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Biomedical subjects

L Muhe

Publications and source records attributed to L Muhe.

34 records · Page 2Linked to original sources
PubMed1997

A four-year cohort study of HIV seropositive Ethiopian infants and children: clinical course and disease patterns.

Sixty-two HIV positive infants who were admitted to the Missionaries of Charity Orphanage in Addis Ababa were followed From July 25, 1991 to July 30, 1995 for a total period of 4 years. Regular clinical examination and treatment by a paediatrician was being offered to these infants in addition to monitoring of their HIV serostatus every three months until the age of 18 months and every year after that. Among those aged above 18 months, 14 children were HIV sero-positive and alive and 4 children were HIV sero-positive but died. Thirty-three children had sero-reverted to negative. The mother-to-child transmission was crudely estimated at 29% to 47%. Among the clinical signs, generalized lymphadenopathy, hepatomegaly, splenomegaly, wasting, stunting and delayed motor development were found more commonly in the definitely HIV positive children. Upper respiratory tract infections, acute diarrhoea, pneumonia, pyogenic skin infections, sepsis and candidal infections were the commonest causes of illness. Comparison of the HIV positive with the HIV negative cases indicates that the risk is higher for the indefinitely HIV positive group for episodes of acute diarrhoea, pneumonia, sepsis and candidal infections.

Child↗
PubMed1996

A one-year community study of under-fives in rural Ethiopia: health and behavioural determinants of morbidity.

Based on a one-year weekly home surveillance study, morbidity patterns of 1,304 children under five years of age in a rural Ethiopian community were measured, together with nutritional and health behavioural determinants. Using Poisson regression models, the study showed that nutritional and health care factors make a significant impact on under-five morbidity. Gastroenteritis was particularly associated with child care factors, while acute respiratory infections were particularly associated with nutritional factors. Lack of immunization, low birthweight and pre-term delivery (more than one month early) were not found to have any independent effect on morbidity. Breast feeding was universal, but the introduction of supplementary foods was found to protect from excess morbidity. The study concludes by discussing possible applications of the results in intervention programmes.

Age Distribution↗
PubMed1996

Mothers' perceptions of signs and symptoms of acute respiratory infections in their children and their assessment of severity in an urban community of Ethiopia.

Standard case management strategy has been recommended to reduce the high mortality rate in children with acute respiratory infections (ARI). Appropriate case management has been shown to prevent such deaths, but only if families recognize signs of possible pneumonia and seek care promptly from a trained health worker. The purpose of the present study was to assess mothers' perception and interpretation of ARI signs and symptoms in relation to that of a physician in an urban community in Addis Ababa. Two hundred and twenty-two mothers who brought their children to hospital with cough or difficulty in breathing and an equal number of control mothers were studied. Most mothers did not recognize these signs, including the key signs of pneumonia-rapid breathing and chest indrawing. While it was shown that between two physicians there was good agreement on kappa values above 70% for most ARI signs, there was little agreement between physicians and mothers or between mothers whose children came for ARI problems and mothers of hospital controls. The few mothers who recognized these signs did not interpret them as serious. The study concludes by recommending intensive health education and further ethnographic studies on community beliefs about ARI in children, with particular emphasis on documentation of the terms, signs and symptoms by which families recognize the illness.

Acute Disease↗
PubMed1995

A one-year community study of under-fives in rural Ethiopia: patterns of morbidity and public health risk factors.

A prospective weekly home surveillance study was undertaken to determine morbidity patterns within the Butajira Rural Health project in central Ethiopia. Overall prevalence of illness was 5.8% in 1216 person-years observed among rural Ethiopian children aged under 5 years. Acute respiratory infections (ARI) (prevalence 2.8%) and acute diarrhoea (2.4%) were the commonest conditions. Episodes of illness were distributed unequally among children, with a mean of 2.34 episodes per child. These included an average of 1.13 episodes of ARI (of which 0.16 had lower respiratory symptoms [ALRI]) and 1.17 episodes of acute diarrhoea. Sanitation factors were the principal risks for gastroenteritis, while living in rural areas predisposed children to ARI. Parental factors such as illiteracy were also linked to morbidity.

Acute Disease↗
PubMed1994

The Butajira Rural Health Project in Ethiopia: a nested case-referent (control) study of under-5 mortality and its health and behavioural determinants.

The associations between under-5 mortality and its health and behavioural determinants were investigated in a rural district of Ethiopia, by means of a concurrent case-referent technique nested within a study-base population established in 1987. Three-hundred and six infant and child deaths registered over a period of 1 year, were contrasted with 612 controls, matched for age, sex and study area. Data were collected by trained non-medical workers using a structured questionnaire. Breastfeeding and supplementary feeding came out as strongly protective against under-5 mortality, even when controlling for parental and environmental determinants. Early termination of breastfeeding was demonstrated to have a substantial impact on mortality, particularly on that caused by diarrhoea. Late introduction of supplementary feeding, particularly of protein origin, was also associated with increased under-5 mortality. When the relative impacts of parental, environmental and behavioural determinants are compared, the greater impact of parental factors can be demonstrated, especially among infants.

Age Factors↗
PubMed1993

Prevalence of potential respiratory disease bacteria in children in Ethiopia. Antimicrobial susceptibility of the pathogens and use of antibiotics among the children.

Acute respiratory infections are primary causes of morbidity and mortality in children in developing countries. This project was designed to investigate antimicrobial susceptibility of respiratory tract pathogens isolated from children in rural and city areas, and to contribute to the rational choice of antibiotics for respiratory tract infections in children in Ethiopia. Nasopharynx and throat cultures were taken from all children under five years of age in three study areas representing different levels of contact with health care and accessibility to modern drugs, such as antibiotics. In all, 1126 children were cultured. Haemophilus influenzae and Streptococcus pneumoniae were both found in 85-90% of the children, and beta-haemolytic streptococci group A in 12%. The level of antimicrobial resistance was low. None of the 954 strains of H. influenzae were beta-lactamase producers. Pneumococci were susceptible to penicillin. The use of antibiotics was also low; 11 of 1126 children had antibiotics on the day of culture or the day before. The choice of antibiotics was not limited by resistance, and emphasis could be put on low cost, minimizing adverse drug reactions and ecological impact.

Anti-Bacterial Agents↗
PubMed1993

The Butajira project in Ethiopia: a nested case-referent study of under-five mortality and its public health determinants.

During one year of follow-up, 306 deaths of children under the age of 5 years were included in a concurrent case-referent study that was based on a population estimated at 28,780 in 1987. A total of 612 live referents, matched for age, sex and study area, were also selected from the study population through density sampling. Data were collected by lay reporters by verbal autopsy. For the study period the estimated cumulative under-five mortality rate was 293 and the infant (0-11 months old) mortality rate was 136 per 1000. Major probable causes of death were diarrhoeal disease or acute respiratory infections (ARI). The relative importance of parental and environmental characteristics was assessed using conditional multiple logistic regression analysis. Under-five mortality was associated with paternal illiteracy, maternal ethnicity, and not being in the committee of people's organizations. Parental factors affected the infants relatively more than they did the children, especially with regard to ARI mortality. This was also noted with "absence of window", a proxy measure for evaluating the type of housing. In terms of etiological fractions a greater number of under-five deaths could be ascribed to parental than environmental conditions, with relatively more infants being affected than children.

Case-Control Studies↗
PubMed1993

Epidemic meningococcal meningitis in children. A retrospective analysis of cases admitted to ESCH (1988).

One hundred twenty four cases of meningococcal meningitis were seen at the Ethio-Swedish Children's Hospital (ESCH) during the epidemic period December 1, 1987 to January 31, 1989. Data on demographic and clinical profile of patients were collected and analyzed. Two thirds of patients were above 5 years of age. Fifty percent of the patients came from the "mercato area" of the city of Addis Abeba, Higher 3, 4, 5 & 6. Thirteen cases were from outside Addis Abeba. The main clinical presentations were fever and vomiting in all age groups and headache in those above 5 years of age. The classical meningeal signs were rare in those below 5 years of age. The most common neurological deficit was loss of hearing. Mortality was very low (only 3 deaths). Continuous surveillance of demographic and clinical indicators is recommended as they could be useful early warning signs of an epidemic.

Adolescent↗
PubMed1992

A one-year study of streptococcal infections and their complications among Ethiopian children.

Post-streptococcal complications are known to be common among Ethiopian children. Little is known, however, about the epidemiology of beta-haemolytic streptococci in Ethiopia. A total of 816 children were studied during a one-year period: 24 cases of acute rheumatic fever (ARF), 44 chronic rheumatic heart disease (CRHD), 44 acute post streptococcal glomerulonephritis (APSGN), 143 tonsillitis, 55 impetigo, and 506 were apparently healthy children. Both ARF and APSGN occurred throughout the year with two peaks during the rainy and cold seasons. The female:male ratio among ARF patients was 1.4:1 and 1:1.9 among APSGN. The monthly carrier rate of beta-haemolytic streptococci group A varied from 7.5-39%, average being 17%. T type 2 was the most frequent serotype. Marked seasonal fluctuations were noted in the distribution of serogroups among apparently healthy children. Beta-haemolytic streptococci group A dominated during the hot and humid months of February-May. Strains were susceptible to commonly used antibiotics, except for tetracycline.

Carrier State↗
PubMed1991

The Butajira rural health project in Ethiopia: mortality pattern of the under fives.

A total of 492 deaths of children below 5 years of age were registered during a 2-year period of demographic surveillance in a rural population of Ethiopia, where an epidemiologic study base population of 28,780 individuals was established in 1987. Data were collected by lay-reporters using a verbal autopsy method. The under-five cumulative mortality rate was 209 per 1000 children. When sub-divided into infants and children 1-4 years, the respective yearly mortality rates were 101 and 32.3 per 1000. There were considerable variations within the district by Peasants' Associations. Rural Lowlands experienced the highest mortality rates, especially for children 1-4 years. Mortality trends over a 2-year period indicate a significant increase for the child population, but not for infants. Similar trends were observed for boys and girls although the rates for boys were generally higher especially during infancy. More deaths occurred in the months of April, June, and July, and October and November indicating two peak seasons in both years. More deaths occurred in Peasant's Associations that were furthest from the health centre. Major probable causes of death were acute respiratory infections, measles, and diarrhoea. It is concluded that even in rural areas of a developing country it is possible to collect from mothers the much needed and valid fertility and mortality data through epidemiological surveillance by using lay-reporters.

Age Factors↗
PubMed1990

Profile of cardiac diseases in Ethiopian children.

A review of cardiac admissions to the Ethio-Swedish Children's Hospital from January 1981 to December 1988 revealed 365 cases. Patients were included in the study if they had clinical, laboratory and echocardiographic (M, 2D-Modes, doppler) proofs of the specific disease entity. One hundred and ten patients were eligible. This accounted for 0.65% of all admissions (N = 16,905). Rheumatic heart disease accounted for 54.5% (N = 60), congenital heart disease for 35.5% (N = 39), and acquired heart disease of nonrheumatic origin for 10% (N = 11) or cardiac admissions. Of patients with rheumatic heart disease, the mitral valve was involved in 41.7% (N = 25). Pure mitral stenosis was seen in 8.3% (N = 5). Ventricular septal defect was seen in 33.3% (N = 13) of patients with congenital heart disease. The mean hospital stay for patients with rheumatic heart disease was 35.4 days, and 24.7 days for patients with congenital heart. As rheumatic heart disease predominates, methods for decreasing its incidence are discussed.

Adolescent↗
PubMed1987

Rapid etiological diagnosis of pyogenic meningitis by coagglutination, latex agglutination and immunoosmophoresis of cerebrospinal fluid, serum and urine.

Three rapid diagnostic methods for the detection of bacterial antigen-COA (Coagglutination), LA (latex agglutination) and IEOP (immunoelectroosmophoresis); DM (direct microscopy after Gram staining) and culture of cerebrospinal fluid (CSF) have been compared in 53 bacterial meningitis patients and in 13 controls. Urine samples were assayed for antigens in connection with CSF in 32 for COA, LA, and IEOP. The cause of meningitis was S. pneumoniae in 31, H. influenzae type b in 16 and N. meningitidis in 6 using the methods for diagnosis by LA in 100%, COA in 94%, culture in 89%, IEOP in 81% and DM in 78% of the CSF samples. None of the CSF from controls were positive by any of the methods. LA and COA detected antigen in CSF in all 4 patients on 4th and 5th day of treatment but none of the tests were helpful 7-10 days later. LA was effective in detecting antigen in urine in 10/10 (100%) H. influenzae type b, 17/20 (85%) S. pneumoniae prior to antibiotic treatment. IEOP was helpful in antigen detection better in serum than in urine in 5/6 H. influenzae type b and 9/11 S. pneumoniae meningitis. In general we have found LA and COA as simple, rapid specific and sensitive tests and can be applied even in field situations and that LA can be used for antigen detection in urine and IEOP in serum. A large scale study is needed in order to standardize methods for antigen detection in serum and urine.

Adolescent↗