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Introduction: Unused and/or expired pharmaceuticals stored in households are potential health and environment hazards that require safe disposal. In Eritrea, there has not been a proper household medicines disposal system and pharmaceutical wastes had been disposed of irrationally. The study was therefore conducted to assess community's understanding and disposal practices of unused/expired medications and willingness to participate in a household medicines take-back system. Methods: A cross-sectional study was conducted from January to February 2023 in randomly selected households of Asmara. The study participants were selected using a multi-stage-cluster sampling. Data, collected through face-to-face interview using a structured questionnaire, were double entered using CSPro version 7.3 software package and analyzed using SPSS version 26. Results: A total of 327 participants were enrolled in the study with a predominance of female respondents (84%). The most commonly used disposal practices were throwing with household garbage (65.6%), followed by dumping under soil (38.7%) and flushing down the toilet/sink (15.2%). Around three-quarters (70.5%) of the households had unused/expired medicines stored at home during the data collection period with intention to use being the most common reason for storage (83.9%). Analgesics and anti-infectives were the most commonly stored classes of medicines, and more than half of the anti-infectives were stored for future use. The mean knowledge score of participants was 7.31/11 (95% CI: 7.09– 7.52). Moreover, participants had a satisfactory willingness to participate in a household medicines take-back system, with a mean attitude score of 16.89/20 (95% CI: 16.45– 17.29). Lack of awareness, negligence, time/health constraints, fear of accountability/stigma, accessibility and reluctance were reported as possible challenges in establishing a household medicines take-back system. Conclusion: Unnecessary storage and improper disposal of household unused/expired medicines along with inadequate knowledge on disposal mechanisms were common in households of Asmara. Hence, public education on proper disposal as well as coordinated efforts for the establishment of safe disposal mechanisms are recommended. [ABSTRACT FROM AUTHOR]

Background. Antimicrobial resistance poses a significant global threat to the treatment of bacterial infections, particularly in low- and middle-income regions such as Africa. This study is aimed at analyzing antimicrobial resistance patterns in vaginal swab samples from patients at the National Health Laboratory from 2019 to 2022. Methods. This retrospective study examined patient records from vaginal swab analyses performed at the National Health Laboratory between January 1, 2019, and December 31, 2022. Ethical approval was obtained from the Ministry of Health Research Ethical Approval and Clearance Committee on 15/02/2023. Results. Of the 622 samples, 83% underwent microbial isolation and identification. Citrobacter spp. exhibited high resistance (>43%) to antibiotics such as cephalexin, ceftazidime, nalidixic acid, ampicillin, gentamicin, and tetracycline. E. coli showed resistance rates of more than 50% to ampicillin, trimethoprim-sulfamethoxazole, and tetracycline. Klebsiella spp. and Proteus spp. exhibited resistance rates that exceeded 47% to specific antibiotics. Gram-positive bacteria have resistance rates of more than 49% with ampicillin, trimethoprim-sulfamethoxazole, tetracycline, oxacillin, vancomycin, and penicillin G. In particular, S. aureus demonstrated no resistance to rifampicin or clindamycin, while Streptococcus spp. showed 100% resistance to rifampicin and vancomycin. Several species, including Proteus species, Streptococcus spp., S. aureus, and Klebsiella spp. exhibited multidrug resistance. Conclusion. Most gram-negative bacteria displayed higher resistance of >45% to ampicillin, trimethoprim-sulfamethoxazole, and tetracycline. Among gram-positive bacteria, a higher resistance rate with ampicillin, trimethoprim-sulfamethoxazole, tetracycline, oxacillin, vancomycin, and penicillin G was recorded. S. aureus showed no resistance to rifampicin and clindamycin, and Strep. spp. indicated 100% resistance to rifampicin and vancomycin. This study highlights critical gaps and areas for further exploration. Expanding the spectrum of antibiotics tested and investigating underlying multidrug resistance mechanisms would provide a more comprehensive understanding of resistance patterns. [ABSTRACT FROM AUTHOR]

Background. Proper antenatal care is one of great means of reducing maternal and child morbidity and mortality. However, determining level of knowledge and practice is vital, and the objective of this study was to evaluate this gap among pregnant women in Amatere Health Center, Massawa city, Eritrea, 2019. Methods. A cross-sectional study with systematic sampling was conducted. All pregnant mothers who were resident of Massawa city and visiting Amatere Health Center for their current pregnancy were included in the study. An interviewer-administered structured questionnaire was used as data collection tool. Results were presented using descriptive statistics, percent, and frequencies. Results. A total of 289 pregnant mothers were enrolled in the study with a mean age of 27.7 years. Most mothers reported that high blood pressure (92.4%), maternal smoking (97.6%), alcohol consumption (97.2%), infection (92.7%), and medicines (98.3%) had affected fetal growth during pregnancy. Practically, two-thirds (59.4%) of the mothers were visiting the health facility during the first three months of their pregnancy. Majority of mothers had good knowledge (84.1%) and attitude (99%), but they had low level of practice (45%). Marital status, occupation, gravidity, and parity had showed statistically significant association to their comprehensive knowledge (p < 0.001). And their gravidity (p < 0.003) and parity (p < 0.001) had also showed statistically significant association to their level of practice. Conclusion. Even though majority of the pregnant mothers had high level of knowledge and attitude, their practice towards ANC was relatively low. Age, marital status, and occupation showed statistically significant association to their comprehensive knowledge. Moreover, multiparous and multigravida mothers were having higher level of knowledge and practice on antenatal care. Enhancing community awareness on early starting of antenatal care and improving their practice through proper counseling are highly recommended. [ABSTRACT FROM AUTHOR]

Background: Eritrea has achieved the global target (90%) for tuberculosis (TB) treatment success rate. Though, events of unsuccessful TB treatment outcomes (death, treatment failure, lost to follow up and not evaluated) could lead to further TB transmission and the development of resistant strains. Hence, factors related to these events should be explored and addressed. This study aims to fill the gap in evidence by identifying the determinants of unsuccessful TB treatment outcomes in Eritrea's Northern Red Sea region. Methods: A retrospective cohort study was conducted in Eritrea's Northern Red Sea region. Data collected using a data extraction tool was analyzed using Stata version 13. Frequencies, proportions, median and standard deviations were used to describe the data. Furthermore, univariable and multivariable logistic regression analysis were performed to determine the risk factors for unsuccessful TB treatment outcomes. Crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence interval (CI) presented and p-value < 0.05 was considered statistically significant. Results: Among 1227 TB patients included in this study, 9.6% had unsuccessful TB treatment outcomes. In multivariable logistic regression analysis, TB cases 55–64 years old (AOR: 2.75[CI: 1.21–6.32], p = 0.016) and those ≥ 65 years old (AOR: 4.02[CI: 1.72–9.45], p = 0.001) had 2.7 and 4 times higher likelihood of unsuccessful TB treatment outcome respectively. In addition, HIV positive TB patients (AOR: 5.13[CI: 1.87–14.06], p = 0.002) were 5 times more likely to have unsuccessful TB treatment outcome. TB treatment in Ghindae Regional Referral Hospital (AOR: 5.01[2.61–9.61], p < 0.001), Massawa Hospital (AOR: 4.35[2.28–8.30], p< 0.001) and Nakfa Hospital (AOR: 2.53[1.15–5.53], p = 0.021) was associated with 5, 4 and 2.5 higher odds of unsuccessful TB treatment outcome respectively. Conclusion: In this setting, old age, HIV co-infection and health facility were the independent predictors of unsuccessful TB treatment outcome. [ABSTRACT FROM AUTHOR]

Background: Everybody is exposed to ultraviolet radiation and the natural source of ultraviolet radiation is sunlight. The objective of this study was to determine the prevalence of solar keratopathy, pterygium and cataract and further to evaluate other factors that cause blindness to the inhabitants of the Northern Red Sea Zone islands of Eritrea. Methods: It was a community-based cross-sectional study of all people aged 40 years and above, with a census sampling method. Study participants were screened for presence of solar keratopathy and other ocular diseases, and data were collected by a checklist from March 20 to April 20, 2021. Data were entered on an Excel sheet and transported to SPSS version 21. Results were presented with frequencies and percentages and chi-squared bivariable analysis was carried. P-value less than 0.05 was considered significant. Results: The prevalence of solar keratopathy and cataract was 19.6% and 15.8%, respectively. Pterygium (40%) and pinguecula (32.1%) were also commonly found in the community. Participants aged 70 years and above (P< 0.001), fishermen (P< 0.001), housewife (P< 0.001) and females (P< 0.001) had a higher rate of blindness. The prevalence of solar keratopathy was higher with increased age and work experience (P< 0.001). Fishermen and housewives had higher rates of solar keratopathy (44.6%) and cataract (30.2%), respectively, (P< 0.001). Respondents aged 40 to 49 years had the highest prevalence of pterygium (44.1%) and pinguecula (39.1%) (P< 0.001). Conclusion: The prevalence of solar keratopathy, cataract, pterygium and pinguecula was high in the community. Fishermen with increased work experience were having the highest prevalence of blindness and solar keratopathy. Age, occupation, work experience, sex, vision problems and history of eye operations had showed significant association with visual acuity, solar keratopathy, cataract, pterygium, and pinguecula. Community awareness about the preventive aspects of these diseases is highly recommended. [ABSTRACT FROM AUTHOR]

Background: Hypertension and diabetes are key determinants of cardiovascular risks. The objective of this study was to calculate 10-year incidence of cardiovascular risk, determine cardiovascular risk factors, and evaluate how diabetes and hypertension are controlled in patients in Massawa Hospital, Eritrea. Methods: This was a hospital-based cross-sectional study using census sampling. A checklist and interview were used as data-collection tool from October 10 to November 20, 2020. Written consent was obtained from each study participant before starting the study. Descriptive statistics were wasused, and results are presented in percentages in tables, p< 0.05 was considered significant. Results: A total of 600 patients were enrolled in the study, dominated by the Tigrigna (58.7%) and Tigre (26.7%) ethnic groups. About half the patients (58.8%) had a body-mass index of 18– 25 kg/m2, with abdominal circumference of < 95 cm (74%). Most (93.5%) patients had < 10% risk of cardiovascular complications in the coming 10 years. Age showed significant association with hypertension, diabetes mellitus, cardiovascular risk, and poor glycemic and blood-pressure control (p< 0.001). Body-mass index, abdominal obesity, and history of stroke were associated with hypertension and diabetes mellitus (p< 0.001). Moreover, smoking, hypertension, and monthly income were associated with higher cardiovascular risk (p< 0.001). In addition, hypertension and abdominal obesity were associated with glycemic control (p< 0.001), and blood-pressure control was significantly associated with diabetes and hypertension (p< 0.001). Conclusion: Age and hypertension were associated with diabetes, cardiovascular risk and poor glycemic control, and smoking, abdominal obesity, and monthly income also significant associations with higher cardiovascular risk and glycemic control. Cessation and adjustment of modifiable factors, such as smoking, hypertension, and regular exercise are highly recommended. [ABSTRACT FROM AUTHOR]

Introduction: use of traditional cautery for the treatment of varied ailments is one of the most ancient and harmful traditional medical practices that is still in use. This study was conducted to assess the knowledge, attitude, practice and to estimate the prevalence of traditional cautery among patients visiting Massawa hospital. Methods: a hospital-based cross-sectional study was conducted in Massawa hospital from February 20 to April 20, 2019. The study enrolled all patients aged >18 years, non-critical and willing to participate. Results: a total of 900 participants were enrolled in the study. The study was dominated by Muslims (81.4%) with a median age of 42 years (IQR: 20). Self-reported prevalence of traditional cauterization was found to be 43.6% and 63% of them did their latest cautery between 2011 and 2019. Metal rods were used as cauterant in 92.3% and 47.9% reported that traditional practitioners used the same cauterant for different people. One-third of the respondents reported that it is a safe practice and 47% had the understanding that it cannot transmit communicable diseases. Moreover, 90.4% of the study participants reported that they knew someone who did cautery. Respondents with poor knowledge (AOR=6.45, 95% CI: 4.69-8.87) and attitude (AOR=8.68, 95% CI: 6.31-11.95) were more likely to practice cauterization compared to those with good knowledge and attitude. Conclusion: the practice of cauterization in visitors of Massawa hospital was rampant which is mainly associated with poor knowledge and attitude of the respondents, limited access to health facilities and religious/cultural conviction. [ABSTRACT FROM AUTHOR]