Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis
Kenaw Tegegne Tefera,
Fasil Wagnew,
Yihalem Abebe Belay,
Dawit Eyayu,
Daniel Bekele Ketema
Issue:
Volume 6, Issue 4, July 2021
Pages:
42-57
Received:
10 May 2021
Accepted:
5 July 2021
Published:
13 July 2021
Abstract: Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.
Abstract: Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and incon...
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Nurses Knowledge, Practice, and Associated Factors Toward Prevention of Surgical Site Infection in Benishangul Gumuz Hospitals Northwest Ethiopia 2021
Paulos Jaleta,
Mulugeta Adimasu,
Muluwas Amentie
Issue:
Volume 6, Issue 4, July 2021
Pages:
58-65
Received:
30 July 2021
Accepted:
9 August 2021
Published:
18 August 2021
Abstract: Introduction: Surgical Site Infection (SSI) is one of the most common types of Healthcare associated infection which is considered to be 20% to 25% of all infections. It is an infection which occurs within 30 days after a surgical procedure or up to one year in those surgical patients in which an implant has been placed in an organ. SSI were the leading infections in developing country and strikingly higher proportions recorded in developed countries. Objective. nurses’ knowledge, practice, and associated factors towards surgical site infection prevention in Benishangul Gumuz Regional north West Ethiopia 2021. Methods: A facility based cross-sectional study was conducted among staff nurse in Benishangul Gumuz regional hospitals, western Ethiopia from janury 1st to October 1st 2021. A total of 218 nurses were recruited consecutively as study subjects. Data was collected using structured questionnaire. The collected data was analyzed using SPSS version 20.0 and descriptive statistic was used to indicate the frequency and percentage of variables and chi-square was used to determine the predictors of nurse’s knowledge and practice at P values <0.05 was considered determine significant association. Result: about two handed eighteen study subject were interviewed the finding shows that 51.8% of nurse were not knowledgeable and around 47.2% of nurses were having poor practice toward SSI prevention. Chi-square test shows that variables like marital status, working period and work experience has got association with nurses’ knowledge and practice toward SSI prevention. finally training standard SSI prevention guideline close monitoring is required from respective facility and stakeholders.
Abstract: Introduction: Surgical Site Infection (SSI) is one of the most common types of Healthcare associated infection which is considered to be 20% to 25% of all infections. It is an infection which occurs within 30 days after a surgical procedure or up to one year in those surgical patients in which an implant has been placed in an organ. SSI were the le...
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Onychomycosis in the Military Hospital of Marrakesh: A Five-year Experience
Fatima Babokh,
Zineb Nassiri,
El Mostafa El Mezouari,
Redouane Moutaj
Issue:
Volume 6, Issue 4, July 2021
Pages:
66-69
Received:
25 July 2021
Accepted:
10 August 2021
Published:
27 August 2021
Abstract: Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This is a retrospective study that included 875 patients and took place in the Avicenna Military Hospital of Marrakesh over a period of 5 years. Direct examination on a slide with a coverslip after clarification with potassium hydroxide (KOH 30%), as well as culture on Sabouraud media supplemented with chloramphenicol and chloramphenicol with cycloheximide were systematically carried out. Incubation was carried out in 20-25°C for dermatophytes and 37°C for yeasts and molds. The tubes were regularly controlled (twice a week) for at least four weeks before giving negative results. Between January 2015 and July 2019, 875 patients were enrolled in this study. Sex ratio (M:F) was 1.06. The average age was 48 years. Toenails were affected in 683 cases (78%), fingernails in 192 cases (21.9%), and both fingernails and toenails in 120 cases (13.7%). Pachyonychia was present in 63% of the cases (551/875), subungual hyperkeratosis in 50.8% of the cases (444/875) and xanthonychia in 43% of them (376/875). 61% (625 / 875) of direct examinations were positive, of which 83% (522/625) were confirmed by positive culture. Dermatophytes were isolated in 86.8% of the cases (n=759), yeasts in 13% (n=113) and molds in 0.2% of the cases (n=2). Candida albicans was the only identified yeast in this series (13%), found mainly in fingernails. In addition, toenail onyxis was mainly caused by dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes var interdigital represented 80.8% and 6% of isolated dermatophytes, respectively. This work attests the contribution of mycological examination to the confirmation of fungal origin of onychopathies and the treatment orientation. Trichophyton rubrum was isolated in the majority of our cases.
Abstract: Onychomycosis is a nail fungal infection caused by dermatophytes, becoming one of the most frequent reasons for consultation in mycological dermatology in Morocco. The purpose of this work is to describe the epidemiology of onychomycosis and to specify the most frequently isolated fungal agents in the Avicenna Military Hospital of Marrakesh. This i...
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