Determinants of Disease Progression in Autosomal Dominant Polycystic Kidney Disease.

BACKGROUND: Despite its severity, there has been a lack of adequate study on autosomal dominant polycystic kidney disease (ADPKD) in Ethiopia. This study assessed the clinical profile and determinant factors contributing to renal disease progression. METHODS: A retrospective study was conducted on 114 patients for 6 years in Addis Ababa. Patients with ADPKD who had follow-up visits at two health centers were included. RESULTS: The mean age at diagnosis was 42.7 ± 12.7 years, with 43% reporting a positive family history of ADPKD. Approximately 22 patients (20%) developed end-stage renal disease, and 12 patients died. The mean estimated glomerular filtration rate at the initial visit was 72.4 mL/min/1.73 m2. The key risk factors associated with disease progression included younger age at diagnosis [adjusted Odds Ratio (aOR): 0.92, 95% CI: 0.87-0.98; p = 0.007], male gender (aOR: 4.5, 95% CI: 1.3-15.95, p = 0.017), higher baseline systolic blood pressure (aOR: 1.05, 95% CI: 1.01-1.10, p = 0.026), and the presence of comorbidities (aOR: 3.95, 95% CI: 1.10-14.33, p = 0.037). The progression of renal disease in ADPKD patients significantly correlates with age at diagnosis, gender, presence of comorbidities, and higher baseline systolic blood pressure. CONCLUSIONS: These findings underscore the importance of early detection and management of hypertension and comorbidities in ADPKD patients to mitigate disease progression and improve treatment outcomes.

Patterns and Complications of Congenital Heart Disease in Adolescents and Adults in Ethiopia.

BACKGROUND: Congenital heart disease (CHD) encompasses morphofunctional anomalies in the heart and circulatory system present at birth, which may not become apparent until later in life. In Ethiopia, there needs to be more understanding of the prevalence, patterns, and associated complications of CHD malformations. This study aimed to investigate the patterns and complications of CHDs among patients receiving follow-up care at a specialized university referral hospital in Ethiopia. METHODS: A hospital-based cross-sectional study was conducted on 199 patients with CHDs to assess the patterns and complications of defects. Retrospective data were collected from 16,972 patients who had follow-ups at a cardiac clinic in 2021 using medical records, and a statistical analysis was performed with SPSS version 24. RESULTS: The most prevalent types of CHDs in our study population were atrial septal defects (ASDs) at 41.2% (82 cases), ventricular septal defects (VSDs) at 26.6% (53 cases), and patent ductus arteriosus (PDAs) at 9.5% (19 cases). Complications related to CHDs were observed in 69.3% (138) of patients, with 30.7% (61) experiencing a single complication and 39.2% (87) experiencing multiple complications. CONCLUSION: This study found a higher prevalence of CHDs in females (77.8%) compared to males, a trend consistent across various atrial and ventricular defect types. Individuals aged 15 to 25 years exhibited the highest incidence of ASD and VSD. Moreover, CHD-related anomalies were present in 69.3% of the patients studied.

Challenges in sourcing bodies for anatomy education and research in Ethiopia: Pre and post COVID-19 scenarios.

BACKGROUND: The relevance of anatomical dissection in instructing anatomy to medical, dental, and other health science students is indisputable. Ethiopian anatomists encountered challenges in obtaining human bodies for anatomy education and research, both prior to and following the COVID-19 outbreak. The challenges intensified during the pandemic, significantly affecting anatomy education in Ethiopia. This study seeks to investigate the sources of bodies for anatomy, spanning the periods before and after COVID-19, with a particular focus on identifying the primary challenges associated with sourcing of bodies in Ethiopia. METHODS: Fifty (50) anatomists completed a survey distributed to ten (10) randomly chosen medical institutions in Ethiopia. The survey gathered information on the body profile (number of bodies, age, sex, sources, and methods of body disposal), and the challenges faced during the sourcing of bodies in the years 2018 and 2023. RESULTS: A total of sixty-three (63) bodies were used by the sampled medical institutions between 2018 and 2023 academic years. All (100%) of the bodies used were unclaimed human bodies. Most (66.7%) of these bodies were males. The majority (65.5%) of these bodies were sourced from Tikur Anbessa hospital in Addis Ababa. None (0%) of the sampled medical institutions had body donation programs. Disposal of human tissues encompassed various methods, including the retention of skeletons, prosection of vital organs, and burial of remaining tissues. Economic constraints and the absence of a legal framework document were the main challenges in acquiring bodies in the pre-pandemic period. The COVID-19 pandemic prevention policies and the civil war further exacerbated the challenges in sourcing of bodies for anatomy dissections during the post-pandemic period. CONCLUSION: The reliance on unclaimed human bodies for anatomy education and research in Ethiopian medical institutions mirrors a common practice across many African countries. The authors suggest the development of a legislative framework or operational guidelines, coupled with empowering the medical institutions to outsource their own funding that will ultimately lead to an increased number of bodies available for anatomical dissection. Over time, implementation and promotion of body donation programs may also resolve body shortages for anatomy education in Ethiopia.