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1.
Cancer Control ; 29: 10732748221127156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36113140

RESUMO

BACKGROUND: Common mental disorders (CMD) are the most usual reactions following cancer diagnosis causing significant psychological sufferings. Even though research-based evidence is necessary for mental health promotion and intervention activities, there is a scarcity of evidence in Ethiopia to assist policy makers' efforts in reforming mental health care particularly that of cancer patients. OBJECTIVE: The main objective of this research is to assess the magnitude of common mental disorders and associated factors among cancer patients who have a follow-up treatment at Black Lion Specialized Hospital, Addis Ababa, Ethiopia. METHOD: Institutional-based cross-sectional study was conducted from August 1 to September 30, 2020. A systematic random sampling technique was used to select 396 study participants. A Self-Reporting Questionnaire (SRQ-20) and interviewer-administered structured questionnaire were employed to collect data. Data were analyzed using descriptive statistics and logistic regression. Odds ratios with 95% confidence intervals was used to report the findings. RESULT: A total of 396(230 men and 160 women) participants took part in the study. The overall magnitude of CMD among cancer patients was found to be 70.3%, of which the rate was 73.5% among women and 67.8% among men, in the last 4 weeks. Being women (AOR = 1.74; 95%CI: 1.00, 3.02), unemployed (AOR = 3.035, 95% CI: 1.37, 6.72), average monthly income of less than 1600 Ethiopian Birr (AOR = 2.838; 95%CI: 1.58, 5.08), being on cancer treatment for more than 5 years (AOR = 2.653, 95% CI: 1.39, 5.03), poor social support (AOR = 3.618, 95% CI: 1.33, 9.80), and current use of substances (AOR = 6.852; 95% CI: 2.038, 23.034) were the factors significantly associated with CMD. CONCLUSION AND RECOMMENDATION: Common mental disorders are one of the major health concerns among cancer patients. Common mental disorders were found to be more common in females and among current users of a psychoactive substance. Therefore, cancer patients need special attention of not only physicians but also that of mental health professionals for possible detection and early treatment of mental disorders. Rendering social and economic support may reduce the negative effects of the illness.


Assuntos
Transtornos Mentais , Neoplasias , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Masculino , Transtornos Mentais/epidemiologia , Neoplasias/epidemiologia , Prevalência
2.
BMJ Open ; 12(9): e065799, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104127

RESUMO

OBJECTIVES: This study aimed to examine COVID-19 patients' experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks. DESIGN: This study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis. SETTING: This study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China's response to the first wave of the COVID-19 pandemic. PARTICIPANTS: A total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients; (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties. RESULTS: Three themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients' evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient-healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients. CONCLUSIONS: Our findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients' perspectives into healthcare service appraisal in emergency shelter hospitals.


Assuntos
COVID-19 , COVID-19/epidemiologia , Hospitais , Hospitais Especializados , Humanos , Unidades Móveis de Saúde , Pandemias
3.
Artigo em Inglês | MEDLINE | ID: mdl-36141996

RESUMO

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5-17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe "Access" category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the "Watch" category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system.


Assuntos
Antibacterianos , Conjuntivite , Doença Aguda , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Ciprofloxacina , Estudos Transversais , Feminino , Gentamicinas , Gana , Hospitais Especializados , Humanos , Masculino , Pomadas , Padrões de Prática Médica , Tetraciclinas , Tobramicina
4.
BMJ Open ; 12(9): e061061, 2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36167381

RESUMO

OBJECTIVE: To develop and validate a risk prediction model for the prediction of preterm birth using maternal characteristics. DESIGN: This was a retrospective follow-up study. Data were coded and entered into EpiData, V.3.02, and were analysed using R statistical programming language V.4.0.4 for further processing and analysis. Bivariable logistic regression was used to identify the relationship between each predictor and preterm birth. Variables with p≤0.25 from the bivariable analysis were entered into a backward stepwise multivariable logistic regression model, and significant variables (p<0.05) were retained in the multivariable model. Model accuracy and goodness of fit were assessed by computing the area under the receiver operating characteristic curve (discrimination) and calibration plot (calibration), respectively. SETTING AND PARTICIPANTS: This retrospective study was conducted among 1260 pregnant women who did prenatal care and finally delivered at Felege Hiwot Comprehensive Specialised Hospital, Bahir Dar city, north-west Ethiopia, from 30 January 2019 to 30 January 2021. RESULTS: Residence, gravidity, haemoglobin <11 mg/dL, early rupture of membranes, antepartum haemorrhage and pregnancy-induced hypertension remained in the final multivariable prediction model. The area under the curve of the model was 0.816 (95% CI 0.779 to 0.856). CONCLUSION: This study showed the possibility of predicting preterm birth using maternal characteristics during pregnancy. Thus, use of this model could help identify pregnant women at a higher risk of having a preterm birth to be linked to a centre.


Assuntos
Nascimento Prematuro , Etiópia/epidemiologia , Feminino , Seguimentos , Hospitais Especializados , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos
5.
PLoS One ; 17(8): e0268558, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35972926

RESUMO

BACKGROUND: At birth, continuous flow of nutrients to the fetus in utero interrupted due to cut of the route /umbilical cord/. Instead of the cord, breast-mouth connection will be the next route in the extra uterine life. Nevertheless, limited data in our locality show the duration for how long immediate newborns are fasting. OBJECTIVE: This study aimed to assess time to initiation of breastfeeding and its predictors among postnatal mothers within 12 hours of birth in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2020. METHODS: A Facility based prospective follow-up study was conducted among 475 participants who were selected using systematic random sampling techniques. To collect the data, techniques including interview, chart review and observation were used. Data was entered to Epi-data version 3.1 and analyzed by STATA 14 software. A cox proportional hazards regression model was fitted to identify predictors for survival time. Results of the final model were expressed in terms of adjusted hazard ratio (AHR) with 95% confidence interval, statistical significance was declared with P-value is less than 0.05. RESULTS: Newborns were fasting breast-milk for the median time of 2 hours. In this study, 25% of participants initiated breastfeeding within 1 hour, pre-lacteal while 75% initiated within 3 hours. Gave birth to multiple babies (AHR 0.37, 95% CI (0.19, 0.69)), operative delivery (AHR 0.77, 95% CI (0.62, 0.96)), got advice on timely initiation of breastfeeding immediately after delivery (AHR 0.79, 95% CI (0.63, 0.97)), pre-lacteal feeding initiation (AHR 10.41, 95% CI (2.82, 38.47)) and neonatal sickness (AHR 0.08, 95% CI (0.03-0.19)) were statistically significant predictors for time to initiation of breastfeeding. CONCLUSION: Fifty percent of mothers initiated breastfeeding within 2 hours. Most of them didn't initiate breastfeeding based on world health organization's recommendation, within one hour after delivery. Multiple birth, operative delivery, getting advice on timely initiation of breastfeeding immediately after delivery, giving pre-lacteal feeding and neonatal sickness were found to be predictors of time to initiation of breastfeeding.


Assuntos
Jejum , Hospitais Especializados , Etiópia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estudos Prospectivos
6.
PLoS One ; 17(8): e0271895, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939445

RESUMO

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.


Assuntos
Anemia , Neoplasias da Mama , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Estudos Transversais , Índices de Eritrócitos , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Masculino , Estudos Prospectivos
7.
Ethiop J Health Sci ; 32(4): 773-780, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35950074

RESUMO

Background: Developmental delay is a major health problem throughout the world causing significant individual disability. Even though physical examination and patient history are the most important and basic evaluations of patients with developmental delay, additional investigations are usually required in supporting or reaching a diagnosis among which is neuroimaging. This study aims to assess brain Magnetic resonance imaging (MRI) patterns in patients presented with developmental delay. Method: A retrospective analysis of 164 patients who had undergone brain Magnetic Resonance Imaging (MRI) evaluation for the developmental delay was done. The study was conducted between March to November 2021 G.C at Tikur Anbessa Specialized Hospital (TASH). The patients' clinical history and magnetic resonance imaging reports were reviewed from their medical records. All patients with developmental delay who had brain MRI evaluation at TASH and at one private diagnostic center in Addis Ababa were included in the study. Results: A total of 164 patients were included in this study of which 95(57.9%) were male and 69(42.1%) female patients were seen. A total of 120 patients (73.2%) showed abnormal brain MRI studies. Previous neurovascular insults were the most common abnormalities seen in 75(45.7%) patients followed by imaging findings of congenital and developmental abnormalities seen in 20(12.2%) patients. Conclusion: Brain MRI is an important input in the evaluation of patients with developmental delay. It can give evidence for the cause of developmental delay, especially in the diagnosis of perinatal/hypoxic-ischemic insults, and congenital and developmental malformations.


Assuntos
Hospitais Especializados , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Etiópia , Feminino , Humanos , Masculino , Gravidez , Estudos Retrospectivos
8.
BMC Pregnancy Childbirth ; 22(1): 665, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36028804

RESUMO

BACKGROUND: Apgar score is used to evaluate the neonates' overall status and response to resuscitation, as well as its prognosis beyond the neonatal period. Low fifth minute Apgar scores is more frequent and is associated with markedly increased risks of neonatal mortality and morbidity. In Ethiopia, the prevalence of birth asphyxia is high (22.52%). Birth asphyxia contributes to significant neonatal morbidities and mortalities due to severe hypoxic-ischemic multi-organ damage, mainly brain damage. Therefore, this study was aimed to identify determinants of low fifth minute Apgar score among newborns delivered by cesarean section. METHODS: An unmatched case control study design was conducted. The Apgar score is based on measures of heart rate, respiratory effort, skin color, muscle tone, and reflex irritability. The data collection tool or checklist was adapted from previous study done at Addis Ababa, Ethiopia. In this study, cases were all newborns with Apgar score < 7 whereas controls were all newborns with Apgar score > = 7. The study participants were selected by simple random sampling technique. Data was into Epidata version 4.6 and exported to SPSS software version 24. Multivariable logistic regression was used to identify the independent effect of different factors at P < 0.05. RESULT: Factors associated with low Apgar score were fetal birth weight < 2.5 kg [adjusted odds ratio (AOR) = 8.17, 95% confidence interval (CI): 1.03 ‒ 64.59] P = 0.046, skin incision to delivery time (AOR = 5.27; 95% CI: 2.20 ‒ 12.60) P = 0.001, pregnancy induced hypertension (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) P = 0.002, antepartum hemorrhage (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, general anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) P = 0.001, meconium stained amniotic fluid (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) P = 0.009 and emergency cesarean section (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) P = 0.019. CONCLUSIONS: Fetal birth weight < 2.5 kg, skin incision to delivery time, pregnancy induced hypertension, antepartum hemorrhage, type of anesthesia, meconium stained amniotic fluid and type of cesarean section were factors independently associated with Apgar score. Therefore, it is important to work on identified risk factors to reduce the impacts low fifth minute Apgar score in the in early adulthood..


Assuntos
Asfixia Neonatal , Hipertensão Induzida pela Gravidez , Complicações do Trabalho de Parto , Complicações na Gravidez , Adulto , Índice de Apgar , Asfixia , Peso ao Nascer , Estudos de Casos e Controles , Cesárea , Etiópia , Feminino , Hemorragia , Hospitais Especializados , Humanos , Recém-Nascido , Gravidez , Universidades
9.
BMC Health Serv Res ; 22(1): 1058, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35982435

RESUMO

BACKGROUND: Measuring the caregivers' satisfaction is vital for the effectiveness of childcare. Children admitted to pediatric wards require special hospital situations, a bespoke approach from the medical team, and the participation of caregivers. It is important to give attention to the caregivers while planning for child services. The purpose of this study was to assess the caregiver's satisfaction with the services provided in pediatric wards of Jimma University Medical Center and identify its associated factors. METHODS: Facility-based cross-sectional study design was done at Jimma University Medical Center. Participants in the study were primary caregivers who spent two or more days in the pediatric ward with their admitted children. Data were collected from 400 selected caregivers. A consecutive sampling method was employed. Principal component analysis was done for all Likert scale instruments to extract factor (s) representing each of the scales and to have factor scores. Variables with the Likert scale were treated as continuous after principal component analysis was employed. Using these factor scores, a multiple linear regression analysis was carried out to identify factors associated with caregivers' satisfaction with service in pediatric wards. A significance level of less than 0.05 was used in the final model to determine statistical significance. RESULT: This study showed that caregivers' satisfaction with the services in the pediatric ward was 68%. Level of education (ß = -0.24, (95% CI; -.411, -.070)), availability of basic facilities (ß = 0.163, (95% CI; .063, .263)), patience to listen to patients' problem (ß = 0.431, (95% CI; .324, .537, staff communication with client (ß = 0.163, (95% CI; -4.839, -1.610)), availability of laboratory tests and its service (ß = -0.964, (95% CI; -1.435, -.493)), availability of drug, imaging and service at radiology (ß = 2.907, (95% CI; 1.470, 4.344)) and availability of pathology and its service (ß = 1.869, (95% CI; .993, 2.746)) were significant factors associated with caregivers satisfaction with health service in pediatrics ward. CONCLUSION: Caregivers were moderately satisfied. Education level, availability of basic facilities communication with client, and the availability of laboratory tests and drugs were factors that significantly associated with caregiver satisfaction. Hospital should avail laboratory tests and drugs in order to maintain high levels of caregiver satisfaction.


Assuntos
Satisfação do Paciente , Pediatria , Centros Médicos Acadêmicos , Cuidadores , Criança , Estudos Transversais , Etiópia , Hospitais Especializados , Humanos , Satisfação Pessoal , Inquéritos e Questionários
10.
Ethiop J Health Sci ; 32(3): 513-522, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35813672

RESUMO

Background: Despite a global decline in under-five deaths, the neonatal mortality rate remains slow in developing countries and birth asphyxia remains the third cause of neonatal deaths. Globally, neonatal deaths accounts for 45% of under-five deaths, birth asphyxia causes 23-40% of neonatal deaths in Ethiopia. There is limited data on risk factors of asphyxia in Ethiopia, particularly in the study area. Therefore, this study aimed to identify the risk factors of birth asphyxia among newborns. Methods: This research followed a hospital-based unmatched case-control study design at Debre Markos comprehensive specialized referral hospital, Northwest Ethiopia, among 372 newborns (124 cases and 248 controls). Data were collected by interviewing index mothers and chart review using a pre-tested questionnaire. Then it was entered in Epi-data version 3.1 and transferred to STATA version 14.0 for analysis. Bivariate and multiple variable logistic regression were carried out to the possible risk factors. Finally, statistical significance was declared using adjusted odds ratio with 95% CI and p-value <0.05. Results: Prolonged labor >12, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, noncephalic presentation, comorbidity, birthweight<2500grams were found to be significant factors of birth asphyxia. Conclusion: In this study, Prolonged labor >12 hours, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, non-cephalic presentation comorbidity, fetal distress, birthweight<2500grams were found to be risk factors of birth asphyxia were risk factors of birth asphyxia. Therefore, to reduce neonatal mortality associated with birth asphyxia, attention should be given to holistic pregnancy, labor and delivery care, and post-natal care. Moreover, interventions aimed at reducing birth asphyxia should target the identified factors.


Assuntos
Asfixia Neonatal , Morte Perinatal , Asfixia/epidemiologia , Asfixia/etiologia , Asfixia Neonatal/epidemiologia , Asfixia Neonatal/etiologia , Peso ao Nascer , Estudos de Casos e Controles , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Lactente , Recém-Nascido , Gravidez , Encaminhamento e Consulta , Fatores de Risco
11.
PLoS One ; 17(7): e0271568, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35849602

RESUMO

BACKGROUND: Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria. METHODS: This study adopts a descriptive cross-sectional study design. A standardized data collection questionnaire developed by the Initiative for Cardiovascular Health Research in Developing Countries was adapted to electronically collect data from all the 744 CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan between 4th November 2019 to the 31st January 2020. A sensitivity analysis, using rank-dependent thresholds of CHE which ranged from 5%-40% of household total expenditures was carried out. The international poverty line of $1.90/day recommended by the World Bank was utilized to ascertain poverty headcounts pre-and post OOP payments for healthcare services. Categorical variables like household socio-demographic and clinical characteristics, CHE and poverty headcounts, were presented using percentages and proportions. Unadjusted and adjusted logistic regression models were used to assess the factors associated with CHE and poverty. Data were analyzed using STATA version 15 and estimates were validated at 5% level of significance. RESULTS: Catastrophic OOP payment ranged between 3.9%-54.6% and catastrophic overshoot ranged from 1.8% to 12.6%. Health expenditures doubled poverty headcount among households, from 8.13% to 16.4%. Having tertiary education (AOR: 0.49, CI: 0.26-0.93, p = 0.03) and household size (AOR: 0.40, CI: 0.24-0.67, p = 0.001) were significantly associated with CHE. Being female (AOR: 0.41, CI: 0.18-0.92, p = 0.03), household economic status (AOR: 0.003, CI: 0.0003-0.25, p = <0.001) and having 3-4 household members (AOR: 0.30, CI: 0.15-0.61, p = 0.001) were significantly associated with household poverty status post payment for medical services. CONCLUSION: OOP medical spending due to CVDs imposed enormous strain on household resources and increased the poverty rates among households. Policies and interventions that supports universal health coverage are highly recommended.


Assuntos
Doenças Cardiovasculares , Gastos em Saúde , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Doença Catastrófica , Estudos Transversais , Feminino , Hospitais Especializados , Humanos , Masculino , Nigéria/epidemiologia , Inquéritos e Questionários
12.
PLoS One ; 17(7): e0271287, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35802663

RESUMO

BACKGROUND: Adverse pregnancy outcomes are the main causes of maternal and neonatal morbidity and mortality and long-term physical and psychological sequels in low- and middle-income countries, particularly in Africa and Asia. In Ethiopia, maternal mortality remained high despite the country's maximum effort. This study aimed to assess adverse pregnancy outcomes and associated factors among deliveries at Debre Berhan Comprehensive Specialized Hospital, Northeast Ethiopia. METHODS: A retrospective cross-sectional study was done among deliveries at Debre Berhan Comprehensive Specialized Hospital from January 1, 2017, to December 31, 2018. The data was collected using a structured and pre-tested questionnaire by reviewing labor and delivery service log books and admission or discharge registration books. The data were entered into a Microsoft Excel spreadsheet and analyzed using SPSS version 25. Logistic regression analysis was computed to identify independent predictors of pregnancy complications. RESULT: In this study, the magnitude of adverse pregnancy outcomes was 28.3%, 95% CI (25.7-30.9). The most frequently recorded obstetric complications were obstructed labor (7.4%), retained placenta (5.3%), and hypertensive disorders of pregnancy (2.4%). Whereas stillbirths (10%), malpresentation (3%), and prematurity (2.3%) frequently occurred fetal/neonatal complications. There were 29 maternal deaths and the possible causes of death were obstructed labor (51.7%), hemorrhage (44.7%), eclampsia (24.1%), and sepsis (6.9%). Home delivery (AOR (CI = 4.12 (2.30-7.15) and low birth weight (AOR (CI = 1.63 (1.36-1.96) were significant associates of adverse pregnancy outcomes. CONCLUSION: The magnitude of adverse pregnancy outcomes was high. Obstructed labor, retained placenta, hypertension in pregnancy, malpresentation, prematurity, and stillbirth are the commonest adverse pregnancy outcomes. Place of delivery and birth weight were independent predictors of adverse pregnancy outcomes. Institutional delivery, early detection and management of complications, and adequate nutrition and weight gain during pregnancy should be encouraged to minimize the risk of adverse pregnancy outcomes.


Assuntos
Placenta Retida , Resultado da Gravidez , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Natimorto/epidemiologia
14.
BMC Pregnancy Childbirth ; 22(1): 557, 2022 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-35820860

RESUMO

BACKGROUND: Currently, studies showed that eosinophil count had clinical significance in the diagnosis and prognosis of diseases. But, the clinical significance of eosinophil count in pregnancy specifically in preeclampsia (PE) is not well studied. The main objective of the present study was to assess the diagnosis value of eosinophils counts among pregnant women with PE. METHODS: A comparative cross-sectional study was conducted on a total of 126 pregnant women at the University of Gondar Comprehensive Specialized Hospital, using a convenient sampling technique. Socio-demographic and clinical data were collected by questionnaire and datasheet from patient's charts, respectively. A total of six ml of blood was collected from each study participant; three ml for complete cell count analysis using Sysmex XS-500i hematology analyzer and three ml for liver function tests using Humastar 200 chemistry analyzer. The data were entered into Epi-data and exported to SPSS 20 for analysis. The independent t-test was used for normally distributed data and, the Mann-Whitney U test was used for non-normally distributed data. Binary logistic regression and receiver operative curve analyses were also done to assess the diagnosis value of eosinophils count. P-value < 0.05 was considered statistically significant. RESULTS: The eosinophils count of PE pregnant women were significantly lower than the normotensive (NT) pregnant women (median (IQR): 50 (10-200) vs. 120 (60 - 270); (p = 0.002). The eosinophil count ≤ 55 cells/µL had an AUC of 0.66 (95% CI; 0.56-0.75) for diagnosis of PE with a sensitivity of 50.8%, specificity of 77.8%, and positive and negative predictive value of 69.6% and 61.3%, respectively. The abnormal AST and ALT results were significantly higher among PE pregnant women compared to NT pregnant women (AOR: 14.86; 95% CI: 4.97-44.4 and Fischer exact test p-value = 0.001, respectively). CONCLUSION: The eosinophil count ≤ 55cells/µl had a reasonable/acceptable AUC which may use in the diagnosis of PE. AST and ALT were also significantly higher in PE pregnant women compared to NT pregnant women. Multicenter longitudinal studies with a large sample size are recommended to verify the role of eosinophil count in the diagnosis of PE.


Assuntos
Pré-Eclâmpsia , Gestantes , Estudos Transversais , Eosinófilos , Etiópia , Feminino , Hospitais Especializados , Humanos , Pré-Eclâmpsia/diagnóstico , Gravidez
15.
Medicine (Baltimore) ; 101(29): e29905, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35866778

RESUMO

Opportunistic infections (OIs) in HIV patients are infections that are more common or more severe as a result of HIV-mediated immunosuppression. The advances in the capacity of antiretroviral therapy (ART) have diminished the incidence of OIs. However, even in the ART era, HIV-related OIs continue to be major causes of hospitalization and mortality. Therefore, this study aims to identify time to occurrence, predictors, and patterns of OIs incidence among HIV-positive patients attending ART clinic of Salale University Comprehensive Specialized Hospital, Ethiopia. A retrospective cohort study was conducted between 1st September 2016 and 1st September 2021. All 419 patients diagnosed during the study period were recruited. Data were extracted from both patient medical records and ART logbooks. Stata-16 was used for data analysis. Follow-up time was calculated from the date of HIV diagnosis to the date of OIs occurrence or censoring. Cox proportional hazards regression model was used to identify the predictors of OIs incidence. The total person-time of the follow-up was 8656 person-months of observation. During the follow-up time, 199 (47.49%) of the patients had developed OIs. The incidence rate of OIs was 23 (95%CI: 20, 26) per 1000 person-months of observation. The median OIs free survival time was 36 (95%CI: 31, 40) months. Predictors such as residence, cd4 category, baseline hemoglobin level, ART side effects, isoniazid preventive therapy, and chronic disease comorbidity were significantly predicted OIs incidence. The study area's OIs incidence remained high, requiring prompt action. To reduce the morbidity and mortality associated with OIs, HIV-positive patients with the predictors of rural residence, low CD4 category, low baseline hemoglobin level, ART side effects, not taking IPT, and baseline chronic disease comorbidity necessitate close follow-up and monitoring. Thus, we recommend focused and evidence-informed strategies to address OIs burden and improve outcomes.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Infecções por HIV , Infecções Oportunistas Relacionadas com a AIDS/complicações , Etiópia/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Hemoglobinas , Hospitais Especializados , Humanos , Incidência , Estudos Retrospectivos , Universidades
16.
Int J Nurs Pract ; 28(5): e13085, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35903948

RESUMO

AIM: To investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID-19. BACKGROUND: At the end of 2019, COVID-19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored. METHODS: During February 2020, we recruited 114 patients with mild or common type COVID-19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors. RESULTS: The fear of disease progression scores of patients with mild or common COVID-19 was at the low-to-moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID-19 were factors potentially associated with fear of progression. CONCLUSION: With a high prevalence of fear of disease progression in patients with COVID-19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning.


Assuntos
COVID-19 , COVID-19/epidemiologia , China/epidemiologia , Medo , Hospitais Especializados , Humanos , Unidades Móveis de Saúde , Transtornos Fóbicos , SARS-CoV-2
17.
Front Public Health ; 10: 876558, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35801246

RESUMO

In the event of pandemic, it is essential for government authority to implement responses to control the pandemic and protect people's health with rapidity and efficicency. In this study, we first develop an evaluation framework consisting of the entropy weight method (EWM) and the technique for order preference by similarity to ideal solution (TOPSIS) to identify the preliminary selection of Fangcang shelter hospitals; next, we consider the timeliness of isolation and treatment of patients with different degrees of severity of the infectious disease, with the referral to and triage in Fangcang shelter hospitals characterized and two optimization models developed. The computational results of Model 1 and Model 2 are compared and analyzed. A case study in Xuzhou, Jiangsu Province, China, is used to demonstrate the real-life applicability of the proposed models. The two-stage localization method gives decision-makers more options in case of emergencies and can effectively designate the location. This article may give recommendations of and new insights into parameter settings in isolation hospital for governments and public health managers.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Surtos de Doenças , Hospitais Especializados , Humanos , Unidades Móveis de Saúde , SARS-CoV-2
18.
Front Public Health ; 10: 909241, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35712278

RESUMO

Coronavirus disease 2019 (COVID-19) broke out in 2019. In the past 4 years, China has adopted many measures to control the epidemic, including building Fangcang shelter hospitals to isolate confirmed positive cases. Therefore, we aim to explore the mental health status of medical staff in the Wuhan Fangcang shelter hospital and discuss the relevant factors that affect the medical staff's mental status. The subjects of the research were staff from several Fangcang shelter hospitals in Wuhan during the epidemic of COVID-19. Patient Health Questionnaire-9 items Scale (PHQ-9) was used to assess the severity of the participants' depressive symptoms, and Generalized Anxiety Disorder-7 items Scale (GAD-7) was used to evaluate the severity of the participants' anxiety symptoms. The demographic information and health adjustment methods were collected in a self-made questionnaire, and regression analysis on related factors that affect mental health was performed. The three most frequently used methods of psychological adjustment for the staff in the Fangcang shelter hospital are common recreational activities, such as reading, streaming videos, listening to music, and playing games. (93.8%), communicating with colleagues in the Fangcang shelter hospital (92.5%), and communicating with family members and friends (78.3%). Binary logistic regression analysis showed that developing depression symptoms has relation to 2 factors, which are having not participated in medical emergency rescue missions (odds ratio = 2.610; 95% confidence interval 1.398-4.872, P = 0.003) and inadequate training before entering the shelter hospital (odds ratio = 2.804, 95% confidence interval 1.293-6.08, P = 0.009). Compared with adequate pre-job training, insufficient training increases the risk of anxiety symptoms (odds ratio = 2.692; 95% confidence interval 1.3-5.575, P = 0.008). Lack of experience and inadequate training in medical emergency rescue missions exposed the medical staff to a higher risk of developing symptoms of depression and anxiety. Psychological adjustment methods that are helpful to adjust their mental state are most commonly used.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade , Big Data , COVID-19/epidemiologia , Hospitais Especializados , Humanos , Corpo Clínico , Unidades Móveis de Saúde , SARS-CoV-2
19.
BMJ Open ; 12(6): e057235, 2022 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725251

RESUMO

OBJECTIVE: The aim of this study was to assess the prevalence of anaemia and its associated factors at the time of antiretroviral therapy (ART) initiation among HIV-infected adults at Debre Markos Comprehensive Specialized Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted among 473 patients' charts enrolled from 2014 to 2018 at Debre Markos Comprehensive Specialized Hospital. Patients' chart numbers were selected from the computer using a simple random sampling technique. Data were entered using Epi Info V.7.2.2.6 and analysed with Stata V.14.0. Anaemia prevalence at the time of ART initiation was computed and described using frequency tables. To identify factors for anaemia, bivariate and multivariate logistic regression models were fitted. Model fitness was checked using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: From 473 patients' charts, 468 charts were included in the analysis, and a total of 164 anaemia cases were recorded. The overall prevalence of anaemia among HIV-infected adults at the time of ART initiation was 35.04% (95% CI: 30.84% to 39.49%). After multivariate analysis, an increased risk of anaemia was seen among males (adjusted OR (AOR)=2.45; 95% CI: 1.51 to 3.98); those not attending formal education (AOR=2.38; 95% CI: 1.12 to 5.05); those who had baseline CD4+ T cell count ≤200 cells/mm3 (AOR=4.67; 95% CI: 2.78 to 7.85); had body mass index (BMI) <18.5 kg/m2 (AOR=2.43; 95% CI: 1.42 to 4.16) and had ambulatory/bedridden baseline functional status (AOR=2.69; 95% CI: 1.41 to 5.12). CONCLUSION: The current study showed that a significant proportion of HIV-infected adults developed anaemia at the time of ART initiation. Hence, giving special attention to those who have not attended formal education, were males, had decreased baseline CD4+ T cell count, had lower BMI and patients with ambulatory/bedridden baseline functional status is crucial to reduce the health impact of anaemia. The result will provide insight into the development of new anaemia preventive strategies.


Assuntos
Anemia , Infecções por HIV , Adulto , Anemia/epidemiologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Hospitais Especializados , Humanos , Masculino , Prevalência , Estudos Retrospectivos
20.
BMC Pregnancy Childbirth ; 22(1): 498, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715769

RESUMO

BACKGROUND: Postpartum hemorrhage is one of the leading causes of maternal deaths worldwide. Early recovery is a performance indicator and better health outcome of patients with postpartum hemorrhage. Therefore, this study aimed to assess time to recovery from postpartum hemorrhage and its predictors in Debre Markos Comprehensive Specialized Hospital, Ethiopia, 2020. METHODS: A retrospective follow-up study was conducted among 302 women who were diagnosed with postpartum hemorrhage from January 1, 2016 to December 31, 2020 at Debre Markos Comprehensive Specialized Hospital. Consecutive sampling technique was employed. To show the statistical significant difference between each group of variables, log rank test was used. Kaplan Meier analysis to estimate time to recovery and cox proportional-hazard regression analysis to determine independent predictors were carried out cautiously. Adjusted hazard ratio used to determine the strength of association. RESULT: The median recovery time from postpartum hemorrhage was 13 h with range of (10 to 17 h). Blood transfusion (AHR: 1.8, 95% CI (1.39, 2.57)), NASG utilization (AHR: 6.5, 95% CI (4.58, 9.42)) fluid resuscitation (AHR 2.9, 95% CI (1.48, 5.54)), active management of third stage of labor (AHR: 1.7, 95% CI (1.18, 2.45)) and history of antenatal care follow-up (AHR: 2.6, 95% CI (1.91, 3.56)) were the predictors, which shorten the recovery time. Comorbidities like anemia at the time of admission (AHR: 0.62 95% CI (0.44, 0.89)), retroviral infection (AHR: 0.33, 95% CI (0.16, 0.67)) and Hepatitis B-Virus infection (AHR: 0.52, 95% CI (0.32, 0.82)) delay the recovery rate from postpartum hemorrhage. CONCLUSION: Mothers in North-West Ethiopia stays morbid from postpartum hemorrhage for more than half a day. Their recovery time was affected by Non-Pneumatic Anti-Shock Garment utilization, implementation of emergency management components like blood transfusion and fluid resuscitation, history of antenatal care follow up, and being comorbid with viral infections. Non-pneumatic anti-shock garment application to every mother with postpartum hemorrhage and implementation of proper emergency management approach are vital for rapid recovery from postpartum hemorrhage.


Assuntos
Hemorragia Pós-Parto , Etiópia/epidemiologia , Feminino , Seguimentos , Hospitais Especializados , Humanos , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/terapia , Gravidez , Estudos Retrospectivos
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