Sonographic Evaluation of the Morphology of Kidneys Among Apparently Healthy Children in Northwest Ethiopia, 2021: The Normal Limits and Percentile Curves.

Background: Establishing a customized reference chart and curve of renal size for a specific population of the same sociodemographic characteristics enables a better interpretation of sonographic assessments. Objective: To evaluate the morphology of kidneys using ultrasound and establish the normal limits and percentile curves among apparently healthy children in northwest Ethiopia, 2021. Design: A hospital-based cross-sectional study design. Setting: The study was conducted in Debre Markos comprehensive specialized hospital, Finote Selam general hospital, and Bichena primary hospitals. Patients: The study participants were 403 apparently healthy school-age children, from December 2019 to June 2020. Methods: Data were collected using a structured questionnaire, physical examination, and ultrasound. We used EPI-Data Version 3.1 for data entry. Height and body surface area-related kidney length and volume curves and tables were generated after lambda-mu-sigma (LMS) quantile regression with a Box-Cox Transformation to Normality using the vector generalized additive model (VGAM) method and generalized additive model for location, scale and shape (GAMLSS) (R, VGAM, and GAMLSS package). Results: The height and body surface area of children was the best predictor of the sonographic dimensions of the kidneys. Reference intervals were established using height and body surface area specific for clinically practical dimensions of the kidney (length and volume). Limitations: Calibration of measuring tools in the hospitals was not conducted frequently; community fatigue due to presence of many research projects in the selected hospitals was observed. Conclusions: According to this study, the children are considered to have normal sonographic dimensions if ultrasound values lie between the 2.5th and 97.5th percentile based on their respective height and body surface area.

Contexte: L'établissement d'un tableau de référence et d'une courbe de la taille des reins adaptés à une population spécifique ayant les mêmes caractéristiques sociodémographiques permet d'améliorer l'interprétation des évaluations échographiques. Objectif: Examiner par échographie la morphologie des reins chez les enfants apparemment en bonne santé du nord-ouest de l'Éthiopie et en tirer des limites normales et des courbes de percentiles (2021). Conception: Étude transversale en milieu hospitalier. Cadre: L'étude a été réalisée à l'hôpital spécialisé Debre Markos, à l'hôpital général Finote Selam et dans les hôpitaux de soins primaires de Bichena. Sujets: L'étude porte sur 403 enfants d'âge scolaire en apparente bonne santé, entre décembre 2019 et juin 2020. Méthodologie: Les données ont été recueillies à l'aide d'un questionnaire structuré, d'un examen physique et d'une échographie. Nous avons utilisé EPI-Data version 3.1 pour la saisie des données. Des courbes et des tableaux relatifs à la longueur et au volume des reins en fonction de la taille et de la surface corporelle ont été générés après une régression quantile LMS avec une transformation vers la normalité de type Box-Cox en utilisant la méthode VGAM et GAMLSS (packages R, VGAM et GAMLSS). Résultats: La taille et la surface corporelle des enfants se sont avérés le meilleur prédicteur des dimensions échographiques des reins. Les intervalles de référence ont été établis en fonction de la taille et de la surface corporelle spécifiques aux dimensions cliniquement pratiques des reins (longueur et volume). Limites: L'étalonnage des outils de mesure dans les hôpitaux n'a pas souvent été effectué; une certaine fatigue due à la présence de nombreux projets de recherche dans les hôpitaux sélectionnés a été observée dans la communauté. Conclusion: Selon cette étude, les enfants sont considérés comme ayant des dimensions échographiques normales si les valeurs échographiques se situent entre le 2,5e et le 97,5e percentile selon leur taille et leur surface corporelle respective.

Effects of dietary diversification during pregnancy on birth outcomes in east Gojjam, northwest Ethiopia: A prospective cohort study.

Introduction: Adequate nutrient intake during pregnancy is an important key factor affecting fetal growth and birth outcomes, as well as maternal health, as demonstrated by experimental animal studies. However, the few human studies available, especially those conducted in the least developed countries (LDCs), are much less consistent. Therefore, this study aimed to investigate the association between dietary diversification during pregnancy and birth outcomes in Gojjam, Ethiopia. Methodology: A facility-based prospective cohort study was conducted on 416 pregnant mothers (exposed and non-exposed) from December 2019 to January 2020. Information about the Women's Dietary Diversity Score (WDDS) was collected using the Food and Agricultural Organization's guidelines. Data were collected through interviewer-administered questionnaires and measurements. Log-binomial regression analysis was performed to estimate the relative risk of adverse birth outcomes. Energy, macronutrient, and micronutrient amounts were calculated using the nutrition survey software version 2007. The differences between groups were noticed using analysis of variance. Eta squared was estimated in the current study. Results: The overall magnitude of low birth weight, preterm birth, and stillbirth in the study area, respectively, was 41%, 38%, and 4%. After adjustment for baseline characteristics, this study revealed that pregnant women in the inadequate WDDS group were at increased risk of LBW (ARR = 6.4; 95% CI: 3.4, 12) and PTD (ARR = 6.3; 95% CI: 3.3, 11.95) as compared with their counterparts but no difference in the occurrence of stillbirth (ARR = 1.08; 95% CI: 0.20, 5.79). Conclusion: Overall, this study found a large magnitude of low birth weight and preterm birth. Inadequate intake of dietary diversity during pregnancy significantly increased the rate of low birth weight and preterm birth. Thus, we recommend the concerned body to work on improving the feeding practices of pregnant mothers in the study area.

The neurodevelopmental basis of schizophrenia: clinical clues from craniofacial dysmorphology in northwest Ethiopia, 2020.

BACKGROUND: The neurodevelopmental speculation of schizophrenia states that the pathogenesis of schizophrenia starts with early fetal or neonatal neurocraniofacial development rather than youthful adulthood when manic signs and symptoms are evident. However, there is no direct evidence of a pre-or peri-natal lesion associated with schizophrenia, rather indirect evidence of impaired development can be seen in macroscopic anatomical variations as well as microscopic immunohistochemical anomalies. One approach to studying neurodevelopmental disturbances among schizophrenic patients is somatic physical evidence or neurodevelopmental markers. Thus Our study aimed to assess the neurodevelopmental basis of schizophrenia clinical clues from anthropometric assessment of craniofacial dysmorphology among schizophrenic patients in North West Ethiopia 2019-2020. METHOD: Institutional-based comparative cross-sectional study design was conducted in Debre Markos comprehensive specialized hospitals in 190 schizophrenic patients, 190 1st-degree relatives, and 190 healthy controls. Data were collected using standard methods, entered into EpiData version 3.1, and exports to SPSS version 24 for analysis. Descriptive data were analyzed using descriptive statistics. Welch ANOVA and post hoc comparison, a Games-Howell test, were conducted. Significance was set at a p-value of α = 0.05. Read back analysis was also conducted for the conclusion. RESULTS: Five hundred seventy study samples, male 375(65.8%), and female 195 (34.2%), were included in this study. The Games-Howell test revealed that the coronal arc length and sagittal arc length among schizophrenic patients were statistically significantly longer than the healthy controls (p < 0.006; p < 0.001, respectively). However, the difference between schizophrenic and healthy control regarding head circumference was marginally significant (p = 0.056). Schizophrenic patients had a significantly shorter total facial height (p < 0.001) and upper facial height (p < 0.001) than healthy controls. Regarding facial depth, schizophrenic patients had significantly shallow upper facial depth (p < 0.001), middle facial depth (p = 0.046), and lower facial depth (p < 0.001). CONCLUSION: our finding indicated indirect evidence for disturbed craniofacial development in schizophrenia patients, and close and read back analysis of the result supported the neurodevelopmental basis of disease.

Sonographic evaluation of spleen size in apparently healthy children in north-west Ethiopia, 2020: time to define splenomegaly.

BACKGROUND: Assessment of spleen size is an important part of the clinical skills of medical students and physicians. Many diseases can affect the size of the aforementioned organ, ranging from infective processes to malignant disorders. However, to detect changes, prior knowledge of the actual normal size of these viscera is required in the population being studied. Establishing a customized chart and curve for a specific population of the same sociodemographic characteristics enables a better interpretation of sonographic assessments. METHODS: A hospital-based cross-sectional study design was conducted among 403 children in primary and referral hospitals of the east and west Gojjam zone. Data were collected using a structured questionnaire, physical examination, and ultrasound. The collected data were entered into Epi Data version 3.1 and exports to SPSS version 24 for analysis. Descriptive data were analyzed using descriptive statistics. A Pearson product-moment correlation was run to determine the relationship between age, anthropometric measurements of children, and ultrasound measurements of the spleen. Reference intervals were established using non-parametric reference limits (2.5th -97.5th ) and (5th - 97th ) percentiles by MedCalc software version 20.0.3. RESULTS: Four hundred three children aged from 7 to 15 years were included in this study. The mean sonographic longitudinal (length), anteroposterior(depth) and transverse (width) dimension of the spleen was, (8.24 ± 1.26 cm), (3.98 ± 0.57 cm), and (4.26 ± 0.59 cm) respectively. The mean volume of the spleen was 75.04 ± 23.92 cm3. The height and body surface area of children were best correlated with sonographic dimensions of the spleen. Reference intervals were established using height, age, and body surface area specific for clinically practical dimensions of the spleen. CONCLUSIONS: According to this study, the children are considered as having enlarged longitudinal dimension of the spleen(splenomegaly) if he or she has a size above 97.5th percentile based on their respective height.

Behavioral Response to HIV/AIDS Prevention Messages Among Students in Selected Universities of Amhara Region, Northwest Ethiopia: An Extended Parallel Process Model.

BACKGROUND: HIV/AIDS is a global pandemic. Sub-Saharan Africa accounts for two-thirds of the newly HIV-infected cases in the world. Similarly, the prevalence of HIV infections among Ethiopian university students has also increased as HIV prevention was not sufficiently prioritized. In order to decrease the surge of the HIV pandemic, prevention messages that encourage individuals to reduce sexual and risk behaviors still remain a key intervention strategy. Besides this, the behavioral response to HIV prevention messages among Ethiopian universities is not well studied. OBJECTIVE: To assess students' behavioral response to HIV/AIDS prevention messages in selected universities of the Amhara region using an extended parallel process model (EPPM), in 2019. METHODS: A facility-based cross-sectional study was employed among 423 eligible students from January to February, 2019 using a stratified sampling technique. The dependent variable is response to HIV/AIDS prevention messages (danger control and fear control) which is addressed by EPPM. The model explains the components of threat (perceived susceptibility and perceived severity) and efficacy (response efficacy and self-efficacy). Subtracting wings of threat component score from efficacy wings score gives the critical value. If the critical value had positive scores, it showed responses of danger control; if the critical value was negative, it showed response of fear control. A logistic regression model was fitted to assess the association between the dependent and independent variables. RESULTS: The response rate of this study was 94.6%. Among 400 respondents, 263 (65.8%; 95%CI: 61-70) of them were in the danger control response whereas 137 (34.2%; 95%CI: 30- 39) were in fear control response. Moreover, 200 (50%) of the participants had adequate knowledge and 180 (45%) had a favorable attitude towards HIV/AIDS prevention messages. Danger control response for HIV prevention messages was higher among first-year students (AOR=5.5; 95%CI: 1.5-19) and third-year students (AOR=3.9; 95%CI: 2-14) compared with fifth-year students. Similarly, those students who reside on the campus were 60% times less likely to develop danger control when compared with students who live with their family (AOR=0.4; 95%CI: 0.2-0.9). Besides this, students who had adequate knowledge (AOR=2.6; 95%CI: 1.5-4.5) and students who receive fear-inducer messages (AOR=4.5; 95%CI: 3-25] were more likely to develop danger control responses. CONCLUSION AND RECOMMENDATION: Nearly two-thirds of the participants were in the danger control response. Year of study, with whom students currently live, type of message they received, and the knowledge level of respondents were the factors associated with students' response to HIV/AIDS prevention messages. Therefore, the messages must aim at enhancing threat component perception with appropriate efficacy messages to control danger and promote behavioral change.

Minor Physical Anomalies Among Schizophrenic Patients as a Biomarker of Its Developmental Origin in Northwest Ethiopia.

PURPOSE: Although there are highly precise and advanced diagnostic methods, the etiology and pathophysiology of schizophrenia remain poorly understood. There are several theories about schizophrenia origin, among which the neurodevelopmental theory is widely accepted. Our study aimed to assess minor physical anomalies among schizophrenic patients as putative indices of its developmental origin in North West Ethiopia 2018-2019. PATIENTS AND METHODS: Institutional-based comparative cross-sectional study design was conducted in Debre Markos comprehensive, specialized hospitals in 190 schizophrenic patients, 190 healthy controls, and 190 1st-degree relatives. Data were collected using standard methods, entered into EpiData version 3.1, and exported to SPSS version 24 for analysis. Descriptive data were analyzed using descriptive statistics, and discriminant function analysis was conducted and a value of 0.03 was taken as the cutoff point for prediction of group status of the study samples. RESULTS: Five hundred seventy study samples, male 375 (65.8%), and female 195 (34.2%), were included in this study. The discriminate function 1 and 2 revealed a significant association between groups and all predictors, accounting for 83.5% and 16.5% of between-group variability, respectively. However, closer analysis of the structure matrix revealed longitudinally furrowed tongue, ≥Five palate ridges, high steeples palate, transversely and randomly furrowed tongue, protruding supraorbital ridge as significant predictors. CONCLUSION: Depending on predictor variables in this study, minor physical anomalies can serve as a biomarker for early screening of schizophrenic patients and clue for its developmental origin.

Precancerous lesions of the cervix and its determinants among Ethiopian women: Systematic review and meta-analysis.

INTRODUCTION: Precancerous lesions of the cervix are changes in cervical cells that make them more likely to develop into cancer. Understanding the prevalence and determinants of the precancerous lesions of the cervix among women helps to take an action like vaccination programs, improving screening coverage, and close management and follow-up which could decrease the morbidity and mortality caused by cervical cancer. MATERIALS AND METHODS: The international databases, PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct and Cochrane Library and unpublished reports were systematically searched. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was employed to analyse the data. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence of precancerous lesions of the cervix in Ethiopia. Determinants of the precancerous lesion of cervix (early initiation of sexual intercourse, multiple sexual partners, and history of sexually transmitted infection) were analysed. RESULTS: Thirteen studies fulfilled the inclusion criteria and included in the meta-analysis. The I2 test result showed high heterogeneity (I2, 93.2%, p = <0.001). Using the random effect analysis, the pooled prevalence of precancerous lesions of the cervix among women in Ethiopia was 14.21% (95% CI (10.49, 17.94). After adjusting of publication bias using trim-and-fill method, the pooled prevalence was 9.43% (95% CI (5.23, 13.62). Women who had multiple sexual partners in their lifetime (OR:2.67 CI: 1.49,4.79) and had a history of sexually transmitted infections (OR:6.22 CI: 2.99,12.92) were more likely to have a precancerous lesion of the cervix. CONCLUSION: The pooled prevalence of the precancerous lesions of the cervix among Ethiopian women was 9.43%. It was associated with having multiple sexual partners and a history of sexually transmitted infections.

Determinants and seasonality of major structural birth defects among newborns delivered at primary and referral hospital of East and West Gojjam zones, Northwest Ethiopia 2017-2018: case-control study.

OBJECTIVE: Although infant mortality because of birth defect has increased in both developed and developing countries, had not got attention like other health issues at national, regional, or local levels. Documenting the risk factors that influence the occurrence of birth defects and its seasonality will help to inform the community and to develop preventive strategies for the country. RESULTS: Factors associated with higher likelihood of a major structural birth defects included maternal age; neonates born from women living in urban; and in Dega; history of fever during pregnancy; intake of herbal medicine; and drinking alcohol. Counselling for pregnancy preparation and folic acid supplementation was found protective for the likelihood of birth defect.

Assessment of Reliability of Greulich and Pyle (GP) Method for Determination of Age of Children at Debre Markos Referral Hospital, East Gojjam Zone.

BACKGROUND: Greulich and Pyle standards are the most widely used age estimation standards all over the world. The applicability of the Greulich and Pyle standards to populations which differ from their reference population is often questioned. This study aimed to assess the reliability of Greulich and Pyle (GP) method for determination of age of children at Debre Markos Referral Hospital, East Gojjam Zone, Ethiopia. SUBJECTS AND METHODS: Hospital based cross sectional study design was applied to children who came to Debre Markos Referral Hospital from May to October 2015 and fulfilled the inclusion criteria of the study. The data was analyzed using SPSS version 20 and medcalc version 15 softwares. Significance was set at α = 0.05. RESULTS: A total of 108 radiographs were analyzed. Chronological age in most of the children was under estimated. The mean under-estimation was 11.8 months in the female sample and 8.7 months in the male sample. Greulich and Pyle method became inapplicable for the sample at 16 years for females and 16.5 years for males and later. Delay in skeletal maturation was observed in both sexes, but the females in the sample matured earlier than the males. CONCLUSION: The findings of this study suggest against the applicability of GP atlas which were not directly applicable to an East Gojjam Zone population. Large scale studies should be planned and nationwide guideline, and atlas which can easily be used throughout the country should be developed.