Dyslipidemia and associated factors among adult cardiac patients: a hospital-based comparative cross-sectional study.

BACKGROUND: Atherosclerotic vascular diseases are a leading global cause of morbidity and mortality. Dyslipidemia, a major modifiable risk factor for cardiovascular disease, remains poorly understood among adult cardiac patients in in the study area. This study aims to determine the prevalence of dyslipidemia and identify associated factors in this population. METHODS: Hospital-based comparative cross-sectional study was conducted from May to August 2021. A total of 319 participants (153 cardiac cases, 166 healthy controls, aged ≥ 18) were included in the study. Socio-demographic, anthropometric, behavioral, and clinical data were collected using the WHO STEPS survey instrument through systematic sampling. Overnight fasting blood samples were obtained, and serum lipid profiles were analyzed using a COBAS 6000 analyzer. Data were analyzed with SPSS version 20.0, employing bivariable and multivariable logistic regression. Statistical significance was set at p < 0.05. RESULTS: The overall prevalence of dyslipidemia, encompassing at least one lipid abnormality, was 80.3% among 256 participants. Among cardiac cases, the prevalence rates were as follows: 72.5% for low HDL-cholesterol, 12.4% for hypercholesterolemia, 9.8% for elevated LDL-cholesterol, and 30.1% for hypertriglyceridemia. In controls, corresponding rates were 69.9%, 9.6%, 7.2%, and 32.5%. Significant factors linked to low HDL- cholesterol were female gender (AOR: 2.8, 95% CI 1.7-4.7) and obesity (AOR: 2.8, 95% CI 1.1-7.5). Abdominal obesity was associated with hypercholesterolemia (AOR: 5.2, 95% CI 1.9-14.3) and elevated LDL-cholesterol (AOR: 5.1, 95% CI 1.6-15.8). High blood pressure, overweight, and abdominal obesity were significantly linked to hypertriglyceridemia (p < 0.05). CONCLUSION: Dyslipidemia was high among the study participants. Overweight, obesity, central adiposity, and high blood pressure were significantly associated with dyslipidemia in cardiac patients. This alarms the need for lipid profile assessment for patients periodically, with treatment follow-up to monitor any rising patterns and cardiovascular-related risks.

Effect of dolutegravir-based first-line antiretroviral therapy on weight and body mass index among adult people living with HIV on follow up at health facilities in Hawassa city administration, Southern Ethiopia: a retrospective cohort study.

BACKGROUND: The nature and burden of weight gain associated with antiretroviral treatment (ART) using a combination of Tenofovir disoproxil fumarate, lamivudine and dolutegravir (TLD) among people living with HIV (PLWH) has not been thoroughly investigated in Ethiopia. Therefore, this study aimed to evaluate changes in body weight and body mass index (BMI) in adults who initiated TLD or switched to TLD compared to those who received a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapies. METHODS: A retrospective cohort study was conducted among adult PLWH who had been receiving ART between February 2017 and October 2022 in Hawassa city administration, Sidama region. Linear mixed-effects model was used to examine BMI and body weight trends over time, while a binary logistic regression was performed to identify factors associated with a ≥ 10% weight gain. RESULTS: A total of 524 adult PLWH with a median age of 35 (interquartile range: 30-41) years were included. TLD-initiated arm experienced significantly greater mean weight (8.6 kg vs. 4.95 kg, p < 0.0001) and BMI (3.11 kg/m2 vs. 1.84 kg/m2, p < 0.0001) increase than the NNRTI-based arm at two years. However, the switched arm showed no significant difference in weight (5.6 kg) and BMI (2.13 kg/m2) compared to the NNRTI-based arm (p > 0.05). There was a significant interaction effect between ART regimens and time in predicting weight and BMI gain (p < 0.01). Initiating ART with TLD had higher odds of ≥10% body weight gain at two years (adjusted odds ratio [AOR]: 1.9; 95% CI: 1.19-3.04). Other baseline factors such as age ≥40 years (AOR: 2.02; 95% CI: 1.35-3.02), weight <50kg (AOR: 3.0; 95% CI: 1.86-4.84), advanced disease stages (AOR: 1.78; 95% CI: 1.1-2.86) and ambulatory-bedridden functional status (AOR: 2.0; 95% CI: 1.05-3.8) were also associated with ≥10% weight gain. CONCLUSION: Initiating ART with TLD was significantly associated with greater weight and BMI gain than the NNRTI-based regimens. Therefore, the cardio-metabolic implications of weight gain after the TLD initiation in this population should be monitored and thoroughly investigated.

A significant interaction effect was observed between ART regimens and time in predicting weight and BMI gain.Starting ART with TLD was associated with a significant weight gain and treatment-emergent overweight/obesity than the NNRTI-based therapies.ART initiating with TLD had 1.9 times higher odds of >10% body weight gain than the NNRTI-based therapies.

Dyslipidemia and its associated factors among adult cardiac patients at Ambo university referral hospital, Oromia region, west Ethiopia.

BACKGROUND: Cardiovascular disease is a cluster of illnesses that affect the heart and blood vessels. Dyslipidemia is the most common risk factor for cardiovascular disease, causing more than 4 million deaths each year worldwide. However, there is very little evidence concerning the prevalence and pattern of dyslipidemia among cardiac patients in Ethiopia. METHODS: Hospital-based cross-sectional study was conducted from June to September 2022 at Ambo University referral hospital. Data on socio-demographic, clinical and anthropometric features were collected from adults with cardiac diseases using a convenient sampling technique. Lipid profiles and uric acid were measured from overnight fasting blood. The national cholesterol education program adult treatment panel (NCEP-ATP) III criteria was used to define dyslipidemia. RESULTS: A total of 269 participants were enrolled and the overall 76.6% [95% confidence interval (CI):72.1-81] of patients had at least one dyslipidemia. The prevalence of total cholesterol (TC) ⩾200 mg/dl, triglyceride (TG), LDL-cholesterol and HDL-cholesterol < 40 mg/dl were 38.9%, 44.6%, 29.4%, and 53.5%, respectively. Age > 54 was associated with TC and TG dyslipidemia, adjusted odds ratio (aOR) and (95% CI) were 2.6(1.4-4.8) and 2.4(1.2-4.7), respectively. While, a family history of heart disease, sedentary lifestyle and obesity were associated with TC dyslipidemia, aOR (95%CI) were 1.9(1.1-3.5), 1.4 (1.4-14.6) and 6.7 (1.4-32.5), respectively. In addition, diabetetes mellitus and abdominal obesity were significantly associated with TG dyslipidemia, aOR (95%CI) were 1.9(1.0-3.6) and 2.6(1.16-5.8), respectively. Moreover, uric acid was positively correlated with TC and TG level. CONCLUSIONS: The results indicate that more than 75% of the cardiac patients had at least one dyslipidemia. This reflects the need for regular monitoring of lipid profiles and intensive counseling in this population to mitigate further cardio-metabolic complications.

Experience of dolutegravir-based antiretroviral treatment and risks of diabetes mellitus.

HIV-infected people have started to live longer since the introduction of antiretroviral therapy, however various co-morbid illnesses have emerged. Three HIV-infected individuals, all at least 43 years old, reported with a new onset of type 2 diabetes after switching to dolutegravir-combined antiretroviral therapy regimen. These three people were switched to integrase strand transfer inhibitor (dolutegravir)-based first-line antiretroviral treatment after receiving non-nucleoside reverse transcriptase inhibitor-combined first-line antiretroviral treatment for at least 6 years, as recommended by the World Health Organization for Sub-Saharan African countries, including Ethiopia.All of the given cases had normal plasma fasting sugar (fasting blood sugar <100 mg/dL) at the time of switching. Polyuria, polydipsia, considerable weight loss, and fatigue were all classified as signs of diabetes mellitus in the two male cases. In addition, their laboratory results demonstrated hyperglycemia (plasma fasting blood sugar > 200 mg/dL and urine glucose level ⩾2+) with no ketonuria after switching to dolutegravir for 4-10 months. A glycemic control was achieved, and metformin medication was continued. After 6 months of dolutegravir treatment, the third female case developed diabetic ketoacidosis and severe hyperglycemia (fasting blood glucose level 600 mg/dL, urine glucose level 3+, and ketonuria 3+). To recover from diabetic ketoacidosis, the patient was given intravenous normal saline and regular insulin. Her glycemic control was then restored, and she was switched to NPH insulin. For all of the cases presented, the dolutegravir-based regimen was maintained. Antiretroviral regimens using dolutegravir have the potential to cause hyperglycemia and other side effects. As a result, blood glucose monitoring is required throughout treatment initiation and regularly throughout treatment follow-up, particularly for those on dolutegravir-combined antiretroviral therapy regimens.

The First Experience of Effective 3rd Line Antiretroviral Therapy - A Case of 40-Year-Old Female Retroviral-Infected Patient at Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.

BACKGROUND: Treatment failure continues to be an impediment to the efficacy of highly active antiretroviral therapy (HART) in the treatment of human immunodeficiency virus type 1 infection (HIV-1). The World Health Organization (WHO) recommends third-line antiretroviral therapy (ART) for patients who have failed second-line ART. Darunavir (DRV) boosted with ritonavir (DRV/r) has a higher genetic barrier to resistance, is active against multidrug-resistant HIV isolates, retaining virological activity even when multiple protease mutations are present, and has been shown to be cost-effective when compared to other boosted protease inhibitors (PIs). CASE SUMMARY: This is a case of a 40-year-old female known HIV/AIDS patient who has been on ART for the last 14 years with good adherence and regular follow-up, and who is now on 3rd line ART medication with TLD (tenofovir/lamivudine/dolutegravir)+DRV/r (in her 11th month) after being diagnosed with second-line treatment failure. After 6 months and 1 week of therapy, the viral load (VL) was sent, and the result was undetectable. The patient's clinical conditions had greatly improved. CONCLUSION: Third-line ART therapy, which was once thought to be a salvageable treatment, is now the primary option for second-line ART failure. TLD in combination with ritonavir-boosted darunavir is found to be effective at lowering viral loads in the blood below detectable limits. Despite a lack of data on the use of third-line ART in Ethiopia, access to third-line ART containing ritonavir-boosted darunavir is recommended because it has been shown to be an effective alternative for patients who have failed second-line ART. We recommend that more research be done with a larger sample size, and that the findings in this paper be used with caution.

Knowledge and Practice of Infants Exposure to Sunlight Among Lactating Mothers Attending at Yirgalem Hospital, Sidama Regional State.

BACKGROUND: Exposure to sunlight is vital for the synthesis of vitamin-D and vitamin D plays an important role in growth and bones strength. Therefore, this study aimed to assess the knowledge and practice of infants exposure to sunlight among lactating women. METHODS: A cross-sectional study was conducted from May 01 to 30, 2019 among 327 infant coupled lactating mothers attended at Yirgalem General Hospital. An interviewer-administered questionnaire was used to collect relevant data through a convenient sampling technique. RESULTS: A total of 84.7% of respondents exposed infants to sunlight. More than 94% knew the benefit of exposing infants to sunlight. About 20.9%, 25.6%, and 19.9% of mothers exposed infants to sunlight within 15, 16 to 30, and 31 to 45 days of birth, respectively. In addition, 59.9% of respondents exposed infants to sunshine daily and 72.2% exposed without clothing the infants' body. Moreover, 63.5% of mothers have applied lubricants and overall 54.5% of mothers exposed infants to sunlight in good practice. Unemployed women were 4.7 times more likely (aOR; 95%CI: 4.7; 2.0-11.4) to expose infants to sunlight when compared to those employed, while women whose husbands have at least secondary education level were 5.1 times more likely (aOR; 95%CI: 5.1; 1.6-16.1) to expose infants to sunlight when compared to those unable to read and write. CONCLUSION: More than 45% and more than one-third of lactating mothers had poor practice and exposed infants to sunlight for inadequate time, respectively. Therefore, the finding indicates a need for awareness creation to increase women's knowledge and practice toward the exposure of infants to sunlight.

Prevalence and Associated Factors of Dyslipidemia Among Psychiatric Patients on Antipsychotic Treatment at Hawassa University Comprehensive Specialized Hospital.

BACKGROUND: Dyslipidemia is one of the adverse metabolic outcomes associated with psychotropic medications and the nature of the mental illness itself. Therefore, this study aimed to assess magnitude of dyslipidemia and associated factors among patients with severe mental illness on antipsychotic treatments. METHODS: A cross-sectional study was conducted among 245 patients with severe mental illness in Hawassa University Comprehensive Specialized Hospital, Sidama Regional state, Southern Ethiopia. Socio-demographic and other important data were collected using a structured questionnaire through a systematic random sampling technique. Individual dyslipidemia was characterized by the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) guideline. RESULTS: Mean total cholesterol (TC) was significantly higher in males when compared to females (162.2 mg/dl vs 121 mg/dl, P = .023). While, mean LDL-cholesterol was significantly higher in females when compared to males (100.9 mg/dl vs 93.6 mg/dl, P = .028). Overall 58.4% (95% CI: 52.2-64.8) of participants had at least 1 dyslipidemia. The prevalence of TC ⩾200 mg/dl, HDL-cholesterol <40 mg/dl, triglyceride (TG) and LDL-cholesterol were 61 (24.9%), 75 (30.6%), 66 (26.9%), and 47 (19.2%), respectively. Female sex and smoking were significantly and positively associated with LDL-c dyslipidemia, the aOR (95% CI) were 2.1 (1.0-4.2) for female sex and 3.4 (1.1-10.5) for smoking. Also, Age >40 years was significantly associated with TC dyslipidemia, the aOR (95% CI) was 2.0 (1.1-3.7). CONCLUSION: More than half of psychiatric patients are at risk of developing cardiovascular and other related health problems. Therefore, periodic screening of lipid profiles during healthcare follow-up is mandatory to limit risks of cardiovascular-related comorbidities among patients with severe mental illness.

Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia.

INTRODUCTION: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. METHODS: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients' medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. RESULT: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). CONCLUSION: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.

Satisfaction and its associated factors of infants' vaccination service among infant coupled mothers/caregivers at Hawassa city public health centers.

Studies conducted on caregivers' satisfaction on child vaccination services were very scarce including the study area. Therefore, this study was aimed to assess satisfaction and associated factors in vaccination service among infant coupled mothers/caregivers attending at public health centers. A cross-sectional study was conducted on 404 infant coupled mothers/caregivers from 15 March to 15 April 2018 in the selected health centers of Hawassa city, Southern Ethiopia. A systematic random sampling technique was applied to collect relevant data through exit interview with an interviewer-administered structured questionnaire. The overall proportion of the mothers/caregivers who satisfied with their children immunization service was 76.7%. In addition, 89.7%, 77.1%, 77.2%, 65.8%, and 68.3% were satisfied with conveniences of waiting area, cleanliness of immunization rooms, distance from nearby health center, service providers approach and waiting time to get service, respectively. In addition, caregivers living closer to health centers were 5.9 times more likely to be satisfied than their counterparts, the adjusted odds ratio and 95% confidence interval [AOR and 95%CI : 5.9(1.6-22.4)]. Caregivers who waited for ≤30 minutes to get service were 7.3 times more likely to be satisfied than those waited for >30 minutes [AOR and 95% CI: 7.3(3.9-13.6)]. The study indicated the overall satisfaction of caregivers concerning vaccination service to be suboptimal. Maternal/caregivers satisfaction plays a great role to follow vaccination schedule properly and completeness of immunization service for their infants.

Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia.

BACKGROUND: Currently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital. METHODS: A retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists. RESULTS: Of the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%). CONCLUSION: This study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.

Postpartum left ovarian vein thrombosis.

Left ovarian vein thrombosis is a very rare and infrequent thrombotic condition that mainly occurs in the postpartum or postoperative period. We report a case of a 25-year-old para-1 woman who presented with 2 weeks of postpartum fever and dull aching abdominal pain more on the left side. Before operation, the diagnosis was left adnexal mass secondary to questionable ovarian cyst torsion and she underwent laparotomy. Her intraoperative findings revealed a firm left broad ligament mass with extension to retroperitoneum and it was difficult to demarcate the proximal end. Moreover, on the second day of postoperation, abdominal Doppler ultrasound indicated enlargement of the left ovarian vein that was filled with thrombi having hypoechoic and intermediate echogenicity. After the confirmation of left ovarian vein thrombosis, the case was treated with anticoagulants and broad-spectrum antibiotics and then well improved. Our case climaxes an instant diagnosis and therapeutic significance concerning ovarian vein thrombosis to early manage/avert complications. Besides, the ovarian vein thrombosis diagnosis requires a high index of suspicion for a case presented with fever and abdominal pain.

Strabismus prevalence and associated factors among pediatric patients in southern Ethiopia: a cross-sectional study.

OBJECTIVE: To assess the strabismus prevalence and associated factors among children aged ≤15 years. METHODS: This hospital-based cross-sectional study was conducted from March 2017 to October 2017 in the Department of Ophthalmology & Optometry, Hawassa University Comprehensive Specialized Hospital. Interviewer-administered questionnaires were used to collect relevant data and clinical examinations were performed for patient diagnosis. RESULTS: Overall, 582 children participated in the study (response rate, 97%). The prevalence of childhood strabismus was 17.9% [95% confidence interval: 14.6-21.1]. Additionally, 9.6%, 16.7%, and 9.6% of the children had anisometropia, amblyopia, and dense cataract, respectively. Among the 16.7% of children with amblyopia, 56.7% had strabismus; among the 22.5% of children with clinically significant refractive error, 52.7% had strabismus. Moreover, among the 9.6% of children with anisometropia, 58.9% had strabismus. The presence of amblyopia (adjusted odds ratio [95% confidence interval]: 3.9, 1.7-8.6), age <5 years (13.5 [5.0-36.1]), age 5 to 10 years (6.1 [2.3-16.3]), and clinically significant refractive error (13.3 [5.8-30.6]) were significantly associated with childhood strabismus. CONCLUSIONS: The prevalence of strabismus was relatively high among patients in this study. Early screening for childhood strabismus is essential. A well-controlled community-based study is needed to confirm strabismus prevalence and predictors.

The magnitude of undiagnosed diabetes and Hypertension among adult psychiatric patients receiving antipsychotic treatment.

BACKGROUND: Patients with severe mental illness (SMI) are at increased risk of developing non-communicable diseases that could cause significantly lower life expectancy when compared to the general population. This study aimed to assess the magnitude and predictors of undiagnosed type-2 diabetes and hypertension among adult patients with SMI on antipsychotic treatments. METHODS: A hospital-based cross-sectional study was conducted on 237 psychiatric patients from January to June 2019 at Hawassa University Comprehensive Specialized Hospital, Hawassa, Southern Ethiopia. All relevant information was collected using a structured interviewer-administered questionnaire with a systematic random sampling technique. A total of 4-5 mL of overnight fasting venous blood was collected from each patient. Serum lipid profiles and fasting blood sugar (FBS) were measured using the A25™ BioSystem Random Access chemistry analyzer. To identify predictors of hyperglycemia and raised blood pressure, multiple linear regression analysis was done using SPSS version 23. Statistical significance was set at p value < 5%. RESULTS: From 247 patients with SMI approached, 237 (58.2% male and 41.8% females) were take part in the study giving a response rate of 95.9%. The overall 31.2% (95%CI: 24.1-37.6) and 27.8% (95%CI: 23.2-33.4) of patients had hyperglycemia and raised BP. The magnitude of prediabetes and type-2 diabetes was 24.9% (95%CI:19.4-30.4), and 6.3% (95% CI: 3.4-10.1), respectively. While the magnitude of prehypertension and hypertension was 23.2% (95%CI: 17.3-29.5) and 4.6% (95%CI: 2.1-8.0), respectively. In multiple linear regression analyses: age, HDL-cholesterol, physical activity and Triglyceride/HDL-cholesterol ratio were positively correlated with FBS. While, HDL-cholesterol, waist circumference, physical activity, total cholesterol/HDL-c ratio, and body mass index were positively correlated with systolic and diastolic blood pressures. CONCLUSION: The findings indicate a need to assess blood glucose and blood pressure at baseline before the commencement of any antipsychotic therapy and during therapeutic follow up to manage any increasing trends. Moreover, close monitoring of patients with severe mental illness on antipsychotic therapy is exclusively recommended.

Knowledge, Attitudes, and Practices of Hand Washing among Aderash Primary Schoolchildren in Yirgalem Town, Southern Ethiopia.

BACKGROUND: Hand washing is a simple, convenient, and cost-effective means to limit the transmission of communicable diseases. Improving the practice of hand washing is vital to decrease hygiene-related morbidity and mortality, particularly in developing countries. As such, this study aimed to assess knowledge, attitudes, and practices of hand washing among schoolchildren in Aderash primary school, Yirgalem town. METHODS: A cross-sectional study was conducted on 279 schoolchildren from March to May 2019. A pretested structured questionnaire was applied to collect all relevant information using simple random sampling. Data entry and clearance was done with Epi-Info version 7 and exported to SPSS version 20 for analysis. Adjusted ORs with 95% CI were used to assess statistically significant variables (p<0.05). RESULTS: Overall, 62.7% of schoolchildren had adequate knowledge of hand washing, 61.3% exhibited positive attitudes toward hand washing and 39.1% had good hand-washing practices. Over three quarters (89%) of them had good knowledge of washing hands with soap. About 24%, 56.6%, 9.3%, 6.5%, and 3.6% of children reported washing hands after defecation, before meals, after meals, after work, and after play, respectively. In addition, 73.8% of them reported washing hands with soap if their hands looked dirty or smelled bad. Urban dwelling increased knowledge of hand washing of 1.3-fold (95% CI 1.2-2.85). CONCLUSION: Even though >60% of children had adequate knowledge and exhibited positive attitudes toward hand washing, proper hand-washing practices was <40%. Therefore, much effort should be directed toward improving children's understanding of the benefits of proper hand washing in schools.

Blood transfusion-transmissible malaria and its cost analysis in Hawassa regional blood bank, Southern Ethiopia.

BACKGROUND: Blood transfusion is an intervention used to save life particularly for those patients who survive only with receiving blood. Establishing effective diagnostic test menus concerning the screening of transfusion-transmissible infections in the blood banks play a vital role to safeguard recipients from transfusion-transmissible infections. OBJECTIVE: The aim of this study was to assess blood transfusion-transmissible malaria and its screening cost analysis in Hawassa regional blood bank, Hawassa, Sothern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted from April to May 2018 among 414 voluntary blood donors. Each participant's blood sample was screened for most transfusion-transmissible infections using antigen/antibody tests, while rapid diagnostic test and microscopy were used for malaria screening and confirmation. In addition, the cost screening of transfusion-transmissible infections was calculated using activity-based costing method. RESULTS: The overall seropositivity of transfusion-transmissible infections was 7.0% and the positivity rate of hepatitis B virus, syphilis, and Plasmodium falciparum was 5.6%, 1.0%, and 0.5%, respectively. The cost per test of each transfusion-transmissible infection was US$5.04 for human immunodeficiency virus, US$4.61 for hepatitis B virus, US$5.11 for hepatitis C virus, and US$4.75 for syphilis, while the cost per test of malaria rapid diagnostic test was US$4.74 and this is comparatively lower than the cost per test of other transfusion-transmissible infections except for hepatitis B virus. In addition, total cost of laboratory incurred for transfusion-transmissible infections screening is estimated to be US$213,634.5 per year, while it becomes US$265,537.5 if the malaria screening cost is added. This means 19.54% of the total cost of laboratory incurred per year or US$51,903. CONCLUSION: The positivity rate of malaria parasites among voluntary blood donors was 0.5%, and it might be increased if the study was conducted in high transmission seasons. A cost of malaria screening is comparatively lower than costs of other transfusion-transmissible infections except for hepatitis B virus. Therefore, the screening of malaria parasites should be considered as one of the test menus of transfusion-transmissible infections in blood banks, especially in malaria-endemic areas.

Seropositivity of West Nile Virus Among Acute Febrile Patients in Southern Ethiopia.

BACKGROUND: West Nile virus (WNV) is one of the widely distributed arboviruses in the world, and it is a pathogen of both humans and animals. The evidence that supports the prevalence of the WNV infection in Ethiopia is very scarce. Hence, this study aimed to assess the seropositivity of WNV among patients with acute febrile illness. METHODS: This health institution-based descriptive cross-sectional study was conducted on 532 acute febrile patients from May to August 2016 in Arba Minch Zuria district selected public health facilities, Southern Ethiopia. A pre-structured questionnaire was used to collect socio-demographic and clinical related information of the participants through convenient sampling techniques. In addition, trained nurses who were working in the health centers were responsible for interviewing acute febrile patients. About 5 mL of venous blood was collected aseptically from each of the study participants for the screening of the WNV immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies using indirect immunofluorescence technique (IIFT) as per manufacturer's protocol. Data analysis was done using statistical package for social sciences (SPSS) version 20 software and the results were presented by frequency and percentage using tables. RESULTS: A total number of 529 acute febrile patients (42.7% males and 57.3% females) were enrolled in the study with a response rate of 99.4%. The overall 7.4% of acute febrile patients were seropositive for WNV-specific IgG and the rate was higher in males (9.7%) when compared to females (5.6%). While the overall 4.5% were seropositive for WNV-specific IgM and the rate was 6.6% in males and 3.0% in females. CONCLUSION: The finding of this study is an important alarm for clinicians/physicians to diagnose febrile patients in the divergent direction including with the diagnosis of flaviviruses. In addition, the finding will further contribute to understanding the epidemiology of WNV fever in Ethiopia and it will play a role in the delivery of public health measures to decrease the risk of WNV exposure in the areas.

Prevalence and Associated Factors of Metabolic Syndrome Among Patients with Severe Mental Illness at Hawassa, Southern-Ethiopia.

BACKGROUND: Patients with severe mental disorders have a high risk of metabolic-related complications like metabolic syndrome (MetS), diabetes mellitus (DM), hypertension and lipid derangements, and these factors may predispose them to a high mortality rate. Data is very scarce regarding MetS among patients with severe mental illness in Ethiopia. Therefore, this study aimed to assess the prevalence of MetS and its associated factors among patients with severe mental illness. METHODS: A cross-sectional study was conducted in Hawassa University Comprehensive Specialized Hospital from January to June 2019 among adult patients attending a psychiatric outpatient department, Southern Ethiopia. A systematic random sampling technique was used to select 245 study subjects. Socio-demographic and other data were collected using a structured questionnaire. Both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) guidelines were used to define MetS. RESULTS: The prevalence of MetS was 24.5% and 26.9% by NCEP-ATP and IDF criteria respectively. In both definitions, females had significantly higher MetS when compared to males (31.4% vs 19.6%; p=0.03 by NCEP), and (34.3% vs 21.7%; p =0.03 by IDF), respectively. Duration >5 years with mental illness indicated higher MetS when compared to duration ≤ 5 years (42.9% vs 19.9%, p=0.001; and 46.9% vs 21.9%, p<0.0001) in NCEP and IDF, respectively. In addition, marital status [AOR (95% CI): 2.4 (1.1-5.3)], and BMI [AOR (95% CI): 8.4(4.0-17.6)], duration > 5 years with mental illness [AOR (95% CI): 2.8(1.2-6.5)], and age >40 years [AOR (95% CI): 2.7(1.2-6.1)] were significantly associated factors of MetS by NCEP. While BMI, age >40 years and duration > 5 years with mental illness were associated with MetS by IDF. CONCLUSION: Long-time experience with severe mental illness and antipsychotic therapy might predispose patients to metabolic complications with significant risks of cardiovascular events. Therefore, intensive screening of patients for MetS/components is required during follow-up based on national non-communicable diseases guideline. Besides, the proper intervention of patients concerning lifestyle changes and averting risk full behaviors is mandatory.

Predictors of Adherence Toward Specific Domains of Diabetic Self-Care Among Type-2 Diabetes Patients.

BACKGROUND: Adequate knowledge, awareness, and adherence to diabetic self-care practices are vital tools to protect patients from risks of disease complications, developing comorbidity and mortality. Therefore, this study aimed to assess specific domains of diabetic self-care practice and associated factors among patients with type-2diabetes in Hawassa University Comprehensive Specialized Hospital, Sidama regional state. MATERIALS AND METHODS: A hospital-based cross-sectional study design was conducted on 217 patients with type 2 diabetes from January 01 to April 30, 2020. A structured questionnaire and the Summary of Diabetes Self-Care Activities (SDSCA) tool were used to collect relevant data through interviewer administration. Statistical analysis was done using SPSS version 23. RESULTS: A total of 207 patients with type-2 diabetes were participated in the study with a 95% response rate. Overall 47.8% (95%CI: 41.2-55) of patients adhered to diabetic self-care practice. Concerning the specific domain of self-care practice, 54.6%, 39.1%, 28%, and 65.2% of patients adhered to a healthy diet, physical exercise, self-monitoring blood glucose (SMBG), and diabetic foot care practices, respectively. Besides, all patients received at least 80% of the prescribed doses and frequency of anti-diabetic agents and 60.4% had good glycemic control. Receipt of advice from treating physicians and having no familial history of diabetes were significantly associated with adherence toward eating a healthy diet, diabetic foot care, and SMBG. While male sex was associated with adherence toward healthy diet management. Moreover, having glucometer, age, male sex, diabetes duration ⩾ 5 years, and anti-diabetic treatment modality were associated with adherence toward SMBG. CONCLUSION: This study indicates 52.2%, 72%, and 60.1% of diabetes patients did not adhere to diabetic self-care, SMBG, and physical exercise, respectively. Improving awareness and regular diabetic education is imperative to scale up patients' adherence toward diabetic self-care practice.

Factors associated with the length of stay in emergency departments in Southern-Ethiopia.

OBJECTIVES: This cross-sectional study was conducted on 399 patients at Hawassa University Comprehensive Specialized Hospital from February 15 to March 30/2018 to assess the length of stay (LOS) and its associated factors in emergency departments (EDs). RESULT: About 91.5% patients were stayed in the EDs for greater than 24 h in different reasons. Inadequacy of beds in inpatient wards, overcrowding, absence of different laboratory test profiles and delay in radiological services were showed a significant differences in LOS greater than 24 h when compared to LOS ≤ 24 h in EDs (p < 0.05 for all). In addition, admission beds [adjusted odds ratio: 8.7 (95% CI 3.2-23.2)]; overcrowding [adjusted odds ratio: 3.6 (95% CI 1.6-8.3)]; laboratory test profiles [adjusted odds ratio: 5.1 (95% CI 1.9-14.1)], and radiology services [adjusted odds ratio: 3.7 (95% CI 1.5-9.2)] were significantly and positively associated with LOS greater than 24 h in EDs. Further, a significant proportion of patients were stayed for unnecessary extended length of time in EDs due to different factors. Therefore, the commitment of organization is crucial to provide sufficient number of admission beds, to scale-up laboratory test profiles and to decrease radiology service turn-around time in order to improve LOS in EDs.

Influences of gender in metabolic syndrome and its components among people living with HIV virus using antiretroviral treatment in Hawassa, southern Ethiopia.

BACKGROUND: Data regarding the influences of gender in metabolic syndrome (MetS) among patients using antiretroviral treatment (ART) in Ethiopia is scarce. The aim of this study was to assess the influences of gender in MetS and its components among HIV-infected patients receiving ART. METHODS: A cross-sectional study was conducted between February 2012 and April 2013. Data on demographic, clinical and anthropometric characteristics were collected from 185 HIV patients using ART. Glucose and lipid profiles were measured from overnight fast blood. The International Diabetes Federation (IDF) and United States national cholesterol education program: adult treatment (US NCEP-ATP) panel III criteria were used to define MetS. RESULT: A total number of 185 (36.8% males and 63.2% females) participants were recruited in this study. The overall prevalence of MetS was 24.3 and 17.8%, diagnosed using IDF and NCEP-ATP criteria respectively. Using IDF criteria, MetS was significantly higher in females compared to males (33.3 vs. 8.8%; p = <0.0001) respectively. Low HDL-c and central obesity were significantly higher MetS components in female compared to males (p = 0.003); and (p = <0.0001, using IDF and NCEP-ATP criteria) respectively. BMI >25 kg/m(2) was significantly associated with MetS in both IDF and NCEP-ATP criteria: unadjusted (UOR) and adjusted odds ratio (AOR) with 95% CI were 3.0 (1.3-6.5) and 3.8 (1.5-9.8); as well as 3.2 (1.4-7.4) and 3.4 (1.4-7.4) respectively. Furthermore age >40 years was significantly associated with MetS using NCEP-ATP: UOR and AOR (95% CI) were 3.1 (1.2-8.3), and 3.8 (1-13.70) respectively. CONCLUSION: Comprehensive medical care approach including with MetS components are a crucial instruments in order to minimize the risk of developing cardiovascular diseases in HIV-infected patients using ART.