Ethiopian Journal of Health Sciences

Table of content

Yibeltal Siraneh — 2024-08-10

Table of content for this issue.

Editorial message (Combating Antimicrobial Resistance in Africa: A Call for Multidimensional Strategies to a Growing Crisis)

Esayas Kebede Gudina — 2024-08-10

Editorial message

Prevalence and Phenotypic Characterization of Antibiotic-resistant Enterococcus Species Isolated from Chicken Faecal Samples in Accra, Ghana

Philip Asumang — 2024-08-10

BACKGROUND: Enterococci are bacteria found naturally in the gastrointestinal tract of both chickens and humans, serving as a commensal bacterium. These opportunistic pathogens are recognized for their involvement in human diseases like urinary tract infections (UTIs), endocarditis, and sepsis. Infection sources encompass food, hospital environments, and animals, particularly chickens. Their increasing resistance to multiple drugs poses a growing concern for public health

This study aimed to isolate the enterococcus species and to determine their antibiotic susceptibility profiles.

METHOD: Swab samples of gut content from poultry in specific slaughterhouses located within selected markets in Accra were collected, cultured on MacConkey agar No.2, and incubated overnight for growth. Colonies suspected to be Enterococcus species were subjected to biochemical testing, and confirmed colonies underwent antibiotic testing against commonly used medications for bacterial infections. The Kirby-Bauer disk diffusion method was used to assess the antibiotic susceptibility of the recovered isolates.

RESULTS: Among the 160 samples examined, 97 (61%) were found to be contaminated with Enterococcus species. Each of the isolates displayed resistance to a minimum of three antibiotic classes tested in the study. Notably, high levels of resistance were observed for specific antibiotics, including penicillin (91.75%), vancomycin (87.63%), and tetracycline (80.41).

CONCLUSION: The findings of this study revealed a high prevalence of multi-drug resistant Enterococcus species isolated from chicken rectal swab samples collected from three selected markets in Accra, Ghana. All the isolates exhibited resistance to at least three classes of antibiotics tested.

Hysterosalpingography and Endocervical Microbial Assessment of Infertile Women in Ogun State, Nigeria

Abiola O. Adekoya — 2024-08-10

BACKGROUND: Infertility is a global health issue with varying etiology. This study determined the prevalence and pattern of tubal and uterine pathologies with genital tract microbial infection among infertile women in Ogun State, Nigeria.

METHODS: A cross-sectional study was conducted in a year among 230 infertile women aged 20 years and above scheduled for hysterosalpingography (HSG). Samples for high vaginal and endocervical swabs were analyzed as part of the study.

RESULTS: The mean age was 34.65 (6.18) years, and the age group 30 – 39 years had the highest frequency of infertility. The mean duration of infertility was 4.93 (3.88) years, and secondary infertility (77.8%) was higher than primary infertility (22.2%). Tubal pathology was the most common (36.1%), followed by uterine pathology (30.0%), where the tubal blockage was 82.5% and hydrosalpinx was 17.5%. There were 57 (54.8%) and 47 (45.2%) patients with single and bilateral tubal blockage, respectively. Hydrosalpinx was observed in four (20%), nine (45%), and seven patients (35%) with a right, left and bilateral distribution, respectively. Univariate regression analysis showed older women with tubal pathology were 2.01 times more likely to be infertile than the younger patients (95% CI: 1.042 – 4.100, p = 0.005), and patients with longer duration of infertility were 1.1 more likely to be infertile than patients with shorter infertility duration (95% CI: 0.995 – 1.187, p = 0.010). Of the microbes, 33.9% and 22.2% were isolated in the high vaginal and endocervical swabs of participants with tubal pathologies.

CONCLUSION: Increasing age, infertility duration, and genital microbes are significant risk factors for tubal infertility; hence, their prompt evaluation is essential.

Surveying the Digital Competencies of Health Profession Educators at Ethiopian Higher Education Institutions

Equlinet Misganaw Amare — 2024-08-10

BACKGROUND: The digital competency of health professional educators is crucial for institutions to develop digital skill policies and initiatives, plan professional development, and integrate technology into teaching practices. However, the development of policies, initiatives, and professional development programs related to digital skills is limited in low and middle-income countries due to a lack of empirical evidence. This study seeks to evaluate the digital competency of health professional educators in Ethiopian medical education.

METHODS: A survey was conducted at public Higher Education Institutions that provide health training programs in Ethiopia from April to September 2023 using the digital competency level assessment tool. Descriptive statistics were used to summarize the skill levels, and a chi-square test analysed the relationship between digital skills and various factors.

RESULTS: This study involved 498 health professional educators from 16 institutions. Most were male and taught clinical science. Over half worked in research institutions and held academic positions as assistant professors or above. About 10% were beginners in digital skills, with over half at an explorer level. Only a small percentage were experts. The majority had low digital skill competency, with only 7.2% showing high competency. There was no significant association between digital skill competency and factors like the type of institutions, program, course type or academic rank

CONCLUSIONS: There is a notable lack of digital skill competency among faculty members, with the majority lacking expertise in this area. Educators require guidance, collaborative encouragement, and knowledge exchange to enhance their digital competencies and effectively harness technology in their teaching.

In vivo Antimalarial and Liver Function Profiles of Methanol Extract of Salvia officinalis (Common Sage) Leaf in Plasmodium berghei-Infected Mice

Azukaego Thomas Hughs Mokogwu — 2024-08-10

BACKGROUND: Salvia officinalis (Common Sage) plant, is used as herbal medicine. The study was aimed at investigating the antimalarial potential and liver function profiles of the Methanol Extract of Salvia officinalis.

METHODS: Mice infected with Plasmodium berghei were treated (p.o) with the extract in the curative, suppressive, and prophylactic antimalarial models at doses of 250mg/kg, 500mg/kg, and 1000mg/kg. The positive control drug used was artemether/ lumefantrine (7mg/kg A/L) while the negative control was 10mk/kg of Tween 80.

RESULTS: The curative stage showed a significant (p < 0.001) dose-dependent antiplasmodial effect (of the methanol extract of S. officinalis leaf) compared with the negative control (Group 1). At doses of 250, 500, and 1000mg/kg, the Salvia officinalis extract produced parasite suppression of 37.13%, 57.18% and 66.80% respectively. While the positive control group produced parasite percentage suppression of 74.38%. There was a significant chemo-suppressive effect (p < 0.001) at all doses of the methanol extract of Salvia officinalis leaf.The leaf extracts demonstrated a prophylactic significant (p < 0.001) activity. There was no significant effect (p > 0.05) on packed cell volume at doses of 250 and 500mg/kg while 1000mg/kg body weight showed a significant (p < 0.05) effect. There was a reduction in the level of activity of the enzymes and other parameters in the liver function tests with an increase in the dosage of the leaf extract.

CONCLUSION: The methanol extract of Salvia officinalis possesses in vivo antiplasmodial activities and could be a lead plant in the development of antiplasmodial agents.

Magnitude and Risk Factors for Paediatric Congenital Heart Surgery Complication and its association with Patient Outcomes in the Cardiac Center of Ethiopia

Mohammed Nasir Beshir — 2024-08-10

BACKGROUND: Congenital heart disease surgery is related to significant postoperative complications which have been associated with poor patient outcomes. However, the prevalence, predictors, and effect of complications on outcomes have only been evaluated in a few numbers of studies. This study aimed to assess the magnitude of postoperative complications after congenital heart surgery, their predictors, and the associations between complications and patient outcomes.

METHODS: A retrospective, single-center cross-sectional study was done at the Cardiac Center of Ethiopia (CCE) on children who had undergone cardiac surgery between 2009 and 2022. All 919 pediatric patients aged below 18 years who had undergone congenital heart surgery were included in the study.

RESULT: Of the 919 patients who underwent surgery in the cardiac center of Ethiopia, Ventricular septal defect( VSD) was the most common diagnosis (41%) and VSD patch closure (39.4%) was the most common surgical procedure. The presence of at least one complication was identified in 39.5% of patients. Of all patients, 11.3% had cardiac, 23.1% had extra-cardiac complications, and 5.3%% had major complications. Higher age at diagnosis, lower weight at admission, cyanotic congenital heart disease, higher Risk adjustment for congenital heart surgery score (RACH-1 score), higher vasoactive inotropic score, Cardiopulmonary bypass use during surgery, higher cardiopulmonary bypass time, higher aortic cross-clamp time, higher duration of surgery, and the higher number of surgeries were associated with complications. The duration of mechanical ventilation, length of intensive care unit stays, and length of hospital stay was significantly prolonged in patients with complications.

CONCLUSION: Congenital heart disease surgeries pose a high risk of complications, and these complications are associated with poor patient outcomes in Ethiopia. Therefore, predicting complications based on risk factors and early detection and treatment is crucial to improve the patient's outcome.

Assessment of Knowledge, Practice, Perception, and Expectations of Artificial Intelligence in Medical Care among Staff of a Tertiary Hospital

Daniel, Aondona David — 2024-08-10

BACKGROUND: Artificial intelligence (AI) is the simulation of human intelligence processes by machines, especially computer systems. AI technology has wide applications in biomedicine and has real practical benefits in many medical applications. The aim was to assess the knowledge, practice, perception, and expectations about AI technology among staff of Federal Medical Centre Makurdi Benue state, Nigeria.

METHODS: This was a descriptive cross-sectional study over a period of three months from March to May 2023. The respondents were 18 years and above. The questionnaire was self-administered employing convenience sampling method to recruit responders. Data analysis was done using SPSS version 20.

RESULT: A total of 384 respondents were recruited. The mean (SD) age of the respondents was 42.3(±11.1). Most were aged 41-50 (34.4%). There were more females (56% (215)). Most of the respondents (69% (264)) attested to knowing AI technology. However, the majority (87% (231)) of the 264 respondents who knew about AI technology did not have in-depth knowledge. Regarding practices, more than half of the respondents (55.3%) did not think AI makes their task easy. The majority of the respondents (90.3%) believed AI technology is essential in the medical field and most of the respondents (12.2%) were expecting to acquire AI technology skills in the future.

CONCLUSION: The in-depth knowledge of AI technology was low. Most of the staff thought that AI technology did not make their task easy although they believe AI is essential in medical field and they expect the acquisition of more skills on AI technology in future.

Knowledge, Attitude and Practice of Mothers in the Management of Diarrhoea among Under-five Children in a Rural area of India

Kayala Venkata Jagadeesh — 2024-08-10

BACKGROUND: Diarrhoea is defined as the passage of loose, liquid or watery stools more than three times a day. Though simple and effective treatment measures are available which can markedly reduce diarrhea associated morbidity and mortality, yet in developing countries due to poor diarrhea and Oral rehydration therapy (ORT) related knowledge, diarrhoea still continues to be a major public health problem. The study aimed to estimate the knowledge, attitude and practice of mothers in the management of diarrhoea among under-five children in a rural area of India.

METHODS: A Cross-sectional study was conducted among mothers having children below five years of age in rural area of India. Proportionate sampling technique was used to recruit mothers. A pretested, pre designed structured questionnaire was used to obtained the data.

RESULTS: A total of 382 mothers were participated in the study. The mean age of study participants was 25.72 ± 3.98 years. Overall knowledge score showed that (74.6%) three-fourth of the study participants had average knowledge regarding diarrhoeal management. Majority of the mothers (62.6%) showed positive attitude in diarrhoea management. The practice scores showed that nearly half of the study participants (50.3%) had good practice regarding diarrhoea management.

CONCLUSION: The knowledge of mothers regarding management of diarrhoea among under-five children was average and most mothers had positive attitude. However, only half of the mothers had good practice.

Bibliometric Insights into Research on Frailty and Falls

Norbayah Zainal — 2024-08-10

BACKGROUND: Global population aging has sparked research into frailty and falls given their impact on older adults. This study provides a bibliometric analysis of frailty and fall literature to identify publication trends, leading contributors, impactful works, and conceptual themes.

METHODS: Frailty and fall publications were retrieved from Scopus and Web of Science databases without date restrictions. Data was analyzed using ScientoPy, and VOSviewer to generate statistics, visualizations, and maps based on temporality, productive countries, institutions, citations, subject categories, and keyword occurrences.

RESULTS: After pre-processing, 345 publications remained (84.6% Web of Science, 15.4% Scopus). The literature has grown steadily since 1990, led by the United States, China, and Japan. Prolific institutions were identified, including Pittsburgh University. Highly cited impactful studies were published across journals like the Journal of the American Geriatrics Society. Geriatrics/gerontology was the dominant subject category. Keyword co-occurrence analysis revealed clusters focusing on geriatric physical health, cardiovascular health, cognition, interventions, and mortality.

CONCLUSIONS: This bibliometric analysis synthesizes a comprehensive overview of frailty and fall research, identifying rising publication and citation trends, leading global contributors, impactful studies, and thematic focuses. The findings can inform resource allocation, international collaboration, impactful evidence utilization, and future research planning to advance frailty science and clinical care for older populations. Ongoing investigation is warranted into frailty mechanisms, assessment, management, and multidomain interventions.

Beyond the Brain-Vogt-Koyanagi-Harada Syndrome (VKH): A Rare Brain Eye and Ear (BEE) Syndrome Presenting initially as Aseptic Meningitis- a Neurologist Perspective

Erum Shariff — 2024-08-10

BACKGROUND: The triad of central nervous system, hearing, and visual disturbances is an often encountered scenario. Vogt Koyanagi-Harada (VKH) is a rare syndrome affecting tissues with melanocytes and characterized by bilateral diffuse granulomatous uveitis, meningeal involvement, and hearing impairment. VKH is considered a rare cause of Brain Eye and Ear (BEE) syndrome.

CASE: We describe a case of a 32-year-old healthy lady who was admitted to neurology with the initial impression of aseptic meningitis. She had subacute onset of headache and fever, associated with blurring of vision and painful eye movements. Visual acuity 20/250 of the right eye and 20/80 of the left eye. Intra-ocular pressure measured 12 for the right eye and 14 for the left eye, and extraocular muscle movements were full. Slit lamp examination showed a quite conjunctiva and clear cornea; however, there was an anterior chamber reaction of 2+ cells. The fundus exam showed mild vitritis with hyperemic disc swelling of both eyes and exudative retinal detachment bilaterally. Macular optical coherence tomography (OCT) demonstrated the presence of vitritis, pockets of subretinal fluids with bacillary layer detachment, and choroidal thickening. She was treated with steroids and mycophenolate mofetil with an excellent outcome.

CONCLUSION: Early diagnosis has good outcomes and of crucial to prevent damage to the photoreceptors and subsequent poor visual outcomes. The presence of a distinctive expression in one BEE organ should prompt the appropriate investigations and multidisciplinary team involvement to avoid permanent vision loss.