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Eden Tefera,1 Azwihangwisi Helen Mavhandu-Mudzusi2 1Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Health Studies, University of South Africa, Pretoria, South AfricaCorrespondence: Eden Tefera, Email edengirmaye@gmail.comPurpose: The aim of the study was to explore and describe the lived experiences of HIV-positive adults on antiretroviral therapy (ART) initiation in West Shoa Zone, Ethiopia.Materials and Methods: A descriptive phenomenological design was utilized in the study to gain insight into participants’ lived experiences regarding ART initiation in West Shoa Zone, Ethiopia. Data were collected through semi-structured in-depth interviews and analyzed by means of thematic analysis.Results: The study found that spousal influence, denial of status, inconsistent ART initiation protocol, poverty, fear of side effects, religion and shortages of staff were factors that caused delayed ART initiation. A low CD4 count, the development of opportunistic infections and the prevention of future illness were factors that promoted ART initiation.Conclusion: This study provides an overview of experiences of adults living with HIV regarding ART initiation. The study emphasizes the need to improve adequate provision of resources to address issues related to finance, human capital, guidelines and inequity to enhance early ART initiation among HIV-positive adults in West Shoa Zone. The study findings have implications for policy implementation, ART service delivery, and the enhancement of prompt ART initiation in the study settings.Keywords: antiretroviral therapy, early antiretroviral therapy initiation, HIV, lived experience

Tshireletso Ramaphane,1 Alemayehu M Gezmu,1 Endale Tefera,1 Lesego Gabaitiri,2 Seeletso Nchingane,3 Motlalekgomo Matsheng-Samuel,3 Dipesalema Joel1 1Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 2Department of Statistics, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana; 3Princess Marina Hospital, Department of Pediatrics, Gaborone, BotswanaCorrespondence: Alemayehu M GezmuDepartment of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Bag UB00713, Gaborone, BotswanaEmail gezmuam@ub.ac.bwIntroduction: Microalbuminuria is considered the earliest sign of diabetic nephropathy among patients with type 1 diabetes mellitus (T1DM). The prevalence of microalbuminuria among African children with T1DM is reported to be high, yet its prevalence and population-specific risk factors in Botswana are not known.Aim: This study aimed to determine the prevalence of microalbuminuria among children and young adults with T1DM in Botswana and identify factors associated with microalbuminuria in this population.Methods: A retrospective cross-sectional study was conducted on 127 T1DM patients aged < 24 years followed at a pediatric endocrinology clinic in Botswana from 2010 to 2017. Clinical, laboratory, and demographic data were collected using chart review and patient surveys. Descriptive statistics were reported as mean and standard deviation for continuous variables, and frequency and percentage for categorical variables. Prevalence of microalbuminuria was calculated as a simple proportion. Group comparison was done using two-sample independent t-test, X2-test, or Fisher’s exact test and logistic regression to assess for associations. Level of significance was set at p< 0.05.Results: There were a total of 71 (55.9%) females. The mean age was 18.7 (± 5) years and mean duration of T1DM was 6.6 (± 4.6) years. Most study participants were of African descent. The prevalence of microalbuminuria was 28.3%. Group comparison revealed gender (p= 0.040), duration of diabetes (p= 0.002), systolic blood pressure (p=0.003), baseline glycated hemoglobin (HbA1c) (p=0.009) and Tanner’s stage (p=008) to be significantly associated with microalbuminuria. On binary logistic regression, only gender (p=0.039) and baseline HbA1c (p=0.039) were independently associated with the presences of microalbuminuria.Conclusion: This study identified a high prevalence of microalbuminuria among children and young adults with T1DM in Botswana and reaffirms the importance of early detection, glycemic control, and regular screening to prevent diabetic nephropathy.Keywords: microalbuminuria, diabetic nephropathy, type 1 diabetes mellitus, pediatrics diabetes

Alemayehu Mekonnen Gezmu,1 Shiang-Ju Kung,2 Jemal Zeberga Shifa,3 Britt Nakstad,1,4 Merrian Brooks,1,5 Dipesalema Joel,1 Tonya Arscott-Mills,1,5 Edelis Castellanos Puerto,6 Jūratė Šaltytė Benth,7,8 Endale Tefera1 1Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 2Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 3Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 4Institute of Clinical Medicine and Centre of Global Health, University of Oslo, Oslo, Norway; 5Center for Global Health, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 6Department of Allergy and Immunology, University Hospital Calixto Garcia, Havana, Cuba; 7Institute of Clinical Medicine, Campus Ahus, University of Oslo, Blindern, Norway; 8Health Services Research Unit, Akershus University Hospital, Lørenskog, NorwayCorrespondence: Alemayehu Mekonnen GezmuDepartment of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Private Bag UB00713, Gaborone, BotswanaTel +26774063734Fax +2673105979Email gezmuam@ub.ac.bwPurpose: This study aims to describe the spectrum of allergic diseases of children and adolescents in a single allergy treatment centre in Botswana, over a period of 8 years.Patients and Methods: A retrospective cross-sectional study was conducted using medical records of all patients aged 18 years or younger, seen at an allergy treatment centre in Botswana. Data were presented descriptively. Association between variables was explored by χ2-test.Results: Four hundred and seven patients with a mean age of 5.8 years (SD 4.4) at the time of presentation included 239 (58.7%) females and 365 (87.5%) black Africans. The most common diseases were asthma (n=249, 61.2%) followed by allergic rhinitis (AR) (n=232, 57.0%) and atopic dermatitis (AD) (n=165, 40.5%). One hundred and fifteen cases (46.2%) of asthmatic patients were skin prick test positive; sensitized to grass, moulds, dust mites and animal dander, in decreasing frequency, whereas those with allergic rhinitis (AR) and allergic conjunctivitis (AC) were sensitized to trees and all allergens identified in asthmatics. Concomitant asthma was diagnosed in 171 (73.7%) with AR, 71 (68.3%) with AC, 75 (45.5%) with AD and 42 (47.7%) with food allergy. The most common triggers for asthma exacerbations include upper respiratory tract infections, weather changes, and exposure to passive cigarette smoke. Paternal allergy and allergic disease in grandparents are predisposing factors for asthma (p=0.016 and p=0.001, respectively). Paternal allergy is also predisposed to AR (p=0.007), while maternal history of allergic disease was associated with AD (p=0.019).Conclusion: The most common chronic pediatric conditions seen in our allergic disease study were asthma, allergic rhinitis and atopic dermatitis with the most common triggers being viral upper respiratory tract infections, weather changes and exposure to cigarette smoke, all of which are modifiable risk factors. This exploratory study lays the foundation for future interventional studies that may be directed towards the spectrum of allergic diseases.Keywords: pediatric allergy, asthma in children, allergic rhinitis, atopic dermatitis

The fast economic growth, urbanization, and industrialization of Ethiopia led to the requirement for the establishment of various infrastructures and many residential building constructions consuming different types of materials. Reinforced steel bar is one of the most consumed construction materials in Ethiopia. The demand for reinforced steel bars in Ethiopia is satisfied by the local production and international market. However, most people lack trust to the use local products without justified reasons. This investigation work was done to evaluate the performance of the locally produced rebar concerning the Compulsory Ethiopian Standard (CES) to develop trust in contractors and consultants of different projects. A Compulsory Ethiopian Standard (CES) is an Ethiopian standard that has been prepared under the direction of the Technical Committee for Concrete and Concrete Products and published by the Ethiopian Standards Agency (ESA). Experimental works were done on rebar of grades B400BWR and B500BWR with different diameters collected from four different factories. The collected samples were investigated based on their yield strength, ultimate tensile strength, elongation, hardness, chemical composition, and microstructure formation of the product. The yield strength, ultimate tensile strength, and elongation of the rebar were analyzed based on the tension test results obtained from the 2000 KN Universal Testing Machine (UTM), and the chemical composition analysis was done using the Spark Emission Spectrometer Analyzer. The micro-hardness test was done using the Vickers Hardness Tester with 3kgf and 15-s dwell time at a 0.5 mm gap along the cross-section of the rebar. Microstructure analysis is done using EDX scanning electron microscope (SEM) and optical microscopy with different magnifications and resolutions on the cross-section of the rebar. From the tested samples one sample failed from B400BWR to achieve the minimum required yield strength of 400 MPa stated by CES 101, 2017. Samples of B500BWR satisfy all the requirements stated by the standard even if there is an increment up to 41 % beyond the minimum requirement.

The contents of phosphorous (P), calcium (Ca), sulphur (S), manganese (Mg), sodium (Na), potassium (K), iron (Fe), and copper (Cu), in graminaceae and legumes used for ruminant nutrition in the city of Adama, Eth i-opia, were determined. The samples were taken at random, from grazing areas near the city, and in the food market for these animals. The Molibdovanate method was used to determine P ; Ca,Mg and Cu were determined by the atomic adsorption spectroscopic met hod with flame; Na and K were determined by flame photo-metry; and S, by the turbidimetric method. The values were compared with the values reported for these animal requirements. Deficiencies of Cu, P and Na were found in all the samples analyzed. King Grass, wheat and teff stalks, important sources of nutrients du ring the dry season, were the scarcest. Statistics (P < 0.05) showed that, as a group, graminaceae were more mineral deficient than legumes. A study of certain mineral sources from the area is recommended for use as raw materials for salt production.

Se determinó el contenido de Fósforo (P), Calcio (Ca), Azufre (S), Magnesio (Mg), Sodio (Na), Potasio (K), Hie-rro (Fe) y Cobre (Cu) en gramíneas y leguminosas utilizadas para la alimentación de rumiantes en la ciudad de Adama, Etiopía. Las muestras fueron tomadas aleatoriamente en áreas de pastoreo cercanas a la ciudad y en el mercado de alimentos para este tipo de animales. Para la determinación de P se utilizó el método del molibdovanadato; el Ca, Mg y Cu se determinaron por espectroscopia de absorción atómica con llama; el Na y el K por fotometría de llama y el S por un método turbidimétrico. Los tenores de los elementos fueron comparados con los valores reportados de r e-querimientos de cada uno de ellos para este tipo de animales. Se encontró deficiencia de Cu, P y Na en todas las muestras analizadas. El king grass y la paja de trigo, que junto a la paja de tef son fuente principal de alimento duran-te la seca fueron los de mayor déficit. Estadísticamente (P < 0,05) se aprecia que, consideradas como grupo, estas gramíneas son más deficientes en el contenido de los minerales analizados que las leguminosas. Se recomienda estudiar algunas fuentes de minerales de la zona para utilizarlas como materias primas paras la producción de sales.

Background: Heart failure is a rare manifestation of metastatic disease of the carcinoma of an unknown primary, malignancy that requires extensive work-up to identify the primary site. Initial consideration of rare etiologies in patients presented with a common clinical syndrome is challenging., Case Presentation: A 35-year-old Black woman presented with shortness of breath at rest, orthopnea, paroxysmal nocturnal dyspnea, chest pain, a blood-tinged productive cough, and fever for 2 weeks. She also had progressive body swelling, easy fatigability, loss of appetite, and abdominal pain during the same week's duration. Body imaging revealed large pleural and pericardial effusions, metastatic liver lesions, and bilateral pulmonary vascular segmental and subsegmental filling defects. Pericardial and pleural fluid cytology suggest malignant effusion. Liver lesions and core needle biopsy indicated adenocarcinoma of unknown origin, and the carcinoembryonic antigen level also increased significantly., Conclusion: Carcinoma of unknown primary origin commonly presents in an advanced stage and is often accompanied by clinical features of site metastasis. This case highlights heart failure as an unusual first manifestation of adenocarcinoma with an unknown primary origin., (© 2024. The Author(s).)

The aim of the study was to compare preoperative factors and postoperative outcomes in patients with heel ulcerations that primarily had a transtibial (below the knee) amputation (N = 38) versus vertical contour calcanectomy (n = 62). The groups had no statistical difference between their Charlson Comorbidity Index Score, a prognostic score of 10-year survival in patients with multiple comorbidities. The odds of primary closure were 21.1 times higher in patients that underwent below knee amputation compared to patients that underwent vertical contour calcanectomy (OR 21.1 [95% CI 3.89-114.21]). The odds of positive soft tissue culture at time of closure were 17.1 times higher for patients that underwent vertical contour calcanectomy (OR 17.1 [95% CI 5.40-54.16]). The odds of a patent posterior tibial artery were 3.3 times higher for patients that underwent vertical contour calcanectomy (OR 3.3 [95% 1.09-10.09]). The secondary aim of the study was to evaluate preoperative factors and postoperative outcomes in patients with failed vertical contour calcanectomy, defined as needing a below knee amputation. The odds of vertical contour calcanectomy failure was 13.7 times higher in male patients (OR 13.7 [95% CI 1.80-107.60]). Vertical contour calcanectomy failure was 5.7 times higher in patients with renal disease (OR 5.7 [95% CI 1.10-30.30]), and vertical contour calcanectomy failure was 16.1 times higher for patients who needed additional surgery post closure (OR 16.1 [95% CI 1.40-183.20])., (Copyright © 2024 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Weekend effect' is a term used to describe the increased mortality associated with weekend emergency admissions to hospitals compared with admissions on weekdays. This effect was not investigated in Ethiopia among adult patients admitted to hospitals. We aimed to find out whether the weekend effect exists in the country's a teaching hospital., Methods: The study was conducted among adult medical patients admitted at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from September 2020 to September 2023. We extracted the data from the electronic medical records, and those with missed outcomes, length of hospital stays, and diagnosis were excluded. We used a multivariable logistic regression model to determine the association between the outcome and risk factors. The Cox proportional hazard model was utilized to establish the correlation between admission times and mortality risk incidence. Statistical significance was determined using a P value of less than 0.05. The Kaplan-Meier curve was utilized to estimate the risk of in-hospital mortality over the duration of the hospital stay., Results: A of 5564 patients were admitted to medical wards (n = 5001) and intensive care unit (ICU) (n = 563) during the study periods. In binary multivariable analysis, weekend medical wards and ICU admitted adult medical patients had a 38% (AOR, 1.38, 95% CI, 1.17, 1.65) and 50% (AOR, 1.50, 95% CI, 1.02, 2.20) higher in-hospital mortality compared weekdays admitted patients, respectively. The cumulative mortality risk incidence was higher among medical ward-admitted patients (AHR, 1.26, 95% CI, 0.09, 1.46, P value = 0.051) and significantly higher among ICU-admitted adult patients (AHR, 1.28, 95% CI, 1.21, 1.75, P value = 0.01) during the weekends. There was no statistically significant mortality difference among night versus day or office hours versus off-office hours admitted patients. Moreover, we did identify significant differences in the duration of hospital stays between weekends and weekdays., Conclusions: In this study, weekend-admitted adult medical patients in wards or ICUs have higher in-hospital mortality rates. This underscores a need for comprehensive nationwide data to improve weekend admitted patients' quality of care and treatment outcomes., Competing Interests: All authors declared that, there is no conflict of interest., (Copyright: © 2024 Arega et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective and Background: Epilepsy patients rank memory problems as their most significant cognitive comorbidity. Current clinical assessments are laborious to administer and score and may not always detect subtle memory decline. The Famous Faces Task (FF) has robustly demonstrated that left temporal lobe epilepsy (LTLE) patients remember fewer names and biographical details compared to right TLE (RTLE) patients and healthy controls (HCs). We adapted the FF task to capture subjects' entire spontaneous spoken recall, then scored responses using manual and natural language processing (NLP) methods. We expected to replicate previous group level differences using spontaneous speech and semi-automated analysis., Methods: Seventy-three (N=73) adults (28 LTLE, 18 RTLE, and 27 HCs) were included in a case-control prospective study design. Twenty FF in politics, sports, and entertainment (active 2008-2017) were shown to subjects, who were asked if they could recognize and spontaneously recall as much biographical detail as possible. We created human-generated and automatically-generated keyword dictionaries for each celebrity, based on a randomly selected training set of half of the HC transcripts. To control for speech output, we measured the speech duration, total word count and content word count for the FF task and a Cookie Theft Control Task (CTT), in which subjects were merely asked to describe a visual scene. Subjects' responses to FF and CTT tasks were recorded, transcribed, and analyzed in a blinded manner with a combination of manual and automated NLP approaches., Results: Famous face recognition accuracy was similar between groups. LTLE patients recalled fewer biographical details compared to HCs and RTLEs using both the gold-standard human-generated dictionary (24%±12% vs. 31%±12% and 30%±12%, p=0.007) and the automated dictionary (24%±12% vs. 31%±12% and 32%±13%, p=0.007). There were no group level differences in speech duration, total word count, or content word count for either the FF and CTT to explain difference in recall performance. There was a positive, statistically significant relationship between MOCA score and FF recall performance as scored by the human-generated (ρ= .327, p= .029) and automatically-generated dictionaries (ρ= .422, p= .004) for TLE subjects, but not HCs, an effect that was driven by LTLE subjects., Discussion: LTLE patients remember fewer details of famous people than HCs or RTLE patients, as discovered by NLP analysis of spontaneous recall. Decreased biographical memory was not due to decreased speech output and correlated with lower MOCA scores. NLP analysis of spontaneous recall can detect memory dysfunction in clinical populations in a semi-automated, objective, and sensitive manner.

A transtibial amputation is the traditional primary staged amputation for source control in the setting of non-salvageable lower extremity infection, trauma, or avascularity prior to progression to proximal amputation. The primary aim of the study is to compare preoperative risk factors and postoperative outcomes between patients who underwent transtibial amputation versus ankle disarticulation in staged amputations. A retrospective review of 152 patients that underwent staged below the knee amputation were compared between those that primarily underwent transtibial amputation (N = 70) versus ankle disarticulation (N = 82). The mean follow-up for all 152 patients was 2.1 years (range = 0.04-7.9 years). The odds of incisional healing were 3.2 times higher for patients with guillotine amputation compared to patients with ankle disarticulation (odds ratio [OR] = 3.2, 95% confidence interval [CI] = 1.437-7.057). The odds of postoperative infection is 7.4 times higher with ankle disarticulation compared to patients with guillotine amputation (OR = 7.345, 95% CI = 1.505-35.834). There were improved outcomes in patients that underwent staged below the knee amputation with primarily guillotine transtibial amputation compared to primarily ankle disarticulation. Ankle disarticulation should be reserved for more distal infections, to allow for adequate infectious control, in the aims of decreasing postoperative infection and improving incisional healing rates. Levels of Evidence: 3, Retrospective study ., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Minimally invasive approaches to lung resection have become widely acceptable and more recently, segmentectomy has demonstrated equivalent oncologic outcomes when compared to lobectomy for early-stage non-small cell lung cancer (NSCLC). However, studies comparing outcomes following segmentectomy by different surgical approaches are lacking. Our objective was to investigate the outcomes of patients undergoing robotic, video-assisted thoracoscopic surgery (VATS), or open segmentectomy for NSCLC using the National Cancer Database., Methods: NSCLC patients with clinical stage I who underwent segmentectomy from 2010 to 2016 were identified. After propensity-score matching (1:4:1), multivariate logistic regression analyses were performed to determine predictors of 30-d readmissions, 90-d mortality, and overall survival., Results: 22,792 patients met study inclusion. After matching, approaches included robotic (n = 2493; 17%), VATS (n = 9972; 66%), and open (n = 2493; 17%). An open approach was associated with higher 30-d readmissions (7% open versus 5.5% VATS versus 5.6% robot, P = 0.033) and 90-d mortality (4.4% open versus 2.2% VATS versus 2.5% robot, P < 0.001). A robotic approach was associated with improved 5-y survival (50% open versus 58% VATS versus 63% robot, P < 0.001)., Conclusions: For patients with clinical stage I NSCLC undergoing segmentectomy, compared to the open approach, a VATS approach was associated with lower 30-d readmission and 90-d mortality. A robotic approach was associated with improved 5-y survival compared to open and VATS approaches when matched. Additional studies are necessary to determine if unrecognized covariates contribute to these differences., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Vitamin K antagonists (VKA) is the primary anticoagulant in most settings of Sub-Saharan Africa. Understanding the quality of anticoagulation services in the continent is vital in optimising the intended benefits. This study assessed the quality of anticoagulation and associated factors among VKA-treated patients in nine SSA countries. We conducted a retrospective cohort study of randomly selected patients on anticoagulation from 20 clinics in Botswana, the Democratic Republic of Congo, Ethiopia, Gambia, Ghana, Mozambique, Nigeria, Tanzania, and South Africa. Eligible participants were those on VKAs for at least three months and with at least four international normalised ratios (INR) results in 2019-2021. We report the proportion of INR values in the therapeutic range, time-in-therapeutic range (TTR) using the Rosendaal method, and the proportion of patients with TTR ≥ 65% (optimal anticoagulation). The mean age was 51.1(16.1) years, and 64.2% were women. The most common indications for VKA included venous thromboembolism (29.6%), prosthetic valves (26.7%) and atrial fibrillation/flutter (30.1%). We analysed 6743 INR tests from 1011 participants, and of these, 48.5% were sub-therapeutic, 34.1% therapeutic, and 17.4% were supratherapeutic relative to disease-specific reference ranges. TTR was calculated for 660 patients using 4927 INR measurements. The median (interquartile range [IQR]) TTR was 35.8(15.9,57.2) %. Optimal anticoagulation control was evident in 19.2% of participants, varying from 2.7% in Tanzania to 23.1% in Ethiopia. The proportion of patients with TTR ≥ 65% was 15,4% for prosthetic heart valves, 21.1% for venous thromboembolism and 23.7% for atrial fibrillation or flutter. Countries with universal health coverage had higher odds of optimal anticoagulation control (adjusted odds ratio (aOR) 1.79, 95% confidence interval [CI], 1.15- 2.81, p = 0.01). Patients on VKAs for different therapeutic indications in SSA had suboptimal TTR. Universal health coverage increased the odds of achieving TTR by 79%. The evidence calls for more intensive warfarin management strategies in SSA, including providing VKA services without out-of-pocket payments., (© 2024. The Author(s).)

In this paper, an experimental evaluation of a newly developed flat plate double pass solar air heater combined with aluminum cans for drying red pepper was presented. The proposed solar dryer system was designed, modeled, and evaluated. Solar air heater trials were carried out using the absorber's top and bottom plate and aluminum cans for red pepper drying at Bahir Dar, Ethiopia. To test the solar dryer, 100 pieces of red paper were obtained from the Bahir Dar region of Ethiopia for the purpose of experimentation. Microsoft Excel was used to perform statistical analysis of eleven mathematical models. The results show that the mixed-mode solar greenhouse dryer takes less time to dry red pepper than the open solar dryer. In the midday, the solar insolation reached 973 W/m 2 and the minimum solar insolation was 220 W/m 2  and air is expelled at a rate of 0.0383 kg/s. According to the experimental results, the dryers chamber temperature ranged from 30.9 to 54 °C, while the ambient temperature was between 22.6 and 28.2 °C. The mixed-mode double pass achieves up to 46% and 28% efficiency when used with aluminum can dryers and conventional open sun dryers, respectively. A drying rate of 0.0003395 kg/s was achieved for the open sun dryer system and 0.0000365 kg/s for the mixed mode solar dryer. Using mixed-mode and open-sun solar dryers, the logarithmic model was found to be most effective in explaining the red pepper behavior. Furthermore, a comparison was made between the experimental and predicted moisture ratios through the calculation of the coefficient of determination (R 2 ), the reduced chi-square (X 2 ), and the root mean square error (RMSE). The results show that the logarithmic model achieved the highest value of the correlation coefficient (R 2 ), which was determined to be 0.9978 and 0.9989, while the logarithmic model achieved the lowest value of Chi-square (X 2 )., (© 2024. The Author(s).)

Background: Surgical treatment has transformed the course and outcome of congenital heart defects in high-income countries, but children with congenital heart diseases in sub-Saharan Africa, where access to cardiac surgery is limited, often experience the natural course of untreated lesions and their complications. The objective of this study was to determine the prevalence of hematologic derangements among Ethiopian children with unoperated cyanoticcongenital heart diseases, to identify factors associated with coagulopathy in this population, and to describe how these complications are managed in this setting., Methods: In this single-center cross-sectional study, we prospectively collected clinical and demographic data from children (<18 years) with cyanotic congenital heart diseases. Blood samples were collected to measure hematologic parameters. Polycythemia was defined as hematocrit >50% and thrombocytopenia as <150,000 per microliter., Results: Among 70 children recruited, the overall prevalence of polycythemia and thrombocytopenia was 63% (n=44) and 26% (n=18), respectively. On multivariate logistic regression analysis, hematocrit ≥65% (p-value=.024), and oxygen saturation <85% (p-value=.018) were independently associated with moderate or severe thrombocytopenia. Thirty-one (44%) patients had undergone therapeutic phlebotomy, and 84% (26/31) of these patients received iron supplementation., Conclusion: We report a high prevalence of polycythemia and thrombocytopenia in Ethiopian children with untreated cyanotic congenital heart diseases. There was variable implementation of iron supplementation and therapeutic phlebotomy, highlighting the need to optimize supportive management strategies in this population to mitigate the risk of life-threatening complications., (© 2023 Selamawit Alemseged, et al.)