Selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Asthma is a chronic inflammatory disease that affects the lungs. Variation in whole blood cell lines is caused by the progression and severity of asthma. Common hematological abnormalities encountered during asthma include eosinophilia, neutrophilia, leukocytosis, and increased erythrocyte sedimentation rate. The main aim of this study was to assess the selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia from March to May 2021. METHODOLOGY: A hospital-based cross-sectional study was conducted on a total of 320 asthmatic patients in Northwest Ethiopia. A simple random sampling technique was employed to select study participants. A pre-tested structured questionnaire and a checklist were used to collect data. Blood samples were collected from asthmatic patients for complete blood count and erythrocyte sedimentation rate determination. Hematological profiles were analyzed by Unicel DxH 800 (Beckman Coulter, Ireland). The erythrocyte sedimentation rate was determined by using the Westergren method. The data were entered into EpiData version 3.0.4 and analyzed with a statistical package for social science version 20 software. The bi-variable and multi-variable binary logistic regression models were used to assess the factors associated with hematological abnormalities. A p value of less than 0.05 in the multivariable logistic regression analysis was considered statistically significant. RESULTS: The overall prevalence of neutrophilia, eosinophilia, thrombocytopenia, leukocytosis, and basophilia was 35.3%, 20%, 11.9%, 10.3%, and 4.1%, respectively. Neutrophilia was associated with a lack of physical activity (AOR = 3.25; 95% CI 1.43-7.37) and a history of taking non-asthmatic drugs within the previous three months (AOR = 2.63; 95% CI 1.22-5.65). Being admitted to the emergency department (AOR = 0.27; 95% CI 0.11-5.67) was found to be associated with eosinophilia. In addition, being admitted to the emergency department (AOR = 5.44; 95%CI: 2.6-11.3) was associated with thrombocytopenia. CONCLUSION: The current study demonstrated the predominant prevalence of neutrophilia, followed by eosinophilia, among asthma patients. Therefore, hematological abnormalities should be taken into account for proper monitoring and management of asthmatic patients.

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. METHODS: Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS: A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. CONCLUSION: The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

Coagulopathy and its associated factors among patients with a bleeding diathesis at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

BACKGROUND: Coagulopathy is the major cause of mortality and morbidity throughout the world. Globally, about 26-45% of healthy people have a history of bleeding symptoms, which may be a result of thrombocytopenia, factor deficiency, or pathological inhibitory. OBJECTIVE: To assess coagulopathy and its associated factors among patients with bleeding diathesis at the University of Gondar Specialized Referral Hospital from January to May 2020. METHOD: A cross-sectional study was conducted on 384 study participants with bleeding diathesis recruited by using a convenient sampling technique. Socio-demographic and clinical characteristics were collected by using questioners. Then 6 ml venous blood was collected with a needle and syringe method. About 3 ml blood was transferred to EDTA test tube for platelet count and 2.7 ml blood was transferred to a test tube containing 0.3 ml of 3.2% sodium citrated anticoagulant for coagulation test. For those study participants with prolonged coagulation tests, a mixing test was done. Blood film and stool examination were also done for malaria and intestinal parasite identification, respectively. The data were entered into EPI-Info version 3.5.3 and then transferred to SPSS version-20 for analysis. Descriptive statistics were summarized as percentages, means, and standard deviations. Bivariate and multivariate logistic regression was used to identify the associated factors, and a P-value less than 0.05 was considered statistically significant. RESULTS: In this study, the prevalence of coagulopathy was 253/384 (65.9%; 95% CI: 61.16, 70.64). From them, 21.3% (54/253), 51.4% (130/253), and 27.3% (69/253) had only thrombocytopenia, only prolonged coagulation test, and mixed abnormality, respectively. Among participants with prolonged coagulation time, the prevalence of factor deficiency was 21.1% (42/199). Cardiac disease (AOR = 4.80; 95% CI: 2.65, 23.1), and other chronic diseases (AOR = 8.1; 95% CI: 1.84, 35.58) were significantly associated with coagulopathy. CONCLUSION: In this study, coagulopathy due to inhibitory was a public health problem. The participants with cardiac and other chronic diseases were at high risk for coagulopathy. Therefore, mixing tests could be done for all prolonged coagulation tests and it could be considered as a routine laboratory test.

Role of Erythropoiesis Stimulating Agents in the Treatment of Anemia: a Literature Review.

BACKGROUND: Erythropoiesis stimulating agents are exogenous erythropoietin medications that are used to stimulate the bone marrow red blood cells' production for the management of anemia of chronic kidney disease, some anticancer drugs, myelodysplastic syndrome, and others. Currently, there are different erythropoiesis stimulating agents accessible in the market. The objective of this narrative literature review is to summarize the role of some erythropoiesis stimulating agents in the treatment of anemia. METHODS: The following method was used to prepare this narrative literature review. The comprehensive computerized search of literatures was carried out using PubMed, Cochrane library, Google scholar, and Science direct. Keywords such as recombinant human erythropoietin, epoetin, darbepoetin, continuous erythropoietin receptor agonist, pegzyrepoetin alfa, erythropoiesis stimulating agents in combination with anemia/anaemia were used. The pertinent original and review full articles which are written in the English language were included in this narrative review. RESULTS: From the discussions of the literature, erythropoiesis stimulating agents that are produced by different biosimilar manufacturers have different clinical characteristics and stabilities as a result of their chemical modifications. The chemical modifications of erythropoiesis stimulating agents like glycosylation and polyethylene glycosylation determine the half-life, affinity to erythropoietin receptor, and immune response of the agents. Erythro-poiesis stimulating agents are categorized as short-acting and long-acting agents due to their chemical structures that influence the clinical efficacy and safety of the agents. CONCLUSIONS: The effectiveness of the agents is different in different patients depending on the individual characteristics and etiologies of anemia. The agents not only have the benefits but also, they have the risks for the patients. Hence, the risks and benefits of erythropoiesis stimulating agents must be given special consideration in the managements of anemia to get maximum efficacy for anemic patients. The treatment is dependent on hemoglobin levels of individual patients. The physician must follow the patients during and after therapy using erythropoiesis stimulating agents.

Prevalence of Anemia and Iron Deficiency Among Pregnant Women Attending Antenatal Care Service at University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Anemia, particularly pregnancy related iron deficiency anemia, increases the risk of maternal morbidity and mortality and the effects are more devastating in less developed and developing continents where pregnant women have low socioeconomic status. Thus, this study aimed to assess the prevalence and associated factors of anemia and iron deficiency anemia among pregnant women. METHODS: This institution based, cross-sectional study was conducted from January 1 to April 30, 2015 on a total of 217 pregnant women attending at University of Gondar Hospital, Northwest Ethiopia. A structured, pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, and clinical condition. About 3 mL blood sample was collected for hemoglobin and serum ferritin deter-mination. Hgb concentrations and other RBC parameters were analyzed using a Cell Dyne 1800 hematology analyzer. Serum ferritin was measured by an automated Elecsys 1,020 using commercial kits. The data was entered to Epi info version 3.5.3 software and analyzed using SPSS 20. Frequency, proportion, and summery statistics was used to describe the study population in relation to study variables. Bi-variable and multi-variable statistical analysis was used. P-value < 0.05 was considered as statically significant. RESULTS: Out of 217 women enrolled in the study, 28 (12.9%) were found to be anemic with 75% mild, 21.4% moderate and 3.6% severe type of anemia. Anemia was more prevalent in the first (21%) and third (17.9%) trimesters. The overall prevalence of iron deficiency anemia was 3.2% (7/217) while from anemic pregnant women one fourth (25%) of them developed iron deficiency anemia. CONCLUSIONS: The overall prevalence of anemia was low and it was considered a mild public health problem. In this study, there were no statistically associated risk factors for anemia. Based on this finding, iron supplementation should be encouraged as a prophylactic measure.

Hematological Indices of Pregnant Women at the University of Gondar Referral Hospital, Northwest Ethiopia: a Comparative Cross-Sectional Study.

BACKGROUND: Pregnancy is a natural physiological variation as a result of hormonal and metabolic changes. Worldwide a large proportion of women are expected to die each year as a result of pregnancy complication related to hematological profile alterations. Therefore, this study is aimed at assessing hematological indices of pregnant in comparison with non-pregnant women. METHODS: A comparative cross-sectional study was conducted among pregnant and non-pregnant women at the University of Gondar Hospital, from February to April 2015. A blood sample was collected from 139 pregnant and 139 age-matched non-pregnant women using systematic random sampling technique. Data analysis was made using SPSS version 20. Level of significance was analyzed using independent t-test and Mann-Whitney U test. A p-value ≤ 0.05 was considered statistically significant. RESULTS: In this study, pregnant women had significantly higher WBC count [(7.08 ± 2.07 vs. 5.77 ± 1.85) x 109/L], MCV [(93.16 ± 3.44 vs. 90.74 ± 4.12) fL], MCHC [(30.40 ± 1.19 vs. 29.47 ± 1.46) pg], Neutrophil count [(4.73 ± 1.86 vs. 3.06 ± 1.47) x 109/L], Lymphocyte count [(1.65 ± 0.41 vs. 1.2 ± 0.54) x 109/L], RDW [(49.35 ± 2.9 vs. 46.37 ± 2.73) fL], PDW [(14.02 ± 0.6 vs. 13.12 ± 0.19) fL], and MPV [(10.49 ± 0.95 vs. 10.06 ± 1.18) fL] compared with controls. The RBC count [(4.55 ± 0.38 vs. 5.14 ± 0.53) x 1012/L], Hb [(13.73 ± 0.96 vs. 15.30 ± 1.074) g/dL], Hct [(42.14 ± 2.55 vs. 47.16 ± 3.36)%], and Platelets [(196.07 ± 48.88 vs. 249.36 ± 62.73) x 109/L] were significantly lower among pregnant women compared to the control group, respectively. This study also indicated that there was a significant difference in MCV, MCH, platelet count, absolute lymphocyte count and RDW across the three trimes-ters of pregnancy. CONCLUSIONS: This study found a statistically significant difference in the majority of hematological indices between pregnant and non-pregnant women. Trimesters of pregnancy have an influence on some hematological indices. This study provides baseline data for basic hematological indices changes, and it is vital especially in the antenatal care assessment to avoid pregnancy-related adverse outcomes.

The Role of Neutrophil to Lymphocyte Count Ratio in the Differential Diagnosis of Pulmonary Tuberculosis and Bacterial Community-Acquired Pneumonia: a Cross-Sectional Study at Ayder and Mekelle Hospitals, Ethiopia.

BACKGROUND: The differential diagnosis of pulmonary tuberculosis and bacterial community-acquired pneumonia is often a challenging phenomenon. The neutrophil to lymphocyte count ratio, a suitable indicator of inflammation, has been demonstrated to be a useful biomarker for predicting bacteremia. The main aim this study is to evaluate the role of neutrophil to lymphocyte count ratio in the differential diagnosis of pulmonary tuberculosis and bacterial Community-Acquired Pneumonia at Ayder and Mekelle hospitals, Mekelle, Ethiopia. METHODS: A hospital based cross-sectional study was conducted from February to May 2017 on a total of 146 patients at Ayder and Mekelle hospitals. After taking written informed consent, study participants were interviewed for a detailed history and 5 mL of blood was collected for hematological analysis. Pulmonary tuberculosis was diagnosed by using Ziehl-Neelsen and Gene X-pert. Community acquired pneumonia was diagnosed using sputum culture. Student's t-test, Pearson's chi-square test, and receiver operating characteristics curve analysis were used. A p-value < 0.05 was considered statistically significant. RESULTS: The neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate were significantly higher in pulmonary tuberculosis patients than bacterial community-acquired pneumonia patients. Neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate with cutoff values of ≥ 2.72 and ≥ 39, respectively, showed the highest area under the curve (AUC = 0.69; 95% CI: 0.62, 0.77). CONCLUSIONS: Neutrophil to lymphocyte count ratio and eythrocyte sedimentation rate together at a time with their respective cutoff values gave a 69% accuracy in differentiating pulmonary tuberculosis from bacterial community-acquired pneumonia. Therefore, neutrophil to lymphocyte count ratio and erythrocyte sedimentation rate can be used in differentiating pulmonary tuberculosis from PTB patients from bacterial Community-acquired pneumonia, especially in resource-limited settings.

Under nutrition, maternal anemia and household food insecurity are risk factors of anemia among preschool aged children in Menz Gera Midir district, Eastern Amhara, Ethiopia: a community based cross-sectional study.

BACKGROUND: In Ethiopian, the prevalence of anemia among preschool aged children widely varied across regions. Since anemia adversely affects the cognitive and physical development of the children, it is important to determine its burden for implementing appropriate measurements. Therefore, this study was aimed at determining the anemia prevalence and associated factors among preschool aged children. METHOD: A community based cross-sectional study was conducted on a total of 432 preschool children in Menz Gera Midir district from January to May, 2017. A multi stage sampling procedure was applied to select the target groups. Hemocue analyzer for Haemoglobin determination; anthropometric measurements for assessment nutritional status, structured questionnaires for socio-demographic and economic variables were used for data collection. The morphological appearance of red blood cell was assessed microscopically to determine type of anemia. Descriptive statistics were employed to summarize the data and binary logistic regression was used for inferential statistics. A p value less than 0.05 was considered as statistically significant. RESULT: The overall prevalence of anemia was 123 (28.5%); of which 38 (30.9%) and 85 (69.1%) were moderate and mild, respectively. Morphologically about 50.4, 37.4 and 12.2% were microcytic hypochromic, normocytic normochromic and macrocytic anemias, respectively. Child age 6-11 months (COR: 5.67, 95% CI: 2.2, 14.86), child age 12-23 months (COR: 5.8, 95% CI: 2.3, 14.7), wasting (COR: 3.5, 95% CI: 1.2, 9.8), stunting (COR: 3.8, 95% CI: 1.92, 7.77), underweight (COR: 2.12, 95% CI: 1.07, 4.38), MUAC measurement below 13 cm (COR: 5.6, 95% CI: 2.83, 11.15), household headed by female (COR: 3.24, 95% CI: 1.1, 9.63), maternal anemia (COR: 4, 95% CI: 2.2, 7.23) and household food insecurity (COR: 2.12, 95% CI: 1.09, 4.12) were significantly associated with anemia. CONCLUSION: The prevalence of anemia among the children was found to be high and associated with child age group, child nutritional status, house hold headed by female, maternal anemia and household food insecurity. Further studies on nutritional anemia, community based nutritional education, iron supplementation to children at risk should be promoted.

Haematological and immunological reference intervals for adult population in the state of Amhara, Ethiopia.

OBJECTIVE: Reference intervals (RIs) currently being used in Ethiopia are derived from western populations. Thus, this study aimed to establish locally derived haematological and immunological RIs. METHOD: The study was conducted in Amhara State, Ethiopia with a total of 967 (55.2% males) participants. 56.9% of males and 43.1% of females were eligible for haematological and immunological RI determination. A non-parametric test was used for the determination of upper (97.5th percentile) and lower (2.5th percentile) reference interval limits with 95% CI. The Harris and Boyd Rule was used to determine the need of partitioning of reference intervals based on gender. RESULT: The established 95% reference intervals (2.5th-97.5th percentile) were: for WBC: 3-11.2 × 109 /l; for platelet: 90-399 × 109 /l; for RBC: 4-6 × 1012 /l for males and 3.5-5.6 × 1012 /l for females; for haemoglobin: (Hgb) 12-18.9 g/dl for males and 10.7-17.5 g/dl for females; for PCV: 35.7-55.3% for males and 32.2-50.1% for females; for CD4: 400-1430 × 109 /l for males and 466-1523 × 109 /l for females; for CD4 percentage: 18-49.1% for males and 21.3-52.9% for females; for MCV: 81-100 fl; for MCH: 25.3-34.6 pg; MCHC: 28.8-36.9%; for RDW: 11.6-15.4% and for MPV: 8-12.3 fl. Males had significantly higher RBC, Hgb and PCV than females. CD4 counts and CD4 percentage were significantly higher in females. CONCLUSION: The reference intervals established in this study differ from others and thus should be used for the interpretation of laboratory results in diagnosis and safety monitoring in clinical trials in Amhara.

Human blood platelets and viruses: defense mechanism and role in the removal of viral pathogens.

Platelets are small non-nucleated cell fragments and the second most abundant cell that play crucial role in managing vascular integrity and regulating hemostasis. Recent finding shows, beyond its hemostatic function platelets also play a main role in fighting against pathogen including viruses. With their receptors, platelet interacts with viral pathogen and this interaction between platelets and viral pathogens result in activation of platelets. Activated platelet releases different molecules that have antiviral activity including kinocidins and other platelet microbicidal peptides. In addition, activated platelet has antiviral role by different mechanism including; phagocytosis of viral pathogen, produce reactive oxygen species and interact with and activate other immune cells. In other side, antiplatelet treatments are one of defending mechanism of viral pathogen. This narrative review summarizes what is known regarding the role of human platelets in fighting viral pathogen.

Clinical Laboratory Reference Intervals in Ethiopia: Current Status and Future Considerations: Review.

Background: Clinical laboratory reference intervals are derived from a sample of selected healthy population and they are used for disease diagnosis, management, and monitoring. International guidelines recommended that laboratories and manufacturers are supposed to establish their own RIs for a certain group of population. Therefore, the aim of this narrative review is to summarize the current status and to show future directions regarding reference intervals of clinical laboratory parameters among Ethiopian population. Methods: PubMed, Google Scholar, and Google databases were searched to access relevant reference interval studies in Ethiopia. Journal articles, guidelines, reports, and related documents published in English language were included without publication period restriction. Results: Fifteen studies were conducted to establish local reference intervals for hematology, immunology, and clinical chemistry parameters in Ethiopia from 1999 - 2018. The majority of those studies determined clinical laboratory reference intervals for adults only. Some other Ethiopian reference interval studies did not include the majority of routine hematology and clinical chemistry parameters. In addition, the studies we reviewed did not consider the cultural, ethnic, demographic, and geographical diversity of Ethiopian population. Conclusions: There is limited data regarding locally established reliable clinical laboratory reference intervals in Ethiopia though attempts are made. Therefore, further local reference interval studies should be undertaken considering the cultural, ethnic, demographical, and geographical diversity of the Ethiopian population.

Prevalence and types of thyroid malignancies among thyroid enlarged patients in Gondar, Northwest Ethiopia: a three years institution based retrospective study.

BACKGROUND: Thyroid carcinoma is the leading cause of death among endocrine cancers second to carcinoma of the ovary. Now a day, the incidence of thyroid malignancy is increasing more rapidly than any other malignancy. But data on the prevalence of thyroid malignancy among thyroid enlarged patients were very limited in the study area. Therefore, this study was aimed to determine the prevalence of thyroid malignancies among thyroid enlarged patients. METHODS: Data of 846 thyroid enlarged patients registered from January 2010 to February 2013 were collected from fine needle aspirate cytology and histology (for inconclusive and the neoplastic cases) log books. It was entered and analyzed using SPSS version 20. Odds ratio was calculated to assess the presence and strength of association between the outcome variable and the explanatory variables. P-values less than 0.05 were considered statistically significant. RESULTS: Among the 846 thyroid enlarged patients, 62(7.3%) were confirmed to have malignancy. Among malignancies papillary thyroid carcinoma was the leading, 28 (45.2%), followed by follicular thyroid carcinoma, 18 (29%), and the least type of thyroid malignancies were medullary thyroid carcinoma and hurtle cell carcinoma, each accounts 1 (1.6%). Severe form of thyroid malignancy, undifferentiated thyroid carcinoma, was also accounted significant proportion, 12.9%. Older patients having an age of greater than 60 years and patients with solitary thyroid enlargement were more affected by malignancy compared to the reference age group, 11-20 years and diffused type of enlargement respectively (AOR: 10.96 (3.15-38.1; AOR: 8.82 (3.49-22.32) respectively). CONCLUSIONS: The prevalence of thyroid malignancy was significantly high and the leading type of malignancy was papillary thyroid carcinoma followed by follicular thyroid carcinoma. Thyroid malignancy was found to have statistically significant association with type of enlargement and age.

Human leukocyte antigen alloimmunization prevention mechanisms in blood transfusion.

In many fields of clinical medicine and blood transfusion, the human leukocyte antigen (HLA) system is crucial. Alloimmunization happens as a result of an immune response to foreign antigens encountered during blood transfusion. This gives rise to alloantibodies against red blood cells (RBCs), HLA, or human platelet antigen (HPA). HLA alloimmunization following allogeneic transfusion was shown to be a result of contaminating white blood cells (WBCs) present in the product. It is a common complication of transfusion therapy that leads to difficulties in clinical intolerance and refractoriness to platelet transfusion during patient management. Single-donor platelets, prophylactic HLA matching, leukoreduction, and irradiation of cellular blood products are some of the mechanisms to prevent HLA alloimmunization during a blood transfusion. Now, the best approach to reduce the occurrence of primary HLA alloimmunization is the removal of WBCs from the blood by filtration.

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.

Anemia and associated factors among internally displaced children at Debark refugee camp, North Gondar, Northwest Ethiopia.

BACKGROUND: Children in refugee camps, due to their living conditions, are the most vulnerable groups to suffer from anemia. Nutritional deficiencies, especially iron deficiency is the most common causes of anemia. However, there is limited information on the prevalence and associated factors of anemia in Ethiopia. Hence, this study aimed to assess the prevalence and associated factors of anemia among internally displaced children at Debark refugee camp, Northwest Ethiopia. METHODS: A cross-sectional study was conducted on 354 internally displaced children, at Debark refugee camp from March to May 2022. A systematic sampling technique was employed. The socio demographic characteristics were collected by using structured questionnaire via face-to-face interview with the caregivers. The hemoglobin level was determined using HemoCue301+. Form anemic children, venous blood sample was collected for iron profile analysis. Parasitological and anthropometric measurements were also done. The data were entered using Epi-data version 4.6.0.6 and exported to STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression analysis were done. Both crude odds ratio and adjusted odds ratio with the corresponding 95% confidence interval were calculated to measure the strength of association. P-Value < 0.05 was considered as statistically significant association. RESULTS: From the total of 354 children included in this study, more than half (54.8%) of them were male. The median age of children was 7 years with interquartile range of (4-10) years. The total prevalence of anemia in this study was 33.62% (95% CI:28.7, 38.7). Moderate type anemia was predominant in this study. From anemic children 30 (25.2%) had iron deficiency anemia. In this study, low dietary diversity (AOR = 4.9; 95% CI: 2.0, 11.7), duration in the camp more than six months (AOR = 4.2; 95% CI:1.9, 9.4), presence of diarrhea (AOR = 2.7; 95% CI:1.3, 5.7), fever (AOR = 3.4; 95% CI:1.6, 7.1), and wasting (AOR = 3.6; 95% CI:1.3, 10.3) were significantly associated with the prevalence of anemia. CONCLUSION: Anemia was moderate public health problem in the current study. Focused policies and strategies towards to internally displaced children should be designed to reduce anemia, by preventing the significant risk factors associated with anemia.

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.

Distribution of ABO and Rh-D Blood Group Antigens Among Blood Donors in the Amhara Regional State, Ethiopia.

BACKGROUND: The ABO and Rh blood group systems are the most commonly used blood group systems in clinical settings. They are clinically significant for blood transfusion, organ transplantation, genetic studies, forensic determinations, and medico-legal issues. Therefore, this study aimed to determine the distribution of ABO and Rh-D blood groups among blood donors in the Amhara regional state, Ethiopia. METHODS: A cross-sectional study was conducted from March 2016 to September 2018 among blood donors in the four blood bank districts (Gondar, Bahir Dar, Debre Markos, and Dessie) of the Amhara regional state, Ethiopia. A total of 1040 blood donors aged from 18 years old to 60 years old were included using a simple random sampling technique. A structured questionnaire and a data collection sheet were used to obtain the socio-demographic data and blood group types of study participants. The ABO and Rh-D blood groups were typed using commercially prepared antisera after 1 mL of blood was taken from blood bags. The data was cleared by Epi-Info Version 7 and extracted into SPSS version 25 for analysis. The distribution of data was checked by using the Shapiro-Wilk test. Then, the data was presented in tables and figures. RESULTS: In this study, out of 1040 study participants, 55.6% were males with a median age of 20 years (IQR = 19-24 years). In this study, the distribution of ABO blood types O, A, B, and AB was 41.6% (433/1040), 28.7% (298/1040), 22.2% (229/1040), and 7.7% (80/1040), respectively. On the other hand, the Rh-D positivity was 92.5% (962/1040). CONCLUSION: The overall predominant ABO blood group in the Amhara regional state was O (41.6%), and the least was AB (7.7%). Besides, the overall Rh-D negative blood distribution was 7.5%, which ranged from 4.46% to 9.6%. Therefore, this information would be useful to the blood banks, especially in the planning of blood transfusion programmers.

Anemia and its predictors among adult non-dialysis chronic kidney disease patients in Southern Ethiopia: a cross-sectional study.

BACKGROUND: Anemia is an adverse outcome and common complication in chronic kidney disease patients. This is usually associated with iron deficiency, inflammation and blood loss. However, little is known about the prevalence of anemia and its predictors among chronic kidney disease patients in Southern Ethiopia. This study aimed to determine anemia and its predictors among adult non-dialysis chronic kidney disease patients in Southern Ethiopia. METHODS: A cross-sectional study was conducted on 384 chronic kidney disease patients from February to April 2019. Socio-demographic and clinical data were collected using questionnaires and medical records. Adjusted hemoglobin was taken to define anemia using the level of Hgb <13 mg/dL for males and <12 mg/dL for females; and blood films and serum ferritin were done for anemic participants. SPSS version 25.0 was used for data analysis. Frequency distribution tables and graphs were used to describe descriptive statistics. A bivariate logistic regression model was used to determine the predictors; p <.05 was considered statistically significant. RESULTS: Overall prevalence of anemia was 44.0% (95% CI: 39.0%, 48.9%); of which 7.1%, 62.1% and 30.8% of anemic patients had mild, moderate and severe anemia, respectively. The prevalence of anemia increased from 20.6% in stage 2 to 100% in stage 5. Morphologically, normocytic normochromic anemia was the most predominant type. Cardiovascular disease (AOR = 2.37, 95% CI: 1.35, 4.16), diabetes mellitus (AOR = 2.77, 95% CI: 1.08, 7.14), stage 3b chronic kidney disease (AOR = 2.74, 95% CI: 1.31, 5.73) and stage 4 and 5 chronic kidney disease patients (AOR = 7.11, 95% CI: 3.22, 15.72) showed significant association with anemia. CONCLUSION: Anemia was a severe public health problem and associated with cardiovascular disease, diabetes mellitus and stages of chronic kidney disease. Thus, early diagnosis, treatment and prevention of anemia are recommended.

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.

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.