Background: Critically ill children have a lower nutritional reserve, compounding the restricted food intake during intensive care unit (ICU) and hospital stays, and scarce data are available to point out the problem. Therefore, this review aimed to assess the pooled prevalence of malnutrition among critically ill children. Methodology: This systematic review was conducted in accordance with the JBI methodology for systematic reviews of prevalence and incidence. Databases including, PubMed/MEDLINE, CINAHL/EBSCO, HINARI, Google Scholar, and gray literatures were used to find relevant articles. Eligible studies were critically appraised by two independent reviewers. Systematic review and meta-analysis was conducted using STATA 17 software. Funnel plot and at the 5% significance level, Egger’s test were used to check for publication bias. Result: From a total of 15 studies with 4331 study participants, the pooled prevalence of malnutrition in critically ill children was 37.19% (95% CI; 35.89–38.49) with a significant statistical heterogeneity (I2 = 98.6, P = < 0.0001). High income countries reported the lower pooled prevalence of malnutrition among critically ill children (30.14%, 95% CI; 28.41, 31.88). No publication bias was reported and sensitivity analysis suggested that no significance difference was shown in the prevalence of malnutrition among critically ill children with the pooled prevalence. Conclusion: The current systematic review and meta-analysis showed that more than one in three critically ill children was malnourished. Serious medical conditions in children that deserve admission to the intensive care unit could be a complication of malnutrition that may end up in deaths unless the undernutrition is addressed together with critical care intervention. Hence, specific strategies to prevent malnutrition among this neglected segment should be integrated with the existing healthcare systems and nutritional programs.
Under-reporting of COVID-19 and the limited information about circulating SARS-CoV-2 variants remain major challenges for many African countries. We analyzed SARS-CoV-2 infection dynamics in Addis Ababa and Jimma, Ethiopia, focusing on reinfection, immunity, and vaccination effects. We conducted an antibody serology study spanning August 2020 to July 2022 with five rounds of data collection across a population of 4723, sequenced PCR-test positive samples, used available test positivity rates, and constructed two mathematical models integrating this data. A multivariant model explores variant dynamics identifying wildtype, alpha, delta, and omicron BA.4/5 as key variants in the study population, and cross-immunity between variants, revealing risk reductions between 24% and 69%. An antibody-level model predicts slow decay leading to sustained high antibody levels. Retrospectively, increased early vaccination might have substantially reduced infections during the delta and omicron waves in the considered group of individuals, though further vaccination now seems less impactful.
28 June 2023 in Risk Management and Healthcare Policy
Background: Cancer has been the leading cause of death worldwide with its various enormous socio-economic impacts. Hence, early palliative care implementation is a potent addition to oncology for the treatment of physical, mental, and psychological pain in cancer patients. Therefore, this article aims to assess the prevalence of patients requiring palliative care and its associated factors among admitted cancer patients. Methods: A cross-sectional study was conducted among cancer patients who were admitted to oncology wards during the data collection period at St. Paul Hospital, Ethiopia. The Palliative Care Indicators Tool in Low-Income Settings (SPICT-LIS) was used to determine the need for palliative care. The collected data was entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 26 for analysis. A multivariable logistic regression was used to analyze the predictors of palliative care need. Results: A total of 301 cancer patients were included in this study, with a mean age of 42 years (SD=1.38). The prevalence of palliative care needs among the patients in this study was 10.6% (n=32). The study revealed that the need for palliative care increases as the age of the patient increases and suggested that cancer patients who were above 61 years old were two times (AOR=2.39 95% CI=0.34– 16.55) more likely to need palliative care than others. Male patients had a significantly higher requirement for palliative care compared to female patients (AOR=5.31, 95% CI=1.68– 11.79). Conclusion: The manuscript describes the palliative care needs of patients with cancer admitted to St. Paul Hospital in Ethiopia. The study revealed that the health status of a significant number of cancer patients in the hospital was deteriorating. Hence, the hospital administrators and the oncology ward staff are recommended to pay attention to the identified factors.
Background: Tuberculosis (TB) is a common and often deadly infectious disease caused by various strains of mycobacterium, usually mycobacterium tuberculosis in humans. The disease has major causes of morbidity and mortality, particularly where the diagnostic and control program is not far extended. Objective: To compare the treatment outcomes of tuberculosis patients in a private clinic with a governmental health center in Jimma city, Ethiopia. Methods: A 10-year cross-sectional retrospective systemic record review was conducted to compare the treatment outcomes, and to describe the socio-demographic factors associated with the outcome in a private clinic with a governmental health center in Jimma city, Jimma, Ethiopia from September 12, 2007, to September 10, 2017. Finally, SPSS/EPI INFO analyzed data. Results: The present study revealed that within a 10 year duration the private clinic gives anti-TB treatment coverage for 582 patients whereas the governmental health center treats 510 patients. The treatment success rate of the private clinic is 98.1% which is 1.03-fold that of the governmental health center (95.3%); while the treatment failure of the private clinic was 0.2%, but there was no treatment failure in the governmental health center. Conclusion: Both sectors achieved the expected WHO targets by newly recommended strategy for TB treatment, DOTS (Directly Observed Treatment Short Course) and treatment success is much better to standard. This shows good progress of DOTS strategy and a decrease of noncompliance in this area. Age, educational level, and the types of TB diagnosis and treatment outcome of the patients were statistically associated in both sectors. Better counseling and awareness about the disease should have to be given for every anti-TB treatment receiving patients, despite their educational level and occupational status in both sectors.
Advance care planning (ACP) allows individuals to express their values and preferences for future medical care, yet participation remains low globally. Und
21 November 2023 in Disaster Medicine and Public Health Preparedness
The coronavirus disease 2019 (COVID-19) pandemic has provided a great lesson for the globe about the necessity and significance of pandemics-related preparedness in all settings. Public health emergency operation centers play critical roles in preparing for and responding to public health events and emergencies by coordinating and pooling resources. In this article, we aimed to share lessons learnt from the public health response to the louse-borne relapsing fever (LBRF) outbreak coordinated by the emergency operation center established to respond to the COVID-19 pandemic in Jimma, Ethiopia. After the major waves of COVID-19 outbreaks in Ethiopia were over, Jimma University Medical Center (JUMC) reported clusters of louse-borne relapsing fever cases from Jimma Main Prison. Accordingly, Jimma Emergency Operation Center (JEOC) established for the COVID-19 pandemic was immediately alerted and effectively coordinated the overall response. As a result, the outbreak was contained within the prison without spreading to the community and the outbreak ended within a shorter period compared to previous LBRF outbreaks in Ethiopia. This indicates the necessity of establishing and sustaining public health emergency operation centers to prepare for and combat potential future public health emergencies.