Abstract: Background: Teenage pregnancy is directly related to high incidence of pregnancy related complications contributing to maternal morbidity and mortality and social problems. There are no enough data on teenage pregnancy and related complications in Ethiopia and in Benishangul Gumuz region in particular. Objective: To investigate the magnitude and factors associated with teenage pregnancy among teenage females visiting Assosa general hospital for health care services. Methods: Facility-based quantitative cross-sectional study was carried out among 783 randomly selected teenage females using structured and pre-tested questionnaire from January to April 2014. Results: Teenage pregnancy is estimated at 20.4% in this study. The median age of subjects at first sexual intercourse and at first marriage being 16 and 17 years respectively. High proportion of (46.8%) teenagers had engaged in premarital sex. Among sexually active teenage females, 46.7% experienced their first sexual encounter by coercion. Being young [AOR= 0.21, 95%CI= 0.06-0.67], single [AOR= 0.06, 95%CI= 0.03-0.12], housemaid [AOR= 3.93, 95%CI=1.71-9.04] and use of family planning [AOR= 2.39, 95%CI= 1.20-4.75] have statistically significant association with teenage preganancy. Conclusions and Recommendations: A range of factors including age, marital status, level of education, occupational status, average family income and use of family planning have influence on teenage pregnancy in the study area. Behavioral change communication, strengthening school health program, empowering young women specifically the rural women, and promoting parent-children discussion on sexuality is recommended. Key words: Teenage females, Teenage pregnancy, Risk factors, Assosa General Hospital.

Abstract: Background: Hypertensive Disorders of Pregnancy (HDP) represent the most common medical complication in pregnancy associated with significant maternal and perinatal morbidity and mortality worldwide. Identification of common maternal and perinatal morbidities associated with HDP is important for policy makers to plan to alleviate the problem. Objective: To assess the patterns of HDP and associated factors from September 2011- August 2014 in Debre Berhan Referral Hospital. Method: Institution-based retrospective cross sectional study was conducted by reviewing logbooks and patients charts. Result: HDP complicate 3.9% of pregnancy. The prevalence of HDP shows an increasing trend from 1.8% in 2011 to 5.7% in 2014. Preeclampsia accounts for 67.4% of all case followed by eclampsia which account for 27.8%. In this study, HDP was associated with 35.4% preterm delivery, 30.8% fetal death, 39.4% low birth weight, 38.4% low APGAR score and 8.5% IUGR. About 15.8% of newborns born from mothers with HDP needed resuscitation and 40.1% ICU admission. Maternal death occurs in 2.5% mothers who had HDP with the case fatality rate for eclampsia being 6.67%. HDP contributed for 35% of all maternal deaths. Of all mothers with HDP, 58% were primi-gravida ladies. Conclusion: the prevalence of HDP shows an increasing pattern over the last years. Preeclampsia and eclampsia together take the lion-share of HDP. Primi-gravida women are affected more frequently than multi-gravida women with hypertensive disorders of pregnancy. HDP was associated with major adverse perinatal and maternal outcome Key words : Preeclampsia, eclampsia, Hypertensive disorders of pregnancy (HDP), Maternal and perinatal mortality, Apgar score.

Abstract: Background: Cervical cancer is the second commonest type and third cause of cancer death among women in low-income countries. Women with HIV/AIDS are at greater risk of developing cervical cancer. The study is aimed at identifying determinants for suspected precancerous cervical lesions among HIV- positive women at Mekelle Hospital . Methods: An unmatched case-control study was conducted among randomly selected HIV positive women in Mekelle hospital in 2014. Visual inspection with acetic acid (VIA) is done in HIV positive women by trained nurses routinely. A number of 116 cases, who had suspicious findinsgs on VIA, and 232 HIV-positive controls without suspicious findings on VIA were randomly selected and enrolled into the study. The determinants for precancerous cervical lesion were analyzed using multiple logistic regression and described as adjusted odds ratio (AOR). Results: HIV positive women who had CD4 counts less than 350/mm 3 were two times more likely to have precancerous cervical lesion compared to those with CD4 cells above 350/mm 3 . Women with two (AOR=3.6; 95% CI: 1.7, 7.7) and three (AOR=2.5; 95% CI: 1.2, 5.4) sexual partners were four and three times more likely to have precancerous cervical lesions, respectively,as compared to those who had one sexual partner. Age, History of STI and duration of ART had no influence on presence of VIA positive lesions in HIV positive women. Conclusion : CD4 count cells and number of sexual partners were predictors of VIA positivecervical lesion among HIV positive women. Key words: Precancerous cervical lesion, VIA, HIV positive women, determinants, Tigray.

Abstract: Objective: The current study aimed to assess BTB as a possible risk factor for human TB in the rural community of North Eastern and Western parts of Ethiopia. Method : A case-control design conducted among cattle owning households with TB and without TB. Comparative cervical intradermal test using purified protein derivatives were used to test cattle. Reading of the reaction was done 72 + 4hrs after antigen injection. Based on the skin test reaction measurement, cattle categorized as negative, doubtful and positive. Questionnaires were used to collect factors. Results : Thirty five with TB and 105 households without TB households participated in this study. Of which 49.3% and 61.4% were having the habit of drinking raw milk and eating uncooked meat, respectively. About 70.7% knew chance of disease transmission from animals to humans. Among the TB house holds 31.43% were used house sharing with their cattle. Of the attendants approximately 38% were shared utensil. Based on >2mms as a cutoff value 23.6% an overall apparent bovine tuberculosis (BTB) and 48.6% apparent BTB in households with TB were recorded. The odds for households having bovine TB in their cattle to get tuberculosis was more than 8 times (95% CI; 2.82- 24.60) higher to those owned by households without TB. Conclusion: Bovine TB has been seen as an exposure to human pulmonary TB occurrence. A separate house for cattle should be constructed to minimize the fear of cross infections and further study regarding the possible infection of cattle with M. tuberculosis is suggested.

Abstract: Background: Cervical cancer is the second most common cancer in women globally and the leading cause of cancer deaths in women in low income countries. The majority of cervical cancer related deaths occur in the developing world. It is also an important public health problem in Ethiopia, a country without a well-established control program for the disease. This study assessed the diagnostic and therapeutic facility for cervical cancer (including health providers’ awareness of the disease) in Addis Ababa public health institutions which can be used to develop control strategies and to visualize the amount of resources required. Methods: A cross-sectional study was conducted including all public health institutions in Addis Ababa in August 2010. Health providers’ awareness of cervical cancer was assessed using a self-administered questionnaire. Checklist was used to register diagnostic and therapeutic infrastructure in each health facility. Data was analyzed using STATA. Results: All health providers responded they had heard about cervical cancer. Half of the participants were able to identify common symptoms of the disease. Only 23% of the participants mentioned human papilloma virus (HPV) as the primary cause of cervical cancer. A significant association between awareness and profession was seen. Absence of skilled manpower, equipment and proper documentation was reported in the majority of the institutions. Conclusion: This study assessed the existing skilled man power and infrastructure to diagnose and treat cervical cancer in public institutions in Addis Ababa which is important to develop an effective cervical cancer control program. In addition, the study showed the more work that should be done to improve health providers’ awareness in cervical cancer through education and training. Keywords: Public health institutions, cervical cancer, analysis, infrastructure, awareness Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Abstract: BACKGROUND Mediccil malpractice is professional negligence by a healthcare provider in which the treatment provided falls below the starndard and causes injury or death to the patient. OBJECTIVE To describe the adverse medical events, claims and decisions taken by the Ethiopian Health Professionals Ethics Committee at the Federal level. METHODS A three-year report of the Ethics Committee and relevant documents of proclamations and regulations were reviewed. RESULTS Between January 2011 and December 2013, the committee reviewed 60 complaints against health professionals. About one third of the complaints were filed by the patients and/or their families, about 32% by the police or court and the rest were filed by Addis Ababa health bureau, health professionals and other unrelateed observers. Thirty-nine complaints were related to death of the patient and 15 complaints were about disability. Twenty-five of the claims were against Obstetric and Gynecology specialists and 9 were against general surgeons. The committee verified that 14 of the 60 claims hadethical breach and/or negligence (incompetence). The committee took reasonable time to review complaints and respond the concerned authorities. CONCLUSION The study showed that of the total claims lower than a quarter (23.3%) were proven beyond the benefit ofdoubt. More than 3/4 (76.7) of the complaints were wrong. Hospitals should lead in preventing patient injury. Creation of more awareness among Obstetrics and Gynecology specialists, General and Orthopaedic Surgeons about medical errors is needed and special training should be given.to those joining these specialities.

Abstract: Background: Hepatocellular carcinoma (HCC) is a major cause of cancer death worldwide, accounting for over half a million deaths per year. Hepatocellular carcinoma can occur secondary to viral hepatitis, HBV or HCV. It can also occur secondary to other causes of Cirrhosis ( alcoholism being the other most common cause). Objectives : To describe clinical and laboratory characteristics of Hepatocellular carcinoma in a tertiary care hospital in Addis Ababa, Ethiopia Methods : A retrospective study was conducted in patients admitted to Tikur Anbassa specialized Hospital with a diagnosis of Hepatocellular carcinoma during the period of January 1,2013 to Dec. 31, 2015. Data were collected using structured questionnaire on basic demographic factors, behavioral risks, laboratory profiles and imaging reports. Descriptive analysis was performed on the data collected. Results : Fifty one patients fulfilled the criteria for Hepatocellular carcinoma in the study period. Thirty nine were males and 12 were females. Hepatitis B and C viruses were found to be the causes for HCC in 48% of the cases. History of alcohol abuse was documented in 45% % of the individuals. About 26% of the patients had Ascites, 35 % were found to have portal vein thrombosis, The child-Pugh score for patients who had complete profile were Child A 46%, Child B an equal percentage of 46% and for Child C 0.7%. Conclusion: The contribution of Hepatitis virus is high with equivalent proportion of HBV and HCV. Alcohol intake and unidentified risk factors have also played for another half of the causes. Almost a third of patients have Portal vein thrombosis and 96% were either Child Pugh A or B. Enhancing immunization coverage frequent use of infection prevention and availability of treatment for viral hepatitis will help to reduce Hepatocellular carcinoma. Key words :- Hepatocellular carcinoma, risk factors, Ethiopia

Abstract: Background: In East Africa, particularly in Ethiopia, bacterial keratitis is a major cause of blindness. Objective: The aims of this study were to identify risk factors of bacterial keratitis and the spectrum of bacterial etiologies, and to assess the in-vitro antimicrobial susceptibility of these bacterial isolates at Jimma University Specialized Hospital, Southwest Ethiopia. Methods: A prospective study was employed from January 2012 to June 2012 from which a total of 24 patients with bacterial keratitis were included in the study. Corneal scrapings were collected, transported and microbiologically processed using standard operating procedures. Results: Four different predisposing factors for bacterial keratitis were identified: corneal trauma 9 (37.5%), blepharitis 7 (29.2%), herpetic keratitis, and use of contaminated medications 4.. Bilateral corneal infection was found in 5 (20.8%) of the cases. A total of 24 corneal scrapings were collected for microbiological evaluation, of which 20 (83%) had bacterial growth. The isolated bacterial pathogens were Pseudomonas aeruginosa 10 (41.7%), Staphyloccus aureus 5 (20.8%), Serratia marcescens 3 (12.5%), followed by Streptococcus pneumoniae 2 (8.3%). Antimicrobial susceptibility testing revealed that 85% of Gram-negative bacilli were susceptible to gentamicin and ciprofloxacin, while 86% of Gram-positive cocci were susceptible to vancomycin and Ciprofloxacin. Conclusions: Corneal trauma was the most common risk factor for bacterial keratitis followed by blepharitis. Bacteriological analysis of corneal scrapings also revealed that P. aeruginosa was the most common isolate followed by S. aureus; the antibiotic with the highest susceptibility was ciprofloxacin. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide an update and most effective empirical treatment for bacterial keratitis. Keywords: Antibacterial susceptibility, Bacterial pathogens, corneal trauma, Bacterial Keratitis, Jimma, Ethiopia

Abstract: Background: Spinal injury is a major cause of morbidity and mortality worldwide. Fall and Road traffic accident are the main etiologic factor. Objective: The aim of this study was to asses local hospital patterns of spinal injury and compare them with published reports. Methods and Patients: This is a hospital based cross sectional study of patterns of patients with spine and spinal cord injury seen at the Emergency OPD, Tikur Anbessa Specialized Teaching Hospital (TASTH), Department of Neurosurgery, Addis Ababa, Ethiopia in the period between April 2008 and March 2012. Data was collected using structured questionnaires. The variables included were the Socio-demographic such as age sex, distance of patients’ residence area from the TAH. In addition to the above profiles, causes of injuries, Occupation, diagnosis, time spent between arrival and Admission and decision taken at OPD level. Differences in proportions were examined using Chi-square test. Results: A statistically significant male predominance (84.9 %)(p, 0.0001) was observed, the mean age was 32.8 years, with range10 to 84 years. Mean duration of presentation to TASH was 4.3 days with a range 1 hour-60 days, Fall from height (P<0.001) and Road traffic collisions were the main cause of spine and spinal cord injuries in 36.4% and 32.9% of the patients respectively Most often the cervical spine was involved (33.0%), Sixty-nine (17.9%) patients had associated injuries, majority of respondents (25.5%) were farmers, Majority belonged to ASIA A grade. All the deaths, 7(8.3%) occurred in patients with complete cervical spine lesion. Conclusion: Spinal injury was an important indication for neurosurgical consultations in our service. Complete cord injuries were more common than incomplete and the case incidence from fall was remarkably high. Key words: Spinal cord injury. Patterns, Ethiopia

Abstract: Background: Involvement of health extension workers (HEWs) in Ethiopia, is a vital step in increasing access and utilization of medical abortion and related services. Objective: To explore the acceptability of involvement of HEWs in medical abortion by women who seek services, by abortion service providers, and assess willingness and confidence of HEWs. Methods : In-depth interview was conducted at three purposively selected health facilities in Ethiopia ; namely Marie Stopes Clinic (MSI) Adama clinic, MSI Asella clinic and Adama Government Health Centre from July-August, 2013. The interviews were transcribed verbatim and analysis was done using Atlas ti software. Themes were abstracted from coded text segments. The findings are presented using quotations, Atlas ti networks and queries. Results : Thirty eight (26 eligibility, 12 follow up) women participated in the study and 9 HEWs and 7 service providers were interviewed. Almost all of the interviewed women, service providers and HEWs accepted HEWs involvement in medical abortion services. The HEWs expressed readiness and confidence. Concerns related to the involvement of HEWs included confidentiality, privacy, over dependence on abortion rather than preventing unwanted pregnancy, quality and poor referral system. Conclusions : Expansion of medical abortion services by involving HEWs can contribute to the reduction of abortion related morbidity and mortality. Concerns of the study population should be addressed by training of HEWs for medical abortion, creating better awareness and advocacy among women and communities, addressing quality and referral issues with proper planning, implementing and monitoring of activities. Key words : Medical abortion, Eligibility, Follow up, Health extension worker, Ethiopia

Abstract: Background: Injury remains the major cause of death and disability worldwide, and places an enormous burden on countries with limited resources in which Ethiopia is included. Objective: It is obvious that pre-hospital care is a essential part of the treatment process in many acute disease and trauma Methods: Cross sectional study design using structured interviewing questionnaire which was conducted in 437 Trauma patients who came to emergency department of Tikur Anbesa Specialized Hospital from February 1 to March 30, 2013. Results: Only 73(16.7%) patients got some kind of basic cars like stop bleeding, positioning, immobilization by ambulance staff 41(51.2%), relatives 24(30%) and police and bystanders 14 (20.3%). Commonest means of transportation in which 59% of cases arrived by taxi while about 14.4% were brought in by ambulance. Most patients arrived to definitive care from the scene after are (the golden) hour of injury, has passed; only 81(18.5%) of patients arrived in less than and within one hour. Conclusion: Proportion of patients, who received care before they arrived in the hospital was very small. Time of arrival to definitive care was prolonged and use of ambulances for transportation was minimal. Keywords: Pre-hospital care ,Trauma ,Emergency department and Golden hour

Abstract: 94 Background: Diabetic foot ulcer is one of the most feared and common complications of diabetes. It is a major cause of disability, morbidity and mortality among diabetic patients. effective way of preventing foot ulcers and amputations. Methods: A hospital based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital Diabetes Center on 200 participants using the 60 seconds diabetic foot ulcer screening tool from April to August 2014. Results: A total of 200 patients were included in the study. The male to female ratio was 1 to 2.64 (55 to 145). Among the participants, only 9 (4.5%) had foot examination in the last 5 years. Thirty one (15.5%) participants had history of previous ulcer, 1 (0.5%) had history of amputation, 11 (5.5%) had deformity of shape and structure of the foot. Among the participants, 71 (35.5%) had at least one risk factor for the development of diabetic foot ulcer. Conclusion: Diabetic foot problems are common among the diabetic patients examined at Tikur Anbessa Specialized Hospital Diabetic Center. Screening for diabetic foot ulcer is a very easy practice which will take maximum of 60 seconds per patient. Despite this fact it is barely practiced for outpatients visiting the diabetic clinics. We stress the need for a clinical diagnosis of diabetic foot ulcers using the 60 seconds screening tool. Keywords: Diabetic Foot ulcer, Tikur Anbessa Specialized Hospital, Amputations.

Abstract: Background: Increased urbanization with change in lifestyle in many developing countries exposed them to the challenge of double disease burden, battling with the existing communicable infectious diseases as well as the emerging epidemic of NCDs Objective: To describe trends of medical intensive care unit admission over thirty years in Ethiopia. Methods: MICU registries at Tikur Anbessa Specialized Hospital over a thirty year period were examined for discharge diagnosis. Data included for analysis were selected at ten-year interval of equivalent six- months’ period from December to May of 1981/82, 1991/92, 2001/02 and 2011/12. Variables included were age, gender, residence, discharge diagnosis, duration of stay in hospital, discharge status, admission date, and admission source. Obtained data were cleaned, coded, recoded and edited. The analysis was done using SPSS 15.0 statistical soft ware. Results: A total of 500 cases are included for analysis. Among these 284 (57%) were male. The mean age was 40.2 ± 18 years ranging from 13 to 87 years. The aggregate cardiovascular disease, other non communicable disease and infectious disease as a cause of admission in the past thirty years were 213(42.6), 141(22.8), 105(20.0) respectively. Unlike the other disease category cardiovascular disease increased steeply over the past thirty years. Overall case fatality rate at MICU was 31.6% ranging from 24.8% of other-NCD to 46.7% of infectious diseases. Conclusion: Cardiovascular disease has steeply increased till it became predominant in the last decade at MICU of TASH. Keywords: Cardiovascular disease, Medical Intensive Care Unit

Abstract: Background -Assessment of clinical skills of medical students has a central role in medical education yet the suitable evaluation methods have persistently debated by educators and students. Objectives – To assess perceptions of final year medical students about the Organized Structured Clinical Exam (OSCE) Methods and materials - A cross sectional study was performed to assess views of final year medical students who had taken the OSCE in the Department of Surgery of Mekelle University College of Health Sciences, as well as other traditional exam formats in other departments in the medical school Results - Of the 154 students who took the final qualifying exam, 127 (82.5%) responded to the survey. Eighty-four (66%) of the respondents were males. The OSCE was considered as the best assessment method of practical exams by 70 (55.1%) of the respondents, with the conventional long exam next in preference, by 47 (37%) students. For questions addressing the advantages of the OSCE, the average favorability score was between 4.2 - 4.6 out of Likert’s type 5-point scale rating. Coverage of common and relevant topics, uniform student assessment, and communication skill assessment were items receiving high favorability scores by a particularly high percentage of students, (96.9%, 95.3% and 70.9% of all students, respectively) Conclusions - Most of the students favored the OSCE compared to conventional exam styles. Though the study should be confirmed and extended in other settings, we recommend OSCE to be the main exam type for clinical year surgery examinations. Key words – Final year medical Students, Perceptions, OSCE

Abstract: Background: Only 41% of eligible Ethiopian women completed (PMTCT) therapy in 2012, with MTCT rate of 20%. Objective: This study elicited the perspectives of HIV positive mothers on the situation and the unique beliefs, attitudes, cultural norms and individuals who have influence over them during their pregnancy. Methods: The mixed-methods parent study included community level surveys, focus groups and in-depth individual interviews of HIV positive women with a child at least one year of age in Addis Ababa, Ethiopia: only focus group and interview data are presented here. All tools were completed in Amharic with English translation. Results: 23 women completed in-depth interviews; 27 participated within 4 focus groups. The greatest barriers to PMTCT completion were: feelings of hopelessness and carelessness, lack of understanding of the efficacy of ARV, and negative religious influences. The advice to improve PMTCT adherence most frequently offered included increasing PLWHIV peer support and improving and extending current HIV educational efforts. Participants recommended that PLWHIV mothers be utilized in all PMTCT planning and interventions in the future. Conclusion: Maintaining the motivation to adhere to the entire PMTCT cascade requires that a PLWHIV mother understands the validity of the steps she is taking and receives support for the many challenges she faces. Engaging PLWHIV peers as active members of the health care workforce and expanding their use as educators and counselors is important. Health officials can consider these findings to develop innovative and effective PMTCT interventions. Keywords : Sub-Saharan Africa, PMTCT, women’s perspective

Abstract: Background: Pulmonary tuberculosis (PTB) is one of the most common infectious diseases worldwide, and contributes significantly to morbidity and mortality in developing countries. Despite availability of effective treatment, a significant number of patients suffer from permanent lung damage, which predisposes patients to numerous pulmonary complications. Objective: To assess chronic sequelae of patients treated for PTB in a chest clinic at Tikur Anbessa Hospital Methods: This was a retrospective, cross-sectional analysis of patients registered in a clinical database at the chest clinic of Tikur Anbessa specialized Hospital between January and December 2013. Patients with a history of pulmonary tuberculosis treatment were identified and included in the analysis. Results: Among all patients having follow-up at the chest clinic of TASH during the study period, 134 (18.5%) presented with chronic pulmonary complications of TB. Seventy two patients (54%) were male, and the mean and median ages were 40 and 37 years, respectively. Of the study population, 83 (61.9%) patients had clinically significant parenchymal scarring and fibrosis, 40 (29.9%) had bronchiectasis, 5(3.7%) had Aspergilloma, 4(3%) had granuloma/calcification, one patient (0.7%) had pleural thickening, and one patient (0.7%) underwent pneumonectomy during the study period. Conclusions: Fibrosis and bronchiectasis were the most common pulmonary complications of tuberculosis among patients encountered at the TASH chest clinic during the study period. This demonstrates the impact of pulmonary tuberculosis is beyond management of active disease. Keywords: Sequelae, PTB, chest clinic , TASH

Abstract: A 46 years old female patient presented with worsening of abdominal pain of 12 days duration & abdominal swelling of 15 years. On examination, she had an elliptical, mildly tender mass on the periumblical area extending to the right flank & the suprapubic area. It is mobile & firm in consistency. The intra op finding was huge spleen weighing 2 kgs, rotated 360 degrees clockwise, situated over the right side of the abdomen. This case report showed that a wandering spleen can present acutely with tortion mimicking acute abdomen.

Abstract: Background: Tuberculosis (TB) is a mycobacterial infection mainly affecting the lungs. Early and correct diagnosis of sputum smear negative patients by chest radiography (CXR) is challenging since it depends on reader's ability to detect abnormal findings and to interpret it correctly. Objectives: To evaluate the validity and reliability of CXR the diagnosis of TB among smear negative pulmonary tuberculosis (PTB) Methods: An institutional based cross-sectional study was conducted at seven selected health facilities from October 2011 to September 2012 on 159 adults aged 18 years and above who were newly diagnosed smear negative for PTB patients diagnosed using Chest X-ray (CXR). Morning sputum was collected and cultured from each patient using Lowenstein Jensen media. All the CXRs were revised by senior radiologists in conjunction with the principal investigator. Results: The mean (SD) age of patients involved in the study was 37.1(16.7), ranging from 18 to 87 years. Of the total 159 smear negative PTB patients, the most common CXR finding was consolidation (40.3%) followed by cavitations (23.9%) and nodular lesions (17.0%). Sputum culture results showed that, 47(29.6%) were culture positive, 103(64.7%) were culture negative and 9(5.6%) were contaminated. About 14% (22/159) of the study subjects were HIV positive. The sensitivity and specificity of CXR findings were 77.1% (37/48) and 36.9% (41/111), respectively. The positive and negative predictive values were 34.6% (37/107) and 78.8% (41/52), respectively. Conclusion: CXR can be used as supportive investigative modality to diagnose smear negative Pulmonary TB in conditions where TB culture is no more feasible.

Abstract: Background & Aims: Hepatitis C viral infection is a significant public health challenge with potential risk of progressing to liver cirrhosis and hepatocellular carcinoma (HCC). Actively infected mothers can transmit the virus to their babies who may develop liver cirrhosis and HCC as young adults. We determined the seroprevalence of HCV, its antigenaemia and associated risk factors among pregnant women. Methods: We recruited 400 pregnant women and tested their serum for HCV antibodies using immune-chromatographic test and determined the HCV core antigenaemia among HCV sero-positives by enzyme-immuno-assay (EIA). The bio-socio-demographic variables of the participants were statistically correlated to the test results. Results: Seroprevalence of HCV was 5.8% (23/400) and the prevalence of HCV core antigenaemia was 73.9% (17/23). None of the bio-socio-demographic variables of the participants and other known risk factors evaluated had significant influence on either seroprevalence of HCV or its antigenaemia. Only the employment status of the participants’ husbands (p=0.01) significantly affected seropositivity of HCV. Conclusion: HCV core antigenaemia is high among pregnant women who have antibodies to HCV in our environment and this signifies an active hepatitis C virus infection. Key Words: HCV, core antigen, antibodies, pregnancy, Nigeria

Abstract: 274 Background: Complications due to undetected and uncontrolled hypertension have been recorded to be devastating. Among these are cerebrovascular, cardiovascular and renal complications. Lack of data on the patterns of these complications, combined with the notion that hypertension is only a problem of developed nations, has resulted in missed opportunities for early detection and treatment. Method: A retrospective cross-sectional study was performed through medical chart review of 106 hypertension patients who were admitted with complications of hypertension at Tikur Anbessa Specialized Hospital from January 2013 to January 2014 E.C. Results: A total of 106 medical charts of hypertensive patients were reviewed. Among the patients involved in the study, 51% were male, 45% were in their fifth and sixth decades and two third of them did not have any co morbidity. Sixty seven percent of these patients had cerebrovascular disease (stroke), 11% had stroke and hypertensive heart disease, 8% had stroke, hypertensive heart disease and chronic kidney disease (all three), and 5% had stroke with chronic kidney disease. However, there was no significant association between the considered variables and the outcome. Conclusion: This study has revealed most of the patients have stroke as a complication, therefore preventive or prophylactic measures should be encouraged to avail it. Keywords: Hypertension, Stroke, Tikur Anbessa Specialized Hospital

Abstract: Tracheo-innominate artery fistula (TIAF) is a potentially lethal but rare complication associated with tracheostomy. As tracheostomies are one of the common life saving procedures that are performed routinely in the country, bring this complication to the attention of all health care professionals is of paramount importance. Hence, this case report is prepared.

Abstract: Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

Abstract: Acquired tracheoesophageal fistulae can be diagnosed clinically by features such as cough elicited by swallowing but symptoms can be mild. Here, we report a case of a foreign body induced trachea-esophageal fistula in a 2 year and 6 months old male child with a chronic cough who had long been misdiagnosed and mismanaged.

Abstract: Coccidiodomycosis is a disease caused by the spores of the fungi coccidiodes immitis and pulmonary coccidiodomycosis comes after inhalation of the spores which are mainly found in desert areas of the United States, central and South America. Reported cases from outside the endemic areas have always history of travel to these areas. There are no reports so far from Ethiopia or the whole Africa. We report here a case of pulmonary coccidodomycosis with no history of travel to such areas. A 24 years old female patient from Samre, South-Eastern Tigray, presented with right side chest pain and productive cough of yellowish sputum which sometimes is blood streaked. She had completed anti-tuberculosis treatment without any improvement. With a preliminary diagnosis of pulmonary mass, surgical exploration was made and histology of the excised tissue showed appedrances consistent with pulmonary coccidioidomycosis. There was marked clinical and radiological improvement after three weeks of treatment with ketoconazole. Though there are no reported cases from Ethiopia and Africa as a whole, Coccidiodomycosis should be considered as differential diagnosis especially for patients from arid areas like that of our patient before any empirical treatment.

Abstract: Penile agenesis is one of the rarest urogenital anomalies with only less than 100 cases reported worldwide so far. Only 3 cases have been reported from Africa and to our knowledge none has been reported from our country Ethiopia. Viability depends on associated anomalies. Urogenital anomalies are the most common associated ones accounting for 54% of cases. This case report is unusual presentation, which is the first reported case of penile agenesis associated with left to right, crossed fused renal ectopia.

Abstract: Background : It is widely argued that school teachers in sub-Saharan Africa are being affected and will continue to be affected by the AIDS epidemic. Teachers are considered a high-risk group with respect to HIV/AIDS, particularly in high prevalence countries, where the epidemic has devastating impact on teaching profession Objective : the aim of this study was to examine the trends of mortality among primary and secondary school teachers in Addis Ababa during this era of HIV/AIDS. Methods: Community and school based longitudinal study /verbal autopsy data on deceased teachers of 8 years or from Non.2005-Oct.2013 / was conducted. The data were obtained from family members or care givers of 146 deceased teachers. Each completed verbal autopsy questionnaire was reviewed by two physicians independently. When assigned causes for deaths of teachers by two physicians were not in agreement, then the cases were given to a third physician/Internist/. Cases with inconsistent causes of deaths by three physicians were labeled as “undetermined”. Extended Mntel-Haenszel Chi-square for linear trend was used to check the significance of the trend by using SPSS software version 20. Results: The trend of total and HIV-related mortality among teachers declined from 45 (31%) to 22(15.2%) and 15(10.3%) to 4(2.7%) during the first two years /Nov.2005-Oct.2007/ and the last two years /Nov.2011- Oct.2013/of the study period, respectively. Similarly, the proportionate mortality ratio between the total and HIV/AIDS related mortality declined from 0.33 to 0.18 during the corresponding period. The decline in the HIV/AIDS related mortality was statistically significant with Mantel Haenszel Chi-square=7.04(P<0.01). Conclusions : The findings of this study demonstrate a statistically significant decline in total and HIV/AIDS related mortality among teachers in Ethiopia. However, we suggest nationwide study on the impact of HIV/AIDS in the education sector for more representative data and better interventions. Keywords: Primary and Secondary, Schools, Teachers, Trend, Mortality, HIV/AIDS, Ethiopia

Abstract: Background Addis Ababa University is one of the thirteen medical schools (in twelve countries) in Africa that are recipients of the Medical Education Partnership Initiative (MEPI). MEPI- Ethiopia is a consortia project that involved four Ethiopian medical schools (Addis Ababa, Defense Medical College, Haramaya , and Hawassa) as well as US partner Universities: Alabama, Emory, John Hopkins, California-San Diego, and Wisconsin. With a funding source from the Office of the U.S. Global AIDS Coordinator (OGAC) and the Health Resources and Service Administration (HRSA). Operating with focus under three strategic objectives (improvement of medical education, human capacity building and retention, and enhancement of research and bioethics capacity), the program strives to improve medical education and retention of the health workforce consistent with the mission of the Federal Ministries of Health and Education, which overall will significantly impact the health status of Ethiopians Key accomplishments : Strategic objective1: Improvement of the Medical Education System to manage the increased class size, MEPI supports a small class teaching approach;Provision of teaching aids and learning resources including skills labs, textbooks, microscopes, and other resources; Information Technology (IT) infrastructure enhancement and e-Learning system implementation: Strategic objective 2: Human capacity building and faculty retention ; Scale up of research support for graduates working in remote areas: ‘ Strategic objective 3: Enhancement of research and bioethics capacity : With the supportive supervision of their mentors, the first cohort of 10 undergraduate medial students have completed their research activities and are on the process of developing disseminating results and developing manuscripts for publication.Research culture is being developed among junior medical students ; Furthermore, MEPI supported the establishment of the AAU CHS Office of Research Administration (ORA) that serves as the operational wing of the Office of the Associate Director for Research and Technology Transfer.

Abstract: Background : Leprosy is a chronic infectious disease affecting the skin and peripheral nerves. Early diagnosis and full course treatment are critical for preventing lifelong neuropathy and disability to minimize the occurrence of disability. There is not enough study on prevalence of disability and its determinants. Objective : The objective of this study is to assess the magnitude of disability and associated factors among leprosy patients after treatment in Boru Meda Hospital. Methods : Facility based cross sectional study was conducted among 128 leprosy patients registered at BoruMeda Hospital from January 1, 2010 to December 31, 2012. Data was collected from charts, entered, cleaned, edited using EPI Info Version 3.53 for windows and analyzed by SPSS. Results: Five patients (4%) had Grade 2 disability at discharge; 123 (96%) were discharged with either disability grading 0 or disability grading 1, which are considered to be normal disability grading. Males and rural people were more affected by the diseases: 72% and 92% respectively. Sixty percent of disability occurred due to type one reaction. The mean age of patients and treatment duration were 39.3 years and 60 days respectively. Among the factors type of reaction was significantly associated with disability grading (P=0.02). Conclusion and recommendation: Rural people and males are more affected by leprosy and the prevalence of disability is decreasing. Awareness creation on rural people and patients with leprosy to see healthcare providers as early as possible is warranted. Key words: Leprosy, Grade 2 disability, Multi drug therapy

Abstract: Introduction Medical malpractice is professional negligence by a healthcare provider in which the treatment provided falls below the standard and causes injury or death to the patient. The Ethiopian Health Professional Ethics Committee has the mandate to investigate and propose administrative measures when it has verified breach of standards were made. Study on medical malpractice in Ethiopia is scare. Methods A three-year report of the Ethics Committee was reviewed and relevant proclamations and regulations were reviewed. Results Between Jan 2011 to Dec 2013 the Committee reviewed 60 complaints against health professionals. One third of the complaints were filed by the patients and/or their families and 1/3 were filed by the police or court. Thirty-nine complaints are due to death of the patient and 15 complaints due to disability. Twenty-five of the claims were against Oby-Gyn specialists and 9 claims were against surgeons. The committee verified that 14 of the claims had ethical breach and/or negligence (incompetence). Discussion The low number of claims, as compared to that of developed nations, may indicate that others have not filed claims or may have gone to courts. Many of the claims were against Oby-Gyn specialists followed by surgeons which is similar with the high number of claims against these two disciplines in USA. Conclusion and Recommendation The committee takes reasonable time to review complaints and respond. Hospitals should lead in preventing patient injury. Creation of awareness among Oby-Gyn and surgeons on medical errors is needed and those joining these fields should be inducted on medical errors.