Ethiopian Journal of Health Sciences

Table of content

2024-07-14T18:29:29+00:00

Table of content

Breaking the barriers for conducting clinical trials in Africa: A need for higher commitment and collaborations

2024-07-13T18:38:49+00:00

Editorial message

Household Air Pollution Related to Housing Characteristics and Cooking Conditions in Jimma Town, Ethiopia

2024-07-13T18:49:31+00:00

BACKGROUND: Globally, a substantial burden of disease is attributable to environmental risk factors including indoor air pollution. Nearly half of the world's population relies on solid fuel. Almost all (98.8%) residents in Ethiopia are dependent on biomass fuel as their basic source of energy for cooking. Thus, we set out to quantify the concentration of indoor air pollutants and household exposures in different housing characteristics and cooking conditions

METHODS: A survey was conducted in 280 randomly selected households in Jimma town, Ethiopia. A real-time concentration of fine particulate matters (PM_2.5, PM₁₀) and pollutants including carbon monoxide (CO), carbon dioxide (CO₂), and volatile organic compounds (VOC) were measured using Laser PM_2.5Meter-5800D/5800E and Aeroqual's TM series 500 portable air quality monitors. Data on housing characteristics, kitchen configuration, and ventilation status were collected using observation checklist.

RESULTS: The median concentrations of pollutants in all measured households were PM_2.5; 294 µg/m3, PM₁₀; 270 µg/m3, CO₂; 577 mg/m3, CO; 7.9 mg/m3, and VOC; 1077 mg/m3. Households that used solid fuels had significantly higher concentration of PM2.5 (U = 53.0, p < 0.001), PM₁₀ (U =63.0, p < 0.001),CO₂ (U = 3519.50, p < 0.001), and CO (U = 3246.0, p < 0.001) than households that used clean fuel.

CONCLUSIONS: All households in this study were exposed to high concentration of indoor air pollutants that exceeded WHO’s air quality standard. Effective strategy should be put in place to reduce the emission of air pollutants and to set air quality management and improvements policy

The Relationship between Weight Bias Internalization and Quality of Life among Overweight and Obese Youths in Thailand

2024-07-13T18:54:43+00:00

BACKGROUND: Youth with overweight and obesity are susceptible to weight bias internalization (WBI) and tend to experience impaired quality of life (QOL). However, the evidence regarding the relationship between WBI and QOL remains scarce among Thai youth. Thus, this study aimed to assess the association between WBI and QOL among Thai youth with overweight and obesity.

METHODS: A cross-sectional design was conducted with 667 university youths with overweight and obesity from northeastern Thailand selected by a multistage sampling method. A self-reported questionnaire was used for data collection. Multivariable logistic regression was applied to examine the association between WBI and QOL.

RESULTS: More than half of the youths (51.4%) were females with a mean body mass index (BMI) of 26.5 kg/m² (SD = 2.5). More than one third (37.8%) of the participants had a high level of WBI, and 48.9% reported being dissatisfied with their body image. Our results indicate higher BMI and greater WBI, and body image dissatisfactions were strongly associated with worse QOL overall and across all domains (physical health, psychological health, social relationships, and environment) after adjusting for all covariates.

CONCLUSIONS: WBI, BMI, and body dissatisfaction play an important role in impaired QOL. Thus, the development of intervention strategies or programs should consider the reduction of these factors as a key component of care or treatment for youth with overweight and obesity to improve QOL.

Prevalence and Associated Factors of Unplanned Re-Laparatomy after Non-Trauma Emergency Laparatomy in Resource-Limited Settings, 2023: A Retrospective Chart Review

2024-07-13T19:01:02+00:00

BACKGROUND:Emergency laparatomy may need subsequent re-laparatomy which has high rate of mortality. However, reports on rates and associated factors of un-planned re-laparatomy are few. This study aimed to determine the prevalence and associated factors of re-laparotomy after non-trauma emergency laparatomy at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia, 2023.

METHODS: This was a retrospective chart review conducted at Debre Markos Comprehensive Specialized Hospital in Ethiopia among patients who had undergone emergency laparatomy between January 1, 2019 and December 31, 2022. A sample of 384 individuals were selected using simple random sampling technique. Data were extracted from March 01, 2023, to May 1, 2023, cleaned, entered into Epi-Data version 3.1, and analyzed with STATA version 14.1. Predictor variables with P value < 0.05 in multivariable logistic regression were reported.

RESULTS: From 384 patients who had emergency laparatomy, 33(8.6%) needed re-laparatomy in the early post-operative period. All re-laparotomies were unplanned and done during the primary Hospital admission period. Patients who were hypotensive preoperatively[AOR: 3.3 (95% CI: (1.88, 9.40))] and with longer operation time (greater than 1 hour) [AOR: 4.5 (95% CI: (1.88, 10.64)] had increased risk for unplanned re-laparatomy.

CONCLUSION: The re-laparatomy rate in this study was high with higher risk among patients with preoperative hypotension and longer procedure time. The findings emphasize a need for advocacy on preoperative patient resuscitation and monitoring.

Geo-Mapping of Intestinal Parasitic Infection in a Southern Community in Nigeria

2024-07-14T18:58:07+00:00

BACKGROUND: Intestinal parasitic infection constitutes a global health burden; it has a high prevalence among children in Nigeria. The quest for control is still ongoing. Geographical Information Systems have contributed significantly to solving sundry real-world tasks, from agriculture to emergency planning and control. Therefore, this study was aimed at geo-mapping of intestinal parasites in a Southern community in Nigeria to identify the infection risk areas.

METHODS: A cross-sectional survey and clustered random sampling method were used. Samples were analyzed by direct wet mount and formal ether concentration methods. Geostatistical analyses were done to determine the spatial distribution of these parasites.

RESULTS: The overall prevalence of intestinal parasite in the community was 23.95% and parasites identified were: Ascaris lumbricoides 45(7.23%), Entamoeba histolytica 31(4.98%), Strongyloides stercoralis 13(2.09%), Gardia lambla 12(1.93%), Hookworm 11(1.77%), Trichuris trichiura 10(1.61%), Schistosoma mansoni 9(1.45%) and Diphyllobothrium latum 4(0.64%). The distribution and intensity of the parasites showed that Bolu-Orua, Tungbo, and Ogalawa communities had higher intestinal parasitic infection rates and needs urgent interventions. Part of Sagbama, Aguru, Toru-Orua to Toru-Eden had a moderate intestinal parasitic infection.

CONCLUSION: An infection map was produced for each parasite, and visualizing the spatial distribution of intestinal parasites in these communities brings to bare health risk areas. It will help in the proper application of limited resources in the control and prevention of these parasites.

Prevalence and Associated Factors of Anal Incontinence at Six Weeks after Vaginal Delivery: A Cross-sectional Study at Three Teaching Hospitals in Addis Ababa, Ethiopia

2024-07-14T19:02:37+00:00

BACKGROUND: Anal incontinence is defined as the involuntary loss of fecal material or flatus. The reported prevalence at 6 weeks postpartum varies from 4% to 39%. It is associated with reduced quality of life, negative psychogenic effects and social stigma. This study was done to assess its prevalence at 6 weeks after vaginal delivery and identify the associated factors.

METHODS: This is a cross-sectional descriptive study. Data was collected using questionnaire adapted from International Consultation on Incontinence Questionnaire on Urinary Incontinence–Short Form. Data was analyzed using SPSS version 20.5.

RESULT: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. The majority of the cases, 28 (84.8%), had only flatus incontinence. Participants of age group 20-35 years had significantly lower odds of having anal incontinence compared to those above age 35 (P < 0.05). The odds of having incontinence compared to spontaneous vaginal delivery was about 5 times higher for forceps (AOR= 4.93 (95%CI:1.48, 16.44)) and vacuum (AOR= 5.53 (95%CI:1.18, 25.96)) deliveries. Second stage of labor duration of >120 minutes had more than 4 times odds of developing incontinence compared to duration of <30 minutes (AOR= 4.79 (95%CI:1.01, 22.82)). Second degree perineal tear was the most significantly associated variable compared to those without tear (AOR= 12.31 (95%CI:3.89, 39.00)).

CONCLUSION: The prevalence of anal incontinence at 6 weeks after vaginal delivery was 8.6%. Maternal age, mode of delivery, duration of second stage of labor and perineal tear were the significantly associated factors.

Factors Affecting Voluntary Breath-Holding Duration and Breaking Point in Young Adults

2024-07-15T08:25:27+00:00

BACKGROUND: Studies have reported that breath-holding duration (BHD) in humans varies and can be influenced by several factors. The breaking point is an involuntary respiratory act that overrides the urge to hold one's breath, preventing unconsciousness. This study investigated the effects of the isometric handgrip test, cold pressor test and mental arithmetic task on BHD and its breakpoint in young, healthy Saudi Arabian subjects.

METHODS: This interventional study, with a single-arm design, involved 78 young adults. Before conducting breath-holding duration (BHD) testing, their age, gender, height, weight, and systolic and diastolic blood pressure were recorded. BHD was assessed under various experimental conditions, such as rest, during an isometric handgrip test, a cold pressor test, and mental arithmetic tasks. Blood pressure (BP) and oxygen saturation (SpO2) levels were continuously monitored.

RESULTS: The study subjects had a mean age of 21.23 years, with 47 (60.3%) females and 31 (39.7%) males. The mean Body Mass Index was 24.14 kg/m2. During rest, the mean BHD value was 29.67 seconds, while it was 26.21 seconds during isometric handgrip. The cold pressor test recorded a mean value of 32.69 seconds, and the mental arithmetic test recorded a mean value of 33.08 seconds.

CONCLUSION: The findings of this study indicate a reduction in BHD during isometric handgrip and augmentation during the cold pressor and mental arithmetic tests.

Challenges of Hospital Payment Systems in Iran: Results from a Qualitative Study

2024-07-14T19:38:10+00:00

BACKGROUND: The reform of hospital payment systems is a top priority for policymakers in many countries, including Iran. As knowledge of the current situation and experience with previous reforms are gained, the next phase will focus on improvement. Therefore, this study aims to identify the challenges to hospital payments in the Iranian health system.

METHODS: This qualitative study used semi-structured interviews and focus group discussion meetings to collect data from 29 informants, including physicians, hospital administrators, faculty members, supervisors, and executive managers with expertise in hospital payment systems. Purposive sampling was used to recruit participants. Data were analyzed using content analysis.

RESULTS: The content analysis resulted in five themes and twenty-two sub-themes. Policy and regulation issues, payment methods, fair payment to providers, infrastructure and systems, and behavior of providers were cited as major challenges and drawbacks of Iran’s hospital payment systems.

CONCLUSIONS: Understanding the barriers to hospital payments is essential for reforming or alleviating the problem. This research has shed light on the current state of the hospital payment system in the Iranian health system. Knowledge of the issues with the current system and the needs of healthcare providers is essential for effective reform.

Patterns and Determinants of Family Support among Pregnant Women in Ile-Ife, Nigeria: A Quantitative Cross-Sectional Study

2024-07-15T08:31:04+00:00

BACKGROUND: Effective family support is essential for promoting the well-being of pregnant women and reducing the risk of adverse pregnancy outcomes. This study examined family support patterns and influencing factors among pregnant women attending antenatal clinics in Ile-Ife, Nigeria.

METHODS: This descriptive cross-sectional study involved 384 pregnant women in a Local Government Area in southwestern Nigeria. Three healthcare facilities with the highest antenatal attendance were selected through purposive sampling. Data were collected using a tested and structured questionnaire, which was developed following a review of similar studies. The results were analyzed using SPSS version 20.0, employing Pearson Chi-square tests with a significance level set at p < 0.05.

RESULTS: More than half of the respondents reported inadequate family support in various aspects including tangible/instrumental support (52.9%), emotional support (51.4%), and financial support (54.4%). However, the majority reported significant financial supports from their spouses (60.7%). Religion, educational qualification, and partner's occupation were found to significantly influence the likelihood of women receiving higher levels of social support.

CONCLUSION: Many respondents lacked adequate support from spouses and families. Encouraging family involvement in antenatal care can improve understanding and support, benefiting maternal and child health. Hence, healthcare professionals and policymakers should consider the factors influencing family support options when designing focused interventions to strengthen maternal support systems and address the varied needs of pregnant women.

Keratinizing Pleomorphic Adenoma of the Buccal Mucosa: A Comprehensive Clinical and Histopathological Analysis of a Rare Case

2024-07-15T08:39:38+00:00

Salivary gland tumors make up a relatively small proportion, ranging from 1% to 4%, of all neoplasms in the human body. Among these, pleomorphic adenoma stands out as a distinct benign tumor of the salivary glands, characterized by a combination of epithelial and mesenchymal elements.Only 0.3% to 1.5%, of biopsies in oral and Maxillofacial pathology laboratories are associated with tumors originating from minor salivary glands.Keratinizing pleomorphic adenoma, a rare variant accounting for 5-10% of all pleomorphic adenomas, differs from the typical form due to the presence of keratin within the tumor cells, serving as a distinguishing histological feature. The incidence of keratinizing pleomorphic adenoma is not well-established but is believed to be less than 1 case per 100,000 people per year. Here we present an atypical histopathological variation of pleomorphic adenoma, featuring extensive keratinization and manifesting in a less typical anatomical location in a 57-year-old male patient.

Ureterocoele Complicated By Cystolithiasis in a 23-Year-Old: A Case Report

2024-07-15T08:10:36+00:00

The cystic dilatation of the lower part of the ureter is known as ureterocoele which has been associated with other anomalies such as stenotic ureteric orifice, duplicated urinary system, and hydronephrosis along with or without other clinical sequelae. Notably, the accurate and prompt diagnosis is challenging due to non-specific symptoms that could mimic other urogenital systems diseases. Imaging evaluation is the gold standard of accurate diagnosis and comprehensive clinical examination.The possible complications associated with ureterocoele include urinary tract obstruction, reflux, continence, and renal function derangements. Thus, we present a 23-year-old male patient, who presented to the general outpatient clinic of the Federal Teaching Hospital, Abakaliki, in September 2018 with a complaint of right-sidedabdominal pain and hot sensation, intermittent haematuria, and pain during micturition of one-year duration. He was evaluated with ultrasonography that showed moderate right hydronephrosis with a large curvilinear calculus adjacent to the dilated ureteric end, and intravenous urography revealed a dilated right distal ureteric end with a peripheral halo, giving the cobra head the appearance of ureterocoele.The patient underwent open cystolithotomy with marsupialization of the distal end of the right ureter. He showed remarkable post-operative improvement and was discharged after two weeks. Two months of post-operative follow-up was uneventful.