Assessment of Variation in Clinical Presentation of Visceral Leishmaniasis Among Patients Attending the Tropical Diseases Teaching Hospital in Sudan

Background: Visceral leishmaniasis (also known as Kala-azar) is a systemic parasitic infection with many clinical presentations. The present study assesses the variation in presentations among patients who attended the Tropical Diseases Teaching Hospital (TDTH) in Khartoum, Sudan. Methods: This analytical cross-sectional, hospital-based study was conducted at the TDTH between November 2019 and September 2020. Medical records of patients who presented at the TDTH were reviewed using a structured data extraction checklist. The Chi-square test was used to determine the associations between sociodemographic and clinical presentations of patients. P-value < 0.05 was considered as statistically significant. Results: Out of 195 patients, 79.5% were male and 48.2% were <31 years old. Fever was the main clinical presentation (90.2%) while 53.3% presented with weight loss and 72.3% and 39% presented, respectively, with splenomegaly and hepatomegaly. HIV was detected in 4.6% of the patients. RK39 was the main diagnostic test. We found a significant association between the abdominal distention and the age of the patients (P < 0.05) ­ age groups 11­20 and 41­50 years were more likely to present with abdominal distention than other age groups. Conclusion: There is no exact clinical presentation or routine laboratory findings that are pathognomonic for visceral leishmaniasis; therefore, it should be considered in the differential diagnosis of any patient with fever, weight loss, and abdominal distention, and among patients with HIV.

Pregnant Women's Satisfaction and Comprehension Level of Information Given during HIV Counseling and Testing for PMTCT in Public Health Facilities in Addis Ababa

Background: In Ethiopia PMTCT services began in 2003; but only 0.8of HIV infections among births to HIV positive mothers were averted in 2005/6 through PMTCT. Objective: To determine the pregnant women's satisfaction and comprehension level of the information given during pre- and post- HIV counselling and testing for PMTCT in public health centers in Addis Ababa City. Method: A cross-sectional study was conducted on purposively selected 10 health centers in Addis Ababa from April to May 2008. Data were collected at exit points using a pre-tested structured questionnaire adapted from UNAIDS tools. Descriptive and analytic statistics were computed. Result: Of the 422 women interviewed; 314 (74.6) had discussion on MTCT/PMTCT; and 287 (91.4) of those 314 reported to have comprehended the information. Of the 196 third trimester mothers; 83 (42.3) were counselled on infant feeding options; among whom 59 (71.1) reported to have comprehended the explanations well. Two hundred eighty-eight (68.4) of the 422 clients had held discussions on HIV/AIDS; and 261 (90.6) reported that they had understood the discussions well. The odds of knowing why HCT is offered during pregnancy was higher among clients who spent 5-15 minutes on discussion with their counsellors [OR=2.1; 95CI: 1.03; 4.24]. Conclusion: About 3/4th of the ANC clients were covered with PMTCT counseling in the ANC and the vast majority of the women interviewed reported that they were satisfied with the counselling and counsellors' interactions with them. However; when prompted at the exit points; 21of the mothers didn't know why they were offered HCT particularly during pregnancy

Magnitude and variation of traffic air pollution as measured by CO in the city of Addis Ababa, Ethiopia

Background: Air pollution level in Addis Ababa is presumed to be high due to the prevalence of old vehicles and substandard road infrastructures. This study assessed CO concentration as a measure of traffic air pollution. Materials and methods: a total of 80 road side and 24 on-road daily traffic air samples during wet and dry seasons of 2007 and 2008; respectively; were taken using CO data logger. A structured checklist was used to document related data. Downloaded data from the CO sampler was used to generate summary statistics and data presentations. Data quality of CO measurement was ensured using calibration checks. Results: The mean for 15 minutes CO concentration was 2.1 ppm (GM=1.3) and 2.8 ppm (GM=2.2) for wet and dry seasons; respectively. The concentrations from season to season varied statistically. The CO temporal and spatial profiles among the two seasons were similar. The overall mean on-road CO concentration was 5.4 ppm (GM=5.3). Fifteen percent of roadside samples and all on-road samples exhibited more than 50of the 8-hr CO WHO guideline.. Daily CO maxima were observed in early mornings and late afternoons. Conclusions: The consistency in spatial and temporal profiles and the variation on both on-road and road side traffic lines imply that vehicles are the main source of traffic air pollution. There is a concern that the CO 8-hr World Health Organization guideline might be exceeded in future. [Ethiop. J. Health Dev. 2010;24(3):156-166]

Effectiveness of IEC interventions in reducing HIV/AIDS related stigma among high school adolescents in Hawassa, Southern Ethiopia

Background: Stigma and discrimination are among the major challenges in HIV/AIDS to disease prevention while IEC interventions are among the mechanisms to mitigate them. Objective: To determine the effectiveness of IEC interventions. Methods: Interventional study was conducted from January to March 2007 among high school adolescents in Awassa Town using four different IEC interventions namely; interpersonal communication; pamphlets; educational video and the combination of the three interventions. Results: Stigmatizing attitudes ranged from 0-65.2. Multivariate logistic regression analyses showed grade; religion; beliefs in HIV transmission by witchcraft and HIV transmission by feeding on uncooked egg/meat of chicken that swallowed used condom were independent predictors of avoidant behavioral intentions. Residence; fathers' education;television ownership; witchcraft transmission; healthy looking person can have HIV; HIV prevention by having sex with virgin girls and PLWHA with multiple sexual partners were found to be the main determinants of coercive attitude. ANOVA (F-statistics) revealed that the interventions were effective with and statistics=17.484 (pvalue 0.0001).Conclusion: Misconceptions on HIV transmission and prevention; stigmatizing and discriminatory attitudes were prevalent among the adolescents. Remarkable reduction in HIV related misconceptions; stigmatizing and discriminatory attitudes were observed. Hence; campaigns using combined IEC interventions on HIV/AIDS need to be intensified to dispel some of the prevailing misconceptions and associated stigma and discrimination among school adolescents