Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 4, Issue 3, May 2015

  • Authors: Bereket Zeleke, Girmay Admasu, Tigist Getachew, Endalish Kebede, Goshu Belay, Amanuel Abraha, Dawit Yihdego, Mengistu Hailemariam, Misganaw Birhaneselassie

    Abstract: Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.

    Received: Mar. 1, 2015 Accepted: Mar. 19, 2015 Published: Mar. 23, 2015

    DOI: 10.11648/j.cmr.20150403.11 View: Downloads:

  • Authors: Birhanu Alemu, Asrat Demessie, Atsede Fantahun, Kahsu Gebrekirstos

    Abstract: Background: Post-exposure prophylaxis is short-term antiretroviral or immune globulin treatment to reduce the likelihood of viral infection after exposure to the blood or body fluids of an infected person. Timely post-exposure prophylaxis after needle stick exposure to high risk body fluids in work area can reduce the rate of transmission of human immunodeficiency virus significantly. Methods: This institution based cross sectional study was conducted in purposively selected 251 health personnel. Structured questionnaire which was adapted from similar study conducted in Addis Ababa city was used to collect data. Data was analyzed using chi-square test. Ethical clearance was obtained from Addis Ababa University, College of Health Sciences, Department of Nursing and Midwifery. Results: From the total study participants 88.8% respondents had information about post-exposure prophylaxis and 85.7% know presence of post-exposure prophylaxis in their hospital. In addition to that 48.2% respondents responded correctly to the use of post-exposure prophylaxis. From the study participants almost half of the non-health professionals didn’t know about post-exposure prophylaxis. Conclusion: Out of the total respondents, majority of them had good level of awareness about post exposure prophylaxis.

    Received: Mar. 5, 2015 Accepted: Mar. 19, 2015 Published: Mar. 23, 2015

    DOI: 10.11648/j.cmr.20150403.12 View: Downloads:

  • Authors: Mesfin Worku Hordofa, Teshome Befikadu Adela

    Abstract: Introduction: Tuberculosis (TB) is a chronic communicable disease caused by Mycobacterium tuberculosis (MTB). M. tuberculosis is a slow- growing bacterium, resistant to most conventional antimicrobial agents partly due to its impermeable cell wall. It may persist in a dormant or latent form, unsusceptible to agents targeting growing bacteria. The Gen Xpert MTB/RIF is an automated molecular test which detects DNA sequences specific for MTB and RIF resistance by polymerase chain reaction with fully integrated sample processing in patients suspected of drug sensitive or multidrug resistant pulmonary tuberculosis. Objective: to determine Rifampicin Mono-Resistance Mycobacterium tuberculosis among patient attending atYirgalem Hospital from August-December, 2014.Method:A cross sectional study was conducted on Rifampicin Mono-Resistance in Mycobacterium tuberculosis among patient attending at Yirgalem Hospital from August-December, 2014,Yirgalem, Ethiopia. Result: A total of 236 participants were included under this study. Among these, males (57.6%) are slightly dominating female. Concerning to treatment history, 177 (75.0%) are new and the rest 59 (25.0%) retreated. Fifty eight (24.6%) of the total subjects were suspected for MDR tuberculosis. Twenty two (9.3%) of the subjects were smear positive. The highest positive finding of rifampcin susceptible Mycobacterium tuberculosis bacilli observed within age group of 16-30.The overall prevalence of pulmonary tuberculosis was 16.5%. From this prevalence, 3.4% was shared by Rifampcin mono-resistant Tuberculosis. Conclusion: Based on our study finding, The overall prevalence of pulmonary tuberculosis was 16.5%. From these, 3.4% was account for Rifampicin Mono-Resistance Mycobacterium tuberculosis among study subject. Most of the affected study subjects were productive age group. Therefore, we recommend that there should be enhanced efforts in detection of MDR tuberculosis in study area to control dissemination of the disease among the community.

    Received: Mar. 23, 2015 Accepted: Apr. 9, 2015 Published: Apr. 29, 2015

    DOI: 10.11648/j.cmr.20150403.13 View: Downloads:

  • Authors: Dereje Lelissa, Matiyas Yilma, Weldesenbet Shewalem, Amanuel Abraha, Mesfin Worku, Henock Ambachew, Misganaw Birhaneselassie

    Abstract: Background: Anemia is regarded as a major risk factor for unfavorable outcome of pregnancy both for the mother and the fetus. Methodology: A heath center based cross-sectional study was conducted in Boditii Health Centers from April 12 to June 23, 2012. Data was collected using pretested questionnaire, which contains socioeconomic, demographic and clinical characteristics of pregnant women shown to have association with anemia. A total of 125 pregnant women were enrolled in this study. HGB was measured using the Sahli-Hellinge method of HGB determination. Data was entered and statistical analysis was performed using SPSS version 16, software. Association between variables was done using chi square, and statistical significance was considered at P value < 0.05. Result: The prevalence of anemia obtained in this study was 77/125 (61.6%), based on the WHO criterion for the diagnosis of anemia in pregnancy, i.e. hemoglobin <11.0 g/dl (PCV <33%). In terms of severity, mild anemia was present in 41(53.2%) of women, moderate anemia was present in 36 (46.8%), and there were no cases of severe anemia. The prevalence of anemia in this study was 58.4% and 41.5% for primigravida and multigravida, respectively (P<0.05). Anemia was also found to increase as the gestational age increases, showing the highest prevalence in the third trimester (46.7%) than second (45.4%) and first trimester (7.8%), (P<0.001). Conclusion and Recommendation: From our results, we can conclude that anemia in pregnant women was highly prevalent in Boditti town. Our study revealed that the prevalence of anemia is higher in primigravidea than multigravidea. Anemia also increased as the gestational age increases. Intervention including health education about causes of anemia and its risk factors and antenatal care (ANC) follow up should be improved.

    Received: Apr. 14, 2015 Accepted: Apr. 26, 2015 Published: May 8, 2015

    DOI: 10.11648/j.cmr.20150403.14 View: Downloads:

  • Authors: Hijrah Harmansyah, Ema Alasiry, Dasril Daud

    Abstract: Background: Infant mortality rate (IMR) was found to increase in the newborn. The most frequent causes of death are infection, prematurity, low birth weight (LBW), neonatal asphyxia and birth trauma, respectively. Absolute neutrophil count (ANC) can be used as a marker of infection because of its faster, easier, simpler and cheaper nature. Objective: The study aims to identify the influence of an increase and decline in ANC on newborns from mothers with risk factors for early onset sepsis. Methods: This study was conducted as a a prospective cohort study from December 2013 to July 2014. The population included 120 newborns whose mother has risk factors of early onset sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital, and joined hospital. The subjects were divided into three groups, ANC <1800/mm3, ANC 1800-5399/mm3 and ANC >5400/mm3. Results: Newborn from mother with risk factor of infection with ANC >5400/mm3 and ANC 1800-5399/mm3 shows a significant difference with p = 0.000 (p<0.001); OR 8.143; IK 95% 2.440-27.173. Cut off point of 10.710-10890/mm3 was found from ROC analyses in ANC >5400/mm3 group with sensitivity and specificity 89.47% and 80.95% respectively; PPV (Positive predictive value) 80.95%; NPV (Negative predictive value) 89.47%; p=0.000; OR 36.125; IC 95% 5.820 – 224.224. Conclusions: Absolute neutrophil count >10.710/mm3 in a term newborn from mother with infection risk factors can be used as predictor for early onset sepsis 36 fold higher than the ANC <10.710/mm3.

    Received: Apr. 22, 2015 Accepted: May 6, 2015 Published: May 19, 2015

    DOI: 10.11648/j.cmr.20150403.15 View: Downloads:

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