Background: Previous works show that noncommunicable diseases (NCDs) are on the rise in developing nations, including Ethiopia, in the background of preexisting communicable diseases (CDs). Data on hospital admission in sub-Saharan Africa are scarce, particularly prospectively collected, and hence this study was done to close the gap in acquiring accurate diagnosis usually faced with retrospective data. We aimed to describe medical admission patterns, their outcomes and determinants at Ayder Comprehensive Specialized Hospital (ACSH) in Tigray, Ethiopia. Methods: Data were collected prospectively from November 1, 2017 to October 31, 2018 for all medical admissions. Sociodemographic profiles, final diagnosis, outcome of hospitalization, and complications were recorded using a data-abstraction checklist. Data were analyzed using SPSS 26. Results: There were 2084 medical admissions over 1 year. Median age was 45 years (IQR 31). A majority (1107, 53.1%) were male. The age-group 25– 34 years had the most admissions (19.0%). NCDs constituted 68.2% of admissions. According to the International Classification of Diseases, patients were admitted most frequently due to disease of the circulatory system (36.7%) followed by infectious or parasitic diseases (24.1%). Of NCDs, cardiovascular diseases contributed to 53.9%, followed by cancers (8.6%). Of CDs, HIV/AIDS contributed to 31.3%, followed by tuberculosis (22.8%). A total of 1375 (66%) were discharged improved, while 311 (14.9%) died. On multivariate analysis, the in-hospital mortality was significantly higher (18.7%) for CDs than NCDs (13.2%, AOR 1.8, 95% CI 1.4– 2.3; P< 0.001). Bed occupancy of ACSH medical wards and ICU was 54%. Conclusion: NCDs were leading causes of medical admissions in ACSH. The presence of CDs and the development of complications were associated with higher risk of death. Attention should be given by policy-makers to curb the higher morbidity from NCDs and mortality from CDs.

Background: As developing countries experience the epidemiologic transition to chronic diseases, morbidity and mortality from stroke is expected to rise. Stroke and other non-communicable diseases are increasing in Ethiopia but prospective data are scarce and there are not enough data regarding the characteristics, risk factors and mortality of stroke. Objective: Aimed at determining the risk factors, clinical profiles and treatment outcomes of stroke admissions in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. Methods: This is a prospective cross-sectional study of all adult stroke patients admitted over consecutive 12 months period in medical ward and ICU of Ayder Comprehensive sSpecialized Hospital, northern Ethiopia. Medical residents through a pre-designed questionnaire collected data. Monovariate analysis, bivariate analysis and multivariate analysis to control for confounder variables were done using software SPSS version 26. P < 0.05 was considered statistically significant. Results: There were 272 stroke admissions to medical ward and ICU over the 1-year period. Stroke comprised 13.05% of total medical admissions. Ischemic stroke accounted for 62.9% of stroke admissions. Stroke in the young accounted for 14.7% of all stroke admissions. Hypertension was the most common risk factor identified, found in 51.8%. Diabetes mellitus and atrial fibrillation were the other common risk factors. The in-hospital mortality was 13.6%. The only independent predictor of mortality identified was presence of complications, AOR [95% CI] of 2.4 [1.4, 5.3], P-value of 0.028. Aspiration pneumonia was the most common complication. Conclusion: This study showed a high burden of stroke among medical admissions in northern Ethiopia. Being the most common risk factor for stroke, the high burden of undiagnosed and untreated hypertension needs special attention and efforts on community awareness should be enhanced. The relatively higher mortality illustrates the need to establish stroke centers to enhance the quality of stroke care.

Background: Documentation of cardiovascular diseases (CVDs) including major contributors to hospitalization and their outcomes in sub-Saharan Africa and Ethiopia is important to prioritize further research, prevention and treatment strategies. Objective: This study aimed to describe the clinical profiles of CVD admissions, risk factors, and patient outcomes at Ayder Comprehensive Specialized Hospital (ACSH) in Tigray, Ethiopia. Methods: Data of patients with the diagnosis of CVD was collected prospectively from Nov. 1, 2017 – Oct. 31, 2018 for patients admitted to medical wards and ICU of ACSH. Socio-demographic profiles, final admission diagnosis, duration of hospital stay and outcomes of hospitalization were variables recorded using a data abstraction checklist. Diseases were categorized using the World Health Organization’s International Classification of Diseases (ICD)-10 coding system. Data was analyzed using SPSS version 26. Results: Of the 2084 admissions over 1 year period, 767 (36.5%) had CVDs. The mean age of the study population was 53.4 ± 19.4 years with 55% females. Leading CVD admissions were stroke (35%), Venous thromboembolism (17%), rheumatic heart disease (RHD) (16.2%), ischemic heart disease (IHD) (11.3%) and cardiomyopathy (CMP) (7.4%). Heart Failure (HF) was found in 300 (39.1%) patients with structural heart disease. The structural cardiac lesions in those with HF were RHD (36%), CMP (19%), IHD (18%) and Cor pulmonale (9%). The in-hospital mortality of all CVD admissions was 13.2%. Of the total 101 CVD deaths most were because of stroke (n=37, 36.6%) followed by IHD (18.8%). Hypertension was the most frequent risk factor (28.8%). Conclusion: This study shows stroke to be the most common form of CVD and RHD to be the main reason for HF among hospital admissions in Northern Ethiopia, ACSH. Hypertension is the leading reported risk factor and hence the need to give high priority to hypertension and RHD control programs.

Intramuscular (IM) Benzathine penicillin G administration (BPG) is essential to prevent the progression of acute rheumatic fever (RF) to rheumatic heart disease (RHD). Fatal adverse events during BPG administration have been reported. This study aimed to characterise the clinical features and outcomes of RHD patients who developed adverse events with BPG administration for RHD prophylaxis in Ethiopia.