Red blood cell distribution width (RDW) is a measure of the change in size of red blood cells and it is used in combination with other hematological parameters for the differential diagnosis of anemias. Recent evidence suggested that the change in RDW level may be a predictive biomarker of morbidity and mortality in cardiovascular diseases (CVDs). Cardiovascular diseases are the most common cause of death globally as compared to cancer and communicable diseases. Early diagnosis and prompt intervention of these diseases are very important to minimize their complications. Nowadays, the diagnosis of most cardiovascular diseases majorly depends on clinical judgment, electrocardiography and biochemical parameters. Red blood cell distribution width as a new predictive biomarker may play a pivotal role in assessing the severity and progression of CVDs. However, the underlying mechanisms for the association between RDW and CVDs are not clear. A deeper understanding of their association could help the physicians in more careful identification, early prevention, intervention, and treatment to prevent adverse cardiovascular events. This review aims to elaborate on the recent knowledge on the association between RDW and cardiovascular diseases and some possible pathophysiological mechanisms.

Introduction In Ethiopia, more than four million children are anticipated to live under particularly difficult circumstances. Street children are subject to violence, a lack of health care, and a lack of education. Which denies them the right to live in a secure environment and exposes them to different health problems. Currently, little is known about the prevalence of Streetism, including health conditions. Therefore, this study was aimed to assess the health status of street children and determinants of Streetism. Methods Mixed methods (sequential) were employed from February 1 to 28, 2021. Quantitative cross-sectional study design and phenomenological qualitative designs were applied. Overall, 220 street children were involved in the study. The most common reason that forced the children to resort to a street way of life is to look for a job and quarreled with parents. The data were collected using interviews methods. Chi-square test and multiple binary logistic regression were applied to examine the variations among variables with the health status of street children. Qualitative data were analyzed using the thematic analysis technique. Results The study included a total of 220 street children. As to the quantitative study, the majority of study participants (92.73%) drank alcohol regularly. Depression (39.22%) and peer pressure (43.14%) were the most common initiation causes of drinking alcohol. According to a qualitative study report, "Street children are mostly affected by the communicable disease” and… They are addicted to substances like benzene” which had a profound effect on their health.” Furthermore, the study discovered a statistically significant association between respondents’ health status and sociodemographic characteristics (age and educational status), job presence, and drug use. Conclusion This study identified the factors that drove street children to live on the streets, such as the inability to find work and disagreements with their parents. The majority of the street children were affected by preventable and treatable diseases. Unfortunately, almost all street children reported drinking alcohol, which exposed them to a variety of health problems. In general, the study discovered that street children require immediate attention. Decision-makers and academicians should collaborate to develop a plan for these children’s health and social interventions.

Background: Diabetes has been proposed to inflict an insult on the hematopoietic milieu marked by changes in hematological indices including red blood cell parameters. Thus, this study aimed to assess the red blood cell parameters and their correlation with glycemic control in type 2 diabetic adult patients in comparison with apparently healthy individuals. Methods: A comparative cross-sectional study was conducted at the chronic illness clinic of Hiwot Fana Comprehensive Specialized University Hospital from May 20 to July 10, 2022. A total of 220 (110 type 2 diabetic patients and 110 controls) study participants were selected by a simple random sampling technique. Five milliliters of venous blood were collected by the vacutainer blood collection technique. Red blood cell parameters and blood glucose levels were determined using UniCel DxH 800 and Biosystems A25 analyzers, respectively. Independent sample t-test and Pearson correlation test were used for the data analysis. P-value <0.05 was considered statistically significant. Results: Statistically significant difference was observed in RBC parameters of T2DM patients and the control group. The mean RBC count, Hgb, Hct (P < 0.001), and MCHC (P = 0.002) in patients with type 2 diabetes was significantly lower than in the control group. However, the mean of RDW was significantly increased in type 2 diabetic patient groups than in the control group (P < 0.001). The mean RBC count, Hct, and Hgb in patients with good glycemic control were significantly higher than the patients with poor glycemic control. Besides, a statistically significant negative correlation was observed between glycemic control and RBC count, Hgb, and Hct level in diabetic patients. Conclusion:In this study, a statistically significant difference was observed in red blood cell parameters of type 2 diabetic patients compared to the control group. A significant negative correlation was noted between glycemic control and RBC parameters in type 2 diabetic patients. Therefore, evaluation of RBC parameters should be considered for better management of patients with type 2 diabetes mellitus.

Background Infections of sterile body fluids are susceptible to serious invasive bacterial infections and critical, with high morbidity and sequelae risk. This study has not been conducted previously in eastern Ethiopia. Objective The present study was designed to determine the bacterial profile, associated factors, and their susceptibility to antimicrobial agents of isolates among patients with sterile body fluids at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Methods Hospital-based cross-sectional study was conducted from April to June 2021 among 204 patients selected using a convenient sampling technique. Data were collected using a pretested structured questionnaire. All consenting patients submitting body fluid specimens for testing at the clinical laboratory were included and analyzed using standard microbiology methods. Antimicrobial susceptibility testing was performed using the disk diffusion method and interpreted as per Clinical and Laboratory Standards Institute guidelines. Data were double entered into Epi data version 4.6, exported, and analyzed using Statistical Package for Social Science version 25. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value <0.05 was considered to be statistically significant. Results The overall prevalence of bacteria among different sterile body fluid samples was 16.7% (95% CI: 12–22%). Most of the bacterial isolates (70.6%) were Gram-negative bacteria, mainly K. pneumoniae (26.5%) and E. coli (20.6%) . Multidrug resistance was identified in 76.5% of the isolates. Being inpatient (AOR = 3.59; 95% CI: 1.52, 8.51) and turbid appearance (AOR = 4.35; 95% CI: 1.67, 11.29) were significantly associated with culture growth rate. Conclusion The prevalence of bacterial isolates in this study comprises about 17%. Gram-negative bacteria, particularly K. pneumoniae and E. coli, were the major etiologic agents. Being inpatient and the turbid appearance of the specimen were significantly associated with the culture-positive result. Significant numbers of multidrug-resistant bacteria were isolated, mainly against beta-lactams. Therefore, culture and susceptibility testing should be an integral part of the laboratory investigation.

Background: COVID-19 brought significant challenges to public health. It changed the view of global health and safety, trust in the healthcare system, and clients’ willingness to seek healthcare. To contain the course of the COVID-19 pandemic and its detrimental effects, understanding peoples’ health behavior, especially healthcare-seeking, and determining the community risk perception is very important. Thus, this study aimed to determine the health-seeking behavior, community’s risk perception to COVID-19 pandemics, and factors influencing the community risk perception in Harari regional state, Ethiopia. Methods: Community-based cross-sectional study was conducted from 5 to 30 February 2021. A total of 1320 adult (>18 years) participants were selected using systematic random sampling. The data were collected using an online kobo collect toolbox and analyzed using descriptive statistical tests. Chi-square test and multiple binary logistic regression were applied to examine the difference between variables. A p-value < 0.05 was considered to be of statistical significance. Results: The study included 1296 respondents >18 years old. The overall prevalence of willingness to seek healthcare in the study area was 35.6% (95% CI: 33%–38.3.0%). The mean cumulative score of risk perception was 30.5 (SD ± 7.25) with the minimum and maximum score of 13 and 63, respectively. A total of 656 (50.6%) of the participants had low-risk perceptions concerning COVID-19. The study found a statistically significant association between risk perception and sociodemographic characteristics (age, educational status, and income), and knowledge of the respondents. Conclusion: The overall prevalence of willingness to seek healthcare was 35.6%. Healthcare intervention aimed to contain the COVID-19 pandemic should consider the factors associated with the study area. Similarly, the study found a low-risk perception among the community that needs critical action to manage the COVID-19 pandemic and to protect the community as a whole. Thus, it is necessary to improve community risk perception through health education.

Background Malaria is a major public health problem with the highest morbidity and mortality in developing countries. Hematological changes play a great role in malaria pathogenesis through platelets and platelet parameters. However, the changes in platelet parameters are not clearly described in Ethiopia. Therefore, this study aimed to compare platelet parameters and their correlation with parasitemia among malaria-infected adult patients and healthy adults. Methods An institutional-based comparative cross-sectional study was conducted involving 186 (93 malaria-infected patients and 93 healthy adults) study participants using a convenient sampling technique at Jinella health center, Harar, Eastern Ethiopia, from July 10–August 10, 2022. Five milliliters of venous blood were collected from each study participant, and platelet parameters were analyzed using a Unicel (DxH 800) automated hematologic analyzer. A drop of blood was taken from malaria-suspected patients for blood film preparation. Results between two groups were compared using the Mann–Whitney U -test. Spearman’s rank correlation coefficient was used to evaluate the relationships between two continuous variables. A P-value of < 0.05 was considered statistically significant. Results Platelet, plateletcrit, and mean platelet volume of malaria-infected patients were significantly lower as compared with healthy adults (103 x10 3 cells/μL vs 268 x10 3 cells/μL, 0.13 fl vs 0.23 fl, and 9.6 fl vs 15.3 fl), respectively). Conversely, platelet distribution width and platelet large cell ratio were higher in malaria-infected patients than healthy adults (19.2% vs 15.3% and 0.35% vs 0.29%), respectively). Parasitemia levels had a moderately inverse correlation with platelet count (r= −0.419) and a weakly positive correlation with mean platelet volume (r=0.278). Conclusion The platelet, plateletcrit, and mean platelet volume of malaria-infected patients were significantly lower as compared with healthy adults. Malaria parasitemia had a moderate inverse correlation with platelet count and a weak positive correlation with mean platelet volume. Thrombocytopenia and alteration of platelet parameters should be considered in malaria patients.

Background Folate deficiency (FD) can cause adverse health outcomes of public health significance. Although FD is a significant micronutrient deficiency in Ethiopia, concrete evidence is limited. Therefore, this systematic review and meta-analysis was designed to estimate the pooled prevalence of FD among women of reproductive age (WRA). Methods A systematic literature search was performed using MEDLINE, Embase, CINAHL, Google Scholar, African Journals Online (AJOL), The Vitamin and Mineral Nutrition Information System (VMNIS) of the World Health Organization (WHO), Global Health Data Exchange (GHDx), and institutional repositories of major universities and research centers. Additionally, we scanned the reference lists of relevant articles. Two authors independently selected the studies, extracted the data, and the study risk of bias. Heterogeneity was assessed using the I2 statistic. We used a random-effects model to estimate the pooled mean serum/plasma folate and the pooled prevalence of FD. Begg’s and Egger’s tests were used to check publication bias. Results Ten studies—nine cross-sectional and one case-control—with a total of 5,623 WRA were included in the systematic review and meta-analysis. Four (WRA = 1,619) and eight (WRA = 5,196) cross-sectional studies were used to estimate the pooled mean serum/plasma folate and prevalence of FD, respectively. The pooled mean serum/plasma folate concentration estimate was 7.14 ng/ml (95% CI: 5.73, 8.54), and the pooled prevalence of FD was estimated to be 20.80% (95% CI: 11.29, 32.27). In addition the meta-regression analysis showed that the sampling technique was significantly associated with mean serum/plasma folate concentration. Conclusions FD is a significant public health issue among WRA in Ethiopia. Therefore, the public health strategies of the country should focus on promoting the consumption of folate-rich foods, strengthening the coverage of folic acid supplementation and its adherence, and swift translation of the mandatory folic acid fortification into action. Systematic review registration PROSPERO 2022—CRD42022306266.

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