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Verification and Comparison of Sysmex KX-21N, Cell-Dyn 1800 and Horiba ABX Micros ES 60 Automated Hematology Analyzers at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia
No full textBackground: Laboratory testing plays a crucial role in the detection, diagnosis and treatment of
disease in patients. Analytical evaluation of a new analyzer or method should be done in order to
confirm the declared specifications before its introduction into the routine use. Agreement of all
automated hematology analyzers must be carried out in all laboratories. But, the practice of using
automated analyzers interchangeably without evaluation is common in our country including
Tikur Anbessa specialized hospital (TASH).
Objective: To verify performance and compare agreement of Cell-Dyn 1800, Sysmex KX-21N
and Horiba ABX micros ES 60 hematology analyzers found in TASH.
Methods: A cross sectional study was conducted to verify performance and assess agreement
between Cell-Dyn 1800, Sysmex KX-21N and Horiba ABX micros ES 60 hematology analyzers
at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. The study period was from
February to May 2017. According to the CLSI guideline a total of 267 samples were analyzed in
duplicates on the three analyzers to verify and compare them. Data cleaning and analysis were
performed by Microsoft excel 2007 and SPSS version 20.
Result: We found that minimal carryover (< 0.5%) and excellent linearity for white blood cell,
hemoglobin, red blood cell and platelet (r > 0.999). Precision was good for all major CBC
parameters with % CV< 2.0. Agreement between most of the parameters of the analyzers lies in
the limits of agreement for more than 95% of cases according to the Bland-Altman plot analysis.
Pearson correlation and linear regression graph showed that the three analyzers were well
correlated (r > 0.900) for major CBC parameters. The correlation of WBC differentialneutrophil and lymphocyte were excellent (r > 0.920). Poor correlation was observed in mixed
cells (r=0.005) especially in the high levels between Horiba and Sysmex. There was also
moderate correlation in mean platelet volume (MPV) between analyzers of Horiba and Sysmex
(r= 0.593 and r=0.572) at normal and high levels respectively.
Conclusion: The overall performance of the three analyzers is excellent. They agree well with
each other and can be used interchangeably with care in mixed cells and MPV
Assesment of Magnitude and Associated Factors of Neonatal Hyperbilirubinemia at Neonatal Intensive Care Unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2017
No full textBackground: Neonatal hyperbilirbinemia (NH) is a recognized cause of brain damage and
bilirubin encephalopathy resulting in long-term sequel like sensory-neuronal hearing loss in the
survivors and death.
Objective: To assess magnitude and associated factors of NH among neonates admitted at
neonatal NICU from September 11/2014 to September 11/2016 in TASH.
Methodology: Retrospective cross sectional study was conducted on neonates admitted at NICU
of TASH and 356 neonates were systematically selected among all admitted neonates. Study was
conducted from January 2017 to June 2017. Supervisors and data collectors were BSc health
professionals. Pre-test was conducted on 5% of sample before the starting of actual data
collection. Checklist was adopted and modified from literatures to collect data. Supervisors were
checked the collected data daily for completeness. Data was first entered to Epi Info version 7
and exported to SPSS version 20.0 to clean and analyze data. Relation between dependent and
independent variables were assessed and presented using odd ratios and confidence intervals.
Statistical association was considered as significant if p-value was less than 0.05. Ethical
clearance for the study was received from Addis Ababa University, College of Health Sciences.
A formal letter was written to TASH and permission was secured at all levels.
Result: Medical record of 356 neonates were reviewed and 160(44.9%) of them developed NH.
89(25%) of males and 71(19.9%) of females were developed neonatal hyperbilirubinemia. Their
serum bilirubin level was from 5.6mg/dl to 77.7mg/dl. Among associated factors of NH: ABO
incompatibility 57(35.6%), sepsis 30(18.8%), idiopathic cause 22(13.8%), breast feeding
jaundice 16(10%) and Rh isoimmunization 14(8.8%). Age of neonates was significantly
associated with neonatal hyperbilirubinemia in logistic regression.
Conclusion and Recommendation: Magnitude of neonatal hyperbilirubinemia in this study was
near to half of selected neonates. Among identified associated factors of NH, ABO
incompatibility and sepsis were the leading cause. So, early prevention and timely treatment of
NH is important since it was a cause of long term complication and death in neonates
Schistosoma Mansoni Infection and Response Rate for Praziquantel in Pre-School Aged Children Attending ERER Health Center Somali Regional State, Eastern Ethiopia
No full textBackground: Intestinal schistosomiasis is one of the most widespread parasitic infections in
tropical and subtropical countries. In sub-Saharan Africa, the recommended strategy to control
schistosomiasis is preventive chemotherapy. Though World Health Organization (WHO)
recommends praziquantel for the control and treatment of schistosomiasis, Pre-school aged children
(PSAC) are excluded from population treatment programs mainly due to paucity of data on
response rate.
Objective: The aim of this study is to assess the magnitude of Schistosoma mansoni infection and
response rate to praziquantel treatment in pre-school aged children (≤ 5 years of age).
Methods: Facility based prospective study was conducted between April to June 2016 at Erer
Health Center, Eastern Ethiopia. Stool sample was collected and examined with double Kato-Katz
for two consecutive days from children attending the health center and repeated after four weeks of
post-treatment from those who had been infected with S. mansoni. Response rate of praziquentel
was assessed after treatment with praziquantel at a single dose of 40mg/kg given by health
professionals at health center. Interview was used to assess socio demographic background and
clinical data. Data analysis was performed using SPSS version 20. Bivariate and multivariate
analysis was performed to test statistical association of dependent and independent variables.
Results: The prevalence of S. mansoni among PSAC was 25%. The result showed a 96.4% cure
rate and 99.4% egg reduction rate four weeks post treatment resulting in good response rate. Age of
children and frequency of taking children to the river was significantly associated with S. mansoni
infection. The more often children were taken to river during fetching water also associated to S.
mansoni infection with (AOR=3.86).
Conclusion: This study reveals that treatment of S. mansoni infection with praziquantel shows good
response in pre-school children. Thus, it is recommended that FMOH should include pre-school
children in S. mansoni endemic areas in mass de-worming campaign through administering
praziquantel
Assesment of Patterns and Outcomes of Chest Injury among Adult Patients Received Trauma Care at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethhiopia
No full textIntroduction: Globally, injury continues to be an important cause of morbidity and mortality both in the developed and developing countries. It is the major public health problem in every country across the world and causing approximately 5.8 million deaths per year. The Chest trauma is a disease that has worsened long with growing urbanization and industrialization; due to worldwide increases in violence, constructions and vehicle number.
Objective: The objective of this study was to assess the patterns and outcomes of chest injuries among adult patients admitted with chest trauma in Tikur Anbessa specialized teaching hospital (TASTH) over one year period between January 1, 2016 to December 31, 2016.
Methods and Materials: Hospital based retrospective descriptive cross- sectional study designs were used to assess magnitude and outcomes of chest injury among patients admitted to TASTH. The collected data were to Epi data software version 3.3.1. Then, the entered data was exported to SPSS, version 21 for analyses. Descriptive statistics was used to present the results. Logistic regression was used to determine association between dependent and independent variables. Association between variables was taken as statistically significant for all variables resulted in p-value of <0.05 on multiple logistic regression.
RESULTS: A total of 192 chest injury patients were treated at TASTH. Fifty three of them were died during treatment. Age [AOR 8.9(95% CI, 1.51-53.24)], time of presentation to hospital after injury [AOR 4.6(95% CI, 1.19-18.00)], Length of stay in hospital [AOR 0.12(95% CI, 0.02-0.58)], presence of extra-thoracic associated body region injury [AOR 25(95% CI, 4.18-150.02)] and development of complications [AOR 23(95% CI, 10-550)] were determinant of mortality in the present study.
Conclusions and recommendations: Chest trauma predominantly affects the male and economically productive age group with high morbidity and mortality in this environment. Road traffic accident was the leading cause of chest trauma in this study outcome. The study calls for early recognition and management of complications, awareness creations to society on their health seeking behavior, adequate provision of ambulance service and road traffic accidents prevention to reduce the morbidity and mortality resulting from chest injuries
Knowledge and Practice Assessment of Active Manegement Third Stage of Labor among Obstetric Care Providers at Selected Government Hospitals in Addis Ababa, Ethiopia 2017
No full textBack ground: The third stage of labor is considered to be the most hazardous stage for the
birthing woman due to the risk of profuse hemorrhage. Over 90% of women who die of
postpartum hemorrhage, the most important cause is uterine atony, there is severe lack of
knowledge, skill and practice among attendant at birth needs toward the third stage of labor, as
well as access to required supplies and equipment
Objective: To assess the Knowledge and Practice of Obstetric Care Providers on active
management third stage of labor at selected government hospitals in Addis Ababa, Ethiopia
2017.
Methods: Institution based cross sectional study design was conducted from March to April
2017 among Obstetric Care Providers at selected government hospital in Addis Ababa,
Convenience sampling method were carried out. The questionnaires have closed ended questions
and which covers socio demographic information, knowledge, and practice of obstetric care
providers on active management of third stage of labor. It was in English language and
completeness checked, coded and entered into Epi-Data version 3.1 and analyzed using SPSS
version 22. Confidence interval 95% and P-Value 50%
Result: From the total of 136 participants the response rate was 135(99.3%). 90(66.7%) had
overall good knowledge. qualification of the respondents was significantly associated to
knowledge; interns are 5.5 times more likely knowledgeable than residents. were as Sex is
significantly associated with practice. Females are 2.56 times more likely associated than males
Conclusion: Results from this study showed poor Knowledge and practice of obstetric care
providers towards AMTSOL. Almost half of the respondents had poor knowledge and more than
half are with poor practice. Therefore, extensive training and supervision should be provided to
all obstetric care providers especially those who have done at labor and delivery unit to public
hospita
Designing a Web-Based Eye Bank Information Management System for the Eye Bank of Ethiopia
No full textBackground: Eye donation can be defined as the ultimate humanitarian act of charity. In most case,
many people are not willing to donate their organs after they die. Furthermore, public also do not know
the procedure and the way to register, even willing to donate their eye after death, there is less
advertisement, and awareness about eye donation among the community. Besides that, the interested
people face many problems to register themselves because they are busy with works, and need to get the
application form from only the Eye Bank of Ethiopia.
Objective: the main objective of this project is to design a web-based eye bank information management
system for the Eye Bank of Ethiopia.
Methodology: the project will use object oriented system analysis and design approach and includes data
collection tools such as (interview, observation and relevant document review techniques) to collect
sufficient data needed for the system to be developed. Analysis and design of the proposed system will be
performed using the UML tools.
Tools and Techniques: Word document, Visio diagrams, Edraw Max are some of the tools used to create
this document. UML diagrams are created to describe the scenarios.
Summarization: All the systems processes and its boundary were identified and described by using use
case diagram. Seventeen processes with their corresponding actors were identified for the system. The
flows of the process were presented using activity diagrams sequence diagram. The object models were
described by using class diagram. And finally, the system prototype was developed for the user interface
testing. The results of the user interface testing shows that User test for the system prototype was done
and it shows that 86% of the participants in the evaluation and testing have shown positive attitude and
response for the system usability. In this project, I analyzed the current manual system, design, and try to
implement prototype a Web-based Eye Bank Information Management System to the Eye Bank of
Ethiopia. The prototype can be developed through iterative process along with users‟ feedback. From the
user test for the system prototype it is identified that some parts need to be improved
Recommendation: The federal minster of health might support give guarantee by assigning sufficient
budget and manpower. The Eye Bank of Ethiopia provide sustainable budget for the implementation of
EBIMS and should collaborate with health institutes and also should provide information to the people to
increase the awareness for maximizing number of pledge donors
The investigator recommends future researchers to implement the complete web-based Eye Bank
Information Management System by enriching it with additional functionalities like equipment
registration
Microfacies Analysis and Paleontology of Carbonate Rocks in Shanan Section; South Eastern Ethiopia
No full textShanan section is situated in Southeastern Ethiopian plateau has a thick succession of carbonate
rocks. These studies generally considered the stratigraphy, paleontology, microfacies analysis,
biostratigraphy and determine depositional environments of Shanan section carbonates. Based
on thin section analysis of 40 samples collected the compositional and textural types of
rocks were studied and grouped into six microfacies associations which are characteristic
for lagoon, platform margin, foreshoal and offshore environments. The presences of micritic,
bioclastic wackestone and peloidal grainstone microfacies at lower Shanan indicate lagoon
deposits. The Bioclastic peloidal grainstone and ooilitic grainstone facies present following the
lagoon facies carbonates are indicators of carbonate shoal/barrier deposits of shallow marine
setting .The middle Shanan layers conformably overlies the lower Shanan and consists of the
foreshoal microfacies of thick, allochemical rich wackestone-grainstone limestone’s, mainly
dominated by reworked intraclastic grains. A low energy deposit of offshore environment is
characterized by fine grained dark gray blackish micritic limestones with some cherts present at
upper Shanan section. The overall microfacies and facies successions throughout the unit show
that the environments ranges from lagoon, high energy platform margin carbonate sand bodies,
foreshoal deposits and offshore deposits successively from bottom to top. Based on the presence
of index fossils of Pfenderina cf.salernitana and Kurnubia palastiniensisthe age of this carbonate
rocks determined to be Callovian to Oxfordian time. Paleontological study of Shanan section
shows that the carbonates are rich in macro and microfossils that supply additional data for
stratigraphic and paleoenvironmental interpretations. Eoguttulina polygona, Lenticulina
subalata, Lenticulina quenstedti, Verneuilinoides minuata, Haplophragmoides bartensteini and
Choffatella.sp, are species of foraminifera collected also 5 genera of ostracods such as,
Cytherelloidea.sp., Progonocythere.sp., Procytheridea.sp., Bairdia.sp, and Paracypris.sp are
identified. From macrofossils different species of bivalves, gastropods and brachiopods are also
identified.The carbonate deposits of the section are correlated with some of equivalent deposits
in Southeastern plateau and major regional sedimentary basins ofEthiopia
Physicochemical and Microbial Quality of Drinking Water from Source to Household Taps: The Case of Legedadi Reservoir
No full textIn Ethiopia, only 52% and 28% of the population have access to safe water and sanitation
coverage, respectively; as a result, 60-80% of the population suffers from waterborne and waterrelated diseases. The purpose of this study was to evaluate the physico chemical and microbial
quality of drinking water supplied to Addis Ababa from Legedadi reservoir (source), treatment
and distribution systems(household taps) by examining water quality parameters. A total of seven
sampling sites were chosen along the water course. To characterize the water quality, was
examined using 20 water quality parameters:- water temperature, electrical conductivity,
turbidity, pH, lead (Pb), total suspended solids, total dissolved solids, copper (Cu), total nitrogen,
total phosphorus, free chloride, nitrate-nitrogen, sulfide(S-2), sulfate(SO4-2), dissolved oxygen,
biological oxygen demand, chemical oxygen demand, total coli form, fecal coli form and E-coli.
By using, Gravimetric, Volumetric, flame emission spectrophotometer, AAS, electrometric (pH
value selective electrode) and nephelo metric (turbidity) analyses methods. The output result of
water quality parameters at dry and wet seasons at the source, treatment site and household taps
concentration of total coli-form, E-coli, turbidity, COD, T-N, Pb, were all are above the drinking
water standard limit. All parameters showed increment in concentration from treatment site to
distribution system both in wet and dry season. Therefore, it can be concluded that along
distribution system, the drinking water is prone to contamination and the water quality decline
along distribution system. In terms of microbial result, the drinking water showed fecal source of
contamination which makes it not suitable for drinking water purpose. In addition in Legedadi
reservoir, high level of nutrient and chemical load were recorded; therefore it is recommended
that human and livestock interference to the reservoir should be restricted and upper catchment
agriculture activity should be controlled finally waste disposal and wastes management system of
distribution lines in the city should be properly constructed and well protected from pollution
Suffering Under God’s Wings: Rethinking Genocide as a Social Sin in Rwanda
No full textThe Tutsi genocide in Rwanda recalls another instance in human
history where beliefs and faith in God were tested. It left survivors
struggling with bitterness and longing for revenge. The experience of
unresolved suffering after this genocide is always present in the mind of
ordinary believers and theologians. In this experience of suffering, people
want to know where was God, and why God did not intervene in such
instances as prayers and traditions of Christianity informed them. The
Christian answers to their questions from the Christian tradition,
especially through theodicy, prove inadequate and unhelpful for the
victims and perpetrators to use in their healing processes. Christians are
left without a clue as to what it takes to walk with such a horrific
experience of genocide and be able to continue to believe in God.
Viewing this genocide as a social sin, however, brings the Christian
questions to address human actions and interactions and takes away the
power of sin. It reduces paralyzing shame and guilt since it shows people
how they are compelled by human sinful structures to do evil. The
structures enabled individuals and society to sin by omission and commission. The neighbor became a source of death instead of a
messenger of the love of God.
Christians look at sin within the perspective of God’s infinite mercy.
Sin does not have the final words on human actions. Through personal
and social contrition and conversion accompanied by acts of kindness and
solidarity, the survivors and the perpetrators of this genocide are able to
see new light and hope and can begin to heal. It is within these conditions
that the lens of social sin takes away the power genocide has over the
people, and they can become more aware of how sin obstructed them from
seeing the face of a loving God
Evaluation and Comparison of Serum Lipid Profiles between Newly Diagnosed and Tamoxifen Treated Breast Cancer Female Patients Attending the Oncology Clinic at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia
No full textBackground: Breast cancer is the most common cancer in women worldwide and the second most common cancer overall. It is the leading cause of cancer death in less developed countries including Ethiopia. Dyslipidemia in breast cancer patients has long been considered as the risk factor for cardiovascular diseases. Estrogen induces hyperlipidemia through its multiple effects on lipid metabolism. Tamoxifen used for breast cancer treatment, is essentially anti-estrogenic, however, currently, it has been suggested that its estrogenic activity is mainly responsible for the changes in lipid parameters. Because marked hyperlipidemia is a potent risk factor for life-threatening acute pancreatitis and arteriosclerosis, plasma lipid levels should be tested periodically in breast cancer patients. However, detection of lipid profiles in newly diagnosed and tamoxifen treated breast cancer women have not been investigated yet in our country, Ethiopia.
Objective: Therefore, the aim of this study was to evaluate and compare serum lipid profiles between newly diagnosed and tamoxifen treated breast cancer women attending the oncology clinic at TASH.
Patients and methods: Comparative cross-sectional study design was used to determine fasting serum lipid profiles in newly diagnosed and tamoxifen treated women with breast cancer in the oncology clinic of TASH. Convenience sampling method was applied to recruit study subjects and 52 breast cancer women treated with tamoxifen for three months and above and 51 new medically diagnosed breast cancer women without treatment were included and serum lipid parameters (TG, TC, HDL-C, and LDL-C) were measured.
Result: In breast cancer women receiving tamoxifen, the mean serum TC and LDL-C levels were significantly reduced but TG levels were insignificantly decreased accompanied by the elevation of HDL-C though it was insignificant as compared to those women with no treatment.
Conclusion: lipid profile is significantly improved upon tamoxifen treatment and this confirms that tamoxifen has cardio protective roles in lipid metabolism