Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study.

INTRODUCTION: Diabetic ketoacidosis is an acute complication of diabetes mellitus that is characterised by hyperglycemia, acidosis, and ketonuria. Diabetes is the most challenging public health problem in the twenty-first century for both developed and developing countries. OBJECTIVE: To assess the incidence of Diabetic ketoacidosis and its determinants among adult people with diabetes at an Ethiopian Hospital. METHOD: An institution-based retrospective cohort study was conducted among 390 adult people with diabetes attending services at Wolida Comprehensive Specialized Hospital. The consecutive sampling method was used to select study participant charts. Data were collected using a checklist prepared from different literature. The data were entered into EPI data version 4.6.0.5 and exported to STATA version 14.0 for further analysis. The Wiebull model was the best fitted model that was selected using the log-likelihood ratio method and the Akakian information criterion. Hazard ratios with their 95% confidence interval and p-value were computed. RESULT: From the total 405 charts reviewed, 390 adult charts were included for analysis. A total of 121 DKA occurred from 5471 person-months of observation. The overall incidence rate of diabetic ketoacidosis was found to be 2.2 per 100 person-months (95% CI: 1.8- 2.6). Being urban dweller (AHR: 0.59, 95% CI: 0.36-0.99), having no family history of DM (AHR: 0.55, 95%CI: 0.31-0.97), presence of infection (AHR: 2.60, 95%CI = 1.06-6.39), having of any comorbidities (AHR: 4.31, 95% CI: 1.70-10.90), and having poor glycemic control (AHR: 7.45, 95% CI: 3.84-14.47) were significant determinants. CONCLUSION AND RECOMMENDATIONS: The overall incidence of diabetic ketoacidosis in study area was relatively high. Poor glycemic control, the presence of infection, and comorbidity were determinants of diabetic ketoacidosis. There is a need to have close follow-up of people with diabetes who have comorbidity, infection, and poor glycemic control.

Time to recovery and its predictors following traumatic injuries among injured victims in Dessie Comprehensive Specialized Hospital, North East of Ethiopia, 2022: a retrospective follow-up study.

BACKGROUND: Injuries are an extremely important public health problem worldwide. Despite being largely preventable and despite government efforts, injuries continue to be a major public health issue. Thus, the study tends to evaluate the time to recovery and its predictors for traumatic injuries. METHODS: A hospital-based retrospective follow-up study was used. A total of 329 medical charts were actually reviewed. Traumatic injury victims from January 1, 2018-December 31, 2022 were included, and a simple random sampling technique was utilized. The data was gathered by reviewing medical charts. Data was coded and entered into Epi-Data Manager version 4.6.0.4 statistical software and further analyzed using STATA version 17. Descriptive statistics were performed to see the frequency distribution of variables. A Kaplan-Meier survival estimate and log rank test were performed to plot the overall survival curve and compare the difference in recovery among predictor categories, respectively. A model fitness test was done by using the Cox-Snell residual test and Harrell's C concordance statistic. Finally, a Cox proportional hazard model was fitted to determine the effect of predictors on recovery time from traumatic injuries. RESULTS: The median time to recovery of traumatic injuries was 5 days (IQR: 3-10 days), with an overall incidence density of 8.77 per 100 person-days of observation. In the multivariable cox proportional regression model, variables such as being male (AHR: 0.384, 95%CI: 0.190-0.776, P-value: 0.008), the Glasgow coma scale of 13-15 (AHR: 2.563, 95%CI: 1.070-6.139, P-value: 0.035), intentional injury (AHR: 1.934, 95%CI: 1.03-3.632, P-value: 0.040), mild traumatic brain injury (AHR: 2.708, 95%CI: 1.095-6.698, P-value: 0.031), and moderate traumatic brain injury (AHR: 2.253, 95%CI: (1.033-4.911, P-value: 0.041) were statistically significant variables. CONCLUSIONS: The median recovery time for traumatically injured respondents was 5 days. Independent predictors such as the Glasgow coma scale, time taken for surgical management, intent of injury, and traumatic brain injury were statistically significant with time to recovery from trauma.

Knowledge, attitude, practice and determinants of exclusive breastfeeding among women in Ethiopia: Systematic review and meta-analysis.

Objective: This study aimed to assess the pooled estimate of Ethiopia's women's knowledge, attitudes, practices, and determinants of exclusive breastfeeding. Methods: PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed. Results: Out of 995 studies reviewed, 33 met our eligibility criteria and were included in this meta-analysis study. The total number of study participants was 13,397. The pooled prevalence of good knowledge, positive attitude, and poor practice of kangaroo mother care were 74.2% (95% CI: 62.9-85.4), 77.2% (95%CI: 68.3-86.0), and 58.3% (95% CI: 49.9-66.6), respectively. In sub-group analysis, the highest prevalence of knowledge was in institution-based studies (78.3%) and unpublished studies (76.3%). A positive attitude was also highest in institutional-based studies (81%). The highest practice prevalence was in Afar (68%) and the lowest was in Addis Ababa (34.6%).Women who had a secondary level of education (AOR = 3.3; 95%CI: 1.8-6.0) were a housewife (AOR = 3.1; 95%CI: 2.1-4.7), delivered vaginally (AOR = 2.0; 95%CI: 1.4-2.9), health facility delivery (AOR = 3.3; 95%CI: 2.1-5.1) and attending antenatal care were predictors of exclusive breastfeeding. Conclusion: Although women have good knowledge and positive attitude toward exclusive breastfeeding, there is a significant gap in exclusive breastfeeding practice. Maternal education, occupation, vaginal delivery, institutional delivery, and antenatal care visit were predictors of exclusive breastfeeding. It is recommended to strengthen maternal and child health services.

Incidence and predictors of common opportunistic infection among HIV -infected children attending antiretroviral treatment clinic at Northeast Ethiopia, public hospitals 2022: A multicenter retrospective follow-up study.

Background: Opportunistic infections (OIs) are illnesses that attack people with weakened immune systems, such as HIV patients, more frequently and severely. The majority of opportunistic infections (OIs) are the leading causes of morbidity and mortality in HIV/AIDS patients, emerging at the end of the illness. The objective of this study was to assess the incidence and risk factors of opportunistic infections (OIs) in HIV-infected children receiving antiretroviral therapy in public hospitals in Northeast Ethiopia. Methods: A multicenter retrospective follow-up study was undertaken at public hospitals in northeast Ethiopia from September 1, 2010, to January 30, 2022. A total of 341 HIV-infected children on antiretroviral therapy were included in the study. Data was entered using Epi-Data Manager version 4.6.1, and it was analyzed using STATA version 16.1. The opportunistic infection free-survival time was estimated using the Kaplan-Meier survival curve. Bivariable and multivariable Cox proportional hazard models were used to investigate the determinants of opportunistic infections. Results: The overall incidence rate of opportunistic infections (OIs) was 6.0 (95% CI: 5.0-7.1) per 100 child-years of observation. This study's participants were observed for a minimum of 9 months and a maximum of 122 months, for a total of 21,629 months, or 1802.4 years. Children with WHO clinical stages III and IV (AHR: 1.77; 95% CI: 1.13, 2.77), non-users of Cotrimoxazole Preventive Therapy (CPT) (AHR: 2.10; 95% CI: 1.40, 3.08), and low hemoglobin levels (10 mg/dl) (AHR: 1.88; 95% CI: 1.25, 2.82) were identified as significant predictors of opportunistic infection. Conclusion: In this study, the incidence rate of opportunistic infections among HIV-infected children was found to be high when compared to other studies. Low hemoglobin levels (10 mg/dl), low CD4 counts or percentages, clinical stages III and IV, and non-users of CPT were all associated with higher rates of opportunistic infection.

Malaria among under-five children in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria. METHODS: The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger's and Begg's statistical tests. RESULTS: Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria. CONCLUSION: More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.

Time to recovery and its predictors among critically ill patients on mechanical ventilation from intensive care unit in Ethiopia: a retrospective follow up study.

INTRODUCTION: For critically ill patients, mechanical ventilation is considered a pillar of respiratory life support. The mortality of victims in intensive care units is high in resource-constrained Sub-Saharan African countries. The recovery and prognosis of mechanically ventilated victims are unknown, according to evidence. The goal of the study was to see how long critically ill patients on mechanical ventilation survived. METHODS: A retrospective follow-up study was conducted. A total of 376 study medical charts were reviewed. Data was collected through reviewing medical charts. Data was entered into Epi-data manager version 4.6.0.4 and analyzed through Stata version 16. Descriptive analysis was performed. Kaplan- Meier survival estimates and log rank tests were performed. Cox proportional hazard model was undertaken. RESULTS: Median recovery time was 15 days (IQR: 6-30) with a total recovery rate of 4.49 per 100 person-days. In cox proportional hazard regression, diagnosis category {AHR: 1.690, 95% CI: (1.150- 2.485)}, oxygen saturation {AHR: 1.600, 95% CI: (1.157- 2.211)}, presence of comorbidities {AHR: 1.774, 95% CI: (1.250-2.519)}, Glasgow coma scale {AHR: 2.451, 95% CI: (1.483- 4.051)}, and use of tracheostomy {AHR: 0.276, 95% CI: (0.180-0.422)} were statistically significant predictors. DISCUSSION: Based on the outcomes of this study, discussions with suggested possible reasons and its implications were provided. CONCLUSION AND RECOMMENDATIONS: Duration and recovery rate of patients on mechanical ventilation is less than expected of world health organization standard. Diagnosis category, oxygen saturation, comorbidities, Glasgow coma scale and use of tracheostomy were statistically significant predictors. Mechanical ventilation durations should be adjusted for chronic comorbidities, trauma, and use of tracheostomy.

Refractive errors and associated factors among patients visiting BoruMeda Hospital's secondary eye Unit in Dessie Town, South Wollo Zone, Ethiopia.

BACKGROUND: In Ethiopia, refractive error is the second leading cause of vision impairment and the third main cause of blindness. Because refraction services are scarce and difficult to obtain, many people with refractive error live with impaired vision or blindness for the rest of their lives. OBJECTIVE: The primary goal of this study was to determine the prevalence of refractive errors and associated factors among patients who visited Boru Meda Hospital. METHODS: A retrospective cross-sectional study was conducted from April to June 2018, all patients who visited Boru Meda Hospital's secondary eye unit were deemed our source population; the sample frame was the secondary eye unit outpatient departments register. To select samples, simple random sampling was used. Data was entered by using Epi-data version 3 and analysed with Statistical Package for Social Science 20. Tables and graphs were used to display descriptive statistics, and logistic regression was used to examine the relationship between the dependent and independent variables. At p < 0.05, statistical significance was inferred. RESULTS: Refractive error was detected in 42 (18.3%) of study participants. The average age was 46.69 ± 20.77. There were 136 men and 93 women in this group (59.4 and 40.6%, respectively). Myopia was the most frequent refractive defect, accounting for 52.4% of all cases. CONCLUSION & RECOMMENDATION: Refractive error is a widespread problem in our study area that affects people of all age groups. We recommend patients to have screening on regular basis so that refractive anomalies can be detected early.

Preparedness of governmental hospitals for COVID 19 prevention and care in Eastern Amhara region, Amhara Ethiopia, 2020.

BACKGROUND: Coronavirus disease affects the world in multidisciplinary ways. In Ethiopia, it affects many people, including health professionals. Health institutions should have been ready to handle COVID-19 cases and protect their staff from this pandemic. Hospitals in eastern Amhara provide services for more than 30 million people. OBJECTIVES: To assess the readiness of government hospitals in eastern Amhara for coronavirus disease prevention and treatment in 2019. METHODS: The institutional-based descriptive cross-sectional study design was conducted in 28 governmental hospitals in the eastern Amhara region. A structured checklist exported to the word processing system online link was created. Randomly selected nurses in each hospital were virtually trained and collected the data; the link was shared with them. We use SPSS version 23 for data cleaning and analysis. For data summary and presentation, frequency, mean, tables, graphs, and text were used. Using concept analysis, different sections of these hospitals were assessed. A linear regression was done and Pearson correlation coefficient (r) values were used to measure the degree of relationship between dependent and independent variables. RESULTS: This study indicates that more than half (57.14%) responded "no" to the questions, suggesting unpreparedness. The age of the hospital (r = 0.25), distance from the regional capital city (r = 0.113), distance from the capital city (r = 0.125), and location of the hospital (r = 0.094) had little relationship with the readiness of the hospital for COVID-19 disease prevention and care. CONCLUSION AND RECOMMENDATION: In this most hospitals were not ready to handle COVID-19 cases and couldn't protect staff from this pandemic. Therefore, local and regional health offices and the federal ministry of health, as well as other health organizations, should enhance their capacity to fight COVID 19.

Incidence and Predictors of Opportunistic Infections Among Adult HIV Infected Patients on Anti-Retroviral Therapy at Dessie Comprehensive Specialized Hospital, Ethiopia: A Retrospective Follow-Up Study.

Background: Opportunistic infections are the major causes for morbidity and mortality due to HIV infections. Despite advances in HIV diagnosis and management, the incidence of opportunistic infections remains high. This study aimed to assess the incidence and predictors of opportunistic infections among persons living with HIV/AIDS in Ethiopia. Methods: A retrospective follow-up study was conducted on 354 samples of adults living with HIV on antiretroviral therapy at Dessie Comprehensive Specialized Hospital. Simple random sampling technique was used to select study participants. The data collection format was taken from national antiretroviral intake and follow-up forms. Epi-data Version 4.6.1 and STATA Version 16 software were used for data entry and data analysis respectively. The Cox-proportional hazards regression model was fitted. Kaplan-Meier survival curve was used to estimate opportunistic infections-free survival time. Both bi-variable and multivariable Cox-proportional hazard regression analysis were done to identify predictors of opportunistic infections. Results: Of the total 354 peoples living with HIV, 114 (32.2%) developed OI, with an incidence rate of 13.5 per 100 person-year (95% CI: 10.8-15.6). Advanced World Health Organization clinical disease stage (IV) (AHR: 2.1 (95% CI: 1.16, 3.8)), being bedridden (AHR: 1.66 (95% CI: 1.04, 2.65)), poor adherence (AHR: 1.7 (95% CI: 1.1-2.63), and low CD4 count (AHR: 1.92 95% CI: 1.14-3.22) were significant predictors of OIs. Conclusion: Opportunistic infection among HIV/AIDS continues to be a significant public health concern in Ethiopian health care setting. Our results indicate that the incidence of OI is high. Besides, Stage IV HIV status, being bedridden, low CD4 count and poor adherence independently predicts an increased incidence/decreased survival time of OIs among PLWHIV. Early care-seeking and initiation of HAART and continuous follow-up of patients to take their drug timely are essential to curb the incidence of opportunistic infections and improve overall health. Further research on this area is highly recommended.

Emergency and Disaster Handling Preparedness Among Front Line Health Service Providing Nurses and Associated Factors at Emergency Department, at Amhara Regional State Referral Hospitals, Ethiopia.

INTRODUCTION: Globally around 1.6 million individuals have died as a result of disasters per year. These disruptive events that happen in the world each day result in damage to individuals, families, and communities. METHODS: An institution-based cross-sectional study was conducted. All frontline health-care providers at the emergency departments of Amhara Regional State Referral Hospitals during the study period were considered as studied subjects. Data were collected through a self-administered technique. Once all essential data were collected, data were coded and entered into epidata manager (v4.6.0.2) statistical software. SPSS version 26 was used to analyze the findings of this paper. RESULTS: The result of this research study showed that 66.7% were males and 33.3% were females with mean age of respondents being 31.2 ± 5.8. Among respondents, 54% (52.9) % did not have an understanding of disaster preparedness. As a result, the majority of participants, 52 (51%), have inadequate knowledge. Most respondents have adequate attitude (57.8%) and only a few, 12 (11.8%), of respondents were very familiar with regard to disaster and disaster handling preparedness. In multivariate logistic regression, receiving training on the subject (P = 0.000, AOR: 15.109. 95% CI: 3.525-64.769), respondents receiving simulation in the subject of disaster (P = 0.015, AOR: 4.855, 95% CI: 1.366-17.260) and having a direct personal/professional experience of disaster (P = 0.003, AOR: 5.703, 95% CI: 1.825-17.823) were significantly associated. CONCLUSION AND RECOMMENDATION: Disaster handling preparedness, knowledge and familiarity levels were below those expected for emergency department nurses. Capacity building through training, education and simulation is essential.

Timely Initiation of Complementary Feeding and Associated Factors among Mothers of Children Aged 6-24 Months in Dessie Referral Hospital, Northeast Ethiopia, 2019.

BACKGROUND: Timely, appropriate, safe, adequate, and frequent feeding is essential during the transition period for optimal growth and development as well as vulnerability of the child. The age of initiation of complementary feeding needs to be strongly addressed. Thus, the aim of this study was to determine timely initiation of complementary feeding and associated factors among mothers of children aged 6-24 months in Dessie Referral Hospital. METHODS: Institutional-based cross-sectional study was conducted among 280 mothers of children aged 6-24 months. A systematic random sampling technique was employed for selection of study participants by considering the 1st comer as a starting point and then at every 5th interval till the sample size was saturated at exit time. Data were collected using pretested and validated structured interviewer-administered questionnaire. Data were entered to Epi data version 3.1 and exported to SPSS version 20.0 software for analysis. Descriptive statistics and binary logistic regression model were used. RESULTS: Overall response rate was 98.2%. Among 275 mothers with children aged 6-24 months, 36 (13.1%), 179 (65.1%), and 60 (21.8%) mothers started giving complementary feeding for their children early (before six months), timely (at six months), and late (after six months), respectively. Mothers' educational status of grade 9-12 and college and above [AOR = 3.03; 95% CI (1.13-8.14), and AOR = 3.74; 95% CI (1.19-11.70), respectively], getting counsel [AOR = 2.83; 95% CI (1.54-5.21)], and poor knowledge [AOR = 0.37; 95% CI (0.19-0.72)] were found to be independent predictors. CONCLUSIONS: Prevalence of timely initiation of complementary feeding was high as compared to the national prevalence. Mothers' educational status, getting counsel about complementary feeding, and knowledge were factors associated with timely initiation of complementary feeding. Therefore, awareness creation, counseling, and health education should be done on society by concerned bodies to improve timely introduction of complementary feeding level more than this result.