Dolutegravir based therapy showed CD4+ T cell count recovery and viral load suppression among ART naïve people living with HIV AIDS: a pilot evaluation.

Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4+ T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5-732994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes.

Hematological profiles of newborns of mothers with hypertensive disorders of pregnancy delivered at the University of Gondar comprehensive specialized hospital: a comparative cross-sectional study.

BACKGROUND: Hypertensive disorders in pregnancy can cause prenatal placental perfusion with insufficient blood supply to the fetus, resulting in fetal exposure to hypoxia and leading to disturbance of neonatal hematopoietic stem cells. This study aimed to compare the hematological profiles of newborns from mothers with hypertensive disorders and normotensive delivered at the University of Gondar comprehensive specialized hospital. METHODS: A comparative cross-sectional study was conducted from March to May 2022 among 308 newborns from hypertensive and normotensive mothers in equal proportions. A systematic random sampling technique was used to select study participants. Three milliliters of cord blood were collected to perform a complete blood count by Beckman coulter. The results were presented using tables and graphs. Independent t-test and Mann-Whitney U test were done to compare the hematological profiles of the two groups. P-value < 0.05were considered statistically significant. RESULTS: The majority of hypertensive and normotensive mothers' ages were between 20 and 34 years (83.77% and 90.91%, respectively). The hematocrit levels were significantly higher in neonates of hypertensive mothers than the neonates of normotensive mothers (49.10 ± 5.19% and 46.09 ± 7.63% respectively) (P < 0.001) while neutrophil counts were significantly lower in neonates of hypertensive mothers than the neonates of normotensive mothers (6.62 ± 3.30 and 7.55 ± 3.31 × 103 /ul respectively) (P = 0.007). Also, platelets counts were significantly lower in neonates of hypertensive mothers than neonates of normotensive mothers (221.25 ± 83.56 and 260.24 ± 83.01 × 103/ul respectively) (P < 0.001). The platelet and nucleated red blood cell count showed a statistically significant difference among newborns from mothers with superimposed preeclampsia and gestational hypertension. CONCLUSION: Newborns delivered from hypertensive disorders of pregnancy had low white blood cell parameters, low platelet count and high red blood cell parameters compared to controls. As result, newborns may develop leukopenia, thrombocytopenia and polycythemia, respectively. Therefore, newborns should be monitored for early detection and follow-up of hematological abnormalities before complications occurred.

The Association between Neutrophil-to-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Background: Glycated hemoglobin (HbA1c) is a commonly used clinical marker to monitor the control of type 2 diabetes mellitus patients (T2DM). However, it is unable to identify the ongoing inflammatory changes in the body. These factors could be easily identified and monitored by the neutrophil-to-lymphocyte ratio (NLR). Therefore, this study is aimed at investigating the relationship between NLR and glycemic control in T2DM. Method: A comprehensive search of eligible studies was performed in various databases published until July 2021. A random effect model was used to estimate the standardized mean difference (SMD). A metaregression, subgroup, and sensitivity analysis were conducted to search for potential sources of heterogeneity. Result: A total of 13 studies were included in this study. Accordingly, the SMD of the NLR values between the poor and good glycemic control groups was 0.79 (95% CI, 0.46-1.12). Our study also showed that high NLR was significantly associated with poor glycemic control in T2DM patients (OR = 1.50, 95% CI: 1.30-1.93). Conclusion: The results of this study suggest an association between high NLR values and an elevated HbA1C in T2DM patients. Therefore, NLR should be considered a marker of glycemic control in addition to HbA1c in T2DM patients.

The prevalence of anemia among human immunodeficiency virus-infected individuals in East Africa: A systematic review and meta-analysis.

BACKGROUND: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients face several hematological abnormalities. Of these abnormalities, anemia is the most common one. Africa has a high prevalence of HIV/AIDS, especially in the East and South African region, which is heavily affected by the virus. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of anemia among patients with HIV/AIDS in East Africa. METHODS: This systematic review and meta-analysis was conducted based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Google Scholar, Science Direct, Dove Press, Cochrane Online, and African journals online were searched systematically. The quality of the included studies was assessed by 2 independent reviewers using the Joanna Briggs Institute critical appraisal tools. Data were extracted into an Excel sheet and then exported to STATA version 11 for analysis. A random-effect model was fitted to estimate the pooled prevalence and Higgins I2 test statistics were done to test the heterogeneity of studies. Funnel plots analysis and Egger-weighted regression tests were done to detect publication bias. RESULTS: The pooled prevalence of anemia among HIV/AIDS patients in East Africa was 25.35% (95% CI: 20.69-30.03%). A subgroup analysis by highly active antiretroviral therapy (HAART) status showed that the prevalence of anemia among HAART naive HIV/AIDS patients was 39.11% (95% CI: 29.28-48.93%) whereas the prevalence among HAART experienced was 36.72% (95% CI: 31.22-42.22%). A subgroup analysis by the study population showed that the prevalence of anemia among adult HIV/AIDS patients was 34.48% (95% CI: 29.52-39.44%) whereas the pooled prevalence among children was 36.17% (95% CI: 26.68-45.65%). CONCLUSION: This systematic review and meta-analysis revealed that anemia is among the most common hematological abnormalities in HIV/AIDS patients in East Africa. It also underscored the importance of taking diagnostic, preventive, and therapeutic measures for the management of this abnormality.

The magnitude and associated factors of coagulation abnormalities among liver disease patients at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia, 2022.

BACKGROUND: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. METHODS: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood were collected and analyzed by the Genrui CA51 coagulation analyzer. Data were entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. RESULT: In this study, a total of 307 study participants were included. Of them the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anaemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. CONCLUSION: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

MicroRNAs as Quality Assessment Tool in Stored Packed Red Blood Cell in Blood Banks.

Micro-ribonucleic acids are control gene expression in cells. They represent the changed cellular states that occur can be employed as biomarkers. Red blood cells alter biochemically and morphologically while they are being stored, which could be detrimental to transfusion. The effect of storage on the erythrocyte transcriptome is not mostly investigated. Because adult erythrocytes lack a nucleus, it has long been assumed that they lack deoxyribonucleic acid and ribonucleic acid. On the other hand, erythrocytes contain a diverse range of ribonucleic acids, of which micro-ribonucleic acids are key component. Changes in this micro-ribonucleic acid protect cells from death and adenine triphosphate depletion, and they are linked to specific storage lesions. As a result, changes in micro-ribonucleic acid in stored erythrocytes may be used as a marker to assess the quality and safety of stored erythrocytes. Therefore, this review ams to review the role of microRNA in stored packed red blood cells as quality indicator. Google Scholar, PubMed, Scopus, and Z-libraries are used for searching articles and books. The article included in this paper was written in the English language and had the full article. During long storage of RBCs, miR-16-2-3p, miR-1260a, miR-1260b, miR-4443, miR-4695-3p, miR-5100, let-7b, miR-16, miRNA-1246, MiR-31-5p, miR-203a, miR-654-3p, miR-769-3p, miR-4454, miR-451a and miR-125b- 5p are up regulated. However, miR-96, miR-150, miR-196a, miR-197, miR-381 and miR-1245a are down regulated after long storage of RBCs. The changes of this microRNAs are linked to red blood cell lesions. Therefore, micro-ribonucleic acids are the potential quality indicator in stored packed red blood cells in the blood bank. Particularly, micro-ribonucleic acid-96 is the most suitable biomarker for monitoring red blood cell quality in stored packed red blood units.

Blood specimen rejection rate in clinical laboratory: A systematic review and meta-analysis.

Background: Clinical laboratory errors have a great impact on patient safety and treatment. Although specimen rejections result in longer turnaround times and increased health-care costs, different studies present inconsistent findings. Therefore, the study aimed to determine the pooled prevalence of blood specimen rejection in clinical laboratory. Methods: Electronic databases including MEDLINE, PubMed, EMBASE, HINARI, Cochrane Library, Google Scholar, and Science Direct were comprehensively searched. Articles were screened and the data extracted independently by authors. Publication bias was checked by funnel-plots and Egger's statistical test. Pooled prevalence was estimated using a random-effects model. The I2 statistical test were performed to assess heterogeneity. The possible sources of heterogeneity were analyzed through subgroup and sensitivity analysis. Results: Total of 26 articles with 16,118,499 blood sample requests were included in the meta-analysis. The pooled prevalence of blood specimen rejection in the clinical laboratory was 1.99% (95% CI: 1.73, 2.25). Subgroup analysis showed that, the highest prevalence of specimen rejection was observed in Asia [2.82% (95%CI: 2.21, 3.43)] and lowest in America [0.55% (95%CI: 0.27, 0.82)]. The leading cause of blood specimen rejection in clinical laboratories were clotted specimen (32.23% (95%CI: 21.02, 43.43)), hemolysis (22.87% (95%CI: 16.72, 29.02)), insufficient volume (22.81% (95%CI: 16.75, 28.87)), and labelling errors (7.31% (95%CI: 6.12, 8.58)). Conclusion: The pooled prevalence of blood specimen rejection rate is relatively high especially in developing regions. Therefore, proper training for specimen collectors, compliance with good laboratory practices specific to specimen collection, transportation, and preparation is required to reduce the rejection rate.

Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study.

BACKGROUND: Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months. METHODS: A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition. RESULT: In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82). CONCLUSION: According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.

Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis.

BACKGROUND: High monocyte to lymphocyte ratio (MLR) values may be associated with the risk of active tuberculosis (TB) infection in adults, infants, and postpartum women with HIV infection. It may also serve as an indicator of the effectiveness of anti-TB treatment. Thus, the main aim of this study is to ascertain the accuracy of MLR for the diagnosis of TB and its role in monitoring the effectiveness of anti-TB therapy. METHODS: This systematic review and meta-analysis followed the preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. All statistical analyses were performed using STATA 11 and Meta-DiSc software. The Quality assessment of Diagnostic Accuracy Studies tool was used to evaluate the methodological quality of the included studies. The area under the hierarchical summary receiver-operating characteristic hierarchical summary ROC curve [(HSROC) curve (AUC)] was also calculated as an indicator of diagnostic accuracy. RESULTS: A total of 15 articles were included in this study. Accordingly, the result showed that elevated MLR is associated with increased risks of TB disease [odd ratio = 3.11 (95% CI: 1.40-6.93)]. The pooled sensitivity and specificity of MLR for identifying TB were 79.5% (95% CI: 68.5-87.3) and 80.2% (95% CI: 67.3-88.9), respectively. The AUC of HSROC was 0.88 (95% CI: 0.857-0.903), indicating the excellent diagnostic performance of MLR for TB. This study also showed that there is a significant reduction in the MLR value after anti-TB treatment in TB patients (standardized mean difference  = 0.68; 95% CI: 0.007, 1.43). CONCLUSIONS: Generally, MLR can be considered as a crucial biomarker to identify TB and monitor the effectiveness of anti-TB therapy.

Relationships of ABO and Rhesus blood groups with type 2 diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVES: The susceptibility to type 2 diabetes mellitus (T2DM) has been linked to blood type. We aimed to characterize the relationships of the ABO and Rhesus blood groups with T2DM. METHODS: Literature searches were performed using the Medline, PubMed, Scopus, Cochrane, EMBASE, and Google Scholar databases to identify studies published up to 31 March 2022. The PRISMA guidelines were used for reporting. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained using fixed-effects models. RESULTS: Twenty-six studies of 6870 patients with T2DM and 11,879 controls were identified. Compared with the other ABO groups, people with blood type B were at higher risk of T2DM (OR: 1.30, 95% CI: 1.20-1.41), while group O was associated with a lower risk (OR: 0.92, 95% CI: 0.86-0.98). There were no significant associations of T2DM with blood types A or AB, or Rh factor. CONCLUSION: Individuals with blood type B are at higher risk of developing T2DM. Therefore, they should be screened for T2DM on a frequent basis and be made aware of the importance of maintaining a balanced diet and regular exercise for the prevention of obesity and T2DM. PROSPERO REGISTRATION NUMBER: CRD42022353945.

Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital.

Background: Heart disease is a leading cause of hospitalization, death, and poor physical function due to comorbid conditions such as atrial fibrillation and stroke. It affects the blood hemostatic system, vasculature, and flow dynamics, causing both arterial and venous thrombosis. Thus, this study aimed to determine the magnitude of coagulation abnormalities among patients with heart disease attending the University of Gondar Comprehensive Specialized hospital. Methods: A cross-sectional study was conducted on a total of 98 patients with heart disease. Pretested structured questionnaires were used to collect data on socio-demographic and clinical variables. About 6 mL of venous blood was collected with the vacutainer method and analyzed using Huma cue-due plus and Sysmex KX-21N hematology analyzers for assessing coagulation abnormalities. Stool samples were processed via a direct wet mount. Thin and thick blood films were examined to assess malaria parasites. Data was entered into EPI-Info version 3.5.3 and then transported to SPSS version 20 for analysis. Descriptive statistics were summarized using frequency and percentage. Univariate and multivariate logistic regression models were fitted to identify factors associated with coagulopathy. P-value <0.05 was considered to be statistically significant. Results: The overall magnitude of coagulation abnormalities (thrombocytopenia, prolonged prothrombin time, and activated partial thromboplastin time) in patients with heart diseases was 85.7% (95% CI: 81.96, 89.45). Besides, prolonged prothrombin time, prolonged activated partial thromboplastin time, and thrombocytopenia were detected in 83.7%, 33.7%, and 12.2% of the study participants, respectively. Participants who are taking medications for chronic disease (AOR = 0.17; 95% CI: 0.04, 0.69), participants with stroke (AOR = 20; 95% CI: 14.7, 35), and participants taking antibiotics (AOR = 8.17; 95% CI: 1.66, 40.27) were significantly associated with prolonged coagulation time. Conclusion: This study showed that patients with heart disease had prolonged prothrombin time, activated partial thromboplastin time, and thrombocytopenia. Therefore, coagulation parameters are required to be checked regularly to monitor coagulation disorders and their complications in heart disease patients.

Hematological abnormalities before and after initiation of cancer treatment among breast cancer patients attending at the University of Gondar comprehensive specialized hospital cancer treatment center.

BACKGROUND: Breast cancer is the most frequent and fatal cancer type globally. The fatality rate of breast cancer is mostly due to disease complications like hematological alterations. Therefore, this study aimed to assess the hematological abnormalities before, during, and after the initiation of cancer treatment in breast cancer patients at the University of Gondar comprehensive specialized hospital. METHODOLOGY: Hematological profiles were collected from 267 breast cancer patients who attended the cancer treatment center from September 2017 to August 2021. A data extraction sheet was used to extract data from the patient's medical chart, including sociodemography, clinical, and hematological profiles. EPI info version 3.5.1 and SPSS Version 25 softwares were used for data entrance and analysis, respectively. Descriptive statistics were summarized using frequency and percentage. The Friedman test followed by a Wilcoxon signed rank test was used to compare the mean difference between the hematological profiles at zero and after the 4th and 8th cycles of treatment. RESULT: Of the total participants, 91% were females, and the median age of the study participants was 45 (IQR = 36, 55) years. Red blood cell, white blood cell, and lymphocyte counts, as well as hematocrit and hemoglobin values, were significantly reduced after the initiation of cancer treatment, while the platelet count and red cell distribution width were significantly increased. The prevalence of anemia was 21.7% (95% CI: 16.6, 26.8), 22.7% (95% CI: 17.6, 27.8), and 26.4% (95% CI: 21.3, 31.5) before, during, and after the initiation of cancer treatment, respectively. The prevalence of leukopenia before, during, and after treatment was 9.7%, 18.8%, and 15.1%, respectively. Finally the prevalence of thrombocytopenia was 6.3%, 3.4%, and 8% at before, during, and after treatment, respectively. CONCLUSION: This study concluded that many hematological parameters were significantly affected by the breast cancer treatment. Therefore, proper patient follow-up and provide appropriate interventions related to their hematological abnormalities is crucial. It is also important to conduct further prospective studies to confirm the findings of this study.

Role of complete blood cell count parameters in the diagnosis of neonatal sepsis.

BACKGROUND: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality in developing countries like Ethiopia. The investigation of neonatal sepsis needs the application of inclusive diagnostic tools. Therefore, this study aimed to assess the role of CBC parameters in diagnosing neonatal sepsis. METHODS: A comparative cross-sectional study was conducted from September 2020 to November 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 250 neonates were included using a convenient sampling technique. A structured questionnaire and a data collection sheet were used to obtain the socio-demographic and clinical characteristics of the study participants. A venous blood sample was collected for CBC and blood culture tests. Epi-Info Version 7 and SPSS Version 25 were used for data entry and analysis, respectively. The data distribution was checked by the Shapiro-Wilk test. Then, an independent t-test was conducted to compare CBC parameters, and the significant parameters were recruited for the ROC curves analysis. The Younden index test was used to determine the cutoff point for the sensitivity and specificity. A p-value of <0.05 was considered statistically significant. RESULTS: Out of 250 study participants, 144 (57.6%) were males, with a median age of 6 days (IQR = 4 days). Early-onset and late-onset sepsis were developed in about 29.6% (37/250) and 70.4% (88/250) of the neonates, respectively. The TLC and ANC parameters were significantly lower in cases than in control groups. The TLC, Hgb, lymphocyte count, and ANC parameters have a sensitivity of 64.8, 68, 33.6, and 49.6%, respectively. Their specificity in the diagnosis of neonatal sepsis was 64.8, 53.6, 83.2, and 90.4%, respectively. CONCLUSION: Total leucocyte count, ANC, and platelet count all showed significant associations with neonatal sepsis. Besides, the TLC, ANC, and platelet counts had good sensitivity and specificity in diagnosing neonatal sepsis. Therefore, these parameters can be used as a diagnostic tool for neonatal sepsis in resource-limited areas.

Peripheral Cytopenia and Its Associated Factors in Type 2 Diabetes Mellitus Patients, Northwest Ethiopia.

Background: Hematological abnormalities are linked with diabetes mellitus (DM) and play a major role in diabetes-related micro- and macro-vascular complications. Therefore, this study aimed to investigate the magnitude of peripheral cytopenia and associated factors in type 2 diabetes (T2DM) patients. Methods: A cross-sectional study was conducted from March to May 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 357 T2DM participants were selected using a simple random sampling technique. A total of 3 mL of venous blood samples were collected using the vacutainer method for the complete blood count (CBC). A univariate and multivariate regression analysis were used to investigate the association between dependent and independent variables. P-value ˂0.05 was considered statistically significant. Results: The magnitude of cytopenia, bicytopenia, and pancytopenia were 21% (95% CI: 17.1, 25.53), 1.1% (95% CI: 0.44, 2.85), and 0.56% (95% CI: 0.01, 1.12), respectively. Furthermore, the magnitudes of anemia, leucopenia, and thrombocytopenia were 8.7% (95% CI: 6.18, 12.06), 10.9% (95% CI: 8.09, 14.59), and 5.3% (95% CI: 3.43, 8.16), respectively. Being male (AOR: 3.23; 95% CI: 1.43, 7.56), lack of exercise (AOR: 2.70; 95% CI: 1.137, 6.43), and never married (AOR: 3.90; 95% CI: 1.248, 12.18) were all associated with anemia. Conclusion: This study showed that T2DM causes disturbances in the hematological parameters and leads to a mild level of cytopenia. It is, therefore, suggested that hematological abnormalities, especially cytopenia, should be monitored and controlled on a regular basis in T2DM patients for better prognosis and quality of life.

Hematological Abnormalities in Culture Positive Neonatal Sepsis.

Background: In neonatal sepsis, anemia, leukocytosis, thrombocytopenia, and a shortened coagulation time are the most common hematologic abnormalities. However, there is inadequate information regarding the hematological abnormalities in neonatal sepsis. Thus, we aimed to determine the magnitude of hematological abnormalities in neonatal sepsis. Methods: This is a cross-sectional study that included 143 neonates with culture proven sepsis aged 1-28 days from September 2020 to November 2021 at the University of Gondar Specialized Referral Hospital. The sociodemographic data was collected using a pre-tested structured questionnaire, and the clinical and laboratory data was collected using a data collection sheet. A total of 2 mL of venous blood was taken using a vacutainer collection device for the complete blood count (CBC) and blood culture analysis. A univariate and multivariate logistic regression model was used to investigate factors associated with hematological abnormalities in neonatal sepsis. Statistical significance was declared when a p-value was less than 0.05. Results: The prevalence of anemia, thrombocytopenia, and leucopenia in neonatal sepsis was 49% (95% CI: 40.89-57.06), 44.7% (95% CI: 36.8-52.9), and 26.6% (95% CI: 22.01-29.40), respectively. On the other hand, leukocytosis and thrombocytosis were found in 7.7% (95% CI: 4.35-13.25) and 11.9% (95% CI: 7.56-18.21), respectively. Being female (AOR: 3.3; 95% CI: 1.20-3.82) and being aged less than 7 days (AOR: 2.44; 95% CI: 1.6-6.9) were found to be significant predictors of anemia. Conclusion: The magnitude of anemia, leucopenia, and thrombocytopenia is high in neonatal sepsis. Furthermore, being female and being younger than 7 days were risk factors for anemia. Thus, the diagnosis and treatment of anemia, leucopenia, and thrombocytopenia prevents further complications in neonatal sepsis.

Coagulation parameters in lung cancer patients: A systematic review and meta-analysis.

BACKGROUND: Hypercoagulability in lung cancer patients is associated with a high incidence of mortality and morbidity in the world. Therefore, this meta-analysis aimed to explore the correlation of the basic coagulation abnormalities in lung cancer patients compared with the control. METHOD: PubMed, Scopus, and other sources were employed to identify eligible studies. The outcome variable was expressed using mean ± standard deviation (SD). Heterogeneity among studies and publication bias were evaluated. The quality of included studies was also assessed based on Newcastle-Ottawa Scale checklist. RESULT: Finally, through a total of eight studies, prolonged prothrombin time (PT; standard mean difference [SMD]: 1.29; 95% CI: 0.47-2.11), plasma D-dimer value (SMD 3.10; 95% CI 2.08-4.12), fibrinogen (SMD 2.18; 95% CI:1.30-3.06), and platelet (PLT) count (SMD 1.00; 95% CI 0.84-1.16) were significantly higher in lung cancer patients when compared with the control group. The single-arm meta-analysis also showed that compared with control, lung cancer patients had high pooled PT 13.7 (95% CI:12.2-15.58) versus 11.79 (95% CI = 10.56-13.02), high D-dimer 275.99 (95% CI:172.9-11735.9) versus 0.2 (95% CI:0.20-0.37), high plasma fibrinogen 5.50 (95% CI:4.21-6.79) versus 2.5 (95% CI:2.04-2.91), and high PLT count 342.3 (95% CI:236.1-448.5) versus 206.6 (95% CI:176.4-236.7). CONCLUSION: In conclusion, almost all the coagulation abnormalities were closely associated with lung cancer, and hence coagulation indexes provide an urgent clue for early diagnosis and timely management.

Knowledge, attitude and practice towards COVID-19 among secondary school students in Gondar town, Northwest Ethiopia.

BACKGROUND: In Ethiopia, an array of measures have been adopted to control the rapid spread of the Coronavirus Disease 2019 (COVID-19) pandemic. Such control measures could significantly influence the knowledge, attitudes, and practices (KAP) towards COVID-19 in the general population. However, still, there is scarce information regarding the KAP of students towards the COVID-19 pandemic. Therefore, this study aimed to assess KAP and associated factors towards COVID-19 among secondary school students in Gondar town, Ethiopia. METHODS: A cross-sectional study was conducted from February to April 2021 on a total of 395 participants. Proportional sample allocation was used in 4 randomly selected schools. Then, students from each of the schools were recruited by using a systematic random sampling technique. Socio-demographic data and questions regarding the KAP were collected via a self-administered questionnaire. Statistical analysis was performed by using SPSS 20. Logistic regression analyses were used to identify the associated factors and p-value <0.05 was considered statistically significant. RESULTS: The mean age of study participants was 17.7±1.5 years and slightly more than 2/3 (67.3%) ranges from 17-19 years old. In this study, 86.3% (95% CI: 83-90) of study participants had good knowledge about COVID-19. Students having urban residence (AOR, with 95% CI: 5.6 (1.76-17.6), fathers with a diploma and above educational status (AOR, with 95% CI: 3 (1.2-7.5), and uses television or radio as a source of information (AOR, with 95% CI: 3.7 (1.5-9.3) tended to have good knowledge about COVID-19. About 381 (86.3%) had good attitude towards COVID-19 infections, while 238 (60.3%) of the participants had a good practice to prevent COVID-19 infections. CONCLUSIONS: The majority of the secondary school students in Gondar town have good knowledge, attitude, and practices towards COVID-19. However, targeted interventions are still necessary, especially for students having poor knowledge and poor practice towards COVID-19. This study also found that urban residence, a father with a diploma and above educational status, and using television or radio as a source of information about COVID-19 were significantly associated with the knowledge level of the study participants.

Anemia in African malnourished pre-school children: A systematic review and meta-analysis.

Generating accurate epidemiological data on the magnitude of anemia in malnourished children is a vital step for health policymakers. Therefore, this study is aimed to synthesize the overall magnitude of anemia in African malnourished pre-school children. We have searched the databases PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, and Google to identify relevant articles. Joana Brigg's Institute critical appraisal tool was used to assess the quality of articles. A random-effects model was applied to estimate the pooled prevalence of anemia in malnourished children. The I2 statistics were used to examine heterogeneity among the included studies. In the presence of heterogeneity, a subgroup analysis has been used. The funnel plot analysis and Egger's tests were used to investigate the presence of publication bias. A total of 15 articles with 12,211 study participants were included in this study. Anemia was observed in 57.53% (95% CI: 47.05, 68.01) of African malnourished pre-school children. Moreover, the prevalence of anemia was 58.52% (95% CI: 43.04, 73.81) and 56.18% (95% CI: 40.24, 72.13) in HemoCue and auto-machine diagnosis method of anemia, respectively. This review showed that the magnitude of anemia was high among African malnourished pre-school children. Therefore, planning preventive measures to decrease anemia and its complications in malnourished children in Africa is an important step.

Prevalence of COVID-19 in West Gondar Zone, Northwest Ethiopia: A Population-Based Retrospective Study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, affecting every community directly or indirectly. Therefore, this study aims to investigate the prevalence of COVID-19 infection in the population of the West Gondar zone. METHOD: A retrospective cross-sectional study was conducted from November 2020 to January 2021, in the West Gondar zone, Northwest Ethiopia. Records of study participants with required information like age, gender, travel history, type of specimen taken, and site of specimen taken were included. For analysis, the statistical package for social sciences (SPSS) version 20 software was used. Descriptive statistics were summarized as percentages and means ± standard deviation. The chi-squared test is used to compare categorical data. RESULTS: A total of 1,166 participants were enrolled in this study. Of them, 16 individuals had positive results, giving a prevalence of 1.37% (95% CI: 0.66-2.08). Living in an urban area (P-value = 0.035) and being female (P-value = 0.045) was statistically associated with the positive rate for COVID-19. CONCLUSIONS: This study revealed a low prevalence of COVID-19 infection in the study area despite the increasing and rapid dissemination of the disease. State-wide population prevalence study should be done to estimate the general prevalence of COVID-19 in Ethiopia.

The Prevalence of Coagulopathy and Associated Factors Among Adult Type II Diabetes Mellitus Patients Attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

INTRODUCTION: Diabetes mellitus is a heterogeneous disorder of metabolism which results hyperglycemic-related atherothrombotic complications. These complications are the leading cause of death in diabetes mellitus patients. Therefore, this study was aimed to determine the prevalence of coagulopathy and associated factors among adult type II diabetes mellitus patients attending at University of Gondar comprehensive specialized hospital. METHODS: A facility-based cross-sectional study was conducted among 357 study participants. A questionnaire and a data collection sheet were used to collect the sociodemographic and clinical data, respectively. About 6mL of venous blood samples were collected for coagulation tests and complete blood count. For prolonged coagulation tests, a mixing test was performed. Data were entered into EpiInfo and exported to SPSS for statistical analysis. Then, descriptive statistics were done. A binary and multivariable logistic regression model was used to identify the associated factors. P-value <0.05 was considered as statistically significant. RESULTS: In this study, 357 study participants were included. Of them, 52.1% (186) and 80.7% (288) were females and urban residences, respectively. The prevalence of coagulopathy was 26.6% (95% CI: 22.1, 31.5%). Out of this, 12.3% and 8.7% showed shortened PT and aPTT, respectively. In addition, the prevalence of prolonged PT and aPTT were 5.6% and 3.9%, respectively. From the prolonged PT and aPTT, the prevalence of factor deficiency was 95% and 92.8%, respectively. Being female (AOR = 2.06; 95% CI: 1.11-3.85%), abnormal BMI (AOR = 1.94; 95% CI: 1.08-3.50), and educational status of high school (AOR = 0.26; 95% CI: 0.10-0.83%) were significantly associated with hypercoagulation. CONCLUSION: Coagulopathy is an important public health problem among type II diabetes mellitus patients. Being female and having abnormal BMI were associated with hypercoagulation. Therefore, regular monitoring of coagulation parameters is vital to reduce the consequence of coagulopathy.