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Dupuytren's contracture is believed to be rare in Africa. We have observed the disease in many patients coming to our hospital. This study aimed to provide information concerning the occurrence of the disease and risk factors in these patients. All 75 patients who were referred to the hospital during a 2-year period because of a hand problem that was diagnosed as Dupuytren's contracture were included. The demographic data of the patients and possible risk factors were recorded and compared with a control group. The male to female ratio was 18:1. The little and ring fingers were most commonly affected. A total of 43 had bilateral hand involvement. The condition affected only the left hand in one patient. Six men also had fibromatosis of the soles of the feet and three of the penis. There was a statistically significant association with hypertension and alcohol consumption, but not with diabetes mellitus. We conclude that there are more cases of Dupuytren's contracture in Ethiopia than previously thought. LEVEL OF EVIDENCE: III.
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OBJECTIVE: To determine the incidence of smear-positive tuberculosis (TB) in Dabat District, northern Ethiopia. METHODS: Using a population-based longitudinal design, a TB surveillance system was initiated among 46,165 residents at the Dabat Health and Demographic Surveillance System site. Trained field workers visited each household every third month and interviewed all individuals aged ≥14 years using a uniform questionnaire to detect suspected cases of TB (cough ≥15 days), at which time two sputum (spot-morning) samples were collected for smear microscopy. RESULTS: A total of 281,820 person-months were observed during the 1-year period, which generated 74 smear-positive TB cases. The incidence of smear-positive TB was calculated at 311 per 100,000 person-years (95%CI 240-382). Higher rates were observed among females (incidence rate ratio [IRR] 2.08, 95%CI 1.24-3.52), persons with no schooling (IRR 2.74, 95%CI 1.11-6.78) and urban residents (IRR 2.39, 95%CI 1.39-4.12). CONCLUSION: The incidence of smear-positive TB is high in Dabat District, suggesting a high risk of transmission in the communities. TB control programmes thus need to improve case-finding mechanisms at the community level in Ethiopia, with greater emphasis on risk groups.
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Mycobacterium tuberculosis/aislamiento & purificación , Esputo/microbiología , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Escolaridad , Etiopía/epidemiología , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Microscopía , Persona de Mediana Edad , Análisis Multivariante , Valor Predictivo de las Pruebas , Estudios Prospectivos , Características de la Residencia , Factores de Riesgo , Factores Sexuales , Encuestas y Cuestionarios , Tuberculosis/microbiología , Tuberculosis/transmisión , Salud Urbana , Adulto JovenRESUMEN
BACKGROUND: Suicide is a common problem worldwide and the magnitude is high especially in countries where mental illnesses are prevalent and psychiatric services are poor. OBJECTIVE: To determine the prevalence of suicidal ideation and attempts among patients who attended the Psychiatry clinic of Gondar University Hospital. METHODS: A cross sectional study was conducted from March-December 2006 involving a total of 474 patients. Data was collected using a pre tested structured questionnaire containing basic socio-demographic variables, psychiatric diagnosis, suicidal ideation, suicidal attempt, the methods of suicide attempt and ways of survival from the attempted suicide. It was administered by psychiatry nurses working in the clinic. The data was analyzed anonymously using SPSS software. RESULTS: The commonest mental illness was Major Depressive Disorder (51.3%) followed by Psychosis (38%). Ninety one (19.2 %) patients attempted suicide at least once after the onset of the current mental illness and 307(64.8%) have suicidal ideation. The common method of suicidal attempt was hanging (45.1%) and 69.2% were at home. An association was found between suicidal ideation and attempt (OR=33.7; CI=8.2-138.8, p-value <0.01). CONCLUSION: Suicidal ideation was common in psychiatric patients. It was also associated with suicidal attempt.
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Pacientes Ambulatorios/estadística & datos numéricos , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Estudios Transversales , Etiopía/epidemiología , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Pacientes Ambulatorios/psicología , Prevalencia , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Intento de Suicidio/psicología , Adulto JovenRESUMEN
A fast agglutination screening test (FAST) for the detection of Leishmania antibodies in human serum samples was evaluated under harsh field conditions in northern Ethiopia. Test performance was compared with a standard serological test, namely the direct agglutination test (DAT), and with parasitology. In total, 103 suspected cases were recruited for the study. Based on parasitological examination, 49 patients were confirmed of having visceral leishmaniasis (VL) and the other 54 suspected cases were parasitologically negative. Field evaluation of FAST was possible in blood samples of 89 patients. FAST had 4 false negative results and 13 false positive results. DAT had 2 false negative results and 20 false positive results. A good degree of agreement (86.9%) was observed between FAST and DAT (kappa value 0.73). In this field-based evalauation, the sensitivity and specificity of FAST were found to be 91.1% (95% CI 77.9-97.1) and 70.5% (95% CI 54.6-82.8), respectively, compared with 95.3% (95% CI 82.9-99.2) and 62.3% (95% CI 47.9-74.9) for DAT. FAST had a high predictive value of a negative test, demonstrating that FAST could be utilised to exclude rapidly non-VL patients from a large population of suspects with fever and splenomegaly in endemic areas.
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Anticuerpos Antiprotozoarios/sangre , Leishmaniasis Visceral/diagnóstico , Pruebas de Aglutinación/métodos , Pruebas de Aglutinación/normas , Etiopía , Reacciones Falso Negativas , Reacciones Falso Positivas , Humanos , Leishmaniasis Visceral/sangre , Sensibilidad y EspecificidadRESUMEN
SETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary.
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Antituberculosos/administración & dosificación , Terapia por Observación Directa/normas , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Intervalos de Confianza , Femenino , Humanos , Masculino , Oportunidad Relativa , Prevalencia , Estudios Retrospectivos , Resultado del Tratamiento , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , U.R.S.S./epidemiologíaRESUMEN
OBJECTIVE: To assess the prevalence and risk factors of cigarette smoking and khat chewing. DESIGN: College based cross sectional. SETTING: Four colleges found in north west Ethiopia namely Gondar College of Medical Sciences, Gondar College of Teachers Education, Bahr Dar University Engineering Faculty, and Bahr Dar University Education Faculty. SUBJECTS: All instructors in these colleges. MAIN OUTCOME MEASURES: Prevalence of cigarette smoking and khat chewing. RESULTS: Seventy six (42.0%) instructors were either lifetime smokers or lifetime khat chewers or both. The current prevalence rates of cigarette smoking and khat chewing were found to be 13.3% and 21.0%, respectively. The majority of the instructors started smoking (56.8%) and khat chewing (40.0%) while they were senior high school or first year college students. Most of the instructors (82.1%) knew that cigarette smoking is a risk factor for lung diseases including lung cancer. Statistically significant difference (p<0.05) was seen between the outcome variable and the independent variables faculty, religion, education status, income and family history of khat chewing. CONCLUSION: The prevalence of cigarette smoking seemed to decrease among university instructors but the prevalence of khat chewing is almost the same as it was some years ago. Instructors knew the common health risks associated with cigarette smoking. The high schools and colleges should inform their students about the health and socioeconomic problems associated with cigarette smoking and khat chewing. Additionally, college students need counseling service on ways of coping with their problems.
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Catha , Docentes/estadística & datos numéricos , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Universidades , Adulto , Factores de Edad , Actitud Frente a la Salud , Estudios Transversales , Escolaridad , Etiopía/epidemiología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Motivación , Vigilancia de la Población , Prevalencia , Religión , Factores de Riesgo , Salarios y Beneficios , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
PURPOSE: To identify disabilities and to determine their prevalence, age of onset and perceived cause in one urban and three rural areas in Northern Ethiopia. METHOD: A community based cross-sectional study of households that were selected by systematic sampling. Trained enumerators identified individuals with physical disabilities or epilepsy who were 5 years of age or older. RESULTS: The overall prevalence of disability in 4214 individuals was 4.9%. The more common forms were walking difficulty (1.7%), loss of vision in one or both eyes (1.5%), hand dysfunction (0.8%) and epilepsy (0.7%). Information provided by the interviewees revealed a pattern of early onset, with injury and infection prominent as perceived causes. The importance of injury and infections was confirmed by the findings in half the people with disability, who were examined by a surgeon. CONCLUSIONS: Disability is a major public health problem and more facilities for rehabilitation and social support are needed. Measures that are needed to reduce the prevalence include health promotion, preventing injury, widening immunization coverage, better childhood nutrition and effective treatment for infection and injury. Further research should include younger children, cover a wider range of disability and use more sensitive means to detect hearing loss.
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Personas con Discapacidad/estadística & datos numéricos , Desempeño Psicomotor , Adolescente , Adulto , Distribución por Edad , Anciano , Niño , Preescolar , Estudios Transversales , Personas con Discapacidad/clasificación , Personas con Discapacidad/rehabilitación , Etiopía/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Población Rural/estadística & datos numéricos , Resultado del TratamientoRESUMEN
HIV-1 antibody was detected in 6.0 percent of prisoners in an Ethiopian prison. HIV-1 seropositivity was strongly associated with positive VDRL status (RR = 3.7) and recent admission to prison (RR = 3.5). Seropositive prisoners were more likely to have prostitute contacts. No correlation was found between seropositivity and number of sexual contacts, long-term sex partners, or dental extractions. HIV-1 infection in this area may be of recent origin and the high prevalence may reflect rates in the surrounding community.