melkamu berhane | Jimma University (original) (raw)

Papers by melkamu berhane

International Medical Case Reports Journal, Oct 1, 2021

Background: A child swallowing a long metallic spoon is an extremely rare phenomenon. Foreign bod... more Background: A child swallowing a long metallic spoon is an extremely rare phenomenon. Foreign bodies longer than 6 cm are unlikely to pass through the gastrointestinal tract spontaneously and require endoscopic or surgical removal in order to avoid associated complications, such as visceral perforations. Case Details: A 13-year-old child presented with accidental swallowing of a metallic spoon 10 days prior to hospital admission. He had history of loss of appetite, epigastric and left upper quadrant abdominal pain and started to have high grade intermittent fever 11 days after swallowing the spoon. A plain abdominal radiograph revealed a metallic spoon in the midabdomen. An exploratory laparotomy revealed an 11 cm long metallic spoon impacted at the duodeno-jejunal junction with walled off perforation and erosion of the mesentery of the colon. The metallic spoon was removed and the perforated site was repaired. The surgery was smooth and the patient recovered fully and was discharged seven days post-operation. Conclusion: A swallowed long metallic spoon is unlikely to pass spontaneously and should be removed as soon as possible in order to avoid associated complications like impaction, perforation and subsequent peritonitis.

PubMed, Nov 1, 2021

Background: Congenital anomalies affect 2-3% of all live births. Anomalies of the central nervous... more Background: Congenital anomalies affect 2-3% of all live births. Anomalies of the central nervous system account for the highest incidence followed by that of the cardiovascular and renal systems. There is scarcity of data in developing countries like Ethiopia. The aim of the study was determining the magnitude and type of congenital anomalies and associated factors in neonates admitted to the neonatology ward of Jimma Medical Center, Southwest Ethiopia. Methods: Institution based cross sectional study was done from March 1 to July 30, 2020. A total of 422 mother-infant pairs were enrolled into the study. Structured questionnaires were used to capture the socio-demographic, obstetric and medical characteristics of the mothers, demographic characteristics of the infants and type of congenital anomalies. Univariate and multivariate logistic regression analyses were done and results are presented as narratives and using figures and tables. Results: Closer to one in five neonates admitted to the neonatology ward (78, 18.5%, 95%CI 14.7-22.3) had congenital anomalies; the majority (59, 13.98%) having only one type of anomaly. Anomalies of the nervous system (29, 6.87%) and gastrointestinal system (24, 5.68%) accounted for the majority of the cases. Inadequate antenatal care follow-up (p=0.018, AOR=1.9, 95%CI1.115, 3.257) and lack of folate supplementation during pregnancy (p=0.027, AOR=2.35, 95%CI 1.101, 5.015) were associated with congenital anomalies in the neonates. Conclusion: Congenital anomalies account for significant number of admissions. Significant association was seen between neonatal congenital anomalies and poor antenatal attendance and lack of folic acid supplementation during pregnancy.

Radiation Protection Dosimetry, Mar 1, 2021

Purpose: To obtain local diagnostic reference levels (DRLs) in diagnostic and therapeutic IR proc... more Purpose: To obtain local diagnostic reference levels (DRLs) in diagnostic and therapeutic IR procedures with dose management software to improve radiation protection. Materials and Methods: Dose data of various vascular and nonvascular IR procedures performed within 18 months were collected and analyzed with dose management software. To account for different levels of complexity, procedures were subdivided into simple, standard, and difficult procedures as graded by interventional radiologists. Based on these analyses, local DRLs (given as kerma-area product [KAP]) were proposed. Comparison with dose data of others was conducted, and Spearman correlation coefficients were calculated to evaluate relationships between dose metrics. Results: Analysis included 1,403 IR procedures (simple/standard/difficult, n ¼ 346/702/355). Within the same procedure, KAP tended to increase with level of complexity. Overall, very strong correlation between KAP (Gy • cm 2) and cumulative air kerma (K A,R ; Gy) was observed, and moderate to strong correlation between KAP and time and K A,R and time was observed. For simple procedures, strong correlation was seen between KAP and time and K A,R and time; for standard and difficult procedures, only moderate correlation was seen. Correlation between KAP and time and K A,R and time was strong in nonvascular procedures but only moderate in vascular procedures. Conclusions: Dose management software can be used to derive local DRLs for various IR procedures, taking into consideration different levels of complexity. Proposed local DRLs can contribute to obtaining detailed national DRLs as part of efforts to improve patients' radiation protection further.

Ethiopian Journal of Health Sciences

BACKGROUND: Infections of the central nervous system (CNS) such as meningitis or encephalitis can... more BACKGROUND: Infections of the central nervous system (CNS) such as meningitis or encephalitis can be caused by myriad of microorganisms and may be life-threatening. In Ethiopia, it is an important cause of premature death and disability, being the 9th most common cause of years of life lost and loss of disability adjusted life years. The objective of this study was to estimate the cost of suspected and confirmed bacterial meningitis among inpatient managed patients at JUMC.METHODS: A facility-based cross-sectional study was conducted from July 28 to September 12, 2018. A semi-structured questionnaire was used in this study. Checklists were used to collect the types of laboratory tests performed and prescribed medications. This cost of illness study was conducted from the patient perspectives. We employed a micro-costing bottom-up approach to estimate the direct cost of meningitis. The humancapital approach was used for estimating wages lost.RESULT: Among total patients admitted and ...

IntroductionEstimation of renal size is useful parameter in the diagnosis of abnormal structural ... more IntroductionEstimation of renal size is useful parameter in the diagnosis of abnormal structural change on the kidneys due to the adverse effects of chronic diseases like hypertension. This study evaluated renal volume by ultrasound in relation to body size parameters, notably BMI and body surface area in hypertensive and non-hypertensive individuals.MethodsA hospital-based comparative cross-sectional study was conducted from February to September 2018 at the Radiology department of the Jimma University Medical Center (JUMC). The study included consecutively selected samples of ambulatory hypertensive patients and non-hypertensive controls recruited consecutively on voluntary basis. After providing verbal informed consent, each subject underwent abdominal ultrasound examination; length, width and thickness of both kidneys were measured and used for estimation of renal volume. The statistical evaluation included independent samples t-tests for mean differences with regard to ultrason...

BMC Ear, Nose and Throat Disorders, Dec 1, 2018

Background: Otitis media is among the leading causes of childhood illnesses although it can also ... more Background: Otitis media is among the leading causes of childhood illnesses although it can also affect the adults resulting in frequent physician visits, drug prescription and a key contributor to antibiotic resistance. The aim of this study was to determine the risk factors, bacterial profile, and the antimicrobial susceptibility pattern of the isolates from patients with discharging ears which clinically equates to draining otitis media in developing countries with limited medical resources such as otoscope. Methods: A prospective cross-sectional study was conducted on 173 patients with draining otitis media. The ear discharge specimens were collected and analyzed by standard microbial techniques. The antibiotic susceptibility profiles were determined for 19 different antibiotics by the standard disk diffusion method. Data was analyzed by SPSS version 22 and the P value of less than 0.05 was considered as statistically significant. Results: Among 173 otitis media patients participated in the study; majority, 102(63%) were pediatrics, out of which 72 (41.61%) were in the age group of less than 4 years. Ear infection was bilateral in 39 (22.54%) and chronic in 100 (57.8%) of the patients. Pathogens were isolated from 160 (92.5%) of the patients with a total of 179 isolates. The predominant isolate was Staphylococcus aureus (30.72%) followed by Proteus spp. (17.89%). The result of this study showed that adult age (p = 0.031), rural residence (p = 0.005), previous history of health care visit and treatment (p = 0.000), upper respiratory tract infection (p = 0.018) and presence of cigarette smoker in the house (p = 0.022) had statistically significant association with chronic otitis media. Most of the isolated bacteria showed high level of resistance to ampicillin/amoxicillin (88.3%), penicillin G (79.5%) followed by trimethoprim /sulfamethoxazole (73.8%). Conversely, the majority of bacterial isolates showed moderate susceptibility to ciprofloxacin (72.9%), gentamicin (70.4%), and amikacin (69.3%). Bacterial isolates identified in this study showed trend of multiple drug resistance, majority (67%) being resistant to three or more antimicrobials. Conclusions: Majority of the bacterial isolates were multidrug resistant, hence, efforts to isolate microorganisms and determine the susceptibility pattern should be strengthened to improve the treatment outcome of otitis media instead of the usual trend of empirical treatment.

Research Square (Research Square), Dec 23, 2019

Background: Weight at birth is a good indicator of the newborn's chance for survival, growth and ... more Background: Weight at birth is a good indicator of the newborn's chance for survival, growth and development, as well as long term health and psychosocial development. Low birth weight newborns are at a significantly higher risk of morbidity and mortality contributing a lot to the higher perinatal, neonatal, infant and childhood morbidity and mortality rates specially in the developing countries like Ethiopia. They are also at a higher risk of adulthood illnesses once they survive the early complications. Even if many studies have been done on low birth weight, its associated factors and the short as well as long term outcomes of low birth weight infants in the developed world, little has been done in developing countries like Ethiopia where the burden of the problem is huge. In Ethiopia, few studies have been done on the incidence of low birth weight and associated factors but most of these studies didn't consider many of the factors thought to be associated with low birth weight. Objectives: To determine the incidence of low birth weight and its associated factors in Jimma University Specialized Hospital. Methods and materials: A cross sectional study was conducted on 931 newborns who were born in Jimma University Specialized Hospital from March 1 to May 30, 2014 GC. Data were collected by using structured questionnaire. Maternal and neonatal anthropometric measurements were done by using standard beam balance, tape meter and measuring board. Consecutive sampling technique was used to include all eligible newborns and their mothers until the required sample size is obtained. p value of <0.05 was used to consider significance. Results: The mean (± SD) of birth weights were 3017 ± 612gm. The incidence of low birth weight (birth weight <2500) was 24.4%. The factors found to be associated with low birth weight in this study are female gender, maternal urinary tract infections, preterm delivery, maternal antepartal hemorrhage, and multiple gestations. Conclusion and recommendations: The incidence of low birth weight is found to be high in this study. An attempt to increase the rate of ANC attendance and identifying the medical illnesses as well as obstetric complications and addressing them timely is recommended so that the rate and complications of low birth weight could be minimized.

Archives of Disease in Childhood, Nov 1, 2019

What is already known on this topic? ► Worldwide, about one-sixth of all newborns are low birth w... more What is already known on this topic? ► Worldwide, about one-sixth of all newborns are low birth weight (LBW, <2500 g), which is the single most important underlying risk factor for neonatal death. ► In resource-limited settings, tools to identify LBW and premature newborns are often not readily available. ► Foot length, chest circumference mid-upper arm circumference can be used to identify LBW babies at birth, cutoffs vary by country and ethnic group. What this study adds? ► The optimal cutoffs identified to diagnose LBW in Ethiopia were ≤7.7 cm for foot length, ≤31.2 cm for chest circumference and ≤9.8 cm for mid-upper arm circumference. ► Comparable diagnostic ability was observed when these measurements were taken on day 5 of age. ► The Eregie model for gestational age estimation gives similar results to the New Ballard Score method.

Supplemental material, sj-pdf-1-inq-10.1177_00469580211018290 for Inequitable Utilization of Neon... more Supplemental material, sj-pdf-1-inq-10.1177_00469580211018290 for Inequitable Utilization of Neonatal Health Services in Southwest Ethiopia: The Effects of Socioeconomic Disparities by Kiddus Yitbarek, Sarah Hurlburt, Terje P. Hagen, Melkamu Berhane, Gelila Abraham, Ayinengida Adamu, Gebeyehu Tsega and Mirkuzie Woldie in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

The American Journal of Clinical Nutrition

International Medical Case Reports Journal, 2021

Tropical Medicine & International Health, 2019

Persistent (PD, defined as diarrhoea lasting ≥14 days) and prolonged diarrhoea (ProD, defined as ... more Persistent (PD, defined as diarrhoea lasting ≥14 days) and prolonged diarrhoea (ProD, defined as diarrhoea lasting 7-13 days) are assumed to be closely linked to acute malnutrition. Improved treatment relies on better characterization of these diarrhoeal syndromes. Our objective was to assess the prevalence of prolonged and persistent diarrhoea, to estimate their co-occurrence with acute malnutrition and association with demographic and clinical factors. Methods We conducted a case-control study where cases were children under 5 years of age with diarrhoea and controls were children without diarrhoea, frequency matched weekly by age and district of residency. Controls for cases 0-11 months were recruited from vaccination rooms and controls for cases 12-59 months were recruited by house visits using random locations in the catchment area of the study sites. Data were analysed by mixed model logistic regression. Results We enrolled 1134 cases and 946 controls. Among the cases, 967 (85%) had acute diarrhoea (AD), 129 (11%) had ProD and 36 (3.2%) had PD. Cases more often had acute malnutrition at enrolment (17% vs 4%, p<0.0001) and were born prematurely (5.7% vs 1.8%, p<0.0001) compared with controls. Seventy-five percent of ProPD cases did not have acute malnutrition. Cases with AD and ProPD had different symptomatology, even beyond illness duration. Conclusions ProPD is common among children presenting with diarrhoea and is not confined to children with acute malnutrition. There is an urgent need for studies assessing causes of ProPD with and without acute malnutrition to develop treatment guidelines for these conditions.

PLOS ONE

Background Depression is the most common mental health problem, and frequently associated with ph... more Background Depression is the most common mental health problem, and frequently associated with physical illnesses. A link between depression, dyspepsia and Helicobacter pylori (H. pylori) infection has previously been reported. However, there is limited data regarding the association between these conditions from sub-Saharan Africa where they are highly prevalent. Objective This study aimed at elucidating the potential associations between depression, dyspepsia and H. pylori infection in Ethiopia. Methods We conducted a community based cross-sectional study involving urban and rural residents aged 13 years or older in Jimma Zone, southwest Ethiopia. A total of 871 participants were evaluated using a structured case reporting format for symptoms of dyspepsia and the patient health questionnaire (PHQ-9) for depression. Additionally, participants were assessed for H. pylori infection using stool antigen and serology tests. A multivariate logistic regression was used to identify the ass...

Ethiopian journal of health sciences, Nov 1, 2021

Background Congenital anomalies affect 2–3% of all live births. Anomalies of the central nervous ... more Background Congenital anomalies affect 2–3% of all live births. Anomalies of the central nervous system account for the highest incidence followed by that of the cardiovascular and renal systems. There is scarcity of data in developing countries like Ethiopia. The aim of the study was determining the magnitude and type of congenital anomalies and associated factors in neonates admitted to the neonatology ward of Jimma Medical Center, Southwest Ethiopia. Methods Institution based cross sectional study was done from March 1 to July 30, 2020. A total of 422 mother-infant pairs were enrolled into the study. Structured questionnaires were used to capture the socio-demographic, obstetric and medical characteristics of the mothers, demographic characteristics of the infants and type of congenital anomalies. Univariate and multivariate logistic regression analyses were done and results are presented as narratives and using figures and tables. Results Closer to one in five neonates admitted to the neonatology ward (78, 18.5%, 95%CI 14.7–22.3) had congenital anomalies; the majority (59, 13.98%) having only one type of anomaly. Anomalies of the nervous system (29, 6.87%) and gastrointestinal system (24, 5.68%) accounted for the majority of the cases. Inadequate antenatal care follow-up (p=0.018, AOR=1.9, 95%CI1.115, 3.257) and lack of folate supplementation during pregnancy (p=0.027, AOR=2.35, 95%CI 1.101, 5.015) were associated with congenital anomalies in the neonates. Conclusion Congenital anomalies account for significant number of admissions. Significant association was seen between neonatal congenital anomalies and poor antenatal attendance and lack of folic acid supplementation during pregnancy.

PLOS ONE, Jul 21, 2022

Supporting small and nutritionally at-risk (potentially malnourished) infants under six months is... more Supporting small and nutritionally at-risk (potentially malnourished) infants under six months is a global health priority, albeit with a weak evidence-base. To inform policy and research in this area, we aimed to assess the perceptions and understanding of infant malnutrition and its management among carers, communities, and healthcare workers in rural Ethiopia. Methods We conducted in-depth and key-informant interviews, from May-August 2020 in Jimma Zone and Deder District, Ethiopia. We used purposive sampling to recruit the participants. Interviews were transcribed into Amharic or Afaan Oromo and then translated into English. Atlas ti-7 was used to support data analysis. Findings were narrated based on the different themes arising from the interviews. Results Carers/community members and healthcare workers reported on five different themes: 1) Perceptions about health and well-being: an 'ideal infant' slept well, fed well, was active and looked 'fat'; 2)Perceptions of feeding: overall knowledge of key recommendations like exclusive breastfeeding was good but practices were suboptimal, notably a cultural practice to give water to young infants; 3)Awareness about malnutrition: a key limitation was knowledge of exactly how to identify small and nutritionally at-risk infants; 4) Reasons for malnutrition: levels of understanding varied and included feeding problems and caregiver's work pressures resulting in the premature introduction of complementary feeds; 5) Perceptions about

Survey questionnaire: WCBA_HHQ1_Base_End. The questionnaire has been developed and customized mai... more Survey questionnaire: WCBA_HHQ1_Base_End. The questionnaire has been developed and customized mainly from the Ethiopian Health and Demographic Survey (EDHS) report, maternal health section: https://dhsprogram.com/publications/publication-fr328-dhs-final-reports.cfm We have uploaded the PDF of the questionnaire as an additional file. (PDF 165â kb)

Ethiopian Journal of Health Sciences, 2019

Background Congenital aphalia is an extremely rare, urogenital malformation of the external genit... more Background Congenital aphalia is an extremely rare, urogenital malformation of the external genitalia characterized by congenitally absent penis in a karotypically XY child. It occurs 1 in 30 million live births. So far, only less than 100 cases have been reported. Case Details A 3-hour old newborn was diagnosed with aphalia after being referred from health center for respiratory distress and congenital malformation of the external genitalia. He had deranged renal function tests, hypoplastic kidneys, small patent foramen ovale and ventricular septal defect. Management of the acute conditions and parental counseling were done, but he passed away on the 8th day of life, due to the underlying diseases. Conclusion A patient with aphalia needs thorough evaluation for possible associated malformations. Management is multistaged and multidisciplinary. Parental counselling should be started as early as possible, and their decision should be respected.

Canadian Journal of Gastroenterology and Hepatology

Background. In resource-constrained countries, accurate diagnosis of Helicobacter pylori infectio... more Background. In resource-constrained countries, accurate diagnosis of Helicobacter pylori infection remains a challenge. This study aimed to assess the clinical utility of locally available serological and stool antigen test kits in the management of people with suspected H. pylori infection in Ethiopia. Methods. A community-based cross-sectional study was conducted with apparently healthy adults and children living in southwest Ethiopia. Participants were interviewed for dyspepsia symptoms and related clinical conditions. H. pylori infection was examined using commercially available serological and stool antigen tests. The association between H. pylori tests and dyspepsia symptoms was analyzed using logistic regression models. Results. Out of 1392 participants included in the final analysis, 49.1% and 6.5% tested positive for H. pylori infection with serology and stool antigen test kits, respectively. Participants reporting epigastric symptoms in the past three months (AOR = 1.93, 9...