Background: Menstruation is still regarded as something unclean in many parts of Ethiopia. Despite the challenges related to menstrual hygiene management, it has been routinely overlooked in the school setting. The existing evidence on menstrual hygiene management lacks objective measurement approaches. Therefore, the aim of this study was to assess factors affecting menstrual hygiene management practice among school adolescents in Ambo, Western Ethiopia. Methods: An institutional-based mixed-method cross-sectional study was conducted from 1 to 30 March 2018 with 364 high school females. A systematic random sampling and purposive sampling technique were used to select study participants. We used a self-administered questionnaire, observational checklists, and focus group discussion. Data were analyzed using SPSS statistical software and thematic analysis. Multiple logistic regression analyses were done. With 95% CI, P< 0.05 was considered the level of significance. Results: The prevalence of unsafe menstrual hygiene management practice was 53.6%, and it was affected by factors including age of the females [AOR: 0.16 (0.045, 0.57), P=0.005], frequency of discussing menses [AOR: 0.30, 95% CI: 0.13, 0.71, P-value = 0.006], and source of information about menses [AOR: 3.75, 95% CI: 1.75, 8.00) P= 0.001]. Lack of information about how to manage menses safely and lack of sufficient WASH facility were also identified. Conclusion: High prevalence of unsafe menstrual hygiene management in the study area implies that urgent measures are needed from the concerned body. The school environments were not female friendly for managing their menses safely highlighting that the water, sanitation, and hygiene facilities in the schools need urgent solutions.

BackgroundIn recent years, saprophytic bacteria have been emerging as potential human pathogens causing life-threatening infections in patients with malignancies. However, evidence is lacking concerning such bacteria, particularly in sub-Saharan countries. This study was designed to determine the spectrum and drug resistance profile of the rare bacterial pathogens causing bloodstream infections (BSIs) in febrile cancer patients at a referral hospital in Ethiopia.MethodsBetween December 2011 and June 2012, blood samples were collected from 107 patients with cancer in Tikur Anbessa hospital. Culturing was performed using the blood culture bottles and solid media and the microorganisms were identified using the gram staining and APINE identification kits (Biomerieux, France). The disk diffusion method was used for the antimicrobial susceptibility testing.ResultsOverall, 13 (12.2%) rare human pathogens were isolated from 107 adult febrile cancer patients investigated. Aeromonas hydrophilia species (a fermentative gram-negative rod) was the predominant isolate, 30.8% (4/13), followed by Chryseomonas luteola 15.4% (2/13), Sphignomonas poucimobilis 15.4% (2/13), and Pseudomonas fluorescens 15.4% (2/13). Of the nine isolates tested for a nine set of antibiotics, 89% were resistant to amoxicillin-clavulanic acid, ampicillin, and trimethoprim-sulphamethoxazole.ConclusionsThis study revealed the emergence of saprophytic bacteria as potential drug-resistant nosocomial pathogens in Ethiopian patients with cancer. As these pathogens are ubiquitous in the environment, infection prevention actions should be strengthened in the hospital and early diagnosis and treatment with appropriate antibiotics are warranted for those already infected.

Background. The World Health Organization (WHO) recommends mothers worldwide to exclusively breastfeed infants for the child’s first six months to achieve optimal growth, development, and health. Even though appropriate feeding practice is the most cost-effective intervention to reduce child morbidity and mortality, exclusive breastfeeding practices in developing countries are still low. Objective. The objective of the study was to assess exclusive breastfeeding practice and associated factors among mothers in West Shoa zone. Methods. Community-based cross-sectional study design was conducted from May to December 2018 in the West Shoa zone, Ethiopia, among 710 mothers with 6–9-month-old infants. The multistage stage sampling technique was employed. A pretested structured interviewer-administered questionnaire was used to collect the data. Epi Info version 7.1.2.0 was used to enter the data, and we transferred to SPSS version 25 for analysis. The association between factors and the exclusive breastfeeding were analyzed with bivariate and multivariate logistic regression. Result. A total of 710 women were included with a response rate of 97.9%. The prevalence of unintended pregnancy was 38.7%, and only 65.35% of the respondents reported that they have exclusively breastfed for the first six months of their infant’s life. Marital status (AOR 2.467 (1.333–4.564)), ANC visit (AOR 2.562 (1.250–5.252)), pregnancy intentionality (AOR 4.727 (3.217–6.945)), postnatal care clinic attendance (AOR 3.373 (2.293–4.963)), and counseling on exclusive breastfeeding AOR 2.544 (1.239–5.225) were the factors associated with exclusive breastfeeding. Exclusive breastfeeding practice is still low and actions need to be taken like educating the community about the importance of exclusive breastfeeding using every accessible media. Maternal health service centers should provide counseling and education for women about breastfeeding.

PURPOSE Despite the successes achieved in chronic myeloid leukemia (CML) with tyrosine kinase inhibitor (TKI) therapy, resistance remains an obstacle. The most common mechanism of resistance is the acquisition of a point mutation in the BCR-ABL kinase domain. Few studies have reported African patients with CML in regard to such mutations. We here report the types of BCR-ABL mutations in Ethiopian imatinib-resistant patients with CML and their outcome. PATIENTS AND METHODS Patients with CML with a diagnosis of imatinib resistance who were tested for BCR-ABL mutation between 2014 and September 2019 were included. RESULTS A total of 962 cases of CML on imatinib therapy were reviewed and 164 cases of failure were found. Of these, only 31 cases (19%) had mutation analysis performed. Most cases (94%) were secondary failures. At the time of CML diagnosis, the median age was 33 years and the majority presented with features of advanced-phase disease. Of the 31 patients, 22 mutations were found (65%). The types of mutations detected were as follows: non–P-loop mutations 36% (11), P-loop mutations 13% (four), and alternatively spliced BCR-ABL variants 23% (seven). The splice variant frequently detected was BCR-ABL35INS (20%). Twenty-six of the 31 patients (84%) were switched to second-line TKIs, whereas in four patients (13%), imatinib dose escalation was done. Overall, the outcome revealed that 16 patients (52%) were alive with complete hematologic response, whereas 12 patients (39%) had died. All patients who expressed BCR-ABL135INS were treated with second-line TKIs, and two of them (33%) had died because of disease progression. CONCLUSION In Ethiopia, CML affects the young and point mutations were frequently detected in imatinib-resistant patients. BCR-ABL1 35INS was also prevalent and associated with disease progression.

PURPOSE In developing countries, Hodgkin lymphoma (HL) affects the young population. In Ethiopia, nearly 70% of the population are < 35 years of age. Therefore, this study aimed to elucidate the age distribution, histopathologic patterns, clinical characteristics and treatment outcomes of HL in Ethiopia. MATERIALS AND METHODS Data from clinical records of 133 consecutive patients with HL between 2014 and 2019 were reviewed and collected. Formalin-fixed paraffin-embedded tissue blocks of HL cases were collected and used for subtype classification. RESULTS A total of 68.4% (91) of the patients were male; male-to-female ratio was 2.2:1. The median age was 22 years. The age distribution was 57.1% (76), 30.8% (41), and 2.3% (3) for the age groups (10-29), (30-59), and (60-69) years, respectively. Thirteen percent (12) were associated with HIV. The majority of the cases, 50.4% (67), were of the mixed-cellularity (MCCHL) subtypes and 30% (40) nodular-sclerosis (NSCCHL). Most HIV-associated cases (60%, 6) were of the MCHL subtype. The 4-year overall survival (OS) was 83.1%. The 4-year OS of early-stage patients was 100% and advanced-stage patients with low-risk (International Prognostic Score [IPS] ≤ 2) and high-risk (IPS ≥ 3) were 94.1% and 62.9%, respectively. All patients who received combined-therapy survived, whereas those who received doxorubicin, bleomycin, vinblastine, and dacarbazine only showed a 4-year OS rate of 77.9%. CONCLUSION HL affects the youngest and most productive population in Ethiopia. The treatment outcome is favorable in both HIV-associated and non–HIV-associated HL. However, the study population was likely a highly selected group as the majority of the Ethiopian population do not have access to specialized care.