Migbar Sibhat - Academia.edu (original) (raw)

Papers by Migbar Sibhat

Journal of the American College of Cardiology, Nov 30, 2023

Journal of Neonatology, Feb 5, 2024

The Lancet Public Health

Background Unintentional carbon monoxide poisoning is a largely preventable cause of death that h... more Background Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. Methods As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. Findings In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0•366 per 100 000 (95% uncertainty interval 0•276-0•415), with 28 900 deaths (21 700-32 800) and 1•18 million YLLs (0•886-1•35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800-24 000]), and the 50-54-year age group had the largest number of deaths (2210 [1660-2590]). The highest mortality rate was in those aged 85 years or older with 1•96 deaths (1•38-2•32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2•12 deaths (1•98-2•30) per 100 000. Globally, there was a 53•5% (46•2-63•7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13•6% (11•9-16•0) and 3•5% (1•4-6•2), respectively. Interpretation Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. Funding Bill & Melinda Gates Foundation.

Research Square (Research Square), Nov 16, 2021

Background With expanding access to pediatric antiretroviral therapy, a growing amount of patient... more Background With expanding access to pediatric antiretroviral therapy, a growing amount of patients in the developing world has switched to second-line therapy, and some requiring third-line medications. A delay in switch increases mortality and risk of developing opportunistic infections. There remain limited and often con icting estimates on the use of second-line ART in children. Thus, this study intended to determine the incidence and predictors of switching to second-line antiretroviral therapy among children. Methods Retrospective follow up study was conducted by reviewing all charts. Data were collected by extraction tool; entered using Epi-data; cleaned and analyzed by STATA V-14. Kaplan-Meier curve, log-rank test, and life table were used for data description and adjusted hazard ratios and p-value for analysis by Cox proportional hazard regression. Any variable at P≤0.25 in the bi-variable analysis was taken to multivariate analysis and signi cance was declared at P≤0.05. Data were presented using texts, tables, and gures. Results and conclusion Analysis was conducted on 424 charts with total person-time observation of 11686.1 child-months and incidence switch rate of 5.6 (95% CI 4.36-7.09) per 1000 child-month-observations. Being orphaned [AHR=2.

medRxiv (Cold Spring Harbor Laboratory), Apr 5, 2022

Introduction: COVID-19 remains one of the leading causes of death seeking global public health at... more Introduction: COVID-19 remains one of the leading causes of death seeking global public health attention. Diabetes mellitus is associated with severity and lethal outcomes up to death independent of other comorbidities. Nevertheless, information regarding the determinant factors that contributed to the increased mortality among diabetic COVID-19 patients is limited. Thus, this study aimed at identifying the determinants of mortality among COVID-19 infected diabetic patients. Methods: An unmatched case-control study was conducted on 340 randomly selected patients by reviewing patient records. Data were collected using a structured extraction checklist, entered into Epi data V-4.4.2.2, and analyzed using SPSS V-25. Then, binary logistic regression was used for bivariate and multivariable analysis. Finally, an adjusted odds ratio with 95% CI and a p-value of less than 0.05 was used to determine the strength of association and the presence of a statistical significance consecutively. Results: The study was conducted on 340 COVID-19 patients (114 case and 226 controls).

F1000Research, Nov 16, 2022

Background: The COVID-19 pandemic has caused stress on the health care system of many countries w... more Background: The COVID-19 pandemic has caused stress on the health care system of many countries worldwide. To accommodate the growing number of critically ill patients requiring mechanical ventilation, hospitals expanded and tried to meet overwhelming demands. Despite this, outcomes of patients after mechanical ventilation were devastating, with high mortality rates. Therefore, this study investigated the survival status and predictors of mortality among mechanically ventilated COVID-19 patients. Methods: A retrospective cohort study was applied on the patient charts of 496 critically ill and mechanically ventilated COVID-19 patients at intensive care units of Addis Ababa COVID-19 Care Centers from September 2020 to October 2021. Data were collected using a data extraction checklist and entered into Epi data manager. Then, data were transferred to STATA V-14 for cleaning and analysis. The cox-proportional hazard regression model was used for analysis. Covariates with p-value ≤0.20 in the bivariate analysis were fitted to multivariate analysis after the model fitness test. Finally, statistical significance was decided at p-value <0.05, and hazard ratios were used to determine the strength of associations. Results: Of the 496 patients, 63.3% had died. The incidence rate of mortality was 56.7 (95% CI: 50.80, 63.37) per 1,000 person-days of observation, with 5534 person-day observations recorded. Advanced age (>60 years old) (adjusted hazard ratio (AHR)=1.86; 95% CI: 1.09, 3.15) and being invasively ventilated (AHR=2.02; 95% CI: 1.25, 3.26) were associated with increased risk of mortality. Furthermore, presence of diabetes (AHR=1.50; 95% CI: 1.09, 2.08), shock (AHR=1.99; 95% CI: 1.12, 3.52), and delirium (AHR=1.60; 95% CI: 1.05, 2.44) were Open Peer Review Approval Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article.

International Journal of Neuroscience, Jan 23, 2022

Background: Despite the increase in ventriculoperitoneal shunt surgeries performed for children w... more Background: Despite the increase in ventriculoperitoneal shunt surgeries performed for children with hydrocephalus, the potential complications and survival of patients after the procedure remains the major challenge for both clinical and public health aspects. This study intends to assess the survival status and scrutinize the predictive factors of mortality among children after a ventriculoperitoneal shunt.Methods: A retrospective cohort study was employed by reviewing charts of 337 systematically selected children who have undergone a ventriculoperitoneal shunt from 2016 to 2018 in Addis Ababa. The extraction tool was used for data collection, Epi-data version 4.4.2 for data entry, and Stata version-14 for cleaning and analysis. Kaplan-Meier curve, log-rank test, and life table were used to describe the data. Cox proportional hazard regression model was used for analysis. Any variable at p < 0.25 in the bi-variable analysis was fitted to multivariate analysis, and significance was declared at p ≤ 0.05. Then, AHR with 95% CI was used to report the association and test the statistical significance. Finally, texts and tables were used to present the results.Results and Conclusion: The incidence rate of mortality was 58.4 per 1000 child-months of observation with a median survival time of 12 months (95%CI: 9.04-14.96). Communicative hydrocephalus (AHR: 1.99, 95% CI: 1.18-3.36), post-traumatic brain injury (AHR: 7.43, 95% CI: 3.21-16.88), emergency surgery (AHR: 1.86, 95% CI: 1.17-3.13) as well as revised shunt procedure (AHR: 8.01, 95% CI: 6.12-13.43) were independent predictors of death. Besides, sunset eye (ARH: 2.01; 95% CI: 1.17-3.47), rapidly increased head size (ARH: 2.05, 95% CI: 1.14-3.37), prolonged antibiotics treatment (AHR: 2.46, 95% CI: 1.82-7.37), and gram-negative infections (AHR: 1.95, 95% CI: 1.60-12.64) were also significantly associated. Hence, health professionals ought to give special attention to patients with identified predictors.

Pediatric Health, Medicine and Therapeutics, Mar 1, 2020

Background: Despite many efforts undertaken to control the human immunodeficiency virus epidemic,... more Background: Despite many efforts undertaken to control the human immunodeficiency virus epidemic, it remains to be the major global public health challenge. With expanding access to pediatric antiretroviral therapy, children are more likely to experience treatment failure. All previous studies conducted in Ethiopia estimated treatment failure using only clinical and CD4 criteria. Thus, the ART failure rate is expected to be underestimated in our country. Objectives of the Study: To assess the incidence and predictors of treatment failure among children receiving first-line ART in general hospitals of Mekelle and Southern Zones of Tigray region, Ethiopia, 2019. Methods: Retrospective follow up study was employed. The sample size was estimated based on a Log rank test using Stata V-13 and all 404 charts were taken for review. Data were collected by extraction tool; entered using Epi-data manager; cleaned and analyzed by Stata V-14. Data were described using the Kaplan-Meier curve, Log rank test, life table, and crude hazard ratios and analyzed using adjusted hazard ratios and p-value by Cox proportional hazard regression. Any variable at P <0.05 in the bi-variable analysis was taken to multi-variate analysis and significance was declared at P≤ 0.05. Data were presented using tables, charts, and texts. Results: The incidence rate of ART failure was 8.68 (95% CI 7.1 to 10.6) per 1000 person-month observations with a total of 11,061.5 person-month observations. Children who had tuberculosis at baseline [AHR=2.27; 95% CI 1.12-4.57], advanced recent WHO stage [AHR=5.21; 95% CI 2.75-9.88] and sub-optimal ART adherence [AHR=2.84, 95% CI 1.71-4.72] were at higher hazard for first-line treatment failure. Besides this having a long duration of ART follow up [AHR=0.85; 95% CI 0.82-0.87] was found to be protective against treatment failure. Conclusion and Recommendation: The incidence of first-line ART failure was grown as a major public health concern. Treatment failure was predicted by the duration of follow up, advanced recent WHO stage, sub-optimal adherence, as well as the presence of tuberculosis at baseline. Hence, it is better to give priority for strengthening the focused evaluation of the WHO clinical stage and tuberculosis co-infection at baseline with continuous adherence monitoring.

medRxiv (Cold Spring Harbor Laboratory), Mar 21, 2022

Introduction: Chronic liver disease imposed substantial health and economic burden causing 1.75 m... more Introduction: Chronic liver disease imposed substantial health and economic burden causing 1.75 million deaths and increased hospital admission rates. However, it is a neglected health issue in resource-limited countries like Ethiopia, with the paucity of data on the determinants of chronic liver disease. Besides, available studies considered single or limited factors. Thus, the aim of this study was to assess the determinant factors of chronic liver disease among patients who were attending at the gastroenterology units. Methods: An unmatched case-control study was conducted on 281 (94 cases and 187 controls) systematically selected subjects at tertiary hospitals in Northern Ethiopia from November 2018 to June 2019. Data were collected using an interviewer-administered questionnaire and checklists, entered to Epi data version 4.4.2, and analyzed using SPSS version 25. Bi-variable and multivariate analyses were done using binary logistic regression. Variables with p< 0.25 in the bi-variable analysis were fitted to the final model. An adjusted odds ratio with 95% CI was used to declare significance and associations. Results: An overall 281 (94 cases and 187 controls) patients attending at the gastroenterology units had been included with a response rate of 100%. Being chronic alcohol consumer (AOR=2.8; 95% CI: 1.1-7.0), having a history of herbal medication use (AOR=14; 95% CI: 5.2-42), history of injectable drug use (AOR=8.7; 95% CI: 3-24.8), and hepatitis B infection (AOR=12; 95% CI: 3.0-49) were found to have an independent association with chronic liver disease. Conclusion: Alcohol consumption, history of herbal medication use, hepatitis B infection, and history of parenteral medication use were found to be determinant factors of chronic liver disease. Strengthening viral hepatitis screening activities, interventions focused on behavioral change, and linking traditional healers to the healthcare system is crucial.

eClinicalMedicine

Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incid... more Background The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively.

BMJ Open

ObjectiveThis analysis is to present the burden and trends of morbidity and mortality due to lowe... more ObjectiveThis analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019.DesignThis analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI).Study settingThe study includes nine region states and two chartered cities of Ethiopia.Outcome measuresWe calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates.ResultsIn 2019, LRIs incidence, death and YLLs among all age groups...

Pan African Journal of Emergency Medicine and Critical Care

Background: COVID-19 has made exceptional challenges to public health globally. Healthcare expe... more Background: COVID-19 has made exceptional challenges to public health globally. Healthcare experts who are at the frontline of the outbreak reaction are at increased risk of getting infected. The high infection rate of COVID-19 has been reported amongst frontline health care workers which might be linked to low prevention practice. However, in the context of Ethiopia, studies ascribed to the prevention practice against COVID-19 among healthcare workers are limited. Therefore, this study aimed to assess the Preventive practice against COVID-19 and associated factors among health care workers. Methods and materials: Institution-based cross-sectional study design was conducted on 240 healthcare workers at millennium covid care center and a pretested structured questionnaire was used for the data collection. The data was entered into epi data version 4.4.2.2 and exported to SPSS window version 25 for analysis. Descriptive statics and binary logistic regression were used. Odds ratio wi...

The Lancet Haematology

Background Previous global analyses, with known underdiagnosis and single cause per death attribu... more Background Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures-borrowing strength from predictive covariates and across age, time, and geography-and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13•7% (95% uncertainty interval 11•1-16•5), to 515 000 (425 000-614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41•4% (38•3-44•9), from 5•46 million (4•62-6•45) in 2000 to 7•74 million (6•51-9•2) in 2021. We estimated 34 400 (25 000-45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000-467 000). In children younger than 5 years, there were 81 100 (58 800-108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.

Background Low back pain is highly prevalent and the main cause of years lived with disability (Y... more Background Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings In 2020, low back pain affected 619 million (95% uncertainty interval 554-694) people globally, with a projection of 843 million (759-933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578-1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10•4% (10•9-10•0) and 10•5% (11•1-10•0), respectively. A total of 38•8% (28•7-47•0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change.

Frontiers in Endocrinology, 2021

BackgroundChronic kidney disease (CKD) is a public health problem largely caused by diabetes. The... more BackgroundChronic kidney disease (CKD) is a public health problem largely caused by diabetes. The epidemiology of diabetes mellitus–related CKD (CKD-DM) could provide specific support to lessen global, regional, and national CKD burden.MethodsData were derived from the GBD 2019 study, including four measures and age-standardized rates (ASRs). Estimated annual percentage changes and 95% CIs were calculated to evaluate the variation trend of ASRs.ResultsDiabetes caused the majority of new cases and patients with CKD in all regions. All ASRs for type 2 diabetes–related CKD increased over 30 years. Asia and Middle socio-demographic index (SDI) quintile always carried the heaviest burden of CKD-DM. Diabetes type 2 became the second leading cause of CKD and CKD-related death and the third leading cause of CKD-related DALYs in 2019. Type 2 diabetes–related CKD accounted for most of the CKD-DM disease burden. There were 2.62 million incident cases, 134.58 million patients, 405.99 thousand d...

The Lancet Neurology, 2018

Background Acute meningitis has a high case-fatality rate and survivors can have severe lifelong ... more Background Acute meningitis has a high case-fatality rate and survivors can have severe lifelong disability. We aimed to provide a comprehensive assessment of the levels and trends of global meningitis burden that could help to guide introduction, continuation, and ongoing development of vaccines and treatment programmes. Methods The Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2016 study estimated meningitis burden due to one of four types of cause: pneumococcal, meningococcal, Haemophilus influenzae type b, and a residual category of other causes. Cause-specific mortality estimates were generated via cause of death ensemble modelling of vital registration and verbal autopsy data that were subject to standardised data processing algorithms. Deaths were multiplied by the GBD standard life expectancy at age of death to estimate years of life lost, the mortality component of disability-adjusted life-years (DALYs). A systematic analysis of relevant publications and hospital and claims data was used to estimate meningitis incidence via a Bayesian meta-regression tool. Meningitis deaths and cases were split between causes with meta-regressions of aetiological proportions of mortality and incidence, respectively. Probabilities of long-term impairment by cause of meningitis were applied to survivors and used to estimate years of life lived with disability (YLDs). We assessed the relationship between burden metrics and Socio-demographic Index (SDI), a composite measure of development based on fertility, income, and education. Findings Global meningitis deaths decreased by 21•0% from 1990 to 2016, from 403 012 (95% uncertainty interval [UI] 319 426-458 514) to 318 400 (265 218-408 705). Incident cases globally increased from 2•50 million (95% UI 2•19-2•91) in 1990 to 2•82 million (2•46-3•31) in 2016. Meningitis mortality and incidence were closely related to SDI. The highest mortality rates and incidence rates were found in the peri-Sahelian countries that comprise the African meningitis belt, with six of the ten countries with the largest number of cases and deaths being located within this region. Haemophilus influenzae type b was the most common cause of incident meningitis in 1990, at 780 070 cases (95% UI 613 585-978 219) globally, but decreased the most (-49•1%) to become the least common cause in 2016, with 397 297 cases (291 076-533 662). Meningococcus was the leading cause of meningitis mortality in 1990 (192 833 deaths [95% UI 153 358-221 503] globally), whereas other meningitis was the leading cause for both deaths (136 423 [112 682-178 022]) and incident cases (1•25 million [1•06-1•49]) in 2016. Pneumococcus caused the largest number of YLDs (634 458 [444 787-839 749]) in 2016, owing to its more severe long-term effects on survivors. Globally in 2016, 1•48 million (1•04-1•96) YLDs were due to meningitis compared with 21•87 million (18•20-28•28) DALYs, indicating that the contribution of mortality to meningitis burden is far greater than the contribution of disabling outcomes. Interpretation Meningitis burden remains high and progress lags substantially behind that of other vaccinepreventable diseases. Particular attention should be given to developing vaccines with broader coverage against the causes of meningitis, making these vaccines affordable in the most affected countries, improving vaccine uptake, improving access to low-cost diagnostics and therapeutics, and improving support for disabled survivors. Substantial uncertainty remains around pathogenic causes and risk factors for meningitis. Ongoing, active cause-specific surveillance of meningitis is crucial to continue and to improve monitoring of meningitis burdens and trends throughout the world. Funding Bill & Melinda Gates Foundation.

International journal of pediatrics, Nov 22, 2020

Background. Relapse in children with nephrotic syndrome leads to a variety of complications due t... more Background. Relapse in children with nephrotic syndrome leads to a variety of complications due to prolonged treatment and potential dependency on steroids. However, there is no study conducted to determine the incidence and predictive factors of relapse for nephrotic syndrome in Ethiopia, especially in children. Thus, this study aimed to assess the incidence of relapse and its predictors among children with nephrotic syndrome in Ethiopia. Methods. A retrospective study was conducted by reviewing all charts of children with an initial diagnosis of the nephrotic syndrome in tertiary hospitals from 2011 to 2018. Charts of children with a diagnosis of steroid-resistant cases were excluded. The extraction tool was used for data collection, Epi-data manager V-4.4.2 for data entry, and Stata V-14 for cleaning and analysis. Kaplan-Meier curve, log-rank test, life table, and crude hazard ratios were used to describe the data and adjusted hazard ratios with 95% CI and P value for analysis. Median relapse time, incidence rate of relapse, and cumulative relapse probabilities at a certain time interval were computed. Bivariable and multivariate analyses were performed using the Cox proportional hazard regression to identify the factors associated with relapse. Any variable at P < 0:25 in the bivariable analysis was transferred to multivariate analysis. Then, the adjusted hazard ratio with 95% CI and P ≤ 0:05 was used to report the association and to test the statistical significance, respectively. Finally, texts, tables, and graphs were used to present the results. Results and Conclusion. Majority, 64.5% (40/66), of relapses were recorded in the first 12 months of follow-up. The incidence rate of relapse was 42.6 per 1000 child-month-observations with an overall 1454 child-month-observations and the median relapse time of 16 months. Having undernutrition [AHR = 3:44; 95% CI 1.78-6.65], elevated triglyceride [AHR = 3:37; 95% CI 1.04-10.90], decreased serum albumin level [AHR = 3:51; 95% CI 1.81-6.80], and rural residence [AHR = 4:00; 95% CI 1.49-10.76] increased the hazard of relapse. Conclusion and Recommendation. Relapse was higher in the first year of the follow-up period. Undernutrition, hypoalbuminemia, hypertriglyceridemia, and being from rural areas were independent predictors of relapse. A focused evaluation of those predictors during the initial diagnosis of the disease is compulsory.

International Journal of Africa Nursing Sciences

Journal of Diabetes Research

Introduction. New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-... more Introduction. New onset of diabetes mellitus was noted as the commonest comorbidity in the COVID-19 pandemic, which contributed to a worse prognosis. Existing evidence showed that new-onset diabetes is associated with increased mortality compared to nondiabetic and known diabetic patients in the COVID-19 era. SARS-CoV-2 virus can worsen existing diabetes; at the same time, it can trigger new-onset diabetes that eventually worsens patient outcomes. Thus, this study is aimed at determining the prevalence and factors associated with new onset of diabetes mellitus among COVID-19 patients. Methods. Institution-based retrospective cross-sectional study design was conducted by reviewing 244 patient’s records in the Addis Ababa COVID-19 care center. Descriptive statistics and binary logistic regression were used. During bivariate analysis, variables with p ≤ 0.25 were transferred into multivariate analysis. Adjusted odds ratios to determine the strength and presence of the association with ...