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Gebregergs GB, Sinishaw MA, Shiferaw MB, Antife T, Assefa M, Fiseha D, Klinkenberg E. Evaluation of the postal service for referral of specimen of drug resistance tuberculosis in Amhara region, Ethiopia; mixed method. Afr Health Sci 2021; 21:619-627. [PMID: 34795715 PMCID: PMC8568248 DOI: 10.4314/ahs.v21i2.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In Ethiopia, specimens of presumptive drug resistant tuberculosis cases are transported by courier system from district sample collection centers to reference laboratories. It is essential to track the effectiveness of the referral system and identify challenges in order to take timely and appropriate actions. We assessed turnaround time and quality of specimens, and explored challenges of the specimen referral system in Amhara region, Ethiopia, 2017. METHODS With mixed methods, we retrospectively examined 385 randomly selected presumptive drug resistance TB specimens, and interviewed 53 purposively selected key informants from laboratories and post offices. We calculated median TAT and proportion of acceptable quality. We analyzed qualitative data thematically. RESULTS Of the 385 specimens, 94.5% (364/385) had acceptable quality at arrival in the reference laboratories. All the 364 specimens had result. Three - fourth (76.1%) of results were dispatched to the referring health facilities within the recommended turnaround time. Ineffective communication and lack of feedback among institutions were mentioned as challenges. CONCLUSION The postal service was effective in keeping quality and majority of test results were timely delivered. Yet, there were operational challenges. Therefore, effective communication, using dedicated vehicle for specimen shipment and awareness creation on specimen collection and handling are recommended.
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Affiliation(s)
| | | | | | - Tenagnework Antife
- Research and Technology Transfer Core Process, Amhara Regional Health Bureau, Bahir Dar, Ethiopia
| | - Melkie Assefa
- Private Health Sector Program (PHSP), Abt Associates Inc, Addis Ababa, Ethiopia
| | - Daniel Fiseha
- KNCV Tuberculosis Foundation/USAID Challenge TB, Addis Ababa, Ethiopia
| | - Eveline Klinkenberg
- KNCV Tuberculosis Foundation, The Hague, the Netherlands
- Department of Global Health, Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, the Netherlands
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Rick T, Habtamu B, Tigneh W, Abrha A, van Norden Y, Grover S, Assefa M, Incrocci L. Patterns of Palliative Radiotherapy in Ethiopia. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Woldesonbet Z, Nigussie M, Zeleke T, Bekuretsion Y, Assefa M, Anberbir E, Vetter M, Bukhor J, Barbara S, Kantelhardt E. NanoString nCounter based gene expression assay for the evaluation of breast cancer molecular subtypes in Ethiopian patients. Breast 2019. [DOI: 10.1016/s0960-9776(19)30127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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McCormack VA, Menya D, Munishi MO, Dzamalala C, Gasmelseed N, Leon Roux M, Assefa M, Osano O, Watts M, Mwasamwaja AO, Mmbaga BT, Murphy G, Abnet CC, Dawsey SM, Schüz J. Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting-specific exposures to known and putative risk factors. Int J Cancer 2017; 140:259-271. [PMID: 27466161 PMCID: PMC5763498 DOI: 10.1002/ijc.30292] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/08/2016] [Indexed: 12/30/2022]
Abstract
Esophageal squamous cell carcinoma (ESCC) is one of the most common cancers in most Eastern and Southern African countries, but its etiology has been understudied to date. To inform its research agenda, we undertook a review to identify, of the ESCC risk factors which have been established or strongly suggested worldwide, those with a high prevalence or high exposure levels in any ESCC-affected African setting and the sources thereof. We found that for almost all ESCC risk factors known to date, including tobacco, alcohol, hot beverage consumption, nitrosamines and both inhaled and ingested PAHs, there is evidence of population groups with raised exposures, the sources of which vary greatly between cultures across the ESCC corridor. Research encompassing these risk factors is warranted and is likely to identify primary prevention strategies.
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Affiliation(s)
- V A McCormack
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - D Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - M O Munishi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - C Dzamalala
- College of Medicine, University of Malawi, Blantyre, Malawi
- Malawi Cancer Registry, Malawi
| | - N Gasmelseed
- National Cancer Institute, University of Gezira, Sudan
- Faculty of Science, University of Hafr Al Batin, Saudi Arabia
| | - M Leon Roux
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - M Assefa
- Radiotherapy Center, Addis-Ababa-University, Addis Ababa, Ethiopia
| | - O Osano
- School of Environmental Studies, University of Eldoret, Kenya
| | - M Watts
- Inorganic Chemistry, Centre for Environmental Geochemistry, British Geological Survey, Nottingham, United Kingdom
| | - A O Mwasamwaja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - B T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - G Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - C C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - S M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - J Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
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Gebregergs GB, Alemneh M, Koye DN, Kassie Y, Assefa M, Ayalew W, Temesgen C, Klinkenberg E, Tadesse T. Poor symptomatic tuberculosis screening practices in a quarter of health centres in Amhara Region, Ethiopia. Public Health Action 2014; 4:S8-S12. [PMID: 26478513 DOI: 10.5588/pha.14.0053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/19/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING In 2011, Ethiopia introduced a strategy of symptomatic tuberculosis (TB) screening for patients attending out-patient services to increase identification of presumptive TB. OBJECTIVE To assess implementation and factors affecting symptomatic TB screening at out-patient departments in health centres in the Amhara Region, Ethiopia. DESIGN Using a cross-sectional study design, 86 randomly selected public health centres providing DOTS were included in the study. Data were captured by reviewing TB registers and interviewing key informants at out-patient services. RESULTS Of 86 health centres, 24 (28%) had poor symptomatic TB screening practices, defined as screening <80% of attending out-patients. Having an actively functioning multidisciplinary health centre team to assess TB services (aOR 2.29, 95%CI 2.23-30.80) and partner support for TB activities (aOR 4.84, 95%CI 1.05-22.40) were associated with higher TB screening rates, whereas availability of antiretroviral therapy was negatively associated. In all health centres combined, 1.6% of out-patient department attendees were identified as having presumptive TB. CONCLUSION A quarter of health centres had poor symptomatic TB screening practices in the out-patient services in this study. Strengthening multidisciplinary teams and expanding partner support are recommended to improve TB screening practices at out-patient services in Ethiopia.
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Affiliation(s)
- G B Gebregergs
- Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia ; Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia
| | - M Alemneh
- Bahir Dar Regional Health Research Laboratory Center, Bahir Dar, Ethiopia
| | - D N Koye
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Y Kassie
- Management Sciences for Health/HealTB, Addis Ababa, Ethiopia
| | - M Assefa
- Private Health Sector Program (PHSP), Abt Associates Inc, Addis Ababa, Ethiopia
| | - W Ayalew
- Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia
| | | | - E Klinkenberg
- KNCV Tuberculosis Foundation, The Hague, The Netherlands ; Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - T Tadesse
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Melka A, Tekie-Haimanot R, Assefa M. Aetiology and outcome of non-traumatic altered states of consciousness in north western Ethiopia. East Afr Med J 1997; 74:49-53. [PMID: 9145579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Awareness of the relative prevalence of diseases causing altered states of consciousness (ASC) in a particular geographic locality could greatly facilitate the approach to patient management. This prospective study has, therefore, evaluated 202 patients with ASC admitted to the medical wards of GCMS teaching hospital in a two year period, between January 1994 and December 1995. ASC was defined as a clinical state manifested by conditions ranging from confusion and disorientation in person, place and time to stupor and deep coma. History, physical examination, limited laboratory tests and course of the patient in the hospital were used to identify the aetiology. There were 122 (60.4%) males and 80 (39.6%) females with male to female ratio of 3:2. Most of the patients, 122 (60.4%), belong to the age group below 40 years and the median age was 33 years (range = 15.84). The median duration of hospital stay was six days (range = 1-90). The commonest cause was infections, 111 (55%) followed by metabolic disorders, 45 (22.3%), structural lesions, 30 (14.9%) and poisoning, seven (3.5%). The aetiology was not identified in nine (4.5%) of the patients. Cerebral malaria was the commonest infectious cause followed by chronic meningitis and/or encephalitis. In hospital mortality rate was 60.4%. Unknown diagnosis, structural neurologic and metabolic causes were associated with increased mortality rate, with p values of 0.002, 0.009 and 0.015, respectively. The same was true for presence of HIV infection, P = 0.02. Since infectious causes are the commonest causes in our series, of which most are treatable with a relatively favourable outcome, critical evaluation for infections and early intervention is recommended. In addition, diagnostic facilities, especially for structural central nervous system lesions has to be improved because successful treatment and prognosis depends on the identification of a specific aetiology.
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Affiliation(s)
- A Melka
- Gondar College of Medical Sciences, Department of Internal Medicine, Ethiopia
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Zein ZA, Assefa M. The prevalence of anaemia among populations living at different altitudes in north-western Ethiopia. Ethiop Med J 1987; 25:105-11. [PMID: 3609004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Zein ZA, Assefa M. Blood-pressure levels and hypertension in rural Ethiopian communities. Ethiop Med J 1986; 24:169-78. [PMID: 3780680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Assefa M, Ahmed Zein Z. Health status in the new peasant producers' co-operatives in Gondar Region, Ethiopia. Ethiop Med J 1986; 24:123-32. [PMID: 3720733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Zein ZA, Assefa M. The prevalence of intestinal parasites among farming cooperatives, Gondar region, north-western Ethiopia. Ethiop Med J 1985; 23:159-67. [PMID: 3876933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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