Surveillance on pediatric bacterial meningitis in Gondar University Hospital, Ethiopia from 2012 to 2021: Retrospective analysis

Introduction: Acute Bacterial meningitis is still a major cause of death in under-five children. Surveillance on Pediatric Bacterial Meningitis has been set up by the World Health Organization to generate data on vaccine preventable causes of Meningitis in under-five children. Ethiopia is one of the countries conducting the surveillance and Gondar University Hospital is one of the sentinel surveillance sites. In this study we described the epidemiological data on Bacterial meningitis in under-five children at Gondar University Hospital from 2012-2021. Methods: Data were extracted directly from Gondar University Hospital surveillance database collected from under-five children admitted to the Hospital with suspected meningitis from January 1st, 2012 to December 31st , 2021. Socio-demographic and clinical characteristics were collected using standard pretested questioners. All under-five children with suspected meningitis over the 10-years period were included and descriptive statistics like frequency, percentage, mean, median and standard deviations were used for the characteristics of under-five Children with Suspected Bacterial Meningitis. Results: In this study, a total of 4311 under-five admitted with suspected bacterial meningitis from 2012 to 2021 were enrolled. The majority, 71% of suspected meningitis were reported in infants. The mortality rate in suspected meningitis during the study period was 1%. The majority (92.4 %) had fever at presentation followed by seizure (62.7 %), altered consciousness (58.9 %) and bulged fontanel in 48.3 %, respectively. The commonest bacteria identified by CSF culture and Polymerase Chain Reaction was Streptococcus pneumonia (SPN). There was a reduction of confirmed meningitis cases from 2012 to 2021 (26 cases in 2012 and 6cases in 2021). Conclusions: Streptococcus pneumoniae was the commonest cause of PBM. Bacterial detection by culture was low which showed that Polymerase Chain Reaction (PCR) test should be encouraged to improve bacterial detection.

Time to Discharge and its Predictors among Children Aged 1-60 Months with Severe Acute Malnutrition Admitted to the Therapeutic Feeding Center in A Tertiary Hospital, North West Ethiopia

BACKGROUND: Standard treatment of severe acute malnutrition with medical complication and/or failed appetite test is admission in therapeutic feeding centers for stabilization. Once stabilized, patients will be linked to Outpatient treatment program for rehabilitation. Information regarding time to discharge from inpatient therapeutic feeding centers is limited in Ethiopia. The main objective of this study was to assess the time to discharge and its predictors among children1-60 months with Severe Acute Malnutrition admitted to University of Gondar Hospital. METHODS: Hospital Based retrospective follow up study was conducted in Gondar University Hospital among 282 children aged 1-60 months admitted to inpatient Therapeutic Feeding Center from June 2018 to December 2020. Participants were selected by Simple random sampling technique. Time to discharge from inpatient treatment was estimated using Kaplan-Meir procedure and Log Rank test was used to test observed difference between covariates. Identification of predictors for time to discharge was done by Stratified cox regression model. RESULTS: Overall 282 children were studied; 242 (85.8%) were discharged improved and 40 (14.2%) were censored. The median time to Discharge was 13 days (IQR: 9-18) and the Incidence of discharge was found to be 6.4 (95% CI: 5.6-7.2) per 100 person- day observations. Kwash-dermatosis (AHR=2.4, 95% CI: 1.17-4.8), Anemia (AHR=1.7, 95% CI: 1.1-2.6), pneumonia at admission (AHR=1.6, 95% CI: 1.01-2.63) and Hospital acquired infection (AHR=4.4, 95% CI: 2.4-8.2) were predictors of time to discharge. CONCLUSION: Hospital stay at the stabilization center was prolonged.Pneumonia, anemia, kwash dermatosis and Nosocomial infections were significant predictors of time to discharge

Survival of HIV/AIDS patients treated under ART follow-up at the University hospital, northwest Ethiopia

INTRODUCTION@#The survival of HIV/AIDS patients on antiretroviral therapy (ART) is determined by a number of factors, including economic, demographic, behavioral, and institutional factors. Understanding the survival time and its trend is crucial to developing policies that will result in changes. The aim of this study was to compare the survival estimates of different subgroups and look into the predictors of HIV/AIDS patient survival.@*METHODS@#A retrospective cohort study of HIV/AIDS patients receiving ART at the University of Gondar teaching hospital was carried out. To compare the survival of various groups, a Kaplan-Meier survival analysis was performed. The Cox proportional hazards model was used to identify factors influencing HIV/AIDS patient survival rates.@*RESULTS@#In the current study, 5.91% of the 354 HIV/AIDS patients under ART follow-up were uncensored or died. Age (HR = 1.051) and lack of formal education (HR = 5.032) were associated with lower survival rate, whereas family size of one to two (HR = 0.167), three to four (HR = 0.120), no alcoholic consumption (HR = 0.294), no smoking and chat use (HR = 0.101), baseline weight (HR = 0.920), current weight (HR = 0.928), baseline CD4 cell count (HR = 0.990), baseline hemoglobin (HR = 0.800), and no TB diseases were associated with longer survival rate.@*CONCLUSIONS@#Fewer deaths were reported in a study area due to high patient adherence, compared to previous similar studies. Age, educational status, family size, alcohol consumption, tobacco and chat usage, baseline and current weight, baseline CD4 cell count, baseline hemoglobin, and tuberculosis (TB) diseases were all significant predictors of survival of HIV/AIDS patients.

Assessment of the availability of essential medicines and inventory control practice at university of Gondar comprehensive specialized hospital, Amhara regional state of Ethiopia: institutional based cross-sectional study design

Background:Assessment of availability of essential medicines is a critical component of universal health coverage and important factor to address patients’ satisfaction and increase their health seeking behavior. Proper inventory management of essential drugs in the health facilities is critical in ensuring availability of essential drugs. The objectives of the study were to assess availability of essential medicines and inventory control practice in university of Gondar comprehensive specialized hospital.Methods:The study was conducted using institution based cross sectional study design from March 10 to April 10, 2019. The data was collected by data abstraction formats and structured observation checklist and data was analyzed by Microsoftoffice excel for the assessment of the essential medicine’s availability and inventory control practices in Gondar university comprehensive specialized hospital.Results:The overall average availability of essential medicines during survey period in Gondar university hospital was 79.17%. The average stock out in the last six months period was 41.67%. The mean duration of stock out of essential medicines of the hospital in the last six months period was 31.7 days and average frequency of stock out was 0.7. The discrepancy between physical count and stock record count of essential medicines ranged from 0% to about 95%.Conclusions:The average availability of essential medicines during data collection period was fairly high. However, the facility was stock out for significant percent of essential medicines over the last six monthsperiod and stock out to lesser extent of percent at the time of survey period

Study on the Prevalence and Economic Significance of Bovine Fasciolosis at Gondar Elfora Abattoir, Gondar, Ethiopia

A cross sectional study was conducted to determine the prevalence and economic significance of bovine fasciolosis at Gondar Elfora abattoir, Gondar Ethiopia from November 2018 to April 2019. A total of 384 cattle were selected by systematic random sampling techniques for postmortem examination at Gondar Elfora abattoir. Out of these 90 (23.4%) cattle were found positive for fasciolosis. The prevalence of fasciolosis in poor body conditioned cattle were known to be 30.8% followed by medium body conditioned (22.7%) and good conditioned animal (15.2%) . Statistical analysis of the data showed the presence of significant difference (P=0.028) on the prevalence of fasciolosis on the basis of body condition score. Higher prevalence of bovine fasciolosis in the study area was observed in older than adult animals 28.7% and 19.5% respectively. There was statistically significant association among age of the animal and prevalence of bovine fasciolosis (P=0.037). The predominant Fasciola species identified was Fasciola hepatica 57 (14.8%) followed by Fasciola gigantica 21 (5.5%) and mixed species (Fasciola hepatica and F. gigantica) 12 (3.1%). The total annual economic loss due to bovine fasciolosis in Gondar Elfora abattoir was calculated as 1,919,640 ETB (65,922 USD). The economic loss due to bovine fasciolosis at the study area showed that fasciolosis is an economically important disease in the Gondar Elfora abattoir. Hence, a combination of anthelminthic and vector control measures have to be used to ensure a satisfactory degree of control in the long run

Violence at work: determinants & prevalence among health care workers, northwest Ethiopia: an institutional based cross sectional study

BACKGROUND: Workplace violence is the intentional use of power, threatened or actual, against another person or against a group, in work-related circumstances, that either results in or has a high degree of likelihood of resulting in injury, death, psychological harm, mal development, or deprivation. The aim of this study is to assess magnitude and predictors of workplace violence among healthcare workers in health facilities of Gondar city. METHODS: Institutional based cross sectional study design was employed to conduct this study. The study conducted in Gondar town from February 21 to march 21, 2016. Five hundred fifty three health care workers selected from health facilities of Gondar City administration. A stratified sampling technique was used for selecting the study subjects through simple random sampling. Data was collected by structured self administered questionnaire which is adapted from ILO/ICN/WHO/PSI after it is pretested & prepared in Amharic. The data was coded and entered in to EPI info version 7 and exported to SPSS version 20 software for analysis. The degree of association for variables was assessed using odds ratios with 95% confidence interval and p-value ≤0.05. RESULTS: The prevalence of workplace violence was found to be 58.2% with [95% confidence interval (CI): (53.7, 62.3)] in which verbal abuse 282(53.1%) followed by physical attack 117(22.0%) and 38(7.2%) sexual harassment. Working at emergency departments [AOR = 3.99,95% CI:(1.49,10.73)], working at shifts [AOR = 1.98,95%, CI: (1.28,3.03)],short experiences [AOR = 3.09,95% CI: (1.20,7.98)], being nurse or midwife [AOR = 4.06, 95% CI: (1.20,13.74)] were positively associated with workplace violence. The main sources of violence are visitors/patient relatives followed by colleagues and patients. CONCLUSION: workplace violence is major public health problem across health facilities and the Ministry of Health should incorporate interventions in its different health sector development & management safety initiative.

The impact of work-related risk factors on the development of neck and upper limb pain among low wage hotel housekeepers in Gondar town, Northwest Ethiopia: institution-based cross-sectional study

BACKGROUND@#Musculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers.@*METHODS@#Institution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05.@*RESULTS@#The overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders.@*CONCLUSIONS@#A higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers.

Sick building syndrome and associated risk factors among the population of Gondar town, northwest Ethiopia

BACKGROUND@#Sick building syndrome (SBS) consists of a group of mucosal, skin, and general symptoms temporally related to residential and office buildings of unclear causes. These symptoms are common in the general population. However, SBS symptoms and their contributing factors are poorly understood, and the community associates it with bad sprits. This community-based cross-sectional study was, therefore, conducted to assess the prevalence and associated factors of SBS in Gondar town.@*METHODS@#A community-based cross-sectional study was conducted from March to April 2017. A total of 3405 study subjects were included using multistage and systematic random sampling techniques. A structured questionnaire and observational checklists were used to collect data. SBS was assessed by 24 building-related symptoms and confirmed by five SBS confirmation criteria. Multivariable binary logistic regression analysis was used to identify factors associated with SBS on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. The Hosmer and Lemeshow goodness of fit test was used to check model fitness, and variance inflation factor (VIF) was also used to test interactions between variables.@*RESULTS@#The prevalence of SBS in Gondar town was 21.7% (95% CI = 20.3-23.0%). Of this, the mucosal symptoms account for 64%, the general symptoms account for 54%, and the skin symptoms account for 10%. From study participants who reported SBS symptoms, 44% had more than one symptom. Headache (15.7%), asthma (8.3%), rhinitis (8.0%), and dizziness (7.5%) were the commonest reported symptoms. SBS was significantly associated with fungal growth in the building [AOR = 1.25, 95% CI = (1.05, 1.49)], unclean building [AOR = 1.26, 95% CI = (1.03, 1.55)], houses with no functional windows [AOR = 1.35, 95% CI = (1.12, 1.63)], houses with no fan [AOR = 1.90, 95% CI = (1.22, 2.96)], utilization of charcoal as a cooking energy source [AOR = 1.40, 95% CI = (1.02, 1.91)], cooking inside the living quarters [AOR = 1.31, 95% CI = (1.09, 1.58)], and incensing and joss stick use [AOR = 1.48, 95% CI = (1.23, 1.77)].@*CONCLUSION@#The prevalence of SBS in Gondar town was high, and significant proportion of the population had more than one SBS symptom. Headache, asthma, rhinitis, and dizziness were the commonest reported SBS symptoms. Fungal growth, cleanliness of the building, availability of functional windows, availability of fan in the living quarters, using charcoal as a cooking energy source, cooking inside the quarters, and incensing habit or joss stick use were identified as factors associated with SBS. Improving the sanitation of the living environment and housekeeping practices of the occupants is useful to minimize the prevalence of SBS.

Prevalence of smear positive pulmonary tuberculosis in Gondar prisoners, North West Ethiopia

Objective: To assess the prevalence and risk factors of smear positive pulmonary tuberculosis among Gondar town prisoners, North West Ethiopia. Methods: A cross sectional study was conducted from February to July, 2008 in Gondar Prison. Prisoners with cough duration of more than two weeks were involved in the study by giving three sputum samples and filling the questionnaires prepared for risk factor assessment. Acid fast staining technique was employed to detect the presence of the Mycobacterium tuberculosis bacilli in the sputum samples. Data was analyzed using SPSS version13 computer software and presented in table. Chi-square test was used to assess associations and a P-value less than 0.05 was taken as significant. Results: A total of 384 prisoners, 349 male and 35 females, with a mean age of 33.3 years were involved in the study. The prevalence of smear positive pulmonary tuberculosis among those prisoners with cough duration of more than two weeks was 8.59%. Only the length of imprisonment had a significant association (χ 2= 18.82, P-value<0.0001) with the prevalence of tuberculosis. Conclusions: This study indicated that tuberculosis among prisoners with cough duration of more than two weeks in Gondar prison is very high. Therefore Periodic screening of the prisoners and screening of newly introduced prisoners should be practiced so as to minimize the burden of tuberculosis in prisoners.

Prevalence of smear positive pulmonary tuberculosis in Gondar prisoners, North West Ethiopia

OBJECTIVE@#To assess the prevalence and risk factors of smear positive pulmonary tuberculosis among Gondar town prisoners, North West Ethiopia.@*METHODS@#A cross sectional study was conducted from February to July, 2008 in Gondar Prison. Prisoners with cough duration of more than two weeks were involved in the study by giving three sputum samples and filling the questionnaires prepared for risk factor assessment. Acid fast staining technique was employed to detect the presence of the Mycobacterium tuberculosis bacilli in the sputum samples. Data was analyzed using SPSS version13 computer software and presented in table. Chi-square test was used to assess associations and a P-value less than 0.05 was taken as significant.@*RESULTS@#A total of 384 prisoners, 349 male and 35 females, with a mean age of 33.3 years were involved in the study. The prevalence of smear positive pulmonary tuberculosis among those prisoners with cough duration of more than two weeks was 8.59%. Only the length of imprisonment had a significant association (χ (2)= 18.82, P-value<0.0001) with the prevalence of tuberculosis.@*CONCLUSIONS@#This study indicated that tuberculosis among prisoners with cough duration of more than two weeks in Gondar prison is very high. Therefore Periodic screening of the prisoners and screening of newly introduced prisoners should be practiced so as to minimize the burden of tuberculosis in prisoners.

Prevalence of smear positive pulmonary tuberculosis in Gondar prisoners, North West Ethiopia

Objective:To assess the prevalence and risk factors of smear positive pulmonary tuberculosis amongGondar town prisoners,NorthWestEthiopia.Methods:A cross sectional study was conducted fromFebruary toJuly,2008 inGondarPrison.Prisoners with cough duration of more than two weeks were involved in the study by giving three sputum samples and filling the questionnaires prepared for risk factor assessment.Acid fast staining technique was employed to detect the presence of theMycobacterium tuberculosis bacilli in the sputum samples.Data was analyzed usingSPSS version13 computer software and presented in table.Chi-square test was used to assess associations and aP-value less than0.05 was taken as significant.Results:A total of384 prisoners,349 male and35 females, with a mean age of33.3 years were involved in the study.The prevalence of smear positive pulmonary tuberculosis among those prisoners with cough duration of more than two weeks was8.59%.Only the length of imprisonment had a significant association(χ2=18.82,P-value<0.0001) with the prevalence of tuberculosis. Conclusions:This study indicated that tuberculosis among prisoners with cough duration of more than two weeks inGondar prison is very high.ThereforePeriodic screening of the prisoners and screening of newly introduced prisoners should be practiced so as to minimize the burden of tuberculosis in prisoners.

Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

Objective:To assess the magnitude and antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates from various clinical specimens. Methods:A record based on retrospective study was conducted at Gondar University Teaching Hospital from September 2007 to January 2012. All patients who visited Gondar University Hospital and provided clinical specimens (body fluids, discharge, swab and blood) for routine bacteriological culturing and antimicrobial susceptibility testing were taken for analysis. Clinical specimens were processed for bacterial culture according to the standard procedures. Antimicrobial susceptibility test for isolated organisms was done using agar disk diffusion method. The data were entered and analyzed using SPSS software version 16 package. Results: One hundred and fifty three Streptococcus pneumoniae were isolated from patients who visited Gondar University Teaching Hospital bacteriology laboratory for culture. Majority of the pneumococcal isolates were from inpatients [111(72.5%)], and 74(48.4%) were from body fluids. Out of the total isolates, 93(61%) were found to be resistant to at least one antibiotic used for susceptibility testing. Forty eight (43.2%) of the isolates were multi-drug resistant (resistant to two or more drugs). The resistance rate noted for both ciprofloxacin 17(11.1%) and ceftriaxone 15(9.8%) were alarming. Conclusions: High proportions of the isolates tend to be increasingly resistant to the commonly prescribed drugs. The recommended drug of choice like ciprofloxacin and ceftriaxone were found to be less susceptible in the study area. Based on the findings, we therefore recommend that antimicrobial agents should be inspected for acceptable activity before they are prescribed and administered empirically. Further study with a better design and survey of antimicrobial susceptibility at large scale shoule be performed to draw advanced information.