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Survival analysis of patients under chronic HIV-care and antiretroviral treatment at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
T Assefa, E Wencheko
Ethiopian Journal of Health Development , 2012,
Abstract: Background: Health care planning depends upon good knowledge of prevalence that requires a clear understanding of survival patterns of patients who receive medication, treatment and care. Survival analysis can bring to light the effect that some demographic, social, medical and clinical characteristics have on the mortality rate of HIV-patients. Objectives: The objective of this research undertaking was to estimate mortality rate and identify predictors that have significant impact on the survival status of a sample of patients who received antiretroviral treatment and care in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: The data for this research were collected during the follow-up time from 2005 to 2008. Out of a population of HIV-patients who were taking antiretroviral therapy in the hospital in that period, data on 1,000 patients were used for this study. The study subjects were people in the age range from 15 to 75 years. The Kaplan-Meier Method was employed to estimate mortality; the Cox Proportional Hazards Regression Method was used to identify determinants of mortality. Results: After initiation of the antiretroviral treatment, HIV-positive patients lived for an average of 5.65 years (CI: 3.69-7.61 years); the median survival age was found to be 3.98 years (CI: 2.98-4.97 years). The number of medications, baseline functional status, CD4 count, antiretroviral treatment, age, gender and weight impact the survival experience of the patients. Conclusions: Antiretroviral therapy treatment reduced death among AIDS patients by 50 percent. Providing treatment at health facilities outside big towns and in the country should be given due attention. Similar studies in the future need to consider predictors in addition to those considered in this study. [Ethiop. J. Health Dev. 2012;26(1):22-29]
Assessment of Renal Function among HIV-Infected Patients on Combination Antiretroviral Therapy at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia  [PDF]
Kassahun Eneyew, Daniel Seifu, Wondwossen Amogne, M. K. C. Menon
Technology and Investment (TI) , 2016, DOI: 10.4236/ti.2016.73013
Abstract: Background: Acquired immunodeficiency syndrome (AIDS) is a spectrum of disease states characterized by progressive immunosuppression. Sub-Saharan Africa is heavily affected by human immunodeficiency virus (HIV) and AIDS than any other region of the world. Renal complications are important component of advanced HIV disease, and these complications significantly contribute to morbidity and mortality in HIV/AIDS patients. Aim of the Study: To assess renal function abnormalities in HIV infected patients and compare with treatment-naive and HIV-negative control groups. Methods: A retrospective cross sectional study of comparative nature was designed and samples and biochemical data were collected from July 1/2012 to February 1/2013 in patients attending the ART clinic at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Renal functions of 180 participants were assessed. The data obtained were analyzed using SPSS version 16.0. Result: A total of 180 participants grouped as HIV-negative controls (n = 60), HIV+ treatment-naive (n = 60) and HIV+ on HAART were recruited to participate in this study. Out of 180 participants included in the study, 59 (32.78%) were males and the remaining 121 (67.22%) were females. Mean serum total protein was higher in patients on HAART groups (5.78 ± 1.39) than treatment-naive (4.76 ± 2.19). There was significant reduction (p < 0.05) in serum total protein in both HIV+ groups as compared with the control groups. The mean serum creatinine level was not significantly different among three groups. The mean serum creatinine clearance in treatment-naive groups (111.05 ± 11.33) was lower than the control groups (115.05 ± 44.41) and patients on HAART (114.76 ± 28.54). There was a positive and significant correlation of glomerular filtration rate with BMI on treatment-naive groups. Conclusion: There are no statistically significant differences in the levels of Creatinine clearance and Estimated Glomerular Filtration Rate (eGFR) in HIV positive patients (naive as well as treated) as compared to the negative controls. The prevalence of renal impairment as defined by CrCl < 60 mL/min (eGFR < 60 ml/min/1.73 m2) is higher in treatment-naive participants than those on HAART and HIV-negative control groups.
Communication skills of physicians during patient interaction in an in-patient setting at Tikur Anbessa Specialized Teaching Hospital (TASH), Addis Ababa, Ethiopia, 2009
D Zewdneh, K W/Michael, S Kebede
Ethiopian Journal of Health Development , 2011,
Abstract: Background: Physician-patient relationship is foremost among the numerous qualities needed for sound patient care. In the Ethiopian clinical setting, a vast majority of patients complain that physicians do not interact with them properly. Objective: Assess behavior of physicians (verbal and nonverbal) when interacting with patients. Methods: Randomly selected physicians were observed in doctor-patient interactions in an inpatient setting using a standardized check list at Tikur Anbessa Hospital in November, 2009.Mean comparison of total scores of each category as well as mean interaction and biomedical exam times were made using Pearson’s Chi square, and Student’s T test. Results: 211 interactions were observed. 22.7% were consultants, 49.7% were residents and 26.5% were interns. Mean total score of observed behavior ranged from poor to satisfactory across category and showed statistically significant variations. Average interaction time was 7.87 minutes while average biomedical exam time was 5.05 minutes. The means showed a significant variation (p=0.001 at 95% CI). Conclusion: The study has shown that there is a reasonable ground to suggest that physician-patient interaction has deficiencies. Due attention should be given to improve communication skills of physicians.
Kalayou Kidanu Berhe*, Asrat Demissie , Alemayoh Bayeray Kahsay and Haftu Berhe Gebru
International Journal of Pharmaceutical Sciences and Research , 2012,
Abstract: Background: Diabetes is a group of metabolic disorders that affect the body’s ability to process and use sugar (glucose) for energy. Type 2 diabetes mellitus resulting from the combination of resistance to insulin action and inadequate insulin secretion. The success of long-term maintenance therapy for diabetes depends largely on the patients’ adherence with self-care practices.Objective: The aim of this study was to assess diabetes self-care practices and associated factors among type 2 diabetic patients in Tikur Anbessa Specialized Hospital, Ethiopia. Method: institutional based cross sectional study was employed and 320 study subjects were selected using systematic random sampling technique. And the data was collected using interviewer administered structured questionnaire; data was analyzed and cleaned using SPSS version 16. Scoring method was employed to classify patients’ self-care practice level as adhered or not adhered to self-care practices.Results: Of all respondents 167(52.2%) female. Mean age of the respondents was 55.03±10.7 years with minimum age of 30 and maximum age of 85. The mean duration of diabetes was 12.3±7.6years with minimum of 6 months and maximum of 41 years. Respondents’ self-care practices were, the majority 270 (84.4%) respondents were not adhered to Self-Monitoring of blood glucose practice. A total of 311(97.2%) respondents were adhered to anti-diabetic medication. The majority 252 (78.8%) respondents were not adhered to recommended diet management practices. There was a significant association between Level of education, monthly income, Presence of glucometer at home, marital status, diabetic complication, age and gender and self-care practices. But there was no significant association between duration of diabetes, Occupation and family history of diabetic and self-care practices.Conclusion: findings of this study indicated that majority patients had poor adherence to self-care practices especially in self-monitoring of Blood Glucose and diet management practices.
Ureteroscopy in a Resource Limited Setting: The Tikur Anbessa General Specialized Hospital Experience in Addis Ababa, Ethiopia
D Andualem, L Be-ede, T Mulat, L Samodi
East and Central African Journal of Surgery , 2012,
Abstract: Background: Ureteroscopy (URS) is defined as retrograde instrumentation performed with an endoscope passed through the lower urinary tract directly into the ureter and calyceal system. However, ureteroscopy has gradually become a major diagnostic and therapeutic technique for lesions of both the ureter and intrarenal collecting system. Complications of URS range from minor complications such as colic, fever and haematuria to major complications like ureteric perforation and avulsion Methods: This was a cross sectional study of patients who underwent URS at TAGSH from 11th September 2010 to 10th September 2011. Medical records of patients were reviewed and data retrieved by a preset questionnaire. The clinical notes and imaging studies were examined. After the data was collected, it was analyzed using the statistical software SPSS version 16. Results: The main indications for ureteroscopy in our study were ureteric stones (64.3%), ureteric stricture (7.1%), ureteric obstruction of unknown cause (11.9%) and others such as pelviureteric junction (PUJ) obstruction and non-excreting kidney (16.7%). At ureteroscopy, 38 (45.3%) patients had stone disease confirmed during ureteroscopy, 20 (23.9%) were diagnosed normal and 16 (19.1%) had ureteric stricture. Most patients 56 (66.7%) had no post-operative complications. The overall complication rate of the procedure was 33.3% (n=28). Fourteen (16.7%) patients had abdominal colic, 7 (8.3%) reported haematuria, 3 (3.6%) had post-operative fever while 4 (4.8%) patients had both colic and haematuria. Only a single (1.2%) patient had ureteric perforation. Conclusion: Ureteroscopy is an indispensible diagnostic and interventional procedure. Our study shows we have a long ways to go to improve our therapeutic ureteroscopic ureteric stone lithotripsy. We can also conclude that ureteroscopy is a very safe procedure.
Knowledge and attitude towards mother to child transmission of HIV and it's prevention among post natal mothers in Tikur Anbessa and Zewditu Memorial Hospitals, Addis Ababa
Solomie Jebessa, Telahun Teka
Ethiopian Journal of Health Development , 2005,
Abstract: Background: HIV/AIDS is currently a major public health problem in Ethiopia and mother to child transmission (MTCT) is responsible for 90% of childhood HIV infections. The transmission of HIV from infected mothers to babies could occur during antenatal period, as well as during delivery and breastfeeding (postnatal period). Since breastfeeding is essential for child survival, it is also necessary to assess mothers' knowledge and attitude towards HIV transmission and its prevention during breastfeeding. Objectives: This study attempts to assess mothers' knowledge of MTCT of HIV including breastfeeding, in two government hospitals in Addis Ababa. It also describes mothers' attitudes towards voluntary counseling and testing (VCT) services. Methods: A cross sectional, descriptive study was conducted to assess knowledge and attitude towards MTCT and its' preventive methods on postnatal mothers who delivered at Tikur Anbessa and Zewditu Memorial Hospitals, Addis Ababa, from January to March 2004. A structured, pre-tested questionnaire was used for data collection. Results: A total of 384 mothers were interviewed 78.4% of whom were from Addis Ababa. 87.0% were aged between 16-30 years. Of these mothers 54.9% were primipara, 89.9% were married, and 84.6% were Christians. Amhara (44.5%), Oromo (26.3%), Gurage (17.2%), and Tigre (7.0%) were the major ethnic groups in the study population. All the 384 respondents had heard about HIV/AIDS of which, 82.3 % mentioned the major routes of transmission and 89.8% knew that that HIV could be transmitted from an infected mother to her baby. Most of the respondents (76.8%) knew that MTCT of HIV is preventable, 64.6% knew the protective effect of prophylactic anti-retroviral drugs, 37.1% knew that abstinence from breastfeeding can prevent MTCT, 10.4% knew elective caesarean section (C/S) as a preventive method and 6.9% stated that protection of the mother from HIV is the same as protecting her baby. Those mothers who were from Addis Ababa, and whose educational level was secondary and above were found to be more knowledgeable about MTCT and PMTCT. Three hundred seventeen (82.6%) of the mothers knew what VCT meant and 76.8% of them have positive attitudes to wards VCT. 69.3% of the mother indicated that mothers should be tested before breastfeeding and 67.4% agreed to have VCT before breastfeeding their new babies. 60.2% planned to have VCT before their next pregnancy. Conclusion: This study showed that most mothers in this study knew that HIV could be transmitted from mother to child and that it can be prevented. A majority are of the opinion that VCT can be a preventive strategy and most of them have the intention to have counseling and testing before the next pregnancy. Hence well-organized VCT centers and PMTCT programs should be established to halt the epidemic from affecting the next generation. Ethiopian Journal of Health Development Vol. 19(3) 2005: 211-218
Assessment of risk behaviours and factors associated with oral and peri-oral lesions in adult HIV patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
E Diro, Y Feleke, S Guteta, D Fekade, M Neway
Ethiopian Journal of Health Development , 2008,
High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia
Birkneh Tilahun, Bogale Worku, Erdaw Tachbele, Simegn Terefe, Helmut Kloos, Worku Legesse
Antimicrobial Resistance and Infection Control , 2012, DOI: 10.1186/2047-2994-1-12
Abstract: A total of 400 Blatella germanica roaches were aseptically collected for five consecutive months. Standard laboratory procedures were used to process the samples.From the external and gut homogenates, Klebsiella oxytoca, Klebsiella pneumoniae, Citrobacter spp. Enterobacter cloacae, Citrobacter diversus, Pseudomonas aeruginosa, Providencia rettgeri, Klebsiella ozaenae, Enterobacter aeruginosa, Salmonella C1, Non Group A streptococcus, Staphylococcus aureus, Escherichia coli, Acinetobacter spp. and Shigella flexneri were isolated. Multi-drug resistance was seen in all organisms. Resistance to up to all the 12 antimicrobials tested was observed in different pathogens.Cockroaches could play a vector role for nosocomial infections in a neonatal intensive care unit and environmental control measures of these vectors is required to reduce the risk of infection. A high level of drug resistance pattern of the isolated pathogens was demonstrated.Cockroaches are one of the common-place pests widely distributed in public places, including hospitals, food industries and kitchens [1,2]. They feed on animal products, meat and grease, starchy food, sweets and unprotected materials [3]. The most abundantly distributed cockroach species is Blatella germanica and this is also the case as shown in an Ethiopian study [4-6].The fact that cockroaches carry pathogenic bacteria has been reported for many years. Longfellow in 1912 showed that cockroaches carried pathogens, including Proteus vulgaris, Staphylococcus aureus, Citreus and Bacillus of the subtilis type [7]. Fungi of medical importance such as Candida: Rhizopus, Mucor, Alternaria and Aspergillus spp. were isolated from cockroaches in hospital wards and residential areas [8]. A recent study (2010) in central Tehran, Iran reported that at least 25 different species of medically important bacteria, the most frequent being Klebsiella spp., were isolated from Blatella germanica and Periplaneta americanaI collected from public hospitals
X-ray film reject rate analysis at eight selected government hospitals in Addis Ababa, Ethiopia, 2010
S Teferi, D Zewdneh, D Admassie, B Nigatu, K Kebeta
Ethiopian Journal of Health Development , 2012,
Abstract: Background: Improper practices in radiography that lead to possible repeating of procedures predispose patients for additional cost, more waiting time, and excess dose of ionizing radiation, leading to various dose dependent and dose independent health problems including cancer. In the face of such problems and the scarcity of resources, improving the quality and efficiency of radiology services is imperative. Objective: The purpose of this research was to identify the main causes of film faults as well as the pattern and magnitude of film rejection. Methods: Using a prospective cross-sectional hospital based approach; eight public hospitals were selected in Addis Ababa through convenience sampling. Adult and pediatrics radiographs with film faults were reviewed using a standardized checklist of common causes of reject. The collected data were then entered into a database for analysis using descriptive statistics. Results: Reject rate was calculated in eight governmental hospitals across all plain film examinations. The overall reject rate was 374 (3.1 %) in 12,165 x-ray exposures. Total reject rate by hospital showed 10.5% for Zewditu and 1.53% and 1.87% for Tikur Anbessa Specialized Hospital (TASH) and the Police Hospital, respectively. Conclusions: Rejected films were found to have been caused by numerous factors including poor technical judgment, patient motion, and poor supervision of staff. Hence, strategies need to be developed within medical imaging departments to improve the situation. [Ethiop. J. Health Dev. 2012;26(1):54-59]
Analysis of admissions to the pediatric emergency ward of Tikur Anbessa Hospital in addis Ababa, Ethiopia
D Muluneh, D Shimelis, D Benti
Ethiopian Journal of Health Development , 2007,
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