Background : Tuberculosis is a common and often deadly infectious disease caused by various strains of mycobacterium, usually mycobacterium tuberculosis in humans. Tuberculosis has long been major cause of morbidity and mortality particularly where the diagnostic and control program is not far extended. Objective : - To compare the treatment outcomes and to describe the social demographic factors associated with Tuberculosis patient in private clinic with governmental health centre in Jimma city, Ethiopia from September 12, 2007 to September 10, 2017. Methods and Materials : - A ten years retrospective systemic record review was conducted to compare the treatment outcomes and to describe the social demographic factors associated with Tuberculosis patient in private clinic with governmental health centre in Jimma city, Ethiopia from September 12, 2007 to September 10, 2017. Data was collected by using questionnaire formats. Since all serial numbers of the patients were used no sampling technique was needed. Finally data was analyzed by SPSS/EPI INFO. Result : The present study revealed that within ten years duration private clinic gives anti-TB treatment coverage for 582 patients whereas governmental clinic gives for 510 patients. The treatment success rate of the private clinic is 98.1% which is 1.03 fold than the governmental health center (95.3%). Governmental health center defaulting rate was triple fold of the private clinic 4.1% and 1.2% receptively, while the treatment failure of private clinic was 0.2%, but no treatment failure in governmental health center. Conclusion and Recommendation -Age, educational level and the types of TB diagnosis and treatment outcome of the patients were statistically associated in both sectors. Better counseling and awareness about the disease should have to be given for every anti-TB treatment receiving patients despite of their educational level and occupational status in both sectors. Keywords: Tuberculosis, Treatment outcome, Comparing, Governmental health center, Private clinic

Background Louse-borne relapsing fever (LBRF) remains a cause of sporadic illness and occasional outbreaks in Ethiopia and other east African countries in overcrowded and unhygienic settings. In this article, we present clinical profiles and treatment outcome of patients treated as confirmed or probable cases of LBRF at Jimma Medical Center (JMC) in southwest Ethiopia. Methods Patients treated as confirmed or probable cases of LBRF at JMC during a period of May–July 2022 were prospectively followed during their course of hospital stay. All patients were evaluated with blood film for hemoparasites, complete blood count, and liver enzymes on hospital presentation. They were followed with daily clinical evaluation during their hospital stay. Result Thirty-six patients were treated as cases of LBRF. All patients except one were from Jimma Main Prison in Jimma Town, Ethiopia. All the patients were male with mean age of 28.7 years (SD = 12.7). The diagnosis of LBRF was confirmed by detection of B. recurrentis in blood film of 14 (38.9%) of the patients; the rest were treated as presumptive case of LBRF. Fever, reported by all patients, and an acute onset epistaxis, 30 (83.3%), were the major reasons for healthcare visits. Twenty-two (61.1%) patients were having thrombocytopenia with a platelet count < 150,000/μL; nine (25%) of which had severe forms (<50,000/μL). All patients were treated with oral doxycycline and discharged with improvement after a mean length of hospital stay of 4.25 days (SD = 0.77), range 2–6 days. Public health emergency was activated within two days of the first cases and helped in delousing all the cases and their contacts. Conclusion LBRF remains a public health problem in Ethiopia in settings with poor personal hygiene. Patients with LBRF may present with severe thrombocytopenia and life-threatening bleeding. Early detection and treatment initiation prevents outbreak propagation and improves treatment outcome.

Background Evidence based medicine (EBM) is a newly emerged philosophy of medical education and health care service which brings quality of health service, efficient use of materials, and patient satisfaction. Objective To investigate the effectiveness of clinical integrated short course training of EBM for post-graduation medical specialty students in Ethiopia, 2022. Method Randomized, single blind, superiority trial, and multi-centric experimental study design employed. The eligible candidates randomly assigned to the interventional group and the control group (waitlisted). The allocation of the participant concealed from the principal investigator and participant. Sample size was determined with a two-sided test and α level of 5% and 80% power with the total of 52 calculated sample size and 44 (21 for intervention and 23 for control group) students were used for final analysis. Mann Whitney U test and Independent Sample T test used to test mean difference between intervention and control group after checking normality distributions to estimates the amount by which the training changes the outcome on average compared with the control. The result of the final model expressed in terms of adjusted mean difference and 95% CI; statistical significance declared if the P-value is less than 0.05. Results Among 44 postgraduate students, only 29.5% practices EBM during delivering of clinical services. Overall EBM knowledge was changed with adjusted mean difference (Mean±SD 17.55 (13.9, 21.3), p<000). This training provided significant change in all main domain of EBM, more in validity evaluation of the study (Mean±SD, 3.8(1.3, 6.2), p<0.0018) and impact of study design (Mean±SD, 3.8(2.6, 5.1), p<0.000). There was also significant change of overall attitude with adjusted mean difference (Mean±SD, -8.2(-9.6,-6.7), p = 000). Conclusion Clinical integrated EBM training brought significant change of knowledge and skills of principles and foundations of EBM. Adopting principles of EBM into curricula of postgraduate specialty students would assure the quality of medical care and educations.

Background Cardiovascular diseases (CVD) are the most common causes of mortality and morbidity among diabetic patients. Aspirin is recommended for primary and secondary prevention of cardiovascular events in patients with diabetics who are eligible for therapy based on active international guidelines. However, these active guidelines are underutilized. Hence, this article helps to assess low dose aspirin use and its associated factors in patients with diabetes mellitus on follow-up at the diabetes clinic of Jimma Medical Center (JMC). Method A cross-sectional study was conducted among 388 diabetic patients on follow-up at the diabetic clinic of JMC during October 1, 2020 to November 15, 2020. The collected data were cleaned and entered into EpiData version 4.6 then exported to STATA version 16.0 for analysis. Descriptive statistics and multivariable logistic regression was employed to identify the relationship between dependent and independent variables with declaring statistical significance if P value is less than 0.05. Result Out of the total 388 diabetic patients interviewed, Most of the patients were in the age group of 50-54 (35.8%) with the mean age of 48.8 [48.2, 51.4] years old. About half (48.7%) of them had a history of hypertension. Nearly double of the study participants (47.2%) were utilizing a low dose aspirin. Aspirin was indicated for 80 (20.6%) of the patients despite 21 (26.2%) of them were not using it. It was both indicated and prescribed in 59 (15.2%) of the cases. Older age, longer duration of DM, dyslipidemia, and hypertension were associated with more likely utilization of low dose aspirin. Conclusion About half of the DM patients were utilizing low dose aspirin, while only one fifth of them were having indications to do so. Furthermore, one fourth of the patients were not taking low dose aspirin for the prevention of cardiovascular events despite they were supposed to use it. Therefore, these findings suggest a greater need for physicians to carefully assess the indications to prescribe aspirin with a clear explanation of the it’s advantages in these specific patient population. Ultimately, future studies should examine the influence of updating guidelines on clinician behaviors to avoid irrational use of aspirin and the association of changing trends in preventive aspirin use with the development of CVD in patients with DM.

Background Tuberculosis (TB) is a common and often deadly infectious disease caused by various strains of mycobacterium, usually mycobacterium tuberculosis in humans. The disease has major causes of morbidity and mortality, particularly where the diagnostic and control program is not far extended. Objective To compare the treatment outcomes of tuberculosis patients in a private clinic with a governmental health center in Jimma city, Ethiopia. Methods A 10-year cross-sectional retrospective systemic record review was conducted to compare the treatment outcomes, and to describe the socio-demographic factors associated with the outcome in a private clinic with a governmental health center in Jimma city, Jimma, Ethiopia from September 12, 2007, to September 10, 2017. Finally, SPSS/EPI INFO analyzed data. Results The present study revealed that within a 10 year duration the private clinic gives anti-TB treatment coverage for 582 patients whereas the governmental health center treats 510 patients. The treatment success rate of the private clinic is 98.1% which is 1.03-fold that of the governmental health center (95.3%); while the treatment failure of the private clinic was 0.2%, but there was no treatment failure in the governmental health center. Conclusion Both sectors achieved the expected WHO targets by newly recommended strategy for TB treatment, DOTS (Directly Observed Treatment Short Course) and treatment success is much better to standard. This shows good progress of DOTS strategy and a decrease of noncompliance in this area. Age, educational level, and the types of TB diagnosis and treatment outcome of the patients were statistically associated in both sectors. Better counseling and awareness about the disease should have to be given for every anti-TB treatment receiving patients, despite their educational level and occupational status in both sectors.