International Research Journal of Medicine and Medical Sciences

59-66

Authors: Ban A. Majeed, Christos Hatzigeorgiou, Mishma Farsi, Matthew Heiken, Deepak N. Ayyala and David W. Walsh

The objective of this study is to determine hospitalization and case-fatality rates in adult patients diagnosed with COVID-19 at a large academic medical center in the United States of America which predominately serves rural and underrepresented populations. EMR data abstraction of a cohort of lab-confirmed COVID-19, outpatient and inpatient, adult patients, who tested positive at Augusta University Medical Center (AUMC) in 2020 (N = 18,403) was conducted. Eligible patients were identified using the data mining tool, i2b2. COVID-19 hospitalization and case fatality rates were calculated. Logistic and Poisson regression models were constructed to identify characteristics associated with hospitalization, death, and hospital stay. The hospitalization rate was 3.97%. Patients aged 45-64 and 65+ had significantly higher hospitalization rates. Compared to White, hospitalization rates were higher in Black (AOR 2.35, 95% CI, 1.99-2.77, p 0.001) and Hispanic patients (AOR 1.92, 95% CI, 1.92-3.01, p 0.01). Overall COVID-19 case fatality rate was 0.62% and, in hospitalized patients, was 14.25%. Patients 65+ had higher odds of death (AOR 7.57, 95% CI, 3.25-22.13, p 0.001). Case fatality rates did not vary by race. In conclusion, in a primarily rural and underserved population prior to known effective therapy, overall and hospitalized case fatality rates were similar to studies from large urban areas.

44-52

Authors: Valerie Maboulou, Aicha Ngoutane, Jean Molu, Mohamadou Mansour, Cyrille Kountchou, Ibrahima Djoulde, Vehlima Adamou, Grace Wanda, Roger Ahouga, Marie Amougou, Livo Esemo, Abdouraman Bouba, Marcelle Eyong, Milaine Toukap, Lilian Akwah, Mbakop Calixte, Nkengazong Lucia and Marie Chantal Ngonde Essome

Sickle cell disease is the most common autosomal recessive disease in sub-Saharan Africa. Our study aimed to determine the sickle cell trait, to assess knowledge, attitudes, practices and perceptions regarding sickle cell disease of people living in Yaoundé. We carried out a cross-sectional and descriptive study at the Institute of Medical Research and Medicinal Plants studies in Yaoundé. We included a total of 191 participants of mixed sex and ages ranging from 10 to 70 years old, able to complete a questionnaire and having accepted a blood sample for the hemoglobin electrophoresis test. Data was collected using a questionnaire. We used the Chi-square test to assess the relationships between variables with p-value ˂ 0.05 for meaningful relationships. More than half of the participants were women (59.16%), and the representative age group was 20-29 years old (47.12%). The highest level of education was university level (71.73%). Most of the participants had heard of sickle cell disease (93.72%) and the most talked-about information channel was television (41.90%). The proportions in relation to knowledge about sickle cell disease were as follows: in the transmission mode, 71.73% had mentioned that it is an inherited disease; in prevention mode, 88.08% had mentioned the hemoglobin electrophoresis test. For the follow-up of the disease, 85.86% noted the hospital as the location. Compared to marriage with a sickle cell disease patient, 68.59% answered negatively. There is a significant relationship (p˂0.05) between the level of education and knowledge of sickle cell disease transmission. The results of our study showed that the university population of Yaoundé had a good knowledge of sickle cell disease. Young people are called upon to be tested for sickle cell disease before marriage. Studies on larger samples should be conducted to have a better appreciation of the sickle cell trait in the population of Yaoundé.

19-23

Authors: Gilbert G. Waria, Abel L. Lihweuli, Innocent J. Sanga, Elichilia R. Shao and Debora C. Kajeguka

Hepatitis B virus infection remains a major public health problem across the globe. Health care workers are at highest risk than other groups due to frequent contact with body fluids. Despite efforts made by the Tanzanian government since 2014 towards universal immunization of healthcare workers, still, the coverage has not been explored. The study was done to determine the prevalence of Hepatitis B surface Antigen carriage on Hepatitis B infection and associated factors among Health care workers in Moshi Municipality’s Primary Health facilities. An analytical cross-sectional study was conducted in 30 primary health care facilities located in Moshi Municipality. The study included 197 Health Care workers who were present during data collection. A pre-tested and standardized questionnaire was used to assess the associated factors on Hepatitis B infection. Proportions and frequencies were used to summarize categorical variable while Measure of central tendency and associated measure of dispersion was computed for variables. The prevalence of Hepatitis B surface Antigen carriage was 3.6%. Factors such as education level, occupation, marital status, vaccination, surgery history, skin contact with body fluids seemed to have contributed to HBV seropositivity but none of them had a significant association. The prevalence of Hepatitis B surface Antigen carriage among healthcare workers in Moshi Municipals is relatively low. This low prevalence may be because primary health facilities are exposed to a smaller number of patients who are not critically ill, also may be a low sample size used. Therefore continued education on Hepatitis B control should be provided.

30-36

Authors: Navid Najafi, Mohammad Hadi Gharib, Nematollah Nematollahi and Fatemeh Mehravar

Colorectal cancer (CRC) is the third leading cause of death in the world, accounting for 16% of all new cancer diagnoses. Patients with cancer should be closely monitored before making treatment decisions. Diagnosis of metastatic disease is especially important because it has a significant impact on the therapeutic approach. Magnetic resonance imaging (MRI) is considered a superior method for preoperative evaluation in rectal cancer. Therefore, this study was performed to evaluate MRI findings in patients with rectosigmoid cancer in Golestan province in 2019 and 2020. This is a cross-sectional and descriptive study that was performed on 43 patients with rectal cancer for 2 years in Gorgan. Patients with other cancers, other metastatic cancer, and a history of surgery were excluded. Demographic information (age, gender and ethnicity) was obtained and recorded from patients 'electronic records and patients' MRI information through the picture archiving and communication system (PACS) of Gorgan MRI centers. Among 43 patients with rectosigmoid cancer, 65.1% of them were male and the mean age was 58.58 ± 14.73 years. The average mass length was 48.44 mm and the distance from Anal Verge was 69.81 mm. The tumor morphology of patients' rectosigmoid mass in imaging was related to Semi Circumferncial (62.72%) and Circumferncial (37.21%). T1/T2, N2a, and M0 with the percentages of 41.9%, 39.5%, and 90.7%, respectively, had the highest frequency in patients. TNM Staging was not significantly related to gender or ethnicity. Peritoneal reflection was also more common in Sistani and Turkmen ethnic groups. In conclusion, the results of this study showed that high-resolution MRI under the imaging protocol for obtaining quality images can help to accurately regional staging necessary for optimal treatment.

1-10

Authors: Jemberu Nigussie, Mekuria Kassa, Goitom Halefom, Haven Hadush and Bekahegn Grima

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection in the human body potentiate each other by weakening the immune system and causing death, if untreated. Tuberculosis is a major cause of morbidity and mortality in children infected with the human immunodeficiency virus. Evidence on survival and predictors of mortality among TB and HIV co-infection in children is limited and not well documented in Ethiopia. This study aimed to evaluate the predictors of mortality among children with TB and HIV co-infected in general hospitals in two zones of the Tigray region, North Ethiopia, from 2008-2018. An institution-based retrospective follow-up study was conducted. Data were collected from medical records using a data extraction checklist and then entered using epi-data manager 4.4.2.1 and then exported to STATA version 14 for analysis. The Cox regression model was used for both bivariate and multivariate analyses. Of a total of 253 children included in the analysis, 38(15%) children have died. The overall mortality rate was 0.17 (95% CI: 0.12, 0.23) per 1000 child-month observation. Underweight at baseline (AHR=7.9 (95% CI: 1.3, 49.3)), IPT non user (AHR=3.7; 95%CI: 1.3-10.8), Poor adherence to ART (AHR = 3.8 (95% CI:1.4, 10.5)), Extrapulmonary tuberculosis (AHR = 2.9 (95% CI: 1.1, 7.6)), advanced WHO-staging(III&IV) (AHR=6.8 (95% CI: 1.9, 24.9)) and hemoglobin level <10 mg/dl during follow-up (AHR 3.75 (95% CI: 1.06, 13.28)) were predictors of increased mortality. In conclusion, the mortality rate of children co-infected with TB and HIV was high. Early diagnosis and treatment of TB among HIV-infected children is needed. The treatment of malnutrition and anemia should be given emphasis. Strengthening the administration of preventive therapy (IPT, CPT) and counseling on adherence to ART drugs were crucial interventions to reduce mortality among children co-infected with TB and HIV. Children who have extra-pulmonary tuberculosis and advanced clinical staging (III and IV) need special consideration during treatment.