ABSTRACT
Background: Physiological changes during pregnancy cause alterations in concentration of biochemical analytes. Thus, locally established pregnancy-specific reference intervals are important for accurate diagnosis, treatment, and prognosis of diseases. The objective of the study was to establish reference interval for the common renal and liver function clinical chemistry parameters among pregnant and non-pregnant women of South Wollo zone, Ethiopia. Methods: A community-based cross-sectional study was conducted on a total of 323 apparently healthy study participants randomly selected from South Wollo zone, Ethiopia, from April to June 2019. Medical history, physical examination and sociodemography were collected by using questionnaire. Liver and renal function clinical chemistry tests were done using A25 Biosystems, clinical chemistry analyzer. After the exclusion of outliers, Kolmogorov-Smirnov test was used to check its normality. The 95% RI with 95% confidence interval was established using the nonparametric method. The significance of differences was evaluated using Mann-Whitney U test. Result: There was statistically significant variation between pregnant and non-pregnant women in values of albumin, T. protein, ALP, urea and creatinine, but not for AST, ALT, bilirubin (direct) and bilirubin (total). Reference intervals established for pregnant women includes albumin 26.14-42.87g/L, total protein 48.52-74.71 g/L, AST 2.4-43.6 U/L, ALT 0.94-28.35 U/L, ALP 21.2-337 U/L, bilirubin (direct) 0.03-0.32 mg/dL, bilirubin (total) 0.26-0.94 mg/dL, creatinine 0.29-0.87 mg/dL, urea 7.17-20.82 mg/dL. Albumin: 32.81-47.87, total protein: 56.71-83.9 U/L, AST: 4.2-37.1 U/L, ALT: 2.69-41.18 U/L, ALP: 3.22-278.7 U/L, bilirubin (direct) 0.1-0.51 mg/dL, bilirubin (total) 0.24-1.06 mg/dL, creatinine 0.44-1.00 mg/dL, urea 8.07-27.87 mg/dL for non-pregnant women. Conclusion: The study showed marked difference in albumin, total protein, alkaline phosphatase, urea and creatinine. Therefore, physiological adaptations of pregnancy should be considered when interpreting liver and renal function tests in a pregnant woman.
ABSTRACT
BACKGROUND: Human resources for health-care delivery are essential for attaining global health and development goals. Especially in developing countries, health extension workers are frontline health personnel who can play a key role in preventing and controlling HIV/AIDS. This study aimed to evaluate the performance of health extension workers in HIV-1/2 screening tests. Methodology. A comparative cross-sectional study was carried out to evaluate the performance of health extension workers in HIV-1/2 screening tests. Study participants had performed HIV screening tests on the prepared sample panels. Finally, the percentage of accuracy, error rate, sensitivity, specificity, predictive values, and measure of agreement (kappa) were calculated using SPSS version 26. RESULT: Totally, 1600 HIV screening tests were performed, and of these, 684 and 235 tests were done by HEWs (n = 15) and laboratory personnel (n = 5), respectively, with three discordant results by HEWs from a single sample panel which was weak reactive for HIV antibody test. The sensitivity, specificity, PPV, and NPV of HIV screening tests by HEWs were 97.4%, 100%, 100%, and 97.22%, respectively, and 100% for all parameters when it is tested by laboratory professionals. The measure of kappa agreement was 0.971 (95% CI, 0.932-1) for HEWs and 1 for laboratory personnel compared with the reference result. CONCLUSION: Based on this evidence, we conclude that the potential contribution of HEWs can be invaluable in the expansion of HIV screening tests nationwide to compensate the shortage of laboratory personnel.
