A 21 year old female patient was admitted to Tikur Anbessa Hospital with a diagnosis of primary h... more A 21 year old female patient was admitted to Tikur Anbessa Hospital with a diagnosis of primary hyperparathyroidism secondary to parathyroid adenoma. Her predominant presentation was with an anterior neck mass, diffuse osteoporosis and myopathy. The diagnosis was suggested by her clinical symptoms, physical findings, Laboratory studies and radiological survey. The tissue biopsy was also compatible with of the diagnosis. The parathyroid gland was removed surgically and the patient improved significantly. Primary hyperparathyroidism is extremely rare in young patients and presentation with myopathy is even more rare. Routine determination of serum calcium and phosphorus is recommended in patients with such presentations.
Investments in digital health technologies such as artificial intelligence, wearable devices, and... more Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman’s rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspecti...
Introduction: The burden of raised blood pressure and elevated blood glucose in sub-Saharan Afric... more Introduction: The burden of raised blood pressure and elevated blood glucose in sub-Saharan Africa has been increasing over the last couple of decades. However, a large proportion of the population with raised blood pressure and elevated blood glucose remain undiagnosed contributing to the increasing burden of the problem. There is paucity of published studies describing the burden of major NCDs in sub –Saharan Africa. Likewise, except very few studies in some pocket areas, there was no representative NCD risk factor survey undertaken in Ethiopia. This paper focuses on the data extracted from the survey on the prevalence of selected NCDs to elaborate more on the issues and to show the invisible magnitude of the two major health problems for policy and program development. Methods: A cross sectional study was conducted in Ethiopia using the WHO step-wise approach to the surveillance of NCD risk factors. The survey was carried out between April and June 2015. The data collection proce...
Design: Retrospective analysis. Purpose. To assess the prevalence of center-involving diabetic ma... more Design: Retrospective analysis. Purpose. To assess the prevalence of center-involving diabetic macular oedema (CIDMO) and risk factors. Methods: Retrospective review of patients who were screen positive for maculopathy (M1) during 2010 in East and North Birmingham. The CIDMO was diagnosed by qualitative identification of definite foveal oedema on optical coherence tomography (OCT). Results: Out of a total of 15,234 patients screened, 1194 (7.8%) were screen positive for M1 (64% bilateral). A total of 137 (11.5% of M1s) were diagnosed with macular oedema after clinical assessment. The OCT results were available for 123/137; 69 (56.1%) of these had CI-DMO (30 bilateral) which is 0.5% of total screens and 5.8% of those screen positive for M1. In those with CIDMO 60.9% were male and 63.8% Caucasian; 90% had type 2 diabetes and mean diabetes duration was 20 years (SD 9.7, range 2-48). Mean HbA1c was 8.34%±1.69, with 25% having an HbA1c =9%. Furthermore, 62% were on insulin, 67% were on a...
Introduction : In Ethiopia, non-communicable diseases (NCDs) cause 42% of deaths, of which 27% ar... more Introduction : In Ethiopia, non-communicable diseases (NCDs) cause 42% of deaths, of which 27% are premature deaths before 70 years of age. The Disability Adjusted Life Years (DALYs) increased from below 20% in 1990 to 69% in 2015. With no action, Ethiopia will be the first among the most populous nations in Africa to experience dramatic burden of premature deaths and disability from NCDs by 2040. However, the national response to NCDs remains fragmented with the total health spending per capita for NCDs still insignificant. The focus of this paper is highlighting the burden of NCDs in Ethiopia and analyzing one of the two major WHO recommended policy issues; the status of integrated management of NCDs, in Ethiopia. NCDs are complex conditions influenced by a range of individual, social and economic factors, including our perceptions and behavior. Also, NCDs tend to be easily overlooked by individuals and policy makers due to their silent nature. Thus, effectively addressing NCDs re...
Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in som... more Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat is chewed by an estimated 20 million population every day in the Arabian Peninsula and in Eastern Africa region including Ethiopia. Ethiopia is believed to be the country of origin of khat where millions chew khat on a daily bases. Khat is also one of Ethiopia's biggest export commodities. This particular study assessed the prevalence of khat chewing and its predictors in Ethiopia. Method: We used a community based cross-sectional data collected in 2015 as part of the National STEPs survey on NCD risk factors. .. The target population for this survey was all men and women aged 15-69 years who had been living at their place of residence for at least six months prior to the survey. A mix of stratified, three-stage cluster and simple random sampling were used to the study setting or clusters and households. The sampling frame wa...
Background: Diabetic retinopathy is one of the micro vascular complications of diabetes mellitus.... more Background: Diabetic retinopathy is one of the micro vascular complications of diabetes mellitus. To date there are no studies that show the magnitude of diabetic retinopathy in the pediatric population of Ethiopia with only very few in Africa. The purpose of this study was to determine the prevalence of diabetic retinopathy in children and adolescents at a tertiary center in Ethiopia. Methods: This cross-sectional hospital based descriptive study included children aged between 9 and 17 years attending the endocrine follow-up clinic of Tikur Anbesa Specialized Hospital. A structured questionnaire was used for evaluating sociodemographic data and information pertinent to diabetes. The prevalence of diabetic retinopathy was determined by fundus photography of each eye. Results: A total of 86 patients were examined with a mean age of 13.7 (SD = 1.8) years. At onset of diabetes, 95.6 % of children presented with diabetic ketoacidosis(DKA); 22 children (25.6 %) had at least two episodes of DKA, and 45 children (52.3 %) had poor glycemic control. Background retinopathy was present in four children (4.7 %) with a mean age of 14.25 (SD = 1.89) years and two of them also had maculopathy. Conclusion: Although there are some methodological limitations, this study highlights the difficulties of achieving good glycemic control and the early occurrence of diabetic retinopathy in Ethiopian diabetic children.
Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity a... more Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity and mortality. Tobacco smoking has been identified as one of the major risk factors for NCDs, including cardiovascular, chronic respiratory diseases, and different cancers. Although there is national information on magnitude of tobacco use, to date there is limited nationally representative data on factors associated with tobacco use. The aim of this study is to assess the distribution and predicators of tobacco use in Ethiopian adult population between 15 -59.Objectives: The main aim of this study was to assess the prevalence of tobacco use and its predictor in Ethiopia.Methods: A cross-sectional population based study design was employed among population age from 15- 69 years. A stratified, three-stage cluster sampling was used to identify the study subjects. Households in each cluster were selected using simple random sampling method. The sampling frame was based on the population and ...
Ethiopian Journal of Health Development, Feb 7, 2018
Background: Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitu... more Background: Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, cancers and chronic respiratory diseases, have remained the major burden and threat of the world with quite alarming rise in the developing nations. Eating a diet high in fruits and vegetables is associated with a decreased risk of many chronic diseases. Methods: Community-based cross-sectional survey based on the World Health Organization (WHO) NCD Stepwise approach was done. The survey was conducted in the 9 regions and two city administrations (Addis Ababa and Dire Dawa) in Ethiopia. The target population for this survey included all men and women age 15-69 years old who consider Ethiopia to be their primary place of residence. A single population-proportion formula was used to determine the sample size: design effect coefficient of 1.5, Z-score of1.96, proportion of 35.2%and marginal error of 0.04. A total of 513 EAs were covered nationwide. Thus, 10,260 study participants were included in the study. A mix of sampling approach namely stratified, three-stage cluster sampling, simple random sampling and Kish method were employed to select the study settings and the study participants. Descriptive weighted analysis was done along with complex sample analysis, and bivariate and multivariate analysis was conducted for fruit and/or vegetable intake. Result: The prevalence of fruit and/or vegetable consumption in Ethiopia was found to be (1.5%). More female than male ate fruit and vegetable in Ethiopia. When adjusted for included demographic and residence confounders (age, sex, location, income, education), those in rural area of residence ate ≥5 servings of fruits and vegetable [OR and (95% CI) [2.77 (1.60, 4.80)] than their counterparts. Conclusion and recommendation: Fruits and/or vegetables intake was generally extremely low. As the general level of risk factors rises, more people are put at risk. Preventive interventions to address these behaviours are implemented at individual, group, and community levels and include education, access to fruits and vegetables should therefore aim at reducing risk throughout the population. [Ethiop.
A 21 year old female patient was admitted to Tikur Anbessa Hospital with a diagnosis of primary h... more A 21 year old female patient was admitted to Tikur Anbessa Hospital with a diagnosis of primary hyperparathyroidism secondary to parathyroid adenoma. Her predominant presentation was with an anterior neck mass, diffuse osteoporosis and myopathy. The diagnosis was suggested by her clinical symptoms, physical findings, Laboratory studies and radiological survey. The tissue biopsy was also compatible with of the diagnosis. The parathyroid gland was removed surgically and the patient improved significantly. Primary hyperparathyroidism is extremely rare in young patients and presentation with myopathy is even more rare. Routine determination of serum calcium and phosphorus is recommended in patients with such presentations.
Investments in digital health technologies such as artificial intelligence, wearable devices, and... more Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman’s rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspecti...
Introduction: The burden of raised blood pressure and elevated blood glucose in sub-Saharan Afric... more Introduction: The burden of raised blood pressure and elevated blood glucose in sub-Saharan Africa has been increasing over the last couple of decades. However, a large proportion of the population with raised blood pressure and elevated blood glucose remain undiagnosed contributing to the increasing burden of the problem. There is paucity of published studies describing the burden of major NCDs in sub –Saharan Africa. Likewise, except very few studies in some pocket areas, there was no representative NCD risk factor survey undertaken in Ethiopia. This paper focuses on the data extracted from the survey on the prevalence of selected NCDs to elaborate more on the issues and to show the invisible magnitude of the two major health problems for policy and program development. Methods: A cross sectional study was conducted in Ethiopia using the WHO step-wise approach to the surveillance of NCD risk factors. The survey was carried out between April and June 2015. The data collection proce...
Design: Retrospective analysis. Purpose. To assess the prevalence of center-involving diabetic ma... more Design: Retrospective analysis. Purpose. To assess the prevalence of center-involving diabetic macular oedema (CIDMO) and risk factors. Methods: Retrospective review of patients who were screen positive for maculopathy (M1) during 2010 in East and North Birmingham. The CIDMO was diagnosed by qualitative identification of definite foveal oedema on optical coherence tomography (OCT). Results: Out of a total of 15,234 patients screened, 1194 (7.8%) were screen positive for M1 (64% bilateral). A total of 137 (11.5% of M1s) were diagnosed with macular oedema after clinical assessment. The OCT results were available for 123/137; 69 (56.1%) of these had CI-DMO (30 bilateral) which is 0.5% of total screens and 5.8% of those screen positive for M1. In those with CIDMO 60.9% were male and 63.8% Caucasian; 90% had type 2 diabetes and mean diabetes duration was 20 years (SD 9.7, range 2-48). Mean HbA1c was 8.34%±1.69, with 25% having an HbA1c =9%. Furthermore, 62% were on insulin, 67% were on a...
Introduction : In Ethiopia, non-communicable diseases (NCDs) cause 42% of deaths, of which 27% ar... more Introduction : In Ethiopia, non-communicable diseases (NCDs) cause 42% of deaths, of which 27% are premature deaths before 70 years of age. The Disability Adjusted Life Years (DALYs) increased from below 20% in 1990 to 69% in 2015. With no action, Ethiopia will be the first among the most populous nations in Africa to experience dramatic burden of premature deaths and disability from NCDs by 2040. However, the national response to NCDs remains fragmented with the total health spending per capita for NCDs still insignificant. The focus of this paper is highlighting the burden of NCDs in Ethiopia and analyzing one of the two major WHO recommended policy issues; the status of integrated management of NCDs, in Ethiopia. NCDs are complex conditions influenced by a range of individual, social and economic factors, including our perceptions and behavior. Also, NCDs tend to be easily overlooked by individuals and policy makers due to their silent nature. Thus, effectively addressing NCDs re...
Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in som... more Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat is chewed by an estimated 20 million population every day in the Arabian Peninsula and in Eastern Africa region including Ethiopia. Ethiopia is believed to be the country of origin of khat where millions chew khat on a daily bases. Khat is also one of Ethiopia's biggest export commodities. This particular study assessed the prevalence of khat chewing and its predictors in Ethiopia. Method: We used a community based cross-sectional data collected in 2015 as part of the National STEPs survey on NCD risk factors. .. The target population for this survey was all men and women aged 15-69 years who had been living at their place of residence for at least six months prior to the survey. A mix of stratified, three-stage cluster and simple random sampling were used to the study setting or clusters and households. The sampling frame wa...
Background: Diabetic retinopathy is one of the micro vascular complications of diabetes mellitus.... more Background: Diabetic retinopathy is one of the micro vascular complications of diabetes mellitus. To date there are no studies that show the magnitude of diabetic retinopathy in the pediatric population of Ethiopia with only very few in Africa. The purpose of this study was to determine the prevalence of diabetic retinopathy in children and adolescents at a tertiary center in Ethiopia. Methods: This cross-sectional hospital based descriptive study included children aged between 9 and 17 years attending the endocrine follow-up clinic of Tikur Anbesa Specialized Hospital. A structured questionnaire was used for evaluating sociodemographic data and information pertinent to diabetes. The prevalence of diabetic retinopathy was determined by fundus photography of each eye. Results: A total of 86 patients were examined with a mean age of 13.7 (SD = 1.8) years. At onset of diabetes, 95.6 % of children presented with diabetic ketoacidosis(DKA); 22 children (25.6 %) had at least two episodes of DKA, and 45 children (52.3 %) had poor glycemic control. Background retinopathy was present in four children (4.7 %) with a mean age of 14.25 (SD = 1.89) years and two of them also had maculopathy. Conclusion: Although there are some methodological limitations, this study highlights the difficulties of achieving good glycemic control and the early occurrence of diabetic retinopathy in Ethiopian diabetic children.
Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity a... more Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity and mortality. Tobacco smoking has been identified as one of the major risk factors for NCDs, including cardiovascular, chronic respiratory diseases, and different cancers. Although there is national information on magnitude of tobacco use, to date there is limited nationally representative data on factors associated with tobacco use. The aim of this study is to assess the distribution and predicators of tobacco use in Ethiopian adult population between 15 -59.Objectives: The main aim of this study was to assess the prevalence of tobacco use and its predictor in Ethiopia.Methods: A cross-sectional population based study design was employed among population age from 15- 69 years. A stratified, three-stage cluster sampling was used to identify the study subjects. Households in each cluster were selected using simple random sampling method. The sampling frame was based on the population and ...
Ethiopian Journal of Health Development, Feb 7, 2018
Background: Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitu... more Background: Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes mellitus, cancers and chronic respiratory diseases, have remained the major burden and threat of the world with quite alarming rise in the developing nations. Eating a diet high in fruits and vegetables is associated with a decreased risk of many chronic diseases. Methods: Community-based cross-sectional survey based on the World Health Organization (WHO) NCD Stepwise approach was done. The survey was conducted in the 9 regions and two city administrations (Addis Ababa and Dire Dawa) in Ethiopia. The target population for this survey included all men and women age 15-69 years old who consider Ethiopia to be their primary place of residence. A single population-proportion formula was used to determine the sample size: design effect coefficient of 1.5, Z-score of1.96, proportion of 35.2%and marginal error of 0.04. A total of 513 EAs were covered nationwide. Thus, 10,260 study participants were included in the study. A mix of sampling approach namely stratified, three-stage cluster sampling, simple random sampling and Kish method were employed to select the study settings and the study participants. Descriptive weighted analysis was done along with complex sample analysis, and bivariate and multivariate analysis was conducted for fruit and/or vegetable intake. Result: The prevalence of fruit and/or vegetable consumption in Ethiopia was found to be (1.5%). More female than male ate fruit and vegetable in Ethiopia. When adjusted for included demographic and residence confounders (age, sex, location, income, education), those in rural area of residence ate ≥5 servings of fruits and vegetable [OR and (95% CI) [2.77 (1.60, 4.80)] than their counterparts. Conclusion and recommendation: Fruits and/or vegetables intake was generally extremely low. As the general level of risk factors rises, more people are put at risk. Preventive interventions to address these behaviours are implemented at individual, group, and community levels and include education, access to fruits and vegetables should therefore aim at reducing risk throughout the population. [Ethiop.
Uploads
Papers by Tedla Kebede