Begna Tulu

Methicillin Resistant Staphylococcus aureus among HIV Infected Pediatric Patients in Northwest Ethiopia: Carriage Rates and Antibiotic Co-Resistance Profiles.

Background MRSA infections are becoming more prevalent throughout the HIV community. MRSA infections are a challenge to both physicians and patients due to limited choice of therapeutic options and increased cost of care. Objectives This study was aimed to determine the prevalence of colonization and co-resistance patterns of MRSA species among HIV positive pediatric patients in the Amhara National Regional State, Northwest Ethiopia. Methods Culture swabs were collected from the anterior nares, the skin and the perineum of 400 participants. In vitro antimicrobial susceptibility testing was done on Muller Hinton Agar by the Kirby-Bauer disk diffusion method, using 30 μg cefoxitin (OXOID, ENGLAND) according to the recommendations of the Clinical and Laboratory Standards Institute. Methicillin sensitivity/resistance was tested using cefoxitin. Data was analyzed by descriptive statistics and logistic regression model using Epi Info 7. Results S. aureus was detected in 206 participants (51.5%). The prevalence of MRSA colonization in this study was 16.8%. Colonization by S. aureus was associated with male gender (OR = 0.5869; 95% CI: 0.3812–0.9036; p-value = 0.0155), history of antibiotic use over the previous 3 months (OR = 2.3126; 95% CI: 1.0707–4.9948; p-value = 0.0329) and having CD4 T-cell counts of more than 350 x 106 cells / L (OR = 0.5739; 95% CI = 0.3343–0.9851; p-value = 0.0440). Colonization by MRSA was not associated with any one of the variables. Concomitant resistance of the MRSA to clindamycin, chloramphenicol, co-trimoxazole, ceftriaxone, erythromycin and tetracycline was 7.6%, 6%, 5.25%, 20.9%, 23.9% and 72.1%, respectively. Conclusion High rates of colonization by pathogenic MRSA strains is observed among HIV positive pediatric patients in the Amhara National Regional state.

Prevalence and its associated risk factors of intestinal parasitic infections among Yadot primary school children of South Eastern Ethiopia: a cross-sectional study

BackgroundIntestinal parasitic infections are posing significant morbidity worldwide. In Ethiopia, due to poor socio-economic status, intestinal parasitic infections are highly prevalent. The main aim of this study was to determine the prevalence of intestinal parasites and its associated risk factors among Yadot primary school children which is found in South-Eastern part of Ethiopia, in the district called Delo-Mena.MethodsInstitution based cross-sectional study was employed from March to April 2013. In this study, a total of 340 students were selected using simple random sampling, and data on socio-demographic characteristics and factors associated with the prevalence of intestinal parasites as well as stool samples were collected and processed accordingly. Statistical analysis was done using SPSS version 16, and binary and multivariate logistic regression analysis were conducted to measure the strength of association between dependent and independent variables.ResultsThe overall prevalence of intestinal parasites was 26.2%. Poly-parasitism was detected in 6.2% of the students. Consistently, students who were infected with single, double, triple and quadruple parasites were 20%, 4.7%, 1.2% and 0.3% respectively. In line with this, the most prevalent parasites were Schistosoma mansoni 12.6%, followed by Entamoeba histolytica/dispar 5%, Ascaris lumbricoides 4.7%, and Hymenolepis nana 4.4%. Regarding the risk factors for the infections, not knowing why they wash their hands before meal [(AOR = 0.20, 95% CI = 0.10-0.40), p < 0.001], water contact activities [(AOR = 2.28, 95% CI = 1.19-4.34), p = 0.012], not wearing protective shoe [(AOR = 0.27, 95% CI = 0.15-0.51), p < 0.001] were factors significantly associated with intestinal parasitic infections.ConclusionIntestinal parasitic infections were found to be highly prevalent among Yadot primary school children. Hence, health education, improving sanitation, provision of safe drinking water, increasing latrine use, snail control and deworming to the students are crucial.

Smear positive pulmonary tuberculosis and its risk factors among tuberculosis suspect in South East Ethiopia; a hospital based cross-sectional study

BackgroundTuberculosis remains a deadly infectious disease, affecting millions of people worldwide. Ethiopia ranks seventh among the twenty two high tuberculosis burden countries. The aim of this study was to determine the prevalence of smear positive pulmonary tuberculosis and its associated risk factors in Goba and Robe hospitals of Bale zone.MethodsA cross-sectional study was conducted on tuberculosis suspected patients from February-May 2012. Sputum samples were examined for acid fast bacilli using Ziehl-Neelsen staining and interview was conducted for each patient. Descriptive statistics, binary logistic and multivariable logistic regression analyses were employed to identify factors associated with pulmonary tuberculosis infection.ResultThe prevalence of smear positive tuberculosis was 9.2%. Age >36 (AOR = 3.54, 95% CI = 1. 3–9.82), marital status (AOR = 8.40, 95% CI = 3.02-23.20), family size (AOR = 4. 10, 95% CI = 1.60-10.80), contact with active tuberculosis patient (AOR = 5. 90; 95% CI = 2. 30–15.30), smoking cigarette regularly (AOR = 3. 90; 95% CI = 1. 20–12.40), and human immunodeficiency virus sero-status (AOR = 11. 70; 95% CI = 4. 30–31.70) were significantly associated with smear positive pulmonary tuberculosis.ConclusionThe prevalence of smear positive pulmonary tuberculosis was high in the study area. Age, marital status, family size, history of contact with active tuberculosis patient, smoking cigarettes, and HIV sero-status were among the risk factors significantly associated with acquiring tuberculosis. Hence, strict pulmonary tuberculosis screening of HIV patients and intensification of health education to avoid risk factors identified are recommended.

Attitudes of nurses and physicians towards nurse-physician collaboration in northwest Ethiopia: a hospital based cross-sectional study

BackgroundCollaboration between professionals is important in health institutions where most activities are team-performed. Ineffective nurse-physician collaboration affects patient outcome, nurses’ job satisfaction and organizational cost and is challenged by personal, interpersonal and organizational factors. The main objective of this study was to assess attitudes of nurses and physicians towards nurse-physician collaboration and the level of satisfaction with regard to quality of collaboration between them at Referral Hospitals of Northwest Ethiopia, from February 1st to April 30, 2013.MethodsAn institution based cross-sectional study was conducted among 176 nurses and 53 physicians working in Felegehiwot and Gondar University Referral Hospitals. Data were collected using self-administered questionnaires. Attitudes of nurses and physicians were measured using Jefferson scale of attitudes towards nurse-physician Collaboration. Results were summarized using descriptive statistics and difference of means and proportions were evaluated using student t test p <0.05 was considered as significant.ResultThe overall response rate was 90.50%. Nurses demonstrate more favorable attitudes than physicians with mean score of 49.63 and 47.49 and standard error of mean 0.474 and 0.931 respectively with p = 0.043. For the Jefferson Scale Attitudes towards Nurse-Physician Collaboration includes four subscales, which are: 1) shared education and teamwork, 2) Caring vs curing, 3) nurses autonomy and 4) physician dominance. Nurses scored higher on three subscales (1, 2 and 4). However, statistically significant differences were noted with regard to subscales 2 and 4 (p = 0.01, p = 0.004, respectively).ConclusionThis study identified that neither nurses nor physicians were satisfied with their current collaboration and nurses demonstrated less satisfaction with the current nurse physician collaboration. As compared with physicians nurses had more favorable attitudes towards collaboration specifically toward nurses’ contributions to the psychosocial and educational aspects of patient care, and stronger rejection of a totally dominant physician role.

Burden and determinant factors of anemia among elementary school children in northwest Ethiopia: a comparative cross sectional study

Background: Anemia is an indicator of both poor nutrition and health. In low-income countries like Ethiopia, the prevalence of anemia remains high due to several determinant factors. There is a lack of regular surveillance system to determine the magnitude of anemia among school age children. The aim of this study was to determine the burden and determinant factors of anemia among school children. Materials and Methods: A comparative cross-sectional study was conducted from March 2014 to May 2014 among elementary school children in Northwest Ethiopia. Multi stage and simple random sampling techniques were used to select the schools and the study subjects. Standard questionnaire was employed to assess the socioeconomic status of study participants. Intestinal parasitosis infections and hemoglobin level were determined by formula ether concentration technique and automated hematology analyzer, respectively. Descriptive statistics were used to determine the burden of anemia. Stepwise logistic regression was used to identify the determinants of anemia. Results: Among 2,372 elementary school children, the prevalence of anemia was 7.6% (95 % CI: 7% - 9%). The mean hemoglobin level was 11.6 g/dl ranging from 10 g/dl to 13g/dl. The magnitude of hookworm infection was 530 (22.3%). In multivariate analysis anemia was found associated with residence, source of water, availability of latrine, maternal education, family size and hookworm infection. Conclusion: Anemia still remains as a major public health problem among the school children in the study area. Residence, source of water, availability of latrine, maternal education, family size and hookworm infection are also the major determinant factors for the high prevalence of anemia. Therefore, health education, iron supplement and deworming should be given to school age children.

Treatment Outcomes of Tuberculosis Patients at Bale Robe Hospital Oromia Regional State, Ethiopia: A Five Year Retrospective Study

Objective: Monitoring of tuberculosis treatment outcome is scarcely done in Ethiopia. This study investigated the outcomes of tuberculosis treatment at Bale Robe Hospital in Oromia, Ethiopia. Methods: A retrospective analysis of the profile and treatment outcome of all tuberculosis patients registered from September, 2007 to August, 2012 at tuberculosis Clinic was conducted. Patients’ socio-demographic, clinical, laboratory and treatment outcomes were were extracted from registration document. Bivariate and multivariate logistic regression was used to determine treatment outcomes predictor variables. Results: We analyzed treatment outcomes of 916 tuberculosis patients, of which 544 (59.6 %) were males. Of these 180 (19.7%) were cured, 536 (58.5%) were found completed their treatment, while 82 (9%) were died, in addition, 55 (6.0%) and 54 (5.9%) were defaulters and transferred out respectively. Overall, 716 (78.2%) had a successful and 200 (21.8%) a poor treatment outcome. Being female (AOR 1.23, P=0.05), HIV positive (0.48, P<0.001) and new TB patients (AOR 2.17, P=0.002) were significantly associated with treatment outcome. Patients aged ≤ 14 had significantly high treatment success rate (AOR 4.99, P=0.003) followed by 35-44 years (AOR 3.5, P=0.009) and 25-34 years (AOR 2.52, P=0.029). Tuberculosis patients with HIV co-infection (AOR 4.32, P=<0.001), smear negative pulmonary tuberculosis (AOR 2.00, P=0.05) and age ≥ 65 years (AOR 5.50, P=0.03) were more likely to experience death than their counter parts. Conclusion: The treatment success rate of 78.2% tuberculosis patients was fairly good. However, a high proportion of patients (9%) death and 22.2% of HIV prevalence among TB patients is a serious public health concern that needs to be addressed urgently in the area.