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  1. Article ; Online: Factors associated with sub-optimal control of anticoagulation in patients with prosthetic heart valves taking oral anticoagulants in a sub-Saharan African setting.

    Chalachew, Tigist / Yadeta, Dejuma / Tefera, Endale

    Cardiovascular journal of Africa

    2019  Volume 30, Issue 6, Page(s) 316–320

    Abstract: Background: Replacement of diseased valves reduces the morbidity and mortality rate associated with native valvular disease but comes at the expense of risking complications related to the implanted prosthetic device. Establishing the desired ... ...

    Abstract Background: Replacement of diseased valves reduces the morbidity and mortality rate associated with native valvular disease but comes at the expense of risking complications related to the implanted prosthetic device. Establishing the desired anticoagulation level in a sub-Saharan African setting may be a challenge.
    Objectives: This study was conducted to determine the challenges of maintaining a desired level of anticoagulation and factors associated with sub-optimal anticoagulation in patients with prosthetic heart valves on chronic anticoagulation.
    Methods: We reviewed 73 patients who had undergone prosthetic valve replacement for chronic rheumatic valvular heart disease and were taking warfarin. The follow up ranged from one to 13 years. We studied international normalised ratio (INR) profiles of the patients for the six months preceding the study and defined optimal control as an INR of 2.5-3.5. We aimed to determine if there were factors associated with sub-optimal control of INR.
    Results: Forty-two patients (57.5%) were female. Mean age of the participants was 21.5 ± 3.1 years (range 14-25 years). Warfarin was the anticoagulant in 55 (75.3%) of the patients and 18 (24.7%) were on combined warfarin and aspirin anticoagulation. Thirty-five (47.9%) patients had optimal control of their INR. Educational level of primary school or less, distance from follow-up medical facility of more than 300 km, quarterly or less-frequent check-up visit, and public health institution as a source of free warfarin supply were found to be significantly associated with sub-optimal control of INR.
    Conclusions: Educational level, distance from follow-up facility, number of follow-up visits and source of warfarin supply were found to be significantly associated with sub-optimal control of INR.
    Language English
    Publishing date 2019-05-24
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 2383233-2
    ISSN 1680-0745 ; 1996-3467 ; 1015-9657 ; 1995-1892
    ISSN (online) 1680-0745 ; 1996-3467
    ISSN 1015-9657 ; 1995-1892
    DOI 10.5830/CVJA-2019-024
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    In stock of ZB MED Cologne/Königswinter

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  2. Article: Complementary and Alternative Medicine Use in a Pregnant Population, Northwest Ethiopia.

    Emiru, Yohannes Kelifa / Adamu, Betelhem Anteneh / Erara, Melak / Chanie, Tigist / Gurmu, Abyot Endale

    International journal of reproductive medicine

    2021  Volume 2021, Page(s) 8829313

    Abstract: Background: Complementary and alternative medicine (CAM) appears to be the source of healthcare particularly in the majority of pregnant communities of Africa due to its intrinsic qualities as well as its accessibility and affordability. Despite ... ...

    Abstract Background: Complementary and alternative medicine (CAM) appears to be the source of healthcare particularly in the majority of pregnant communities of Africa due to its intrinsic qualities as well as its accessibility and affordability. Despite acknowledged benefits of CAM use in pregnancy, majority of users are unaware of its safety and effects on fetal development. The present study was aimed at examining CAM use among pregnant women in Northwest Ethiopia to provide an opportunity for future investigations on the effectiveness of CAM modalities in the management of pregnancy-related complications across the country.
    Methods: This was an institution-based cross-sectional study which was conducted at Poly Clinic Health Center in the Northwest part of Ethiopia between March and May 2018. Two hundred and eighty two Ethiopian women were conveniently recruited to take part in the study. Structured questioners were used for the survey. Descriptive statistics of sociodemographic and CAM use characteristics were expressed in frequencies and proportions. Chi-square test was performed to determine the difference between CAM user and nonuser. Besides, binary logistic regression analyses were performed to examine predictors of CAM use in the study population. The result was considered statistically significant if
    Results: The prevalence rate of CAM use in pregnant women was 89.36% with the commonest practice of spiritual healing (65.2%) and herbal supplement (51.8%) CAM therapies. Use of CAM positively associated with marital status and previous number of children. The odds of using CAM among single/not married women were 3.22 times higher (COR: 3.22, CI: 1.07-9.64) as compared to married women. Pregnant women with no children were 3.30 times more likely (COR: 3.30, CI: 0.92-11.84) to use CAM than those women having ≥3 children. Lower odds of using CAM significantly associated with educational level (COR: 0.20, CI: 0.046-0.93) and antenatal care (COR: 0.45, CI: 0.18-1.13) in a binary logistic regression model.
    Conclusions: A considerable number of pregnant women were utilizing CAM including herbal products as part of their maternity care. This finding provides a reference on the use of CAM for policy-makers, health professionals, and parents. Further studies are needed to investigate the effectiveness and safety of specific CAM modalities with particular focus on herbal medicinal products.
    Language English
    Publishing date 2021-08-06
    Publishing country Egypt
    Document type Journal Article
    ISSN 2356-7104
    ISSN 2356-7104
    DOI 10.1155/2021/8829313
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Maternal and fetal outcomes in term premature rupture of membrane.

    Endale, Tigist / Fentahun, Netsanet / Gemada, Desta / Hussen, Mamusha Aman

    World journal of emergency medicine

    2016  Volume 7, Issue 2, Page(s) 147–152

    Abstract: Background: Premature rupture of membrane (PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal ... ...

    Abstract Background: Premature rupture of membrane (PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.
    Methods: A retrospective cross sectional study was conducted using data available at Mizan-Aman General Hospital during a period of 3 years (January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically significant.
    Results: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours (AOR=5.6, 95%CI 1.3-24.1) latency >24 hours (AOR=2.8, 95%CI 1.7-11.8), residing in rural areas (AOR=4.2, 95%CI 3.96-29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.
    Conclusion: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.
    Language English
    Publishing date 2016-06-16
    Publishing country China
    Document type Journal Article
    ZDB-ID 2753264-1
    ISSN 1920-8642
    ISSN 1920-8642
    DOI 10.5847/wjem.j.1920-8642.2016.02.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Audio / Video ; Online: Comparison of Tier 1 and 2 Methodologies for Estimating Intake and Enteric Methane Emission

    Balcha, Endale / Ndung’u, Phyllis / Wilkes, Andreas / Getahun, Daniel / Graham, Michael / Leitner, Sonja / Marquardt, Svenja / Mulat, Daniel / Merbold, Lutz / Worku, Tigist / Arndt, Claudia

    2023  

    Abstract: The objective of this study was to compare gross energy intake (GEI; MJ/animal/day) and enteric methane (CH4) emission factors (EF; CH4 kg/animal/year) of different cattle categories from smallholder systems in Ethiopia based on Intergovernmental Panel ... ...

    Abstract The objective of this study was to compare gross energy intake (GEI; MJ/animal/day) and enteric methane (CH4) emission factors (EF; CH4 kg/animal/year) of different cattle categories from smallholder systems in Ethiopia based on Intergovernmental Panel on Climate Change (IPCC) Tier 1, IPCC Tier 2, and International Livestock Research Institute (ILRI) Tier 2 methodology. The ILRI Tier 2 methodology uses calculations that are based on or modified from equations published in ‘Nutrient Requirements of Domesticated Ruminants’ (CSIRO 2007). In comparison to IPCC, the ILRI methodology is based on metabolizable and not net energy requirements of the animal. Data from Ethiopian smallholder systems were collected four times corresponding to the beginning and end of the three seasons (spring, summer and winter) to account for the effect of seasonality on animal liveweight, diet and performance. There was a high correlation of GEI between IPCC and ILRI Tier 2 methodology (R2=0.87). However, the IPCC Tier 2 methodology estimated a higher GEI than the ILRI methodology (P<0.05; based on one-sample t-test). The mean difference in GEI was 28 MJ/animal/day (s.d. 18.2), which was 27 and 38% of the average GEI estimated by IPCC and ILRI methodology, respectively. Compared to ILRI methodology, IPCC methodology used a greater methane conversion factor (Ym; 7.0 vs 6.3% of GE in feed converted to CH4). Because of the greater GEI and Ym, the IPCC methodology estimated on average 49% greater EFs than the ILRI methodology (48.4 vs 32.4 CH4/animal/day, P<0.05). The EFs calculated across all cattle categories (adult females, intact and castrated males, heifers, young makes, and calves) for IPCC Tier 1 (2019) default EFs were found to be 23-38 and 38-59% lower for the IPCC and ILRI Tier 2 methodology, respectively. Similarly, when compared to Tier 1 methodology, IPCC and ILRI Tier 2 methodology estimated 27 and 51% lower total animal emission from smallholder cattle systems, respectively. The observed difference between the ...
    Keywords mitigation ; climate change ; livestock systems ; methane emission
    Language English
    Publishing date 2023-12-21T11:51:01Z
    Publisher ILRI
    Publishing country fr
    Document type Audio / Video ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: High prevalence of extended-spectrum beta-lactamase-producing Gram-negative pathogens from patients attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region.

    Feleke Moges / Setegn Eshetie / Wondwossen Abebe / Feleke Mekonnen / Mulat Dagnew / Abyot Endale / Azanaw Amare / Tigist Feleke / Mucheye Gizachew / Moges Tiruneh

    PLoS ONE, Vol 14, Iss 4, p e

    2019  Volume 0215177

    Abstract: Background Infections caused by extended-spectrum beta-lactamases (ESBL) producing Gram-negative bacteria has emerge as a global threat in clinical practices. The treat is more serious in developing countries due to inappropriate use, poor adherence, use ...

    Abstract Background Infections caused by extended-spectrum beta-lactamases (ESBL) producing Gram-negative bacteria has emerge as a global threat in clinical practices. The treat is more serious in developing countries due to inappropriate use, poor adherence, use of counterfeit, sub-standard antibiotics and poor infection control practices. Data on ESBL producing Gram-negative bacteria are limited in developing countries including Ethiopia. The aim of this study was therefore, to describe the burden of ESBL producing Gram negative pathogens isolated from patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region. Materials and methods A total of 532 clinical samples of blood, urine, stool, wound, abscess, ear discharge, nasal discharge, cervical discharge and body fluid specimens were aseptically collected and bacteriologically processed. Identification of the bacterial species was performed using an automated system (Vitek-2 Compact 27530, USA) and antibiotic susceptibility test was determined by disk diffusion method and selection of antibiotics were in accordance with CLSI guidelines. The MDR pattern of the Gram-negative pathogens was assessed using phenotypic methods of ESBL and carbapenemase production following standard procedure. Result A total of 532 samples were processed and 263 pathogens were isolated. Of these, 185 (70.3%) were Gram-negative and 78 (29.7%) Gram-positive. Of the Gram-negative bacteria the high proportion of the isolates were identified from blood 146/185 (78.9%) and 29/185 (15.7%) were from urine cultures. The most common isolate in all clinical samples was Klebsiella pneumoniae 97/185 (52.4%) followed by Escherichia coli 23/185 (12.4%), Acinetobacter baumannii 15/185 (17.6%) and Enterobacter aerogenes 12/185(6.5%). Of the total Gram negatives, the prevalence of MDR was 148/185 (80.0%). Of the MDR isolates the prevalence of ESBL producers were, 127/148 (85.8%) and 24/148 (16.2%) were carbapenemase producers. Conclusion and recommendation Prevalence of MDR ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 610 ; 540
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: High prevalence of extended-spectrum beta-lactamase-producing Gram-negative pathogens from patients attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region.

    Moges, Feleke / Eshetie, Setegn / Abebe, Wondwossen / Mekonnen, Feleke / Dagnew, Mulat / Endale, Abyot / Amare, Azanaw / Feleke, Tigist / Gizachew, Mucheye / Tiruneh, Moges

    PloS one

    2019  Volume 14, Issue 4, Page(s) e0215177

    Abstract: Background: Infections caused by extended-spectrum beta-lactamases (ESBL) producing Gram-negative bacteria has emerge as a global threat in clinical practices. The treat is more serious in developing countries due to inappropriate use, poor adherence, ... ...

    Abstract Background: Infections caused by extended-spectrum beta-lactamases (ESBL) producing Gram-negative bacteria has emerge as a global threat in clinical practices. The treat is more serious in developing countries due to inappropriate use, poor adherence, use of counterfeit, sub-standard antibiotics and poor infection control practices. Data on ESBL producing Gram-negative bacteria are limited in developing countries including Ethiopia. The aim of this study was therefore, to describe the burden of ESBL producing Gram negative pathogens isolated from patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region.
    Materials and methods: A total of 532 clinical samples of blood, urine, stool, wound, abscess, ear discharge, nasal discharge, cervical discharge and body fluid specimens were aseptically collected and bacteriologically processed. Identification of the bacterial species was performed using an automated system (Vitek-2 Compact 27530, USA) and antibiotic susceptibility test was determined by disk diffusion method and selection of antibiotics were in accordance with CLSI guidelines. The MDR pattern of the Gram-negative pathogens was assessed using phenotypic methods of ESBL and carbapenemase production following standard procedure.
    Result: A total of 532 samples were processed and 263 pathogens were isolated. Of these, 185 (70.3%) were Gram-negative and 78 (29.7%) Gram-positive. Of the Gram-negative bacteria the high proportion of the isolates were identified from blood 146/185 (78.9%) and 29/185 (15.7%) were from urine cultures. The most common isolate in all clinical samples was Klebsiella pneumoniae 97/185 (52.4%) followed by Escherichia coli 23/185 (12.4%), Acinetobacter baumannii 15/185 (17.6%) and Enterobacter aerogenes 12/185(6.5%). Of the total Gram negatives, the prevalence of MDR was 148/185 (80.0%). Of the MDR isolates the prevalence of ESBL producers were, 127/148 (85.8%) and 24/148 (16.2%) were carbapenemase producers.
    Conclusion and recommendation: Prevalence of MDR and ESBL producing Gram-negative pathogens in this hospital is alarmingly high. Therefore, continuous monitoring of the problem with effective infection prevention and careful selection of empirical therapy are warranted in the study area.
    MeSH term(s) Adolescent ; Adult ; Bacterial Proteins/genetics ; Bacterial Proteins/metabolism ; Child ; Child, Preschool ; Cross-Sectional Studies ; Drug Resistance, Multiple, Bacterial/genetics ; Ethiopia/epidemiology ; Female ; Gram-Negative Bacteria/enzymology ; Gram-Negative Bacteria/genetics ; Gram-Negative Bacteria/isolation & purification ; Gram-Negative Bacterial Infections/enzymology ; Gram-Negative Bacterial Infections/epidemiology ; Gram-Negative Bacterial Infections/genetics ; Hospitals, Special ; Humans ; Male ; Middle Aged ; Prevalence ; beta-Lactamases/genetics ; beta-Lactamases/metabolism
    Chemical Substances Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2019-04-15
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0215177
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  7. Article ; Online: Photographic grading for trachoma diagnosis within trachoma impact surveys in Amhara region, Ethiopia.

    Whitson, Cassidy C / Nute, Andrew W / Hailemariam, Begashaw / Deathe, Andrew R / Astale, Tigist / Ayele, Zebene / Gessese, Demelash / Sata, Eshetu / Zerihun, Mulat / Melak, Berhanu / Haile, Mahteme / Zeru, Taye / Getnet, Banchalem / Wondimteka, Bilen / Kabtu, Endale / Getachew, Habib / Shibiru, Meskerem / Bayecha, Social / Aragie, Solomon /
    Wittberg, Dionna M / Tadesse, Zerihun / Callahan, E Kelly / Keenan, Jeremy D / Admassu, Fisseha / Nash, Scott D

    Transactions of the Royal Society of Tropical Medicine and Hygiene

    2022  Volume 117, Issue 2, Page(s) 111–117

    Abstract: Background: As countries reach the trachoma elimination threshold and cases of trachomatous inflammation follicular (TF) become rare, it becomes difficult to train survey graders to recognize clinical signs. We assess the use of photography as a grading ...

    Abstract Background: As countries reach the trachoma elimination threshold and cases of trachomatous inflammation follicular (TF) become rare, it becomes difficult to train survey graders to recognize clinical signs. We assess the use of photography as a grading tool, the efficiency of an in-country grading center and the comparability of field and photographic grading.
    Methods: During January-February 2017 surveys in Amhara, Ethiopia, field graders assessed TF, trachomatous inflammation intense (TI) and trachomatous scarring (TS). Photographs were taken from each conjunctiva and later graded at the Gondar Grading Center (GGC) at the University of Gondar in Amhara. Two trained ophthalmology residents graded each set of photographs and a third grader provided an adjudicating grade when needed.
    Results: A total of 4953 photographs of 2477 conjunctivae from 1241 participants in 10 communities were graded over 5 d at the GGC. Six examined participants were not photographed. Agreement between field and photographic grades were for TF: percent agreement (PA) 96.7%, κ=0.70 (95% confidence interval [CI] 0.64 to 0.77; for TI: PA 94.7%, κ=0.32 (95% CI 0.20 to 0.43); and for TS: PA 83.5%, κ=0.22 (95% CI 0.15 to 0.29).
    Conclusions: Conjunctival photography may be a solution for programs near the elimination threshold where there are few available community cases for training field graders.
    MeSH term(s) Humans ; Infant ; Trachoma/diagnosis ; Trachoma/epidemiology ; Ethiopia/epidemiology ; Conjunctiva ; Photography ; Inflammation ; Prevalence
    Language English
    Publishing date 2022-09-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 441375-1
    ISSN 1878-3503 ; 0035-9203
    ISSN (online) 1878-3503
    ISSN 0035-9203
    DOI 10.1093/trstmh/trac090
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