Magnitude and associated factors of thrombocytopenia, among pregnant women at Mizan Tepi university teaching hospital south west Ethiopia.

BACKGROUND: Thrombocytopenia in pregnancy is a common multifactorial abnormality of the hematological system, next to anemia. It leads to more increased risk of bleeding during delivery, labour, or the postpartum period. Despite being a significant public health concern, there are limited studies done concerning thrombocytopenia during pregnancy. OBJECTIVE: To assess the magnitude and associated factors of thrombocytopenia among pregnant women at Mizan Tepi University Teaching Hospital from September 2023 to November 2023. METHODS: An institutional-based cross-sectional study was carried out on 230 systematic randomly selected pregnant women who attended antenatal visits from September 2023 to November 2023 G.C using data collection tools. The pretested structured questionnaires were employed to obtain clinical, nutritional, and sociodemographic information. Additionally, three millilitres of venous blood were collected from each participant and analyzed using a Sysmex hematology analyzer. The data was entered into Epidata version 4.6 and analyzed using STATA version 14. Descriptive statistics were computed, and logistic regression was used to identify predictors with a significance level of less than 0.05. RESULTS: Two hundred thirty pregnant women participated in the study. Among study participants, the magnitude of thrombocytopenia was 55(24.35%) with 32 (57.14%) mild, 19 (33.93%) moderate, and 5 (8.93%) severe thrombocytopenia. The determinant factors which shown significant association were Malaria parasite infection (AOR 9.27 at 95% CI 7.42, 10.87), one-year Inter-birth interval (AOR 1.7 at 95% CI 1.24, 2.14), History of abortion (AOR 3.94 95% CI 3.13, 4.86), History of hypertension (AOR 3.12 95% CI 1.56, 4.12), HIV infection (AOR 1.81 95% CI 1.32.2.52) and HBV infection (AOR 3.0 95% CI 2.82, 3.34). CONCLUSION: Thrombocytopenia is a public health problem and mild type of thrombocytopenia was the most predominant. The determinant factors that showed significant association with thrombocytopenia were Malaria Parasitic infection, one-year Inter-birth interval, History of abortion, History of hypertension, HIV infection, and HBV infection. Therefore, pregnant women should be continuously screened for thrombocytopenia to avoid excessive bleeding. Increasing Inter-birth interval, preventing abortion as well as timely diagnosis and treatment of underlying causes such as malaria infection, hypertension, HBV, and HIV is important to reduce the burden of thrombocytopenia.

Seroprevalence of hepatitis B and C viruses among waste handlers in Ethiopia: A systematic review and meta-analysis.

Objective: Hepatitis B virus and hepatitis C virus are the leading causes of global liver-related morbidity and mortality. Waste handlers are one of the high-risk groups for hepatitis B virus and hepatitis C virus acquisition. Thus, the aim of this study was to assess the pooled prevalence of hepatitis B virus and hepatitis C virus among waste handlers in Ethiopia. Methods: Articles were extensively searched in bibliographic databases and gray literature using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 14 software for statistical analysis. A random-effects model was used to compute the pooled magnitude of hepatitis B virus and hepatitis C virus. Heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was performed to assess the impact of a single study on pooled effect size. Result: Of the 116 studies identified, 8 studies were selected for meta-analysis. All studies reported hepatitis B virus, while 5 studies reported hepatitis C virus infection among waste handlers. The overall pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was 5.07% (2.0-8.15) and 1.46% (0.52-2.4), respectively. Moreover, the pooled prevalence of lifetime hepatitis B virus exposure among Ethiopian waste handlers was 33.98% (95% CI: 21.24-46.72). Hepatitis B virus and hepatitis C virus infection were not statistically associated with the type of waste handlers, that is, there was no difference between medical and nonmedical waste handlers. PROSPERO registration: CRD42023398686. Conclusion: The pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was intermediate and moderate, respectively. This showed that there is a strong need to scale up preventive efforts and strategic policy directions to limit the spread of these viruses. Moreover, we also conclude that handling healthcare and domestic waste is associated with a similar risk of hepatitis B virus and hepatitis C virus infection.

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 of biofilm producing Acinetobacter baumannii clinical isolates: A systematic review and meta-analysis.

BACKGROUND: Acinetobacter baumannii, the first human pathogen to be designated as a "red-alert" pathogen, is on the critical priority list of pathogens requiring new antibiotics. Biofilm-associated diseases are the most common infections caused by the antibiotic-resistant bacteria A. baumannii. Multidrug-resistant strains are more easily transmitted around the world due to A. baumannii's ability to produce biofilms, which allows it to develop antibiotic resistance mechanisms and thrive in healthcare environments. As a result, A. baumannii infections are becoming increasingly common in hospital settings allover the world. As a result, a comprehensive systematic review and meta-analysis were carried out to determine the global prevalence of biofilm-producing A. baumannii clinical isolates. METHODS: Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 12 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of biofilm-producing A. baumannii clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size. RESULT: Of the 862 studies identified, 26 studies consisted of 2123 A.baumannii clinical isolates of which 1456 were biofilm-producing. The pooled prevalence of biofilm-producing A.baumannii clinical isolates was 65.63% (95% CI = 56.70%-74.56%). There was substantial heterogeneity with an I2 value of 98.1%. Moreover, 41.34%, 33.57%, and 27.63% of isolates of strong, mild, and weak producers of biofilm. Higher prevalence was found in studies published after 2014 (66.31%); Western Pacific region (76.17%); and Asia (66.22%) followed by the African continent (57.29%). CONCLUSION: The pooled prevalence of biofilm-producing A. baumannii clinical isolates has risen alarmingly, posing a public health risk. This indicates the burden of biofilm-producing A. baumannii infections urges routine screening and appropriate treatment for better management of hospitalized patients, as well as effective controlling of the emergence of drug resistance. Furthermore, this finding is an alert call for the stakeholders to develop strong infection prevention and antibiotics stewardship programs for the prevention and control of biofilm-producing bacterial infections.

Prevalence of asymptomatic malaria and associated factors among pregnant women in Ethiopia: systematic review and meta-analysis.

The proactive identification of asymptomatic patients and the mitigation of associated problems are essential to the elimination of malaria. For asymptomatic malaria and related variables among pregnant women in Ethiopia, there are no national pooled estimates. As a result, the goal of this study is to compile thorough and compelling data from several Ethiopian investigations. Google Scholar, PubMed, Scopes, the Web of Science, the Cochrane Library, and African Journals Online were a few of the electronic resources that were accessed. The investigation included all observational studies. STATA version 15 was used to extract the data from the Microsoft Excel file and conduct the analysis. The estimated pooled prevalence of asymptomatic malaria among pregnant women was calculated using a random-effects model. An inverse variance index (I2) analysis was utilized to find heterogeneity. To assess the publication bias, funnel plots, and Egger's statistical tests were used. The study determined that the combined prevalence of asymptomatic malaria among pregnant women was 7.20 (95% confidence interval = 4.22, 10.18) and 4.69 (95% confidence interval = 2.77, 6.62) by microscopy and rapid diagnostic test, respectively. The presence of stagnant water near their home (odds ratio = 4.31; 95% confidence interval = 1.66, 11.20); not using insecticide-treated nets (odds ratio = 6.93; 95% confidence interval = 3.27, 14.71); the lack of indoor residual spray service (odds ratio = 2.68; 95% confidence interval = 1.63, 4.40); and the presence of pregnant women in their neighborhood (odds ratio = 3.14; 95% confidence interval = 1.4). This study showed that pregnant women have a high pooled prevalence of asymptomatic malaria. Women living in rural areas near stagnant water and those who never used insecticide-treated nets had a two-, four-, or six-fold higher prevalence of asymptomatic malaria, respectively. The use of advanced diagnostic techniques could produce a higher magnitude of the disease. For effective intervention toward elimination, active case detection at the community level is also advised. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023411385; identifier, CRD42023411385.

Clinical profiles, epidemiological characteristics and treatment outcomes of COVID-19 patients in North-eastern Ethiopia: A retrospective cohort study.

BACKGROUND: COVID-19 is a rapidly emerging global health threat and economic disaster. The epidemiology and outcomes of COVID-19 patients in Ethiopia are scarce. Thus, the present study aimed to assess clinical profiles, epidemiological characteristics, and treatment outcomes of patients with COVID-19 and to identify determinants of the disease outcome among COVID-19 patients in North-eastern Ethiopia. METHODS: A retrospective observational cohort study was conducted in North-eastern Ethiopia, from May 2020 to Jan 2022 on a total of 364 SARS-COV-2 infected patients. Demographic and clinical data were abstracted from the medical records of patients. Bivariable and multivariable analyses were conducted to determine the factors associated with the mortality of COVID-19 patients and variables with a P-value < 0.05 were considered statistically significant. RESULT: Among 364 COVID-19 patients included in this study, two-thirds (68.1%) were males with a median age of 34 years. The majority; 42.9% & 33.0% respectively cases were detected at the health facility and community level surveillance. Furthermore, 6.6% of patients had pre-existing comorbidities of which diabetes mellitus (23.1%) and hypertension (15.3%) had the highest frequency. The symptomatic rate of COVID-19 patients was 30.5%. The most common clinical presentations were cough (26.9%), fever (26.1%), and shortness of breath (15.2%). Moreover, the mortality rate of COVID-19 patients was 4.1% which was independently predicted by a history of underlining co-morbidity (AHR:6.09; 95%CI:1.299-28.56; P = 0.022) and a history of severe or critical conditions (AHR 11.8; 95%CI:4.89-28.83; P = 0.003). CONCLUSION: Severe or critical acute COVID-19 and underlining comorbidities are associated with higher mortality. Therefore, critical follow-up and management should be given to patients with underlying diseases is required.

Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study.

Background: Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally. Objective: The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia. Methods: A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant. Results: The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18). Conclusion: The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

The magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults attending University of Gondar comprehensive specialized hospital north west Ethiopia 2021 GC, cross sectional study design.

BACKGROUND: Immune hemolytic anemia commonly affects human immune deficiency infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV which accompanies the greatest percent from acquired hemolytic anemia. OBJECTIVE: The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. METHODS: An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination and antihuman globulin test were performed to diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. RESULT: The overall prevalence of immune hemolytic anemia was 2.8% (10 of 358 participants). Of these 5 were males and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40% mild and 60% moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). CONCLUSION AND RECOMMENDATION: Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.