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Adem M, Mekonen W, Ausman A, Ahmed M, Yimer A. Prevalence of chronic kidney disease and its associated factors among diabetes mellitus patients in Dessie Referral Hospital, South Wollo, Ethiopia. Sci Rep 2024; 14:9229. [PMID: 38649429 PMCID: PMC11035645 DOI: 10.1038/s41598-024-59184-3] [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: 07/06/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
Diabetes mellitus shares a large proportion of kidney failure. Despite many patients suffering from diabetes mellitus and its complications in Dessie City, no study was conducted in the study area that shows the prevalence and associated factors of chronic kidney disease among diabetes mellitus patients. Therefore, this study aims to assess the prevalence of chronic kidney disease and its associated factors among adult diabetes mellitus patients attending Dessie Referral Hospital, South Wollo, Northeast Ethiopia. An institutional-based cross-sectional study was conducted at Dessie Referral Hospital among 267 randomly selected adult diabetic patients. Data were collected using questionnaires administered by interviewers. The glomerular filtration rate was estimated from serum creatinine levels. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26 software. Multi-variable logistic regression was used to determine the strength of association for the associated factors of chronic kidney disease. Variables with a p value < 0.05 were used to ascertain statistically significant associations. A total of 267 diabetic patients participated in this study. About 104 (39%) of the respondents were female and from the total, 133 (48.1%) were hypertensive. The overall prevalence of chronic kidney disease in this study was 31.5% (95% CI 25.3-37.1%). Being older (p-value = 0.003) and having hypertension (p-value = 0.043) were significant factors for chronic kidney disease among diabetes mellitus patients. This study found a high prevalence (31.5%) of chronic kidney disease among diabetic patients. Older age, having hypertension, and elevated serum creatinine were statistically significant associated factors of chronic kidney disease among patients with diabetes mellitus. Thus, clinicians should be aware of the high prevalence of chronic kidney disease in Dessie City. Moreover, emphasis should be given for old age and hypertension as contributing factors to the high prevalence in diabetic patients.
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Affiliation(s)
- Mohammed Adem
- Department of Biomedical Science, School of Medicine, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
| | - Wondyefraw Mekonen
- Department of Physiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmed Ausman
- Department of Midwifery, College of Health Sciences, Samara University, Samara, Ethiopia
| | - Mohammed Ahmed
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ali Yimer
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Gebremedhin T, Aynalem M, Adem M, Geremew D, Aleka Y, Kiflie A. Dolutegravir based therapy showed CD4 + T cell count recovery and viral load suppression among ART naïve people living with HIV AIDS: a pilot evaluation. Sci Rep 2024; 14:3297. [PMID: 38331983 PMCID: PMC10853173 DOI: 10.1038/s41598-024-53282-y] [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: 11/01/2022] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4+ T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5-732994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes.
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Affiliation(s)
| | - Melak Aynalem
- Department of Hematology and Immunohematology, University of Gondar, Gondar, Ethiopia
| | - Mohammed Adem
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia
| | - Demeke Geremew
- Department of Medical Laboratory Sciences, Immunology and Molecular Biology Unit, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yetemwork Aleka
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia.
| | - Amare Kiflie
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia
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Gebremeskele BT, Adane G, Adem M, Tajebe F. Diagnostic performance of CL Detect rapid-immunochromatographic test for cutaneous leishmaniasis: a systematic review and meta-analysis. Syst Rev 2023; 12:240. [PMID: 38115138 PMCID: PMC10731771 DOI: 10.1186/s13643-023-02422-y] [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: 04/26/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Sensitive, robust, and fast point-of-care tests are needed for cutaneous leishmaniasis (CL) diagnosis. The recently developed CL Detect rapid test (InBios) for detecting Leishmania peroxidoxin antigen has been evaluated in several studies. However, diagnostic performances were controversial. Therefore, this systematic review and meta-analysis aimed to determine the pooled sensitivity and specificity of CL Detect for CL diagnosis. METHODS PubMed, Scopus, EMBASE, ScienceDirect, and Google Scholar were sources of articles. We included studies reporting the diagnostic accuracy of CL Detect and CL-suspected patients in the English language. The methodological qualities of the included studies were appraised using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2). Meta-analysis was conducted using Stata 14.2 and R software. RESULTS A total of 9 articles were included. The study sample size ranged from 11 to 274. The sensitivities of the individual studies ranged from 23 to 100%, and the specificities ranged from 78 to 100%. Pooled sensitivity and specificity were 68% (95% CI, 41-86%) and 94% (95% CI, 87-97%), respectively. AUC displayed 0.899. Pooled sensitivity was lower (47%, 95% CI, 34-61%) when PCR was used as a reference than microscopy (83%, 95% CI, 39-97%). Pooled sensitivity was lower (48%, 95% CI, 30-67%) for all lesion durations compared to ≤ 4 months (89%, 95% CI, 43-99%). CONCLUSIONS CL Detect has poor sensitivity and does not meet the minimal sensitivity of 95% of target product profiles designed for CL point-of-care tests. Currently, the CL Detect test looks unsuitable for CL diagnosis, despite its high specificity. Findings are limited by the low number of studies available. Further large-scale studies are recommended. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022323497.
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Affiliation(s)
- Behailu Taye Gebremeskele
- Department of Medical Laboratory Science, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Gashaw Adane
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mohammed Adem
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fitsumbrhan Tajebe
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Geremew D, Geremew H, Tamir M, Adem M, Tegene B, Bayleyegn B. Tuberculosis and isoniazid prophylaxis among adult HIV positive patients on ART in Northwest Ethiopia. PLoS One 2022; 17:e0266803. [PMID: 35452463 PMCID: PMC9032379 DOI: 10.1371/journal.pone.0266803] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 03/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Although antiretroviral therapy (ART) can avert tuberculosis (TB) incidence among human immunodeficiency virus (HIV) infected patients, the concomitant use of ART with isoniazid (INH) has a paramount effect. Despite this evidence, there is a paucity of data regarding TB incidence among HIV patients on ART with and without isoniazid prophylaxis and its predictors. Thus, this study sought to assess the incidence and predictors of TB among adult HIV positive patients on ART.
Methods
This was a hospital based retrospective study including 368 adult HIV positive patients on ART in Gondar comprehensive specialized hospital between January 1, 2016, and April 30, 2019. Data was extracted from clinical laboratory and HIV care ART follow up clinic. The bi-variable and multivariable regression models were used to ascertain predictors of incident TB. Data was analyzed using SPSS version 20 software.
Results
A total of 335 adult HIV positive patients were included in the analysis, of whom, 56 (16.7%) were developed incident TB. Being ambulatory and bedridden (AOR: 2.2, 95% CI: 1.1, 4.6), advanced WHO clinical HIV disease stage (III and IV) (AOR: 3.2, 95% CI: 1.6, 6.1), not taking INH (AOR: 2.8, 95% CI: 1.3, 5.9), and baseline CD4+ T cell count ≤ 200 cell/mm3 (AOR: 3.6, 95% CI: 1.8, 7.2) were found to be the predictors of tuberculosis incidence.
Conclusion
The study indicated a high TB incidence among HIV positive patients in Gondar. Therefore, scaling up the isoniazid preventive therapy program and its strict compliance is necessary to avert HIV fueled tuberculosis in HIV endemic areas.
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Affiliation(s)
- Demeke Geremew
- Department of Medical Laboratory Sciences, Immunology and Molecular Biology Unit, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Mebratu Tamir
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Adem
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanemeskel Tegene
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Bayleyegn
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Forrester JA, Starr N, Negussie T, Schaps D, Adem M, Alemu S, Amenu D, Gebeyehu N, Habteyohannes T, Jiru F, Tesfaye A, Wayessa E, Chen R, Trickey A, Bitew S, Bekele A, Weiser TG. Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study. Br J Surg 2021; 108:727-734. [PMID: 34157086 PMCID: PMC10364890 DOI: 10.1002/bjs.11997] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/17/2020] [Accepted: 07/23/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Clean Cut is an adaptive, multimodal programme to identify improvement opportunities and safety changes in surgery by enhancing outcomes surveillance, closing gaps in surgical infection prevention standards, and strengthening underlying processes of care. Surgical-site infections (SSIs) are common in low-income countries, so this study assessed a simple intervention to improve perioperative infection prevention practices in one. METHODS Clean Cut was implemented in five hospitals in Ethiopia from August 2016 to October 2018. Compliance data were collected from the operating room focused on six key perioperative infection prevention standards. Process-mapping exercises were employed to understand barriers to compliance and identify locally driven improvement opportunities. Thirty-day outcomes were recorded on patients for whom intraoperative compliance information had been collected. RESULTS Compliance data were collected from 2213 operations (374 at baseline and 1839 following process improvements) in 2202 patients. Follow-up was completed in 2159 patients (98·0 per cent). At baseline, perioperative teams complied with a mean of only 2·9 of the six critical perioperative infection prevention standards; following process improvement changes, compliance rose to a mean of 4·5 (P < 0·001). The relative risk of surgical infections after Clean Cut implementation was 0·65 (95 per cent c.i. 0·43 to 0·99; P = 0·043). Improved compliance with standards reduced the risk of postoperative infection by 46 per cent (relative risk 0·54, 95 per cent c.i. 0·30 to 0·97, for adherence score 3-6 versus 0-2; P = 0·038). CONCLUSION The Clean Cut programme improved infection prevention standards to reduce SSI without infrastructure expenses or resource investments.
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Affiliation(s)
- J A Forrester
- Department of Surgery, Stanford University, Stanford, USA
| | - N Starr
- Department of Surgery, University of California San Francisco, San Francisco California USA
| | - T Negussie
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - D Schaps
- Duke University School of Medicine, Durham North Carolina USA
| | - M Adem
- Department of Surgery, Menelik II Referral Hospital, Addis Ababa, Ethiopia
| | - S Alemu
- Departments of Surgery, , Jimma, Ethiopia
| | - D Amenu
- Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Jimma, Ethiopia
| | - N Gebeyehu
- Quality Improvement Department, St Peter's Specialized Hospital, Fitche, Ethiopia
| | - T Habteyohannes
- Department of Surgery, St Peter's Specialized Hospital, Addis Ababa Gulele Subcity, Fitche, Ethiopia
| | - F Jiru
- Department of Health Economics, Management, and Policy, Jimma University Medical Centre, Jimma, Ethiopia
| | - A Tesfaye
- Quality Improvement Department, St Peter's Specialized Hospital, Fitche, Ethiopia
| | - E Wayessa
- Fitche General Hospital, Fitche, Ethiopia
| | - R Chen
- Stanford‐Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University, Palo Alto, USA
| | - A Trickey
- Stanford‐Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University, Palo Alto, USA
| | - S Bitew
- Lifebox Ethiopia, Addis Ababa, Ethiopia
| | - A Bekele
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - T G Weiser
- Department of Surgery, Stanford University, Stanford, USA
- Stanford‐Surgery Policy Improvement Research and Education Center, Department of Surgery, Stanford University, Palo Alto, USA
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
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Abdu A, Cheneke W, Adem M, Belete R, Getachew A. Dyslipidemia and Associated Factors Among Patients Suspected to Have Helicobacter pylori Infection at Jimma University Medical Center, Jimma, Ethiopia. Int J Gen Med 2020; 13:311-321. [PMID: 32606896 PMCID: PMC7306453 DOI: 10.2147/ijgm.s243848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/01/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Dyslipidemia is a group of plasma lipid and lipoprotein abnormality that is metabolically associated, and it is categorized by low HDL-C and increased LDL-C, TGs, and total cholesterol (TC) levels. Colonization of the stomach by Helicobacter pylori (H. pylori) causes chronic inflammation of the stomach wall which can change some biochemical factors in the patient. On the association of H. pylori infection and its contributions to change in serum lipid profile, different studies reported varying outcomes. OBJECTIVE To assess the prevalence of dyslipidemia and associated factors among patients suspected for H. pylori infection in the outpatient department of Jimma University Medical Center, Jimma, Ethiopia. MATERIALS AND METHODS A hospital-based cross-sectional study was conducted from January 03 to April 05, 2019, at Jimma University Medical Center on 369 H. pylori suspected patients. The study subjects were selected by convenient sampling technique. About 5mL of blood was collected from an overnight fasting individual. Data were edited, coded, and entered into Epidata version 3.1 and exported to (SPSS) version 25 for analysis. Bivariate analysis was used to screen those variables which were candidates for multivariate analysis. RESULTS From the total study subjects 77.5% had at least one abnormality in lipid profile and 87.2% of H. pylori positive patients had at least one abnormality in lipid profile. Our study demonstrated that there was significant increase of mean ± SD of TC, TG, and LDL-C in H. pylori positive patients than H. pylori negative patients (P-value < 0.05). After adjusting for traditional dyslipidemia risk factors, H. pylori infection was an independent predictor of dyslipidemia (AOR 2.628, 95% CI 1.477-4.678, P=0.001). CONCLUSION An increase in prevalence of dyslipidemia among H. pylori positive patients indicates H. pylori infected patients have a possibility of altered lipid profile, therefore assessment of lipid profile in H. pylori infected patients is recommended.
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Affiliation(s)
- Ahmedmenewer Abdu
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Waqtola Cheneke
- Department of Medical Laboratory Sciences, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Mohammed Adem
- Medical Laboratory Service, Clinical Chemistry Unit, Jimma University Medical Center, Jimma, Ethiopia
| | - Rebuma Belete
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aklilu Getachew
- Department of Medical Laboratory Sciences, College of Health Sciences, Jimma University, Jimma, Ethiopia
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Adem M, Sani T, Chebude Y, Fetter G, Bosch P, Diaz I. Comparison of the defluoridation capacity of zeolites from Ethiopia and Mexico. B CHEM SOC ETHIOPIA 2015. [DOI: 10.4314/bcse.v29i1.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Madzime S, William MA, Mohamed K, October T, Adem M, Mudzamiri S, Woelk GB. Seroprevalence of hepatitis C virus infection among indigent urban pregnant women in Zimbabwe. ACTA ACUST UNITED AC 2000; 46:1-4. [PMID: 14674198 DOI: 10.4314/cajm.v46i1.8513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the seroprevalence of hepatitis C virus (HCV) infection among indigent pregnant women. DESIGN A serological survey study of indigent pregnant women admitted for labour and delivery. SETTING Harare Maternity Hospital, Harare, Zimbabwe. SUBJECTS A random sample of 1,607 women, delivering at the hospital during the study period agreed to participate in the research. Serum samples were available for 1,591 women. MAIN OUTCOME MEASURES Serum samples were tested for the presence of antibodies to HCV using a second generation agglutination assay and a third generation enzyme immuno-assay (EIA). RESULTS Of the 1,591 women tested 25 (1.6%) were anti-HCV positive (95% confidence interval 1.0% to 2.2%). The frequency of anti-HCV positives was associated with maternal age (p = 0.0202) and maternal syphilis status (p = 0.020). Gravidas aged 25 to 29 years had the highest anti-HCV seroprevalence (3.4%) as compared with gravidas of other age categories (1.0% to 1.5%). Women with serologic evidence of syphilis infection during the index pregnancy had an increased prevalence of anti-HCV as compared with those women without evidence of syphilis infection (7.9% versus 1.4%, p = 0.020). There was some evidence (p = 0.094) that a positive prior history of delivering a stillborn infant was also associated with an increased prevalence of anti-HCV (4.1% vs 1.4%). Other maternal characteristics, including hepatitis B virus carriage status, parity, and whether she had received prenatal care during the index pregnancy were not determinants of maternal anti-HCV status. CONCLUSIONS Overall, hepatitis C antibody was detected in 1.6% of indigent women delivering at Harare Maternity Hospital. This proportion of anti-HCV positive pregnant women is similar to estimates published for North American and European women. Factors positively associated with maternal seropositivity in our population included maternal age (between 25 to 29 years), prior history of delivering a stillborn infant, and seropositivity for syphilis during the index pregnancy. Given the relatively low seroprevalence of HCV and the fact that risk factors for HCV infection remain largely unknown, more studies are needed to identify high risk populations likely to benefit from HCV screening and treatment programmes.
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Affiliation(s)
- S Madzime
- Department of Obstetrics and Gynaecology, University of Zimbabwe Medical School, P O Box A 178, Avondale, Harare, Zimbabwe
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Madzime S, Adem M, Mahomed K, Woelk GB, Mudzamiri S, Williams MA. Hepatitis B virus infection among pregnant women delivering at Harare Maternity Hospital, Harare Zimbabwe, 1996 to 1997. Cent Afr J Med 1999; 45:195-8. [PMID: 10697914 DOI: 10.4314/cajm.v45i8.8414] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among pregnant women delivering at Harare Maternity Hospital. DESIGN A serological survey study of pregnant women admitted for labour and delivery. SETTING Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June 1997. SUBJECTS A random sample of 1,000 women, delivering at the hospital during the study period agreed to participate in the study. Serum samples were available for 984 women. MAIN OUTCOME MEASURES HBV carriage status was determined by the presence of hepatitis B surface antigen (HBsAg) by enzyme immunoassay (EIA). Maternal HBV infectivity status was determined by testing all HBsAg positive women for the presence of hepatitis e surface antigen (HBeAg) using EIA. RESULTS Overall 246 (25%) women were identified as carriers of HBV (95% confidence interval 22 to 28%). The frequency of HBV carriers did not vary with maternal age, parity or marital status. Only a positive prior history of spontaneous abortion was associated with an increased prevalence of HBV carriage status. Eight of the 246 (3.3%) women identified as HBV carriers tested positive for HBeAg. Hence, 0.8% of the entire study population was found to be at high risk of transmitting HBV to their newborns. CONCLUSIONS Our results demonstrate a high prevalence of HBV carriage among women giving birth at Harare Maternity Hospital. None of the demographic variables studied were important predictors of HBV carriage status. The high carriage rate and low infectivity rates suggest that HBV infection is likely to be acquired by horizontal, rather than by vertical means of transmission. Given the scarcity of financial resources, routine testing of mothers for HBsAg may not be feasible. Our results suggest, however, that mass vaccination of all infants, irrespective of maternal HBV carriage status, may be the most effective approach to HBV prevention and control in Zimbabwe.
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Affiliation(s)
- S Madzime
- Department of Obstetrics and Gynaecology, University of Zimbabwe Medical School, Avondale, Harare, Zimbabwe
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