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Research paper thumbnail of Predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referral teaching hospital in Ethiopia

Abstract Background: The larger fraction of infant mortality is that of neonatal; and early neona... more Abstract Background: The larger fraction of infant mortality is that of neonatal; and early neonatal death is the most significant contributor of neonatal mortality as a whole. There are various factors which may be associated with early neonatal mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting. Objective: This study was made to assess the independent predictors of early neonatal mortality. Methods: From 2001 through 2005, a total of 3789 live born neonates, who were admitted to the neonatal intensive care unit of Tikur Anbessa Hospital, were included in this study. Variables were classified into two: Socio economic/reproductive factors and maternal/newborn factors. Predictors were assessed using a multivariable binary logistic regression. Variables with a p-value of <0.05 were entered into a multivariable logistic model. Results: From the socio-economic/reproductive variables: age less than one day (AOR=2.53...

Research paper thumbnail of Anomalous origin of the left pulmonary artery

IMAGE IN CARDIOLOGY A 4-year-old girl presented to our hospital with a diagnosis of a subpulmonic... more IMAGE IN CARDIOLOGY A 4-year-old girl presented to our hospital with a diagnosis of a subpulmonic ventricular septal defect. It was reported that she had been markedly symptomatic from early infancy with failure to thrive, recurrent lower respiratory tract infection and interruption of breast feeding. She was on furosemide 20mg and spironolactone 6.25mg orally once a day. On physical examination her weight was 14.5kg and her height was 93cm. Her blood pressure was 104/51mmHg in the left arm. No cyanosis was noted. Her chest was clear with good air entry. Her precordium was active and bulging with the apical impulse displaced downward and laterally. She had a pansystolic murmur of 3/6 best heard over the left lower sternal border. The liver was palpable 3cm below the right coastal margin. She had a trace of pedal edema. Her hematocrit was 37.6%. Other hematologic profiles were also within normal limits. The electrocardiogram (EKG) showed sinus rhythm at 108bpm and no remarkable abnor...

Research paper thumbnail of Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia

Advances in Medical Education and Practice, 2015

Research paper thumbnail of High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

Antimicrobial Resistance and Infection Control, 2012

Background: Cockroaches have been described as potential vectors for various pathogens for decade... more Background: Cockroaches have been described as potential vectors for various pathogens for decades; although studies from neonatal intensive care units are scarce. This study assessed the vector potential of cockroaches (identified as Blatella germanica) in a neonatal intensive care unit setup in Tikur Anbessa Hospital, Addis Ababa, Ethiopia.

Research paper thumbnail of Performance evaluation of laboratory professionals on malaria microscopy in Hawassa Town, Southern Ethiopia

BMC Research Notes, 2014

Background: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microsc... more Background: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microscopists has remained the standard laboratory method for the diagnosis of malaria. However, detection and identification of malaria parasites require well trained laboratory personnel. The objective of the study was to evaluate the performance of laboratory technologists and technicians in detecting and identifying malaria parasites in Hawassa town, Southern Ethiopia. Methods: A cross-sectional study design was employed among a total of 80 laboratory professionals working in public and private health facilities. A standardized pre-validated slide panel and questionnaires were distributed to laboratory professionals working at eleven health facilities in Hawassa town, Southern Ethiopia. The panels included ten slides for diagnosis, [slide1:P.falciparum, 104/μl; slide 2:P.falciparum, 53404/μl; slide 3 and 4: mixed infection (both P. falciparum and P. vivax); slide 5:P.vivax, 23503/μl; slide 6:P.vivax, 400/μl; and slides 7, 8, 9 and 10: negative slides].

Research paper thumbnail of Adrenocortical carcinoma in a 3% years old girl with hetro-sexual precocity

Ethiopian medical journal, 2014

Adrenocortical carcinoma is a rare neoplasm in children. Hetro-sexual precocious puberty could be... more Adrenocortical carcinoma is a rare neoplasm in children. Hetro-sexual precocious puberty could be the initial presentation of a rare adrenocortical neoplasm in the pediatric age group. Features of hetro-sexual precocious puberty in a girl should alert the possibility of such a rare disease. We report a rare case of adrenocortical carcinoma in a three years and six months old girl who presented with hetro-sexual precocious puberty of two years duration. Left adrenalectomy was done and histopathology revealed adrenocortical carcinoma.

Research paper thumbnail of Transient left ventricular systolic dysfunction following surgical closure of large patent ductus arteriosus among children and adolescents operated at the cardiac centre, Ethiopia

Journal of Cardiothoracic Surgery, 2013

Background: Patent ductus arteriosus (PDA) is one of the commonest congenital heart diseases that... more Background: Patent ductus arteriosus (PDA) is one of the commonest congenital heart diseases that require closure within the first few months after birth. The residential area of patients affects the size of the PDA: living in highlands, like most places in Ethiopia, is a risk for having larger sized PDA. Closure of these congenital heart defects is usually performed at an early age in places where capable centers are available. In Ethiopia, closure of these defects is done on mission basis often at an older age. Recently, limited reports came about the occurrence of postoperative left ventricular systolic dysfunction (POLVD) following closure of PDA though full explanation is still lacking. Objective: To determine the rate of and time to improvement of POLVD and the factors associated with it in children and adolescents who underwent surgical closure of PDA. Method: All children and adolescents who underwent surgical closure of PDA at the Cardiac Center, Ethiopia (CCE) had postoperative follow up with echocardiography. Serial left ventricular ejection fraction (LVEF) and fiber shortening (FS) values were recorded for all of them. SPSS 20 was used to analyze the data. Results: A total of 36 children and adolescents who underwent surgical closure of PDA from January 2009 to December 2012 and who fulfilled the inclusion criteria were studied. Their mean age at intervention was 8.52 years (SD = 5.23 years), 77.80% were females. The mean duct size as determined by either echocardiography or intraoperative by the surgeon was 10.31 mm (SD = 3.20 mm). They were followed for a mean duration of 24.80 months (SD = 12.36 months) following surgical closure of PDA. The mean LVEF and FS decreased from 65.06% and 35.28% preoperatively to 54.83% and 28.40% post-operatively respectively. Fifteen (42.86%) of the patients had a post-operative LVEF of less than 55%. The mean time to normalization of systolic function was 5.11 weeks (SD = 3.30 weeks). Having an associated cardiac lesion was an independent predictor of POLVD. Conclusions: We conclude that there is a high rate of POLVD following surgical closure of large PDA in highlanders. We recommend a serial and systematic follow up of these children postoperatively. Those with a significant cardiac dysfunction may need cardiac medications like Angiotensin Converting Enzyme Inhibitors (ACEI).

Research paper thumbnail of Time to presentation, pattern and immediate health effects of alleged child sexual abuse at two tertiary hospitals in Addis Ababa, Ethiopia

BMC Public Health, 2014

Background: Children are vulnerable to abuse and violence because their level of development make... more Background: Children are vulnerable to abuse and violence because their level of development makes them unable to protect themselves. Such adversities during early childhood may have a negative impact on the future lives of the victims. This study was done to determine the delay to hospital presentation, clinical manifestations and immediate health effects of child sexual abuse in two tertiary care hospitals in Ethiopia.

Research paper thumbnail of Predictors of treatment failure and time to detection and switching in HIV-infected Ethiopian children receiving first line anti-retroviral therapy

BMC Infectious Diseases, 2012

Background: The emergence of resistance to first line antiretroviral therapy (ART) regimen leads ... more Background: The emergence of resistance to first line antiretroviral therapy (ART) regimen leads to the need for more expensive and less tolerable second line drugs. Hence, it is essential to identify and address factors associated with an increased probability of first line ART regimen failure. The objective of this article is to report on the predictors of first line ART regimen failure, the detection rate of ART regime failure, and the delay in switching to second line ART drugs.

Research paper thumbnail of Predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referral teaching hospital in Ethiopia

Abstract Background: The larger fraction of infant mortality is that of neonatal; and early neona... more Abstract Background: The larger fraction of infant mortality is that of neonatal; and early neonatal death is the most significant contributor of neonatal mortality as a whole. There are various factors which may be associated with early neonatal mortality and they have been the reasons for the wide variation in mortality rates among the health facilities reporting. Objective: This study was made to assess the independent predictors of early neonatal mortality. Methods: From 2001 through 2005, a total of 3789 live born neonates, who were admitted to the neonatal intensive care unit of Tikur Anbessa Hospital, were included in this study. Variables were classified into two: Socio economic/reproductive factors and maternal/newborn factors. Predictors were assessed using a multivariable binary logistic regression. Variables with a p-value of <0.05 were entered into a multivariable logistic model. Results: From the socio-economic/reproductive variables: age less than one day (AOR=2.53...

Research paper thumbnail of Anomalous origin of the left pulmonary artery

IMAGE IN CARDIOLOGY A 4-year-old girl presented to our hospital with a diagnosis of a subpulmonic... more IMAGE IN CARDIOLOGY A 4-year-old girl presented to our hospital with a diagnosis of a subpulmonic ventricular septal defect. It was reported that she had been markedly symptomatic from early infancy with failure to thrive, recurrent lower respiratory tract infection and interruption of breast feeding. She was on furosemide 20mg and spironolactone 6.25mg orally once a day. On physical examination her weight was 14.5kg and her height was 93cm. Her blood pressure was 104/51mmHg in the left arm. No cyanosis was noted. Her chest was clear with good air entry. Her precordium was active and bulging with the apical impulse displaced downward and laterally. She had a pansystolic murmur of 3/6 best heard over the left lower sternal border. The liver was palpable 3cm below the right coastal margin. She had a trace of pedal edema. Her hematocrit was 37.6%. Other hematologic profiles were also within normal limits. The electrocardiogram (EKG) showed sinus rhythm at 108bpm and no remarkable abnor...

Research paper thumbnail of Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia

Advances in Medical Education and Practice, 2015

Research paper thumbnail of High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia

Antimicrobial Resistance and Infection Control, 2012

Background: Cockroaches have been described as potential vectors for various pathogens for decade... more Background: Cockroaches have been described as potential vectors for various pathogens for decades; although studies from neonatal intensive care units are scarce. This study assessed the vector potential of cockroaches (identified as Blatella germanica) in a neonatal intensive care unit setup in Tikur Anbessa Hospital, Addis Ababa, Ethiopia.

Research paper thumbnail of Performance evaluation of laboratory professionals on malaria microscopy in Hawassa Town, Southern Ethiopia

BMC Research Notes, 2014

Background: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microsc... more Background: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microscopists has remained the standard laboratory method for the diagnosis of malaria. However, detection and identification of malaria parasites require well trained laboratory personnel. The objective of the study was to evaluate the performance of laboratory technologists and technicians in detecting and identifying malaria parasites in Hawassa town, Southern Ethiopia. Methods: A cross-sectional study design was employed among a total of 80 laboratory professionals working in public and private health facilities. A standardized pre-validated slide panel and questionnaires were distributed to laboratory professionals working at eleven health facilities in Hawassa town, Southern Ethiopia. The panels included ten slides for diagnosis, [slide1:P.falciparum, 104/μl; slide 2:P.falciparum, 53404/μl; slide 3 and 4: mixed infection (both P. falciparum and P. vivax); slide 5:P.vivax, 23503/μl; slide 6:P.vivax, 400/μl; and slides 7, 8, 9 and 10: negative slides].

Research paper thumbnail of Adrenocortical carcinoma in a 3% years old girl with hetro-sexual precocity

Ethiopian medical journal, 2014

Adrenocortical carcinoma is a rare neoplasm in children. Hetro-sexual precocious puberty could be... more Adrenocortical carcinoma is a rare neoplasm in children. Hetro-sexual precocious puberty could be the initial presentation of a rare adrenocortical neoplasm in the pediatric age group. Features of hetro-sexual precocious puberty in a girl should alert the possibility of such a rare disease. We report a rare case of adrenocortical carcinoma in a three years and six months old girl who presented with hetro-sexual precocious puberty of two years duration. Left adrenalectomy was done and histopathology revealed adrenocortical carcinoma.

Research paper thumbnail of Transient left ventricular systolic dysfunction following surgical closure of large patent ductus arteriosus among children and adolescents operated at the cardiac centre, Ethiopia

Journal of Cardiothoracic Surgery, 2013

Background: Patent ductus arteriosus (PDA) is one of the commonest congenital heart diseases that... more Background: Patent ductus arteriosus (PDA) is one of the commonest congenital heart diseases that require closure within the first few months after birth. The residential area of patients affects the size of the PDA: living in highlands, like most places in Ethiopia, is a risk for having larger sized PDA. Closure of these congenital heart defects is usually performed at an early age in places where capable centers are available. In Ethiopia, closure of these defects is done on mission basis often at an older age. Recently, limited reports came about the occurrence of postoperative left ventricular systolic dysfunction (POLVD) following closure of PDA though full explanation is still lacking. Objective: To determine the rate of and time to improvement of POLVD and the factors associated with it in children and adolescents who underwent surgical closure of PDA. Method: All children and adolescents who underwent surgical closure of PDA at the Cardiac Center, Ethiopia (CCE) had postoperative follow up with echocardiography. Serial left ventricular ejection fraction (LVEF) and fiber shortening (FS) values were recorded for all of them. SPSS 20 was used to analyze the data. Results: A total of 36 children and adolescents who underwent surgical closure of PDA from January 2009 to December 2012 and who fulfilled the inclusion criteria were studied. Their mean age at intervention was 8.52 years (SD = 5.23 years), 77.80% were females. The mean duct size as determined by either echocardiography or intraoperative by the surgeon was 10.31 mm (SD = 3.20 mm). They were followed for a mean duration of 24.80 months (SD = 12.36 months) following surgical closure of PDA. The mean LVEF and FS decreased from 65.06% and 35.28% preoperatively to 54.83% and 28.40% post-operatively respectively. Fifteen (42.86%) of the patients had a post-operative LVEF of less than 55%. The mean time to normalization of systolic function was 5.11 weeks (SD = 3.30 weeks). Having an associated cardiac lesion was an independent predictor of POLVD. Conclusions: We conclude that there is a high rate of POLVD following surgical closure of large PDA in highlanders. We recommend a serial and systematic follow up of these children postoperatively. Those with a significant cardiac dysfunction may need cardiac medications like Angiotensin Converting Enzyme Inhibitors (ACEI).

Research paper thumbnail of Time to presentation, pattern and immediate health effects of alleged child sexual abuse at two tertiary hospitals in Addis Ababa, Ethiopia

BMC Public Health, 2014

Background: Children are vulnerable to abuse and violence because their level of development make... more Background: Children are vulnerable to abuse and violence because their level of development makes them unable to protect themselves. Such adversities during early childhood may have a negative impact on the future lives of the victims. This study was done to determine the delay to hospital presentation, clinical manifestations and immediate health effects of child sexual abuse in two tertiary care hospitals in Ethiopia.

Research paper thumbnail of Predictors of treatment failure and time to detection and switching in HIV-infected Ethiopian children receiving first line anti-retroviral therapy

BMC Infectious Diseases, 2012

Background: The emergence of resistance to first line antiretroviral therapy (ART) regimen leads ... more Background: The emergence of resistance to first line antiretroviral therapy (ART) regimen leads to the need for more expensive and less tolerable second line drugs. Hence, it is essential to identify and address factors associated with an increased probability of first line ART regimen failure. The objective of this article is to report on the predictors of first line ART regimen failure, the detection rate of ART regime failure, and the delay in switching to second line ART drugs.