Skin problems in children under five years old at a rural hospital in Southern Ethiopia

Objective To examine the prevalence of cutaneous disorders in children under 5 years old who attended a rural hospital in Southern Ethiopia. Methods A prospective cross-sectional study was conducted from January 26 to February 20, 2015 in children under 5 years old who attended Gambo Rural Hospital in West Arsi of the Oromia Region, Ethiopia. Results A total of 324 children were included (59.6% male) whose median age was 16.4 months. In total, 147 children [45.4%; 95% confidence interval (CI): 40.0%–50.8%] under 5 years had a skin problem, of which 101 (68.7%) consulted for that reason. The other 46 (31.3%) consulted for a general health problem and the dermatological condition was a secondary finding during the physical exploration. In 93 children (28.7%; 95% CI: 20%–33.8%), it was the main disease, and in 54 children (16.5%; 95% CI: 13.0%–21.1%) it was concomitant with other diseases. The most common dermatological disease was scabies (n = 44, 13.6%; 95% CI: 10.3%–17.7%). Impetigo was diagnosed in 32 children (9.9%; 95% CI: 7.1%–13.3%), of which 23 (71.9%) had complicated impetigo. Nineteen children (5.9%; 95% CI: 3.8%–9.0%) had eczema, 10 (3.1%) had eczema associated to other conditions. The following most frequent skin problems were tinea (n = 9; 2.8%), infected wound and ulcer (n = 7; 2.2%), and burns (n = 6; 1.9%). Conclusions Skin problems, mainly scabies, impetigo, and eczema were common in young children attended at a rural hospital in Southern Ethiopia. Children under 5 years should be examined thoroughly to rule out skin diseases, especially scabies.

Screening for tuberculosis in family and household contacts in a rural area in Ethiopia over a 20-month period

The purpose of this study is to describe the experience of the completion of the Tuberculosis [TB] Contact Screening Logbook [TB-CSL]. The TB-CSL was retrospectively analyzed from July 2007 until June 2012. During the study period, 122 patients were included in the TB-CSL; however, 17 [13.9%] patients with TB were written in the TB-CSL, but without registering any contacts. Of the 105 TB patients with contacts registered, the family and household contacts were finally performed in 68 index TB patients [55.7% of TB patients]. These 68 index TB cases had 299 family and household contacts; the median contact per patient was 4.4 [+/- 1.9]. Of the 299 contacts, 160 [53.5%] were screened. The median of those screened per patient was 2.3 [+/- 1.9]. Of the 160 family and household contacts screened, 34 [31.3%] of them were children

Management and transference of patients diagnosed with tuberculosis in a rural hospital in southern Ethiopia

Treatment of new tuberculosis [TB] cases in Directly Observed Treatment Short Course [DOTS] programmes is believed to be the most valuable strategy for TB control. The aim of this study is to describe the experience of diagnosed cases of TB in a district hospital situated in a rural zone of Ethiopia and of "transferred out" TB cases from the hospital to their local health facilities using the DOTS programme spanning a period of 8 years. Data collection was obtained by using a TB register book in a rural district hospital from 2004 to 2011. The collected information included the type of TB, age, HIV status, and treatment outcomes using standardized definitions; 6459 patients with all forms of TB were diagnosed. Twenty-eight percent were smear-positive pulmonary TB [PTB] cases, 28.97% were smear-negative PTB cases, and 42.8% were extra-pulmonary TB [EPTB]. The global "transferred out" rate was 78.5% [5073/6459]; the "transferred out" rate after diagnosis at hospital and before starting DOTS was 72.6% [4689/6459], and after finishing the intensive phase and admission was 21.8% [385/1770]. The proportion of total cases "transferred out" in smear-negative PTB cases [70.2%] was less than smear-positive PTB cases [79.2%] [odd ratio [OR]: 0.81; 95% confidence interval [CI]: 0.76-0.87] and was higher in EPTB cases [83.3%] [OR: 1.15; 95% CI: 1.05-1.19]. The percentage of "transferred out" after hospital admission was higher in HIV-positive cases [16.8%] than in HIV-negative cases [8.5%] [OR: 2.13; 95% CI: 1.28-3.53]. In conclusion, district hospitals are still important facilities for the diagnosis of TB cases, particularly EPTB