https://www.ajol.info/index.php/ejhd/issue/feed Ethiopian Journal of Health Development 2022-03-16T08:57:30+00:00 Mirgissa Kaba editorejhd@yahoo.com Open Journal Systems <p><span lang="EN-US">The Journal publishes analytical, descriptive and methodological articles, as well as original research, on public health problems, management of health services, health care needs and socio-economic and political factors related to health and development. More specifically, the Journal focus on important topics in health development that include: health policy and health politics; health planning, monitoring and evaluation; health administration and organization of health services; hospital administration; health manpower, including training; health economics, financing, and health development; health statistics and health information systems; maternal and child health, including family planning; environmental health and water; food and nutrition; health education; epidemiology and communicable diseases including HIV/AIDS, TB and STI; community involvement and inter-sectoral approaches to primary health care; drug supply and distribution; socioeconomic factors related to health and health services, medical geography, broader topics on scientific work on health care technologies; rights and obligations of communities in participation in health care; and international health organizations and technical cooperation among developing countries.</span></p> <p>Other websites related to this journal:&nbsp;<span lang="EN-US"><a title="www.ejhd.org" href="http://www.ejhd.org/" target="_blank" rel="noopener">www.ejhd.org</a></span></p> https://www.ajol.info/index.php/ejhd/article/view/222697 The Role of the Private Health Sector in Public Health Emergencies: opportunities and challenges 2022-03-11T09:24:20+00:00 Adamu Addissie adamuaddissie@gmail.com <p>The private health sector is meant to play a complementary role to the public health sector, which provides a significant portion of health care provision in most countries including Ethiopia. The private health sector includes both profit and non-profit entities and their roles extend to all the essential elements of the health care system namely, preventive, curative, human resource, pharmaceuticals, and other areas1. It is not unusual for the private health sector to work hand in hand with the public health sector in various areas, as the private sector is a key constituent in the provision of essential services such as the provision of emergency services. Public private partnership (PPP) is one of the strategic constituents for the Ethiopian ministry of health and has documented successes and best practices</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222698 Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios are useful in differentiation of thyroid conditions with normal and increased uptake 2022-03-11T09:27:28+00:00 Hamdi Afsin hamdiafsin@hotmail.com Gülali Aktas editorejhd@yahoo.com <p>Abstract<br>Background: Thyroid uptake scintigraphy is a useful diagnostic tool in differentiation of thyroid conditions, especially in differentiation of hyperthyroidism from other causes of thyrotoxicosis. Hemogram parameters were introduced as novel inflammatory markers.<br>Objective: To study the association between hemogram indices and thyroid uptake in patients with thyroid diseases in Abant Izzet Baysal University Hospital internal medicine clinic.<br>Methods: Medical data of the patients with thyroid conditions were obtained from institutional databases between January 2019 and January 2020 in Abant Izzet Baysal University Hospital, Bolu, Turkey. According to the uptake the study population was grouped into three groups, decreased uptake, normal uptake and increased uptake groups. Laboratory parameters, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were compared between study groups.<br>Results: Median NLR of normal, increased and decreased uptake groups were 1.5 (1-2.9) %, 2.1 (1.1-26) %, and 2.2 (1.1-10) %, respectively (p&lt;0.001). Median PLR of normal, increased and decreased uptake groups were 99 (42-201) %, 144 (69-264) %, and 121 (67-270) %, respectively (p&lt;0.001). NLR was significantly and positively correlated with CRP (r=0.59, p&lt;0.001), and with ESR (r=0.30, p&lt;0.001). Similarly PLR was also significantly and positively correlated with CRP (r=0.54, p&lt;0.001), and with ESR (r=0.28, p&lt;0.001).<br>Conclusions: We suggest that NLR and PLR could serve as additional diagnostic tools in the differentiation of thyroid conditions with increased uptake from that with normal uptake. [Ethiop. J. Health Dev. 2021; 35(3):149-153]<br>Keywords: thyroid uptake, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, thyroid diseases, inflammatory markers</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222699 Knowledge and perceptions of COVID-19 among government employees in Ethiopia: A cross-sectional study 2022-03-11T09:35:17+00:00 Wakgari Deressa deressaw@gmail.com Alemayehu Worku alemayehuwy@yahoo.com Wondwosson Amogne wonamogne@yahoo.com Sefonias Getachew sefonias.getachew@gmail.com Awgichew Kifle awgistat@gmail.com Workeabeba Abebe workeabebasol@gmail.com <p>Abstract<br>Background: Knowledge and perceptions of the public about the 2019 coronavirus disease (COVID-19) play a critical role in the prevention of the disease through adopting effective preventive measures. The aim of this study was to assess the knowledge and perceptions of COVID-19 as well as the source of information about the disease among government employees.<br>Methods: A cross-sectional survey of 1,573 government employees from 46 public institutions located in Addis Ababa was undertaken from 8th to 19th June 2020. Systematic random sampling or consecutive sampling techniques were used to select the study participants. Paper-based self-administered questionnaires were used for data collection. ANOVA test and t-test were used to assess the difference between the groups.<br>Results: The respondents demonstrated very high knowledge of the cause of COVID-19 (93%), its main clinical symptoms (&gt;90%), modes of transmission (89%), and the main preventive measures (&gt;90%). Almost all respondents reported that people with travel history (86.8%) or people with close contact with COVID-19 patients (93.5%) were at higher risk to coronavirus infection. About 51% of the participants reported that people without travel history or people who had no contact with confirmed cases were also at risk of infection. About 84% of the respondents perceived those older adults above 60 years were most at risk to die from COVID-19. The majority of the respondents reported that adults with other underlying health problems (95.4%), cigarette smokers (88.1%) and substance users (87.5%) were more likely to die from the disease. Television (32.2%) and health workers (30.5%) constituted the most trusted sources of information related to COVID-19.<br>Conclusions: This study has found higher levels of knowledge and perceptions among respondents about COVID-19. Efforts should be focused on improving the knowledge, perceived susceptibility, severity, and benefits of preventive measures by providing timely and adequate information through trusted sources of information. . [Ethiop. J. Health Dev. 2021; 35(3):153-164]<br>Keywords: COVID-19, Ethiopia, Government employees, Knowledge, Perception, SARS-COV-2</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222700 Spatial variation and level of compliance on COVID-19 Prevention strategies in Amhara region, Ethiopia: Observational survey 2022-03-11T09:54:11+00:00 Tadesse Awoke Ayele tawoke7@gmail.com Netsanet Fentahun netsanet_fentahun@yahoo.com Sofonyas Abebaw Tiruneh zephab2@gmail.com Mahteme Haile maykm24@yahoo.com Taye Zeru zerutaye@gmail.com Girum Meseret girum.m21@gmail.com Molalign Tarekegn tamolalign@gmail.com Desalew ‎ Salew desalew131@gmail.com Ale Ayal Ayal-semreab21@gmail.com Melashu Balew bmelashu@gmail.com Tariku Belachew tariku88@hotmail.com Muluken Azage mulukenag@gmail.com <p><strong>Abstract</strong></p> <p><strong>Background: </strong>The &nbsp;novel Coronavirus was first detected in Wuhan, China in &nbsp;December 2019. In Ethiopia, The COVID-19 &nbsp;pandemic was expanding geopgraphically&nbsp; overtime. Understanding the spatial variation of the pandemic and the level of compliances towards COVID-19 &nbsp;prevention strategies is important to guide focused prevention and control efforts. &nbsp;</p> <p><strong>Aim</strong>: This study aimed to explore the level of compliance and spatial variation in COVID-19 prevention strategies in major cities and towns in the Amhara region, Ethiopia.</p> <p><strong>Methods</strong>: A community based observational survey was conducted from June 25 to August 10, 2020, in 16 selected cities and towns of the Amhara region. The level of compliance with hand hygiene, physical distancing and mask utilization as per the WHO recommendations were observed from 6,002 individuals and 346 transport services. Getis-Ord Gi* statistics were used to identify hot spot areas with a low level of compliance with COVID-19 preventive strategies. Spatial interpolation was performed to predict the level of compliance for un-sampled areas in the region.</p> <p><strong>Results:</strong> The practice of hand hygiene, physical distancing and mask utilization were 12.0%, 13% and 26%, respectively. COVID-19 prevention strategies were found to be spacially non-random in Amhara region (Global Moran’s I = 0.23, z-score = 9.5, P-value &lt; 0.001). Poor (Hot Spot Areas) COVID-19 Prevention practices were spatially clustered at Northern Amhara (Metema, Gondar, and Woghemira town) and Western Amhara (Moarkos, Enjibara, And Bahir Dar town).Southern (Shewa Robit, and Kemissie Twon) and Eastern (Dessie, Kombolcha, Wolidiya, and Kobo) parts of the Amhara region were spatially clustered as cold spots (better practice) for COVID-19 prevention strategies. With regards to the practice of COVID19 prevention strategies, practices were low in northern and northwestern parts of the region ( 5%), whereas this was found to be much higher in the southern part of the region (41%).</p> <p><strong>Conclusion</strong>: The level of compliance with regards to hand hygiene, physical distancing and mask utilization exhibit spatial variation across the region. Continuous community-based education using different modalities are necessary to increase the practice of hand hygiene, physical distancing and mask utilization. [<em>Ethiop. J. Health Dev. </em>2021; 35(3):165-176]</p> <p><strong>Keywords:</strong> Hand hygiene, physical distancing, mask utilization, CVOID-19, Amhara, Ethiopia</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222702 Knowledge, attitude, and practice of pain assessment and management in children among pediatric and pediatric surgical residents in Tikur Anbessa Specialized Hospital 2022-03-11T09:57:33+00:00 Degefu Dana namrooddege@gmail.com Muluwork Tefera muluworktef@yahoo.com <p>Abstract<br>Background: Pain is widely prevalent regardless settings and is thought to be one of the main reasons why patients seek medical care. Pain is considered as the “fifth vital sign” and there is a need for it to be assessed and recorded regularly, as with other vital signs. Barriers to appropriate pain management include health worker's insufficient knowledge on pain assessment tools and the general attitude towards patient's pain management.<br>Objective: To assess knowledge, attitude, and practice of childhood pain assessment and the management among pediatrics and pediatric surgical residents in Tikur Anbessa Specialized Hospital.<br>Methodology: A descriptive cross-sectional study was conducted to assess the knowledge, attitude, and practice of pediatric and pediatric surgical residents in TASH based on pediatric pain assessment and management. The data was collected by a standardized pretested questionnaire. Data were analyzed using SPSS computer software version 25.<br>Results: The mean total score of the residents was 14.56 (SD=3.16) from a total of 27 questions consisting of 15 T/F and 12 MCQ questions. The maximum and minimum scores were 25 and 7 respectively. Most of the study groups (86.2%) were not using pain assessment tools. Final-year residents had 5.5(95% CI=1.38-21.85) more than "average and above" scores than the other year residents.<br>Conclusion and recommendation: Knowledge deficit, poor attitude, and poor practice on pediatric pain assessment and management were discovered from this study. The findings of the present study emphasize the need to improve the Knowledge, attitude, and practices of residents on assessment and management of pain in children. [Ethiop. J. Health Dev. 2021; 35(3):177-182]<br>Keywords: Pain, knowledge, attitude, pediatrics</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222704 Cooking smoke (household air pollution) exposure status of households in Ethiopia: A further analysis based on 2016 DHS data. 2022-03-11T10:02:47+00:00 Desta Debalkie Atnafu destad2a@gmail.com Asmamaw Ketemaw asme1917@gmail.com Yonatan Menber editorejhd@yahoo.com Yosef Wassihun editorejhd@yahoo.com Habtamu Alganeh Guadie editorejhd@yahoo.com <p><strong>Abstract</strong></p> <p><strong>Background</strong>: Although currently adoption of modern life style has resulted in &nbsp;reduction of consumption of solid fuels, the dependable source of household energy in developing countries still remain unclean and its incomplete combustion continue to be the most common source of cooking smoke&nbsp; in Ethiopia. As a result, 50-90 % of households emitted cooking smoke which intern leads to various public health concerns. The objective of this study was to describe the household level cooking smoke exposure practices in Ethiopia.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted January 18 to June 27, 2016. From 16,650 households recorded in the 2016 Ethiopian demographic and health survey dataset, households (n=10,904 (weighted)) were included in the study. Proportions were computed and presented in tables and bar graph. Bi-variable analysis was performed using x<sup>2</sup> test to assess the existence of association and multivariable binary logistic regression also computed to identify the independent determinants of cooking smoke exposure status. A p-value of less than 0.05 was considered as a statistical significance cut off value.</p> <p><strong>Results:</strong> The study revealed that 6,695 (61.4%, 95% CI: 59.6-63.2) of households had cooking smoke exposure. The majority of cooking smoke exposure by households was attributable to the uneducated status of household head and rural residence (61.6% and 63.7% respectively). Sex (AOR =0.74, 95% CI: 0.64-0.85), age group of house hold head (AOR= 1.4, 95% CI: 1.49-1.81 and AOR= 1.39, 95% CI: 1.2, 1.63), residence (AOR= 0.55, 95% CI: 0.39-0.78), familiy size (AOR = 1.3, 95% CI: 1.16–1.53), poorest wealth index (AOR= 6.1, 95% CI: 4.5-8.2), and households with television (AOR= 4.9, 95% CI: 3.8-6.3) and electricity for source of room light (AOR=1.52; 95% CI:1.09-2.12) were independent determinants for cooking smoke exposure status.</p> <p><strong>Conclusion:</strong> Cooking smoke exposure in studied households in Ethiopia was a persistent problem. Socio-demographic and economic factors along with advancing of clean energy technologies and behavior intervention need to be implemented to address the problem of household air pollution. [<em>Ethiop. J. Health Dev. </em>2021; 35(3):183-193]</p> <p><strong>Key words: </strong>Cooking, Smoke, Exposure, Household, Ethiopia, EDHS</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222705 Nutritional status, dietary diversity, and food security of adolescent girls in rural Bangladesh 2022-03-11T10:12:31+00:00 Gopal Kumar Ghosh editorejhd@yahoo.com Md Nazrul Islam editorejhd@yahoo.com Khairun Nahar Juthi editorejhd@yahoo.com Afsana Yesmin editorejhd@yahoo.com Tamima Rahman editorejhd@yahoo.com Dr Rokshana Rabeya rokshana.rabeya@primeasia.edu.bd <p>Abstract<br>Background: Childhood malnutrition is widespread in South Asia like many other underdeveloped and developing countries and it continues throughout adolescent age. Poor nutrition of adolescents could lead to various complications later in life. Objective: The objectives of this study are to assess the nutritional status, dietary diversity, and food security of adolescent girls in rural Bangladesh, as well as to assess the factors that influence them.<br>Methods: A cross-sectional study among 422 participants was conducted in two selective areas in the Narayanganj district of Bangladesh. BMI (Body Mass Index)-for-age (z-score) and Height-for-age (z-score) were considered in evaluating the nutritional status of the study participants. Food and Agricultural Organization guidelines 2011 were used to calculate Individual Dietary Diversity Score. Food insecurity was assessed by using the Household Food Insecurity Access Scale version 3.<br>Results: The findings revealed that the prevalence of underweight and stunting were 9.5% and 12.1% respectively. In addition, 13.2% and 4.3% of the respondents were found to be overweight and obese. The height-for-age (z score) was associated with the age of adolescents (p=0.037). Mother’s (p=0.005) education were also correlated with their nutritional status. Outcomes of the Individual Dietary Diversity Score showed that 25.6%, 42.9%, and 31.5% of the adolescents had low, medium, and higher dietary diversity scores respectively, while 7.3% had different degrees of food insecurity.<br>Conclusion: Compared to underweight, overweight and obesity were shown to be more prevalent. However, a small percentage of the individuals reported various levels of food insecurity in this study. To attain an optimal level of nutrition, it is essential to ensure expanded food availability for the rural community. Proper nutrition education at primary and secondary education levels will enable teens to have diversified foods as well as assists in gaining healthy weight. [Ethiop. J. Health Dev. 2021; 35(3):194-199]<br>Keywords: Nutritional status, Dietary diversity, Food security, Adolescents, Rural Bangladesh</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222866 Impact of COVID-19 on Care Seeking Behavior of Patients at Tertiary Care Chronic Follow-up Clinics in Ethiopia: A Cross-Sectional Telephone Survey. 2022-03-16T08:23:22+00:00 Tamirat Moges mogest98@yahoo.com Workeabeba Abebe workeabebasol@gmail.com Alemayehu Worku Yalew alemayehuwy@yahoo.com Henok Tadele henny_2007@yahoo.com Tewodros Haile drtewodroshaile@gmail.com Damte Shimelis damte_shimelis@yahoo.com Desalew Mekonnen desalewm@yahoo.com Wondwosson Amogne wonamogne@yahoo.com Ayalew Moges ayalewmg@yahoo.com Abebe Habtamu Tamire tamireabebe05@gmail.com Rahel Argaw Kebede rahelarg@gmail.com Sewagegn Yeshiwas sewageghyeshiwas060@gmail.com Hyleyesus Adam editorejhd@yahoo.com Asrat Dimtse editorejhd@yahoo.com Wakgari Deressa deressaw@gmail.com <p>Abstract<br>Background: Health service delivery and the uptake of health services were greatly affected by COVID-19. The current study assessed the change in patients' care-seeking behavior after the first COVID-19 case was reported in Ethiopia.<br>Methods: A cross-sectional survey was conducted among patients who were appointed at Tikur Anbessa Specialized Hospital (TASH), between mid-March to mid-June 2020. Data was collected through telephone, using a pre-tested, structured questionnaire. Data were analyzed using SPSS software version 25. Descriptive statistics and binary logistic regression models were used to describe the data and assess factors associated with loss to follow-up (LTFU).<br>Results: Among 644 interviewed patients, 70% were lost to follow-up. Fear of COVID-19 infection (87.1%) and transportation problem due to lockdown (82.7%) were among the main reasons for loss to follow-up. Patients aged ≥60 years had highest odds of missing a follow-up in the multivariable logistic regression analysis. The odds of loss to follow up (LTFU) for the fear of COVID-19 was 13 times higher than among patients who did not have fear (AOR=13.39, 95% CI: 7.96-22.50). The odds of loss to follow up among patients who reported transportation problems were 3.6 times higher than among those who did not have transport problems (AOR=3.64, 95% CI: 1.93-6.88,). The odds of loss to follow up among patients with severe and very severe illness were about three times higher (AOR=2.7, 95% CI: 1.48-5.01).<br>Conclusion: Patient’s care-seeking behavior with chronic medical conditions at the chronic care clinics of TASH were seriously compromised during COVID-19. Patient’s age (&gt;60 years), chronic disease severity, fear of COVID 19 and transportation problems significantly predicted LTFU. Strategies such as task shifting and establishment of telemedicine services should be explored to meet the ongoing health needs of chronically ill patients on established follow up care. [Ethiop. J. Health Dev. 2021; 35(3):200-207]<br>Keywords: Care-seeking behavior, chronic disease, COVID-19, Ethiopia, Loss to follow up</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222878 Bakuchiol protects against adverse cardiac remodeling after myocardial infarction 2022-03-16T08:30:56+00:00 Yun-Jiao Duan editorejhd@yahoo.com Zhu-Xia Shen editorejhd@yahoo.com Ting Huang editorejhd@yahoo.com Hui-Hui Gu editorejhd@yahoo.com Yu-Tian Wu editorejhd@yahoo.com Yu-Min Sun editorejhd@yahoo.com Jun Wang wangjun_@fudan.edu.cn <h2>Abstract</h2> <p><strong>Background: </strong>Myocardial infarction (MI) is closely related to heart failure and death. Cardiac fibrosis after MI is related to profound changes in cardiac structure and geometry, leading to decreased cardiac function. Unfortunately, effective therapies to prevent excessive cardiac fibrosis and improve cardiac function are limited. Consequently, new therapeutic strategies are urgently required to protect cardiac function after MI. Bakuchiol (BAK), extracted from the plant seeds of <em>Psoralea corylifolia</em>, has shown protective effects against pathological cardiac hypertrophy. However, it is unclear whether BAK could improve cardiac function and reduce cardiac fibrosis.</p> <p><strong>Objective:</strong> To assess the reportability of bakuchiol as an alternative treatment against adverse cardiac remodeling after myocardial infarction.</p> <p><strong>Methods: </strong>To address this question, a MI model was built on adult wild-type C57/BL 6N mice (male, 6–8 weeks, Zhejiang Vital River Laboratory Animal Technology Co., Ltd) by left coronary artery ligation and gavage with BAK (60 mg/kg/day) for 28 consecutive days. Chest cardiac ultrasonography was performed 7 and 28 days after MI using the Vevo 2100 system to assess ventricular shape and function in model mice. The effects of BAK on cardiac remodeling and function were assessed after MI. Effects of BAK on isoprenaline-induced cardiac fibroblast proliferation and migration were also studied.</p> <p><strong>Results: </strong>ABAK can attenuate adverse cardiac remodeling and maintain left ventricular ejection fraction and fraction shortening. Furthermore, mice treated with BAK a showed lower fibrosis and wider left ventricular thickness than those without BAK. In addition, BAK can inhibit cardiac myofibroblast differentiation after MI. After stimulation with isoprenaline, BAK inhibited cardiac fibroblast proliferation and migration. At the molecular level, extracellular signal-regulated kinase 2 (ERK2) and transforming growth factor (TGF)-β1 were inhibited in both MI mice and isoprenaline-stimulated cardiac fibroblasts after BAK treatment.</p> <p><strong>Conclusions: </strong>Our data suggest that BAK treatment, as a novel therapeutic strategy, protects against adverse cardiac remodeling and maintains cardiac function after MI, likely via the ERK2 and TGF-β1 signaling pathways. [<em>Ethiop. J. Health Dev. </em>2021; 35(3):208-219]</p> <p><strong>Key Words</strong>:Bakuchiol, myocardial infarction, cardiac fibrosis, cardiac fibroblast, ERK2, TGF-β1</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222883 The effect of multidrug-resistant infections in cancer hospital intensive care unit 2022-03-16T08:40:51+00:00 Cui Qiulian cuiqiulian469@163.com Zhang Zhijun zhangzhijun5454@163.com Guan Yanliang guanyanliang345@163.com <p>Abstract<br>Background: For millennia, health-care-associated infections (HAI) have had a negative impact on healthcare systems. Multidrug-resistant Infections (MDRI) have exacerbated the issue in recent years, owing to the abuse of standard antibiotics in dealing with bacterial infection concerns. The bacteria show adaptability in hostile living conditions by resisting most known antibiotics and their combinations. This imposes a new burden on the hospital's health care, especially for patients in the ICU. This risk is amplified when considering, cancer patients who are at greater risk of serious sepsis, Hospital acquired infection (HAI), and with a multi-drug resistant bacterium (MDRB). This is a global issue which needs to be addressed and should have a clear health policy to tackle this problem.<br>Objective: The goal of this study was to identify the infectious diseases', microbial and antibiotic resistance profiles, and their impact on the mortality of multi-drug resistant (MDR) infections in a range of distinct locales throughout the world.<br>Materials and Methods: A 5-year retrospective descripted HAI study on patients at the Mexican Oncology Center Intensive Care Unit was carried out from January 2007 until December 2011. Patient features and co-morbidities, the tumor and treatment data, microbiology, and patterns of pharmaceutical resistance of all isolates have been collected.<br>Results and Discussions: 1418 patients were treated by the intensive care unit during the study period, with 159 of them occurring every 3000 23.2 days in 134 infections with a frequency of 11.2 % of workers. There were 266 types of microorganisms. MDR-HAI 's gross incidence was 39.5%. The most common microorganisms are: 54 (20%) Escherichia Coli (94%); 32 (12%) Staphylococcus aureus (90% are methicillin-resistant); 32 (12%) Enterococcus faecal (18.7% are vancomycin-resistant); and 20 (6%) Acinetobacter baumanni (both MDR). Microorganisms among the most popular are 252 (17.8 percent) of patients who were treated in intensive care died. Of the 58 (23%) HAI patients died and 51 (88%) were MDR isolated (p = 0.05) patients.<br>Conclusion: The production of MDR bacteria is a daunting challenge for clinicians with inadequate treatment possibilities. The risk of developing bacterium MDR-HAI, which has a negative effect on survival, is high for serious cancer patients in intensive care. [Ethiop. J. Health Dev. 2021; 35(3): 220-226]<br>Keywords: Health Care-associated Infections (HAI), ICU, oncology, multi-drug resistant bacteria (MDRB), Antibiotics</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222887 Pediatric gynecology: ovarian teratomas in children 2022-03-16T08:45:09+00:00 Pang Xinqin editorejhd@yahoo.com Qiu Zihong editorejhd@yahoo.com Xu Shucui xushucui224@163.com <p>Abstract<br>Background: Despite teratoma being a usual histological type of embryonic ovarian tumor among juveniles, for this age group, the proper treatment is still unclear. Ovarian teratoma may have a genetic background. The maturity and immaturity of the ovarian teratoma can also be challenging for decision-making in terms of the treatment strategy. Globally the Epidemiological rate of the sacrococcygeal teratoma is about 0.0014 to 0.0033 % among the newborn. Ovarian teratoma is the most common disease. While the malignancy in the germ cell is about 3 among the other cancers, the reported cases about 0.0003, which is gradually increasing daily.<br>Objective: Ovarian teratoma is still a mystery to the doctors, and the clinician due to lack of information regarding its cause, its proper treatment policy, and lack of family awareness. In this paper we discuss the causative agent, symptoms. treatment and effect of the ovarian teratoma, which will help in future therapy and research to find a possible cure or treatment option?<br>Material and Methods: The study complies with Arksey and O'Malley's methodological structure. This research utilized the EQUATOR elements and conducted a meta-analysis (PRISMA-ScR). This research utilized reliable scientific methodical data that was available. The data analysis was conducted on the authentic and verified available resources. The following information was gathered from the reviewed articles for this study: What is the focus of the study? What's the topic? Will an ovarian teratoma in children have a special zone? Who is better qualified to test for terratomas? Are the gaps in the research? What fields require more research? Are their explanations in some areas for inadequate research?<br>Results and Discussions: In 11 regions, we found 23 studies. 18 history, 3 forward-looking studies and 3 experimental studies. There are 6 trials of two groups of tumors, namely mature, 5 immature and 13 trials. More than 50 patients participated in a total of 9 trials. the name of the journal, main author, the place of origin, year of publication, cover, the form of study, population, age group, Research group, objectives, general method overview, most relevant measurement findings and individual research findings was studied.<br>Conclusion: This research found several information deficits in the database of pediatric ovarian teratoma. This subject, overall, has not been fully researched especially with regards to, this cancer and patient population, which require further research. [Ethiop. J. Health Dev. 2021; 35(3):227-233]<br>Keywords: Ovarian teratoma, Ovarian neoplasm, Gynecology, Pediatrics</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222889 Nursing resources and major respiratory assessment and immobility complications among bedridden patients 2022-03-16T08:51:49+00:00 Yuanyuan Li liyuanyuan0943@gmail.com Yan Jiang jiangyan0746@gmail.com Pingping Qu qupingping4521@outlook.com Yu Tang tangyu0694@aol.com Ying Liu liuying0635@gmail.com <p>Abstract<br>Background: Being bedridden is the most common clinical manifestation in people, which results in physiological problems in the body such as, urinary tract infection, deep vein thrombosis, pneumonia, etc. Being bedridden requires regular nursing intervention.<br>Objectives: There is a deficiency in the unit level information about nursing resource information and immobility problems. To explore China's nursing resources and study the relationship between significant immobility problems and nursing resources, a nationwide, cross-sectional study was designed. A total of 19,531 patients participated in this study.<br>Materials and Methods: Data was collected through the question-answer method from the nursing professionals and patients. The trained researchers measured the bedridden incidents. Patient characteristics data have been collected from the hospital record book. A multi-regression analysis was conducted to determine the relationship between the nursing resources and the patient's complication.<br>Results: This study consisted of 19,530 patients. There were 70.88% wards present in the tertiary hospital, of which, 81.7% were critical wards and 88.2% were non-critical wards. 60.9% hospitals have the bed to nurse ratio is 1:0.4. The 51.28% critical ward achieved an average bed to nurse ratio of 1:2.05. Of the total sample, 68.75% are nurses with a BSc or higher qualification (P75: 84.21%, P25: 41.67%). About 25% of nurses have ≤3 years’ experience (P75: 38.5%, P25: 16.7%). While 16.7% of nurses were senior or intermediate (P75: 25%, P25: 10.62%). The average age of the patients was 56.4. While a total of 56% of the patients were female patients. 35.9% of patients were bedridden for ≤three days. 4-7 days bed-ridden patients made up 30.92% of the total, and &gt; 8-day bed-ridden patients made up 33.2% of the total. Multivariate analysis proved that wards meeting the bed-to-nurse criteria, had lower immobility complications than the wards not meeting the criteria. (B=0.43, 95% confidence interval =0.01-0.86, Odd ratio= 1.55, 95% confidence interval =1.001-2.39).<br>Conclusions: A higher number of nursing staff and the senior and intermediate nursing staff chiefly contribute to reducing the significant immobility problems. Nursing experience is significantly related to immobility complications. However, the relationship between nursing education level and major immobility complications requires further research. [Ethiop. J. Health Dev. 2021; 35(3): 234-238]<br>Keywords: Nursing resources; Aging; bedridden patients; pneumonia.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222801 Critical care of the burn patient: the first 48 hours 2022-03-15T04:14:32+00:00 Dandan Zhao zhaodandanii@163.com Xiaohong Huang huangxiaohongii@163.com <p><strong>Abstract</strong></p> <p><strong>Background: </strong>The management of patients who have suffered burns is crucial in the clinical field. They have multiple complications which require treatment and have a high risk of mortality. Patients may survive, but they will need to live with the scars or deformities for a lifetime. Complications include edema, increased cardiac output, severe pain, and organ deformities. So, they require more comparative care than other medical complications. Treatment and nursing of burn patients is still a very challenging task for the health personnel.</p> <p><strong>Objective: </strong>This work aims to highlight the nursing methods used on burn patients and to identify the relationship between mortality and the physiological and other conditions of the patients.</p> <p><strong>Material and method: </strong>Different published data was collected and summarized, and the required data was extracted for further analysis using the statistical software.</p> <p><strong>Result:</strong> This study observed that patient mortality has different factors like total body surface, age group, burning area percentage, and hospital treatment duration which is the marking factor in the patient mortality. This study also found that there are no gender biases for the different age groups. No one factor is responsible for the patient's death.</p> <p><strong>Discussion: </strong>There are needs for prolonged and delicate treatment methods for the burn patients. As several complications arise, it is challenging for the nurses and health care personnel to keep tracking the patient's condition and giving the proper treatment. Despite the difficulties, the attentive nursing was desperately needed to properly treat burn victims.</p> <p><strong>Conclusion: </strong>Though the survival rate is very high immediate treatment is necessary for burn patients. It is crucial to give the initial therapy for burn patients due to other physical complications. Depending on the patient's condition, the mortality rate also varies. Despite all difficulties, good nursing and medication can completely cure burn injuries. [<em>Ethiop. J. Health Dev.</em> 2021; 35(3): 239-243]</p> <p><strong>Keywords:&nbsp; </strong>Shock<strong>, </strong>inhalation injury, interquartile range, total body surface area.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222802 Early clinical effects of percutaneous endoscopic focal cleaning and drainage in the treatment of single level suppurative spondylitis 2022-03-15T04:19:09+00:00 Qinghua Guan guanqinghuaaaa@163.com Rongrong Huang editorejhd@yahoo.com Jingqi Han editorejhd@yahoo.com Peng Zheng zhengpengkkk@163.com <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Suppurative spondylitis is 4% of all osteomyelitis, including discitis, epidural abscess, and vertebral osteomyelitis. It is generally seen in young adults and elderly persons and specifically persons with weak immune systems. Suppurative Spondylitis patients, after experiencing a failure in the medicinal therapy, choose to undergo surgery. Few patients have deplorable conditions for surgery.</p> <p><strong>Objective:</strong> The objective of this study is to find out the effectiveness of the surgery procedure in the patient’s body.</p> <p><strong>Methods:</strong> &nbsp;The most recently published research was collected, and the surgery information and their aftermaths of Percutaneous Endoscopic Discectomy (PED) was summarized. Data was taken from the previously published journal and analyzed and plotted using Excel software.</p> <p><strong>Results and Discussions:</strong> Recently, several studies have reported the positive outcomes of endoscopy treatments in the suppurative spondylitis, which allows for the drainage of the epidural abscess without opening the infected area, and this is applicable irrespective of the patient's condition. In article, the findings, and the different kinds of suppurative spondylitis were reviewed using the previously published data and the applicability of the percutaneous spondylitis in the patient’s body and their side effects were examined (paralysis, weakness and epidural abscess formation).</p> <p><strong>Conclusion:</strong> After summarising all the effects, we can conclude that endoscopy must be an alternative to surgery for suppurative spondylitis. [<em>Ethiop. J. Health Dev.</em> 2021; 35(3): 244-248]</p> <p><strong>Keywords:</strong> Suppurative spondylitis, percutaneous endoscopy, osteomyelitis, conservative treatment.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222803 PPAR agonists for the treatment of cardiovascular disease in patients with Diabetes 2022-03-15T04:21:44+00:00 Zheng Xia zhengxiaxsx@163.com Guo Lixia guolixiasd@163.com Zhang Zhijun zhangzhijunxc@163.com <p>Abstract<br>Background: PPAR agonists are drugs that act upon peroxisome proliferator-activated receptors. They are used for treating symptoms like metabolic syndrome, especially for lowering triglycerides and blood sugar.<br>Objective: PPAR mediated treatment in type 2 diabetes patients and has certain cardiovascular benefits at the post-ischemic stroke. In the Asian diabetic and Hypertension case, patients have additional help from the PPAR therapy for an unknown reason. The objective of this study is to find out the Pioglitazone treatment effectiveness in the patient’s body.<br>Methods: Between 2008 and 2020, admitted patients for ischemic stroke from Taiwan's National health insurance research database were studied. Type II Diabetes mellitus and hypertension patients were also included. Patients were grouped into Pioglitazone and Non-Pioglitazone based on treatment. A propensity score for balancing the baseline characteristics, medication and severe stroke was used. The significant result was achieved for the recurrent ischemic stroke. Subgroup analysis is done in the recurrent ischemic stroke in Pioglitazone and Telmisartan treated patients. Further trend analysis was done for the ischemic stroke risk patients, and a dose-dependent result for the different pioglitazone possession ratio was done under significance level &lt;0.1 and &lt;0.05, respectively.<br>Results: In the Pioglitazone group, there were 3190 patients, and in the non-Pioglitazone group, there were 32645 patients. Pioglitazone treated patients have a low risk for the Ischemic stroke, as compared to the recurrent and non-Pioglitazone treated group (0.91 sub-distribution hazard ratio; and Confidence interval level is 0.84 to 0.99). Pioglitazone related to the reduced ischemic stroke (p-value for interaction is 0.071). A correlation was found between the PPAR- gamma treatment and ischemic stroke (p-value is 0.076). The dose-specific result also proved that a significant relationship of Pioglitazone in increasing dose causes less recurrent Ischemic stroke (p value=0.068)<br>Conclusions: According to this study, Pioglitazone treatment in type 2 diabetes patients and hypersensitive Ischemic stroke patients is linked to minor ischemic stroke which is recurrent in Asian people. Pioglitazone and the telmisartan treatment have an increasing pleiotropic effect related to the higher PPAR- gamma effects. Further research needs to be conducted with the PPAR mechanism's details to confirm the PPAR effect on Ischemic stroke treatment. [Ethiop. J. Health Dev. 2021; 35(3): 249-257]<br>Keywords: PPAR agonist, Dyslipidaemia, Thiazolidinediones, Type 2 diabetes, Pioglitazone, PPAR-alpha, PPAR-gamma, Insulin resistance, Alecardio.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222804 Clinical value of Chinese and western medicine for the treatment of early-stage avascular necrosis of the femoral head 2022-03-15T04:25:13+00:00 Xiaomei Wang xiaomeiwang1@163.com Lili Xu lilixu987@163.com Jingqi Han jingqihan9@163.com Peng Zheng pengzheng96@163.com <p><strong>Abstract</strong></p> <p><strong>Background: </strong>Informally known as femoral or pelvic head necrosis, avascular necrosis is a disease in which the bone disintegrates&nbsp; due to a disruption in blood supply to the head of the femur bone. It results in the loss of strength and hardness of the bone, which cannot maintain&nbsp; the bodyweight&nbsp; and eventually becomes deformed.</p> <p><strong>Objective:&nbsp;</strong>This study aims to identify Traditional Chinese Medicine's (TCM) therapeutic effect and its interventional therapy for the early-stage treatment of avascular necrosis of the femoral head.</p> <p><strong>Methods: </strong>According to the Fiat system, 19 hips in 97 cases. There is 0 hip at stage 0;8 at phase I; 11 at stage II, which were divided into three groups randomly, namely Group A, B and C. Group A was treated by Chinese medicine; group B was treated by interventional therapy while group C interventional therapy is followed by Chinese medicine. CT and Angiography were done before and after treatment.&nbsp;</p> <p><strong>Results: </strong>&nbsp;patients were researched within 1 to 3 years of follow-up after treatment. In group C, Angiography and clinical rate shows an increase in vessel count, which is higher than in group A&nbsp; and group B (P&nbsp; &lt;0.01).&nbsp;</p> <p><strong>Conclusions:</strong> Interventional therapy followed by Chinese medicine is the preferred choice to treat early-stage avascular necrosis of the femoral head. [<em>Ethiop. J. Health Dev. </em>2021; 35(3): 258-263]</p> <p><strong>Keywords: </strong>femoral head necrosis; a combination of TCM and western medicine; interventional radiology.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222805 Psychiatric Morbidity in Patients with Psoriasis, Acne, Vitiligo and Other Dermatological Disorders 2022-03-15T04:27:10+00:00 Jing Jai missjiaj@163.com <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Mental co-morbidity is the presence of more than one problem in a person. Mental co-morbidity is widely pervasive in dermatological patients. In the instance&nbsp;&nbsp; that an individual is determined to have both social nervousness problem and significant burdensome requests, they are said to have comorbid uneasiness, a demanding issue that may be a consequence of various kinds of infections, including skin issues (skin inflammation, psoriasis, dermatitis, vitiligo, and other dermatological problems) which provide further complications.</p> <p><strong>Objective:</strong> This research aims to discover the commonness of mental issues in dermatology outpatients and to examine the variables that influence the mental manifestations.</p> <p><strong>Materials and Methods:</strong> In a dermatology outpatient center, 90 patients were chosen and given an Overall Wellbeing Poll (GHQ) following their dermatologic assessment. The normalized individual meeting was directed by confiding in people to build up a mental finding in patients. The outcomes were tested by utilizing a defined irregular inspecting technique. Mental co-morbidity was assessed using a small scale (Smaller than expected Global Neuropsychiatric Interview) and General Wellbeing Poll. The dermatologists followed the region of the sores and supplied an essence of the determination, and as a result they evaluated the risk factors.</p> <p><strong>Results</strong><strong>:</strong> In a record, 512 inquiries were given to the members, of which 123 were returned. The inescapability of mental sickness was 52% in the investigation gathering, and these gatherings were similar on the socio-segment boundaries. From the outcomes, higher chances of mental problems in men as opposed to ladies was observed. Additionally, the ladies with sores in the skin or facial part shifted more towards simultaneous maniacal issues.</p> <p><strong>Conclusion:</strong> This study included hospital officials and personal dermatologists. It gave a detailed view of the disease and its relation to morbidity, which helps them counter-treat the patients based on their severity level. It’s an easy tool to compile the details of the patients, which in turn helps to differentiate patients according to the level of their psychiatric disturbances and psychological hazards. [<em>Ethiop. J. Health Dev.</em> 2021; 35(3): 264-269]</p> <p><strong>Keywords:</strong> American Psychological Association, Psychiatric co-morbidity, General Health Questionnaire (GHQ), MINI (Mini International Neuropsychiatric Interview), dermatological disorders.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222806 Obesity, Endogenous Hormones, and Endometrial Cancer Risk 2022-03-15T04:31:48+00:00 Gong Cuilan gongcuilannnny@163.com Yang Xiaomei yangxiaomeiiii@163.com Xue Shuang xueshuangggg@163.com Yin XiLing yinxilingggg@163.com Zhang Yan zhangyannnny@163.com <p>Abstract<br>Background: Endometrial disease is one of the most serious problems in the modern era. The absence of actual work, excessive body weight, and terrible food propensities are reasons behind the shifts of endogenous chemicals, leading to the danger of developing the endometrial disease. Additionally, because of epidemiological examinations, ≥40% of this occurrence has stoutness as a significant danger factor for premenopausal just as postmenopausal ladies, making this investigation more pertinent.<br>Objective: This research aims to study and understand the link between endometrial cancer and obesity and its impact on the public health domain.<br>Materials and Methods: The survey was conducted utilizing PubMed and Google Scholar Search Engines. Poll information was gathered and anthropometric estimation digests from MEDLINE and EMBASE were evaluated. Additionally, data from a particular area based on dietary components and their impact on endometrial malignancy was collected.<br>Results: From the restrictive relapse examination, it has been found that expanding levels of free testosterone, estrone, total testosterone, all-out estradiol, and free estradiol are undoubtedly connected with the endometrial disease hazard among postmenopausal ladies. Androstenedione, sex chemical restricting globulin, and dehydroepiandrosterone sulfate isn't the danger factor. There were no links between serum sex chemical focuses with endometrial malignancy hazard for premenopausal ladies. However, the sample was too small to draw significant conclusions with this regard.<br>Discussion: Given the strong relationship between heaviness and extended endometrial threatening development risk and mortality, explaining the instruments whereby this connection happens may enrich our perception of this infection's aetiology and help make other efficient frameworks for harm expectation. There are a couple of proposed instruments whereby heaviness can incite endometrial carcinogenesis. These consolidate pathways, including endogenous sex steroid synthetics, insulin resistance, and inflammation.<br>Conclusion: In postmenopausal ladies, high blood centralizations of estrogens and free testosterone are related to the endometrial malignant growth hazard. Free testosterone and increased blood concentration of estrogen enhance the risk of endometrial cancer in postmenopausal women. [Ethiop. J. Health Dev. 2021; 35(3): 270-275]<br>Keywords: Obesity, Endometrial cancer, Endogenous hormone, Premenopausal, Postmenopausal, Estrogens, Testosterone, Progesterone.</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222807 Impact of Telemedicine System Automatic Reminder on Outcomes in Women with Gestational Glycosuria 2022-03-15T04:35:10+00:00 Ying Sun editorejhd@yahoo.com Ouyang Lingying ouyanglingyingi@163.com <p><strong>Abstract</strong></p> <p><strong>Background:</strong> Telemedicine is part of the health care information system that helps collect and share data efficiently. Healthcare information processing includes data storage, analysis, retrieval, data sharing for knowledge and communication purposes, and decision-making through the obtained data. Health information technology characterizes computer and communication features that can be webbed to build a system for dynamic health data. In this study, we are trying to determine the effect of the telemedicine system on gestational diabetic patients.</p> <p><strong>Objective:</strong> The objective of this research is to identify the telemedicine system effect on gestational diabetic patients.</p> <p><strong>Method:</strong> An internet-based telemedicine and interactive voice response telephone-communication system was used to contact patients and doctors. At the same time, a total of eighty patients with gestational diabetes mellitus were randomly divided among the two groups, which amounted to forty patients each. One group was given a telemedicine system while another group was treated with the general medical treatment (control group) and requested to monitor their blood glucose level four times per day. Women in the telemedicine group have transited the information with the help of the internet while the other group submitted their report manually using the paper logbook entry method. Data collection includes maternal glucose control, new-born birth weight, and the data transmission of the intervention group.</p> <p><strong>Result:</strong> There was no substantial variation between the telemedicine and control group patients regarding the maternal blood glucose value and the new-born birth weight. Telephone access and the reminder system enhance the transmission rate in the telemedicine group than the control group (p&lt;0.001).</p> <p><strong>Discussion:</strong> Though the telemedicine group had no significant impact on the gestational patients' blood glucose levels, telemedicine has been shown to improve healthcare efficiency. For example, by controlling the site, insurance, pre-pregnancy BMI, and group assignments, the site difference effects are reduced, allowing patients to receive better care.</p> <p><strong>Conclusion:</strong> Newly developed telemedicine is a breakthrough for the medical field. It helps doctors keep updated by efficiently collecting data and allows patients to perform routine self-management for their data submission, which also helps them get better treatment. [<em>Ethiop. J. Health Dev.</em> 2021; 35(3): 276-280]</p> <p><strong>Keywords:</strong> Telemedicine; Gestational Diabetes mellitus; Diabetes; IVR; Computer; Glycosuria</p> 2021-11-25T00:00:00+00:00 Copyright (c) https://www.ajol.info/index.php/ejhd/article/view/222893 <Brief Communication/Case Study> Pattern of Ear, Nose and Throat Diseases in Addis Ababa 2022-03-16T08:55:36+00:00 Tolcha Kebebew tolchakebebew@gmail.com Assefa Tesfaye editorejhd@yahoo.com <p>Abstract<br>Background: Estimate of Ear, Nose and Throat (ENT) diseases is not well documented in Ethiopia. This paper describes the pattern of ear, nose, and throat diseases among patients who attended the ENT unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The purpose of this research was to provide policymakers and health planners with a description of the pattern of ENT diseases in Addis Ababa.<br>Methodology: Analysis of medical records of patients who visited the Outpatient Department (OPD) of the ENT Unit of Tikur Anbessa Specialized Hospital from September 2014 to July 2016 was conducted. Socio-demographic and disease information including age, gender, region of residence, type of visit, diagnosis, and the number of visits were retrieved from OPD records. Descriptive analysis of the pattern of ENT diseases was conducted. The pattern was also disaggregated and presented by gender, age, and type of visit (new/repeat).<br>Result: A total of 12,268 OPD records were included in the analysis. About half of patients attending the unit were children under 18 years of age while 54% of them were male. On average, each patient visited the unit 2.2 times in about two years period. The most common diagnoses were adenotonsillar hypertrophy (ATH), (32.8%) and otitis media (24.9%).<br>Conclusion: In this study, it is found that adenotonsillar hypertrophy (ATH) and otitis media are the most common ENT diseases among children under the age of 18 years. We recommend consideration of ATH and otitis media as a priority public health problem among children. We also recommend a community-level prevalence study for designing interventions targeting these priority ENT diseases.<br>[Ethiop. J. Health Dev. 2021; 35(3): 281-286]<br>Key Words: Ear, nose and throat; ENT; Tikur Anbessa Specialized Hospital; Ethiopia</p> 2021-11-25T00:00:00+00:00 Copyright (c)