IntroductionThe neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU) of University of Gondar Hospital.Materials and methodsA retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.ResultsA total of 769 neonates was included in the study. There were 448 (58.3%) male neonates, and 398 (51.8%) neonates were rural residents. More than two-thirds of the 587 deliveries (76.3%) were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%), sepsis 522 (67.9%), prematurity 250 (34.9%), polycythemia 242 (31.5%), hypoglycemia 142 (18.5), meconium aspiration syndrome 113 (14.7%), and perinatal asphyxia 96 (12.5%). The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9) of which 69 (62.7%) deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64), instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31), and early onset neonatal sepsis (AOR: 2.66; 95% CI: 1.62–6.11).ConclusionHypothermia, sepsis, and prematurity were the main reasons for NICU admission. Neonates often died within the first 24 hours of age. Implementing a better referral link and timely intervention could decrease neonatal mortality and morbidities in Gondar, Ethiopia.
ObjectiveTo assess the prevalence of diabetes mellitus (DM) and associated factors among HIV-infected adults in northwest Ethiopia.DesignHospital-based cross-sectional study.SettingHIV clinic of the University of Gondar Hospital, Ethiopia.ParticipantsAll HIV-infected adults who visited the HIV clinic from December 2013 to the end of February 2014 were the source population.MeasuresA structured and pretested questionnaire incorporating the WHO STEPwise approach was used. A multivariate logistic regression analysis was applied to assess factors associated with DM.ResultsThe overall prevalence of type 2 DM was 8% (95% CI 5.5% to 10.5%). The prevalence of DM was higher (13.2%; 95% CI 8.0% to 18.3%) among subjects receiving pre-antiretroviral treatment (pre-ART) than among those taking ART (5.1%; 95% CI 2.6% to 7.6%). Thirteen (35.1%) of the DM cases were newly identified during the study. Obesity (adjusted OR (AOR) 6.55; 1.20 to 35.8), hypertension (AOR 3.45; 1.50 to 7.90), being in the pre-ART group (AOR 4.47; 1.80 to 11.08), hypertriglyceridaemia (AOR 2.24; 1.02 to 49.5) and tertiary-level education (AOR 11.8; 2.28 to 61.4) were associated with DM.ConclusionsOverall DM prevalence was high, particularly among subjects in the pre-ART group. More educated, hypertensive and obese HIV-infected adults were more likely to have DM as a comorbidity. Health policy and the clinical management of HIV-infected individuals should take into account the rising DM.
BackgroundAccording to a report on the worldwide trends in blood pressure from 1975 to 2015, mean blood pressure is increasing in low and middle income countries while it is either decreasing or stabilizing in high income countries. Few studies have been published on the prevalence of hypertension in Ethiopia demonstrating an increased trend; however, these studies had small sample size and were limited to participants older than 35 years; which left the burden among adolescents and young adults unaddressed. The aim of this study was to assess prevalence of hypertension (HTN) and associated factors in Gondar city.MethodA population based cross-sectional study was conducted among 3227 individuals in Gondar city. A multistage cluster random sampling was used. The Kish method from World Health Organization (WHO) STEPS instrument of random sampling method was used for selecting one individual older than or equal to 18 years from each household. WHO and International Diabetic Association (IDA) criterion was used to classify HTN.ResultThe overall prevalence of HTN was 27. 4% [95% CI: (25. 8–28.9)]. The prevalence for participants in the age group of ≥35 years was 36. 1%. It consistently increased from 9.5% in the age group of 18–25 years to 46.3% in the age group of ≥65 years (P-value < 0. 001). Only 47% of the participants had ever had any kind of blood pressure measurement. Being elderly (AOR = 5. 56; 95% CI: 3. 71–8. 35), obese (AOR =2. 62; 95%CI: 1. 70–4. 03), widowed (AOR = 1. 87; 95%CI: 1. 27–2. 75), separated (AOR = 1. 87; 95%CI: 1. 27–2. 75), daily alcohol user (AOR = 1. 51; 95%CI: 1. 02–2. 23), male gender (AOR = 1. 42; 95%CI: 1. 18–1. 72) and born in urban area (AOR = 1. 31; 95%CI: 1. 10–1. 56) were found to be independently associated with HTN.ConclusionThere is a high prevalence of hypertension in Gondar city and is showing increasing trend compared to previous reports. Interventions to raise awareness and to improve both capacity and accessibility of facilities for screening hypertension are highly recommended.
IntroductionThere are few studies on the hematologic parameters of HIV-infected individuals in Ethiopia; of these, almost all studies researched adults. Our current study is unique in that it mainly focused on the pediatric population and compared both pre- and post-antiretroviral therapy (ART) children. Inference from this study can be used for other developing countries where the burden of HIV disease is high.ObjectiveThe aim of this study was to identify hematologic abnormalities in HIV-infected children before and after initiation of ART.MethodologyA cross-sectional study was conducted on HIV-infected children from June 1 to August 30, 2015. Data were collected using a pretested and structured questionnaire. Statistical analysis was performed using SPSS 20 version.ResultsThe median age of study subjects was 10 years with an interquartile range (IQR) of (6, 12). Two-thirds (74.3%) of study subjects received ART for >1 year. The median of CD4 count before ART was 490 cells/mm3 with an IQR of (286, 765); this increased to 663 cells mm3 with an IQR of (499, 908) after ART. Likewise, the median of hemoglobin before ART was 11.5 mg/dL with an IQR of (9.9, 13), which increased after ART to 13 mg/dL with an IQR of (11.8, 14). The prevalence of anemia was 42.8% before and 18.9% after ART initiation. The median of absolute neutrophil count before ART was 3×103 with an IQR of (2.1, 4.6) and after ART, it became 3×103 with IQR of (1.9, 4.2). Age <5 years (adjusted odds ratio [AOR]: 2.76; 95% CI: 1.5, 5.0), an advanced stage of AIDS (AOR: 2.8; 95% CI: 1.4, 5.6) and CD4% <25% (AOR: 2.4; 95% CI: 1.2, 4.9) were significantly associated with anemia before ART initiation, while opportunistic infections were associated with anemia after initiation of ART (AOR: 2.3; 95% CI: 1.08, 4.8).ConclusionART positively or negatively affects the hematologic profile of HIV-infected children. The current study demonstrated a significant reduction of anemia after initiation of ART.
Background Pneumonia causes about two million under-five deaths each year, accounting for nearly one in five child deaths globally. Knowing the determinants of under-five pneumonia is useful for prevention and intervention programs that are aimed to control the disease. Thus, the main aim of this study was to assess the determinants of under-five pneumonia at Gondar University Hospital, Ethiopia. Methods An institution-based unmatched case-control study was carried out from April 1 to April 30, 2015, taking a sample size of 435 study participants (145 cases and 290 controls). The researchers used a systematic random sampling technique for selecting cases and controls. Data were entered and cleaned using Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable analysis was performed, and variables with a p value less than 0.2 were entered into multivariable logistic regression. Determinant factors were identified based on p value less than 0.05 and adjusted odds ratio with 95% confidence interval (AOR with 95% CI). Results An increased odds of pneumonia was associated with children who had diarrhea in the past fifteen days of data collection (AOR = 6.183; 95% CI: 3.482, 10.977), children's mothers who did not hear about how to handle domestic smoking (AOR = 5.814; 95% CI: 2.757, 12.261), and children of mothers who did not follow proper handwashing practice (AOR = 3.469; 95% CI: 1.753, 6.863). Conclusions Being infected with diarrhea, not knowing how to handle domestic smoking, and poor compliance with proper handwashing practice were identified as determinants of pneumonia. Dedicated, coordinated, and integrated intervention needs to be taken to enhance proper handwashing practice by mothers/caregivers, improve the indoor air quality, and prevent diarrheal diseases at the community level.
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