Assessment of Smear-Positive Pulmonary Tuberculosis and Associated Factors among Patients Visiting Health Facilities of Gedeo Zone, Southern Ethiopia: A Cross-Sectional Study.

Introduction: Tuberculosis (TB) was one of the top causes of ill health and the leading cause of deaths worldwide until the coronavirus (COVID-19) pandemic. Hence, this study is aimed at assessing the prevalence of sputum smear-positive TB and associated factors among TB-suspected patients attending in Gedeo Zone health facilities, Southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 220 TB-suspected patients in Gedeo Zone health facilities from July 01 to Sep 30, 2021. Patients were grouped as smear positive if one sputum out of two was positive or two sputum smears became positive. Various descriptive statistics were computed using the SPSS-25, and factors to smear positivity were identified by multivariable logistic regression analysis. Odds ratio at 95% CI and p values < 0.05 were considered as indicators of statistical association. Results: The overall prevalence of smear-positive TB in Gedeo Zone health facilities was 18.2%, which is significantly high, and the MTB detection rate of GeneXpert was 29.5%. Contact with a TB patient, cigarette smoking, and previously treatment for TB were factors significantly associated with smear-positive TB. Conclusion: The prevalence rate of smear-positive PTB in the study area was 18.2% and 29.5% by direct sputum AFB and sputum GeneXpert, respectively. As a result, we recommend intervention on the identified associated risk factors and further studies to ascertain risk factors and their magnitude at the community level.

Pattern of disease and determinants of mortality among ICU patients on mechanical ventilator in Sub-Saharan Africa: a multilevel analysis.

BACKGROUND: The global mortality rate of patients with MV is very high, despite a significant variation worldwide. Previous studies conducted in Sub-Saharan Africa among ICU patients focused on the pattern of admission and the incidence of mortality. However, the body of evidence on the clinical outcomes among patients with MV is still uncertain. OBJECTIVE: The objective of this study was to investigate the pattern of disease and determinants of mortality among patients receiving mechanical ventilation in Southern Ethiopia. METHODS: Six hundred and thirty patients on mechanical ventilation were followed for 28 days, and multilevel analysis was used to account for the clustering effect of ICU care in the region. RESULTS: The incidence of 28-day mortality among patients with MV was 49% (95% CI: 36-58). The multilevel multivariate analysis revealed that being diabetic, having GSC < 8, and night time admission (AOR = 7.4; 95% CI: 2.96-18.38), (AOR = 5.9; (5% CI: 3.23, 10.69), and (AOR = 2.5; 95% CI: 1.24, 5.05) were predictors. CONCLUSION: The higher 28-day mortality among ICU patients on mechanical ventilation in our study might be attributed to factors such as delayed patient presentation, lack of resources, insufficient healthcare infrastructure, lack of trained staff, and financial constraints. TRIAL REGISTRATION: The protocol was registered retrospectively on ( NCT05303831 ).

Time from symptom onset to severe COVID-19 and risk factors among patients in Southern Ethiopia: a survival analysis.

OBJECTIVE: This study aimed to assess the time to severe coronavirus disease 2019 (COVID-19) and risk factors among confirmed COVID-19 cases in Southern Ethiopia. METHOD: This two-center retrospective cohort study involved patients with confirmed COVID-19 from 1 October 2020 to 30 September 2021. Kaplan-Meier graphs and log-rank tests were used to determine the pattern of COVID-19 severity among categories of variables. Bivariable and multivariable Cox proportional regression models were used to identify the risk factors of severe COVID-19. RESULTS: Four hundred thirteen patients with COVID-19 with a mean age of 41.9 ± 15.3 years were involved in the study. There were 194 severe cases (46.9.1%), including 77 (39.6%) deaths. The median time from symptom onset to severe COVID-19 was 8 days (interquartile range: 7-12 days). The risk factors for severe COVID-19 were age >65 (adjusted hazard ratio [AHR] = 2.65, 95% confidence interval [95%CI]: 1.02, 3.72), cough (AHR = 1.59, 95%CI: 1.39, 2.84), chest pain (AHR = 1.47, 95%CI: 1.34, 2.66), headache (AHR = 2.04, 95%CI: 1.43, 2.88), comorbidity (AHR = 1.3, 95%CI: 1.01, 2.04), asthma (AHR = 1.6. 95%CI: 1.04, 2.24), and symptom onset to admission more than 5 days (AHR = 0.48, 95%CI: 0.34, 0.68). CONCLUSION: Patients with symptoms and comorbidities should be closely monitored.

Case Report: Kanamycin Ototoxicity and MDR-TB Treatment Regimen.

INTRODUCTION: Aminoglycosides are ototoxic drugs because they have the ability to destroy the inner ear structures irreversibly. They are used to treat Gram-negative bacterial infections that are aerobic and as a second-line treatment for tuberculosis. CASE PRESENTATION: A 40-year-old male from Dilla presented with right side chest pain and cough which is productive of whitish sputum of one-year duration, after investigation the diagnosis of multiple-drug resistant tuberculosis (MDR-TB) was made and the patient was started with a short-term MDR-TB treatment regimen (4-6 KM-Mf-Pto-Cfz-Z-HH-E/5Mfx-Cfz-Z-E). Two and half months after the initiation of treatment, he developed decreased bilateral hearing ability and he had also vertigo, but this patient has no hearing impairment before the initiation of the anti-TB treatment. Then the diagnosis of sensor neural hearing loss secondary to drug toxicity (kanamycin) was made. Then the treatment was discontinued for four days as a result of ototoxicity and the patient was referred to Yirgalem Hospital for further workup and management. CONCLUSION: Injectable-containing MDR-TB regimens can cause permanent hearing loss. Hearing loss during treatment for MDR-TB with kanamycin can occur at any time. Systematic monitoring of AEs during and after the end of treatment needs to be strengthened in most TB programs. It is important to monitor for hearing loss and kidney function.

Novel Coronavirus (COVID-19)-Associated Guillain-Barre' Syndrome: Case Report.

Though the novel corona virus (COVID-19) mostly affects the respiratory system, it can also result in several neurological complications. One of these is Guillain-Barré Syndrome (GBS) and which is rare and only reported from some parts of the world during this pandemic. Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy. Patients can present with limb or cranial-nerves weakness, loss of deep tendon reflexes, sensory and dysautonomic symptoms. The main pathophysiology for the clinical presentation is demyelination and/or axonal damage to peripheral nerves or roots. Neurological manifestations are more commonly associated with severe COVID-19 infection. Here, we present a case of Guillain-Barré syndrome associated with COVID-19 in Ethiopia.

Magnitude, Symptom Presentation and Correlates of Psychological Distress Among People with Epilepsy in Southern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Psychological distress is a common co-morbid condition among people with epilepsy. Untreated comorbid psychosocial problems are associated with increased morbidity and health-care costs, and negatively affects treatment outcome of people with epilepsy. Therefore, the aim of this study was to describe the prevalence of psychological distress and to identify its associated factors among people with epilepsy attending outpatient treatment in Gedeo zone public hospitals, Southern Ethiopia. PATIENTS AND METHODS: This was an institution-based cross-sectional study conducted at Gedeo zone public hospitals from July 1st to October 1st, 2019. Self-reporting questionnaire was used to screen individuals with epilepsy for the presence of co-morbid psychological distress. A face to face interview was conducted among 321 anti-epileptic medication followers. The collected data were entered into Epi-Data version 3.1 and then exported to SPSS version 20 for further analysis. Binary logistic regression was computed to identify factors associated with psychological distress. Statistically, significant association was set at p-values of <0.05 in the final model with a corresponding 95% confidence interval. RESULTS: The prevalence of psychological distress was found to be 38.3% with 95% CI (34.1, 42.7) among people with epilepsy attending outpatient follow-up in Gedeo zone public hospitals. Being female [OR=1.57 (95% CI: 1.01-4.80)], uncontrolled seizures [OR=1.96 (95% CI: 1.21-3.18)], and longer duration of illness [OR= 3.16 (95% CI: 1.75-5.73)] were variables found to have statistically significant association with psychological distress. CONCLUSION: The findings of this study revealed that more than one-third of people with epilepsy screened positive for psychological distress. Therefore, this demonstrates a need to design and implement programs focusing on the prevention, early screening, and providing appropriate interventions for psychological distress among people with epilepsy.