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Tsehay YT, Bogale AD, Mulatu S, Netsere HB, Adal O, Messelu MA, Mamo ST, Demile TA, Abebe GK, Mekonnen GB, Belay AE, Wondie WT, Belayneh AG. Magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia: systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:2940-2950. [PMID: 38694295 PMCID: PMC11060307 DOI: 10.1097/ms9.0000000000001978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 05/04/2024] Open
Abstract
Background Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia. Methods This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger's regression test. Heterogeneity across studies was assessed by I2 statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian-Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality. Results The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70-5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality. Conclusion and recommendations The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes.
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Affiliation(s)
| | | | | | | | - Ousman Adal
- Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar
| | - Mengistu Abebe Messelu
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos
| | - Sosina Tamre Mamo
- Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar
| | - Tiruye Azene Demile
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar
| | - Gebremeskel Kibret Abebe
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Woldia University, Woldia
| | - Gebrehiwot Berie Mekonnen
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor
| | | | - Wubet Tazeb Wondie
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Asnake Gashaw Belayneh
- Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar
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Chanie ES, Moges N, Baye FD, Mekonnen GB, Fekadie MM, Bazezew LY, Anley DT, Zemene MA, Gebeyehu NA, Adella GA, Kassie GA, Mengstie MA, Seid MA, Abebe EC, Gesese MM, Tegegne KD, Kebede YS, Bantie B, Feleke SF, Dejenie TA, Bayih WA, Kassaw A, Dessie AM, Azanaw MM, Chanie SS. Estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa: a systematic review with meta-analysis. Sci Rep 2024; 14:6494. [PMID: 38499717 PMCID: PMC10948888 DOI: 10.1038/s41598-024-55730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.
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Affiliation(s)
- Ermias Sisay Chanie
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Natnael Moges
- Department of neonatal health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fikadie Dagnew Baye
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrehiwot Berie Mekonnen
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mengistu Melak Fekadie
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Lakachew Yismaw Bazezew
- Department of neonatal health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of midwifery, College of medicine and Health science, Wolaita sodo university, Wolaita, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Woliata, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Woliata, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of medicine and health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of physiology, Department of Biomedical science, college of health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of midwifery, College of medicine and Health science, Wolaita sodo university, Wolaita, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of comprehensive Nursing, College of Health sciences, Wollo university, Wollo, Ethiopia
| | - Yenealem Solomon Kebede
- Department of medical laboratory science, College of health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of comprehensive Nursing, College of Health sciences, Debre Tabor university, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Epidemiology and preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia, and Department of Maternal and neonatal health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Kassaw
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sewunt Sisay Chanie
- Department of comprehensive Nursing, College of Health sciences, Debre Berhan university, Debre Berhan, Ethiopia
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Wondie WT, Legesse BT, Mekonnen GB, Degaga GT, Zemariam AB, Gedefaw GD, Abebe DE, Kassie YT, Gonete AT, Belay AE, Wubneh CA. Incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first seven days in Northwest Ethiopia Comprehensive Specialized Hospitals, 2023: A retrospective follow-up study. BMJ Open 2023; 13:e079063. [PMID: 37984945 PMCID: PMC10660425 DOI: 10.1136/bmjopen-2023-079063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Respiratory distress syndrome is a catastrophic respiratory problem among low birth weight neonates. It increases the suffering of neonates and the economic expenditure of the countries. Notably, it is a major public health issue in low-income and middle-income countries such as Ethiopia. Despite this, studies regarding respiratory distress syndrome among low birth weight neonates were limited in Ethiopia. OBJECTIVE To assess the incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first 7 days in Northwest Ethiopia Comprehensive Specialized Hospitals. METHOD Multicentred institution-based retrospective follow-up study was conducted from 19 September 2021 to 1 January 2023, among 423 low birthweight neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.6. and analysed using STATA V.14. The Kaplan-Meier failure curve and log-rank test were employed. Bivariable and multivariable Weibull regression was carried out to identify predictors of respiratory distress syndrome. Statistical significance was declared at a p≤0.05. RESULT The incidence rate of respiratory distress syndrome was found to be 10.78 (95% CI 9.35 to 12.42) per 100 neonate days. Fifth minute Appearance, Pulse, Grimace, Activity, Respiration (APGAR score) <7 (AHR 1.86; 95% CI 1.18 to 2.92), multiple pregnancy (AHR 1.43; 95% CI 1.04 to 1.96), caesarean section delivery (AHR 0.62; 95% CI 0.41 to 0.93), prematurity (AHR 1.56; 95% CI 1.06 to 2.30) and birth weight <1000 g (AHR 3.14; 95% CI 1.81 to 5.40) and 1000-1499 g (AHR 2.06; 95% CI 1.42 to 2.83) were significant predictors. CONCLUSION The incidence of respiratory distress syndrome was higher than other studies conducted on other groups of neonates. Multiple pregnancy, fifth minute APGAR score, caesarean section, prematurity, extremely low birth weight and very low birth weight were predictors of respiratory distress syndrome. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention for these predictors.
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Affiliation(s)
- Wubet Tazeb Wondie
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bruck Tesfaye Legesse
- Department of Pediatrics and Neonatal Nursing, Wollega University, Nekemte, Ethiopia
| | - Gebrehiwot Berie Mekonnen
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gosa Tesfaye Degaga
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, Woldia University, Woldia, Ethiopia
| | - Gezahagn Demsu Gedefaw
- Department of Neonatal Health Nursing, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Dereje Esubalew Abebe
- Department of Medical Physiology College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and Critical Care Nursing,College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Almaz Tefera Gonete
- Pediatrics and Child Health Nursing, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | | | - Chalachew Adugna Wubneh
- Department of Pediatrics and Child Health Nursing, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Mekonnen GB, Birhane BM, Engdaw MT, Kindie W, Ayele AD, Wondim A. Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study. Front Pediatr 2023; 11:1107321. [PMID: 37205221 PMCID: PMC10185808 DOI: 10.3389/fped.2023.1107321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/30/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Globally, opportunistic infections are the leading causes of morbidity and mortality among HIV-infected children, contributing to more than 90% of HIV-related deaths. In 2014, Ethiopia launched and began to implement a "test and treat" strategy aiming to reduce the burden of opportunistic infections. Despite this intervention, opportunistic infections continue to be a serious public health issue, with limited evidence available on their overall incidence among HIV-infected children in the study area. Objective The study aimed to assess the incidence of opportunistic infections and to identify predictors of their occurrence among HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals in 2022. Methods A multicenter, institution-based retrospective follow-up study was conducted among 472 HIV-infected children receiving antiretroviral therapy at Amhara Regional State Comprehensive Specialized Hospitals from May 17 to June 15, 2022. Children receiving antiretroviral therapy were selected using a simple random sampling technique. Data were collected using national antiretroviral intake and follow-up forms via the KoBo Toolbox. STATA 16 was used for data analyses, and the Kaplan-Meier method was used to estimate probabilities of opportunistic infection-free survival. Both bi-variable and multivariable Cox proportional hazard models were employed to identify significant predictors. A P-value <0.05 was taken to indicate statistical significance. Results Medical records from a total of 452 children (representing a completeness rate of 95.8%) were included and analyzed in the study. The overall incidence of opportunistic infections among children receiving ART was 8.64 per 100 person-years of observation. The predictors of elevated incidence of opportunistic infections were: a CD4 cell count below a specified threshold [AHR: 2.34 (95% CI: 1.45, 3.76)]; co-morbidity of anemia [AHR: 1.68 (95% CI: 1.06, 2.67)]; ever having exhibited only fair or poor adherence to ART drugs [AHR: 2.31 (95% CI: 1.47, 3.63)]; never having taken tuberculosis-preventive therapy [AHR: 1.95 (95% CI: 1.27, 2.99)]; and not having initiated antiretroviral therapy within 7 days of HIV diagnosis [AHR: 1.82 (95% CI: 1.12, 2.96)]. Conclusion In this study, the incidence of opportunistic infections was high. Early initiation antiretroviral therapy has direct effect on boosting the immunity, suppressing viral replications and increases the CD4 count, so that the occurrence of opportunistic infection will reduce the incidence of OIs.
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Affiliation(s)
- Gebrehiwot Berie Mekonnen
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Correspondence: Gebrehiwot Berie Mekonnen
| | - Binyam Minuye Birhane
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Melaku Tadege Engdaw
- Social and Population Health Unit, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wotetenesh Kindie
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, and Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Amare Demsie Ayele
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Amare Wondim
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Matula S, Mekonnen GB, Báťková K, Nešetřil K. Simulations of groundwater-surface water interaction and particle movement due to the effect of weir construction in the sub-watershed of the river Labe in the town of Děčín. Environ Monit Assess 2014; 186:7755-7770. [PMID: 25086713 DOI: 10.1007/s10661-014-3964-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 07/24/2014] [Indexed: 06/03/2023]
Abstract
Steady- and transient-state simulations of groundwater flow and particle movement in the sub-watershed of the river Labe in Děčín town was carried out using Visual MODFLOW software. The simulations were performed for calibration and for the scenarios that the change in the water level of the river Labe was undergoing. Steady-state simulation was carried out for the sake of calibration of model outputs. For transient simulation, two different scenarios were considered in order to investigate the response of the aquifer system to the stresses applied on surface water of the river. The simulation results have shown that the surface water and groundwater interactions, and the subsequent particle movement were affected by the stresses applied on the surface water in the river Labe. The first scenario involved the rapid recharge of surface water to the aquifer in the vicinity of the river while particles still move towards the river at the places far away from the river. At the end of the second scenario, particles still tend to move towards the river slowly and finally tend to stay within the aquifer as equilibrium of hydraulic gradient is reached between the surface and groundwater levels. The time series graphs of hydraulic heads at all observation wells show that the groundwater level in the surrounding aquifer rises significantly as a result of recharges from the river. The local water balance of the study area was calculated and expressed as the rates of water entering and leaving the system. At the end of the second scenario, the difference between the rate of flow into and out of the model area was 0.73 m(3) day(-1).
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Affiliation(s)
- S Matula
- Faculty of Agrobiology, Food and Natural Resources, Department of Water Resources, Czech University of Life Sciences, Kamýcká 129, 165 21, Praha 6, Czech Republic
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