Ethiopian medical journal (Ethiop Med J )

Publisher: Ethiopian Medical Association


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    Ethiopian medical journal
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Publications in this journal

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    ABSTRACT: Tuberculous lymphadenitis (TBLN) is a common form of extra pulmonary tuberculosis where lymph nodes particularly from cervical, axillary and inguinal sites are mostly involved, however, its diagnosis poses a major challenge in resource limited settings. To identify the etiological species of Mycobacteria responsible for TBLN in Derra area, a rural district in Ethiopia, where the status of TBLN is unknown. A total of 153 patients who were clinically suspected for TBLN, between the periods of August 2004 and February 2005 were included in the study. Fine needle aspirates (FNA) were collected and processed from 145 participants and further analyzed using Ziehl Neelsen staining, culture, cytology and polymerase chain reaction (PCR) using sets of primers, targeting the IS6110 insertion sequence and the pncA gene allelic variation at position 169. Out of the 145 FNA samples, 66 (45.5%) demonstrated growth on Lowenstein-Jensen (LJ) medium and 115 (79.3%) cases were confirmed as TBLN by a combination of results from acid fast bacilli (AFB) smear examination, culture, cytology and PCR. From the 145 clinically suspected TBLN cases, 108 (75%) were identified by PCR at complex level of which 107/108 (99.1%) were positive for M. tuberculosis and 1/108 (0.9%) was positive for M. bovis using pncA primers. The study indicates that M. tuberculosis is the major cause of tuberculous lymphadenitis in Dera area.
    Ethiopian medical journal 01/2014; Suppl 1:7-14.
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    ABSTRACT: The human immunodeficiency virus (HIV) epidemic facilitated the resurgence of extrapulmonary tuberculosis (TB) and other opportunistic diseases. This study assessed the sociodemographic and cytopathologic patterns of enlarged cervical lymph nodes among HIV positive and negative patients.
    Ethiopian medical journal 01/2014; 52(1):19-25.
  • Ethiopian medical journal 01/2014; Suppl 1:2 p preceding 1.
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    ABSTRACT: The risk of transmission of tuberculosis is high in crowded conditions. Addis Ababa has a relatively high burden of tuberculosis and its city buses are often filled with commuters. Tuberculosis is a potential occupational hazard for city bus drivers and cash collectors. The objective of this study was to estimate the proportion of tuberculosis among city bus drivers and cash collectors. We estimated the proportion of tuberculosis of all forms among city bus drivers and cash collectors of the Addis Ababa City Bus Organization, from January 2003 to December 2004. Study participants were screened with clinical, bacteriological and chest X-ray examination from January 2003 to December 2004. Sixteen cases of tuberculosis were identified among 903 study participants (466 city bus drivers and 437 cash collectors) examined, of whom 12 were already on anti-TB treatment and 4 were diagnosed during the study. The proportion of all forms of tuberculosis, smear-positive pulmonary tuberculosis and extra-pulmonary tuberculosis was 16/903 (1772/100,000), 4/903 (443/100,000) and 3/903(332/100,000), respectively. The proportion of all forms of tuberculosis among the study population was higher than the notification case rates for Addis Ababa reported in 2003, which indicates the need for a routine screening of city bus drivers and cash collectors. Measures such as opening windows and reducing crowding in buses are recommended as a means of reducing the risk of exposure to bus drivers and cash collectors.
    Ethiopian medical journal 01/2014; Suppl 1:31-5.
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    ABSTRACT: Cardiovascular disorders vary throughout the world in type and distribution especially between the developed and the developing countries. Data on spectrum of cardiovascular diseases in Ethiopia is scarce.
    Ethiopian medical journal 01/2014; 52(1):9-17.
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    ABSTRACT: A 16 years old female patient diagnosed to have thalassemia syndrome in Black lion Hospital based on clinical presentation, complete blood count, peripheral morphology and bone marrow findings.
    Ethiopian medical journal 01/2014; 52(1):43-7.
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    ABSTRACT: Chronic meningitis is inflammation of the meninges where signs and symptoms develop and last for at least four weeks without alleviation. Little is known about the current etiology and incidence of the disease in adults living in developing countries. The objective of this study was to elucidate the most common etiologies of chronic meningitis in adult Ethiopian patients and give an aid in the empiric therapy. A total of 53 adult patients (median age 32 years) having chronic meningitis and who were admitted at Tikur Anbessa Teaching Hospital and Ye'huleshet Clinic, Addis Ababa, Ethiopia were recruited between 2003 and 2004. Of the 53 patients, bacteriological, molecular and immunological investigations were done for 52 of the study participants to detect Cryptococcus neoformans, Mycobacterium tuberculosis, Toxoplasma gondii, Brucella and Neisseria meningitides infections. Forty eight of the participants were HIV positive and 15% (8/52) of the CSF were positive with Cryptococcal latex antigen detection test; in addition, M. tuberculosis DNA was detected using PCR from CSF ofpatients infew of the patients. Multiple infections were observed in studyparticipants with < 0.1 to 1 CD4 to CD8 ratio. Chronic meningitis mostly occurred in HIV infected patients, where most of the infections were attributed to Cryptococcus neoformans whereas M. tuberculosis appeared secondary.
    Ethiopian medical journal 01/2014; Suppl 1:43-8.
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    ABSTRACT: We report a 16 year old male patient from rural Ethiopia with pathologically and intraoperatively proven thoracic para spinal and epidural hydatidosis, a very rare involvement, who presented with progresive both lower limb weakness, loss of pain, touch and properioception and double incontinence of two weeks prior to hospital admission. The pathological, radiological (MRI and plain x-ray) and the intra operative findings are briefly discussed with literature review.
    Ethiopian medical journal 01/2014; 52(1):49-51.
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    ABSTRACT: It has been few years since the launching of provider-initiated HIV counselling and testing (PICT) for all tuberculosis (TB) suspected patients and patients presenting with signs and symptoms of TB. However, little is known about the prevalence of HIV in new smear positive confirmed TB cases in Addis Ababa. To determine the proportion of HIV among newly diagnosed smear positive TB cases, who were screened between February 2007 and July 2010 in Addis Ababa. A total of 418 pulmonary TB patients and 188 HIV positive non-TB cases were recruited from different health centres in Addis Ababa. All TB patients were tested for HIV. Of the total 418 new smear positive TB patients tested for HIV, 97 (23.2%) were HIV positive. The occurrence of HIV among TB patients was significantly higher in females, 50/182 (27.7%) compared to males, 47/236 (19.7%) (P < 0.05). The mean CD4 lymphocyte count among HIV positive active TB cases was significantly lower (P < 0.05) (210 +/- 23.9 cells/microL) compared to the counts among non-TB HIV positive cases (407.01 +/- 31.3 cells/microL). The proportion of HIV was significantly higher in the age group 31-40 (46.3%) and > 41 (42.2%) year (p < 0.001) compared to younger, 18-20 (3.75%) and 21-30 (17.8%) years of age groups. The occurrence of HIV in smear positive TB cases is high, with a higher proportion seen among females compared to males.
    Ethiopian medical journal 01/2014; Suppl 1:1-6.
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    ABSTRACT: Research involves gathering data, then collating and analyzing it to produce meaningful information. However, not all research is good quality and many studies are biased and their results untrue. Critical appraisal is the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context. This paper attempted to point out the weak and strong points of the study, taking into account sources of bias that were introduced in the article "Visual acuity and road traffic accident (RTA) in Jimma town" published in the Ethiopian Medical Journal.
    Ethiopian medical journal 01/2014; 52(1):37-42.
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    ABSTRACT: Cutaneous leishmaniasis is endemic to many parts of the world and has re-emerged in a number of endemic countries in recent years. Environmental changes, immune status of the host and treatment failure are the three most important risk factors associated with the re-emerging and spread of Leishmaniasis. Cutaneous leishmaniasis (CL) ranges from localized, self-healing type to the disfiguring mucocutaneous and diffuse cutaneous type. To access the trend of CL patient flow in ALERT Hospital, Addis Ababa, Ethiopia. Patients' clinical and laboratory records were collected retrospectively for 1651 leishmaniasis suspected individuals from ALERT Hospital, from January 1, 2007 to December 30, 2010. From the suspected individuals, 234 cases were positive for Leishmania species with Giemsa stain and/or histopathology and confirmed for CL, of whom 30 (12.8%) were diagnosed in 2007, 29 (12.4%) in 2008, 75 (32.1%) in 2009, and 100 (42.7%) were in 2010. The overall proportion of cases with leishmaniasis among the suspected cases was 234/1651 (14.2%). The distribution of CL reports was higher for patients coming from Addis Ababa surrounding areas and Oromia region, 96/234 (41.03%) and 71/234 (30.34%), respectively. In general, the trend of leishmaniasis in and around Addis Ababa seems to be increasing, which calls for further detailed epidemiological studies, including vector and reservoir host studies, to help in the prevention and control of the disease.
    Ethiopian medical journal 01/2014; Suppl 1:37-41.
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    ABSTRACT: Contraceptive method mix and choice is not uniform across all countries. Literatures have shown that a significant variation exists in contraceptive method mix among regions and countries. In Africa most mothers rely on short-term contraceptives such as pills and injectables or traditional methods while in Asia and Latin America permanent methods mainly male and female sterilizations are commonly used. Though long-term methods of contraception are recommended for its effectiveness and efficiencies in countries like Ethiopia where high fertility rate is a concern, its choice and utilization remains low.
    Ethiopian medical journal 01/2014; 52(1):27-35.
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    ABSTRACT: The rising number of tuberculosis cases is putting a considerable strain on health budgets, and threatens to drain resources essential to health and welfare services. The objective of this study was to estimate the cost of tuberculosis to outpatients and their families in a rural district health center, Addet Health Center, Yilmana Densa District, Amhara National Regional State in Ethiopia. Cross-sectional study was conducted to estimate the cost of tuberculosis to outpatients and their families. Data were collected on diagnosis, treatment, transportation, food and other expenses, and also income losses due to tuberculosis before and after the diagnosis of tuberculosis. Data were entered to Epi-Info and transferred to SPSS 13 for analysis. Mean, median, range and standard deviation were used to describe the data. The mean direct cost and indirect cost of tuberculosis to outpatients and their families were 1078.00 Birr and 2080.43 Birr, respectively, at the time of study. The mean total cost of tuberculosis to outpatients and their families was 3159.23 Birr. Cost of tuberculosis to patients and their families, especially before the identification of the disease was found to be very high. Therefore, consequences of tuberculosis to patients and their families are particularly serious and potentially devastating.
    Ethiopian medical journal 01/2014; Suppl 1:23-30.
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    ABSTRACT: Human Papilloma virus associated cervical cancers are more prevalent in developing countries compared to developed countries. Cervical cancer is reported as the most frequent malignancy among women visiting hospitals in Ethiopia. This study is a pilot study designed to examine the prevalence and genotypes of HPV in twenty Ethiopian women, clinically diagnosed to have cervical neoplasia, while visiting gynecology unit of a tertiary level referral hospital in Addis Ababa. The objective of this study was to detect the presence of HPV L1 gene and respective genotypes among women clinically diagnosed with different grades of cervical neoplasia. A total of 20 fresh biopsy samples were collected from clinically diagnosed cases, DNA extracted and further amplified using PCR for HPV L1 and beta globin genes. The PCR amplicons were denatured and allowed for hybridization onto a nitrocellulose strip containing the type-specific probes for 27 HPV genotypes representing both high and low risk groups as well as beta globin genes. Socio-demographic characteristics and clinical findings of the participants were recorded on structured questionnaires. Amplification of HPV L1 gene by PCR detected 17 cases out of 20. Based on reverse line blot hybridization assay, the most frequent genotype identified was HPV16 (13/20). Mixed infection of HPV 16 with HPV 33, HPV 35, HPV 45 and HPV 58 was detected from other four study participants. Human papilloma virus type 16 was the most prevalent genotype identified from the subjects screened Further investigation with statistically sound sample size would help to clearly visualize the existing trend in Ethiopia regarding factors for high risk HPV positivity and multiple gravidity, young age at first coitus and cervical neoplasia.
    Ethiopian medical journal 01/2014; Suppl 1:49-52.
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    ABSTRACT: Caesarean delivery (C/D) can be done in the first or second stage of labor. One fourth of the primary C/D are reported to be performed in the second stage of the labor but are more complicated compared to the ones performed in the first stage.
    Ethiopian medical journal 01/2014; 52(1):1-8.
  • Ethiopian medical journal 01/2014; 52(1):2p preceding 1.
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    ABSTRACT: Epidemic dropsy results from the consumption of edible oils adulterated with argemone mexicana oil. In a 2008 epidemic in Addis Ababa five patients died and in one of these a partial autopsy has been performed. The clinical impression of acute respiratory distress syndrome has been confirmed by the demonstration of massive diffuse alveolar damage. These features are consistent with findings reported in similar epidemics.
    Ethiopian medical journal 10/2013; Suppl 2:33-7.
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    ABSTRACT: Worldwide, for every woman that dies of maternal causes, there are at least 20 more women who suffer from infection, disabilities and injuries relating to pregnancy and childbirth. To determine the magnitude and the role of socio-economic, demographic and reproductive factors on the occurrence of maternal morbidity in the study population. During the months of January to February 2012, a community based cross sectional survey was conducted to assess magnitude and factors affecting maternal morbidity in selected kebeles of Wukro and Butajira districts, Tigray and Southern Nation Nationalities and People's (SNNP) regions respectively, Ethiopia. A total of 4949 women who had deliveries in the two years preceding the survey were included. Following description of variables under the study, bivariate and Multivariable statistics were used to see the relationship between different factors and maternal morbidity. A total of 688 (14.2%) women reported that they had at least one form of morbidity. The three most frequent reported maternal morbidity during antenatal period were severe headache 89 (17.2%), lower abdominal pain (15.1%) and excessive vomiting (11.4%). Of the 220 women who reported to have morbidity during labor and delivery, prolonged labor (more than 24 hours) was accounted for 89 (40.5%) followed by hemorrhage and premature rapture of membranes in 74 (33.6%) and 23 (10.5%) of the cases respectively. Lower proportion of maternal morbidity was reported in Wukro than Butajira district [AOR (95% CI) = 0.17 (0.12, 0.25)]. Poorest and poor women were more likely to report to be sick [AOR (95% CI) = 1.79 (1.10, 2.91)] and [AOR (95% CI) = 1.65 (1.10, 2.47)] respectively. Women with parity of 5-6 and > or = 7 children respectively were also more likely to be morbid [AOR (95% CI) = 1.52 (1.11, 2.09)] and [AOR (95% CI) = 2.01 (1.38, 2.91)]. Women who had facility delivery were found more likely to have reported maternal morbidity with [AOR (95% CI) = 3.73 (2.96, 4.71)] High parity, wealth status and facility delivery were found to be independent predictors of maternal morbidity. Empowering women through improving their resource generation capacity, and access to family planning services to those with high parity would diminish the likelihood of having maternal morbidity.
    Ethiopian medical journal 10/2013; 51(4):239-48.

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