; 2.31 (95% CI: 1.20-4.42)], maternal age <18 years [AHR; 3.08 (95% CI: 1.64-5.81)] and maternal age >35 years [AHR; 3.83 (95% CI: 2.00-7.31)], neonatal sepsis [AHR; 2.33 (95% CI: 1.38-3.94)], neonatal respiratory distress syndrome [AHR; 1.92 (95% CI: 1.27-2.89)], necrotizing enterocolitis [AHR; 3.09 (95% CI: 1.69-5.64)] and birth weight <1000 gm [AHR; 3.61 (95% CI: 1.73-7.55)] were found to be significant predictors. CONCLUSION: This study showed that two of the seven low birth weight neonates died during the follow-up period. Therefore, it is better for health care providers and other stakeholders to focus more on early diagnosis and management of low birth weight neonates with sepsis, respiratory distress syndrome, necrotizing enterocolitis and counseling mothers on the risk of having a child in early and old age.

Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis.

INTRODUCTION: Several kinds of researches are available on preterm mortality in the East Africa continent; however, it is inconsistent and inconclusive, which requires the pooled evidence to recognize the burden in general. PURPOSE: To collect and synthesis evidence on preterm mortality and identify factors in the East Africa continent. METHODS: PubMed, Google Scholar, Hinary, Cochrane library, research gate, and institutional repositories were retrieved to identity eligible articles through Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The articles were selected if the publication period is between 2010-2021 G.C. Data were extracted by a standardized JBI data extraction format for mortality rate and stratified the associated factors. Then exported to STATA 14 for further analysis. I2 and Egger's tests were employed to estimate the heterogeneity and publication bias respectively. Subgroup analysis based on country, study design, year of publication, and the sample size was also examined. RESULT: This meta-analysis included 32 articles with a total of 21,405 study participants. The pooled mortality rate among preterm in the East Africa continent was found to be 19.2% (95% CI (confidence interval (16.0-22.4)). Regarding the study design, the mortality rate was found to be 18.1%, 19.4%, and 19.7% concerning the prospective cohort, retrospective cohort, and cross-sectional studies. The pooled odds of mortality among preterm with respiratory distress syndrome decreased survival by nearly three folds [AOR (Adjusted odds ratio = 3.2; 95% CI: 22, 4.6)] as compared to their counterparts. Similarly, preterm neonates presented with birth asphyxia were nearly three times higher in death as compared with preterm without birth asphyxia [AOR = 2.6; 95% CI: 1.9, 3.4]. CONCLUSION: Preterm mortality was found to be unacceptably high in Eastern Africa continent.Fortunately, the main causes of death were found to be respiratory distress syndrome and birth asphyxia which are preventable and treatable hence early detection and timely management of this problem are highly recommended to improve preterm survival.