Millennium Journal of Health

Beyond the surface: Unmasking the ubiquity of Trauma Normalization

Eshetu Tumiso — Mon, 22 Jul 2024 00:00:00 +0000

No Abstract

Pattern and predictors of mortality in emergency department of Saint Paul Hospital millennium medical college Addis Ababa, Ethiopia: Hospital based cross-sectional study

Mon, 22 Jul 2024 00:00:00 +0000

Background: The declared goal of creating an exceptional acute care system demands regressive administrative monitoring and evidence-based action. The goal of this study was to look at the pattern and determinants of all-cause mortality at St. Paul Hospital's Millennium Medical College's Emergency Department.

Methods: A total of 388 emergency department patient charts were included. Quota sampling using standardized questioner from previous study was employed. Single proportion formula was used to determine sample size. The data was analyzed using SPSS Version 25. The association between relevant characteristics with early emergency mortality was examined using the, binary and multinominal logistic regression analysis. Statistical significance was determined at p- values < 0.05

Results: From Jan 1, 2020-June 30, 2022, a total of 22,982 adult acutely sick patients visited the Emergency Department (ED). There were 693 (3.02%) deaths registered in ED. Three hundred eighty-eight charts fulfilled the inclusion criteria were analyzed. In the multinominal logistic regression, orange triage category (AOR=10.2 95% CI:1.3-76.3), Duration of Chief complaint < 24 hours, respiratory illness (AOR = 12.5, 95% CI: 1.3-120.5), liver diseases (AOR = 20.5, 95% CI: 1.9-210.4), Upper GI bleeding (AOR = 14.5, 95% CI: 1.0-194.9), Diabetic mellitus and its complication (AOR = 34.4, 95% CI: 2.5-472.3), severe anemia (AOR = 29.5, 95% CI:2.1-413.2), and sepsis/ septic shock (AOR = 9.4, 95% CI:1.0-87.0) as principal diseases, are associated with high likelihood of early ED mortality.

Conclusion: Orange triage category, duration of chief complaint less than 24 hours and principal diagnosis being respiratory, liver, UGIB, severe anemia, DM and its complications and sepsis has association with early ED mortality.

Pattern and clinical profile of patients with cleft lip and palate at pediatrics surgical hospital in Ethiopia

Tesfaye Mulate, Firaol Dandena — Mon, 22 Jul 2024 00:00:00 +0000

Background: Cleft lip and palate are among the most common congenital anomalies of the head and neck region. Oral-facial clefts can be observed on the lips, jaw bones, and hard and soft palates. This study aimed to assess the Pattern, clinical of children with cleft lip and/or palate who visit CURE Children’s Hospital Ethiopia.

Methods: A retrospective chart review was conducted on patients who were operated from January 1, 2016 to December 31, 2022, at the Cure Children’s Hospital in Ethiopia. The Demographic and clinical data of cleft patients were collected using Smile Train Express (STX). The collected data underwent analysis using descriptive statistics with SPSS version 26.

Results: The study included 1379 surgeries done on patients with non-syndromic cleft palate or lip. The average age at surgery was 21 months, with a male-to-female ratio of 1.78:1. The left side was the most affected, and it was unilateral. The commonest surgery done was primary unilateral lip-nose repair, with 694 (50.3%). The most common surgical technique used is Millard rotation advancement 823 (59.7%). Regarding post-operative complications, palatal fistula surgeries done for 73 (8.3%) patients and lip and nose revisions done for 38(2.75%).

Conclusion: The study reveals the common form of presentation was a left-sided, unilateral cleft lip, which is treated with unilateral lip-nose repair. The high magnitude of the palatal fistula is also reported, with the most common millard rotation advancement surgical treatment in the study area. Therefore, policymakers and health planners should strengthen early treatment of congenital anomalies in children and create awareness about the availability of treatment to prevent long-term deformities related to cleft lip and palate.

Case report for neglected patella fracture after simple tension band wiring (TBW), qudricepsplasty, and POP splitting in resource-limited setup: A case report

Habtewold Mulat, Samuel Workineh, Tariku Beriso, Simone Stefano Finzi — Mon, 22 Jul 2024 00:00:00 +0000

Background: Patella fractures are common, and they account for about 1% of skeletal injuries. Open reduction and internal fixation is the standard of care to restore quadriceps function and prevent knee stiffness as well as osteoarthritis. Patella fractures rarely progress into nonunion with an incidence of 2.4 to 12.5.
Presentation of case: We present a case of 30 years 30-year-old male patient who presented with a left neglected patella fracture following a fall-down accident 1 and a half years. At presentation, he had left knee pain, and swelling and was unable to flex his knee. Radiographic examination showed displaced, sclerotic patella fracture nonunion.
Conclusion: Preoperative isometric quadriceps exercises, tension band wire with V-Y advancement, short-term splitting with plaster of Paris for soft tissue rest, and early post-op rehabilitation is a good treatment option for neglected patella fracture in a resource-limited setup with less complication.

Pre-triage screening and isolation of patients suspected of COVID-19 in the Emergency Department of St. Paul`s Hospital Millennium Medical College

Mon, 22 Jul 2024 00:00:00 +0000

Background: Early identification and isolation of suspected Coronavirus Disease 2029 (COVID-19) patients decrease disease transmission in the emergency department. Using clinical pre-triage criteria, suspected patients were kept in the isolation ward and treated for the identified illness until the confirmatory test for Severe Acute Respiratory Syndrome- Corona Virus 2 (SARS-COV2) arrived. However, the effectiveness of the pre-triage screening was not known.

Objectives: The main goal of this study was to describe the clinical characteristics of isolated COVID-19-suspected patients at the emergency department of St. Paul’s Hospital Millennium Medical College.

Methods: A hospital-based cross-sectional study was conducted involving patients who were suspected to have COVID-19 but waiting for the confirmatory result and those who tested positive for COVID-19 after emergency department presentation. Trained general practitioners collected data using a structured questionnaire, and entered it into SPSS version 25 for cleaning and analysis. Descriptive statistics were used to analyze the data. The findings are presented using tables and text descriptions.

Results: A total of 4,350 patients were screened and 202 patients fulfilled COVID-19 suspect criteria and triaged to the isolation ward; among which 130 (64.3%) tested positive for COVID-19. In addition, 40 patients who were not suspected at triage, tested positive for COVID-19 after they were kept in the emergency department. Cough 54 (26.7%) and shortness of breath 31 (15.4%) were the most common presenting symptoms and the number of lymphocytes decreased in 161 cases (79.7%).

Conclusion: One fifth of COVID-19 patients were missed to be isolated during triaging and mixed with other patients. Emergency rooms should be well designed to prevent cross-transmission of disease.

Admission Pattern and Factors Associated with Treatment Outcome of Orthopedics Patients in Intensive Care Unit of Addis Ababa Burn Emergency and Trauma (AaBET) Hospital

Mateyas Bizualem, Milkias Tsehaye, Habtewold Mulat, Getachew Tilahun — Mon, 22 Jul 2024 00:00:00 +0000

Background: Trauma is the main cause of death and disability worldwide. As a result of increased trauma burden, orthopedics patient account for a considerable and growing proportion of patients in intensive care unit. Access to intensive care is an important part of the health care system to reduce mortality and morbidity.

Objective: To assess admission patterns and factors associated with treatment outcomes of orthopedics patients in the ICU of Addis Ababa Burn Emergency and Trauma (AaBET) Hospital.

Method: The study employed analytical cross-sectional study design, reviewing ICU admissions of orthopedic patients from June 2017 to November 2021. A total of 117 patients were included. Descriptive statistics such as mean, median, and standard deviation (SD) were used to summarize the demographic data and pattern of injury. Univariate and multivariate logistic regression analysis were applied to assess the impact of various factors on the outcome variable and p-values < 0.05 were considered statistically significant.

Result: The study included 117 orthopedic patients who had been admitted to the ICU, with a 6.3:1 male-to-female ratio. Traumatic causes of admission accounted for 93.2% of the admissions. Road traffic accidents 88(75.2%) and fall-down accidents from a height 20 (17.1%) were the two most common mechanisms of injury. Fracture was present in 109 (93.2%) patients. Apart from orthopedics conditions associated medical, surgical, and neurosurgical conditions were present in 84(72.4%), 75(64.7%), and 74(63.8%)cases respectively. Respiratory failure 57 (48.7%) was the major reason for admission. The overall ICU mortality was 24 (20.5%). Factors associated with death outcome in the ICU include GCS ≤8 (P=.045) (AOR=4.344, 95% CI; 1.106- 17.064), septic shock (P=.030) (AOR=10.495, 95% CI; 1.257, 87.630) and ICU length ≤5 days (P=.015) (AOR=4.118, 95% CI; 1.306, 12.986).

Conclusion: Traumatic admission as a result of road traffic accident accounted for the largest proportion of orthopedics patients to end up in AaBET ICU. To reduce the observed mortality, more emphasis should be given for orthopedic patients with GCS ≤8, septic shock, and those within the first five days of admission.

Use of postnatal care services and determinant actors among women who gave birth in Addis Ababa

Henok Ketema, Kidanemariam G/Michael, Yonas Haylu — Mon, 22 Jul 2024 00:00:00 +0000

Background: A large proportion of maternal and neonatal deaths occur during the first 48 hours after birth. Prompt postnatal care (PNC) for both the mother and the child is important to treat any complications arising during and after delivery. There is limited information about postnatal care services use and associated factors among women who gave birth in Addis Ababa. Therefore, this study aimed to assess postnatal care services use and determinant factors among women who gave birth in Addis Ababa, Ethiopia.

Methods: Community-based cross-sectional study was conducted in Addis Ababa from October 05 to November 30, 2019. Multistage sampling technique was employed to select the study participants. The data was collected using interviewer administered structured questionnaires and analyzed using Statistical Product and Service Solutions (SPSS) version 23.0. Binary and multivariable logistic regression was used to see the association between independent and dependent variables and p-value ≤ 0.05 were considered as statistically significant.

Results: A total of 731 participants were included in the study, making the response rate of 97.2%. The prevalence of postnatal care services utilization was 92.1%. Family size (AOR=2.76, 95%CI: 1.28-5.91), husband’s occupation (AOR=0.07, 95%CI: 0.001-0.57), (AOR=2.59, 95%CI: 1.12-6.02), number of antenatal care visit (AOR=2.59, 95%CI: 1.12-6.02), presence of danger signs (AOR=0.07, 95%CI: 0.03-0.17), were significantly associated with postnatal services utilization.

Conclusion: The prevalence of Postnatal care services use was high (92.1%)compared to most international data. Family size, husband’s occupation, number of ANC visit, and experiencing danger signs were significantly associated with Post natal care service utilization.

Knowledge, attitude, practices, and associated factors about glycemic control among Diabetes Mellitus patients at Tikur Anbessa Specialized Hospital

Yemane Mezgebe, Lemlem Beza, Birhanu Tesfaye, Yemane Gebremedhin — Mon, 22 Jul 2024 00:00:00 +0000

Background: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to absolute or relative insulin deficiency, and it remains the fourthleading cause of death worldwide. Poor understanding of the disease could affect glycemic control, and result in preventable diabetic complications. Good knowledge,attitude, and practice of glycemic control are vital to increasing the quality of life and reducing complications and death.

Methods and Materials: A cross-sectional study was conducted to assess the knowledge, attitude, and practices of diabetic patients regarding glycemic control. Three hundred sixty-one patients were enrolled using a systematic random sampling in a teaching hospital in Addis Ababa, Ethiopia. Epi-data 3.2 was used for data entry and SPSS 26 used for data analysis, using descriptive and analytic statistics. Binary logistic regression was used to identify associations between dependent and independent variables, with p-values <0.25 and <0.05 indicating statistical significance in bivariateand multivariable analysis, respectively.

Results: Nearly half (48.8%) of the respondents were male. Good practice was independently associated with male gender, who were 1.62 times more likely to havegood practice. However, those participants aged 18–35 years (72%) were less likely to have good practice towards glycemic control, followed by the age group of 51–65 years (51%).

Conclusion: More than half of the respondents’ glycemic control knowledge, attitude, and practice were associated with good practice. The young and middle-aged groupsshowed poor practice. These findings corroborate the need to improve diabetic patients' glycemic control awareness, with a focus on females and young age groups.

Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Health Professionals Working in Health Centers in the West Shoa Zone, Oromia, Ethiopia

Dawit Bekele Hordofa, Nagasa Dida, Yadeta Dessie Balcha — Mon, 22 Jul 2024 00:00:00 +0000

Background: The Integrated Management of Neonatal and Childhood Illness is a strategic approach to enhancing the health, growth, and development of under-fives by reducing mortality, morbidity, and disability. Implementing the IMNCI guideline and associated factors still need to be discovered in the study area.

Objective: To assess the utilization of the IMNCI guidelines and associated factors among health professionals working in health centers in West Shoa Zone, Oromia, Ethiopia, 2022.

Methods: A facility-based cross-sectional study was conducted from June 20 to July 20, 2022, in the West Shoa Zone, Oromia. Among the 22 districts, six were selected by simple random sampling. A sample size 255 was proportionally allocated to 27 health centers (HCs) in the selected districts. Finally, the study unit was selected using simple random sampling. Data were collected through selfadministered questionnaires, checklist observation used to evaluate adherence, an inventory checklist used to assess the availability of resources, and a key informant's interview guide. Quantitative data were coded, entered into Epi-data 3.1, and exported to SPSS version 25 for processing and analysis. In a bi-variable analysis, variable with a p-value< 0.25 was selected for multivariate logistic regression analysis. The strength of association was measured by the AOR at 95% CI and significance variables of P-value< 0.05. Qualitative data were analyzed thematically and triangulated, and associated factors were presented in narrative form.

Results: 27 inventories, 162 observation sessions and ten KIIs were conducted, and participants’ response rate of 98%. This study's overall IMNCI guideline implementation rate was low at 64.1%. Factors that affected the utilization of IMNCI guidelines among health professionals were a shortage of staff [AOR = 1.2, 95% CI: 1.12 - 3.36], lack of knowledge [AOR=3, 95% CI: 1.25- 7.21], and always referring to the IMNCI guidelines while managing children [AOR = 6.53, 95% CI: 2.03 - 21.01].

Conclusions: The utilization of IMNCI guideline status in the study area was low. The identified factors associated with health professionals were lack of knowledge, shortage of staff, and always referring to the IMNCI guidelines while managing under-fives. Health professional emphasize to IMNCI guideline while managing under-fives.