Incidence of lost to follow up among HIV-positive children on antiretroviral therapy in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: At the end of 2022, globally, only 46% of children (aged 0-14 years) on ART had suppressed viral loads. Viral load suppression is crucial to reduce HIV-related deaths. To suppress the viral load at the expected level, children must be retained in ART treatment. Nevertheless, lost to follow-up from ART treatment continues to be a global challenge, particularly, in developing countries. Previously, primary studies were conducted in Ethiopia to assess the incidence of lost to follow-up among HIV-positive children on ART treatment. However, variations have been seen among the studies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled incidence of lost to follow-up among HIV-positive children on ART and identify its associated factors in Ethiopia. METHODS: We searched PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online to obtain articles published up to November 20, 2023. Critical appraisal was done using the Joanna Briggs Institute checklist. Heterogeneity was identified using I-square statistics. Funnel plot and Egger's tests were used to identify publication bias. Data was presented using forest plots and tables. Random and fixed-effect models were used to compute the pooled estimate. RESULTS: Twenty-four studies were included in the final analysis. The pooled incidence of lost to follow-up among HIV-positive children on ART was 2.79 (95% CI: 1.99, 3.91) per 100-child-year observations. Advanced HIV disease (HR: 2.20, 95% CI: 1.71, 2.73), having opportunistic infection (HR: 2.59, 95% CI: 1.39; 4.78), fair or poor ART treatment adherence (HR: 2.92, 95% CI: 1.31; 6.54) and children aged between 1-5 years (HR: 2.1,95% CI: 1.44; 2.95) were factors associated with lost to follow up among HIV positive children on ART. CONCLUSIONS: The overall pooled incidence of lost to follow-up among HIV-positive children on ART is low in Ethiopia. Therefore, counseling on ART drug adherence should be strengthened. Moreover, emphasis has to be given to children with advanced HIV stage and opportunistic infection to reduce the rate of lost to follow up among HIV-positive children on ART. TRIAL REGISTRATION: Registered in PROSPERO with ID: CRD42024501071.

Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.

Background: Diabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus. Methods: Articles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author's name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins' I2 statistics. Egger's test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect. Results: Initially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and -0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, -1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: -0.99, basophils: 0.34, lymphocytes: -0.19 and monocyte: -0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were -0.10, -0.69, 0.19, and -0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: -0.57 (106/µL), Hb: -0.73 g/dL and HCT: -1.22%, Where as in T1DM RBC, Hb and HCT were -1.23 (106/µL), -0.80 g/dL and -0.29%, respectively. Conclusion: Patients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters. Systematic review registration: https://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].

Prevalence and associated factors of prediabetes in adult East African population: A systematic review and meta-analysis.

Introduction: Diabetes mellitus is a major public health problem with serious consequences, and more than three-fourths of diabetes live in low- and middle-income countries. According to a recent study, people with prediabetes have nearly six times the risk of developing diabetes than those with normal glucose levels. However, due to the inconsistency and absence of representative data, this study aimed to estimate the prevalence of prediabetes and its associated factors in the adult East African population. Methods: Databases were systematically searched for articles published between January 1, 2013, and December 30, 2022. All observational community-based studies that reported prediabetes prevalence and/or associated factors in adult East African populations were included in the meta-analyses. Three authors independently extracted all required data using the Excel data extraction format and analyzed using Stata™ Version 11. An I2 test was conducted to determine significant heterogeneity. Finally, a random effects model was used to determine the overall prevalence of prediabetes and its associated factors. The study was registered with Prospero number CRD42023389745. Results: The search strategy identified 267 articles. After screening for full-text review, twenty-one articles were included in the final analysis. The overall prevalence of prediabetes was 12.58 % (95 % CI:10.30, 14.86 %) in the adult East African population. Furthermore, the subgroup analysis revealed that prediabetes in the urban population 20 % (95 % CI: 1.60, 38.37) was twice as prevalent as in rural 10.0 % (95 % CI: 5.52, 14.48) populations. The prevalence of prediabetes by the ADA diagnostic criteria was 21.45 % (95 % CI: 15.54, 27.35) three times higher than the WHO 7.20 % (95 % CI: 5.70, 8.69). Moreover, prediabetes was significantly associated with old age (OR = 1.64, 95 %, CI: 1.07, 2.53), hypertension (OR = 2.43, 95 %, CI: 1.02-5.79), obesity and overweight (OR = 1.70, 95 %, CI: 1.09,2.65). Conclusion: This study showed a high prevalence of prediabetes, which was significantly associated with old age, hypertension, and high BMI. This study suggests that health policymakers should pay attention to the prevention and control strategies that is targeted at those with obesity, hypertension, and old age.

Prevalence and Associated Risk Factors of Intestinal Parasites among Children under Five Years of Age Attended at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia: A Cross-Sectional Study.

Background: In regions of the world with low resources, such as Ethiopia, intestinal parasite diseases are still highly prevalent, especially in children. Poor personal and environmental hygiene, as well as unsafe and low-quality drinking water, are the main causes of this. This investigation aimed to determine the frequency of intestinal parasites and risk factors among children under 5 years age at Bachuma Primary Hospital in 2022. Materials and Methods: : A cross-sectional study was carried out from October 2022 to December 2022 at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia. Stool sample was collected from randomly selected children who were ordered to have their stool examined at the hospital laboratory and wet mount was prepared using normal saline to detect the different stage of intestinal parasites microscopically. Moreover, data related to the sociodemographic and associated risk factors was collected using a structured questionnaire. Descriptive statistics were computed to describe the characteristics of the study participants and determine the prevalence of intestinal parasites. Data were entered into Epi-data manager and analysed using statistical packages for social sciences (SPSS) version 25.0, respectively. Bivariate and multivariate logistic regression analyses were performed, with variables with a p value of <0.05 considered statistically significant. Result: : Infection with at least one intestinal parasite among children was 29.4% (95% CI: 24.5-34.7). Ascaris lumbricoide and Giardia lamblia were responsible for 8% (26/323) and 4% (13/323) of the prevalence of helminth and protozoans, respectively. A multivariate logistic regression analysis revealed that children whose residence was rural had an adjusted odds ratio (AOR) of 5.048 (p=0.001), those who did not wash their hands before meals had an AOR of 7.749 (p=0.001), a child with not trimmed fingernails had an AOR of 2.752 (p=0.010), a child who frequently experienced stomach pain and whose source of water was pond had an AOR of 2.415 (p=0.028) and 3.796 (p=0.040), respectively. Conclusion: In this study, the prevalence of intestinal parasites recorded was low. Rural residency, absence of child hand washing practice before meal, and not trimming fingernail were among factors significantly associated with intestinal parasite infection.

Dyslipidemia and Its Associated Factors Among Helicobacter pylori-Infected Patients Attending at University of Gondar Comprehensive Specialized Hospital, Gondar, North-West Ethiopia: A Comparative Cross-Sectional Study.

Background: Dyslipidemia refers to a lipid profile disturbance due to decreased high-density lipoprotein cholesterol and elevated low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Helicobacter pylori infection can lead to some appetite-related disorders that may cause deregulated absorption of nutrients in the digestive system, contributing to changes in serum lipids. The purpose of this study is to assess dyslipidemia and its associated factors among H. pylori-infected patients attending at University of Gondar Comprehensive Specialized Hospital. Methods: A comparative cross-sectional study was conducted on 231 H. pylori-positive and control groups, which were included by the convenience sampling technique from March to May 2021 at University of Gondar Specialized Hospital. Sociodemographic and behavioral characteristic data were collected using a pretested questionnaire, and 5mL of venous blood were used to determine the lipid profiles using DxC 700 AU chemistry analyzer. The data were analyzed using SPSS version 25. Mann-Whitney U-test and multivariable logistic regression were applied, and P-value <0.05 is considered statistically significant. Results: The magnitude of dyslipidemia among H. pylori-infected patients was 71.8% (95% CI: 62.7-79.7). There was a statistically significant difference in lipid profiles between H. pylori-infected patients and control groups. The median (IQR) of lipid profiles in H. pylori-infected patients and control groups were for low-density lipoprotein: 108 (89.8, 145.5) vs 95 (79.45, 115.8, P<0.001), for triglycerides: 93 (65,117) vs 83 (58.5, 102, P=0.031), and cholesterol: 143 (119.5, 169,) vs 125 (110,143, P<0.001) mg/dl, respectively. Helicobacter pylori infection, alcohol drinking, unable to read and write, primary school, and secondary school were a significant associated variables with dyslipidemia (P<0.05). Conclusion: There was a median lipid profile statistically significant difference between H. pylori-positive and control groups. Helicobacter pylori infection, educational status, and alcohol drinking habit had statistically significant association with dyslipidemia.

Trend Analysis and Forecasting the Spread of COVID-19 Pandemic in Ethiopia Using Box-Jenkins Modeling Procedure.

INTRODUCTION: COVID-19, which causes severe acute respiratory syndrome, is spreading rapidly across the world, and the severity of this pandemic is rising in Ethiopia. The main objective of the study was to analyze the trend and forecast the spread of COVID-19 and to develop an appropriate statistical forecast model. METHODOLOGY: Data on the daily spread between 13 March, 2020 and 31 August 2020 were collected for the development of the autoregressive integrated moving average (ARIMA) model. Stationarity testing, parameter testing and model diagnosis were performed. In addition, candidate models were obtained using autocorrelation function (ACF) and partial autocorrelation functions (PACF). Finally, the fitting, selection and prediction accuracy of the ARIMA models was evaluated using the RMSE and MAPE model selection criteria. RESULTS: A total of 51,910 confirmed COVID-19 cases were reported from 13 March to 31 August 2020. The total recovered and death rates as of 31 August 2020 were 37.2% and 1.57%, respectively, with a high level of increase after the mid of August, 2020. In this study, ARIMA (0, 1, 5) and ARIMA (2, 1, 3) were finally confirmed as the optimal model for confirmed and recovered COVID-19 cases, respectively, based on lowest RMSE, MAPE and BIC values. The ARIMA model was also used to identify the COVID-19 trend and showed an increasing pattern on a daily basis in the number of confirmed and recovered cases. In addition, the 60-day forecast showed a steep upward trend in confirmed cases and recovered cases of COVID-19 in Ethiopia. CONCLUSION: Forecasts show that confirmed and recovered COVID-19 cases in Ethiopia will increase on a daily basis for the next 60 days. The findings can be used as a decision-making tool to implement health interventions and reduce the spread of COVID-19 infection.

Depression, Anxiety, and Stress Symptoms and Its Associated Factors Among Residents of Gondar Town During the Early Stage of COVID-19 Pandemic.

PURPOSE: An acute respiratory disease caused by the novel coronavirus disease (COVID) was identified in late 2019. COVID-19 triggered a wide range of psychological problems, such as anxiety, depression, and stress. However, studies on mental health status in developing countries including Ethiopia related to COVID-19 are very limited. Therefore, this study was aimed at determining the magnitude of depression, anxiety, and stress, and their associated factors among Gondar town population during the early stage of the COVID-19 pandemic. PATIENTS AND METHODS: A community-based cross-sectional study was conducted among 660 residents of Gondar town in April 2020. A multi-stage sampling technique was employed to select study participants. A 21 item depression, anxiety, and stress scale (DASS-21) was used. Variables with a p-value <0.05 in the final model were declared as statistically significant. Hosmer and Lemeshow goodness of fit test was used to check the model fitness. RESULTS: In this study, the prevalence of depression was 32.0% (95% CI: 28.4-35.5), anxiety 25.8% (95% CI: 22.4-29.1), and stress 14.7% (95% CI: 12.0-17.4), respectively. The odds of developing depression was higher among female respondents (AOR=2.30, 95% CI: 1.01, 3.83) and ever smokers (AOR=2.8, 95 CI: 1.23, 6.28) as compared to their counterparts. Besides, history of medical illness and ever smoking increase the odds of anxiety by 2.3 (AOR=2.3; 95% CI: 1.42-3.76), and 2.8 (AOR=2.8; 95% CI: 1.23-3.83), respectively. Furthermore, being unemployed and family size of <5 increase the odds of stress by 2.1 (AOR=2.1; 95% CI: 1.17-3.83) and 1.8 (AOR=1.8; 95% CI: 1.09-2.81), respectively. CONCLUSION: In this study, the overall depression, anxiety, and stress were significantly high. There are number of factors associated with depression, anxiety, and stress. Designing and implementing tailored strategies for COVID-19 prevention and control could be supremely important to reduce mental health problems in the community.

Total Clinical Chemistry Laboratory Errors and Evaluation of the Analytical Quality Control Using Sigma Metric for Routine Clinical Chemistry Tests.

BACKGROUND: Currently, the use of clinical laboratory tests is growing at a promising rate and about 80% of the clinical decisions made are based on the laboratory test results. Therefore, it is a major task to achieve quality service. This study was conducted to assess the magnitude of errors in the total testing process of Clinical Chemistry Laboratory and to evaluate analytical quality control using sigma metrics. METHODS: A cross-sectional study was conducted at Dessie Comprehensive Specialized Hospital Clinical Chemistry Laboratory, Northeast Ethiopia, from 10 February 2020 to 10 June 2020. All Clinical Chemistry Laboratory test requests with their respective samples, external quality control and all daily internal quality control data during the study period were included in the study. Data were collected using a prepared checklist and analyzed using SPSS version 21. RESULTS: A total of 4719 blood samples with their test requests were included in the study. Out of 145,383 quality indicators, an error rate of 22,301 (15.3%) was identified in the total testing process. Of the total errors, 76.3% were pre-analytical, 2.1% were analytical and 21.6% were post-analytical errors (p<0.0001). Of the total 14 analytes in the sigma metric evaluation, except ALP, all routine clinical chemistry tests were below the standard (<3). In multivariate logistic regression, the location of patients in the inpatient department was significantly associated with the specimen rejection ((AOR=1.837, 95% CI (1.288-2.618), p=0.001). CONCLUSION: The study found a higher frequency of errors in the total testing process in the Clinical Chemistry Laboratory and almost all test parameters had an unsatisfactory sigma metric value.

Extra-Analytical Clinical Laboratory Errors in Africa: A Systematic Review and Meta-Analysis.

BACKGROUND: Clinical laboratory testing is a highly complex process involving a different procedure. Laboratory errors may occur at any stage of the test process, but most errors occur during extra-analytical phases. The magnitude of clinical laboratory errors, in particular extra-analytical errors, was inconsistent in different studies. METHODS: A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The extracted data were entered into a Microsoft Excel spreadsheet and transferred to STATA version 11 for the analysis. Random effect model was used to estimate pooled prevalence of extra-clinical laboratory errors and I2 statistic was used to assess heterogeneity between the studies. Funnel plot analysis and Egger weighted regression test were performed to detect the publication bias. Egger weighted regression test with P-value <0.05 was considered to be a statistically significant publication bias. RESULTS: A total of 1,381 studies were searched, 19 were included in this systematic review and meta-analysis. A total of 621,507 pre-analytical and 51,859 post-analytical outcomes of quality indicators were reported. A total of 145,515 samples were assessed for rejection and 62,513 laboratory requests were evaluated for incompleteness. The pooled prevalence of pre-analytical and post-analytical errors in Africa was 17.5% (95% Cl: 11.55, 23.45) and 10.99% (95% Cl: 5.30, 16.67) respectively. The pooled prevalence of specimen rejection and laboratory request forms incompleteness in Africa was 2.0% (95% Cl: 0.86, 3.14) and 7.55% (95% Cl: 2.30, 12.80) respectively. CONCLUSION: The study found high prevalence of pre- and of post-analytical clinical laboratory errors in Africa. In addition, the study showed that the standard completion of the laboratory request forms was poor and there were significant numbers of specimen rejections. Therefore, clinical laboratories should ensure compliance with standard operating procedures, the laboratory information system, the cooperation of the entire staff and the targeted training of sample collectors.

Knowledge, Attitudes and Practices Toward Prevention and Early Detection of COVID-19 and Associated Factors Among Religious Clerics and Traditional Healers in Gondar Town, Northwest Ethiopia: A Community-Based Study.

BACKGROUND: COVID-19 control measures efforts are affected by the knowledge, attitudes, and practices of the public, particularly religious clerics and traditional healers, who have close contact and are widely accepted by a significant number of community members. METHODS: A community-based cross-sectional study was conducted to determine knowledge, attitudes and practices towards COVID-19 and its associated factors among religious clerics and traditional healers in Gondar town. Study participants who met our inclusion criteria were selected using a simple random sampling technique. Data were collected by trained data collectors through face-to-face interviews. The reliability of the questionnaire was assessed using Cronbach's alpha. Knowledge, attitudes and practices scores were calculated to give the overall knowledge, attitude and practice score. Binary logistic regression was fitted to identify associated factors and odds ratio was used to measure the strength of the association. RESULTS: A total of 410 religious clerics and traditional healers were included in the study with a response rate of 97.1%. Of the total participants, 60.7% (95%: CI (56-65%)) had good knowledge, 34.1% (95%: CI (30-39%)) had a positive attitude and 15.6% (95%: CI (12-19%)) had good practices towards prevention and early detection of COVID-19. Less than one third of the participants practiced physical distancing (28%) and facemask use (17.8%). In multivariate logistic regression, age, educational status and marital status were significantly associated with knowledge score. Likewise, age and marital status were significantly associated with the positive attitude score. In addition, age, educational status, and the presence of underlying disease were significantly associated with the good practice score. CONCLUSION: Majority of the participants had poor practice and negative attitudes. Therefore, there should be a sensitization program to fill the gap in the knowledge, attitudes and practice measures of COVID-19 especially for elderly and illiterates.

Knowledge and Practices towards Prevention and Early Detection of Chronic Kidney Disease and Associated Factors among Hypertensive Patients in Gondar Town, North West Ethiopia.

BACKGROUND: Chronic kidney disease is a global health problem with serious adverse effects, including kidney failure, cardiovascular disease, and premature death. Improving awareness and practice on the impact, prevention, and early detection of chronic kidney disease will reduce the significant economic and public health burden. METHODS: A cross-sectional study was conducted to determine knowledge and practice towards prevention and early detection of chronic kidney disease and its associated factors among hypertensive patients in Gondar town in 2019. The study included hypertensive patients visiting health institutions from February to March 2019. Data was collected using a semistructured questionnaire and individuals who fulfilled our inclusion criteria were selected using a systemic random sampling technique. Epi Info software version 7 was used for data entry, and SPSS version 20 was used for descriptive and logistic regression analysis. RESULT: Out of a total of 442 participants, 434 completed the questionnaire, with a response rate of 98.1%. Of the total, 298 (68.7%) had good knowledge of chronic kidney disease with a mean knowledge score of 8.78 ± 2.80 and 210 (48.4%) had good practice with mean practice score of 6.58 ± 1.61. Educational status, residence, and duration of hypertension were significantly associated with the knowledge and practice scores of the participants in the multivariate logistic regression analysis. CONCLUSION: More than half of the participants had good knowledge about chronic kidney disease and its risk factors. However, the level of preventive practice among participants was low. The educational status, residence, and duration of hypertension were significantly associated variables with knowledge and practice scores in multivariate logistic regression.

Gonadal and Cortisol Hormone Profile among Male Chronic Khat, Marijuana, and Heroin Abuses.

BACKGROUND: Drugs of abuse could interfere with the hypothalamic-pituitary-gonadal axis, causing impaired functions of the gland and associated functions of target organs. Drugs of abuse tend to cause changes in the endocrine system, and these changes could be physiological, molecular, biochemical, genetic, and cellular. METHOD: A case-control study design was conducted from a total of 171 male consented study participants (148 drug abusers and 23 controls). The serum gonadal and cortisol hormone levels were assayed using the electrochemiluminescence immunoassay method. Socio-demographic variables were collected using a semi-structured questionnaire by the interview method. Nonparametric statistical tools (Mann-Whitney test and median) were used to compare the groups. In all cases, P < 0.05 was considered statistically significant. RESULT: The median age for drug abusers and control groups was 27, and the age difference between drug abusers and control group was not statistically important. The median estradiol levels among chronic khat chewers (39.4 pg/ml), marijuana (44 pg/mL), and users of heroin (40.2 pg/mL) were significantly higher than control groups (23 pg/mL), P < 0.003. However, the median luteinizing hormone levels among chronic khat chewers (5 IU/L), marijuana users (5 IU/L), and heroin users (5.6 IU/L) were significantly lower than those of control groups (6.2 IU/L), P < 0.02. The median testosterone levels among chronic khat chewers (6.1 ng/mL), marijuana users (6.3 ng/mL), and heroin users (6.6 ng/mL) were significantly lower than control groups (8.0 ng/mL), P < 0.003. However, cortisol and follicle stimulating hormone did not show statistically significant difference between users of khat, marijuana, and heroin compared with the control group. CONCLUSION: The drug abuser group had significantly lower testosterone and luteinizing hormone levels compared with control groups. Drug abuse has been shown to affect gonadal hormones in an unusual physiological phenomenon. These findings reveal the need for intervention programs to solve these problems.

Thyroid Dysfunction and Cytological Patterns among Patients Requested for Thyroid Function Test in an Endemic Goiter Area of Gondar, North West Ethiopia.

BACKGROUND: Thyroid dysfunction is the most common endocrine disorder in clinical practice, and about half of the population with thyroid dysfunction remains undiagnosed. There is a fairly wide spectrum of thyroid dysfunction, which can be identified by patterns of thyroid function test results. The prevalence of thyroid dysfunction among the population varies in different studies. METHODS: A cross-sectional study was conducted from February 8th to April 8th, 2017, among patients who requested for the thyroid function test in an endemic goiter area at the Gondar Hospital, University of Gondar. A pretested structured questionnaire was used to collect the data. Three milliliters of blood samples was collected in a plain test tube and centrifuged for serum separation. The thyroid function test was done by using the MINI-VIDAS automation following the manufacturer manual (Setema PLC, Italy). Data were entered and analyzed using SPSS version 20. Descriptive statistics were used for data presentation, and P value < 0.05 was considered significant. RESULT: Of the total 384 study participants, 346 (90.1%) were females and the study participants' mean age was 38 ± 13.9 years. The overall thyroid dysfunction prevalence was 26.3% (101): 1.6% was identified as subclinical hypothyroidism, 0.5% hypothyroidism, 9.6% subclinical hyperthyroidism, and 14.6% hyperthyroidism, and 23.4% had goiter. Furthermore, for cytological pattern analysis, 144 study participants who fulfilled indications for fine-needle aspiration cytology (FNAC) in thyroid nodules were included. Of the total, 3 (2.1%) had thyroid carcinoma, 46 (32%) had cystic degenerated follicular cells, and 82 (57%) had nodular thyroid goiter. In addition, a clinical presentation of a total of 144 study participants, showed lymphadenites in 7 participants (4.8%), hypertension in 9 (6.2%), and cardiac failure in 12 (8.3%). CONCLUSION: The prevalence of thyroid dysfunction was high. The majority of thyroid dysfunction cases were newly diagnosed and more common in females. In addition, the most common disorders were subclinical hyperthyroidism and hyperthyroidism. Follicular cell with cyst degeneration and thyroid nodular goiter were the predominant FNAC findings. For early diagnosis and appropriate intervention in goiter endemic areas, the thyroid function test should be closely monitored.

The Burden of Undiagnosed Diabetes Mellitus in Adult African Population: A Systematic Review and Meta-Analysis.

BACKGROUND: The prevalence of diabetes is rapidly increasing in Africa. Type two diabetes may remain undetected for many years, leading to severe complications and healthcare costs. This underlines the importance of understanding the magnitude of undiagnosed diabetes in different populations of Africa. This study is intended to summarize and pool the results of community-based studies to provide a continental level estimate of the undiagnosed diabetes mellitus. METHODS: We searched MEDLINE/PubMed, HINARI, Cochrane Library, and Google Scholar for community-based studies on diabetes mellitus in Africa. Descriptive information for the original studies was presented in a table, and the quantitative results were presented in forest plots. The Cochran's Q test and I 2 test statistic were used to test heterogeneity across studies. The pooled prevalence of undiagnosed diabetes and subgroup analyses within urban and rural population and diagnostic methods were computed by a random effects model from 2011 to 2017. RESULTS: One hundred fifty-seven articles were identified through electronic searching using keywords. Of these, seventeen studies, with a total population of 20,350, met the inclusion criteria. A random effects meta-analysis showed that the pooled prevalence of undiagnosed diabetes mellitus in African population was 5.37% (95% CI: 4.57, 6.81). The pooled prevalence from subgroup analyses indicated that undiagnosed diabetes mellitus in the urban population (8.68%, 95% CI: 5.33, 12.03) is twice higher than that in the rural population (3.93%, 95% CI: 2.91, 4.95). The prevalence of UDM by OGTT (8.84%, 95% CI: 1.95, 15.73) was higher than that by the FPG diagnostic method (4.54%, 95% CI: 3.59, 5.49). CONCLUSION: This study found high proportions of undiagnosed diabetes mellitus in different communities of the African countries. Policy makers must consider diagnostic strategies to improve screening for the undiagnosed diabetes mellitus cases for effective care, which can bring about a substantial reduction in diabetes-related complications and mortality. This review is registered with PROSPERO registration number CRD42018092637.

The Prevalence of Malaria among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: Malaria during pregnancy remains a major public health concern in tropical and subtropical countries. Moreover, malaria is increasingly associated with unwanted pregnancy outcomes such as an increased risk of abortion, stillbirth, premature delivery, and low-birthweight infants. Since pregnant women are most vulnerable to malaria, implementation of the appropriate prevention and control measures among this group is very important. Therefore, the current review was designed to assess the prevalence of both symptomatic and asymptomatic malaria among pregnant women in Ethiopia. METHOD: In this systematic review and meta-analysis we have followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The databases used were PubMed, Google Scholar, HINARI, and Science Direct literature. Search terms used were "prevalence", "malaria", "pregnant women", and "Ethiopia". Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled meta-logistic regression was computed to present the pooled prevalence with a 95% confidence interval (CI). RESULT: Among a total of 10207 studies, seven studies were included in this analysis. The estimated pooled prevalence of malaria among pregnant women in Ethiopia was 12.72% (95% CI: 7.45, 17.98). In subgroup analysis, the prevalence of malaria showed a significant variation between asymptomatic and symptomatic cases, which was 7.83% (95% CI: 2.23, 13.43) and 17.97% (95% CI: 7.31, 28.92), respectively. CONCLUSION: The current systematic review and meta-analysis showed that the pooled prevalence of malaria among pregnant women was found to be relatively higher compared with the general population. Therefore, the existing prevention and control measures should be strengthen.

Knowledge, Attitude, and Practice towards Glycemic Control and Its Associated Factors among Diabetes Mellitus Patients.

BACKGROUND: Diabetes mellitus is a metabolic disorder of multiple etiologic factors characterized by chronic hyperglycemia with disturbance of carbohydrate metabolism. It can play the vital role in the cause of morbidity and mortality through continued clinical consequence. Therefore, good knowledge, attitude, and practices of glycemic control are necessary in promoting care, in enhancing better therapeutic outcomes, and in the prevention and management of diabetes complications. METHODS: A cross-sectional study design was conducted to determine knowledge, attitude, and practice towards glycemic control and its associated factors. Diabetic patients who were attending the University of Gondar Hospital from March to May 2018 were included in the study. The data was collected using questionnaires, and individuals that can fulfill our inclusion criteria were selected by a simple random sampling technique. SPSS version 20 was used for descriptive and logistic regression analysis, and finally, the variables were summarized and presented using tables and graphs. RESULTS: Of the total 403 participants, 216 (53.6%) were males and 176 (43.7%) were illiterate. Of the total, 250 (62%) had good knowledge, 271 (67.2%) had a good attitude, and 300 (74.4%) had good practice towards glycemic control. In multivariate logistic regression, occupational status and marital status were significantly associated with the knowledge of participants towards glycemic control. Occupational status, educational status, and marital status were significantly associated with attitude and practice towards glycemic control. CONCLUSION: More than half of the participants had good knowledge, attitude, and practice towards glycemic control. Occupational status and marital status were significantly associated with knowledge, attitude, and practice towards glycemic control.

Prevalence of Diabetes Mellitus, Prediabetes and Its Associated Factors in Dessie Town, Northeast Ethiopia: A Community-Based Study.

BACKGROUND: Diabetes mellitus is becoming an epidemic public health problem in developing countries such as Ethiopia. As the International Diabetes Federation indicates, the number of adults living with diabetes globally has been increasing from time to time. If early screening and follow-up are done, diabetes is a manageable disease. However, diabetes study at the community level in Ethiopia is limited and scarce. Therefore, the present study was conducted to assess the current prevalence of DM, prediabetes and its associated factors in Dessie Town, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted from January to March 2019 among people aged 18 years and above in Dessie Town, Northeast Ethiopia. A multistage sampling technique was used to select a total of 587 study participants. Sociodemographic and behavioral characteristic data were collected using a pretested semi-structured questionnaire. Venous blood samples were used to determine the level of blood glucose and lipid profile. Diagnosis and classification of diabetes mellitus and prediabetes were based on the criteria of the American Diabetes Association. RESULTS: The prevalence of diabetes mellitus and prediabetes was 6.8% (95% CI 4.9-9.0) and 15.7% (95% CI 12.9-18.7), respectively. The prevalence of previously undiagnosed diabetes mellitus was 72.5%. Positive family history of diabetes mellitus (AOR: 20.24, 95% CI 4.74-86.43), smoking habit (AOR: 12.12, 95% CI 2.30-63.73), overweight (AOR: 21.95, 95% CI 6.73-71.603), systolic hypertension (AOR: 4.61, 95% CI 1.09-19.50) and hypercholesterolemia (AOR: 8.97, 95% CI 2.05-39.23) were significantly associated with diabetes mellitus. Prediabetes was associated with advanced age (AOR: 3.55, 95% CI 1.16-10.79), marital status (single) (AOR: 3.06, 95% CI 1.40-6.67), educational status (illiterate) (AOR: 2.35, 95% CI 1.04-5.35) and overweight (AOR: 2.11, 95% CI 1.05-4.23). CONCLUSION: There was a higher prevalence of diabetes mellitus and prediabetes. In addition, the prevalence of undiagnosed diabetes mellitus was high in our study area. Therefore, targeting the control and prevention strategy to such modifiable risk factors associated with diabetes and prediabetes may contribute to the reduction of the prevalence and further complications of diabetes mellitus.

Errors in the Total Testing Process in the Clinical Chemistry Laboratory at the University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Laboratory services have been described as the major processes contributing to safe patient care in the modern healthcare sector. However, occurrences of errors in the overall testing processes impair the clinical decision-making process. Such errors are supposed to be high in resource-poor countries, like Ethiopia. The objective of this study was to assess errors in the total testing process in the Clinical Chemistry laboratory of the University of Gondar Hospital, Northwest Ethiopia. METHODS: A cross-sectional study was conducted at the University of Gondar Hospital from February to March 2016. All the required data were collected using established quality indicators. Data were analyzed using SPSS version 20. Frequencies and cross-tabulations were used to summarize descriptive statistics. RESULTS: A total of 3259 samples and corresponding laboratory request forms were received for analysis. The analysis of the overall distribution of errors revealed that 89.6% were pre-analytical errors, 2.6% were analytical, and 7.7% were post-analytical errors. Of the pre-analytical errors, incomplete request form filling was the most frequent error observed, followed by sample rejection rate (3.8%). Analytical errors related to internal and external quality control exceeding the target range, (14.4%) and (51.4%) respectively, were reported. Excessive turnaround time and unreported critical value cases were the major defects in the post-analytical phase of quality assurance. CONCLUSION: The present finding showed relatively high frequency of errors, which alarms the importance of quality indicators to assess errors in the total testing process. The University of Gondar Hospital laboratory should improve the quality of healthcare services based on these findings using laboratory standards.

Undiagnosed Diabetes Mellitus and Associated Factors among Psychiatric Patients Receiving Antipsychotic Drugs at The University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Undiagnosed diabetes mellitus cases are at higher risk for diabetic related complications. In low-income African countries, patients with undiagnosed diabetes mellitus account for 75% of diabetes cases. Psychiatric disorders have a greater impact on the global burden of diseases and disability associated with chronic diseases like diabetes mellitus and cardiovascular diseases. METHODS: Institution based cross-sectional study was conducted at the University of Gondar Hospital from February to April 2016. A total of 205 psychiatric patients aged above 15 years that were taking antipsychotic were included by the simple random sampling method. Fasting blood glucose, triglycerides and cholesterol level were determined from venous blood samples to evaluate diabetes mellitus based on WHO criteria. RESULTS: Among 205 psychiatric patients taking antipsychotics, 15(7.3%) had undiagnosed diabetes mellitus. Duration of antipsychotic treatment and sex had a statistically significant association with the prevalence of undiagnosed diabetes mellitus. As the duration of antipsychotic drug treatment increased by one year, the risk of having a diabetes mellitus increase by 1.47 times (AOR: 1.47 CI: 1.021-2.125). CONCLUSION: The prevalence of undiagnosed diabetes mellitus among psychiatry patients taking antipsychotics was higher than the estimated diabetes national prevalence of Ethiopia. Screening of diabetes mellitus in particular, patients having a longer duration of antipsychotic treatment is mandatory to bring more undiagnosed cases for medical attention.

Knowledge, Attitude and Practice Regarding Blood Donation among Graduating Undergraduate Health Science Students at the University of Gondar, Northwest Ethiopia.

BACKGROUND: Blood transfusion is one of the most essential needs to manage patients suffering from various medical conditions. Nowadays, voluntary blood donors are the only source of blood in the blood banks. There is a great need to create awareness among the population at large and students about blood donation to maintain a regular blood supply. Health Science students can be used as best model to lead this initiative. Hence, the aim of this study was to assess the knowledge, attitude and practice regarding blood donation among graduating undergraduate Health Science students. METHODS: A descriptive cross-sectional study was conducted among graduating undergraduate Health Science students at University of Gondar using structured pre-tested self-administered questionnaire. Stratified sampling technique was employed to select study participants. A total of 225 students participated in the study. Data was entered into and analyzed using SPSS software version 20. Mean score was used to categorize the knowledge and attitude. Binary logistic regression model was fitted to identify factors associated with knowledge, attitude and practice regarding blood donation. RESULT: Among 255 undergraduate Health Science graduate students, 123(48.2%) and 202(79.2%) had adequate knowledge about and positive attitude regarding blood donation, respectively. About 12.5% of them had ever donated blood before. Age ≥25 years was significantly associated with practice of blood donation (AOR=4.33; 95%CI: 1.60, 11.76). CONCLUSION: Although the majority of the students had positive attitude regarding blood donation, blood donation practice was low. Age was found to be significantly associated with blood donation practice. Targeted strategies should be designed to increase awareness of health science students about blood donation. Strategies which encourage the students to donate blood voluntarily should also be designed.