Establishment of local diagnostic reference levels for common adult CT examinations: a multicenter survey in Addis Ababa.

BACKGROUND: In medical imaging, a computed tomography (CT) scanner is a major source of ionizing radiation. All medical radiation exposures should be justified and optimized to meet the clinical diagnosis. Thus, to avoid unnecessary radiation doses for patients, diagnostic reference levels (DRLs) have been used. The DRLs are used to identify unusually high radiation doses during CT procedures, which are not appropriate for the clinical diagnosis. It has been successfully implemented in Europe, Canada, Australia, the United States, several industrialized countries, and a few underdeveloped countries. The present study aimed to establish DRLs for the head, chest, and abdominopelvic (AP) CT procedures in Addis Ababa, Ethiopia. METHODS: A pilot study identified the most frequent CT examinations in the city. At the time of the pilot, eighteen CT scan facilities were identified as having functioning CT scanners. Then, on nine CT facilities (50% of functional CT scanners), a prospective analysis of volume CT dose index (CTDIvol) and dose length product (DLP) was performed. We collected data for 838 adult patients' head, chest, and AP CT examinations. SPSS version 25 was used to compute the median values of the DLP and CTDIvol dose indicators. The rounded 75th percentile of CTDIvol and DLP median values were used to define the DRLs. The results are compared to DRL data from the local, regional, and international levels. RESULT: The proposed DRLs using CTDIvol (mGy) are 53, 13, and 16 for the head, chest, and AP examinations respectively, while the DLP (mGy.cm) for the respective examinations were 1210, 635, and 822 mGy.cm. CONCLUSION: Baseline CT DRLs figures for the most frequently performed in Addis Ababa were provided. The discrepancies in dose between CT facilities and as well as between identical scanners suggests a large potential for dose optimization of examinations. This can be actually achieved through appropriate training of CT technologists and continuous dose audits.

Level of Awareness of Mammography among Breast Cancer Patients Attending Follow-up at a Tertiary Hospital, Addis Ababa, Ethiopia.

Background: Breast cancer is the most common cancer type and the most common cancer related cause of death worldwide in women. This study was aimed to assess the awareness of mammography among breast cancer patients attending follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: Hospital based cross sectional study was conducted from July 01 to August 30, 2017 at Tikur Anbessa Specialized Hospital. Interviewer administered questionnaire was used to obtain data from 270 breast cancer patients who came to radiology department for follow up imaging. Collected data were checked for completeness, coded and entered into Epi Info 3.1 software and exported to SPSS Version 21 for analysis. Results: Two hundred and twenty four (83%) of the study participants had no awareness of mammography while 46 (17%) of them had awareness of mammography. Out of the total 270 women, only 38(14.1%) had mammography test. In multivariate logistic regression analysis; level of education was found to have significant association with awareness of mammography. Women with breast cancer who completed secondary education were 4.5 times (AOR= 4.5; 95% CI: 1.39, 14.77) more likely to have awareness of mammography compared to women with breast cancer who were illiterate. Conclusion: This study revealed low awareness, knowledge and practice of mammography among women with breast cancer. Knowledge of participants about risk factor for breast cancer was also low.

COVID-19 vaccine hesitancy among Ethiopian healthcare workers.

INTRODUCTION: COVID-19 poses significant health and economic threat prompting international firms to rapidly develop vaccines and secure quick regulatory approval. Although COVID-19 vaccination priority is given for high-risk individuals including healthcare workers (HCWs), the success of the immunization efforts hinges on peoples' willingness to embrace these vaccines. OBJECTIVE: This study aimed to assess HCWs intention to be vaccinated against COVID-19 and the reasons underlying vaccine hesitancy. METHODS: A cross-sectional survey was conducted among HCWs in Addis Ababa, Ethiopia from March to July 2021. Data were collected from eligible participants from 18 health facilities using a pre-tested semi-structured questionnaire. Data were summarized using descriptive statistics and multivariable logistic regression was performed to explore factors associated with COVID-19 vaccine hesitancy. A p<0.05 was considered statistically significant. RESULTS: A total of 614 HCWs participated in the study, with a mean age of 30.57±6.87 years. Nearly two-thirds (60.3%) of HCWs were hesitant to use the COVID-19 vaccine. Participants under the age of 30 years were approximately five times more likely to be hesitant to be vaccinated compared to those over the age of 40 years. HCWs other than medical doctors and/or nurses (AOR = 2.1; 95%CI; 1.1, 3.8) were more likely to be hesitant for COVID-19 vaccine. Lack of believe in COVID-19 vaccine benefits (AOR = 2.5; 95%CI; 1.3, 4.6), lack of trust in the government (AOR = 1.9; 95%CI; 1.3, 3.1), lack of trust science to produce safe and effective vaccines (AOR = 2.6; 95%CI; 1.6, 4.2); and concern about vaccine safety (AOR = 3.2; 95%CI; 1.9, 5.4) were also found to be predictors of COVID-19 vaccine hesitancy. CONCLUSION: COVID-19 vaccine hesitancy showed to be high among HCWs. All concerned bodies including the ministry, regional health authorities, health institutions, and HCWs themselves should work together to increase COVID-19 vaccine uptake and overcome the pandemic.

Lack of pocket money impacts Ethiopian undergraduate health science students learning activities.

BACKGROUND: The cost of university presents various challenges with regards to students' daily learning activities. This is particularly evident in developing countries, where higher education students face acute financial problems that greatly affect their daily educational activities. In Ethiopia, public university students do benefit from governmental cost-sharing programs. Moreover, health sciences students have additional costs during their clinical placements that are above the common expenses for university students. OBJECTIVES: Authors aim to explore the challenges that undergraduate health sciences students in their clinical year face with limited pocket money, as well as how students perceive these limited funds affecting their learning activities and their ability to meet challenges. METHODS: This descriptive qualitative study was conducted at the Department of Medical Radiologic Technology, College of Health Sciences, at Addis Ababa University in Ethiopia. Interviews were conducted between January 28, 2019 and February 1, 2019 with twelve students; and only ten participants were included in the study. The semi-structured questions explored participants' experiences and perceptions regarding the challenges of a lack of pocket money and its impacts on their learning activities. Their reaction to financial challenges was assessed. RESULTS: Four themes that are related to the impact of a lack of money on learning activities emerged from our interviews. First, students believed that their difficulty in obtaining pocket money from family or other funding sources contributed to their financial stress, which negatively impacted their learning. Moreover, their difficulty in affording the basic needs for a student greatly affected their learning abilities in the classroom as well as in their clinical placements. The ability to self-manage was also a significant concern for students, with the pressure to use self-control and proper money management adding to their financial stress. Lastly, students observed that the lack of pocket money affected their ability to make social connections at university, which they saw as negatively impacting their learning abilities. CONCLUSION: Ethiopian undergraduate health sciences students faced many challenges due to the lack of pocket money and these challenges affected student learning both directly or indirectly. Based on our data, we believe that the underlying causes of student financial hardship can be addressed by increasing public awareness of university expenses, clarifying the cost-sharing system to the public, redesigning the cost-sharing policy, and improving university services. Additionally, teaching students self-management skills is also another area that could increase student success.

Assessment of Knowledge and Attitude of Tuberculosis Patients in Direct Observation Therapy Program towards Multidrug-Resistant Tuberculosis in Addis Ababa, Ethiopia: A Cross-Sectional Study.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is becoming a major challenge of tuberculosis (TB) control program globally but more serious in developing countries like Ethiopia. In 2013, a survey result showed that in Ethiopia, tuberculosis patients from new cases and retreatment cases had resistance to at least isoniazid and rifampicin with a significant increase over time. Inadequate knowledge and wrong perception about MDR-TB by patients were detrimental to TB control programs. The study aimed at assessing the knowledge and attitude of TB patients of direct observation therapy program towards multidrug-resistant tuberculosis in health centres of Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted in 10 health centres of Addis Ababa which were selected by simple random sampling technique. A total of 422 TB patients were included in the study, and participants from each health centres were taken proportional to the number of clients in each health centres. Data was entered and analyzed using SPSS version 20. Association between outcome and independent variables was explored using logistic regression. RESULTS: The level of knowledge of TB patients about MDR-TB was poor and only 55.0% of TB patients attained good overall knowledge. A significant association was found between good knowledge and attending tertiary level of education (AOR = 4.3, 95%CI = 1.9, 9.8), gender (AOR = 1.62, 95%CI = 1.1, 2.4), income of respondents' family (OR = 0.4, 95%CI = 0.2, 0.9), and sleeping practice (AOR = 8.0, 95%CI = 4.0, 15.7). Nearly three-fourths (73.5%) of TB patients had a favourable attitude towards MDR-TB. Occupational status (AOR = 4.4, 95%CI = 2.5, 7.6) and sleeping practices (AOR = 2.4, 95%CI = 1.2, 5.0) were significantly associated with the attitude of the TB patients. CONCLUSIONS: Knowledge of TB patients toward MDR-TB was poor. Although a large proportion of patients had a favourable attitude, it still needs to be improved. Hence, efforts should be made to implementing health education to improve awareness of TB patients about MDR-TB.

Prevalence of Tuberculosis and Treatment Outcomes of Patients with Tuberculosis among Inmates in Debrebirhan Prison, North Shoa Ethiopia.

BACKGROUND: Prevalence of tuberculosis in vulnerable groups such as prisoners is usually high, and the problem is worsened by poor treatment outcomes. In spite of this, there is limited information regarding tuberculosis in prisons of Ethiopia. Hence, this study was aimed to assess the prevalence of tuberculosis and treatment outcomes of patients with tuberculosis among inmates of Debrebirhan prison in North Shoa, Ethiopia. METHODS: A retrospective cross-sectional study was conducted among inmates of Debrebirhan prison. Data were collected by reviewing the medical charts and other records of prison inmates diagnosed and treated for tuberculosis between September 2010 and August 2015. Data were entered and analyzed using SPSS version 21.0. RESULTS: A total of 162 patients with tuberculosis were registered and treated at Debrebirhan prison health center within the five years study period. The overall average prevalence was found to be 32 per 1538 (2139 per 100,000) prison inmates. Regarding treatment outcome, 44(27.2%) were cured, 59(36.42%) completed treatment, 2(1.24%) were treatment failures, 6(3.72%) died and 51(31.5%) were not evaluated. The five year's treatment success rate was found to be 63.62%. Area of residence (AOR= 3.59; 95% CI: 1.44, 8.93), duration of imprisonment (AOR = 3.67; 95% CI: 1.53, 8.78) and history of tuberculosis were significantly associated with treatment outcome of tuberculosis. CONCLUSION: This study showed high prevalence of tuberculosis in Debrebirhan prison. It also revealed that the treatment success rate of patients with tuberculosis was lower than the target set by World Health Organization.