Project description:BackgroundCompassion is the first ethical principle of health care to provide high- quality care that influences patient satisfaction and treatment outcome. However, there is limited data on the level of compassionate mental health care practice in low-resource countries like Ethiopia.ObjectivesThis study aimed to assess the level of perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, North West, Ethiopia, 2022.MethodsAn institutional-based cross-sectional study design was conducted from June 18 to July 16, 2022, at Tibebe Ghion Specialized and Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling technique was used. The level of perceived compassionate care was assessed by the validated 12-item Schwartz Center Compassionate Care Scale among 423 patients with mental illness. Epicollect-5 was used to collect data, which was then exported to the Statistical Product and Service solution version 25 for analysis. Variables with a P-value < 0.05, and 95% confidence interval (CI) were used to declare significant variables at the multivariate logistic regression analysis.ResultThe level of perceived good compassionate care was 47.5% (95% CI 42.6%-52.4%). Factors including urban residence (AOR = 1.90; 95%CI 1.08-3.36), duration of illness < 24 months (AOR = 2.68; 95% CI 1.27-5.65), strong social support (AOR = 4.43; 95%CI 2.16-9.10), shared decision making (AOR = 3.93; 95% CI 2.27-6.81), low perceived stigma(AOR = 2.97; 95% CI 1.54-5.72) and low patient anticipated stigma (AOR = 2.92; 95% CI 1.56-5.48) were positively associated with good compassionate care.Conclusion and recommendationLess than half of the patients had received good compassionate care. Compassionate mental health care needs public health attention. Policymakers should emphasize on compassionate care continuity by including it in the health care curriculum and design appropriate policies to strengthen compassionate care.

Project description:BackgroundThe complication of prematurity is the second commonest cause of under-five mortality in Ethiopia. Amhara region has the highest neonatal mortality rate in the country. There was no previous study and this study aimed to assess the survival of preterm neonates and its associated factors of preterm neonatal mortality admitted to Felege Hiwot Specialized Hospital, Bahir Dar, Ethiopia, to take necessary action to maximize survival of preterm babies in developing countries.MethodsA retrospective cross-sectional study was conducted among 686 preterm neonates admitted in Felege Hiwot Specialized Hospital from 1 August 2017 to 30 July 2018. Kaplan-Meier survival curve was used to show the survival rate of preterm neonates and the multivariate Cox proportional hazards model was used to identify covariates of survival of preterm neonates. Those variables having a p-value less than 0.05 were statistically significant for the survival of preterm neonates.ResultOut of 686 preterm neonates admitted from 1 August 2017 to 30 July 2018, 49.1% neonates were improved and discharged and 36.1% died. The survival rate was 0%, 19.4%, 46.7% and 75% for gestational age <28 weeks, 28-31 + 6 weeks, 32-33 + 6 weeks and 34-36 + 6 weeks, respectively. In the multivariate Cox regression model, respiratory distress syndrome, necrotizing enterocolitis, asphyxia, hospital-acquired infection, birth weight, gestational age and place of delivery were significantly associated with time to death of preterm neonates at 95% confidence level (p < 0.05).ConclusionThe mortality rate (36.1%) of preterm neonates is unacceptably high in Felege Hiwot hospital compared to other similar hospitals in Ethiopia. More than 50% of preterm neonatal deaths can be prevented with available resources. Neonatal units with adequate and committed manpower, using a strict aseptic technique, proper follow-up, early detection and timely management of complications, are recommended to improve the survival of preterm neonates.

Project description:BackgroundsCongestive heart failure is a serious chronic condition when the heart's muscles become too damaged and a condition in which one or both ventricles cannot pump sufficient blood to meet the metabolic needs of the body. This study aimed to identify factors affecting the complications time of congestive heart failure patients treated from January 2016 to December 2019 at Felege Hiwot comprehensive specialized referral hospital in Bahir Dar, Ethiopia.MethodsA hospital-based retrospective data collection was collected from the medical charts of 218 randomly selected congestive heart failure patients. The Kaplan-Meier curve and the Cox proportional hazards model were used to compare and identify the factors associated with time to complication in patients with congestive heart failure.ResultsThe median complication time of congestive heart failure patients was 22 months [95% CI: 21.98-28.01]. About 194 (88.99%) of the patients were complicated. The Kaplan-Meier curve depicts the survival probability of complicated patients decreasing as the complication time increases. The hazard ratios for serum sodium concentration, left ventricular ejection fraction, patients from rural areas, age of patients, serum hemoglobin concentration, and New York heart association classes I, II, and III were given 0.94 [95% CI: 0.90-1.00], 0.74 [95% CI: 0.65-0.85], 0.75 [95% CI: 0.68-0.84], 1.28 [95% CI: 1.12-1.46], 0.89 [95% CI: 0.85-0.94], 0.44 [95% CI: 0.36-0.53], 0.54 [95% CI: 0.47-0.62] and 0.73 [95% CI: 0.65-0.81] respectively, and they are statistically associated with the complication time of congestive heart failure patients.ConclusionsThe median complication time of congestive heart failure patients was 22 months. This study strongly suggests that healthcare awareness should be strengthened earlier about the potential complications for patients with lower serum sodium concentrations below the threshold and aged congestive heart failure patients to reduce the risk of developing complications.

Project description:BackgroundInfections caused by extended-spectrum beta-lactamases (ESBL) producing Gram-negative bacteria has emerge as a global threat in clinical practices. The treat is more serious in developing countries due to inappropriate use, poor adherence, use of counterfeit, sub-standard antibiotics and poor infection control practices. Data on ESBL producing Gram-negative bacteria are limited in developing countries including Ethiopia. The aim of this study was therefore, to describe the burden of ESBL producing Gram negative pathogens isolated from patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region.Materials and methodsA total of 532 clinical samples of blood, urine, stool, wound, abscess, ear discharge, nasal discharge, cervical discharge and body fluid specimens were aseptically collected and bacteriologically processed. Identification of the bacterial species was performed using an automated system (Vitek-2 Compact 27530, USA) and antibiotic susceptibility test was determined by disk diffusion method and selection of antibiotics were in accordance with CLSI guidelines. The MDR pattern of the Gram-negative pathogens was assessed using phenotypic methods of ESBL and carbapenemase production following standard procedure.ResultA total of 532 samples were processed and 263 pathogens were isolated. Of these, 185 (70.3%) were Gram-negative and 78 (29.7%) Gram-positive. Of the Gram-negative bacteria the high proportion of the isolates were identified from blood 146/185 (78.9%) and 29/185 (15.7%) were from urine cultures. The most common isolate in all clinical samples was Klebsiella pneumoniae 97/185 (52.4%) followed by Escherichia coli 23/185 (12.4%), Acinetobacter baumannii 15/185 (17.6%) and Enterobacter aerogenes 12/185(6.5%). Of the total Gram negatives, the prevalence of MDR was 148/185 (80.0%). Of the MDR isolates the prevalence of ESBL producers were, 127/148 (85.8%) and 24/148 (16.2%) were carbapenemase producers.Conclusion and recommendationPrevalence of MDR and ESBL producing Gram-negative pathogens in this hospital is alarmingly high. Therefore, continuous monitoring of the problem with effective infection prevention and careful selection of empirical therapy are warranted in the study area.

Project description:BackgroundVisceral leishmaniasis is a vector-borne disease caused by Leishmania donovani transmitted by sand fly species. It is the third most common vector-borne disease globally. Visceral leishmaniasis is endemic in Ethiopia with an estimated annual incidence ranging from 3700 to 7400 cases. This research aimed to assess the clinical presentations and laboratory profiles of visceral leishmaniasis for early diagnosis and timely initiation of management.ObjectiveTo describe the clinical and laboratory manifestation and diagnostic modalities of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, from 1 September 2016 to 30 August 2019.MethodInstitution-based retrospective cross-sectional study was conducted among 141 patients admitted to Felege Hiwot Hospital from 1 September 2016 to 30 August 2019. Descriptive statistics were used to describe the clinical presentation and laboratory profiles of patients with visceral leishmaniasis.ResultsAmong a total of 141 enrolled patients in the study, males were affected 13-fold. Most of them were travelers to endemic areas during the winter season for labor work. The mean duration of illness was 48 days. Common symptoms were fever (96.5%), weightless (82.5%), jaundice (18.4%), vomiting/diarrhea (13.5%), and bleeding episodes (11.3%). Splenomegaly was seen in 98.6%, ascites in 35.5%, and lymphadenopathy in 9.9%. Lymphadenopathy was seen significantly in HIV patients (40%). Anemia was seen in 95%, thrombocytopenia in 90.2%, leukopenia in 86.4%, and pancytopenia in 79.4%. Half of the patients had coinfection. Neutropenic sepsis was seen in 21.3%. The diagnosis was made by tissue aspiration in 65% of patients.ConclusionThe majority of patients who were diagnosed to have visceral leishmaniasis were young male adults who traveled to the endemic areas seasonally. Fever and splenomegaly were seen as the commonest clinical presentation. Lymphadenopathy occurred in high frequency among HIV co-infected patients. Anemia was the commonest hematologic finding.

Project description:IntroductionPerinatal asphyxia is failure to maintain normal breathing at birth. World Health Organization indicates that perinatal asphyxia is the third major cause of neonatal mortality in developing countries accounting for 23% of neonatal deaths every year. At global and national level efforts have done to reduce neonatal mortality, however fatalities from asphyxia remains high in Ethiopia (24%). And there are no sufficient studies to show incidence and prediction of mortality among asphyxiated neonates. Developing validated risk prediction model is one of the crucial strategies to improve neonatal outcomes with asphyxia. Therefore, this study will help to screen asphyxiated neonate at high-risk for mortality during admission by easily accessible predictors. This study aimed to determine the incidence and develop validated Mortality Prediction model among asphyxiated neonates admitted to the Neonatal Intensive Care Unit at Felege-Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.MethodRetrospective follow-up study was conducted at Felege-Hiwot Comprehensive Specialized Hospital from September 1, 2017, to March 31, 2021. Simple random sampling was used to select 774 neonates, and 738 were reviewed. Since was data Secondary, it was collected by checklist. After the description of the data by table and graph, Univariable with p-value < 0.25, and stepwise multivariable analysis with p-value < 0.05 were done to develop final reduced prediction model by likelihood ratio test. To improve clinical utility, we developed a simplified risk score to classify asphyxiated neonates at high or low-risk of mortality. The accuracy of the model was evaluated using area under curve, and calibration plot. To measures all accuracy internal validation using bootstrapping technique were assessed. We evaluated the clinical impact of the model using a decision curve analysis across various threshold probabilities.ResultIncidence of neonatal mortality with asphyxia was 27.2% (95% CI: 24.1, 30.6). Rural residence, bad obstetric history, amniotic fluid status, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck were identified in the final risk prediction score. The area under the curve for mortality using 7 predictors was 0.78 (95% CI 0.74 to 0.82). With ≥ 7 cutoffs the sensitivity and specificity of risk prediction score were 0.64 and 0.82 respectively.Conclusion and recommendationIncidence of neonatal mortality with asphyxia was high. The risk prediction score had good discrimination power built by rural residence, bad obstetric history, stained amniotic fluid, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck. Thus, using this score chart and improve neonatal and maternal service reduce mortality among asphyxiated neonates.

Dataset Information

Two–Dimensional and Doppler trans-thoracic echocardiographic patterns of suspected pediatric heart diseases at Tibebe-—Ghion specialized Teaching Hospital and Adinas General Hospital, Bahir Dar, North-west Ethiopia:–An experience from an LMIC

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