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1. Stabilizing time and its predictors among 1–59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study

Author

Wagnew Tesfay, Mebrahtu Abay, Berhane Fseha Teklehaimanot, and Ataklti Gebremedhin

Subjects
Severe acute malnutrition, Stabilizing time, Emergency, Tigray, Ethiopia, Pediatrics, RJ1-570
Abstract

Abstract Background Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting. Methods Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis. Results From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89 g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221–0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568–13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094–3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065–2.071) were identified as significant predictors of stabilizing time. Conclusion All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.

Published
2024
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2. The burden, admission, and outcome of COVID-19 in Africa: protocol for a systematic review and meta-analysis

Author

Degena Bahrey Tadesse, Gebreamlak Gebremedhn Gebremeskel, Guesh Gebreayezgi Asefa, Mebrahtu Abay, and Gebre Teklemariam Demoz

Subjects
Admission, Africa, COVID-19, burden, outcome, Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

ABSTRACTBackground: According to the World Health Organization (WHO), the outbreak of coronavirus disease in 2019 (COVID-19) has been declared as pandemic and public health emergency that infected more than 5 million people worldwide at the time of writing this protocol. Strong evidence for the burden, admission, and outcome of COVID-19 has not been published in Africa. Therefore, this protocol will be served as a guideline to conduct a systematic review and meta-analysis of the burden, admission, and outcome of COVID-19 in Africa. Methods: Published and unpublished studies on the burden, admission, and outcome of COVID-19 in Africa and written in any language will be included. Databases (PubMed / MEDLINE, Google Scholar, Google, EMBASE, Web of Science, Microsoft Academic, WHO COVID-19 database, Cochran Library, Africa Wide Knowledge, and Africa Index Medicus) from December 2019 to May 2020 will be searched. Two independent reviewers will select, screen, extract data, and assess the risk of bias. The proportion will be measured using a random-effects model. Subgroup analysis will be conducted to manage hetrogeinity. The presence of publication bias will be assessed using Egger's test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported per the PRISMA-P guidelines. Conclusion: This systematic review and meta-analysis protocol will be expected to quantify the burden, admission, and outcome of COVID-19 in Africa. Systematic review registration: This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) in March 2020 and accepted with the registration number: CRD42020179321(https://www.crd.york.ac.uk/PROSPERO).

Published
2020
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3. Intention to use long-acting and permanent contraceptive methods and associated factors in health institutions of Aksum Town, North Ethiopia

Author

Hailay Syum, Gizienesh Kahsay, Teklehaymanot Huluf, Berhe Beyene, Hadgu Gerensea, Gebreamlak Gidey, Haftom Desta, Mebrahtu Abay, Haben Nuguse, and Kebede Haile

Subjects
LAPMs, Intention to use, Factors, Axum, Ethiopia, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective In Ethiopia, the majority of married women practice predominantly short-acting contraceptive methods. Therefore this study aims to assess intention to use LAPMs and its determinants among short-acting users in Health Institutions of Aksum Town, North Ethiopia. Results Prevalence of intention to use LAPMs was 52.1% (95% CI 47.4–57.0). Good knowledge on LAPMs [AOR = 2.15; 95% CI (1.29, 3.56)], positive attitude towards LAPMs [AOR = 3.41; 95% CI (1.99, 5.85)], 18–24 years of age [AOR = 3.18; 95% CI (1.30, 7.79)], being primary school in educational level [AOR = 0.34; 95% CI (0.14, 0.78)], decision on the number of children jointly with partner [AOR = 2.05; 95% CI (1.01, 4.18)], having more than two children [AOR = 10.67; 95% CI (1.29, 88.31)], and no [AOR = 10.21; 95% CI (3.10, 33.58)] and one [AOR = 4.70; 95% CI (1.68, 13.13)] extra number of children desired were factors significantly associated with having intention to use LAPMs compared to their counterparts. The intention to use LAPMs was low. Therefore, appropriate information, education and communication strategies must be designed to raise awareness and change the negative attitude of the community on LAPMs.

Published
2019
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4. Diarrheal disease in under-five children among model and non-model families in northern Ethiopia, 2017: a comparative cross-sectional study

Author

Berhe Beyene Gebrezgiabher, Teklehaymanot Huluf Abraha, Desalegn Tetemke, Gebreamlak Gidey, Negasi Asres, Alias Tesfamariam, Zemichael Weldegebrial, Teklit Angesom, and Mebrahtu Abay

Subjects
Diarrhea, Model and non-model families, Ethiopia, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective Diarrheal disease in under-five children among model families is expected to be lower than non-model families. Therefore, this study compared the prevalence and associated factors of diarrheal diseases among under-five children between model and non-model families. A comparative cross-sectional study was conducted from May to June 2017 among 322 children from each model and non-model family. Using multistage sampling technique data were collected through interview and observation. Both bi-variable and multivariable analyses were used to compute the statistical associations. Statistical significances were declared at 95% CI and p value

Published
2019
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5. Unmet need for modern contraception and associated factors among reproductive age group women in Eritrean refugee camps, Tigray, north Ethiopia: a cross-sectional study

Author

Kidane Gebrecherkos, Brhane Gebremariam, Abebaw Gebeyehu, Hailay Siyum, Gizienesh Kahsay, and Mebrahtu Abay

Subjects
Unmet need, Contraceptive use, Reproductive age women, Refugee camp, Tigray, Ethiopia, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective Millions of women want to delay or avoid pregnancy, but they are not using contraception, especially in refugee settings. Due to lack of contraception, one fifth of reproductive age group women suffered from unwanted pregnancy and unsafe abortion, which accounted for 78% of maternal mortality in refugee camps. Therefore, the aim of this study was to assess the prevalence of unmet need for modern contraception and its associated factors among reproductive age group women in Eritrean refugee camps, Tigray, Northern Ethiopia, 2016. Results 400 women of reproductive age group interviewed. Prevalence of unmet need for modern contraception in this study was found to be 41.8% (95% CI 36.99%, 46.63%).Respondents’ unfavorable attitude towards modern contraceptive methods [AOR = 0.372, 95% CI 0.170, 0.818] and the availability of modern contraceptive methods [AOR = 3.501, 95% CI 1.328, 9.231] were factors significantly associated with unmet need for modern contraception. Respondents’ attitude towards modern contraceptive methods and availability of modern contraceptives were independent predictors of unmet need. Governmental and non-governmental organizations should design programs to create behavioral change in women’s attitude towards contraceptive use and to secure the availability of contraceptive methods in refugee camp settings.

Published
2018
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6. Survival status and predictors of mortality among children with severe acute malnutrition admitted to general hospitals of Tigray, North Ethiopia: a retrospective cohort study

Author

Gebremicael Guesh, Getu Degu, Mebrahtu Abay, Berhe Beyene, Ermyas Brhane, and Kalayu Brhane

Subjects
Survival status, Severe acute malnutrition, Mortality, Tigray region, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective Despite the presence standard protocol for management of severe acute malnutrition case-fatality rates in African hospitals remain unacceptably high. The case in Ethiopia is not different from others. Therefore, this study was aimed to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to stabilization centers of general hospitals in Tigray region, northern Ethiopia. A 24 months retrospective longitudinal study was conducted among 569 randomly selected medical records of children admitted to stabilizing centers. Both bi-variable and multivariable Cox regression analysis was conducted to identify predictors of mortality. Association was summarized using AHR, and statistical significances were declared at 95% CI and P-value

Published
2018
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7. Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia.

Author

Wagnew Tesfay, Mebrahtu Abay, Solomon Hintsa, and Tekia Zafu

Subjects
Medicine, Science
Abstract

BackgroundSevere acute malnutrition is defined by MethodsSample size was calculated using STATA version 12.0. A retrospective cohort study was conducted using pretested questionnaire in the public hospitals in Aksum on children aged 0-59 months. Cleaned data was entered to Epi info version 7.1.4 and then exported into SPSS version 21 for analysis. Bivariable and multivariable analyses were performed using Kaplan Meier and Cox regression models. During bivariable analysis, variables with p-value < 0.05 were selected for multivariable analysis to identify independent factors associated with length of stay.ResultsA total of 564 participants enrolled to the study. The rate of recovery was 56% with median length of stay of 15 days (95% CI: 14.1, 15.9). The independent predictors of length of stay to recovery were presence of diarrhea at admission (AHR = 0.573, 95% CI: 0.415-0.793), being HIV positive (AHR = 0.391, 95% CI: 0.194-0.788), palmar pallor (AHR = 0.575, 95% CI: 0.416-0.794), presence of other co-morbidities at admission (AHR = 0.415, 95% CI: 0.302-0.570) and not being treated with plumpy nut (AHR = 0.368, 95% CI: 0.262-0.518).ConclusionsLength of stay is in the acceptable range of the international and national set of standards. Nevertheless, the recovery rate was lower compared to the Sphere standard. Presence of diarrhea, palmar pallor, HIV other co-morbidities and not treated with plumpy nut were found independent protective factors for recovery from sever acute malnutrition.

Published
2020
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8. Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia

Author

Zeray Baraki, Mebrahtu Abay, Lidiya Tsegay, Hadgu Gerensea, Awoke Kebede, and Hafte Teklay

Subjects
Medication administration error, Pediatrics, Inpatient, Tigray, Ethiopia, RJ1-570
Abstract

Abstract Background Medication administration error is a medication error that occurs while administering a medication to a patient. A variety of factors make pediatrics more susceptible to medication errors and its consequences. In low-income countries, like Ethiopia, there is no sufficient evidence regarding medication administration error among pediatrics. The aim of this study is, therefore, to determine the magnitude and factors associated with medication administration error among pediatric population. Methods A prospective observational based cross sectional study design was conducted from January to April 2017. Data collection was done using pre-tested structured questionnaire and blind observation checklist to health professionals in charge of administering selected medications. A total of 1282 medication administrations were obtained using single population proportion formula from patients in the selected public hospitals and the samples were selected using multistage sampling technique. Multivariable logistic regression using odds ratio and 95% confidence interval was used to determine the relationship between the independent and dependent variables. Variables with p-value

Published
2018
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9. Breast self-examination practice and associated factors among women aged 20–70 years attending public health institutions of Adwa town, North Ethiopia

Author

Mebrahtu Abay, Gemechis Tuke, Eleni Zewdie, Teklehaymanot Huluf Abraha, Teklit Grum, and Ermyas Brhane

Subjects
Breast self-examination, Practice, Women, 20–70 years, Adwa, Ethiopia, Medicine, Biology (General), QH301-705.5, Science (General), Q1-390
Abstract

Abstract Objective Breast cancer is the leading cause of cancer mortality worldwide. The incidence of breast has been increasing in most regions of the world. Regular breast self-examination is one of the most cost-effective methods for early detection of breast cancer in asymptomatic women. Despite this fact, breast self-examination practice remains low in Ethiopia. Therefore, the aim of this study is to assess breast self-examination practice and associated factors among women aged 20–70 years attending public health institutions of Adwa town, North Ethiopia. Results From the total study participants, only 26 (6.5%) of them had ever practice breast self-examination, and only 25 (6.25%) of them practice breast self-examination regularly. Being a government employee (AOR = 0.22, 95% CI = 0.071–0.683), having good perceived confidence to do breast self-examination (AOR = 5.32, 95% CI = 1.89–14.95) and having perceived good susceptibility to develop breast cancer (AOR = 3.79, 95% CI = 1.74–9.74) were the factors significantly associated with breast self-examination. Breast self-examination practice among the study participants was low. Therefore, informing every woman is susceptible to breast cancer, improving the confidence of women is recommended to increase breast self-examination practice.

Published
2018
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10. Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia

Author

Mekdemariam Getachew, Mebrahtu Abay, Hiwet Zelalem, Tirhas Gebremedhin, Teklit Grum, and Alemayehu Bayray

Subjects
Adherence, Iron-folic acid supplementation, Anemia, Pregnant women, Eritrean refugee camps, Ethiopia, Gynecology and obstetrics, RG1-991
Abstract

Abstract Background Globally, anemia is a public health problem affecting the life of more than two billion people. Pregnant women are at high risk of iron deficiency anemia due to increased nutrient requirement during pregnancy. Iron-folic acid supplementation is the main strategy for prevention and control of iron deficiency anemia and its effectiveness depends on adherence to Iron-Folic Acid tablets. In the refugee camps of Ethiopia, despite the efforts made to reduce iron deficiency anemia during pregnancy, information about adherence to iron-folic acid supplementation and its associated factors are lacking. The objective of this study was to assess magnitude and factors associated with adherence to iron-folic acid supplementation, among pregnant women, in Shire refugee camps. Methods Institution based cross-sectional study with mixed design (quantitative and qualitative) was carried out among pregnant women in Shire refugee camps from September to November 2015. For quantitative data, a sample of 320 pregnant women was systematically selected and data were collected via interview administered structured questionnaire. Quantitative data were coded and entered into Epi-info version 3.5.1 and exported into a statistical package for social sciences (SPSS) Version 19.0 software for analysis. Bivariable and multivariable logistic regressions were employed to identify the predictors at p-value

Published
2018
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11. Prevalence and factors associated with intestinal parasites among food handlers of food and drinking establishments in Aksum Town, Northern Ethiopia

Author

Dejen Gezehegn, Mebrahtu Abay, Desalegn Tetemke, Hiwet Zelalem, Hafte Teklay, Zeray Baraki, and Girmay Medhin

Subjects
Intestinal parasites, Prevalence, Food handlers, Food and drinking establishments, Aksum, Ethiopia, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Various epidemiological studies indicate that the prevalence of intestinal parasites is high in developing countries and those parasites are major public health importance in Sub-Saharan Africa. Their distribution is mainly associated with poor personal hygiene, environmental sanitation and lack of access to clean water. This study was conducted to estimate the prevalence of intestinal parasitic infection and identify factors associated with intestinal parasitic infection among food handlers in the Aksum Town of Tigray Regional State, North Ethiopia. Methods A cross-sectional study design was used among 400 randomly selected food handlers who were selected as respondents. Data were collected by face to face interviewer administered questionnaire supplemented with observational checklist. Fresh stool samples were collected from respondents and were examined microscopically for the presence of any of intestinal parasites using standard laboratory methods. Multivariable logistic regression model using Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) was fitted to analyze the independent predictors of intestinal parasitic infections. Result The mean age of the food handlers included in this study was 26.0 years. Of the total respondents, 72.5% were females, 63% have completed at least secondary school educational level. Five species of Intestinal Parasites (IPs) were identified. The overall prevalence of being infected with at least one intestinal parasite was 14.5%, 95% CI (11.3, 18.0). The odds of being positive for at least one intestinal parasitic infection was 12.3 times higher among food handlers who practice medical checkup every 9 months compared to those who have a medical checkup every 3 months. The odds of being positive for intestinal parasitic infection was 3 times higher among food handlers with no formal education compared to those who have a level of education secondary school and above. Food handlers who received food hygiene and safety training were 66% less likely to be positive for at least one intestinal parasitic infection as compared to those who did not receive training. Conclusion Prevalence of parasitic infection among food handlers observed in the current study is relatively low but is still a public health importance. Number of medical checkup, training in food hygiene and safety, feedback from customers and level of education were significantly associated with reduced odds of being infected with parasitic infection. Hence, these factors should be focused by policy makers and implementers to further bring the prevalence below the level of public health importance.

Published
2017
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12. Determinants of pre-eclampsia/Eclampsia among women attending delivery Services in Selected Public Hospitals of Addis Ababa, Ethiopia: a case control study

Author

Teklit Grum, Abiy Seifu, Mebrahtu Abay, Teklit Angesom, and Lidiya Tsegay

Subjects
Determinants, Pre-eclampsia/Eclampsia, Women, Ethiopia, Gynecology and obstetrics, RG1-991
Abstract

Abstract Background Pre-eclampsia is a pregnancy-specific hypertensive disorder usually occurs after 20 weeks of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In Ethiopia, the major direct obstetric complications including pre-eclampsia/eclampsia account for 85% of the maternal deaths. Unlike deaths due to other direct causes, pre-eclampsia/ eclampsia related deaths appear to be increasing and linked to multiple factors, making prevention of the disease a continuous challenge. The aim of this study is to assess determinants of pre-eclampsia/eclampsiaamong women attending delivery services in selected public hospitals in Addis Ababa, Ethiopia. Methods Hospital based unmatched case control study design was employed. The study wasconducted in Addis Ababa among women attending delivery services in two public hospitals from December, 2015 G.C. to February, 2016 G.C. with sample size of 291 (97 cases and 194 controls). Women with pre-eclampsia/eclampsia were cases and women who had not diagnosed for pre-eclampsia/eclampsia were controls. Case-control incidence density sampling followed by interviewer administered was conducted using pretested questionnaire. The data was entered in Epi Info 7 software and exported to STATA 14 for cleaning and analysis. Descriptive statistics were used todisplay the data using tables compared between cases and controls. To compare categorical variables between cases and controls Chi-squared testwas used. Both bivariable and multivariable logistic regression analyses were computed to identify the determinants of pre-eclampsia/eclampsia. Results Factors that were found to have statistically significant association with pre-eclampsia or eclampsia were primigravida (AOR: 2.68, 95% CI: 1.38, 5.22), history of preeclampsia on prior pregnancy (AOR: 4.28, 95% CI: 1.61, 11.43), multiple pregnancy (AOR: 8.22, 95% CI: 2.97, 22.78), receiving nutritional counseling during pregnancy (AOR: 0.22, 95% CI: 0.1, 0.48) and drinking alcohol during pregnancy (AOR: 3.97, 95% CI: 1.8, 8.75). Conclusions The study identified protective and risk factors for pre-eclampsia/eclampsia. To promptly diagnose and treat pre-eclampsia, health workers should give special attention to women with primigravida and multiple pregnancy. Besides, health care providers should provide nutritional counseling during ANC, including avoiding drinking alcohol during their pregnancy.

Published
2017
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13. Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study

Author

Berhe Beyene Gebrezgiabher, Teklehaymanot Huluf Abraha, Etsay Hailu, Hailay Siyum, Getachew Mebrahtu, Berihu Gidey, Mebrahtu Abay, Solomon Hintsa, and Teklit Angesom

Subjects
Psychiatry, RC435-571, Psychology, BF1-990
Abstract

Background. Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods. An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results. Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion. Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations.

Published
2019
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14. Assessment of community led total sanitation and hygiene approach on improvement of latrine utilization in Laelay Maichew District, North Ethiopia. A comparative cross-sectional study.

Author

Brhane Gebremariam, Gebremedhin Hagos, and Mebrahtu Abay

Subjects
Medicine, Science
Abstract

BACKGROUND:Lack of latrines remain a widespread health and environmental hazard in many developing countries. Low latrine utilization mostly affects the poor, rural and marginalized communities as the majority of those who do not use improved latrines live in rural areas where 90% of all open defecation takes place. The counterpart to this problem, Community-Led Total Sanitation, and hygiene (CLTSH) is an approach that involves facilitating a process to inspire and empower communities to stop open defecation and to build and use latrines in a participatory manner. OBJECTIVE:This study was aimed at assessing the Community Led Total Sanitation and Hygiene approach on improvement of latrine utilization in Laelay Maichew District of Central Zone, Northern Ethiopia. METHODS:A comparative cross-sectional study was conducted in Laelay Maichew District of Central Zone, Northern Ethiopia from November 2016 to January 2017. The study subjects were randomly selected 388 households from CLTSH implemented kebeles and 388 households from CLTSH non-implemented kebeles. Systematic random sampling technique was used to select households among proportionally allocated sample frame of households. Then, Interview of household heads using semi-structured questionnaire was conducted to collect data. Finally, data were entered and analyzed using SPSS version 20.0. Bivariate Logistic regressions model was used to identify candidates of multiple logistic regressions. Those P-values < 0.25 were considered as candidates to multiple logistic regressions to determine independent factors of latrine utilization. Variables with Odds Ratio at 95% CI and P-value < 0.05 was considered statistically significant. The study obtained approval from Aksum University Institutional Review Board before its commencement. RESULT:This study indicated that the level of latrine utilization and latrine availability in CLTSH implemented kebeles were greater than that of CLTSH Non-implemented kebeles. The finding of this study revealed that the rate of latrine utilization in the rural community of Laelay-matches district was about 47.4%, 95% CI (42.9%-51.8%). The majority (71.1%) of household in CLTSH implemented kebeles and (93.5%) of households in CLTSH non-implemented kebeles did not have hand washing facility near the latrine. Households which had no fresh excreta in around latrine were significantly 11.5 times higher than [AOR: 11.5, 95% CI (0.18, 50.2)] utilizing their latrine in CLTSH implemented kebeles. CONCLUSION:The study showed that the level of latrine utilization in CLTSH implemented and that of CLTSH non-implemented kebeles was low. Therefore, concerted efforts should be made by local and national governmental and non-governmental organization to should be used to promote behavioral change in the communities to implement community-led total sanitation and hygiene for improving latrine utilization.

Published
2018
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15. Essential neonatal care utilization and associated factors among mothers in public health facilities of Aksum Town, North Ethiopia, 2016.

Author

Megbey Berhe, Araya Abraha Medhaniye, Gizienesh Kahsay, Ermyas Birhane, and Mebrahtu Abay

Subjects
Medicine, Science
Abstract

BACKGROUND:Globally, neonatal death accounts about 44% of child death in 2013. Ethiopia is one of the ten countries with the highest number of neonatal death. Worldwide, more than 43% of deaths among under five year children is contributed by neonates. Half of the neonatal death occur in the first day of life. Recommendations about newborn care practices may conflict with local beliefs and practices. So, it is important to understand the existing newborn care practice and factors affecting it in order to take interventions so as to decrease neonatal death. OBJECTIVE:To assess magnitude of essential neonatal care utilization and associated factors among women visiting public health facilities in Aksum Town, Tigray, Northern Ethiopia, 2015. METHODS:Facility based cross sectional study was conducted from December 30, 2015 to January 31, 2016.The sampled population are 423 women who gave live births within the last 6 months prior to data collection. Systematic random sampling technique was employed. Data were entered, coded and cleaned using Epi info version 7, and SPSS Version 21 software was used for analysis. Both bivariable and multivariable logistic regression models were used to determine factors associated with essential neonatal care utilization. Variables with P-value

Published
2017
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16. Determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia: A case-control study.

Author

Solomon Hintsa, Lamessa Dube, Mebrahtu Abay, Teklit Angesom, and Abdulhalik Workicho

Subjects
Medicine, Science
Abstract

BACKGROUND:Diabetic nephropathy is the most serious complication of diabetes which leads to end-stage renal failure and other complication of diabetes mellitus. Determinants of Diabetic nephropathy are not consistent in different studies and associated factors to chronic complications of diabetes are not specific and there are limited studies specific to diabetic nephropathy. Thus, the aim of this study is to identify determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia. METHODS:A case-control study was conducted from February 14 to May 8 2016. Diabetic patients who developed nephropathy in the last two years were the cases and diabetic patients free of nephropathy were controls. Cases and controls were identified detailed review of the chronic care follow up chart. Then simple random sampling was used to select sample of 420 (with control to case ratio of 4:1) resulting in 84 cases and 336 controls. Record review and interviewer administered questionnaire were used to collect data. Data was coded and entered in to Epi-Data version 3.1 and then exported to STATA 12 for analysis. Variables with P-values< 0.25 in Bivariate logistic regression were selected for multiple logistic regressions to determine independent determinants of diabetic nephropathy. OR was calculated with 95% CI to show strength of association. RESULT:The mean age (±Standard deviation) for the cases and the controls were 52(SD: ±1.34) and 42.4(SD: ±0.8) respectively. In multiple logistic regressions age of patient (AOR: 1.037 95%CI: 1.01-1.064), duration of diabetes after diagnosis (AOR for one year increase: 1.09 95%CI: 1.036-1.15), not-adhered to blood glucose measurement at home (AOR: 6.81 95%CI: 1.15-40.24), having Systolic Hypertension (AOR;2.13 (1.002-4.51), poor glycemic control (AOR;2.71 95%CI: (1.49-4.95), being overweight(AOR;2.7(1.47-4.96) were the independent predictors of diabetic nephropathy. CONCLUSION:In the light of these findings, targeted interventions should be designed at the follow up clinic to address the risk of developing diabetic nephropathy among the risk groups.

Published
2017
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17. Understanding the performance of a pan-African intervention to reduce postoperative mortality: a mixed-methods process evaluation of the ASOS-2 trial

Author

Nicola Vickery, Timothy Stephens, Leon du Toit, Dawid van Straaten, Rupert Pearse, Alexandra Torborg, Lucy Rolt, Mariechen Puchert, Graham Martin, Bruce Biccard, Bruce M. Biccard, Maia Lesosky, Tim Stephens, Landon Myer, Agya BA. Prempeh, Hyla-Louise Kluyts, Akinyinka Omigbodun, Adesoji Ademuyiwa, Muhammed Elhadi, Mohamed Elfagieh, Bernard Mbwele, Mpoki Ulisubisya, Lazaro Mboma, Daniel Z. Ashebir, Mahlet Tesfaye Bahta, Mohammed Hassen, Mikiyas Teferi, Yakob Seman, Eugene Zoumenou, Adam Hewitt-Smith, Janat Tumukunde, Dolly Munlemvo, Atilio Morais, Apollo Basenero, Pisirai Ndarukwa, Nazinigouba Ouerdraogo, Maman Sani Chaibou, Mohyeddine Zarouf, Ahmed Rhassane El Adib, Veekash Gobin, Zimogo Sanogo, Youssouf Coulibaly, Zipporah Ngumi, Tarig Fadalla, Cynthia Iradukunda, Vénérand Barendegere, Isaac O. Smalle, Mustapha Bittaye, Ahmadou Lamin Samateh, Mahmoud Elfiky, Maher Fawzy, Wakisa Mulwafu, Vanessa Msosa, Lygia Lopes, Akwasi Antwi-Kusi, Hamza D. Sama, Patrice Forget, Rupert M. Pearse, Marichen Puchert, Kris Schwebler, Freddy Kabambi, Tebogo Mabotja, Leandys Cobas, Albino Freitas, Maria Antunes, Bartolomeu Cabo, Domingos Paulo, Carlos Camongua, Yvette Avognon, Osseni Marcos, Raymond Kintomonho, Onesime Demahou, Gisèle Hounsa, Hugues Chobli, Elie Fassinou, Aurore Zoglobossou, Blaise Tchaou, Charles Tchegnonsi, Fifame Amadji, Francine Bossa, Ernest Ahounou, Djima Alao, Roushdane Odérémi, Afissatou Montairou, Oswald Gbehade, Romaric Tobome, Adam Boukari, Patrick Bakantieba, Arouna Sambo, Fanou Lionelle, Nounagnon Gilbert, Julien Attinon, Roger Klikpezo, Aumar Dadjo, Dénis Fanou, Gilberte Hounkpe, Bachabi Fafana, Néné Nguilu, Bodourin Dossou-Yovo, Chantal Segla, Mohamed Toko, Evelyne Gnele-Dedewanou, Michel Noukounwoui, Ethienne Yado, Timothé Gouroubéra, Valéry Adjignon, Serge Mewanou, Aïcha Tchomgang, Urielle Agossou, Fernand Soton, Charbel Azanlin, Lidwine Zomahoun, Rawéléguinbasba Armel Flavien Kabore, Salam Savadogo, Fatou Fleur Rosine Sanou, Farid Belém, Victoria Hien, Cheik Tidiane Hafid W. Bougouma, Sie Ahmed Ouattara, Mariam Bambara Kabore, Ouedraogo Nazinigouba, Papougnezambo Bonkoungou, Martin Lankoandé, Mireille Traoré, Patrick Sawadogo, Inès Wenmenga, Boureima Kinda, André Simporé, Christian Sapo, Salah Idriss Traore, Haoua Dipama, Lydie WR. Kaboré, Salifou Napon, Télesphore G. Kaboré, Arouna Louré, Pélagie PP. Tondé, Christian Zoundi, Martin Lankoande, Harouna Sanou, Remy Ndikumana, Carlos Nsengiyumva, Gregory Sund, Alliance Niyukuri, Axel Kwizera, Jean-Claude Niyondiko, Adolphe Manzanza Kilembe, Jean Pierre Mwema Ilunga, Nehema Hailemariam Sarah, Gabriel Mubobo Makeya, Idesbald Mwebe Mwepu, Ted Botawaosenge Likongo, Richard Kapela Mvwala, Raphael Nzau Kapend Mubunda, Noellie Kanka Mukuna, Julie Djondo Pembe, Nicolas Lumuanga Ndaye, Eric Bibonge Amisi, Mike Ilunga Madika, Joe Kembo Lungela, Didier Ndonda Mayemba, Philomene Mamba Diyoyo, Alex Mbo Ngalala, Martin Mamba Mukenga, Patricia Tito Kabuni, Dany Bolimo Mpoto, Herve Inesnku Mole, Louise Keby, Oria Andavo Buti, Anselme Phaka, Belinda Mayenge, Jean Jeacques Kabuley Kalongo, Timothe Kemfuni Mawisa, Rodrigue Tondo Ngwizani, Kuyala Leya, Dieudonne Kisile Sanduku, Timothe Nkemfuni Mawisa, Coco Nseke Mfumu, Mbuta Bolenge, Desire Kinzenzengu Kabuce, Patrick Kintieti, Amelia Mbuluku, Vicky Mahuwa, Tharcice Khonde Mabiala, Guilain Ngoy, Patrick Boloko, Nono Mazangama Mvwama, Jose Kengbanda, Pitchou Mushimbonga, Blaise Kuhapala, Nzosani Marcel, Kienze Guylain, Gerard Mboma, Sandra Zalambo Sagboze, Michel Muteya Manika, Jean Pierre Mumbere Kigayi, Roger Mukanire Cishugi, Placide Buhendwa Mugisho, Roger Baguma, Moïse Kongolo, Michel Mandungu Mbayabu, Crispin Mukendi Muamba, Edmond Banema Kapinga, Vasco Ngolela Kapinga, Guylain Tshimanga Nsumpi, Patrick Kanda Odia, Salomon Bingidimi, Gilbert Kpengbemale, Desire Hubert Bofunga Bosonga Imposo, Patricia Matondo, Servet Lelo, Jeremie Kalambayi, Mohamed Abdel-Ghaffar, Abdelrahman Soliman, Mostafa Abdelrahman, Sameh Shehata, Alia Rabee, Mohamed Abou Heba, Mohamed Rabei Abdelfattah, Tamer Ahmed Maher Ghoniem, Sherif M.K. Shehata, Mohamed Lotfy, Ahmed ElHaddad, Bereket Gebremeskel, Girmay Fisseha, Mebrahtu Abay, Degena Bahrey, Assefa Hika, Abdurezak Ali, Kindie Moges, Jemal Ahmed, Desalegn Abdisa, Abebe Megersa, Wendwosen Abayne, Haftom Berhane, Reiye Esayas, Fitsum Kifle, Kokeb Desita, Abebe Addise, Dagim Shimelash, Shitalem Tadesse, Bezaye Zemedkun, Peniel Kenna, Ayenew Yirdie, Abinet Sisay, Tebikew Gashu, Fassil Mihretu, Yesuf Ahmed, Bekele Debebe, Abdureuf Misgea, Amare Agmas, Rahel Assefa, Abdurahman Gelmo, Seifu Alemu, Brook Damtachew, Merid Mersha, Yaekob Chemere, Samuel Fekadu, Sintayehu Regasa, Bonsa Sileshi, Desalegn Wosen, Rebira Adamu, Gersam Mulugeta, Teshome Bacha, Zewude Gudisa, Kebebe Bekele, Alelign Tasew, Habtamu Gezahegn, Daniel Atlaw, Damtew Solomon, Habtemariam Gebresillasie, Girmaye Tesfaye, Negussie Sarbecha, Biniyam Sahiledengle, Kenbon Seyoum, Gemechu Ganfure, Yohannes Tekalegn, Gosa Tesfaye, Temesgen Ayichew, Shibiru Sendaba, Musefa Redwan, Eyasu Muse, Girma Nina, Bizuneh Sime, Addisalem Tadege, Anbesse Jima, Nugusu Ayalew, Dagmawi Workneh, Daniel Teferi, Momodou T. Nyassi, Landing N. Sanyang, Omar Jallow, Abdoulie Keita, Kitabu Jammeh, Charles Roberts, Patrick Idoko, Kebba Marenah, Masirending Njie, Musa Marena, Karamba Suwareh, Simon Boissey, Fatoumatta Jarjusey, Awa Jah, Awa Sanyang, Dado Jabbi, Kajali Camara, Armando Correa, John Jabang, Lamin Jaiteh, Lamin Dampha, Aminata Manneh, Baboucarr Sowe, Abdoulie Bah, Edrisa Jawo, Victoria Okoje, Momodou Baro, Yaya Bah, Mustapha Njie, Sainabou Mbowe, Ebrima Kanteh, Sarjo Ceesay, Alagie Manneh, Evans Atito-Narh, Adwoa Wilson, Romeo Hussey, Emmanuel Okine, Jemima Kwarteng, Ridge Ntiamoah, Samuel Dadzie, Mark Aseti, Naa Sowah, Akosua Appiah, Charles Bankah, Patrick Mburugu, Thomas Chokwe, Patrick Olang, Vernon Gacii, Susane Nabulindo, Antony Gatheru, Timothy Mwiti, Caroline Mwangi, Julius Muriithi, Daniel Ojuka, Omondi Ogutu, Evans Masitara, Mohamed Chaudhry, Reuben Kamundi, Annmarie Kangangi, Thomas Massaquoi, Stephen Takow, Felister Moraa, Aziz Munubi, Moses Kimani, Adili Wobenjo, Linda Nguu, Vincent Omeddo, Rose Malaba, Ambrose Nabwana, Anita Mwancha, Alexandria Mugaa, John Wamwaki, Joyce Chege, Seymour Sinari, Andrew Ndonga, Rose Shitsinzi, Walter Akello, Winfred Kimani, Elisha Kirwa, Seno Saruni, Andrew Wainaina, Ernest Nshom, Aidah Kenseko, Kizito Shisanya, Purity Wanjiru, Julliah Cherotich, Judy Kimutai, Benson Wahome, Grace Wangui, Dennis Wamalwa, Stephen Mwangi, John Chege, Tabitha Wanjiku, Carolyne Njoki, Wachira Waititu, Conrad Ambani, Samuel Murimi, Sharon Waithira, Nilson Mouti, Collins Kibet, John Kibet, Virginia Sokobe, Beatrice Jeymah, Antony Kamadi, Faith Gichuri, Steve Moses, David Wasike, Favours Adeya, Caesar Bitta, Stephen Ogendo, Killian Kariuki, Hdaya BenAbdalla, Taha Suliaman, Fatima Ali Abokhzam, Mohaned Isa, Mohammed Huwaysh, Asma Bourawi, Kais Alzubaidy, Mohammed Albaraesi, Sumayyah Bahroun, Abdulmueti Alhadi, Ahmed Msherghi, Amira Mohamed, Ala Khaled, Nouran Aljadi, Elham Bareig, Khaled Elgazwi, Adel Elgazwi, Ibrahim El-busife, Safa Owhida, Almahdi Eltwati, Samah Elakeili, Taha Abubaker, Fatima Elkhfeefi, Soha Younis Hasan, Amal Alttaira, Imbarkah Elmraied, Rim Wishah, Omar Abugassa, Hazem Ahmed, Amera Ellafi, Shoukrie Shoukrie, Nawal Aldokali, Aws ElGammudi, Akram Alkaseek, Hoda Elhaddad, Ayyah Alqaarh, Ahlam Brish, Malek Abudsnnuga, Salsabil Albuaishi, Mohammed Albashri, Marwa Morgom, Mohammed Alawami, Eman Shawesh, Abdullah Almabrouk, Moaz Alwarfalli, Nagia Abeid, Anis Buzreg, Ans Malek, Ameerah Abayu, Butaina Abdulhafith, Wedad Abouruwes, Marim Albakuri, Sabria Almuammari, Esam Alsaghair, Fatheia Alreshi, Hassan Badi, Rabiee Alfetoey, Naji Zubia, Bushray Almiqlash, Abdulsalam Alshuhoumi, Rayet Al-islam Ben Jouira, Amaal Dier, Essra Gebril, Mohammed Abdelkabir, Sana Moussa, Marwa Alfitori, Mabroukah Azbeda, Hajar Alamin, Ejmeya Barka, Omlsaad Mosbah, Rema Abdasalam, Miftah Hiyoum, Maryam Abd allateef, Ibrahim Altomi, Mahdi Alsakloul, Ekhlas Karami, Munyah Alriqeeq, Mabruka Omar, Ashraf Samer, Aml Aemeesh, Ahmad Bouhuwaish, Ahmed Elusta, Sultan Ahmeed, Wesal AlFighi Hassan, Mouadah Ali Altayr, Mohamed Addalla, Abrar Geddeda, Kheria Khoja, Doaa Alhaj, Muaad Etturki, Ahmed Elhadi, Ibrahim Ellojli, Anshirah Shuwayyah, Ahmed Elfaghih, Malak Alduwayb, Mohamed Aleiyan, Wedad Aboubreeq, Soliman Alkassem, Sami Ashour, Hayat Ben Hasan, Najat Ben Hasan, Ali Yahya, Palesa Chisala, Edward Kommwa, Lusayo Simwinga, Agness Chalira, Precious Kachitsa, Onias Mtalimanja, Drissa Traoré, Moussa Sissoko, Moussa Camara, Adama Koita, Sekou Koumaré, Omar Sacko, Mahamadou Coulibaly, Lamine Soumaré, Soumaïla Keita, Sidiki Keita, Hamadoun Dicko, Boubacar Diallo, Boureima Bengaly, Mohamed Keita, Siaka Diallo, Drissa Ouattara, Nouhoun Ongoiba, Seydina Beye, Honoré Berthe, Mamadou Diakite, Mamadou Sima, Adégné Togo, Bakary Dembele, Djibo Diango, Moussa Samake, Youssouf Traoré, Louis Traoré, Ongoïba Oumar, Sogoba Gaoussou, Issaga Traoré, Sidy Sangaré, Doua Kanté, Lassana Cissé, Thiam Souleymane, Keita Koniba, Sundaresan Maiyalagan, Julien Chong, Adil Mohit, Khushyant Mungar, Shankaran Vinayagam, Kevin Ramlochun, Jamie Sim, Desai Sneha, Vishaal Kissoon, Yan Tseung, Mohamed Aboobakar, Nitish Fokeerah, Ravi Ramsewak, Jayprakash Gopall, Meetheelesh Abeeluck, Varun Seewoo, Divyanand Jankee, Ashveen Puryag, Senthil Beemadoo, Yashraj Deenoo, Abhisek Goureah, Munawwara Makoon, Hemanshu Rambojan, Beeharry Shanjugsingh, Kevin Viraswami, Shehzaad Joomye, Ashwant Bhugwandass, Bibi Deelawar, Vakil Leelodharry, Luckshmanraj Mungur, Sajid Aungraheeta, Sirsingh Bhajoo, Manpreet Rajcoomar, Rishi Seetaram, Subha Gaya, Gini Batra, Yoshvin Sunnassee, Shailendra Petkar, Sbai Hicham, Labib Smail, Ait Laalim Said, Motaai Youssef, Mouhssine Doumiri, Mustapha Alilou, Nora Farnaoui, Mustapha Bensghir, Abdelghafour Elkoundi, Abdelhamid Jaafari, Abderhmann Elwali, Mohammed Meziane, Walid Atmani, Houssam Rebahi, Hajar Chichou, Safae Zarouf, Abderraouf Soummani, Abou Elhassan Taoufik, Meryem Essafti, Aminata Oumou Traoré, Hamzaoui Hamza, Adnane Berdai, El allani Linda, Salhi Oussama, Nelson Mucopo, Machado Banze, Mouzinho Saide, Tomas Sitoi, Artur Machava, Antonio Carlos, Amilton Guidione, Antonio Saide de Carvalho, Natacha Gemo, Samiro Sema Camal, Arsénio Cuna, Ornelos Madeira, Ladino Assuade, Dercio Amde Fernandes, Dulce Alexandre Machavae Fernandes, Mandua Sebastião, Bernard Sikombe, Matti Kandjimi, Ayoub Shekimweri, Diana Shilomboleni, Mbaundju Kandjii, Leonard Kabongo, Cholastic Hangero, Ike Ndjoze, Ruben Nailonga, Immanuel Uukonga, Uutoni Nakanyala, Lavinia Johannes, Adrian Haruzuvi, Chris Terblanche, Natangwe Shimenda, Delwina Katjipu, Hilma Shalimba, Juliah Kaweendwa, Ali Mbuyi, John Oyedele, Mapumba Mulolo, Peter Njuki, Mutombo Ndaie, Akutu Munyika, Hilma Katangolo, David Tjiyokola, Tawanda Mhene, Archbald Masiambiri, Paidamoyo Mandudzo, Sandra Kapepiso, Haziel Mavesere, Cedia Tjihoto, Daylight Manyere, Charlotte Kauraisa, Learnmore Garanowako, Michael Tune, William DeKlerk, Benvenue Ndolo, Maria Angula, Ndapewoshali Hishekwa, Elizabeth Nandjendja, Elsabe Tsauses, Eunice Mouton, Kudzai Katandawa, Sophia Bruwer, Jaydee Van Staden, Beata Siteketa, Beata Kaholongo, Martha Ntinda, Pueya Nashidengo, Johanna Kandjumbwa, Lahia Lipumbu, Moussa Sirfi, Fouma Djibo, Moutari Mahaman, Abdoulaye Mahaman Bachir, Maikassoua Mamane, Adakal Ousseini, Maman Noury Hamissou Souley, Rabo Oumarou, Rekia Idrissa, Moussa Ichaou, Amina Saley, Abdoulay Seyni, Sahabi Amadou, Mahamane Sani Mahamane Laminou, Issoufou Moustapha Camara, Moussa Gagara, Hadjara Rabiou Daddy, Harissou Adamou, Ibrahim Amadou Magagi, Oumarou Habou, Sabo Ramatou, Saidu Kadas, Rabiu Mohammed, Abubakar Ballah, Tella Olalekan, Kefas Bwala, Mohammed Adamu, Adamu Isa, Ademola Adeyeye, Samuel Fayose, Akinola Akinmade, Taiwo Ajayi, Elizabeth Nwasor, Saidu Yakubu, Euphemia Ugwu, George Mukoro, Muhammed Ahmed, Gideon Akafa, Ahmad Lawal, Daniel Nwoye, Michael Odigbo, Zulaihatu Sarkin-Pawa, Tunde Sholadoye, Benjamin Fomete, Hamisu Yakubu, Abdulkadir Kabiru, Samaila Timothy, Ali Yusuf, Tasiu Saadu, Babangida Mohammed, Abdulghaffar Yunus, Ganiyat Olagunju, Muhammad Aminu, Mohammad Idris, Musliu Tolani, Nasiru Dalhat, Samuel Gana, Talent Adike, Lofty-John Anyanwu, Abdurrahman Sheshe, Sani Aji, Mamuda Atiku, Raphael Attah, Abubakar Muhammed, Rasaki Oseni, Halima Salisu-Kabara, Benjamin Nkemjika, Omotayo Salami, Adekunle Akadri, Bukola Olayinka, Clement Onuoha, Umar Usman Jamaare, Auwalu Saminu Jibrin, Sani Giade Abdullahi, Ibrahim Ishaku, Adenike Odewabi, John Bamigboye, Oladapo Kuforiji, Chidiebere Ogo, Stella Ogunmuyiwa, Abdussemee Abdurrazzaaq, Adebayo Tanimola, Michael Adeyanju, Oluwatimilehin Andero, Temitope Ojo, Olusi Adedotun, Gbadamosi Kehinde, Jimoh Buraimoh, Kabiru Muhammad, Sophia Baidoo, Patrick Okoli, Azeez Adigun, Ekene Ezeonye, Kabir Isa, Yetunde Aremu-Kasumu, Kamil Shoretire, Peter Enesi, Amechi Ezike, Olatunde Olawoye, Emmanuel Ugwu, Christopher Ukah, Abolade Olugbenga, Nwachukwu Chidiebere, Nasiru Abdulraman, Adebiyi Olusegun, Alisa Halisa, Semiat Yusuf, Jamila Salisu, Chidiebube Okoro, Abdul Suleiman, Fabian Onowighose, Aliyu Farinyaro, Suleiman Baba, Umar Abdulmajid, Aisha Abdurrahman, Ogochukwu Obi, Olatunde Alabi, William Adeyemi, Jelili Salau, Jones Taiwo, Nnaemeka Nwafulume, Taiye Ibiyeye, Edith Agu, Ayodeji Danboy, James Abdulazeez, Christopher Ekwunife, Chimaobi Nnaji, Chigozirim Onyekpere, Amara Arunsi, Jude Egwim, Obianuju Nwana, Nnabuike Ojiegbe, Charles Mbamba, Paul Ngwu, Frank Imahigbe, Emmanuel Okoroji, Iloh Ikenna, Abdulrahman Mohammed, Adebayo Adeniyi, Toluwalope Ariyo, Olajide Gabriel, Tesleem Orewole, Salawu Idris, Idowu Adebara, Abiodun Okunlola, Akinwale Akinbade, Oluwasesan Afolabi, Adewumi Bakare, Olabisi Adeyemo, Benjamin Ugwu, Samuel Nuhu, Henry Embu, Erdoo Isamade, Chinedu Obikili, Amaka Ocheke, Solomon Peter, Donald Orshio, Peter Onuminya, Jack Okopi, Olufemi Bankole, Bosede Afolabi, Dapo Osinowo, Ayodeji Oluwole, Muyiwa Rotimi, Ibironke Desalu, Rufus Ojewola, Bolaji Mofikoya, Kola Owonikoko, Adeolu Adeoye, Temidayo Bobo, Taiwo Akinloye, David Ama, Ebere Okoronkwo, Muhammad Mahmud, Jamiu Adebiyi, Temitope Babalola, Mansur Muhammad, Afeez Aruna, Maryrose Osazuwa, Ayodeji Yusuf, Isiaka Lawal, Bitrus Fidelis, Rephath Pius, Cyril Jomosu, Adebayo Adedayo, Abubakar Aliyu, Adaora Agholor, Abdullateef Abdulazeez, Chabiya Bala, Eziamaka Eze, Elizabeth Ani, Uchenna Okeke, Dominica Adebayo, Okechukwu Ekwunife, Victor Modekwe, Chuka Ugwunne, Chukwuemeka Okoro, Chisom Uche, Simeon Olateju, Fred Ige-Orhionkpaibima, Adedapo Adetoye, Olurotimi Aaron, Jeremiah Abimbola, Folayemi Faponle, Olumuyiwa Ajayeoba, Olusoji Jagun, Oluwabunmi Fatungase, Adeniyi Akiseku, Chigbundu Nwokoro, Ramotalai Shoyemi, Ibukunolu Ogundele, Nankat Joseph, Salihu Bura, Chukwuka Nwezoku, Manu Bwala, Meshach Philips, Abubakar Usman, Emmanuel Filibus, Zara Umate, Nwabuoke Chukwuka, Ahmed Nuhu, Watakiri Ibrahim, James Nggada, Ali Izge, Musa Ismail, Olayinka Eyelade, Tinuola Adigun, Babatunde Osinaike, Olayinka Ogunbode, Olusola Idowu, Taiwo Lawal, Temidayo Ogundiran, Olayiwola Shittu, Omobolaji Ayandipo, Stephen Edino, Zumnan Songden, Olumide Akitoye, Bissallah Ekele, Godwin Akaba, Terkaa Atim, Akitoye Adeleke, Owoicho Okochi, Sunday Akeju, Ernest Ukpoju, Osayomwanbo Osaheni, Ifunanya Obaseki, Lateef Kehinde, Osawemwenze Monday, Stanley Nte, Adesuwa Agboifo, Omajuwa Dawodu, Precious Orhiere, David Atiti, Queeneth Kalu, Felix Effiom, Israel Kolawole, Olawale Ojo, Afusat Olabinjo, Olufemi Ige, Beatrice Ogunyemi, Olusola Oladosu, Kikelomo Adesina, Sulaiman Agodirin, Asimiyu Shittu, Audu Idrisa, Sadiq Adamu, Nuhu Ali, Olayinka Adewunmi, Stephen Nwankwor, Akinwumi Olakanmi, Oluseye Ajayi, Ayotolu Ajayi, Victor Ogunmola, Oluwafunke Olakanmi, Adam Kuranga, Enoch Uche, Chukwuemeka Osuagwu, Chukwudi Ilo, Mesi Matthew, Uko Uko, Ngozi Mba, Olubusola Alagbe-Briggs, Amabra Dodiyi-Manuel, Bisola Onajin-Obembe, Bright Obasuyi, Richard Echem, Ihuoma Mike-Elechi, Job Otokwala, Mark Edubio, Catherine Eyo, Isaac Udo, Aliyu Abdulrahman, A.A. Abdullahi, Ibrahim Galadima Bello, Usman Adinoyin Mohammed, Abidemi Oyaromade, Mohammed Bello, Usman Muhammad, Emeri Mbah, Hyacinth Okereke, Almustapha Aminu, Anthony Ahmadu, Abu Rogers, Peter Samai, Sao Amara, Margaret Yankuba, Mary Josayah, Jayah Swarray Jnr, Alusine Dawo, Peter George, Mustapha Kabba, Mohamed Bah, Charles Mondeh, Ibrahim Kapuwa, Mohamed Sheku, Philip Mattia, Brima Sesay, Jones O.A. Omoshoro-Jones, Motselisi Mbeki, Estie Cloete, Philip Anderson, Busi Mrara, Annemarie Steyn, Tsakani Mhlari, Nic Proctor, Caroline Robertson, Gillian Lamacroft, Usha Singh, Sebenzile Sikhakhane, Kelly Gate, Shepherd Nzenza, John Tshimbalanga Kasonga, Sibongile Ndebele, Patrick Lufuta Kande, Jody Davids, Tino-vito Orlandi, Marischka de Jong, Hugo Stark, Francois Roodt, Jonathan Hall, Ian Nortje, Akanimo Akpakan, Vishendran Govindasamy, Ronisha Sathiram, Mohammad Kathrada, Zane Farina, Lucio Frittella, Charles Kohler, Sibuyiselwe Lubelwana, Sarwat Ikram-Hameed, Adriaan Smit, Muneerah Cassiem, Yvonne Freeman, Saaliha Goga, Larissa Cronje, Constantin Buzdugan, Subash Chirkut, Priyadeshni Singh, Sandhya Jithoo, Vivesh Rughubar, John Arnold, Rishan Bipath, Suman Mewa Kinoo, Ncumisa Khanyisa Msolo, Fleur Ackermans-Deijnen, Tshegofatso Mmasello Emma Boka, Martyn Biccard Greenwood, Shakthi Anand Jayrajh, Devarani Naidoo, Syndrini Reddy, Devandiran Harriraman Rungan, Kylene Subrayen, John Roos, Nina Tredoux, Pascal Plumacher, Anthony Reed, Harald Steinhaus, Mariesa Nock, Paul Ryan Herselman, Gareth Davies, Talitha Harvey, Franklin Muller, Willem Naude, Tania Pretorius, Johan Jochemus Swart, Merryn Walls, Prashant Gokal, Nicolette Rorke, Farzaana Dhoodhat, Precious Dzanibe, Mohammed Yusuf Hussain, Ashmita Junpath, Ameela Maharaj, Hylda Makanisi, Khalid Moosa, Ting Ting Wong, Sean Mould, Trisha Ramsamy, Roel Matos-Puig, Hayley Morgan, Nadeem Nabeebuccas, Ria Devi Naidoo, Viantha Pather, Vasheel Vasheel Bahadur, Renilda Pillay, Zahnne Fullerton, Nicole Bell, Bongisa Grey, Vincent Lorenzo Visentin, Hendrik Adriaan Van Zyl, Terri Anne Killingbeck, Emile Maneveldt, Gerhard Thiart, Magdelena May Venter, Oostewalt Swart, Mariette Grobelaar, Carel Cairns, David Bishop, Christien Steenkamp, Thandekile Khumalo, Noel Naidoo, Ross Murray, Martin Kopieniak, Melusi Sishange, Mxolisi Brian Ndimande, Megan Jaworska, Sarwat Ikram, Bence Rainier, Renier J. Liebenberg, Helena D. Zwiegers, Philip M. Nortje, Kamal Bhagwan, Margot Flint, Robert Dyer, Simone Adams, Yoshua Bwambale, Danny Ngomo, Patrice Kanku, Nivashen Pillay, Alexa de Castro, Atisha Maharaj, Janine Carim, Jenna Leigh Taylor, Karl M. Köhne, Leanne W. Drummond, Leanne Temlett, Lieze Geldenhuys, Yvonne Seilbea, Kathryn Naidoo, Nicola A. Kalafatis, Stefné Verwey, Thulile Biyase, Theroshnie Kisten, Belinda S. Kusel, Timothy Craig Hardcastle, Richard Magagula, Christian Kampik, Kuzolunga Xulu, Sivuyisiwe Solala, Mia Sayed, Basil Enicker, Anil Madaree, Innocent Mukama, Gladmore Madombwe, Nonhlanhla Zulu, Nompumelelo Gasa, Nokuzula Kanjana, Sebenzile Buthelezi, Thembelihle Buthelezi, Andries Brink, Francois Potgieter, Busisiwe Mrara, Zaynab Alexander, Charles Choto, Paula Ima, Zintle Gxagxisa, Baphethuxolo Ningiza, Gillian Lamacraft, Jerome Mogorosi, Nadia du Plessis, Leonie de Man, Suné Thompson, Gerrit van Heerden, Edwin W. Turton, Pieter M. van der Linde, Josephine K. Teme-Pitse, Reitumetse Tladi, Gillian D. Saffy, Ene-Mari Roscher, Kristel Fortune, George Barnard, Tiisetso Makhasane, Evan Bowen, Akangcha Pal, Rachel Moore, Maria Fourtounas, Mary Augusta Adam, Renessa Arumugan, Gabriella Hyman, Jaclyn Jonosky, Maninginingi Makondo, Heveshan Moodley, Phillip Munda, Mzwandile Nyalungu, Victor Olusola, Sohan Zane Pinto, Tristan Pillay, Lucinda Singh, Paul Mwindekuma Wondoh, John Devar, Boitumelo Baloyi-Mnisi, Zach Koto, Matlou Ernest Mabitsela, Sibongile Ruth Ndlovu, Branny Mthelebofu, Colin Beck, Matthew Dold, Alice Fan, Shannon MacQueen, Thembani Matabata, Catherine Mpehle, Charné Kulenkampf, Tsakani McCreath Mhlari, Simangele Cecilia Nyoka-Mokgalong, Felix Thumba Masinge, Randhir Ramnath Gunpath, Maropeng Petrus Pat Mothwa, Jo-Anne Asenath Mothwa, Danai Mhlanga, Jamie-Lyn Colly, Aunel Mallier Peter, Khalid Ben Hameda, Pulane Mokae, Stella Josephine Moumakoe, Kelechi Ekeh, Nezingu Lengo, Marnus Booyens, Inge Louise Seale, Pieter Daniel Theron, Nicolaas Abraham Schuman, Amber Carlyn Sonn, Jacobus Lukas Stander, Nadia Cloete, Marius Cloete, Catherine Ann Makepeace, Ronel van der Westhuizen, Leanne Robyn Messiahs, Amy Ruth Visagie, Fatima Vawda, Frans Christiaan Voster, Deepika Dhilraj, Oliver Smith, Stefan Bolon, Daniel Montwedi, Motsilisi Mbeki, Jayde Wyngaard, Mthunzi Ngcelwane, Thomas Kleyenstuber, Phyllis Phukubye, Liesel Schärf, Grace Laker, Elizabeth Semenya, Reinhard Dembskey, Thomas Tarlton, Tapiwa Jiri, Ngoie Hubert Mushid, Nhlanhla Samuel Ngwenya, Hazel Morongoa Mogodi, Carmen Sinevici, Anthony Osarogie Usenbo, Naledi Fodo, Anesu Chimini, Ntetelelo Sikobi, Sinovuyo Nokwange, Mluleki Noqhamza, Qumba Thembisa, Kajake Anantha Padmanabha Bhat, Rabin Mathew, Katrin Middleton, Abdus-sami Adewunmi, Craig Dickson, Humairah Bulbulia, Bianka Bester, Michelle de Klerk, Christia Benade, Francois Viljoen, Monique Fischer, Khalid Alfaki, Abdalmalik Awad, Abdelsalam Algray, Mohammed Elsiddig, Suha Mohamed, Salih Mahmoud, Muhammed Osman, Asia Elgailany, Mazin Suliman, Hanaa Mohammed, Lina Aljeally, Mohammed Dirar, Mohammed Osman, Mazin Mohamed, Mohamed Elhasan, Abrar Widatalla, Abubakr Abubakr, Eman Mohamed, Alshareef Nour, Ntonto Doris Gama, Dolorosa Khetsiwe Shabangu, Cynthia Iradikunda, Samuel Mkoko, Paul Kisanga, Emmanuel Lema, Benson Lyimo, Mohamed Binde, Alphonce Chandika, Salim Salim, Sylvia Jumbe, Abel Makubi, Vihar Kotecha, Felician Kachinde, Museleta Nyakiroto, Emmanuel Jitambi, Venant Geofrey, Johaphes Josiah, Phinius Makubi, Frank Manumbu, Suzan Mlingwa, Ernest Ibenzi, Peter Mbelle, Kato Peleus, Enid Chiwanga, Nillah Richard, Shoo Leonard, Paulo Sanka, Subira Mushi, Bashir Nyangasa, Mohamed Janabi, Naizihijwa Majani, Pedro Palangyo, Evarist Nyawawa, William Ramadhan, Faraj Lydenge, Gileard Gabriel Masenga, Sakina Rashid, Mubashir Jusabani, Ansbert Ndebea, Jenitha Cheru, Margaret Henjewele, Greyson Kilimanjaro, Sarah Sikimata, Deocles Donatus, Hazina Maduhu, Tumaini Mariro, Given Massasi, Moshi Moshi Shabani, Braison Cholela, Marco Mgeleka, Yohatinus Mbilinyi, Faraja Chiwanga, Bilton Exavery, Caspar Haule, Samson Ndile, Sirili Harya, Julieth Magandi, Deogratius Manyama, Redempta Matindi, Adam Moshi, Daudi Kitwana, Merida Makia, Philip Muhochi, Miriam Herman, Clauda Miombo, Furaha Kahindo, Langtone Kishebuka, Elijah Ussiri, Gloria Kinasa, Patrick Adel, Eric Malaba, Vensesla Sakwari, Sadot Lugereka, Mohamed Mungia, George Mocha, Herman Wella, Cecilia Protas, Patrick Karua, Ahmada Kashagama, Faraja Mwasambugu, Suzana Kajeri, Jacquiline Mchilla, Elibariki Lucumay, Robert Maise, Amon Marti, Beatrice Mahundi, Frederika Jager, Charles Majani, Ludovick Rukeha, Tareeq Mohamed, Nabila Fuad, Winifrida Halinga, Elias Chrisant, Gilbert Msoma, Titus Kihwili, Gadiel Temu, Naima Yusuf, Rashid Saleh, Rashid Inoja, Eva Shang'a, Stella Ibrahim, Hussein Msuma, Edwin Edward, Paul Kilamile, Stephen Mwakyolile, Talkana Adja, Edem Gueouguede, Hafoudhoi Oussene Seddoh, Saliou Adam, Pilakimwe Egbohou, Mawunyo Ahomagnon, Olivier Kadjossou, Abdul-Bassiti Boukari, Mary T. Nabukenya, Ruth Muhindo, Peter Waswa, Peter Kaahwa Agaba, Daphne Kabatoro, Joseph Kayongo, Margaret Naggujja, Nabasiige Rehema, Phiona Nansubuga, Daniel Kavuma, Aggrey Lubikire, Hope Bisilikirwa, Godfrey Ssebaggala, Emmanuel Muwema, Humble Joan Agaba, John Kiconco, Nicholas Wataaka, Bonet Chan, Mary Juliet Nampawu, Fred Bulamba, Emmanuel Bua, Christine Mugala, Caroline Nyakato, John Paul Ochieng, Linda Kyomuhendo Jovia, George Kateregga, Rachel Alum, Lazia Najjuma, Gorret Nampiina, Andrew Kintu, Joshua Sempiira, Luzige Simon, Peter Kayima, Jacob Eyul, Erick Odwar, Rita Nkwine, Christine Namata, Elizabeth Nabakka, Denis Kakaire, Velda Mushangwe-Mtisi, Erisha Munhamo, Celestino Dhege, Juliet Hungwa, Hemish Jasi, Crispin Ntoto, Derek Matsika, Brightson Mutseyekwa, Joseph Zimbovoora, Beaulah Gudyanga, Dennis Mazingi, Chenesa Mbanje, Busisiwe Mlambo, Michael Chiwanga, Harunavamwe N. Chifamba, Sarudzai Zhou, Esta Hove, Shamiso Dende, Beauty Manjengwa, Penias Kapisa, null Mashava, Caritas Chiura, Locadia Katsukunya, Godfrey Muguti, Doreen Mashava, Elton Ndhlovu, Zanele Mangwangwa, and Nombulelo Dube

Subjects
medicine.medical_specialty, Interprofessional Relations, media_common.quotation_subject, Psychological intervention, Fidelity, Postoperative Complications, Surveys and Questionnaires, Intervention (counseling), Humans, Medicine, Postoperative Period, Cooperative Behavior, Nursing management, media_common, Response rate (survey), business.industry, Standard of Care, Odds ratio, Hospitals, Confidence interval, Clinical trial, Anesthesiology and Pain Medicine, Population Surveillance, Africa, Physical therapy, business
Abstract

Background The African Surgical OutcomeS-2 (ASOS-2) trial tested an enhanced postoperative surveillance intervention to reduce postoperative mortality in Africa. We undertook a concurrent evaluation to understand the process of intervention delivery. Methods Mixed-methods process evaluation, including field notes, interviews, and post-trial questionnaire responses. Qualitative analysis used the framework method with subsequent creation of comparative case studies, grouping hospitals by intervention fidelity. A post-trial questionnaire was developed using initial qualitative analyses. Categorical variables were summarised as count (%) and continuous variables as median (inter-quartile range [IQR]). Odds ratios (OR) were used to rank influences by impact on fidelity. Results The dataset included eight in-depth case studies, and 96 questionnaire responses (response rate 67%) plus intervention fidelity data for each trial site. Overall, 57% (n=55/96) of hospitals achieved intervention delivery using an inclusive definition of fidelity. Delivery of the ASOS-2 interventions and data collection presented a significant burden to the investigators, outstripping limited resources. The influences most associated with fidelity were: surgical staff enthusiasm for the trial (OR=3.0; 95% confidence interval [CI], 1.3–7.0); nursing management support of the trial (OR=2.6; 95% CI, 1.1–6.5); performance of a dummy run (OR=2.6; 95% CI, 1.1–6.1); nursing colleagues seeing the value of the intervention(s) (OR=2.1; 95% CI, 0.9–5.7); and site investigators' belief in the effectiveness of the intervention (OR=3.2; 95% CI, 1.2–9.4). Conclusions ASOS-2 has proved that coordinated interventional research across Africa is possible, but delivering the ASOS-2 interventions was a major challenge for many investigators. Future improvement science efforts must include better planning for intervention delivery, additional support to investigators, and promotion of strong inter-professional teamwork. Clinical trial registration ClinicalTrials gov NCT03853824.

Published
2021

18. Enhanced postoperative surveillance versus standard of care to reduce mortality among adult surgical patients in Africa (ASOS-2): a cluster-randomised controlled trial

Author

Bruce M Biccard, Leon du Toit, Maia Lesosky, Tim Stephens, Landon Myer, Agya BA Prempeh, Nicola Vickery, Hyla-Louise Kluyts, Alexandra Torborg, Akinyinka Omigbodun, Adesoji Ademuyiwa, Muhammed Elhadi, Mohamed Elfagieh, Bernard Mbwele, Mpoki Ulisubisya, Lazaro Mboma, Daniel Z Ashebir, Mahlet Tesfaye Bahta, Mohammed Hassen, Mikiyas Teferi, Yakob Seman, Eugene Zoumenou, Adam Hewitt-Smith, Janat Tumukunde, Dolly Munlemvo, Atilio Morais, Apollo Basenero, Pisirai Ndarukwa, Nazinigouba Ouerdraogo, Maman Sani Chaibou, Mohyeddine Zarouf, Ahmed Rhassane El Adib, Veekash Gobin, Zimogo Sanogo, Youssouf Coulibaly, Zipporah Ngumi, Tarig Fadalla, Cynthia Iradukunda, Vénérand Barendegere, Isaac O Smalle, Mustapha Bittaye, Ahmadou Lamin Samateh, Mahmoud Elfiky, Maher Fawzy, Wakisa Mulwafu, Vanessa Msosa, Lygia Lopes, Akwasi Antwi-Kusi, Hamza D Sama, Patrice Forget, Dawid van Straaten, Rupert M Pearse, Marichen Puchert, Lucy Rolt, Kris Schwebler, Freddy Kabambi, Tebogo Mabotja, Leandys Cobas, Albino Freitas, Maria Antunes, Bartolomeu Cabo, Domingos Paulo, Carlos Camongua, Yvette Avognon, Osseni Marcos, Raymond Kintomonho, Onesime Demahou, Gisèle Hounsa, Hugues Chobli, Elie Fassinou, Aurore Zoglobossou, Blaise Tchaou, Charles Tchegnonsi, Fifame Amadji, Francine Bossa, Ernest Ahounou, Djima Alao, Roushdane Odérémi, Afissatou Montairou, Oswald Gbehade, Romaric Tobome, Adam Boukari, Patrick Bakantieba, Arouna Sambo, Fanou Lionelle, Nounagnon Gilbert, Julien Attinon, Roger Klikpezo, Aumar Dadjo, Dénis Fanou, Gilberte Hounkpe, Bachabi Fafana, Néné Nguilu, Bodourin Dossou-Yovo, Chantal Segla, Mohamed Toko, Evelyne Gnele-Dedewanou, Michel Noukounwoui, Ethienne Yado, Timothé Gouroubéra, Valéry Adjignon, Serge Mewanou, Aïcha Tchomgang, Urielle Agossou, Fernand Soton, Charbel Azanlin, Lidwine Zomahoun, Rawéléguinbasba Armel Flavien Kabore, Salam Savadogo, Fatou Fleur Rosine Sanou, Farid Belém, Victoria Hien, Cheik Tidiane Hafid W Bougouma, Sie Ahmed Ouattara, Mariam Bambara Kabore, Ouedraogo Nazinigouba, Papougnezambo Bonkoungou, Martin Lankoandé, Mireille Traoré, Patrick Sawadogo, Inès Wenmenga, Boureima Kinda, André Simporé, Christian Sapo, Salah Idriss Traore, Haoua Dipama, Lydie WR Kaboré, Salifou Napon, Télesphore G Kaboré, Arouna Louré, Pélagie PP Tondé, Christian Zoundi, Harouna Sanou, Remy Ndikumana, Carlos Nsengiyumva, Gregory Sund, Alliance Niyukuri, Axel Kwizera, Jean-Claude Niyondiko, Adolphe Manzanza Kilembe, Jean Pierre Mwema Ilunga, Nehema Hailemariam Sarah, Gabriel Mubobo Makeya, Idesbald Mwebe Mwepu, Ted Botawaosenge Likongo, Richard Kapela Mvwala, Raphael Nzau Kapend Mubunda, Noellie Kanka Mukuna, Julie Djondo Pembe, Nicolas Lumuanga Ndaye, Eric Bibonge Amisi, Mike Ilunga Madika, Joe Kembo Lungela, Didier Ndonda Mayemba, Philomene Mamba Diyoyo, Alex Mbo Ngalala, Martin Mamba Mukenga, Patricia Tito Kabuni, Dany Bolimo Mpoto, Herve Inesnku Mole, Louise Keby, Oria Andavo Buti, Anselme Phaka, Belinda Mayenge, Jean Jeacques Kabuley Kalongo, Timothe Kemfuni Mawisa, Rodrigue Tondo Ngwizani, Kuyala Leya, Dieudonne Kisile Sanduku, Timothe Nkemfuni Mawisa, Coco Nseke Mfumu, Mbuta Bolenge, Desire Kinzenzengu Kabuce, Patrick Kintieti, Amelia Mbuluku, Vicky Mahuwa, Tharcice Khonde Mabiala, Guilain Ngoy, Patrick Boloko, Nono Mazangama Mvwama, Jose Kengbanda, Pitchou Mushimbonga, Blaise Kuhapala, Nzosani Marcel, Kienze Guylain, Gerard Mboma, Sandra Zalambo Sagboze, Michel Muteya Manika, Jean Pierre Mumbere Kigayi, Roger Mukanire Cishugi, Placide Buhendwa Mugisho, Roger Baguma, Moïse Kongolo, Michel Mandungu Mbayabu, Crispin Mukendi Muamba, Edmond Banema Kapinga, Vasco Ngolela Kapinga, Guylain Tshimanga Nsumpi, Patrick Kanda Odia, Salomon Bingidimi, Gilbert Kpengbemale, Desire Hubert Bofunga Bosonga Imposo, Patricia Matondo, Servet Lelo, Jeremie Kalambayi, Mohamed Abdel-Ghaffar, Abdelrahman Soliman, Mostafa Abdelrahman, Sameh Shehata, Alia Rabee, Mohamed Abou Heba, Mohamed Rabei Abdelfattah, Tamer Ahmed Maher Ghoniem, Sherif M.K. Shehata, Mohamed Lotfy, Ahmed ElHaddad, Bereket Gebremeskel, Girmay Fisseha, Mebrahtu Abay, Degena Bahrey, Assefa Hika, Abdurezak Ali, Kindie Moges, Jemal Ahmed, Desalegn Abdisa, Abebe Megersa, Wendwosen Abayne, Haftom Berhane, Reiye Esayas, Fitsum Kifle, Kokeb Desita, Abebe Addise, Dagim Shimelash, Shitalem Tadesse, Bezaye Zemedkun, Peniel Kenna, Ayenew Yirdie, Abinet Sisay, Tebikew Gashu, Fassil Mihretu, Yesuf Ahmed, Bekele Debebe, Abdureuf Misgea, Amare Agmas, Rahel Assefa, Abdurahman Gelmo, Seifu Alemu, Brook Damtachew, Merid Mersha, Yaekob Chemere, Samuel Fekadu, Sintayehu Regasa, Bonsa Sileshi, Desalegn Wosen, Rebira Adamu, Gersam Mulugeta, Teshome Bacha, Zewude Gudisa, Kebebe Bekele, Alelign Tasew, Habtamu Gezahegn, Daniel Atlaw, Damtew Solomon, Habtemariam Gebresillasie, Girmaye Tesfaye, Negussie Sarbecha, Biniyam Sahiledengle, Kenbon Seyoum, Gemechu Ganfure, Yohannes Tekalegn, Gosa Tesfaye, Temesgen Ayichew, Shibiru Sendaba, Musefa Redwan, Eyasu Muse, Girma Nina, Bizuneh Sime, Addisalem Tadege, Anbesse Jima, Nugusu Ayalew, Dagmawi Workneh, Daniel Teferi, Momodou T Nyassi, Landing N Sanyang, Omar Jallow, Abdoulie Keita, Kitabu Jammeh, Charles Roberts, Patrick Idoko, Kebba Marenah, Masirending Njie, Musa Marena, Karamba Suwareh, Simon Boissey, Fatoumatta Jarjusey, Awa Jah, Awa Sanyang, Dado Jabbi, Kajali Camara, Armando Correa, John Jabang, Lamin Jaiteh, Lamin Dampha, Aminata Manneh, Baboucarr Sowe, Abdoulie Bah, Edrisa Jawo, Victoria Okoje, Momodou Baro, Yaya Bah, Mustapha Njie, Sainabou Mbowe, Ebrima Kanteh, Sarjo Ceesay, Alagie Manneh, Evans Atito-Narh, Adwoa Wilson, Romeo Hussey, Emmanuel Okine, Jemima Kwarteng, Ridge Ntiamoah, Samuel Dadzie, Mark Aseti, Naa Sowah, Akosua Appiah, Charles Bankah, Patrick Mburugu, Thomas Chokwe, Patrick Olang, Vernon Gacii, Susane Nabulindo, Antony Gatheru, Timothy Mwiti, Caroline Mwangi, Julius Muriithi, Daniel Ojuka, Omondi Ogutu, Evans Masitara, Mohamed Chaudhry, Reuben Kamundi, Annmarie Kangangi, Thomas Massaquoi, Stephen Takow, Felister Moraa, Aziz Munubi, Moses Kimani, Adili Wobenjo, Linda Nguu, Vincent Omeddo, Rose Malaba, Ambrose Nabwana, Anita Mwancha, Alexandria Mugaa, John Wamwaki, Joyce Chege, Seymour Sinari, Andrew Ndonga, Rose Shitsinzi, Walter Akello, Winfred Kimani, Elisha Kirwa, Seno Saruni, Andrew Wainaina, Ernest Nshom, Aidah Kenseko, Kizito Shisanya, Purity Wanjiru, Julliah Cherotich, Judy Kimutai, Benson Wahome, Grace Wangui, Dennis Wamalwa, Stephen Mwangi, John Chege, Tabitha Wanjiku, Carolyne Njoki, Wachira Waititu, Conrad Ambani, Samuel Murimi, Sharon Waithira, Nilson Mouti, Collins Kibet, John Kibet, Virginia Sokobe, Beatrice Jeymah, Antony Kamadi, Faith Gichuri, Steve Moses, David Wasike, Favours Adeya, Caesar Bitta, Stephen Ogendo, Killian Kariuki, Hdaya BenAbdalla, Taha Suliaman, Fatima Ali Abokhzam, Mohaned Isa, Mohammed Huwaysh, Asma Bourawi, Kais Alzubaidy, Mohammed Albaraesi, Sumayyah Bahroun, Abdulmueti Alhadi, Ahmed Msherghi, Amira Mohamed, Ala Khaled, Nouran Aljadi, Elham Bareig, Khaled Elgazwi, Adel Elgazwi, Ibrahim El-busife, Safa Owhida, Almahdi Eltwati, Samah Elakeili, Taha Abubaker, Fatima Elkhfeefi, Soha Younis Hasan, Amal Alttaira, Imbarkah Elmraied, Rim Wishah, Omar Abugassa, Hazem Ahmed, Amera Ellafi, Shoukrie Shoukrie, Nawal Aldokali, Aws ElGammudi, Akram Alkaseek, Hoda Elhaddad, Ayyah Alqaarh, Ahlam Brish, Malek Abudsnnuga, Salsabil Albuaishi, Mohammed Albashri, Marwa Morgom, Mohammed Alawami, Eman Shawesh, Abdullah Almabrouk, Moaz Alwarfalli, Nagia Abeid, Anis Buzreg, Ans Malek, Ameerah Abayu, Butaina Abdulhafith, Wedad Abouruwes, Marim Albakuri, Sabria Almuammari, Esam Alsaghair, Fatheia Alreshi, Hassan Badi, Rabiee Alfetoey, Naji Zubia, Bushray Almiqlash, Abdulsalam Alshuhoumi, Rayet Al-islam Ben Jouira, Amaal Dier, Essra Gebril, Mohammed Abdelkabir, Sana Moussa, Marwa Alfitori, Mabroukah Azbeda, Hajar Alamin, Ejmeya Barka, Omlsaad Mosbah, Rema Abdasalam, Miftah Hiyoum, Maryam Abd allateef, Ibrahim Altomi, Mahdi Alsakloul, Ekhlas Karami, Munyah Alriqeeq, Mabruka Omar, Ashraf Samer, Aml Aemeesh, Ahmad Bouhuwaish, Ahmed Elusta, Sultan Ahmeed, Wesal AlFighi Hassan, Mouadah Ali Altayr, Mohamed Addalla, Abrar Geddeda, Kheria Khoja, Doaa Alhaj, Muaad Etturki, Ahmed Elhadi, Ibrahim Ellojli, Anshirah Shuwayyah, Ahmed Elfaghih, Malak Alduwayb, Mohamed Aleiyan, Wedad Aboubreeq, Soliman Alkassem, Sami Ashour, Hayat Ben Hasan, Najat Ben Hasan, Ali Yahya, Palesa Chisala, Edward Kommwa, Lusayo Simwinga, Agness Chalira, Precious Kachitsa, Onias Mtalimanja, Drissa Traoré, Moussa Sissoko, Moussa Camara, Adama Koita, Sekou Koumaré, Omar Sacko, Mahamadou Coulibaly, Lamine Soumaré, Soumaïla Keita, Sidiki Keita, Hamadoun Dicko, Boubacar Diallo, Boureima Bengaly, Mohamed Keita, Siaka Diallo, Drissa Ouattara, Nouhoun Ongoiba, Seydina Beye, Honoré Berthe, Mamadou Diakite, Mamadou Sima, Adégné Togo, Bakary Dembele, Djibo Diango, Moussa Samake, Youssouf Traoré, Louis Traoré, Ongoïba Oumar, Sogoba Gaoussou, Issaga Traoré, Sidy 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Soummani, Abou Elhassan Taoufik, Meryem Essafti, Aminata Oumou Traoré, Hamzaoui Hamza, Adnane Berdai, El allani Linda, Salhi Oussama, Nelson Mucopo, Machado Banze, Mouzinho Saide, Tomas Sitoi, Artur Machava, Antonio Carlos, Amilton Guidione, Antonio Saide de Carvalho, Natacha Gemo, Samiro Sema Camal, Arsénio Cuna, Ornelos Madeira, Ladino Assuade, Dercio Amde Fernandes, Dulce Alexandre Machavae Fernandes, Mandua Sebastião, Bernard Sikombe, Matti Kandjimi, Ayoub Shekimweri, Diana Shilomboleni, Mbaundju Kandjii, Leonard Kabongo, Cholastic Hangero, Ike Ndjoze, Ruben Nailonga, Immanuel Uukonga, Uutoni Nakanyala, Lavinia Johannes, Adrian Haruzuvi, Chris Terblanche, Natangwe Shimenda, Delwina Katjipu, Hilma Shalimba, Juliah Kaweendwa, Ali Mbuyi, John Oyedele, Mapumba Mulolo, Peter Njuki, Mutombo Ndaie, Akutu Munyika, Hilma Katangolo, David Tjiyokola, Tawanda Mhene, Archbald Masiambiri, Paidamoyo Mandudzo, Sandra Kapepiso, Haziel Mavesere, Cedia Tjihoto, Daylight Manyere, Charlotte Kauraisa, Learnmore Garanowako, Michael Tune, William DeKlerk, Benvenue Ndolo, Maria Angula, Ndapewoshali Hishekwa, Elizabeth Nandjendja, Elsabe Tsauses, Eunice Mouton, Kudzai Katandawa, Sophia Bruwer, Jaydee Van Staden, Beata Siteketa, Beata Kaholongo, Martha Ntinda, Pueya Nashidengo, Johanna Kandjumbwa, Lahia Lipumbu, Moussa Sirfi, Fouma Djibo, Moutari Mahaman, Abdoulaye Mahaman Bachir, Maikassoua Mamane, Adakal Ousseini, Maman Noury Hamissou Souley, Rabo Oumarou, Rekia Idrissa, Moussa Ichaou, Amina Saley, Abdoulay Seyni, Sahabi Amadou, Mahamane Sani Mahamane Laminou, Issoufou Moustapha Camara, Moussa Gagara, Hadjara Rabiou Daddy, Harissou Adamou, Ibrahim Amadou Magagi, Oumarou Habou, Sabo Ramatou, Saidu Kadas, Rabiu Mohammed, Abubakar Ballah, Tella Olalekan, Kefas Bwala, Mohammed Adamu, Adamu Isa, Ademola Adeyeye, Samuel Fayose, Akinola Akinmade, Taiwo Ajayi, Elizabeth Nwasor, Saidu Yakubu, Euphemia Ugwu, George Mukoro, Muhammed Ahmed, Gideon Akafa, Ahmad Lawal, Daniel Nwoye, Michael Odigbo, Zulaihatu Sarkin-Pawa, Tunde Sholadoye, Benjamin Fomete, Hamisu Yakubu, Abdulkadir Kabiru, Samaila Timothy, Ali Yusuf, Tasiu Saadu, Babangida Mohammed, Abdulghaffar Yunus, Ganiyat Olagunju, Muhammad Aminu, Mohammad Idris, Musliu Tolani, Nasiru Dalhat, Samuel Gana, Talent Adike, Lofty-John Anyanwu, Abdurrahman Sheshe, Sani Aji, Mamuda Atiku, Raphael Attah, Abubakar Muhammed, Rasaki Oseni, Halima Salisu-Kabara, Benjamin Nkemjika, Omotayo Salami, Adekunle Akadri, Bukola Olayinka, Clement Onuoha, Umar Usman Jamaare, Auwalu Saminu Jibrin, Sani Giade Abdullahi, Ibrahim Ishaku, Adenike Odewabi, John Bamigboye, Oladapo Kuforiji, Chidiebere Ogo, Stella Ogunmuyiwa, Abdussemee Abdurrazzaaq, Adebayo Tanimola, Michael Adeyanju, Oluwatimilehin Andero, Temitope Ojo, Olusi Adedotun, Gbadamosi Kehinde, Jimoh Buraimoh, Kabiru Muhammad, Sophia Baidoo, Patrick Okoli, Azeez Adigun, Ekene Ezeonye, Kabir Isa, Yetunde Aremu-Kasumu, Kamil Shoretire, Peter Enesi, Amechi Ezike, Olatunde Olawoye, Emmanuel Ugwu, Christopher Ukah, Abolade Olugbenga, Nwachukwu Chidiebere, Nasiru Abdulraman, Adebiyi Olusegun, Alisa Halisa, Semiat Yusuf, Jamila Salisu, Chidiebube Okoro, Abdul Suleiman, Fabian Onowighose, Aliyu Farinyaro, Suleiman Baba, Umar Abdulmajid, Aisha Abdurrahman, Ogochukwu Obi, Olatunde Alabi, William Adeyemi, Jelili Salau, Jones Taiwo, Nnaemeka Nwafulume, Taiye Ibiyeye, Edith Agu, Ayodeji Danboy, James Abdulazeez, Christopher Ekwunife, Chimaobi Nnaji, Chigozirim Onyekpere, Amara Arunsi, Jude Egwim, Obianuju Nwana, Nnabuike Ojiegbe, Charles Mbamba, Paul Ngwu, Frank Imahigbe, Emmanuel Okoroji, Iloh Ikenna, Abdulrahman Mohammed, Adebayo Adeniyi, Toluwalope Ariyo, Olajide Gabriel, Tesleem Orewole, Salawu Idris, Idowu Adebara, Abiodun Okunlola, Akinwale Akinbade, Oluwasesan Afolabi, Adewumi Bakare, Olabisi Adeyemo, Benjamin Ugwu, Samuel Nuhu, Henry Embu, Erdoo Isamade, Chinedu Obikili, Amaka Ocheke, Solomon Peter, Donald Orshio, Peter Onuminya, Jack Okopi, Olufemi Bankole, Bosede Afolabi, Dapo Osinowo, Ayodeji Oluwole, Muyiwa Rotimi, Ibironke Desalu, Rufus Ojewola, Bolaji Mofikoya, Kola Owonikoko, Adeolu Adeoye, Temidayo Bobo, Taiwo Akinloye, David Ama, Ebere Okoronkwo, Muhammad Mahmud, Jamiu Adebiyi, Temitope Babalola, Mansur Muhammad, Afeez Aruna, Maryrose Osazuwa, Ayodeji Yusuf, Isiaka Lawal, Bitrus Fidelis, Rephath Pius, Cyril Jomosu, Adebayo Adedayo, Abubakar Aliyu, Adaora Agholor, Abdullateef Abdulazeez, Chabiya Bala, Eziamaka Eze, Elizabeth Ani, Uchenna Okeke, Dominica Adebayo, Okechukwu Ekwunife, Victor Modekwe, Chuka Ugwunne, Chukwuemeka Okoro, Chisom Uche, Simeon Olateju, Fred Ige-Orhionkpaibima, Adedapo Adetoye, Olurotimi Aaron, Jeremiah Abimbola, Folayemi Faponle, Olumuyiwa Ajayeoba, Olusoji Jagun, Oluwabunmi Fatungase, Adeniyi Akiseku, Chigbundu Nwokoro, Ramotalai Shoyemi, Ibukunolu Ogundele, Nankat Joseph, Salihu Bura, Chukwuka Nwezoku, Manu Bwala, Meshach Philips, Abubakar Usman, Emmanuel Filibus, Zara Umate, Nwabuoke Chukwuka, Ahmed Nuhu, Watakiri Ibrahim, James Nggada, Ali Izge, Musa Ismail, Olayinka Eyelade, Tinuola Adigun, Babatunde Osinaike, Olayinka Ogunbode, Olusola Idowu, Taiwo Lawal, Temidayo Ogundiran, Olayiwola Shittu, Omobolaji Ayandipo, Stephen Edino, Zumnan Songden, Olumide Akitoye, Bissallah Ekele, Godwin Akaba, Terkaa Atim, Akitoye Adeleke, Owoicho Okochi, Sunday Akeju, Ernest Ukpoju, Osayomwanbo Osaheni, Ifunanya Obaseki, Lateef Kehinde, Osawemwenze Monday, Stanley Nte, Adesuwa Agboifo, Omajuwa Dawodu, Precious Orhiere, David Atiti, Queeneth Kalu, Felix Effiom, Israel Kolawole, Olawale Ojo, Afusat Olabinjo, Olufemi Ige, Beatrice Ogunyemi, Olusola Oladosu, Kikelomo Adesina, Sulaiman Agodirin, Asimiyu Shittu, Audu Idrisa, Sadiq Adamu, Nuhu Ali, Olayinka Adewunmi, Stephen Nwankwor, Akinwumi Olakanmi, Oluseye Ajayi, Ayotolu Ajayi, Victor Ogunmola, Oluwafunke Olakanmi, Adam Kuranga, Enoch Uche, Chukwuemeka Osuagwu, Chukwudi Ilo, Mesi Matthew, Uko Uko, Ngozi Mba, Olubusola Alagbe-Briggs, Amabra Dodiyi-Manuel, Bisola Onajin-Obembe, Bright Obasuyi, Richard Echem, Ihuoma Mike-Elechi, Job Otokwala, Mark Edubio, Catherine Eyo, Isaac Udo, Aliyu Abdulrahman, A.A. Abdullahi, Ibrahim Galadima Bello, Usman Adinoyin Mohammed, Abidemi Oyaromade, Mohammed Bello, Usman Muhammad, Emeri Mbah, Hyacinth Okereke, Almustapha Aminu, Anthony Ahmadu, Abu Rogers, Peter Samai, Sao Amara, Margaret Yankuba, Mary Josayah, Jayah Swarray Jnr, Alusine Dawo, Peter George, Mustapha Kabba, Mohamed Bah, Charles Mondeh, Ibrahim Kapuwa, Mohamed Sheku, Philip Mattia, Brima Sesay, Jones O.A. Omoshoro-Jones, Motselisi Mbeki, Estie Cloete, Philip Anderson, Busi Mrara, Annemarie Steyn, Tsakani Mhlari, Nic Proctor, Caroline Robertson, Gillian Lamacroft, Usha Singh, Sebenzile Sikhakhane, Kelly Gate, Shepherd Nzenza, John Tshimbalanga Kasonga, Sibongile Ndebele, Patrick Lufuta Kande, Jody Davids, Tino-vito Orlandi, Marischka de Jong, Hugo Stark, Francois Roodt, Jonathan Hall, Ian Nortje, Akanimo Akpakan, Vishendran Govindasamy, Ronisha Sathiram, Mohammad Kathrada, Zane Farina, Lucio Frittella, Charles Kohler, Sibuyiselwe Lubelwana, Sarwat Ikram-Hameed, Adriaan Smit, Muneerah Cassiem, Yvonne Freeman, Saaliha Goga, Larissa Cronje, Constantin Buzdugan, Subash Chirkut, Priyadeshni Singh, Sandhya Jithoo, Vivesh Rughubar, John Arnold, Rishan Bipath, Suman Mewa Kinoo, Ncumisa Khanyisa Msolo, Fleur Ackermans-Deijnen, Tshegofatso Mmasello Emma Boka, Martyn Biccard Greenwood, Shakthi Anand Jayrajh, Devarani Naidoo, Syndrini Reddy, Devandiran Harriraman Rungan, Kylene Subrayen, John Roos, Nina Tredoux, Pascal Plumacher, Anthony Reed, Harald Steinhaus, Mariesa Nock, Paul Ryan Herselman, Gareth Davies, Talitha Harvey, Franklin Muller, Willem Naude, Tania Pretorius, Johan Jochemus Swart, Merryn Walls, Prashant Gokal, Nicolette Rorke, Farzaana Dhoodhat, Precious Dzanibe, Mohammed Yusuf Hussain, Ashmita Junpath, Ameela Maharaj, Hylda Makanisi, Khalid Moosa, Ting Ting Wong, Sean Mould, Trisha Ramsamy, Roel Matos-Puig, Hayley Morgan, Nadeem Nabeebuccas, Ria Devi Naidoo, Viantha Pather, Vasheel Vasheel Bahadur, Renilda Pillay, Zahnne Fullerton, Nicole Bell, Bongisa Grey, Vincent Lorenzo Visentin, Hendrik Adriaan Van Zyl, Terri Anne Killingbeck, Emile Maneveldt, Gerhard Thiart, Magdelena May Venter, Oostewalt Swart, Mariette Grobelaar, Carel Cairns, David Bishop, Christien Steenkamp, Thandekile Khumalo, Noel Naidoo, Ross Murray, Martin Kopieniak, Melusi Sishange, Mxolisi Brian Ndimande, Megan Jaworska, Sarwat Ikram, Bence Rainier, Renier J Liebenberg, Helena D Zwiegers, Philip M Nortje, Kamal Bhagwan, Margot Flint, Robert Dyer, Simone Adams, Yoshua Bwambale, Danny Ngomo, Patrice Kanku, Nivashen Pillay, Alexa de Castro, Atisha Maharaj, Janine Carim, Jenna Leigh Taylor, Karl M Köhne, Leanne W Drummond, Leanne Temlett, Lieze Geldenhuys, Yvonne Seilbea, Kathryn Naidoo, Nicola A Kalafatis, Stefné Verwey, Thulile Biyase, Theroshnie Kisten, Belinda S Kusel, Timothy Craig Hardcastle, Richard Magagula, Christian Kampik, Kuzolunga Xulu, Sivuyisiwe Solala, Mia Sayed, Basil Enicker, Anil Madaree, Innocent Mukama, Gladmore Madombwe, Nonhlanhla Zulu, Nompumelelo Gasa, Nokuzula Kanjana, Sebenzile Buthelezi, Thembelihle Buthelezi, Andries Brink, Francois Potgieter, Busisiwe Mrara, Zaynab Alexander, Charles Choto, Paula Ima, Zintle Gxagxisa, Baphethuxolo Ningiza, Gillian Lamacraft, Jerome Mogorosi, Nadia du Plessis, Leonie de Man, Suné Thompson, Gerrit van Heerden, Edwin W Turton, Pieter M van der Linde, Josephine K Teme-Pitse, Reitumetse Tladi, Gillian D Saffy, Ene-Mari Roscher, Kristel Fortune, George Barnard, Tiisetso Makhasane, Evan Bowen, Akangcha Pal, Rachel Moore, Maria Fourtounas, Mary Augusta Adam, Renessa Arumugan, Gabriella Hyman, Jaclyn Jonosky, Maninginingi Makondo, Heveshan Moodley, Phillip Munda, Mzwandile Nyalungu, Victor Olusola, Sohan Zane Pinto, Tristan Pillay, Lucinda Singh, Paul Mwindekuma Wondoh, John Devar, Boitumelo Baloyi-Mnisi, Zach Koto, Matlou Ernest Mabitsela, Sibongile Ruth Ndlovu, Branny Mthelebofu, Colin Beck, Matthew Dold, Alice Fan, Shannon MacQueen, Thembani Matabata, Catherine Mpehle, Charné Kulenkampf, Tsakani McCreath Mhlari, Simangele Cecilia Nyoka-Mokgalong, Felix Thumba Masinge, Randhir Ramnath Gunpath, Maropeng Petrus Pat Mothwa, Jo-Anne Asenath Mothwa, Danai Mhlanga, Jamie-Lyn Colly, Aunel Mallier Peter, Khalid Ben Hameda, Pulane Mokae, Stella Josephine Moumakoe, Kelechi Ekeh, Nezingu Lengo, Marnus Booyens, Inge Louise Seale, Pieter Daniel Theron, Nicolaas Abraham Schuman, Amber Carlyn Sonn, Jacobus Lukas Stander, Nadia Cloete, Marius Cloete, Catherine Ann Makepeace, Ronel van der Westhuizen, Leanne Robyn Messiahs, Amy Ruth Visagie, Fatima Vawda, Frans Christiaan Voster, Deepika Dhilraj, Oliver Smith, Stefan Bolon, Daniel Montwedi, Motsilisi Mbeki, Jayde Wyngaard, Mthunzi Ngcelwane, Thomas Kleyenstuber, Phyllis Phukubye, Liesel Schärf, Grace Laker, Elizabeth Semenya, Reinhard Dembskey, Thomas Tarlton, Tapiwa Jiri, Ngoie Hubert Mushid, Nhlanhla Samuel Ngwenya, Hazel Morongoa Mogodi, Carmen Sinevici, Anthony Osarogie Usenbo, Naledi Fodo, Anesu Chimini, Ntetelelo Sikobi, Sinovuyo Nokwange, Mluleki Noqhamza, Qumba Thembisa, Kajake Anantha Padmanabha Bhat, Rabin Mathew, Katrin Middleton, Abdus-sami Adewunmi, Craig Dickson, Humairah Bulbulia, Bianka Bester, Michelle de Klerk, Christia Benade, Francois Viljoen, Monique Fischer, Khalid Alfaki, Abdalmalik Awad, Abdelsalam Algray, Mohammed Elsiddig, Suha Mohamed, Salih Mahmoud, Muhammed Osman, Asia Elgailany, Mazin Suliman, Hanaa Mohammed, Lina Aljeally, Mohammed Dirar, Mohammed Osman, Mazin Mohamed, Mohamed Elhasan, Abrar Widatalla, Abubakr Abubakr, Eman Mohamed, Alshareef Nour, Ntonto Doris Gama, Dolorosa Khetsiwe Shabangu, Cynthia Iradikunda, Samuel Mkoko, Paul Kisanga, Emmanuel Lema, Benson Lyimo, Mohamed Binde, Alphonce Chandika, Salim Salim, Sylvia Jumbe, Abel Makubi, Vihar Kotecha, Felician Kachinde, Museleta Nyakiroto, Emmanuel Jitambi, Venant Geofrey, Johaphes Josiah, Phinius Makubi, Frank Manumbu, Suzan Mlingwa, Ernest Ibenzi, Peter Mbelle, Kato Peleus, Enid Chiwanga, Nillah Richard, Shoo Leonard, Paulo Sanka, Subira Mushi, Bashir Nyangasa, Mohamed Janabi, Naizihijwa Majani, Pedro Palangyo, Evarist Nyawawa, William Ramadhan, Faraj Lydenge, Gileard Gabriel Masenga, Sakina Rashid, Mubashir Jusabani, Ansbert Ndebea, Jenitha Cheru, Margaret Henjewele, Greyson Kilimanjaro, Sarah Sikimata, Deocles Donatus, Hazina Maduhu, Tumaini Mariro, Given Massasi, Moshi Moshi Shabani, Braison Cholela, Marco Mgeleka, Yohatinus Mbilinyi, Faraja Chiwanga, Bilton Exavery, Caspar Haule, Samson Ndile, Sirili Harya, Julieth Magandi, Deogratius Manyama, Redempta Matindi, Adam Moshi, Daudi Kitwana, Merida Makia, Philip Muhochi, Miriam Herman, Clauda Miombo, Furaha Kahindo, Langtone Kishebuka, Elijah Ussiri, Gloria Kinasa, Patrick Adel, Eric Malaba, Vensesla Sakwari, Sadot Lugereka, Mohamed Mungia, George Mocha, Herman Wella, Cecilia Protas, Patrick Karua, Ahmada Kashagama, Faraja Mwasambugu, Suzana Kajeri, Jacquiline Mchilla, Elibariki Lucumay, Robert Maise, Amon Marti, Beatrice Mahundi, Frederika Jager, Charles Majani, Ludovick Rukeha, Tareeq Mohamed, Nabila Fuad, Winifrida Halinga, Elias Chrisant, Gilbert Msoma, Titus Kihwili, Gadiel Temu, Naima Yusuf, Rashid Saleh, Rashid Inoja, Eva Shang'a, Stella Ibrahim, Hussein Msuma, Edwin Edward, Paul Kilamile, Stephen Mwakyolile, Talkana Adja, Edem Gueouguede, Hafoudhoi Oussene Seddoh, Saliou Adam, Pilakimwe Egbohou, Mawunyo Ahomagnon, Olivier Kadjossou, Abdul-Bassiti Boukari, Mary T Nabukenya, Ruth Muhindo, Peter Waswa, Peter Kaahwa Agaba, Daphne Kabatoro, Joseph Kayong, Margaret Naggujja, Nabasiige Rehema, Phiona Nansubuga, Daniel Kavuma, Aggrey Lubikire, Hope Bisilikirwa, Godfrey Ssebaggala, Emmanuel Muwema, Humble Joan Agaba, John Kiconco, Nicholas Wataaka, Bonet Chan, Mary Juliet Nampawu, Fred Bulamba, Emmanuel Bua, Christine Mugala, Caroline Nyakato, John Paul Ochieng, Linda Kyomuhendo Jovia, George Kateregga, Rachel Alum, Lazia Najjuma, Gorret Nampiina, Andrew Kintu, Joshua Sempiira, Luzige Simon, Peter Kayima, Jacob Eyul, Erick Odwar, Rita Nkwine, Christine Namata, Elizabeth Nabakka, Denis Kakaire, Velda Mushangwe-Mtisi, Erisha Munhamo, Celestino Dhege, Juliet Hungwa, Hemish Jasi, Crispin Ntoto, Derek Matsika, Brightson Mutseyekwa, Joseph Zimbovoora, Beaulah Gudyanga, Dennis Mazingi, Chenesa Mbanje, Busisiwe Mlambo, Michael Chiwanga, Harunavamwe N Chifamba, Sarudzai Zhou, Esta Hove, Shamiso Dende, Beauty Manjengwa, Penias Kapisa, null Mashava, Caritas Chiura, Locadia Katsukunya, Godfrey Muguti, Doreen Mashava, Elton Ndhlovu, Zanele Mangwangwa, and Nombulelo Dube

Subjects
Adult, medicine.medical_specialty, Standard of care, business.industry, Psychological intervention, MEDLINE, Standard of Care, General Medicine, Articles, Hospitals, Hospitalization, Intervention (counseling), Relative risk, Emergency medicine, Africa, medicine, Humans, In patient, Female, Cluster randomised controlled trial, Postoperative Period, business, Surgical patients
Abstract

Summary Background Risk of mortality following surgery in patients across Africa is twice as high as the global average. Most of these deaths occur on hospital wards after the surgery itself. We aimed to assess whether enhanced postoperative surveillance of adult surgical patients at high risk of postoperative morbidity or mortality in Africa could reduce 30-day in-hospital mortality. Methods We did a two-arm, open-label, cluster-randomised trial of hospitals (clusters) across Africa. Hospitals were eligible if they provided surgery with an overnight postoperative admission. Hospitals were randomly assigned through minimisation in recruitment blocks (1:1) to provide patients with either a package of enhanced postoperative surveillance interventions (admitting the patient to higher care ward, increasing the frequency of postoperative nursing observations, assigning the patient to a bed in view of the nursing station, allowing family members to stay in the ward, and placing a postoperative surveillance guide at the bedside) for those at high risk (ie, with African Surgical Outcomes Study Surgical Risk Calculator scores ≥10) and usual care for those at low risk (intervention group), or for all patients to receive usual postoperative care (control group). Health-care providers and participants were not masked, but data assessors were. The primary outcome was 30-day in-hospital mortality of patients at low and high risk, measured at the participant level. All analyses were done as allocated (by cluster) in all patients with available data. This trial is registered with ClinicalTrials.gov , NCT03853824 . Findings Between May 3, 2019, and July 27, 2020, 594 eligible hospitals indicated a desire to participate across 33 African countries; 332 (56%) were able to recruit participants and were included in analyses. We allocated 160 hospitals (13 275 patients) to provide enhanced postoperative surveillance and 172 hospitals (15 617 patients) to provide standard care. The mean age of participants was 37·1 years (SD 15·5) and 20 039 (69·4%) of 28 892 patients were women. 30-day in-hospital mortality occurred in 169 (1·3%) of 12 970 patients with mortality data in the intervention group and in 193 (1·3%) of 15 242 patients with mortality data in the control group (relative risk 0·96, 95% CI 0·69–1·33; p=0·79). 45 (0·2%) of 22 031 patients at low risk and 309 (5·6%) of 5500 patients at high risk died. No harms associated with either intervention were reported. Interpretation This intervention package did not decrease 30-day in-hospital mortality among surgical patients in Africa at high risk of postoperative morbidity or mortality. Further research is needed to develop interventions that prevent death from surgical complications in resource-limited hospitals across Africa. Funding Bill & Melinda Gates Foundation and the World Federation of Societies of Anaesthesiologists. Translations For the Arabic, French and Portuguese translations of the abstract see Supplementary Materials section.

Published
2021

19. Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study

Author

Hailay Siyum, Getachew Mebrahtu, Mebrahtu Abay, Etsay Hailu, Berihu Gidey, Teklit Angesom, Teklehaymanot Huluf Abraha, Berhe Beyene Gebrezgiabher, and Solomon Hintsa

Subjects
Article Subject, lcsh:RC435-571, Cross-sectional study, business.industry, lcsh:BF1-990, 030231 tropical medicine, Systematic sampling, Stage ii, Logistic regression, medicine.disease, Mental health, 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, lcsh:Psychology, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), lcsh:Psychiatry, Medicine, Drug side effects, 030212 general & internal medicine, business, Depression (differential diagnoses), Research Article, Demography
Abstract

Background. Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods. An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results. Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion. Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations.

Published
2019

20. The burden, admission, and outcome of COVID-19 in Africa: protocol for a systematic review and meta-analysis

Author

Mebrahtu Abay, Gebreamlak Gebremedhn Gebremeskel, Degena Bahrey Tadesse, Guesh Gebreayezgi Asefa, and Gebre Teklemariam Demoz

Subjects
0301 basic medicine, medicine.medical_specialty, Funnel plot, Epidemiology, 030106 microbiology, Pneumonia, Viral, Immunology, MEDLINE, Admission, Review, Review Article, World Health Organization, Microbiology, burden, 03 medical and health sciences, Betacoronavirus, COVID-19 Testing, Meta-Analysis as Topic, Virology, Drug Discovery, Medicine, Humans, Developing Countries, Pandemics, Protocol (science), business.industry, Clinical Laboratory Techniques, SARS-CoV-2, Public health, Incidence, COVID-19, Civil Defense, Publication bias, Guideline, General Medicine, 030104 developmental biology, Systematic review, Infectious Diseases, Family medicine, Meta-analysis, Africa, Practice Guidelines as Topic, outcome, Parasitology, business, Coronavirus Infections, Systematic Reviews as Topic
Abstract

Background: According to the World Health Organization (WHO), the outbreak of coronavirus disease in 2019 (COVID-19) has been declared as pandemic and public health emergency that infected more than 5 million people worldwide at the time of writing this protocol. Strong evidence for the burden, admission, and outcome of COVID-19 has not been published in Africa. Therefore, this protocol will be served as a guideline to conduct a systematic review and meta-analysis of the burden, admission, and outcome of COVID-19 in Africa. Methods: Published and unpublished studies on the burden, admission, and outcome of COVID-19 in Africa and written in any language will be included. Databases (PubMed / MEDLINE, Google Scholar, Google, EMBASE, Web of Science, Microsoft Academic, WHO COVID-19 database, Cochran Library, Africa Wide Knowledge, and Africa Index Medicus) from December 2019 to May 2020 will be searched. Two independent reviewers will select, screen, extract data, and assess the risk of bias. The proportion will be measured using a random-effects model. Subgroup analysis will be conducted to manage hetrogeinity. The presence of publication bias will be assessed using Egger's test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported per the PRISMA-P guidelines. Conclusion: This systematic review and meta-analysis protocol will be expected to quantify the burden, admission, and outcome of COVID-19 in Africa. Systematic review registration: This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) in March 2020 and accepted with the registration number: CRD42020179321(https://www.crd.york.ac.uk/PROSPERO).

Published
2020
Full Text
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21. Uncontrolled asthma in Ethiopia: a systematic review and meta-analysis

Author

Teklehaimanot Gereziher Haile, Ebud Ayele, Degena Bahrey Tadesse, Mebrahtu Abay, Melaku Negash, Kbrom Gemechu Kiros, Gebre Teklemariam Demoz, and Abrha Hailay

Subjects
Pulmonary and Respiratory Medicine, Funnel plot, Pediatrics, medicine.medical_specialty, business.industry, Public health, Publication bias, medicine.disease, Comorbidity, Asthma, respiratory tract diseases, uncontrolled asthma, asthmatic patient, determinants, Ethiopia, Risk Factors, Meta-analysis, Health care, medicine, Prevalence, Humans, Health education, Anti-Asthmatic Agents, business
Abstract

Introduction: Despite significant improvement in the diagnosis and management of this disorder, asthma in the majority of Ethiopians remains poorly controlled. Although the prevalence of uncontrolled asthma is a public health problem in Ethiopia, its reported prevalence varies from study to study. Hence, this review aims to determine the true prevalence of uncontrolled asthma among asthmatic patients in Ethiopia. Material and methods: Different database searching engines were used including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization (WHO) afro library, and Cochrane review. They were systematically searched for published studies on uncontrolled asthma in Ethiopia from 2014 to 2019. Primary search terms were “asthma”, “uncontrolled asthma”, “uncontrolled wheezing”, and “Ethiopia”. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Guidelines was followed. Publication bias was examined by the funnel plot. The random-effect model was fitted to estimate the pooled prevalence of uncontrolled asthma among asthmatic patients. All statistical analysis was done using R version 3.5.3 and the RStudio version 1.2.5033 software for Windows. Results: The overall pooled prevalence of uncontrolled asthma was found to be 71.67% [95% CI (0.6772; 0.7562)]. Potential associated factors were: unscheduled visits, frequency of short-acting beta2-agonist (SABA) use, type of treatment and perceived rate of asthma control, low monthly income, age group, presence of comorbidity, moderate persistent asthma, severe persistent asthma and use of SABA alone as anti-asthmatic medication, use of biomass fuel for cooking, longer duration of asthma (> 30 years), incorrect inhalation technique, and asthma exacerbation in the last 12 months. Self-perceived poor asthma control was associated with any activity limitation due to asthma, inconsistent inhaled corticosteroid use, and lack of health education on metered-dose inhaler technique [AOR =4.96; 95% CI (1.08–22.89)]. Conclusions: Nearly two-thirds of patients were determined to have uncontrolled asthma. Thus, this evidence suggests that attention should be given to asthma patients and health care providers.

Published
2020

22. Breast self-examination practice and associated factors among women aged 20–70 years attending public health institutions of Adwa town, North Ethiopia

Author

Teklit Grum, Teklehaymanot Huluf Abraha, Gemechis Tuke, Mebrahtu Abay, Ermyas Brhane, and Eleni Zewdie

Subjects
Adult, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Early detection, lcsh:Medicine, Asymptomatic, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Breast cancer, medicine, Humans, Women, 030212 general & internal medicine, skin and connective tissue diseases, lcsh:Science (General), lcsh:QH301-705.5, Breast self-examination, Aged, Cancer mortality, Government, Practice, medicine.diagnostic_test, business.industry, Public health, Incidence (epidemiology), lcsh:R, Adwa, General Medicine, Middle Aged, medicine.disease, Research Note, Cross-Sectional Studies, lcsh:Biology (General), 030220 oncology & carcinogenesis, Family medicine, Female, Public Health, Ethiopia, medicine.symptom, business, 20–70 years, lcsh:Q1-390
Abstract

Objective Breast cancer is the leading cause of cancer mortality worldwide. The incidence of breast has been increasing in most regions of the world. Regular breast self-examination is one of the most cost-effective methods for early detection of breast cancer in asymptomatic women. Despite this fact, breast self-examination practice remains low in Ethiopia. Therefore, the aim of this study is to assess breast self-examination practice and associated factors among women aged 20–70 years attending public health institutions of Adwa town, North Ethiopia. Results From the total study participants, only 26 (6.5%) of them had ever practice breast self-examination, and only 25 (6.25%) of them practice breast self-examination regularly. Being a government employee (AOR = 0.22, 95% CI = 0.071–0.683), having good perceived confidence to do breast self-examination (AOR = 5.32, 95% CI = 1.89–14.95) and having perceived good susceptibility to develop breast cancer (AOR = 3.79, 95% CI = 1.74–9.74) were the factors significantly associated with breast self-examination. Breast self-examination practice among the study participants was low. Therefore, informing every woman is susceptible to breast cancer, improving the confidence of women is recommended to increase breast self-examination practice.

Published
2018

23. Intention to use long-acting and permanent contraceptive methods and associated factors in health institutions of Aksum Town, North Ethiopia

Author

Kebede Haile, Berhe Beyene, Hailay Syum, Haben Nuguse, Teklehaymanot Huluf, Gizienesh Kahsay, Hadgu Gerensea, Gebreamlak Gidey, Mebrahtu Abay, and Haftom Desta

Subjects
Adult, lcsh:Medicine, Axum, Intention to use, Negative attitude, Factors, General Biochemistry, Genetics and Molecular Biology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030212 general & internal medicine, lcsh:Science (General), lcsh:QH301-705.5, computer.programming_language, 030219 obstetrics & reproductive medicine, LAPMs, business.industry, Reproduction, lcsh:R, General Medicine, Middle Aged, Hospitals, Research Note, Contraception, Long acting, lcsh:Biology (General), Family Planning Services, Multivariate Analysis, Female, Ethiopia, Positive attitude, business, computer, lcsh:Q1-390, Demography
Abstract

Objective In Ethiopia, the majority of married women practice predominantly short-acting contraceptive methods. Therefore this study aims to assess intention to use LAPMs and its determinants among short-acting users in Health Institutions of Aksum Town, North Ethiopia. Results Prevalence of intention to use LAPMs was 52.1% (95% CI 47.4–57.0). Good knowledge on LAPMs [AOR = 2.15; 95% CI (1.29, 3.56)], positive attitude towards LAPMs [AOR = 3.41; 95% CI (1.99, 5.85)], 18–24 years of age [AOR = 3.18; 95% CI (1.30, 7.79)], being primary school in educational level [AOR = 0.34; 95% CI (0.14, 0.78)], decision on the number of children jointly with partner [AOR = 2.05; 95% CI (1.01, 4.18)], having more than two children [AOR = 10.67; 95% CI (1.29, 88.31)], and no [AOR = 10.21; 95% CI (3.10, 33.58)] and one [AOR = 4.70; 95% CI (1.68, 13.13)] extra number of children desired were factors significantly associated with having intention to use LAPMs compared to their counterparts. The intention to use LAPMs was low. Therefore, appropriate information, education and communication strategies must be designed to raise awareness and change the negative attitude of the community on LAPMs.

Published
2019

24. Prevalence and factors associated with intestinal parasites among food handlers of food and drinking establishments in Aksum Town, Northern Ethiopia

Author

Hiwet Zelalem, Mebrahtu Abay, Girmay Medhin, Desalegn Tetemke, Dejen Gezehegn, Hafte Teklay, and Zeray Baraki

Subjects
Adult, Male, medicine.medical_specialty, Food handlers, Sanitation, Food Handling, 030231 tropical medicine, Intestinal parasite, medicine.disease_cause, Odds, 03 medical and health sciences, Feces, 0302 clinical medicine, Risk Factors, Environmental health, Surveys and Questionnaires, Epidemiology, medicine, Prevalence, Humans, 030212 general & internal medicine, Intestinal Diseases, Parasitic, Intestinal parasites, business.industry, Public health, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Odds ratio, Aksum, Checklist, Cross-Sectional Studies, Food and drinking establishments, Female, Ethiopia, Biostatistics, business, Research Article
Abstract

Background Various epidemiological studies indicate that the prevalence of intestinal parasites is high in developing countries and those parasites are major public health importance in Sub-Saharan Africa. Their distribution is mainly associated with poor personal hygiene, environmental sanitation and lack of access to clean water. This study was conducted to estimate the prevalence of intestinal parasitic infection and identify factors associated with intestinal parasitic infection among food handlers in the Aksum Town of Tigray Regional State, North Ethiopia. Methods A cross-sectional study design was used among 400 randomly selected food handlers who were selected as respondents. Data were collected by face to face interviewer administered questionnaire supplemented with observational checklist. Fresh stool samples were collected from respondents and were examined microscopically for the presence of any of intestinal parasites using standard laboratory methods. Multivariable logistic regression model using Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) was fitted to analyze the independent predictors of intestinal parasitic infections. Result The mean age of the food handlers included in this study was 26.0 years. Of the total respondents, 72.5% were females, 63% have completed at least secondary school educational level. Five species of Intestinal Parasites (IPs) were identified. The overall prevalence of being infected with at least one intestinal parasite was 14.5%, 95% CI (11.3, 18.0). The odds of being positive for at least one intestinal parasitic infection was 12.3 times higher among food handlers who practice medical checkup every 9 months compared to those who have a medical checkup every 3 months. The odds of being positive for intestinal parasitic infection was 3 times higher among food handlers with no formal education compared to those who have a level of education secondary school and above. Food handlers who received food hygiene and safety training were 66% less likely to be positive for at least one intestinal parasitic infection as compared to those who did not receive training. Conclusion Prevalence of parasitic infection among food handlers observed in the current study is relatively low but is still a public health importance. Number of medical checkup, training in food hygiene and safety, feedback from customers and level of education were significantly associated with reduced odds of being infected with parasitic infection. Hence, these factors should be focused by policy makers and implementers to further bring the prevalence below the level of public health importance. Electronic supplementary material The online version of this article (10.1186/s12889-017-4831-5) contains supplementary material, which is available to authorized users.

Published
2017

25. Post-Cesarean Section Maternal Health Outcome and its Determinants in Tigray Regional State, North Ethiopia

Author

Haileselassie Berhane, Mirkuzie Woldie Kurie, Welay Gebremariam, Abraham Mengstu, and Mebrahtu Abay

Subjects
business.industry, Section (archaeology), Medicine, Maternal health, business, Outcome (game theory), Demography
Abstract

Back ground Cesarean section rate is increasing worldwide. However, the World Health Organization has declared that there is insufficient information on maternal outcome following cesarean section for decision making.Objective The aim of this study was to assess post cesarean section maternal outcome and its associated factors availing evidence for practice and policy.Methods Institution based cross-sectional study was conducted among 357 mothers who underwent cesarean section in six selected public general hospitals of Tigray regional State, Ethiopia. Mothers were followed for the duration of post-operative period until they became safe for discharge. The maternal outcomes were categorized into either adverse or good outcomes depending on whether mothers develop any cesarean section related morbidity or not. Logistic regression model was constructed to determine the AOR and 95% CI of independent factors associated with maternal outcome following cesarean section.Results The proportion of adverse maternal outcome was 19.3% with 95% CI of (15.7% -23.8%). Route of anesthesia administration (AOR = 0.296, 95% CI: 0.126 - 0.695) and referral status (AOR = 0.371, 95%CI: 0.214 - 0.641) were statistically significant factors associated with maternal outcome following cesarean section.Conclusion There was high proportion of adverse maternal outcome. General anesthesia and referral from lower health facilities were associated with higher risk of post-CS adverse maternal outcome. Equipping lower level health facilities with the human and material capacity for timely detection of CS indications and provision of cesarean section services could decrease the number of referrals and subsequent delays that lead to adverse maternal outcome.

Published
2019

26. Diarrheal disease in under-five children among model and non-model families in northern Ethiopia, 2017: a comparative cross-sectional study

Author

Alias Tesfamariam, Berhe Beyene Gebrezgiabher, Desalegn Tetemke, Teklehaymanot Huluf Abraha, Negasi Asres, Zemichael Weldegebrial, Gebreamlak Gidey, Teklit Angesom, and Mebrahtu Abay

Subjects
0301 basic medicine, Diarrhea, Cross-sectional study, Under five children, lcsh:Medicine, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Model and non-model families, Medicine, Humans, Family, 030212 general & internal medicine, Sanitation, lcsh:Science (General), Child, lcsh:QH301-705.5, Maternal history, Behavior, business.industry, lcsh:R, Hygiene, General Medicine, Research Note, 030104 developmental biology, Cross-Sectional Studies, lcsh:Biology (General), Multistage sampling, Latrine, Ethiopia, Diarrheal disease, medicine.symptom, business, Waste disposal, lcsh:Q1-390
Abstract

Objective Diarrheal disease in under-five children among model families is expected to be lower than non-model families. Therefore, this study compared the prevalence and associated factors of diarrheal diseases among under-five children between model and non-model families. A comparative cross-sectional study was conducted from May to June 2017 among 322 children from each model and non-model family. Using multistage sampling technique data were collected through interview and observation. Both bi-variable and multivariable analyses were used to compute the statistical associations. Statistical significances were declared at 95% CI and p value

Published
2019

27. MOESM1 of Intention to use long-acting and permanent contraceptive methods and associated factors in health institutions of Aksum Town, North Ethiopia

Author

Hailay Syum, Gizienesh Kahsay, Teklehaymanot Huluf, Berhe Beyene, Hadgu Gerensea, Gebreamlak Gidey, Haftom Desta, Mebrahtu Abay, Haben Nuguse, and Kebede Haile

Abstract

Additional file 1. A questionnaire used to collect data on intention to utilize long acting contraception among women attending health institutions of Aksum town, Ethiopia.

Published
2019
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29. Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia

Author

Tekia Zafu, Mebrahtu Abay, Wagnew Tesfay, and Solomon Hintsa

Subjects
RNA viruses, Male, 0301 basic medicine, Time Factors, Comorbidity, Pathology and Laboratory Medicine, Weight Gain, Pediatrics, Geographical Locations, 0302 clinical medicine, Immunodeficiency Viruses, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Wasting, Multidisciplinary, Under-five, Prognosis, Hospitals, Hospitalization, Survival Rate, Diarrhea, Medical Microbiology, Viral Pathogens, Child, Preschool, Viruses, Female, Pathogens, medicine.symptom, Research Article, medicine.medical_specialty, Death Rates, Science, Severe Acute Malnutrition, Nutritional Status, Gastroenterology and Hepatology, Microbiology, Pallor, 03 medical and health sciences, Signs and Symptoms, Population Metrics, Internal medicine, Retroviruses, Humans, Microbial Pathogens, Nutrition, Retrospective Studies, 030109 nutrition & dietetics, Population Biology, Hospitals, Public, business.industry, Proportional hazards model, Malnutrition, Lentivirus, Body Weight, Organisms, Infant, Newborn, Biology and Life Sciences, HIV, Infant, Retrospective cohort study, Recovery of Function, Length of Stay, medicine.disease, Health Care, Health Care Facilities, People and Places, Africa, Dietary Supplements, Ethiopia, Clinical Medicine, business, Follow-Up Studies
Abstract

BackgroundSevere acute malnutrition is defined by MethodsSample size was calculated using STATA version 12.0. A retrospective cohort study was conducted using pretested questionnaire in the public hospitals in Aksum on children aged 0-59 months. Cleaned data was entered to Epi info version 7.1.4 and then exported into SPSS version 21 for analysis. Bivariable and multivariable analyses were performed using Kaplan Meier and Cox regression models. During bivariable analysis, variables with p-value < 0.05 were selected for multivariable analysis to identify independent factors associated with length of stay.ResultsA total of 564 participants enrolled to the study. The rate of recovery was 56% with median length of stay of 15 days (95% CI: 14.1, 15.9). The independent predictors of length of stay to recovery were presence of diarrhea at admission (AHR = 0.573, 95% CI: 0.415-0.793), being HIV positive (AHR = 0.391, 95% CI: 0.194-0.788), palmar pallor (AHR = 0.575, 95% CI: 0.416-0.794), presence of other co-morbidities at admission (AHR = 0.415, 95% CI: 0.302-0.570) and not being treated with plumpy nut (AHR = 0.368, 95% CI: 0.262-0.518).ConclusionsLength of stay is in the acceptable range of the international and national set of standards. Nevertheless, the recovery rate was lower compared to the Sphere standard. Presence of diarrhea, palmar pallor, HIV other co-morbidities and not treated with plumpy nut were found independent protective factors for recovery from sever acute malnutrition.

Published
2020

30. Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia

Author

Awoke Kebede, Hafte Teklay, Lidiya Tsegay, Mebrahtu Abay, Zeray Baraki, and Hadgu Gerensea

Subjects
medicine.medical_specialty, Cross-sectional study, Logistic regression, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, Humans, Medication Errors, Medicine, Population proportion, Medication administration error, Prospective Studies, 030212 general & internal medicine, Child, Developing Countries, 030504 nursing, Hospitals, Public, business.industry, lcsh:RJ1-570, Tigray, Infant, Newborn, Infant, lcsh:Pediatrics, Odds ratio, Medication administration, Confidence interval, Checklist, Hospitalization, Personnel, Hospital, Cross-Sectional Studies, Logistic Models, Child, Preschool, Pediatrics, Perinatology and Child Health, Emergency medicine, Observational study, Ethiopia, Clinical Competence, Inpatient, 0305 other medical science, business, Research Article
Abstract

Background Medication administration error is a medication error that occurs while administering a medication to a patient. A variety of factors make pediatrics more susceptible to medication errors and its consequences. In low-income countries, like Ethiopia, there is no sufficient evidence regarding medication administration error among pediatrics. The aim of this study is, therefore, to determine the magnitude and factors associated with medication administration error among pediatric population. Methods A prospective observational based cross sectional study design was conducted from January to April 2017. Data collection was done using pre-tested structured questionnaire and blind observation checklist to health professionals in charge of administering selected medications. A total of 1282 medication administrations were obtained using single population proportion formula from patients in the selected public hospitals and the samples were selected using multistage sampling technique. Multivariable logistic regression using odds ratio and 95% confidence interval was used to determine the relationship between the independent and dependent variables. Variables with p-value

Published
2018

31. Unmet need for modern contraception and associated factors among reproductive age group women in Eritrean refugee camps, Tigray, north Ethiopia: a cross-sectional study

Author

Mebrahtu Abay, Hailay Siyum, Abebaw Gebeyehu, Brhane Gebremariam, Kidane Gebrecherkos, and Gizienesh Kahsay

Subjects
Adult, Health Knowledge, Attitudes, Practice, Adolescent, Cross-sectional study, Refugee, lcsh:Medicine, Reproductive age, General Biochemistry, Genetics and Molecular Biology, Unmet needs, 03 medical and health sciences, 0302 clinical medicine, Refugee camp, Contraceptive Agents, Unsafe abortion, Pregnancy, Medicine, Humans, 030212 general & internal medicine, lcsh:Science (General), lcsh:QH301-705.5, Health Services Needs and Demand, Refugees, business.industry, Refugee Camps, 030503 health policy & services, lcsh:R, Tigray, General Medicine, medicine.disease, Pregnancy, Unwanted, Contraceptive use, Reproductive age women, Research Note, Contraception, Cross-Sectional Studies, lcsh:Biology (General), Unwanted Pregnancy, Female, Ethiopia, 0305 other medical science, business, lcsh:Q1-390, Demography, Unmet need
Abstract

Objective Millions of women want to delay or avoid pregnancy, but they are not using contraception, especially in refugee settings. Due to lack of contraception, one fifth of reproductive age group women suffered from unwanted pregnancy and unsafe abortion, which accounted for 78% of maternal mortality in refugee camps. Therefore, the aim of this study was to assess the prevalence of unmet need for modern contraception and its associated factors among reproductive age group women in Eritrean refugee camps, Tigray, Northern Ethiopia, 2016. Results 400 women of reproductive age group interviewed. Prevalence of unmet need for modern contraception in this study was found to be 41.8% (95% CI 36.99%, 46.63%).Respondents’ unfavorable attitude towards modern contraceptive methods [AOR = 0.372, 95% CI 0.170, 0.818] and the availability of modern contraceptive methods [AOR = 3.501, 95% CI 1.328, 9.231] were factors significantly associated with unmet need for modern contraception. Respondents’ attitude towards modern contraceptive methods and availability of modern contraceptives were independent predictors of unmet need. Governmental and non-governmental organizations should design programs to create behavioral change in women’s attitude towards contraceptive use and to secure the availability of contraceptive methods in refugee camp settings.

Published
2018

32. Survival status and predictors of mortality among children with severe acute malnutrition admitted to general hospitals of Tigray, North Ethiopia: a retrospective cohort study

Author

Ermyas Brhane, Gebremicael Guesh, Getu Degu, Berhe Beyene, Kalayu Brhane, and Mebrahtu Abay

Subjects
Survival Status, Male, Longitudinal study, Pediatrics, medicine.medical_specialty, Time Factors, Consciousness, Severe Acute Malnutrition, Psychological intervention, lcsh:Medicine, HIV Infections, Kaplan-Meier Estimate, Hospitals, General, Severity of Illness Index, General Biochemistry, Genetics and Molecular Biology, Tigray region, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, Mortality, lcsh:Science (General), lcsh:QH301-705.5, Survival status, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, Medical record, lcsh:R, Infant, Newborn, Infant, Retrospective cohort study, General Medicine, medicine.disease, Comorbidity, Research Note, Treatment Outcome, lcsh:Biology (General), Child, Preschool, Female, Ethiopia, business, lcsh:Q1-390
Abstract

Objective Despite the presence standard protocol for management of severe acute malnutrition case-fatality rates in African hospitals remain unacceptably high. The case in Ethiopia is not different from others. Therefore, this study was aimed to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to stabilization centers of general hospitals in Tigray region, northern Ethiopia. A 24 months retrospective longitudinal study was conducted among 569 randomly selected medical records of children admitted to stabilizing centers. Both bi-variable and multivariable Cox regression analysis was conducted to identify predictors of mortality. Association was summarized using AHR, and statistical significances were declared at 95% CI and P-value

Published
2018

36. Effect of late HIV diagnosis on HIV-related mortality among adults in general hospitals of Central Zone Tigray, northern Ethiopia: a retrospective cohort study

Author

Teklit Angesom, Solomon Hintsa, Fessahaye Alemseged, Mebrahtu Abay, and Hadera Belay

Subjects
Pediatrics, medicine.medical_specialty, Epidemiology, 030231 tropical medicine, CD4 cell count, Dermatology, HIV/AIDS - Research and Palliative Care, 03 medical and health sciences, 0302 clinical medicine, Virology, Risk of mortality, medicine, 030212 general & internal medicine, Original Research, business.industry, Proportional hazards model, Health Policy, Incidence (epidemiology), Mortality rate, Hazard ratio, Tigray, HIV, Retrospective cohort study, Confidence interval, Infectious Diseases, HIV-related mortality, Ambulatory, early/late diagnosis, Ethiopia, business
Abstract

Hadera Belay,1 Fessahaye Alemseged,2 Teklit Angesom,1 Solomon Hintsa,1 Mebrahtu Abay1 1Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia; 2Department of Epidemiology, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia Background: The global incidence of HIV infection is not significantly decreasing, especially in sub-Saharan African countries, including Ethiopia. Though there is availability and accessibility of free HIV services, people are not being diagnosed early for HIV, and hence patients are still dying of HIV-related causes. This research is aimed at verifying the effect of late diagnosis of HIV on HIV-related mortality in Central Zone Tigray, Ethiopia. Methods: A retrospective cohort study among adult (≥15 years old) HIV patients in three general hospitals of Tigray was conducted. Record reviews were carried out retrospectively from 2010 to 2015. Sample size was determined using stpower Cox in Stata software. Data were entered into EpiData version 3.1 software and transferred to Stata version 12 for analysis. Both bivariable and multivariable analyses were performed using Cox regression model to compare the HIV-related mortality of exposed (cluster of differentiation 4 cells count

Published
2017

37. Essential neonatal care utilization and associated factors among mothers in public health facilities of Aksum Town, North Ethiopia, 2016

Author

Ermyas Birhane, Megbey Berhe, Mebrahtu Abay, Gizienesh Kahsay, and Araya Abraha Medhaniye

Subjects
Gerontology, Health Knowledge, Attitudes, Practice, Cross-sectional study, Maternal Health, lcsh:Medicine, Logistic regression, Pediatrics, Neonatal Care, Geographical Locations, Labor and Delivery, 0302 clinical medicine, Pregnancy, Medicine and Health Sciences, Odds Ratio, 030212 general & internal medicine, lcsh:Science, education.field_of_study, 030219 obstetrics & reproductive medicine, Multidisciplinary, Under-five, Obstetrics and Gynecology, Breast Feeding, Female, Research Article, Adult, Postnatal Care, medicine.medical_specialty, Adolescent, Population, Parenting Behavior, Mothers, 03 medical and health sciences, Antenatal Care, medicine, Humans, education, Behavior, business.industry, Public health, lcsh:R, Infant, Newborn, Biology and Life Sciences, Neonates, Odds ratio, Patient Acceptance of Health Care, Delivery, Obstetric, Child mortality, Health Care, Cross-Sectional Studies, Social Class, People and Places, Africa, Multivariate Analysis, Birth, Public Health Practice, Women's Health, lcsh:Q, Ethiopia, Neonatology, business, Breast feeding, Demography, Developmental Biology
Abstract

BACKGROUND Globally, neonatal death accounts about 44% of child death in 2013. Ethiopia is one of the ten countries with the highest number of neonatal death. Worldwide, more than 43% of deaths among under five year children is contributed by neonates. Half of the neonatal death occur in the first day of life. Recommendations about newborn care practices may conflict with local beliefs and practices. So, it is important to understand the existing newborn care practice and factors affecting it in order to take interventions so as to decrease neonatal death. OBJECTIVE To assess magnitude of essential neonatal care utilization and associated factors among women visiting public health facilities in Aksum Town, Tigray, Northern Ethiopia, 2015. METHODS Facility based cross sectional study was conducted from December 30, 2015 to January 31, 2016.The sampled population are 423 women who gave live births within the last 6 months prior to data collection. Systematic random sampling technique was employed. Data were entered, coded and cleaned using Epi info version 7, and SPSS Version 21 software was used for analysis. Both bivariable and multivariable logistic regression models were used to determine factors associated with essential neonatal care utilization. Variables with P-value

Published
2017

38. Determinants to antiretroviral treatment non-adherence among adult HIV/AIDS patients in northern Ethiopia

Author

Desalegn Tetemke, Berhe Beyene Gebrezgabher, Yigzaw Kebede, Yalemzewod Assefa Gelaw, Mebrahtu Abay, and Melaku Kindie

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, Anti-HIV Agents, Case–control study, Northern Ethiopia, 030106 microbiology, HIV Infections, Non-adherence, Medication Adherence, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Virology, Internal medicine, medicine, Antiretroviral treatment, Humans, Pharmacology (medical), 030212 general & internal medicine, Adverse effect, Depression (differential diagnoses), Aged, Aged, 80 and over, business.industry, Research, Case-control study, Middle Aged, medicine.disease, Antiretroviral therapy, Non adherence, Case-Control Studies, Immunology, Molecular Medicine, Female, Ethiopia, Substance use, business, Follow-Up Studies
Abstract

Background Adhering 95% and above of antiretroviral therapy reduces the rate of disease progression and death among people’s living human immunodeficiency virus. Though manifold factors have reported as determinant factors of antiretroviral therapy adherence status, perhaps determinants of non-adherence differ up on the activities of patients in the study setting. Methods An institution based unmatched case–control study was conducted in Aksum town. Individuals who had a 6-month follow-up with complete individual information were included in the study. Document review and interviewer based techniques were used to collect the data. Binary logistic regression analysis was used to identify the determinant factors of non-adherence. Results A total of 411 (137 cases and 274 control) study participants were included in the study. The majority of them were male in sex. Having 2 years and above duration on ART [AOR = 7, 95% CI (2.2, 22.6)], history of adverse effect [AOR = 6.9, 95% CI (1.4, 32.9)], substance use [AOR = 5.3, 95% CI (1.4, 20.0)], living with parents [AOR = 3.4, 95% CI (1.2, 10.3)], having depression symptom [AOR = 3.3, 95% CI (1.4, 7.5)]

Published
2017

39. Determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia: A case-control study

Author

Abdulhalik Workicho, Teklit Angesom, Mebrahtu Abay, Solomon Hintsa, and Lamessa Dube

Subjects
Blood Glucose, Male, Systolic hypertension, Physiology, lcsh:Medicine, Blood Pressure, Overweight, Logistic regression, Pathology and Laboratory Medicine, Vascular Medicine, Diabetic nephropathy, 0302 clinical medicine, Endocrinology, Risk Factors, Chronic Kidney Disease, Medicine and Health Sciences, Diabetic Nephropathies, 030212 general & internal medicine, lcsh:Science, Multidisciplinary, Proteinuria, Data Processing, Alcohol Consumption, Middle Aged, Blood Sugar, Body Fluids, Blood, Nephrology, Hypertension, Female, medicine.symptom, Anatomy, Information Technology, Research Article, Adult, medicine.medical_specialty, Computer and Information Sciences, Endocrine Disorders, 030209 endocrinology & metabolism, Nephropathy, 03 medical and health sciences, Signs and Symptoms, Nursing, Diagnostic Medicine, Diabetes mellitus, Internal medicine, medicine, Diabetes Mellitus, Humans, Nutrition, business.industry, lcsh:R, Case-control study, Biology and Life Sciences, medicine.disease, Diet, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Case-Control Studies, Metabolic Disorders, Diabetes Diagnosis and Management, lcsh:Q, Ethiopia, business
Abstract

Background Diabetic nephropathy is the most serious complication of diabetes which leads to end-stage renal failure and other complication of diabetes mellitus. Determinants of Diabetic nephropathy are not consistent in different studies and associated factors to chronic complications of diabetes are not specific and there are limited studies specific to diabetic nephropathy. Thus, the aim of this study is to identify determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia. Methods A case-control study was conducted from February 14 to May 8 2016. Diabetic patients who developed nephropathy in the last two years were the cases and diabetic patients free of nephropathy were controls. Cases and controls were identified detailed review of the chronic care follow up chart. Then simple random sampling was used to select sample of 420 (with control to case ratio of 4:1) resulting in 84 cases and 336 controls. Record review and interviewer administered questionnaire were used to collect data. Data was coded and entered in to Epi-Data version 3.1 and then exported to STATA 12 for analysis. Variables with P-values< 0.25 in Bivariate logistic regression were selected for multiple logistic regressions to determine independent determinants of diabetic nephropathy. OR was calculated with 95% CI to show strength of association. Result The mean age (±Standard deviation) for the cases and the controls were 52(SD: ±1.34) and 42.4(SD: ±0.8) respectively. In multiple logistic regressions age of patient (AOR: 1.037 95%CI: 1.01–1.064), duration of diabetes after diagnosis (AOR for one year increase: 1.09 95%CI: 1.036–1.15), not-adhered to blood glucose measurement at home (AOR: 6.81 95%CI: 1.15–40.24), having Systolic Hypertension (AOR;2.13 (1.002–4.51), poor glycemic control (AOR;2.71 95%CI: (1.49–4.95), being overweight(AOR;2.7(1.47–4.96) were the independent predictors of diabetic nephropathy. Conclusion In the light of these findings, targeted interventions should be designed at the follow up clinic to address the risk of developing diabetic nephropathy among the risk groups.

Published
2017

40. The Impact of Cancer in the Tigray Region of Ethiopia: A Secondary Analysis

Author

Hadgu Gerensea, Mebrahtu Abay, Hafte Teklay, Zeray Baraki, Lidya Tsegay, Teklit Angesom, Desta Siyoum, Eskedar Brhane, Teklit Grum, Solomon Hintsa, Awoke Woldu, Almaz Sied, and Patricia Malloy

Subjects
Cancer Research, Veterinary medicine, Descriptive statistics, business.industry, education, Cancer, Disease, Lymph Node Cancer, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Secondary analysis, Medicine, Lung tumor, 030212 general & internal medicine, business, Socioeconomics
Abstract

Control of communicable diseases has been the focus in the Tigray region. The research team, all of whom live in this region, propose that non-communicable diseases need to have this same control. To comprehend the impact of cancer, a non-communicable disease, the team conducted a secondary analysis of all patients who had received care in the Tigray region over a 4-year period. Over 10,000 registrations were reviewed; descriptive statistics provided the team with a rough estimate of the impact of cancer in this region. What follows is a more descriptive illustration of the impact with recommendations to decision makers in the Tigray region.

Published
2017

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