scholarly journals Determining the Agreement Between an Automated Respiratory Rate Counter and a Reference Standard for Detecting Symptoms of Pneumonia in Children: Protocol for a Cross-Sectional Study in Ethiopia (Preprint)

2019 ◽  
Author(s):  
Charlotte Ward ◽  
Kevin Baker ◽  
Sarah Marks ◽  
Dawit Getachew ◽  
Tedila Habte ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Human Error ◽  
Health Workers ◽  
Addis Ababa ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Reference Standard ◽  
Sectional Study ◽  
Cross Sectional

BACKGROUND Acute respiratory infections (ARIs), primarily pneumonia, are the leading infectious cause of under-5 mortality worldwide. Manually counting respiratory rate (RR) for 60 seconds using an ARI timer is commonly practiced by community health workers to detect fast breathing, an important sign of pneumonia. However, correctly counting breaths manually and classifying the RR is challenging, often leading to inappropriate treatment. A potential solution is to introduce RR counters, which count and classify RR automatically. OBJECTIVE This study aims to determine how the RR count of an Automated Respiratory Infection Diagnostic Aid (ARIDA) agrees with the count of an expert panel of pediatricians counting RR by reviewing a video of the child’s chest for 60 seconds (reference standard), for children aged younger than 5 years with cough and/or difficult breathing. METHODS A cross-sectional study aiming to enroll 290 children aged 0 to 59 months presenting to pediatric in- and outpatient departments at a teaching hospital in Addis Ababa, Ethiopia, was conducted. Enrollment occurred between April and May 2017. Once enrolled, children participated in at least one of three types of RR evaluations: (1) agreement—measure the RR count of an ARIDA in comparison with the reference standard, (2) consistency—measure the agreement between two ARIDA devices strapped to one child, and (3) RR fluctuation—measure RR count variability over time after ARIDA attachment as measured by a manual count. The agreement and consistency of expert clinicians (ECs) counting RR for the same child with the Mark 2 ARI timer for 60 seconds was also measured in comparison with the reference standard. RESULTS Primary outcomes were (1) mean difference between the ARIDA and reference standard RR count (agreement) and (2) mean difference between RR counts obtained by two ARIDA devices started simultaneously (consistency). CONCLUSIONS Study strengths included the design allowing for comparison between both ARIDA and the EC with the reference standard RR count. A limitation is that exactly the same set of breaths were not compared between ARIDA and the reference standard since ARIDA can take longer than 60 seconds to count RR. Also, manual RR counting, even when aided by a video of the child’s chest movements, is subject to human error and can result in low interrater reliability. Further work is needed to reach global consensus on the most appropriate reference standard and an acceptable level of agreement to provide ministries of health with evidence to make an informed decision on whether to scale up new automated RR counters. CLINICALTRIAL ClinicalTrials.gov NCT03067558; https://clinicaltrials.gov/ct2/show/NCT03067558 INTERNATIONAL REGISTERED REPORT RR1-10.2196/16531

scholarly journals Determining the Agreement Between an Automated Respiratory Rate Counter and a Reference Standard for Detecting Symptoms of Pneumonia in Children: Protocol for a Cross-Sectional Study in Ethiopia

10.2196/16531 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e16531
Author(s):  
Charlotte Ward ◽  
Kevin Baker ◽  
Sarah Marks ◽  
Dawit Getachew ◽  
Tedila Habte ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Human Error ◽  
Health Workers ◽  
Addis Ababa ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Reference Standard ◽  
Sectional Study ◽  
Cross Sectional

Background Acute respiratory infections (ARIs), primarily pneumonia, are the leading infectious cause of under-5 mortality worldwide. Manually counting respiratory rate (RR) for 60 seconds using an ARI timer is commonly practiced by community health workers to detect fast breathing, an important sign of pneumonia. However, correctly counting breaths manually and classifying the RR is challenging, often leading to inappropriate treatment. A potential solution is to introduce RR counters, which count and classify RR automatically. Objective This study aims to determine how the RR count of an Automated Respiratory Infection Diagnostic Aid (ARIDA) agrees with the count of an expert panel of pediatricians counting RR by reviewing a video of the child’s chest for 60 seconds (reference standard), for children aged younger than 5 years with cough and/or difficult breathing. Methods A cross-sectional study aiming to enroll 290 children aged 0 to 59 months presenting to pediatric in- and outpatient departments at a teaching hospital in Addis Ababa, Ethiopia, was conducted. Enrollment occurred between April and May 2017. Once enrolled, children participated in at least one of three types of RR evaluations: (1) agreement—measure the RR count of an ARIDA in comparison with the reference standard, (2) consistency—measure the agreement between two ARIDA devices strapped to one child, and (3) RR fluctuation—measure RR count variability over time after ARIDA attachment as measured by a manual count. The agreement and consistency of expert clinicians (ECs) counting RR for the same child with the Mark 2 ARI timer for 60 seconds was also measured in comparison with the reference standard. Results Primary outcomes were (1) mean difference between the ARIDA and reference standard RR count (agreement) and (2) mean difference between RR counts obtained by two ARIDA devices started simultaneously (consistency). Conclusions Study strengths included the design allowing for comparison between both ARIDA and the EC with the reference standard RR count. A limitation is that exactly the same set of breaths were not compared between ARIDA and the reference standard since ARIDA can take longer than 60 seconds to count RR. Also, manual RR counting, even when aided by a video of the child’s chest movements, is subject to human error and can result in low interrater reliability. Further work is needed to reach global consensus on the most appropriate reference standard and an acceptable level of agreement to provide ministries of health with evidence to make an informed decision on whether to scale up new automated RR counters. Trial Registration ClinicalTrials.gov NCT03067558; https://clinicaltrials.gov/ct2/show/NCT03067558 International Registered Report Identifier (IRRID) RR1-10.2196/16531

scholarly journals Assessment of Job Satisfaction Level and Its Associated Factors among Health Workers in Addis Ababa Health Centers: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Mesfin Aklilu ◽  
Waleleng Warku ◽  
Wogayehu Tadele ◽  
Yimer Mulugeta ◽  
Hussene Usman ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Healthcare Workers ◽  
Associated Factors ◽  
Health Workers ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Satisfaction Level ◽  
Sectional Study ◽  
Cross Sectional

Health workers account for the largest share of public expenditures on health and play an important role in improving the quality of health services. There is concern that poor health worker performance limits the effectiveness of health systems strengthening efforts. A cross-sectional study was conducted from September to October 2016 in Addis Ababa health centers. Data were collected from 420 healthcare workers using a pretested and structured questionnaire by trained data collectors. EPI Info 7 was used for data entry, and analysis was done by SPSS version 20. Bivariate and multivariate logistic analyses were used to identify factors associated with the outcome variable and to control confounders. P values less than 0.05 were considered statistically significant. The overall job satisfaction level accounts for 53.8% with 95% CI of (48.9%, 59.0%). Marital status and professional qualification were the potent predictors of job satisfaction. Respondents who never married were 1.65 times more likely to be satisfied in their job than those married or divorced (AOR: 1.65 (95% CI: 1.02, 2.66)). Laboratory professionals and nursing professionals were 2.74 and 1.97 times more likely to be satisfied in their job compared to health officers (AOR: 2.47 (95% CI: 1.14, 6.59) and AOR: 1.97 (95% CI: 1.12, 3.48), respectively). More than half of the healthcare workers in the study area were satisfied in their job. Marital status and healthcare workers’ profession type were predictors of job satisfaction. Research studies indicate that there is a positive relationship between performance and job satisfaction. Accordingly, the present study aimed at determining the level of job satisfaction of health workers and its associated factors in the health centers of Addis Ababa, Ethiopia.

scholarly journals Tired, Worried and Burned Out, but Still Resilient: A Cross-Sectional Study of Mental Health Workers in the UK during the COVID-19 Pandemic

2021 ◽  
Vol 18 (9) ◽  
pp. 4457
Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas
Keyword(s):  
Mental Health ◽  
Emotional Exhaustion ◽  
Organizational Support ◽  
Sleep Problems ◽  
Health Workers ◽  
Maslach Burnout Inventory ◽  
Cross Sectional Study ◽  
Mental Health Workers ◽  
Sectional Study ◽  
Cross Sectional

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.

scholarly journals Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Workers ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

scholarly journals Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044824
Author(s):  
Shegaye Shumet ◽  
Bethlehem W/Michele ◽  
Dessie Angaw ◽  
Temesgen Ergete ◽  
Nigus Alemnew
Keyword(s):  
Social Support ◽  
Bipolar Disorder ◽  
Associated Factors ◽  
Addis Ababa ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Poor Social Support

ObjectivesTo assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.DesignInstitution-based cross-sectional study design.SettingAmanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.ParticipantsWe recruited about 418 participants using systematic sampling technique for an interview during the study period.MeasurementData were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.ResultsThe magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.ConclusionsOne in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.

scholarly journals The Prevalence of Necrotizing Enterocolitis and Associated Factors Among Enteral Fed Preterm and Low Birth Weight Neonates Admitted in Selected Public Hospitals in Addis Ababa, Ethiopia: A Cross-sectional Study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Sitotaw Molla Mekonnen ◽  
Daniel Mengistu Bekele ◽  
Fikrtemariam Abebe Fenta ◽  
Addisu Dabi Wake
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Gestational Age ◽  
Associated Factors ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.

Status of Histopathology Services In Ethiopia

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S120-S120
Author(s):  
G O Yeabyo
Keyword(s):  
Addis Ababa ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Status ◽  
Prevention Of Cancer ◽  
Great Public Health ◽  
Cancer Diseases

Abstract Introduction/Objective Cancer is one of a great public health problem in developing countries like Ethiopia and scarcity of histopathology laboratory is another burden for diagnosis and follow up of cancer diseases. The main purpose of this study is to evaluate the accessibility of histopathology services in Ethiopia. Methods Cross sectional study design were used to analyze the status of histopathology services in Ethiopia. Results There are 13 histopathology laboratories in the nation and a survey was conducted at these institutions. Out of these 13 Histopathology services seven are located in the capital, Addis Ababa and six found out of the capital located in four different regions. About 40,239,100 habitants have no histopathology service around their catchment area. Conclusion There are very limited histopathology laboratories, as a result diagnosis and prevention of cancer diseases are inadequate throughout the country.

scholarly journals Metals Exposures of Residents Living Near the Akaki River in Addis Ababa, Ethiopia: A Cross-Sectional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ellen Yard ◽  
Tesfaye Bayleyegn ◽  
Almaz Abebe ◽  
Andualem Mekonnen ◽  
Matthew Murphy ◽  
...  
Keyword(s):  
Drinking Water ◽  
Addis Ababa ◽  
Urinary Iodine ◽  
Reference Value ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metal Levels ◽  
Akaki River

Background. The Akaki River in Ethiopia has been found to contain elevated levels of several metals. Our objectives were to characterize metals exposures of residents living near the Akaki River and to assess metal levels in their drinking water.Methods. In 2011, we conducted a cross-sectional study of 101 households in Akaki-Kality subcity (near the Akaki River) and 50 households in Yeka subcity (distant to the Akaki River). One willing adult in each household provided urine, blood, and drinking water sample.Results. Urinary molybdenum (p<0.001), tungsten (p<0.001), lead (p<0.001), uranium (p<0.001), and mercury (p=0.049) were higher in Akaki-Kality participants compared to Yeka participants. Participants in both subcities had low urinary iodine; 45% met the World Health Organization (WHO) classification for being at risk of moderate iodine deficiency. In Yeka, 47% of households exceeded the WHO aesthetic-based reference value for manganese; in Akaki-Kality, only 2% of households exceeded this value (p<0.001). There was no correlation between metals levels in water samples and clinical specimens.Conclusions. Most of the exposures found during this investigation seem unlikely to cause acute health effects based on known toxic thresholds. However, toxicity data for many of these metals are very limited.

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