Journal Article > Short ReportFull Text
Morbidity and Mortality Weekly Report. 2015 May 22
Browne L, Menkir Z, Kahi V, Maina G, Asnakew S, et al.
Morbidity and Mortality Weekly Report. 2015 May 22
In early April 2014, two South Sudanese refugees in the Gambella region of western Ethiopia experienced acute onset of jaundice, accompanied by fever. One patient was a pregnant woman aged 24 years evaluated at a routine prenatal clinic visit in Leitchour refugee camp. The second patient was a malnourished boy aged 1 year who resided in Tierkidi refugee camp. The boy died despite hospitalization. During the last 2 weeks of May, four more cases of acute jaundice syndrome (AJS), defined as yellow discoloration of the eyes, were detected in Leitchuor. By mid-June, an additional 50 AJS cases were reported across three large camps in the region, Kule, Leitchuor, and Tierkidi, with 45 (90%) of these cases reported in Leitchuor. Sera collected from a convenience sample of 21 AJS cases were sent to Addis Ababa and Nairobi for real-time polymerase chain reaction testing; 12 (57%) were positive for hepatitis E virus (HEV) RNA. By January 2015, a total of 1,117 suspected cases of hepatitis E meeting the case definition of AJS were reported among refugees in camps across Gambella.
Journal Article > Short ReportAbstract
Pediatr Infect Dis J. 2013 July 30; Volume 33 (Issue 1); DOI:10.1097/INF.0b013e3182a6e1cd
Moons P, Thallinger M
Pediatr Infect Dis J. 2013 July 30; Volume 33 (Issue 1); DOI:10.1097/INF.0b013e3182a6e1cd
During an outbreak of measles in a refugee camp in Ethiopia, 9 patients (age range 4 months to 18 years) were diagnosed with subcutaneous emphysema. Incidence of this rare complication of measles in this refugee camp was higher than previously reported. We hypothesize that the high incidence is most likely related to poor physical state of the refugee population with high rates of malnutrition.
Journal Article > ResearchFull Text
Am J Trop Med Hyg. 2009 June 1; Volume 80 (Issue 6); 929-34.
ter Horst R, Tefera T, Assefa G, Ebrahim AZ, Davidson RN, et al.
Am J Trop Med Hyg. 2009 June 1; Volume 80 (Issue 6); 929-34.
Accuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive.
Journal Article > ResearchFull Text
Ethiop Med J. 2004 July 1; Volume 42 (Issue 3); 173-177.
Reilley B, Hiwot ZG, Mesure J
Ethiop Med J. 2004 July 1; Volume 42 (Issue 3); 173-177.
OBJECTIVES
A study was conducted to assess the acceptability and utilization of voluntary counselling and testing (VCT) and sexually transmitted infection (STI) services in Kahsey Abera Hospital, Humera.
METHODS
Retrospective data was taken from hospital consultation logbooks from January 2002 to February 2003, and focus group discussions were conducted in March 2003 in the community.
RESULTS
While the services were known and utilization is increasing, important misconceptions about the medical services, disease transmission, and STI treatment persist. Although hospital care was generally considered of high quality, persons often go to pharmacies to self-treat for STIs due to concerns about confidentiality, and the stigma of HIV deters many from wanting to know their serostatus.
CONCLUSIONS
Additional education is needed on HIV/AIDS, STIs, and the medical services provided. Education may make use of community health workers or outreach workers in a small group where participants can feel comfortable to ask sensitive questions. HIV/AIDS treatment is planned for the near future and may be significant in reducing HIV/AIDS stigma.
A study was conducted to assess the acceptability and utilization of voluntary counselling and testing (VCT) and sexually transmitted infection (STI) services in Kahsey Abera Hospital, Humera.
METHODS
Retrospective data was taken from hospital consultation logbooks from January 2002 to February 2003, and focus group discussions were conducted in March 2003 in the community.
RESULTS
While the services were known and utilization is increasing, important misconceptions about the medical services, disease transmission, and STI treatment persist. Although hospital care was generally considered of high quality, persons often go to pharmacies to self-treat for STIs due to concerns about confidentiality, and the stigma of HIV deters many from wanting to know their serostatus.
CONCLUSIONS
Additional education is needed on HIV/AIDS, STIs, and the medical services provided. Education may make use of community health workers or outreach workers in a small group where participants can feel comfortable to ask sensitive questions. HIV/AIDS treatment is planned for the near future and may be significant in reducing HIV/AIDS stigma.
Conference Material > Video (talk)
Ali Dubad B
MSF Scientific Days International 2022. 2022 June 7; DOI:10.57740/yt3r-hq09
Journal Article > ResearchFull Text
Cureus. 2024 September 13; Volume 16 (Issue 9); e69358.; DOI:10.7759/cureus.69358
Tigist Workneh Leulseged, Nahom Dessalegn Mekonnen, Yared Adane Minas, Zekarias Tadele Alemneh, Yonas Hailu Gebeyeh, et al.
Cureus. 2024 September 13; Volume 16 (Issue 9); e69358.; DOI:10.7759/cureus.69358
INTRODUCTION
The severe consequences of acute kidney injury (AKI) have been well-documented in high-risk patient populations. However, the effects of milder forms in non-critically ill patients remain understudied, particularly in resource-limited settings. While the risk of mortality associated with these cases is considered low, it can still lead to various complications including prolonged hospitalization, which may influence long-term renal and patient survival. Hence, the objective of this study was to study the impact of non-dialysis-requiring AKI (NDR-AKI) on survival outcomes of non-critically ill medical patients admitted to St. Paul’s Hospital Millennium Medical College in Ethiopia during the period from July 2019 to January 2022.
METHODS
A retrospective cohort study was conducted among 300 non-critically ill medical patients, 93 with NDR-AKI and 207 without AKI. Descriptive statistics, including frequency distributions and median survival times, were employed to summarize the data. Kaplan-Meier curves and the log-rank test were utilized to compare survival experiences of groups. A Cox proportional hazards survival model was fitted to estimate the impact of NDR-AKI on time to recovery. Adjusted hazard ratio (AHR) with 95% confidence interval (CI) was used to report findings.
RESULTS
Two hundred four (68.0%) were discharged after improvement and the median recovery time was 16 days (95%CI: 13.5-18.5 days). Having NDR-AKI was associated with a 43% lower rate of achieving recovery (AHR=0.57, 95%CI=0.38, 0.84, p-value=0.004). Females were found to have a 1.41 times higher rate of recovery (AHR=1.41, 95%CI=1.03,1.94, p-value=0.033). Additionally, having tuberculosis (AHR=0.41, 95%CI=0.23,0.72, p-value=0.002) and being on anticoagulant (AHR=0.67, 95%CI=0.47,0.95, p-value=0.027) were associated with a 59% and 33% lower rate of recovery, respectively.
CONCLUSION
NDR-AKI significantly delays recovery compared to patients without AKI suggesting that even milder forms of AKI in non-critically ill patients can negatively impact patient outcomes. Early identification, prompt management, and addressing underlying causes are key to improving recovery and reducing long-term morbidity and mortality. Strict screening and monitoring of high-risk groups such as men, patients with tuberculosis, and those on anticoagulants is also crucial.
Journal Article > Short ReportFull Text
Clin Infect Dis. 2019 November 2; Volume 71 (Issue 2); 415-418.; DOI:10.1093/cid/ciz1084
Seung KJ, Khan PY, Franke MF, Ahmed SM, Aiylchiev S, et al.
Clin Infect Dis. 2019 November 2; Volume 71 (Issue 2); 415-418.; DOI:10.1093/cid/ciz1084
Delamanid should be effective against highly resistant strains of Mycobacterium tuberculosis, but uptake has been slow globally. In the endTB (expand new drug markets for TB) Observational Study, which enrolled a large, heterogeneous cohorts of patients receiving delamanid as part of a multidrug regimen, 80% of participants experienced sputum culture conversion within 6 months.
Journal Article > ResearchFull Text
PLOS One. 2017 June 5; Volume 12 (Issue 6); e0178996.; DOI:10.1371/journal.pone.0178996
Abongomera C, Ritmeijer KKD, Vogt F, Buyze J, Mekonnen Z, et al.
PLOS One. 2017 June 5; Volume 12 (Issue 6); e0178996.; DOI:10.1371/journal.pone.0178996
BACKGROUND
In Ethiopia, case fatality rates among subgroups of visceral leishmaniasis (VL) patients are high. A clinical prognostic score for death in VL patients could contribute to optimal management and reduction of these case fatality rates. We aimed to identify predictors of death from VL, and to develop and externally validate a clinical prognostic score for death in VL patients, in a high HIV co-infection burden area in Ethiopia.
METHODOLOGY/PRINCIPAL FINDINGS
We conducted a retrospective cohort study in north west Ethiopia. Predictors with an adjusted likelihood ratio ≥1.5 or ≤0.67 were retained to calculate the predictor score. The derivation cohort consisted of 1686 VL patients treated at an upgraded health center and the external validation cohort consisted of 404 VL patients treated in hospital. There were 99 deaths in the derivation cohort and 53 deaths in the external validation cohort. The predictors of death were: age >40 years (score +1); HIV seropositive (score +1); HIV seronegative (score -1); hemoglobin ≤6.5 g/dl (score +1); bleeding (score +1); jaundice (score +1); edema (score +1); ascites (score +2) and tuberculosis (score +1). The total predictor score per patient ranged from -1 to +5. A score of -1, indicated a low risk of death (1.0%), a score of 0 an intermediate risk of death (3.8%) and a score of +1 to +5, a high risk of death (10.4–85.7%). The area under the receiver operating characteristic curve was 0.83 (95% confidence interval: 0.79–0.87) in derivation, and 0.78 (95% confidence interval: 0.72–0.83) in external validation.
CONCLUSIONS/SIGNIFICANCE
The overall performance of the score was good. The score can enable the early detection of VL cases at high risk of death, which can inform operational, clinical management guidelines, and VL program management. Implementation of focused strategies could contribute to optimal management and reduction of the case fatality rates.
In Ethiopia, case fatality rates among subgroups of visceral leishmaniasis (VL) patients are high. A clinical prognostic score for death in VL patients could contribute to optimal management and reduction of these case fatality rates. We aimed to identify predictors of death from VL, and to develop and externally validate a clinical prognostic score for death in VL patients, in a high HIV co-infection burden area in Ethiopia.
METHODOLOGY/PRINCIPAL FINDINGS
We conducted a retrospective cohort study in north west Ethiopia. Predictors with an adjusted likelihood ratio ≥1.5 or ≤0.67 were retained to calculate the predictor score. The derivation cohort consisted of 1686 VL patients treated at an upgraded health center and the external validation cohort consisted of 404 VL patients treated in hospital. There were 99 deaths in the derivation cohort and 53 deaths in the external validation cohort. The predictors of death were: age >40 years (score +1); HIV seropositive (score +1); HIV seronegative (score -1); hemoglobin ≤6.5 g/dl (score +1); bleeding (score +1); jaundice (score +1); edema (score +1); ascites (score +2) and tuberculosis (score +1). The total predictor score per patient ranged from -1 to +5. A score of -1, indicated a low risk of death (1.0%), a score of 0 an intermediate risk of death (3.8%) and a score of +1 to +5, a high risk of death (10.4–85.7%). The area under the receiver operating characteristic curve was 0.83 (95% confidence interval: 0.79–0.87) in derivation, and 0.78 (95% confidence interval: 0.72–0.83) in external validation.
CONCLUSIONS/SIGNIFICANCE
The overall performance of the score was good. The score can enable the early detection of VL cases at high risk of death, which can inform operational, clinical management guidelines, and VL program management. Implementation of focused strategies could contribute to optimal management and reduction of the case fatality rates.
Journal Article > ResearchFull Text
Advances in Medical Education and Practice. 2022 June 6; Volume 13; 595-607.; DOI: 10.2147/AMEP.S358702
Owolabi JO, Ojiambo R, Seifu D, Nishimwe A, Masimbi O, et al.
Advances in Medical Education and Practice. 2022 June 6; Volume 13; 595-607.; DOI: 10.2147/AMEP.S358702
BACKGROUND
This article presents a qualitative study of African anatomists and anatomy teachers on the Anatomage Table-a modern medical education technology and innovation, as an indicator of African anatomy medical and anatomy educators' acceptance of EdTech. The Anatomage Table is used for digital dissection, prosection, functional anatomy demonstration, virtual simulation of certain functions, and interactive digital teaching aid.
MATERIALS AND METHODS
Anatomy teachers [n=79] from 11 representative African countries, Ghana, Nigeria [West Africa], Ethiopia, Kenya, Rwanda [East Africa], Namibia [South Africa], Zambia [Southern Africa], Egypt [North Africa], and Sudan [Central Africa], participated in this study. Focus group discussions [FGDs] were set up to obtain qualitative information from stakeholders from representative institutions. In addition, based on the set criteria, selected education leaders and stakeholders in representative institutions participated in In-depth Interviews [IDIs]. The interview explored critical issues concerning their perceptions about the acceptance, adoption, and integration of educational technology, specifically, the Anatomage Table into the teaching of Anatomy and related medical sciences in the African continent. Recorded interviews were transcribed and analyzed using the Dedoose software.
RESULTS
African anatomists are generally technology inclined and in favor of EdTech. The most recurring opinion was that the Anatomage Table could only be a "complementary teaching tool to cadavers" and that it "can't replace the real-life experience of cadavers." Particularly, respondents from user institutions opined that it "complements the traditional cadaver-based approaches" to anatomy learning and inquiry, including being a good "complement for cadaveric skill lab" sessions. Compared with the traditional cadaveric dissections a majority also considered it less problematic regarding cultural acceptability and health and safety-related concerns. The lifelikeness of the 3D representation is a major factor that drives acceptability.
This article presents a qualitative study of African anatomists and anatomy teachers on the Anatomage Table-a modern medical education technology and innovation, as an indicator of African anatomy medical and anatomy educators' acceptance of EdTech. The Anatomage Table is used for digital dissection, prosection, functional anatomy demonstration, virtual simulation of certain functions, and interactive digital teaching aid.
MATERIALS AND METHODS
Anatomy teachers [n=79] from 11 representative African countries, Ghana, Nigeria [West Africa], Ethiopia, Kenya, Rwanda [East Africa], Namibia [South Africa], Zambia [Southern Africa], Egypt [North Africa], and Sudan [Central Africa], participated in this study. Focus group discussions [FGDs] were set up to obtain qualitative information from stakeholders from representative institutions. In addition, based on the set criteria, selected education leaders and stakeholders in representative institutions participated in In-depth Interviews [IDIs]. The interview explored critical issues concerning their perceptions about the acceptance, adoption, and integration of educational technology, specifically, the Anatomage Table into the teaching of Anatomy and related medical sciences in the African continent. Recorded interviews were transcribed and analyzed using the Dedoose software.
RESULTS
African anatomists are generally technology inclined and in favor of EdTech. The most recurring opinion was that the Anatomage Table could only be a "complementary teaching tool to cadavers" and that it "can't replace the real-life experience of cadavers." Particularly, respondents from user institutions opined that it "complements the traditional cadaver-based approaches" to anatomy learning and inquiry, including being a good "complement for cadaveric skill lab" sessions. Compared with the traditional cadaveric dissections a majority also considered it less problematic regarding cultural acceptability and health and safety-related concerns. The lifelikeness of the 3D representation is a major factor that drives acceptability.
Journal Article > ResearchFull Text
Int J Infect Dis. 2022 September 1; Volume 122; 215-221.; DOI:10.1016/j.ijid.2022.05.039
Zheng Q, Luquero FJ, Ciglenecki I, Wamala JF, Abubakar A, et al.
Int J Infect Dis. 2022 September 1; Volume 122; 215-221.; DOI:10.1016/j.ijid.2022.05.039
BACKGROUND
Cholera remains a public health threat but is inequitably distributed across sub-Saharan Africa. Lack of standardized reporting and inconsistent outbreak definitions limit our understanding of cholera outbreak epidemiology.
METHODS
From a database of cholera incidence and mortality, we extracted data from sub-Saharan Africa and reconstructed outbreaks of suspected cholera starting in January 2010 to December 2019 based on location-specific average weekly incidence rate thresholds. We then described the distribution of key outbreak metrics.
RESULTS
We identified 999 suspected cholera outbreaks in 744 regions across 25 sub-Saharan African countries. The outbreak periods accounted for 1.8 billion person-months (2% of the total during this period) from January 2010 to January 2020. Among 692 outbreaks reported from second-level administrative units (e.g., districts), the median attack rate was 0.8 per 1000 people (interquartile range (IQR), 0.3-2.4 per 1000), the median epidemic duration was 13 weeks (IQR, 8-19), and the median early outbreak reproductive number was 1.8 (range, 1.1-3.5). Larger attack rates were associated with longer times to outbreak peak, longer epidemic durations, and lower case fatality risks.
CONCLUSIONS
This study provides a baseline from which the progress toward cholera control and essential statistics to inform outbreak management in sub-Saharan Africa can be monitored.
Cholera remains a public health threat but is inequitably distributed across sub-Saharan Africa. Lack of standardized reporting and inconsistent outbreak definitions limit our understanding of cholera outbreak epidemiology.
METHODS
From a database of cholera incidence and mortality, we extracted data from sub-Saharan Africa and reconstructed outbreaks of suspected cholera starting in January 2010 to December 2019 based on location-specific average weekly incidence rate thresholds. We then described the distribution of key outbreak metrics.
RESULTS
We identified 999 suspected cholera outbreaks in 744 regions across 25 sub-Saharan African countries. The outbreak periods accounted for 1.8 billion person-months (2% of the total during this period) from January 2010 to January 2020. Among 692 outbreaks reported from second-level administrative units (e.g., districts), the median attack rate was 0.8 per 1000 people (interquartile range (IQR), 0.3-2.4 per 1000), the median epidemic duration was 13 weeks (IQR, 8-19), and the median early outbreak reproductive number was 1.8 (range, 1.1-3.5). Larger attack rates were associated with longer times to outbreak peak, longer epidemic durations, and lower case fatality risks.
CONCLUSIONS
This study provides a baseline from which the progress toward cholera control and essential statistics to inform outbreak management in sub-Saharan Africa can be monitored.