Academic literature on the topic 'Drug abuse – Ethiopia – Addis Ababa'

Background: Although substance use is a known public health problem and a pressing issue in Ethiopia, its real extent and magnitude are not yet properly explored. The current study aimed to determine the extent and predictors of substance use among regular undergraduate students in the Institute of Technology, Addis Ababa University. Methods: An institution-based cross-sectional study was carried among 794 undergraduate regular students at the Institute of Technology, Addis Ababa University, using a self-administered structured questionnaire filled by study participants. Data entry, cleaning, and coding were performed by EPI-INFO version 3.5.1. Statistical Package for Social Sciences; AOR: Adjusted odds ratio (SPSS) SPSS version 21 software was used to analyze data by performing descriptive statistics, bivariate, and multivariate analysis. Results: 73.7% of the study participants used substances at least once. The lifetime use of each substance includes alcohol (68.2%), khat (53.6%), cigarettes (46.1%), and illicit drugs (23.3%). Loss of family (AOR [95%CI], 34.50 [7.569, 157.263]), pocket money between 500 and 999 Ethiopian birr (AOR [95%CI], 9.978 [1.240, 80.280]), and above 1000 Ethiopian birr (AOR [95%CI], 10.831 [1.333, 87.971]) were identified predictors for khat use. The odds of lifetime alcohol use was higher among students coming from a divorced family (AOR [95%CI], 9.346 [3.162, 27.625]), lost one (AOR [95%CI], 37.406 [11.375, 123.008]), or both of their parents (AOR [95%CI], 18.750 [5.798, 60.633]). Students of urban origin (AOR [95%CI], 3.214 [1.950, 5.296]), and students with anxiety symptoms (AOR [95%CI], 2.655 [1.981, 3.557]) have a higher odds of lifetime cigarette smoking. The lifetime exposure to illicit drugs is higher among students in age groups between 20 and 24 years (AOR [95%CI], 5.963 [1.361, 26.135]), students coming from substance user family (AOR [95%CI], 2.172 [1.161, 4.063]), and students of urban origin (AOR [95%CI], 2.661 [1.202, 5.889]). Conclusion: A higher prevalence of substance use requiring administrative and educational interventions was observed. Awareness creation interventions on the potential impacts of substance abuse should be performed.

Purpose Ethiopia is home to a growing population of more than 100 million people. Healthcare in the region functions with a shortage of oncologists. Pharmacists as well as other healthcare providers can assist with expanding patient access to cancer care. A pilot project was proposed to provide education, determine areas to expand pharmacy services in oncology, and recommend interventions at Tikur Anbessa Specialized Hospital and Addis Ababa University. Methods A layered learning practice model comprising of a clinical pharmacist, a post-graduate year two oncology pharmacy resident, and two fourth-year student pharmacists was constructed for the experience. Through collaboration with the College of Pharmacy at Addis Ababa University, an international experience was developed to provide education and advance pharmacy practice at Tikur Anbessa Specialized Hospital. Results Based on findings from a needs assessment, the participants collaborated with key stakeholders to develop practices and procedures for the implementation of high-dose methotrexate and for comprehensive chemotherapy order review. In addition, 17 didactic lectures were provided to nine students enrolled in the Master of Pharmacy in Pharmacy Practice at the College of Pharmacy at Addis Ababa University. Conclusion This experience provided educational and clinical impact using a layered learning practice model, consisting of a clinical pharmacist, pharmacy resident, and pharmacy students in an international setting. There is significant potential for clinical pharmacy to positively impact patient care in the oncology setting in Ethiopia. Future initiatives for advancement include the safe handling of hazardous agents, additional therapeutic drug monitoring, and outpatient oncology pharmacist practice.

Domestic workers are one of the most vulnerable groups of workers. In Ethiopia, however, the vulnerability, legal protection, and work conditions of female domestic workers are not well-documented and researched. Hence, the purpose of this study was to investigate the vulnerability, legal protection, and work conditions of female domestic workers in Addis Ababa, Ethiopia. A cross-sectional qualitative research design was employed using in-depth interviews, key informant interviews, and focus group discussions. The study participants were 15 domestic workers, three officials from the Office of Labor and Social Affairs, and five brokers of domestic workers. Findings indicate that female domestic workers experienced abuse in various forms including verbal or psychological abuse, physical abuse, and sexual assault. Female domestic workers in the study area had few or no labor rights or protection. They rarely had clear contractual relations, worked long hours for low pay, and had little or no privacy. There is neither a proper state institution to promote the rights of domestic workers nor a strong viable movement among or on behalf of domestic workers. Hence, a relevant legislative framework developed by the city and national governments, and strong advocacy efforts to expose their working conditions are needed to improve the work conditions of female domestic workers.

Background. The emergence and spread of multi-drug resistant (MDR) bacteria have become a public health problem in recent years. For the last many years, carbapenem antibiotics have been used successfully to treat infections caused by MDR Enterobacteriaceae. However, recently, Enterobacteriaceae producing carbapenemases have emerged, which confer broad resistance to most β-lactam antibiotics including carbapenems. Therefore, this study is aimed at determining the magnitude of MDR and carbapenemase-producing Enterobacteriaceae (CPE) isolated from various clinical specimens in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted from January to April 2018. A total of 312 Enterobacteriaceae isolates were identified from various clinical specimens. The Phoenix automated system (BD Phoenix100) was used for bacterial identification and antimicrobial susceptibility testing. Potential carbapenemase producers were confirmed by the modified carbapenem inactivation test, and KPC, MBL, and OXA-48 were phenotypically characterized by the disk diffusion method. The data obtained were entered and analyzed using SPSS version 20 software. Descriptive statistics, chi square, bivariate and multivariable logistic regression analyses were performed. P value ≤ 0.05 with corresponding 95% confidence interval was considered for statistical significance. Results. A total of 312 Enterobacteriaceae were recovered. Of these isolates, 68.6% were MDR and 2.6% were CPE with different classes including OXA-48 1.6% (5/312), MBL 0.6% (2/312), and KPC and OXA-48 0.3% (1/312). The predominant bacterial isolates were E. coli 72.4% (226/312) followed by K. pneumoniae 13.8% (43/312). The antibiotic resistance rates of CPE isolates were significantly higher than other MDRE including ampicillin (100% versus 77.6%), cefoxitin (75% versus 20.6%), and piperacillin/tazobactam (50% versus 13.1%). Conclusion. In this study, a relatively higher prevalence of MDR was observed, and the highest resistance was recorded against ampicillin, amoxicillin with clavulanic acid, and sulfamethoxazole-trimethoprim. Detection of CPE is important for implementing appropriate antimicrobial therapy and in controlling the spread of the infection. Furthermore, continuous screening and investigations, including genotypic characterization of CPE, are required for the prevention and control of the spread of antimicrobial-resistant pathogens.

The impact of counterfeit and substandard medicines has been increasing and becoming a public health problem as it significantly increases mortality and morbidity in low income countries. Loratadine is among the drug classes which are most falsified worldwide and is a frequently prescribed anti-allergy medication. As Ethiopia is one of the low-income countries and depends mostly on imported pharmaceutical products, it is necessary to evaluate the quality of drug products being marketed. This study was conducted with the objective of evaluating and comparing the quality of different brands of loratadine 10 mg tablets collected from pharmacy outlets in Addis Ababa city. Tablets were evaluated for weight variation, thickness, hardness, friability, disintegration time and in vitro drug release. All products complied with the pharmacopeial specifications for weight variation and friability. With regard to disintegration time, all sample products disintegrate in less than 15 min as per the pharmacopeial requirement except one product (product E) which is out of the pharmacopeial specification. Dissolution test showed that all the tested products released more than 80% of drug content within 60 min which is in agreement with the pharmacopeial specification.

Background. In Ethiopia, tuberculosis (TB) is one of the most common causes of illness and death. However, there is limited information available on lineages associated with drug resistance among extrapulmonary tuberculosis patients in Ethiopia. In this study, researchers looked into Mycobacterium tuberculosis lineages linked to drug resistance in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia. Methods. On 151 Mycobacterium tuberculosis isolates, a cross-sectional analysis was performed. Spoligotyping was used to characterize mycobacterial lineages, while a phenotypic drug susceptibility test was performed to determine the drug resistance pattern. Data were analyzed using SPSS version 23. Results. Among 151 Mycobacterium tuberculosis complex (MTBC) genotyped isolates, four lineages (L1–L4), and Mycobacterium bovis were identified. The predominantly identified lineage was Euro-American (73.5%) followed by East-African-Indian (19.2%). Any drug resistance (RR) and multidrug-resistant (MDR) tuberculosis was identified among 16.2% and 7.2% of the Euro-American lineage, respectively, while it was 30.8% and 15.4% among the East-African-Indian lineages. Among all three preextensively drug-resistance (pre-XDR) cases identified, two isolates belong to T3-ETH, and the other one strain was not defined by the database. There was no statistically significant association between any type of drug resistance and either lineage or sublineages of Mycobacterium tuberculosis. Conclusion. A higher proportion of any type of drug resistance and MDR was detected among the East-African-Indian lineage compared to others. However, there was no statistically significant association between any type of drug resistance and either lineages or sublineages. Thus, the authors recommend a large-scale study.

PURPOSE A postmarket evaluation of chemotherapy dosage forms in Ethiopia was conducted to test the accuracy of the chemoPAD, a paper analytical device for drug quality screening. MATERIALS AND METHODS In September of 2018 in Addis Ababa, Ethiopia, 41 anticancer drug dosage forms (representing 4 active ingredients, 5 brands, and 7 lot numbers) were collected and were rapidly screened for quality using a chemotherapy paper analytical device (chemoPAD). Confirmatory analysis via high performance liquid chromatography was conducted. RESULTS The chemoPAD showed that the correct active pharmaceutical ingredient was present in doxorubicin, methotrexate, and oxaliplatin injectable dosage forms. However, 11 of 20 cisplatin samples failed the screening test. Confirmatory assay by high-performance liquid chromatography showed that all 20 cisplatin samples—comprising three lot numbers of a product stated to be Cisteen—were substandard, containing on average 54% ± 6% of the stated cisplatin content. Inductively coupled plasma optical emission spectroscopy analysis of five representative samples found 57% to 71% of the platinum that should have been present. The sensitivity of the chemoPAD for detection of falsified products could not be measured (as none were present in these samples), but the selectivity was 100% (no false positives). The sensitivity for detection of substandard products was 55%, and the selectivity was 100% (no false positives). CONCLUSION Although instrumental analysis by pharmacopeia methods must remain the gold standard for assessing overall drug quality, these methods are time consuming and patients could be exposed to a bad-quality drug while clinical workers wait for testing to be performed. The chemoPAD technology could allow clinicians to check at the point of use for serious problems in the quality of chemotherapy drugs on a weekly or monthly schedule.

Background - Khat is a mild stimulant plant chewed by a limited segment of the population mainly in the eastern parts of Ethiopia for social facilitation and religious purposes. In recent decades, the use of khat has spread to all parts of the country and its social, economic and political impact has increased significantly at national level. In cities like Addis Ababa, the traditional purposes are superseded and it is now chewed mainly for recreational purposes. Following this development, many people have raised concerns on the potentially adverse socioeconomic and psychological effects of khat on the current generation, particularly the youth. The main issues raised are the misuse of income, the waste of productive time on chewing khat, and the adverse consequences on family cohesion and health. Those who argue in favor of khat cite its positive impact on increasing productivity, high economic returns and traditional values. These arguments on khat are not based on substantiated evidence and this research attempted to answer this question by assessing the ‘positive’ and ‘negative’ socioeconomic and psychological effects of khat on the chewers living in Addis Ababa. Drug control policies intersect with much of the 2030 Agenda for Sustainable Development and Ethiopia has not yet developed a policy on khat. This research intends to make its contribution to the development of the policy by highlighting the socioeconomic and psychological effects on the chewers. Objective –To assess the effects of khat on the income; use of time/time management/; productivity, and psychological well-being of chewers in the city of Addis Ababa. The study is related to policies of Ethiopia in relation to the production, marketing and consumption of khat. It makes policy recommendations based on the assessed costs and benefits. Methodology - The study, using snowball sampling, was conducted in 2018 with 84 khat users. The data collection methods employed were structured questionnaire focus group discussions, narrations of life stories and interviews with key informants. An extensive literature review was also conducted. Result – Respondents reported the diversion of financial resources to purchase khat compromising other personal and family needs and a waste of working hours on chewing khat. There were mixed results found on its effects on productivity. Users also reported that khat made them vulnerable to other addictions such as alcohol, cigarettes and hard drugs and to a number of social and psychological problems. Conclusion - Khat has a significant adverse impact on income and the efficient use of time of chewers. The findings on the effect on productivity are inconclusive. The reported physical and psychological effects on productivity need to be scientifically proven. Chronic use of khat is detrimental to mental health and leads to other serious health consequences. It distorts social and family relationships and inhibits the ability of the chewer to significantly execute his/her social responsibilities. It hurts the self-esteem of the chewers and makes them lose a sense of purpose in their lives. Thus, there is an urgent need to develop a national policy on khat. However, a comprehensive study should be conducted to exploit the potential benefits of khat (mood lifting and medicinal values) by using khat in a modest and controlled way. The social and economic interest of the suppliers; its religious and cultural significance, and environmental impacts should also be considered.
Development Studies
M.A. (Development Studies)

A quantitative, descriptive, explorative, contextual study was conducted to determine pharmacists and drug vendors' level of knowledge, attitude towards and practice on Emergency Contraceptive (ECl in Addis Ababa. Forty licensed service providers in Addis Ababa were randomly selected during 2008 and interviewed using a structured interview schedule. Data were analysed using a computer software package. The findings revealed that although these service providers were knowledgeable on the purpose and dOSing schedule of EC, they lacked knowledge on side-effects, contra-indications, and types of ECs. Most respondents portrayed a subjective attitude towards easy EC access of especially adolescent girls, since they believed that it will encourage promiscuity and unprotected intercourse. Their knowledge and practice need to be improved, as it has a direct effect on potential users and reducing unwanted pregnancies among young.
Health Studies
M.P.H. (Health Sudies)