Prevalence of goiter and its associated factors among primary school children in Chole District, Arsi Zone, Ethiopia: a cross- sectional study.

BACKGROUND: Goiter remains one of the major public health problems particularly among young children in economically disadvantaged countries like Ethiopia. The aim of the study was to assess the prevalence of goiter and its associated factors among children aged 6-12 years in Chole district, Arsi Zone, Eastern Ethiopia. METHODS: A school based cross-sectional study was conducted in February, 2017 among 422 primary school children in Chole district, eastern Ethiopia. The schools and study subjects were randomly selected. A structured, pretested and interviewer- administered questionnaire was used to collect the required data. It was conducted after getting due consents from the school administration and assent from caregiver/parent. Spot testing kits were used to estimate the level of iodine in salts. Descriptive statistics, cross-tabulations for chi-square test, and bivariate and multivariate logistic regression models were used to show the magnitude of goiter and its associated factors. Odds ratios with 95% confidence intervals were computed to determine the presence and strengths of associations. RESULTS: From the 422 study participants, 407 (96.4%) completed the questionnaire. Of these 205(50.3%) were female. The mean age of participant school children was 9.87(SD ± 1.6) years. The prevalence of goiter among study subjects was 36.6% (95% CI, 31.6-40.8%). History of goiter in the family (AOR = 6.80; 95% CI: 3.34-13.84), cabbage consumption (AOR = 2.52; 95% CI: 1.38-4.60) and living with family in a single room (AOR = 2.30; 95% CI: 1.13-4.67) were positively associated with the development of goiter among primary school children in Chole district, eastern Ethiopia. But consuming milk (AOR =0.37; 95% CI: 0.23-0.59) was found to be negatively associated or protective against the development of goiter among the study subjects. CONCLUSIONS: Iodine deficiency was found to be significant public health problem in the study area. Consuming milk was found to be protective, whereas consuming goitrogenic foods like cabbage were found to be the risk factors for the development of goiter among school -aged children. Thus, ensuring the consumption of iodized salt and promoting iodine rich food items among the community in Chole district and other similar settings in Ethiopia are strongly recommended.

Assessment of national tuberculosis and HIV collaborative program implementation status in health care settings of Ethiopia.

BACKGROUND: Ethiopia has adopted the World Health Organization recommendation for TB and HIV collaborative activities since 2004. These collaborative activities have been scaled up in a phased manner and covered large number of health facilities across the nation. However, there is scarcity of information on implementation of these collaborative activities in Ethiopia. OBJECTIVE: To assess the status of implementation of TB and HIV collaborative activities in health facility settings of Ethiopia. METHODS: A cross sectional study mainly quantitative supplemented by qualitative methods was undertaken from May 10 to July 10, 2014 in 132 selected health facilities. Statistical analysis was performed using SPSS version 20. RESULT: About 81% of the respondents in the selected health facilities reported the screening of People Living with HIV in care for TB at every follow up visit, whereas, only 28.7% of those health facilities reported the screening of PLWHIV for TB at enrolment to HIV chronic care. About half of the public health facilities assessed were not implementing Isoniazid Preventive Therapy and only 18.2% of eligible clients were getting this Preventive Therapy. Among the co-infected patients, 32% were not linked to chronic care services and 45.3% were not getting ART during TB treatment. On the other hand, about two thirds of the co-infected patients are getting the Cotrimoxazole Prophylaxis Therapy. CONCLUSION: Most of anti-TB and HIV collaborative activities were not implemented as expected in the health facilities. Thus it needs integration from the ministry to the health facilities level in order to improve the collaborative activities.

Guillain-Barré syndrome in Ethiopian patients.

This is a ten years retrospective study conducted to assess the clinical profile and outcome of Guillain-Barré Syndrome (GBS) in Ethiopian patients. The medical records of all patients admitted with the diagnosis of GBS to the Department of Internal Medicine, Tikur Anbessa University Hospital, Addis Ababa, Ethiopia during the period September 1992 to September 2001 were reviewed. During the ten-year review period ninety-five patients were admitted with the diagnosis of GBS, of which eighty-one met the National Institute of Neurological and Communicative Disorders and Stroke diagnostic criteria. The mean age (SD) of patients was 34.4 +/- 14.4 years. The male to female ratio was 1.25:1. History of antecedent event such as upper respiratory tract infection, diarrhea and vaccination was obtained in 47/81 (58.1%) of patients. The majority of the patients 62 (78.5%), presented with an ascending areflexic quadriparesis while 10 (12.7%) presented with a descending type of arefilexic quadriparesis, but in 6 (7.4%) of the patients the weakness was confined to the lower extremities (i.e. Paraparetic variant). Signs of autonomic involvement were seen in 25/81 (30.9%). Cytoalbzuminological dissociation in the cerebrospinal fluid was demonstrated in 62.3%. EMG was done in 47 patients The commonest electrophysiologic abnormality encountered was demyelinating picture in 26 (55.3%) followed by mixed and axonal in 12 (25.5%) and 9 (19.1%) respectively). Nineteen (70.3% of 27 GBS patients for whom serology for HIV was done were seropositive. The clinical findings were similar in both groups, except for a higher frequency of CSF pleocytosis, need for ventilatory support and mortality among HIV-positive patients. The overall mortality was 25.9%. This study highlights the importance of GBS as a cause of peripheral nerve disease in our setup. The higher mortality rate observed in this study appeared to be related mainly to the lack of adequate intensive carefacility and highlights the need to improve these services. Further-more, the finding of high frequency of seropositivity among GBS patients in this study underlines the need for further prospective research on the association and clinical course of GBS and HIV, particularly in Africa where HIV/AIDS has become an important public health problem.

Barriers to antiretroviral treatment in ethiopia: a qualitative study.

OBJECTIVE: Ethiopia has made meaningful headway in improving access to HIV care and treatment but client attrition remains a daunting challenge. The objective of this study was to describe the major reasons of patient attrition from treatment at hospital and health center levels in Oromia region of Ethiopia. METHODS: This qualitatively designed study was based on semistructured interview with antiretroviral therapy (ART) service providers and focus group discussions with ART clients. The participants were recruited purposively to obtain robust and programmatically important information on in retention HIV care and treatment. FINDINGS: The analysis identified four major themes: antiretroviral (ARV) medications as ''long-term life support,'' free ART as ''expensive,'' regular follow up as ''devotion to a life-long crisis management,'' and expansion of free ART as ''sharing the new hope,'' CONCLUSION: The finding clearly illustrated that while financial constraints and some sociocultural factors impede adherence, disclosure, community support, and decentralization of ART to primary health care units enhance retention in care and treatment.