Ethiopian Journal of Medical and Health Sciences

Trends of gastro-intestinal tract cancer between 2013 and 2019 in Southern Ethiopia: A retrospective record review

Achamyelesh Gebretsadik — 2024-04-22

Background: Gastrointestinal tract (GIT) cancer is a serious public health concern in both the industrialized and developing nations. In the world today, it is one of the major causes of morbidity and mortality. However, there was insufficient evidence regarding the burden of GIT cancer in Ethiopia and the study area. The present study aimed to assess trends of GIT cancer at Hawassa University Comprehensive Specialized Hospital (HUCSH) between 2013 and 2019.

Methods: A retrospective record review was conducted to determine the trends of gastrointestinal cancer. A review of all patients’ records with a diagnosis of cancer between 2013 and 2019 at HUCSH was conducted by trained data collectors. The logbooks at the units of oncology and pathology yielded a total of 3002 complete records of cancer cases. The data was collected using a checklist from February to May 2020. Descriptive analyses were conducted and presented using tables and figures.

Result: Of a total, 720(24%) gastrointestinal tract cancer cases were identified at HUCSH between 2013 and 2019. The three most frequent forms of GIT cancer were gastric (35.7%, n=257), esophageal (34.1%, n=245) and colorectal (28.3%, n=204). More than half of the cases were male 391 (54.3%) with a male-to-female ratio of 1: 0.84. The majority of the cases came from Oromia (52.6%, n=379), and Southern Nation Nationalities and Peoples (46.7%, n=336) regions. There was a speedy increase in the number of cases though the years. In comparison to 2013, there were more than five-fold increases in all forms of GIT cancers in 2019.

Conclusion: The overall burden and trends of gastrointestinal cancer is highly increasing from year to year. Educating the public about healthy lifestyle changes and raising awareness of the problem can lessen the gastrointestinal cancer burden. Routine registration is also important to monitor and regulate the disease’s progress.

Safety and effectiveness of medical expulsive therapy for ureteric stone in three tertiary Hospitals in Ethiopia

Misganaw Tesfa — 2024-04-22

Background: Urinary tract stone disease is the most common pathology, with a global prevalence of 12%; 20% of them are located in the ureters, of which 70% are in the distal third of the ureters. Within 7 years of treatment, the recurrence rate reaches up to 55%. Medical expulsive therapy for ureteric stones is a non-invasive modality, and avoids complications related to other treatment options. The aim of the present study is to evaluate the safety and effectiveness of medical expulsive therapy for ureteric stone in Tikur Anbesa Specialized Hospital, Menilik II Referral Hospital and Yekatit 12 Hospital Medical College urology divisions.

Methods: Prospective longitudinal study was conducted among patients with ureteric stones in the three hospitals from March 1 to June 31, 2023. Convenient sampling technique was applied to select the study participants. Combination therapy was given randomly to the study participants. Data were collected using data collection tool and analyzed using SPSS version 27. Associations were evaluated using chi-square test adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The results are presented using text, tables, and graphs.

Results: Sixty patients were included with mean age 35+13.71 years and 78.7% of patients were between 20 and 50 years old. Forty-nine (81.7%) of the patients were treated with tamsulosin. Treatment success was 76.7% and confirmed by ultrasound and CT for 86.7% of the cases. Thirteen-point three percent of cases reported drug-related lightheadedness and dizziness. There was no worsening of the disease during treatment period. Higher success rate was noticed in early treatment initiation (AOR: 17.5; 95% CI: 2.2, 139.4). Stone expulsion rate was higher in patients with distal ureteric stones compared to proximal ureteric stones (AOR: 4.5; 95% CI: 1.01, 20.5). Complications were lower in combination therapy than single drug (p= 0.001).

Conclusion: Based on our findings, medical expulsive therapy is successful, safe and the only non-operative modality of treatment for ureteric stones, with high success in distal ureteric stones sized 5 – 10 mm.

Glycemic control and its predictors among ambulatory type 2 diabetic patients attending the diabetic clinic of Hawassa University Comprehensive Specialized Hospital, Ethiopia

Kelbes Aberiso Elema — 2024-04-22

Background: Glycemic control remains the major focus in the management of type 2 diabetes mellitus. Poor glycemic control constitutes a major public health problem and a risk factor for the development of acute and chronic diabetes complications. This study aimed to assess glycemic control and its predictors among adult diabetic patients attending Hawassa Comprehensive Specialized Hospital (HUCSH), south Ethiopia.

Methods: A hospital- based cross-sectional study was conducted among 185 type 2 diabetes patients attending the diabetic clinic at HUCHS from June 1, 2021 to August 31, 2021. A systematic sampling technique was used to select patients identified based on clinical diagnosis. The data was collected via a structured questionnaire first, followed by a review of the patients' medical records. Descriptive statistics and logistic regression analyses were carried out. Logistic regression analysis identified predictors of glycemic control based on variables with a p-value below 0.05.

Results: The prevalence of poor blood glucose control among adult ambulatory type 2 diabetes patients were 70% (95% confidence interval [CI]: 63% - 76%). The median of 3-months fasting blood sugar (FBS) was 149mg/dl (IQR =88, ranging from 70 to 349 mg/dl. Factors associated with good glycemic control were adequate physical activates (adjusted odds ratio (AOR) = 14.26, 95% CI = 3.31–61.47) and treatment with metformin anti-diabetic medication (AOR = 8.20, 95% CI = 1.97–34.04).

Conclusion: Glycemic control status of patients with type 2 diabetes was generally poor. Participants who had adequate physical activities and anti-diabetic treatment with metformin had significantly higher odds of good glycemic control. Educational strategies should focus on optimizing glycemic control approaches that lead to better overall health and reduced risk of complications associated with poorly managed diabetes.

Magnitude of preeclampsia and associated factors among pregnant women who attend antenatal care service at Shashamane Comprehensive Specialized and Melka Oda General Hospitals, Oromia, Ethiopia

Anteneh Fikrie — 2024-04-22

Background: Preeclampsia is the most common medical problem encountered in pregnancy. Despite the high burden of the disease, it remains poorly studied in low- and middle-income countries. Therefore, the study aimed to assess the magnitude of preeclampsia and its associated factors among pregnant women who attended antenatal care (ANC) in two government hospitals in the Oromia region of Ethiopia.

Methods: A facility-based cross-sectional study was employed among 510 randomly selected pregnant women with a gestational age of above 20 weeks attending ANC at Shashamane Comprehensive Specialized and Melka Oda General Hospitals from July 11 to September 9, 2021. Women who had severe illnesses and mental health problems were excluded from the study. A pretested, structured, face-to-face interview questionnaire was used to collect the data. EpiData version 4.6.0.2 and SPSS version 25 were used to enter and analyze the data, respectively. Blood pressure measurements and urinalysis were carried out to identify and diagnose preeclampsia. Bivariable and multivariable binary logistic regressions were done to identify factors associated with preeclampsia. Adjusted odds ratios with 95% confidence intervals and p-values < 0.05 were used to declare statistical significance.

Results: In this study, the magnitude of preeclampsia was found to be 9.02% (95% CI: 6.03%-11.8%). Age <25 years [AOR= 0.49 (95% CI: 0.003, 0.71)], having normal body mass index (BMI) [(AOR=0.07(95% CI: 0.022, 0.22)], and history of previous ANC follows up [AOR=0.26 (95% CI: 0.10, 0.71)] were identified to be negatively associated with preeclampsia. Having a history of renal disease [AOR = 4.89 (95% CI: 1.78–13.25)], having had preeclampsia before [AOR = 5.03 (95% CI: 1.82–13.93)], or having a family history of preeclampsia [AOR = 7.27 (95% CI: 2.36–22.42)] were all linked to having preeclampsia.

Conclusion: The observed magnitude of preeclampsia in this study is comparable to the global level. Being older, overweight, having no previous ANC follow-up, having a history of renal disease, and having a personal and family history of preeclampsia were found to be significant factors. Therefore, healthcare providers and other stakeholders should consider the above risk factors for timely identification and management through regular antenatal monitoring and careful follow-up. Moreover, by increasing awareness about the importance of adopting a healthy lifestyle and receiving regular prenatal care, women can be empowered to proactively mitigate their risk.

Infant care practice and associated factors in Southwest Ethiopia

Bereket Babulo — 2024-04-22

Introduction: Appropriate infant care practices are crucial for the health and wellbeing of infants. It is the care from delivery until they are one year old, and includes clean delivery, thermal care, sanitary care, cord care, eye care, breastfeeding, immunization, and identification of newborn risk indicators. One of the important reasons for the high level of infant deaths in developing countries is poor infant care practice. Infant care practice services are not widely used in Ethiopia, especially in Mari Mansa woreda, and it is unclear what factors influence their use. This study was aimed to assess infant care practices and the factors that determine the practices among mothers who gave birth within the six months prior to the survey in Mari Mansa Woreda, Dawuro zone, Southwest Ethiopia, in 2023.

Methods: A community-based cross-sectional survey was conducted using a multi-stage sampling technique among 522 mothers who gave birth in the six months prior to the survey in Mari Mansa woreda. Face-to-face interviews were conducted with sampled mothers during 10–25 April 2023 using a structured questionnaire. Descriptive statistics such as proportion, frequencies, and measures of central tendency were calculated and presented in tables and figures. Bivariate and multivariable logistic regression analyses were used to explain factors associated with infant care practices among the mothers.

Results: About 44.4% (95% confidence interval [CI]: 40%-48%) of participants had good infant care practices based on seven composite variables. Mothers’ educational status such as being able to read and write (adjusted odds ratio [AOR]: 4.49; 95% CI: 1.75-11.51)], primary education (AOR: 6.52; 95% CI: 2.62-16.19), and college education and above (AOR: 14.88; 95% CI: 4.19-52.88); mothers occupation (government employees) (AOR: 3.07; 95% CI: 1.03-9.17); high household wealth index (AOR: 2.28; 95% CI: 1.27-4.08); and delivery at health facilities (AOR: 4.0, 95% CI: 1.60-10.01) were significantly associated with good infant care practice.

Conclusions: Less than half of the mothers implement good infant care practices. This implies that infant care practices are unsatisfactory in the study area. We recommend that relevant bodies working in the health sector, and community-based associations/organizations should undertake targeted interventions on women’s capacity building activities through education, economic empowerment, and improved access to health services.

Voluntary counseling and testing for HIV/AIDS service utilization and associated factors among Hawassa University students, Ethiopia

Ayantu Melke — 2024-04-22

Introduction: In Ethiopia, voluntary counseling and testing (VCT) has been instrumental in addressing the HIV/AIDS epidemic, although the country's efforts have been somewhat limited. VCT plays a critical role in ensuring individuals receive care, treatment, and support, while promoting HIV status awareness. However, VCT services in Ethiopia have been inconsistent, resulting in underutilization and variable community engagement. Notably, there is a dearth of research on VCT experiences among university students. Thus this study was aimed to assess VCT service utilization and associated factors among students of Hawassa University, Ethiopia.

Methods: Institution-based cross sectional study was conducted from March 18-20, 2022 among 801 under graduate students drawn from selected departments of Hawassa University using multistage sampling technique. The sample size was estimated based on single population proportion with assumption : 95% confidence interval (two sided), 5% margin of error, and 38.6% expected proportion of VCT uptake among youth, 10% non-response rate and other contingencies. It was multiplied by two for the design effect. Finally the sample size was 801. Data were entered and analyzed using SPSS version 26. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were used to assess the association of different factors with VCT utilization.

Results: From 801 participants, majority (94%) were in the age range of 20–24 years. More than half (59%) of respondents haven’t had any type of HIV test. Those who have a drug injection practice were 93 % less likely to utilize VCT (AOR= 0.07, 95% CI: 0.01-0.42). Those who have boy or girl friend were about 4 times more likely to utilize VCT (AOR= 3.9, 95% CI: 1.5- 10.3). Further, those with favorable confidentiality and support were 6 times more likely to utilize VCT (AOR= 6.1, 95% CI: 1.9-19), those with perception of no risk were 5 times more likely to utilize VCT (AOR= 5.1, 95% CI: 2.1- 12) as compared with those who have perception of risk.

Conclusion: the study found low VCT utilization among university students comparable to other studies. The use of VCT was associated with religion, drug injection practice, having boy or girl friend, fear of confidentiality of result and perceived susceptibility. Thus, we recommend special intervention programs targeting injection drug users, their family members, and service providers may increase HIV test. In addition, making HIV testing/VCT clinics more convenient and private would also increase utilization.