scholarly journals Clinical profile, in-hospital outcome and associated factors of stroke after the start of a standard organized stroke care unit at university of Gondar hospital, northwest Ethiopia.

2019 ◽  
Author(s):  
Seid Getahun Abdella ◽  
Nebiyu Bekele Gebi ◽  
Ermias Shenkutie Gerffie ◽  
Koku Sisay Tamirat

Abstract Background: Stroke is the leading public health problem globally. Stroke management largely depends on non-drug interventions. Stroke care units are facilities in hospitals that showed patients increased survival, return home, and regain independence in daily activities. This study was aimed to assess clinical profile, in-hospital outcome and its associated factors of stroke after the start of a standard organized stroke care unit in the study area. Method: Hospital based cross sectional study was conducted from July 2015 to September 2017. A total of 151 stroke patients with computed tomography (CT) scan result were included in the study. Data was collected using standardized questionnaire from secondary sources like patients medical records. Binary logistic regression were fitted to identify predictor variables. Adjusted Odds ratio(OR) with 95% confidence interval was computed and variables with p-value less than 0.05 in the multi-variable regression model considered as significantly associated with the dependent variables. Result: Ischemic stroke (60.3%) subtype was the most common. The median age at presentation was 65 (IQR: 55-75) years. Hypertension (49.7%) and carotid atherosclerosis (54.7%) were the most commonly identified risk factors. Overall In-hospital mortality was 9.3% (95% CI: 5.2%-15.1%), poor disability outcome at discharge was 55.6% (95%CI: 47.3%-63.7%), and median length of hospital stay was 10 (IQR: 7-14) days. Being male (AOR=0.19, 95%CI: 0.038 0.97), longer in-hospital stays (AOR=0.21, 95%CI: 0.048 0.93) were significant predictors of in-hospital mortality. Furthermore increased ICP (AOR=2.81, 95%CI: 1.22 6.92) was also the predictor of poor disability outcome at discharge. Conclusion: In-hospital mortality was lower than previous studies. However post-discharge disability is higher. Male sex, length of in-hospital stay, was significant predictors of in-hospital mortality. Increased intracranial pressure was also significant predictor of poor disability outcome at discharge. Key words: In hospital outcome, Mortality, poor outcome, stroke care unit, Gondar

2019 ◽  
Author(s):  
Seid Getahun Abdella ◽  
Nebiyu Bekele Gebi ◽  
Ermias Shenkutie Gerffie ◽  
Koku Sisay Tamirat

Abstract Background: Epidemiological transitions and widespread risk factors made stroke common health problem in sub-Saharan countries in the early age. Stroke management largely depends on non-drug interventions. Stroke care units are facilities in hospitals which increased patient survival, return home, and regain independence in daily activities. This study was aimed to assess clinical profile, in-hospital outcome and its associated factors of stroke after the start of a standard organized stroke care unit in the study area. Method: An institution based cross-sectional study was employed from July 2015 to September 2017. A total of 151 stroke patients with computed tomography (CT) scan result were included in the study. Data were collected using structured questionnaire from secondary sources of patient medical records. In-hospital mortality and poor post-stroke disability (greater functional impairment, when Modified Rankin Scale score (mRS) ≥3) were outcome variables. Binary logistic regression model was fitted to identify predictor variables. Adjusted Odds Ratio (OR) with a 95% confidence interval (CI) used to assess the strength of association. Variables with p-value less than 0.05 in the multi-variable regression model was considered as significantly associated with the dependent variables. Result: Ischemic stroke (60.3%) subtype was the most common. The median age at presentation was 65 (IQR: 55-75) years. Hypertension (49.7%) and carotid atherosclerosis (54.7%) were the most commonly identified risk factors. Overall in-hospital mortality was 9.3% (95% CI: 5.2%-15.1%), poor post-stroke disability was 55.6% (95%CI: 47.3%-63.7%), and median length of hospital stay was 10 (IQR: 7-14) days. Being male (AOR=0.19, 95%CI: 0.038 0.97), longer in-hospital stays (AOR=0.21, 95%CI: 0.048 0.93) were significant predictors of in-hospital mortality. Furthermore increased ICP (AOR=2.81, 95%CI: 1.22 6.92) was also the predictor of poor post-stroke disability at discharge. Conclusion: Ischemic stroke was the most common stroke subtype. In-hospital mortality was relatively lower. However, greater functional impairment was high at discharge. Stroke morality was observed lower among male and longer in-hospital stay patients, while evidence of increased intracranial pressure was associated with poor post-stroke disability at discharge.


2019 ◽  
Author(s):  
Zewdu Yenegeta Bizuneh ◽  
Ayanaw Tsega ◽  
Yezinash Addis ◽  
Fisseha Admassu

Abstract Introduction: Glaucoma is a global public health problem and it is the leading cause of irreversible blindness worldwide and the fifth cause of blindness in Ethiopia. Even though public knowledge of glaucoma is a key for early case identification and prevention of blindness, it is unknown in the study area, making provision of interventions difficult. Objective: To assess knowledge of glaucoma and associated factors among adults in Gish Abay town, Northwest Ethiopia, 2018 Methods: A Community based cross - sectional study design with systematic random sampling technique was used to select 630 adults. The study was conducted from April 25-May 05, 2018. Data was entered into Epi Info version 7 and was analysed by Statistical Package for Social Sciences version 23. Binary logistic regression model and adjusted odds ratio with 95% confidence level was used to identify the significant factors associated with knowledge of glaucoma. P–value ≤ 0.05 was considered statistically significant. Results: About 594 adults were participated with a response rate of 94%. Nearly 52% of the participants were females with median age of 28 years. The proportion of good knowledge was demonstrated in 68.9% [95% CI; 61, 75.9]. Educational status: secondary education [AOR; 4.01: 1.15, 13.94], college and above [AOR; 4.49: 1.31, 15.32], history of eye examination [AOR; 2.86: 1.05, 7.79] and younger age (18-22) [6.39: 1.82, 22.41] were positively associated with good knowledge of glaucoma. Conclusion and recommendation: The proportion of good knowledge of glaucoma was high. Better educational status, younger age, eye examination at least once in life and higher income level were associated with better knowledge of glaucoma. Recognizing the severity of glaucoma, enhancing knowledge is paramount at the community.


Author(s):  
Fatima Bello Jiya ◽  
Paul Kehinde Ibitoye ◽  
Nma Muhammed Jiya ◽  
Mohammed Hassan Abba

Aims: To determine the clinical and laboratory profile of children with acute post streptococcal glomerulonephritis (APSGN) admitted into Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, the outcome, and factors associated with in-hospital mortality. Study Design: A 5- year retrospective study. Place of Study: Emergency Paediatric Unit (EPU) and Paediatric Medical Ward (PMW) of the Department of Paediatrics, UDUTH Sokoto. Methodology: The records of children aged 4 to 14 years with the diagnosis of APSGN were reviewed. Relevant history, physical examination findings, laboratory and radiologic investigation findings were extracted from their case folders and recorded into a proforma sheet. Data was analyzed using SPSS version 23. (IBM SPSS Inc., USA). The level of statistical significance was set at 5%, which is p-value < 0.05. Results: Fifty-four (0.9%) of the 6128 children were managed for APSGN giving a prevalence of 10.8 APSGN cases per 1000 children. Forty-one folders were utilized for the study. There were 21(51.2%) females and 20(48.8%) males, with F:M ratio of 1.1:1. Mean age at presentation was 9.1± 3.1 years. Majority (92.6%) were ≥5 years and mainly 22(53.7%) of low socio-economic status. The main features were body swelling 40(97.6%), fever 25(61.0%), oliguria 24(58.5%), systemic hypertension 37(90.2%), proteinuria 41(100.0%), and haematuria 41(100.0%). Acute kidney injury was the commonest 25(61.0%) complication. Thirty (73.2%) cases were discharged, 5 (12.2%) died, 6(14.6%) left against medical advice. Low social status (0.03), requirement for dialysis (p=0.003), congestive cardiac failure (p=0.01), and pulmonary oedema (p=0.04) were significantly associated with in-hospital mortality. Requirement for dialysis (p=0.005) was the independent predictor of in-hospital mortality. At three months post discharge, 20(48.8%) of the 31 cases had achieved complete resolution of APSGN. Conclusion: APSGN is common in Sokoto and similar in pattern to other reports from Nigeria. The presence of complications at presentation increases the risk of in-hospital mortality.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249024
Author(s):  
Misganaw Gebrie Worku ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale

Background Though the consequences of teenage pregnancy and early motherhood has been studied very well, little is known about the magnitude as well as the determinants of adolescent fatherhood. Unlike adolescent motherhood, limited public health programs are working on adolescent fatherhood. Currently, in developed countries, there is an increased work to acknowledge teen fathers in clinical practice and in the research forum, but still, there are more issues that need to be addressed in developing countries including Ethiopia. Therefore, this study aimed to investigate the prevalence and associated factors of adolescent fatherhood in Ethiopia based on the nationally representative survey. Methods This study used the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 4455 adolescent men was included for the final analysis. For the associated factors, multilevel logistic regression analysis was conducted to consider the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance (-2LLR) were used for model comparison and for assessing model fitness. The model with the largest adjusted R2, lowest Bayesian Information Criteria (BIC) and the smallest cross-validation prediction error were considered as the best-fitted model. In the multivariable analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the presence of statistically significant factors associated with adolescent fatherhood, and variables with p-value <0.05 were considered as a significant variable. Results The prevalence of adolescent fatherhood in Ethiopia was 6.79% [95%CI; 6.08%, 7.56%]. Adolescent men with contraceptive knowledge [AOR = 4.25; 95%CI = 1.23, 14.69], age in 20 to 24 years [AOR = 7.93; 95%CI = 3.66, 17.27] and being Muslim [AOR = 1.84; 95%CI = 1.02, 3.39] were significantly associated with Higher odds of adolescent fatherhood. Individuals who initiate sex lately [AOR = 0.35; 95%CI = 0.22, 0.54], being in female-headed family [AOR = 0.46; 95%CI; 0.26, 0.82] and being from Amhara region [AOR = 0.35; 95%CI = 0.14, 0.84] were significantly associated with lower odds of adolescent fatherhood. Conclusion In this study, adolescent fatherhood was a common public health problem in Ethiopia as it is closely linked with poor quality of life and premature death (year of potential life lost). Age of respondent, knowledge of respondent about contraceptive methods, early initiation of sex, religion, sex of household head, and region were significantly associated with adolescent fatherhood. Therefore, program planners and decision-makers should give special attention to adolescent men through enhancing reproductive health services utilization and their knowledge towards it to decrease the incidence of adolescent fatherhood.


2020 ◽  
Author(s):  
Zhonghai Zhu ◽  
Christopher R. Sudfeld ◽  
Yue Cheng ◽  
Qi Qi ◽  
Shaoru Li ◽  
...  

Abstract Background: Evidence on the prevalence and associated factors of anemia among young adolescent girls and boys in rural western China is limited. Methods: We used data from a follow-up study of adolescents (10-14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the risk factors for anemia. Results: The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 65% (95% CI 7%, 87%) less likely to be anemic, compared with those of whom had <3 years. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (p-value for interaction was 0.04): males with greater than mild puberty development had 65% (95% CI 17%, 85%) reduced odds of anemia while there was no association among females (OR: 0.72, 95% CI 0.29, 1.78). Consumption of flesh foods, eggs, and having a meal frequency of three times or more per day were associated with 42% (95% CI 11%, 62%), 40% (95% CI 7%, 62%) and 32% (95% CI 4%, 52%) reduced odds of anemia, respectively. Conclusions: Anemia is a public health problem among adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group.


2020 ◽  
Author(s):  
Melak Aynalem ◽  
Elias Shiferaw ◽  
Yemataw Gelaw ◽  
Bamlaku Enawgaw

Abstract Background: Coagulopathy is the major cause of mortality and morbidity throughout the world. Globally, about 26 - 45% of healthy people have a history of bleeding symptoms, which may be a result of thrombocytopenia, factor deficiency, or pathological inhibitory.Objective: To assess coagulopathy and its associated factors among bleeding diathesis patients attending at University of Gondar Specialized Referral Hospital from January to May 2020.Method: A cross-sectional study was conducted on 384 study participants with bleeding diathesis recruited by using a convenient sampling technique. Socio-demographic and clinical characteristics were collected by using questioners. Then 6ml venous blood was collected with a needle and syringe method. About 3ml blood was transferred to EDTA test tube for platelet count and 2.7ml blood was transferred to a test tube containing 0.3ml of 3.2% sodium citrated anticoagulant for coagulation test. For those study participants with prolonged coagulation tests, a mixing test was done to differentiate the causes of coagulopathy whether factor deficiency or inhibitors. Blood film and stool examination were also done for malaria and intestinal parasite identification, respectively. The data were entered into EPI-Info version 3.5.3 and then transferred to SPSS version-20 for analysis. Descriptive statistics were summarized as percentages, means, and standard deviations. Bivariate and multivariate logistic regression was used to identify the associated factors, and a P-value less than 0.05 was considered as statistically significant.Results: In this study, the prevalence of coagulopathy was 253/384 (65.9%; 95% CI: 61.16, 70.64). From them, 21.3% (54/253), 51.4% (130/253), and 27.3% (69/253) had only thrombocytopenia, only prolonged coagulation test, and mixed abnormality, respectively. Among participants with prolonged coagulation time, the prevalence of factor deficiency was 21.1% (42/199). Cardiac disease (AOR = 4.80; 95% CI: 2.65, 23.1), and other chronic diseases (AOR = 8.1; 95% CI: 1.84, 35.58) were significantly associated with coagulopathy.Conclusion: Coagulopathy due to inhibitory was a public health problem. The participant with cardiac and other chronic disease was associated with coagulopathy. Therefore, mixing tests could done for all prolonged coagulation test and it could be considered as a routine laboratory test.


2020 ◽  
Author(s):  
Zhonghai Zhu ◽  
Christopher R. Sudfeld ◽  
Yue Cheng ◽  
Qi Qi ◽  
Shaoru Li ◽  
...  

Abstract Background:Evidence on the prevalence and associated factors of anemia among young adolescentgirls and boys in rural western Chinais limited.Methods: We used data from a follow-up study of adolescents (10-14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the riskfactors for anemia.Results: The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 65% (95%CI 7%, 87%) less likely to be anemic, compared with those of whom had <3 years. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (p-value for interaction was 0.04): males with greater than mild puberty development had 65% (95% CI 17%, 85%) reduced odds of anemia while there was no association among females (OR:0.72, 95% CI 0.29, 1.78). Consumption of flesh foods, eggs,and having a meal frequency of three times or more per day wereassociated with 42% (95% CI 11%, 62%), 40% (95% CI 7%, 62%) and 32% (95% CI 4%, 52%) reduced odds of anemia, respectively.Conclusions: Anemia is a public health problem among adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group.


2019 ◽  
Author(s):  
Merhawit Gebremeskel Hagos ◽  
Teferi Gebru Gebremeskel ◽  
Selam Shushay Kassahun ◽  
Birhane Hailu Gebrezgi ◽  
Manay Kifle Woldegebriel

Abstract Background Delay in receiving immunization is a major public health problem that has been associated with vaccine preventable disease epidemics. In Ethiopia, many children have not received the benefits of age appropriate immunization; thus more than 90% of child deaths are largely due to preventable communicable diseases. Therefore, assessment of magnitude and associated factors of delayed child immunization is essential to prevent morbidity and mortality among children. Objective To assess magnitude and factors associated with delayed immunization among 11 -23 months old children in Edagahamus Town, Tigray, Ethiopia, 2018 G.C. Method and materials A community based Cross-Sectional study was carried out on July1-30, 2018. Simple random sampling method was used to select study participants. Information was collected using structured, pre-tested questionnaire. Vaccination dates were obtained from children immunization cards and timeliness assessed based on the recommended age ranges. Data were entered and analyzed using SPSS version 20.0. Variable with P-value < 0.2 in bivariatewere exported to multivariate. The strength of association was identified using odds ratio with 95% confidence interval (CI) and P-value of <0.05 in multivariate was taken statistically significant. Results In this study the overall magnitude of delayed immunization was29.5%(95%CI 26.7-45). Private firm work of mothers(AOR=0.205 95% CI 0.068-0.617), sickness of the child(AOR= 11.8, 95% CI 6.16-22.65), Mothers who attend tertiary education (AOR 0.169, 95% CI 0.032-0.882) and secondary education (AOR 0.269, 95% CI 0.114-0.636) were significantly associated with delayed immunization. Conclusion From the study it is concluded that the magnitude of delayed immunization for children aged 12-23 months is high (29.5%) in Edagahamus. Delayed immunizations of children were predicted by Mother’s occupation, education and experience of illness of the child.


2021 ◽  
Author(s):  
Kessete Ayelgn ◽  
Tadesse Guadu ◽  
Atalay Getachew

Abstract BackgroundTrachoma is an infectious disease of the eye caused by Chlamydia trachomatis and transmitted via contact with eye discharge from infected persons and leading to blindness worldwide. Children less than 9 years of age affected more seriously. The disease is common where access to water and sanitation are limited.ObjectiveTo determine the prevalence of active trachoma and associated factors among children aged 1–9 years in rural communities of Metema District, West Gondar Zone, Northwest Ethiopia.MethodA community based cross-sectional study design was used to collect data from 792 children aged 1–9 years old in Metema district from April to May 2018. Multistage sampling technique was used to select the study participants. Pretested interviewer-administered structured questionnaire and eye examination using binocular loupe to differentiate trachoma cases was the data collection methods and tools. The bivariable and multivariable binary logistic regression model was employed for analysis. P-value < 0.05 was considered to declare statistical significance.ResultsA total of 752 children aged l-9 years were enrolled in this study with response rate of 94.9%. The overall prevalence of active trachoma among the study participants was 11.8% (95 % CI, 9.5–13.9). Unprotected source of water (AOR = 4.7; 95% CI: 2.5–8.9), lower household water consumption (AOR = 2.8; 95% CI: 1.3-6.0), improper latrine utilization (AOR = 3.2; 95% CI: 1.5–6.7), and frequency of face washing once per day (AOR = 5.3; 95% CI: 1.2–26.6) were the factors significantly associated with active trachoma.ConclusionThe current study revealed a lower overall prevalence of active trachoma (11.8%) than the WHO threshold prevalence (20%) used to declare it as a severe public health problem. All residents and health professional should collaborate on trachoma prevention by implementing the WHO SAFE strategy- surgery for trichiasis, antibiotics, facial cleanliness and environmental improvement for further trachoma elimination.


2020 ◽  
Author(s):  
Sisay Eshete Tadesse ◽  
Tefera Chane Mekonnen ◽  
Yitbarek Wasihun Feleke ◽  
Metadel Adane Mesfine ◽  
Nigus Cherie Bekele ◽  
...  

Abstract Background Worldwide there are up to 300,000 known plant species. But, only 2% are consumed by human. Under nutrition among under five children is still a public health problem. There is an information gap on the importance of agricultural biodiversity in relation to dietary intake and nutritional status. Objective to assess the correlation between agricultural bio-diversity, dietary diversity, household food insecurity and associated factors of wasting among 6-59 months old children. Method A community based cross-sectional study was employed among 367 systematically selected children aged 6-59 months from January to April 2018. The sample size was determined by Epi Info 7.2.5.1. Data were collected by open data kit. Height and weight were measured using height measuring board and SECA Germany. Data entry and analysis was done using Epi Data version 3.1 and STATA version 14. Descriptive statistics was computed and reported using frequency and percentage. Anthropometric measurements were analyzed using WHO Anthro 2005 software. Linear regression and correlation were done. A p-value of < 0.05 and 95% confidence intervals were used to see the statistical significance. Result The prevalence of wasting was 7.3%(95% C.I; 4.6, 10.0). Dietary diversity score is found to be correlated with height for weight Z score (r=-0.11, p-value=0.04) of children. Mother who are unable to read and write (B=-.126, 95% CI: -1.02, -.034) and dietary diversity score (B=.143, 95% CI: .14, 1.86) were factors associated with wasting. Conclusion and Recommendation Wasting is higher than the national target of Ethiopia. Educational status of mother and DDS were factors associated with wasting among children aged 6-59 months. Prevention of nutritional problem should include reducing illiteracy rate among mother/care-givers and promote diversified intake of diet among 6-59 months old.


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