Knowledge, Attitude, and Practice towards Malaria among People Attending Mekaneeyesus Primary Hospital, South Gondar, Northwestern Ethiopia: A Cross-Sectional Study

Background. Malaria is one of the most severe public health problems worldwide. It is a leading cause of suffering, death, and socioeconomic problem, especially in many developing countries like Ethiopia. To introduce appropriate preventive and control measures, assessment of community’s levels of knowledge, attitude, and preventative practices regarding malaria is crucial. This study was aimed at assessing the knowledge, attitude, and practice (KAP) towards malaria and its preventive and control methods among people attending Mekaneeyesus primary hospital, South Gondar, northwestern Ethiopia. Methods. A hospital-based cross-sectional study was conducted from September 2017 to April 2018. A structured questionnaire was administered to collect data on sociodemographic characteristics and KAP of 390 randomly selected individuals. The data collecting tool was pretested before commencing the actual data collection. The data were analyzed using the SPSS version 21 software. P values less than 0.05 were considered statistically significant. Results. The overall prevalence rate of malaria in the study area was 8.5%. Nearly two-third of the participants had good knowledge (63.1%) and positive attitude (62.6%) scores towards malaria while only half of the participants had (50.8%) good practice score towards malaria prevention and control measures. Sex, age category, family monthly income, residence, and occupational and educational status of the participants were significantly associated with knowledge and practice scores ( P < 0.05 ). The odds of malaria were 26.93 ( CI = 3.67 ‐ 197.47 , P = 0.001 ) and 13.09 ( CI = 0.93 ‐ 183.47 , P = 0.036 ) times higher among individuals who had poor knowledge and poor practice towards malaria, respectively, as compared to individuals who were knowledgeable and had good practice score towards malaria. Conclusion. The overall knowledge score, attitude, and practice level of respondents towards malaria was relatively good. However, significant proportion of the participants still have misconception about the cause, sign and symptoms, modes of transmission, and practices towards prevention methods of malaria. Thus, health education which is aimed at raising community’s awareness about the disease is necessary to address the gaps identified by this study.

A mixed methods analysis of the magnitude and associated factors of time management practice among primary hospital employees in North Gondar, Ethiopia

Time management contributes to work efficiency, maintaining balance, and job satisfaction by promoting productivity and success. Most people believe they have so much to do and not enough time, and they attribute their unmet expectations, poor results, and low productivity to a lack of time. The aim of this study was to determine the magnitude and associated factors of time management practice among primary hospital employees in North Gondar, Ethiopia.From March 15 to April 28, 2017, a hospital-based cross-sectional mixed methods (both quantitative and qualitative) study design was conducted in North Gondar Zone. For the quantitative part, pre-tested, standardized questionnaires; as well as an interviewer guide for the qualitative part of the study were used for data collection. Using a random sampling technique, 391 employees were completed the questionnaires. A multivariate and bi-variate logistic regression analysis at AOR with a 95% CI and a p-value of < 0.5 were used to identify significant factors of the study. For qualitative data, thematic content analysis was performed. A total of 391 participants (a response rate of 92.6%) took part in the study. The number of participants who practice time management was 56.4% (95% CI: 49.3%, 61.7%). Organizational policies (AOR: 2.16; 95% CI: 1.02, 4.68), performance appraisal systems (AOR: 2.11; 95% CI: 1.32, 4.66), compensation and benefits system (AOR: 4.18; 95% CI: 2.18, 7.99), employee planning experience (AOR: 2.86; 95% CI: 1.42, 5.75), and residence (AOR: 2.08; 95% CI: 1.08, 4.01) were found predictors of time management practice among primary hospital employees. Overall, there was a moderate level of time management practice in the study area. Significant factors found were organizational policies, compensation and benefits packages, performance appraisal systems, planning experience, and residency. Therefore, managers need to develop an intervention to address all the above factors in order to improve time management practice of primary hospital employees at work.

EPID-25. DISTANCE TRAVELED FOR BRAIN TUMOR CARE IN PAKISTAN: AN LMIC PERSPECTIVE

INTRODUCTION Global oncology development within LMICs (low- and middle-income countries) requires bridging gaps in healthcare systems. Brain tumor care in Pakistan is currently sparse and concentrated in urban centers. Distance traveled to a hospital dictates a patient’s access to care, neurosurgical access, and continuity of care through adjuvant chemoradiotherapy and primary care providers can be disrupted if patients cannot overcome the barriers due to extensive distances traveled. METHODS Data was collected as part of the Pakistan Brain Tumor Epidemiology Study (PBTES) regarding patients with brain tumors who underwent surgical procedures in 2019 at private and public major neurosurgical centers across Pakistan. Using patient addresses, we used a mapping software to calculate the distance traveled by each patient to the primary hospital. Analysis was done using appropriate statistical methods. RESULTS Out of 2403 patients, the mean distance traveled across the country was 240 km. The longest distance traveled within Pakistan was from Skardu to Karachi (2002 km) for resection of a pituitary adenoma (28 hours via car). Only 48% of patients were able to reach their primary hospital within 50 km. 52% of patients had to travel more than 50 km, and 18% had to travel upwards of 500 km to reach their primary hospital. Additionally, 101 patients traveled to Pakistan from other countries for brain tumor surgery (98 patients from Afghanistan [mean distance traveled: 723.6 km], 3 patients from Syria, Oman, and Sudan). CONCLUSION Prior studies have described a cut-off of 50 km as an acceptable limit for distance from the primary hospital in cancer patients for optimal follow-up and outcomes, which is achieved by only 48% of brain tumor patients in Pakistan. Most patients have poor access to surgical care for brain tumors, further compounded by repeat traveling for follow-ups and chemoradiotherapy.

Liver enzymes and lipid profile of malaria patients before and after antimalarial drug treatment at Dembia Primary Hospital and Teda Health Center, Northwest, Ethiopia

Backgroundinfection with malaria in humans involves liver cell destruction, which alters the levels of liver enzymes and lipid profiles. Although a number of studies have been conducted to address the impact of malaria on liver enzymes and lipid profiles, their findings lack consistency and no studies were conducted after antimalarial drug treatment in the Ethiopian context. This study, therefore, is intended to fill this gap. MethodsAn observational cohort study was conducted at Dembia Primary Hospital and Teda Health Center, from June to August 2020. A total of 88 study participants were recruited using random sampling techniques. Socio-demographic data, capillary and venous blood samples were collected from confirmed Plasmodium -infected individuals. Assessment of liver enzymes and lipid profiles was done using Beckman Coulter DC-700 clinical chemistry analyzer. Data were entered using Epi-data and exported to SPSS version 20 software for analysis. One way ANova, independent t-test, and paired t-test were used to compare the mean liver enzymes and lipid profile. A p -value<0.05 was considered statistically significant. RESULTSBefore anti-malaria treatment, among 88 malaria-infected study participants, abnormally elevated AST was observed in 87.5% of them. Similarly, elevated ALT, ALP, and TG were observed among 12.5%, 43.2%, and 17.2% of the study subjects, respectively. A lower level of HDL was observed among 87.5% of the study participants, while LDL and TC levels were within the normal range. After anti-malaria treatment,100% of AST, ALT, HDL, and LDL, and 92% of ALP, 94.3% of TC, and 86.4% of TG results were in the normal range. The mean level of AST (39.70±3.55and 55.35±9.6) and ALT (22.11±11.75, and23.24±16.05) results were increased, whereas HDL (28.88±11.63and22.73±14.26) level decreased from low to higher density parasitaemia. The mean level of AST at posttreatment (33.90±15.15) was significantly lower compared to the pretreatment (47.60±9.65). The mean levels of ALT had not altered during pretreatment(23.53±16.28)and posttreatment (23.49±11.10).Moreover, the mean of HDL, LDL, and TC at posttreatment were found to be increased when compared with pretreatment, though it is statistically insignificant ( P >0.05). CONCLUSIONMalaria parasites could be responsible for increased liver enzymes and certain lipids while decreasing some lipid profiles compared with the normal range. After anti-malaria treatment, these parameters were reversed to normal from 86.4% to 100%. When the mean values are compared, a significant change was observed in AST level while ALT level remains the same. Hence, prompt treatment is important to improve liver enzymes and lipid profile impairment during malaria infection.

Pengaruh Stres Kerja dan Kepuasan Kerja Terhadap Turnover Intention Perawat Rumah Sakit Prima Pekanbaru

This study aims to determine how much influence Job Stress and Job Satisfaction have on Turn Over Intention of Nurses at Prima Pekanbaru Hospital, namely by Testing and Analyzing the Significant Effect of Job Stress and Job Satisfaction on Turn Over Intention Simultaneously, then Testing and Analyzing the Significant Effect Between Job Stress and Job Satisfaction on Turnover Intention Partially. The population in this study were 206 primary hospital nurses. however, as the sample in this study, there were 67 nurses using the slovin formula. The method used is by using purposive sampling method. The research data were analyzed by multiple linear regression analysis and processed using the SPSS for windows version 20 application. The results of the study showed that job stress and job satisfaction had an effect on the turn over intention of nurses at the Pekanbaru Prima Hospital.

Diagnostic Errors of Spinal Cord Injuries in Children with Combined Trauma on the example of Clinical Cases

Diagnostic errors of spinal cord injuries with combined trauma in children are facilitated by the patient’s age, which does not allow foran adequate neurological assessment of motor and sensitive disorders, a reduced state of consciousness in severe traumatic brain injury,the lack of modern methods of neuroimaging in primary hospitals, insufficient qualifications and experience of medical personnel. Aim. To demonstrate outcomes of diagnostic errors in traumatic spinal cord injury in children on clinical examples of two patients. Material and methods. The object of observation was children with severe combined trauma, whose post-traumatic spinal cord injurywas missed in the primary hospital. To diagnose the current condition, the following were used: clinical examination with a neurologicalassessment on the ASIA scale, assessment of motor functioning, laboratory monitoring, instrumental examination, ultrasoundmonitoring, X-ray, MRI, CT, CT densitometry, ECG, echocardiography, USDG. In addition, neuropsychological assessment was made so to evaluate cortical functions and to reveal consequences of traumatic brain injury. Results. The cause of errors in the diagnostics of spinal cord injury in children is the underestimation of state severity due to the combinedtype of injury or small age of the child. Conclusion. The experience of the multidisciplinary team of specialists in the diagnosis and medical rehabilitation of children withspinal cord injury missed in the primary hospital indicates the need to conduct a full-fledged neurological examination, CT accordingto the “head to toe” program and MRI, even if there is a slight suspicion of the spinal cord damage.Underestimation of the severity of the child’s condition with concomitant trauma, including spinal cord injury, leads to the deprivationnot only in the motor function restoration, but also to deterioration in the quality of life of the family and to the problems associatedwith patient’s integration into society.

Prevalence and Factors Associated with Active Trachoma among Children 1-9 years of Age in the Catchment Population of Tora Primary Hospital, Silte zone, Southern Ethiopia, 2020

Background: Trachoma is the foremost cause of wide-reaching, preventable blindness. According to the World Health Organization report, nearly 1.3 million human beings are sightless due to trachoma, whereas about eighty-four million are hurt from active trachoma. A survey revealed that the countrywide prevalence of active trachoma among children aged 1–9 years in Ethiopia was 40.1%. Limited data are present regarding the study area; therefore, the aim of this study was to determine the magnitude and factors associated with active trachoma among 1-9 years of children in the catchment population of Tora Primary Hospital, South Ethiopia. Methods: A community-based cross-sectional study was performed on 589 children in a study place from February 15 to March 13, 2020. We used Epi data program version 3.1 and SPSS version 20 for data entry and analysis, respectively. Results: The overall occurrence of active trachoma in the catchment was 29.4% [CI=25.7, 33.12]. Of these cases, the trachomatous follicle (TF) 90.9%, TI (4.8%), and combination of TF/TI (4.2%) were found. Households’ educational status, frequency of face washing, knowledge about trachoma, source of water for washing purposes, and garbage disposal system were the independently associated factors of active trachoma. Conclusion: In this study area, the occurrence of active trachoma was high. Hence, it needs instant attention, such as constructing a responsiveness application in the community, inspiring children and parents to try out face washing, improving knowledge about trachoma and appropriate excreta disposal.