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1
Alemu, Tadesse, Tirhas Tadesse, and Getasew Amogne. "Glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Ethiopia." SAGE Open Medicine 9 (January 2021): 205031212110230. http://dx.doi.org/10.1177/20503121211023000.
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Objective: The objective of the study was to explore the level of glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Addis Ababa, Ethiopia. Methods: Cross-sectional study design was employed. The sample size was determined using a single proportion formula and 245 patients with type 2 diabetes mellitus were involved in this study. Systematic sampling method was used to select the study subjects. Standard questionnaire was used to collect patient’s biographic data, economic data, self-care activities, and patient compliance to medications. Summary statistics of a given data were calculated. Logistic regression model was used to measure the relationship between the outcome and predictor variable. Direction and strength of association was expressed using odds ratio and 95% confidence interval. Result: More than three-fourth, 191 (80.3%) of diabetic patients had poor glycemic control. Poor glycemic control was found to be 7.03 times higher among diabetic patients with duration of 5–10 years (adjusted odds ratio = 7.03, 95% confidence interval = 2.7–18.6). Similarly, diabetic patients with a duration of above 10 years were poorly controlled their blood sugar level (adjusted odds ratio = 2.3, 95% confidence interval = 1.028–5.08) in comparison to diabetic patients with a duration of fewer than 5 years. It was also found that compliance with a specific diet was significantly associated with good control of blood sugar level (adjusted odds ratio = 3.7, 95% confidence interval = 1.24–11.13). Conclusion: The magnitude of patients with poor glycemic control was high. Duration of diabetes and non-compliance with diets high in fruits, vegetables, and diets low in fat and sugar were significantly related to uncontrolled blood glucose levels. Therefore, developing strategies targeted toward improving blood glucose control with special attention to diabetes mellitus (DM) patients with a duration of ⩾5 years and those who poorly comply with their diet was strongly recommended.
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Berman, Leigh R., Meredith Kavalier, Beshea G. Deressa, Daniel Yilma, Getnet Tesfaw, and Daniel Shirley. "856. Assessment of Hand Hygiene amongst Health Care Professionals at Jimma University Medical Center." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S468. http://dx.doi.org/10.1093/ofid/ofaa439.1045.
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Abstract Background Lack of hand hygiene (HH) amongst healthcare workers (HCWs) contributes to healthcare associated infections and the spread of multidrug-resistant organisms. We assessed HCW HH knowledge, attitudes, and compliance using WHO tools and applied the Systems Engineering Initiative for Patient Safety (SEIPS) model in interviews to help guide and increase sustainability of HH interventions. Methods We conducted a cross-sectional study at Jimma University Medical Center (JUMC) in Jimma, Ethiopia. We assessed HCW’s HH knowledge and attitudes using questionnaires adapted from WHO resources via systematic sampling. Observations of HH practices at WHO’s 5 Moments of HH were conducted by non-identified, trained observers via systematic sampling. 22 semi-structured interviews were conducted via convenience sampling with HCWs using an interview guide based on the SEIPS model. Results We observed 1,386 HH moments and found a compliance rate of 9.38%, with compliance highest after contact with patient surroundings (27.92%) compared to the other four HH moments (1.77 - 9.57%). Of 251 survey participants, 13.6% had prior HH training and 69.9% reported routine HH compliance. The average knowledge score was 61.4%, with no significant difference between participants that identified as trained vs untrained (p=0.41). 68% of interview participants stated they were unaware of JUMC’s Infection Prevention and Control (IPC) team and are more likely to perform HH if a patient appears infectious. Interview participants cited multiple barriers to HH (table 1). Table 1 Conclusion Baseline HH compliance and knowledge were low despite perceived compliance and regardless of prior HH training. Relatively higher compliance after patient contact may be due to perceptions of patient infectiousness. Utilizing the SEIPS model as an adjunct to WHO HH guidelines has provided actionable items upon which the JUMC IPC team can focus to improve HH practices: providing a sustainable supply of alcohol hand rub, ongoing HH education targeting knowledge deficits, and enhanced IPC presence and HH monitoring. Disclosures Meredith Kavalier, MD, University of Wisconsin-Madison Global Health Institute (Grant/Research Support)
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Kefale, Belayneh, Gobezie T. Tegegne, Yitayih Kefale, Mulugeta Molla, Amien Ewunetei, and Amsalu Degu. "Magnitude and determinants of drug therapy problems among type 2 diabetes mellitus patients with hypertension in Ethiopia." SAGE Open Medicine 8 (January 2020): 205031212095469. http://dx.doi.org/10.1177/2050312120954695.
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Introduction: Type 2 diabetes mellitus patients with hypertension are at high risk of drug therapy problems since they are subject to receive multiple drug therapies due to comorbidities. Objectives: To determine the magnitude of drug therapy problems and its determinants among Type 2 diabetes mellitus patients with hypertension. Methods: A cross-sectional study was employed among 423 randomly selected participants based on the inclusion criteria. A structured questionnaire and review of patients’ medical record were employed in the data collection. The classification system used by Cipolle was used to classify and evaluate drug therapy problems. Data were analyzed using Statistical Package for the social sciences version 25.0 software. Multivariate logistic regression analysis was used to identify determinants of drug therapy problems with a statistical significance of p ⩽ 0.05. Results: A total of 491 drug therapy problems with a mean of 1.86 ± 0.53 drug therapy problems per patient were identified, and 62.4% (264) of them experienced at least one drug therapy problem. Non-compliance (197, 40.1%), needs of additional drug therapy (119, 24.2%), and dosage too low (91, 18.5%) were the most frequently observed drug therapy problems in the study setting. Anti-diabetic medications (88.4%), statins (44.5%), and aspirin (33.5%) were the most commonly involved drugs in drug therapy problems. The determinants of drug therapy problems were very low family income (adjusted odds ratio = 4.64, p = 0.010), age (45–65 years old) (adjusted odds ratio = 2.55, p = 0.008), presence of comorbidity (adjusted odds ratio = 9.19, p < 0.001), and taking ⩾5 medications (adjusted odds ratio = 2.84, p = 0.001). Conclusion: Approximately three out of five patients had one or more drug therapy problems encountered. In this study, the most common types of drug therapy problems were non-compliance, needs additional drug therapy, and dosage too low. Family monthly income, age, comorbidities, and number of medications were the significant determinants of drug therapy problems. Therefore, patient education regarding medication adherence, routine medication review, and strengthening clinical pharmacy services should be promoted.
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Awoke, Nefsu, Biftu Geda, Aseb Arba, Tiwabwork Tekalign, and Kebreab Paulos. "Nurses Practice of Hand Hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational Study." Nursing Research and Practice 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/2654947.
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Background. Nurses, who are the majority, can contaminate their hands with different types of microorganism during “clean” activities (e.g., lifting a patient; taking a patient’s pulse, blood pressure, or oral temperature; or touching a patient’s hand, shoulder, or groin). Yet good hand hygiene, the simple task of cleaning hands at the right time and in the right way, can reduce HCAIs that are transmitted by healthcare workers’ hands. Method. Observational study conducted among nurses by observational tool which was adopted from WHO observational tool. And finally compliance was calculated as a percentage (i.e., compliance% = (observed hand hygiene action (HHA) ÷ hand hygiene opportunity (O)) × 100). The data were first coded, entered, and cleaned using EpiData statistical software version 3.1 and then exported into SPSS statistical software version 22 for analysis. Data were presented using descriptive statistics. Result. A total of 110 study participants were observed who gave a response rate of 94.8%. Total of 3902 opportunities and 732 hand hygiene actions were observed with overall compliance of 18.7%. The highest 22.9% hand hygiene practice was observed “before clean∖aseptic procedure.” Highest 19.6% compliance was recorded at night shift and 22.7% in ICU ward of the hospital. Alcohol based hand rub was a major means of method used to clean hands. Conclusion and Recommendation. Observed practice of hand hygiene was poor. Lack of training, conveniently located sink, hand washing agents, and lack of time were major reasons for not practicing hand hygiene. Successful promotion of hand hygiene through instituting system change (e.g., making hand hygiene products available at the point of care) should be considered.
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Duko, Bereket, Asres Bedaso, Getinet Ayano, and Zegeye Yohannis. "Perceived Stigma and Associated Factors among Patient with Tuberculosis, Wolaita Sodo, Ethiopia: Cross-Sectional Study." Tuberculosis Research and Treatment 2019 (May 2, 2019): 1–5. http://dx.doi.org/10.1155/2019/5917537.
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Background. Tuberculosis is a historically stigmatized disease and the stigma associated with it affects the institution, community, and interpersonal factors. Therefore, understanding tuberculosis-related perceived stigma has importance in improving quality of the patients. Objective. The aim of this study was to assess prevalence and factors associated with perceived stigma among patients with tuberculosis attending Wolaita Sodo University Referral Hospital, Ethiopia. Methods. Institution based cross-sectional study was conducted among a total of 417 tuberculosis patients who had treatment follow-up at TB clinics and were recruited for the study. Systematic random sampling technique was used to recruit study participants. A 12-item perceived TB stigma scale was used to assess tuberculosis-related perceived stigma. In addition, Oslo social support scale was used to assess social support related factors. Results. Prevalence of tuberculosis-related perceived stigma by using perceived tuberculosis stigma scale was 42.4%. Patients who had pulmonary TB [AOR=2.49, (95% CI: 1.24, 4.87)], being intensive phase category [AOR=1.42, (95% CI: 1.19, 2.58)], TB/HIV coinfection [AOR= 3.54, (95% CI: 1.37, 9.12)], poor social support [AOR=2.45, (95% CI: 1.18, 5.09)], and using substance (alcohol, khat and cigarette) [AOR=1.78, (95% CI: 1.28, 3.17)] were more likely to have perceived TB stigma when compared to their counter parts. Conclusion. Health education programs should be conducted to reduce TB stigma and improve patients’ compliance.
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Abebe, Ephrem, and Michelle A. Chui. "Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach." INNOVATIONS in pharmacy 9, no. 1 (February 7, 2018): 7. http://dx.doi.org/10.24926/iip.v9i1.950.
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Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach.
Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures.
Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts.
Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors.
Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties".
Treatment of Human Subjects: IRB review/approval required and obtained
Type: Original Research
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Hussen, Feysal Mohammed, Hassen Abdi Adem, Hirbo Shore Roba, Bezatu Mengistie, and Nega Assefa. "Self-care practice and associated factors among hypertensive patients in public health facilities in Harar Town, Eastern Ethiopia: A cross-sectional study." SAGE Open Medicine 8 (January 2020): 205031212097414. http://dx.doi.org/10.1177/2050312120974145.
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Background: Self-care practice is the activity that a hypertensive patient undertakes intending to improve their health. Poor self-care practice leads to uncontrolled hypertension. Therefore, strategies designed to prevent and control hypertension-related death, disability, and morbidity should consider the level of the patient’s self-care practice and risk factors. This study assessed self-care practice and associated factors among hypertensive patients in public health facilities of Harar Town in eastern Ethiopia. Method: An institution-based cross-sectional study was conducted among 398 randomly selected hypertensive patients from 25 March 2019 to 16 April 2019. Pretested structured questionnaires adapted from validated tools were used to collect data from participants using electronic Open Data Kit software through face-to-face exit interview. Data were analyzed by SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with self-care practice. Adjusted odds ratio with 95% confidence interval was used to report association and the significance was declared at p-value < 0.05. Results: Level of good self-care practice was 29.9% (95% confidence interval: 25.3% and 34.7%). Age ⩾ 60 years (adjusted odds ratio = 3.4, 95% confidence interval: 1.2 and 9.3), formal education (adjusted odds ratio = 2.3, 95% confidence interval: 1.3 and 4.2), absence of comorbidities (adjusted odds ratio = 1.8, 95% confidence interval: 1.1 and 3.1), adequate knowledge about hypertension (adjusted odds ratio = 4.7, 95% confidence interval: 2.5 and 8.8), good social support (adjusted odds ratio = 2.7, 95% confidence interval: 1.6 and 4.7), and being khat abstainer (adjusted odds ratio = 1.9, 95% confidence interval: 1.1 and 3.5) were significantly associated with good self-care practice. Conclusion: The prevalence of good self-care practice was low. In this study, good self-care practice was significantly associated with age, formal education, comorbidities, knowledge about hypertension, social support, and current khat chewing condition. Regular check-up and follow-up of patients’ compliance with self-management protocol, and more emphasis should be given to identify factors that potentially impeding patients’ adherence to hypertension self-management protocol.
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Bekele, Firomsa, Tesfaye Tsegaye, Efrem Negash, and Ginenus Fekadu. "Magnitude and determinants of drug-related problems among patients admitted to medical wards of southwestern Ethiopian hospitals: A multicenter prospective observational study." PLOS ONE 16, no. 3 (March 16, 2021): e0248575. http://dx.doi.org/10.1371/journal.pone.0248575.
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Background Drug-related problem (DRP) is an event involving drugs that can impact the patient’s desired goal of therapy. In hospitalized patients, DRPs happen during the whole process of drug use such as during prescription, dispensing, administration, and follow-up of their treatment. Unrecognized and unresolved DRPs lead to significant drug-related morbidity and mortality. Several studies conducted in different hospitals and countries showed a high incidence of DRPs among hospitalized patients. Despite the available gaps, there were scanties of studies conducted on DRPs among patients admitted to medical wards in Ethiopia. Therefore, this study assessed the magnitude of drug-related problems and associated factors among patients admitted to the medical wards of selected Southwestern Ethiopian hospitals. Patients and methods A multicenter prospective observational study was conducted at medical wards of Mettu Karl Hospital, Bedele General Hospital and Darimu General Hospital. Adult patients greater than 18 years who were admitted to the non-intensive care unit (ICU) of medical wards and with more than 48 h of length of stay were included. Identified DRPs were recorded and classified using the pharmaceutical care network Europe foundation classification system and adverse drug reaction was assessed using the Naranjo algorithm of adverse drug reaction probability scale. Hill-Bone Compliance to High Blood Pressure Therapy Scale was used to measure medication adherence. Multivariable logistic regression was used to analyze the associations between the dependent variable and independent variables. Result Of the 313 study participants, 178 (56.9%) were males. The prevalence of actual or potential DRPs among study participants taking at least a single drug was 212 (67.7%). About 125 (36.63%) patients had one or more co-morbid disease and the average duration of hospital stay of 7.14 ± 4.731 days. A total of 331 DRPs were identified with an average 1.06 DRP per patient. The three-leading categories of DRPs were unnecessary prescription of drugs 92 (27.79%), non-adherence (17.22%) and dose too high (16.92%). The most common drugs associated with DRPs were ceftriaxone (28.37%), cimetidine (14.88%), and diclofenac (14.42%). The area of residence (AOR = 2.550, 95CI%: 1.238–5.253, p = 0.011), hospital stay more than 7 days (AOR = 9.785, 95CI%: 4.668–20.511, p≤0.001), poly pharmacy (AOR = 3.229, 95CI%: 1.433–7.278, p = 0.005) were predictors of drug-related problem in multivariable logistic regression analysis. Conclusion The magnitude of drug therapy problems among patients admitted to the medical wards of study settings was found to be high. Therefore, the clinical pharmacy services should be established in hospitals to tackle the DTPs in this area. Additionally, healthcare providers of hospitals also should create awareness for patients seeking care from health facilities of the importance of rational drug usage.
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Kedmi, Meirav, Sara Bar Cohen, Michelle Hauzi, Shlomo Maayan, and Deborah Rund. "Drug Metabolism and Disposition Genes in Israeli HIV Patients: MDR1 and CYP3A4 Polymorphisms May Affect Susceptibility to HIV but Not the Course of the Disease." Blood 106, no. 11 (November 16, 2005): 1434. http://dx.doi.org/10.1182/blood.v106.11.1434.1434.
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Abstract Background: Some studies have suggested a relationship between different alleles of the multidrug resistance gene MDR1, and the course of HIV in treated or untreated patients (pts). It is controvertial whether polymorphisms alter the susceptibility to HIV infectivity. We therefore studied the C3435T polymorphism in MDR1, which may influence HIV. The normal allele has been associated with higher MDR1 activity than the polymorphic allele (Hitzl, 2001). We also studied the A to G polymorphism in the NFSE element of the promoter of the CYP3A4 gene, which metabolizes many important drugs. Methods: 96 pts, of either Ethiopian (57) or Caucasian (39) ethnicity, and 276 controls of these ethnic groups were studied using PCR based techniques. MDR1 activity was analyzed on peripheral blood mononuclear cells of 65 pts using rhodamine extrusion. CD4 counts, clinical course and opportunistic infections were recorded at the Hadassah Hospital AIDS Center where all pts are followed. Our pts are highly compliant with medical therapy and followup. Statistical significance was determined using the Cochrane-Armitage Trends test. Results: We found that the C allele of MDR1 C3435T was highly associated with being an HIV patient (p<0.0001) as compared to controls. The reverse was true for the T allele. This association was found for all patients and also separately for each ethnic group. To analyze if this polymorphism affects the course of HIV, we compared CD4 counts in the patients of both ethnic groups according to genotypes. CD4 counts did not differ according to MDR1 C3435T genotype. Furthermore, C3435T genotypes did not affect the change in CD4 count over time in treated pts. CD4 counts rose following antiretroviral therapy in all pts. Twenty-eight of the pts were positive for HIV infection but were not yet treated. In untreated pts, the TT patients had more severe CD4 deficiency over time compared to CC pts. Our sample size is small, but this concurs with the findings of Lee who found that increased MDR1 activity correlated with decreased viral production (Lee, CG, FASEB J, 2000). Rhodamine extrusion did not vary according to MDR1 C3435T genotype. Opportunistic infections were rare and unaffected by genotype. For the CYP3A4 promoter polymorphism, we found a significantly increased probability of being infected with HIV (p<0.0001) with the presence of the C allele, both in heterozygotes and in homozygotes. There were significantly fewer T alleles among the controls as compared to HIV pts. However when analyzed by ethnic group, this association was only found to be significant for Ethiopians and not for Caucasians (Ethiopians: p< 0.0232 compared to p=0.44). There were no differences found in CD4 count, in treated or untreated patients, or in opportunistic infections according to CYP3A4 genotype. Conclusions: We conclude that for Israeli patients (Ethiopians and Caucasians), susceptibility to HIV infection may be altered according to MDR1 genotype. The C allele was highly associated with infection with HIV for both ethnic groups, as compared to normal controls. For Ethiopians, the CYP3A4 genotype may influence the predisposition to HIV infection (the C allele being associated with being a patient as compared to controls). However, the course of the disease and unsorted lymphocyte MDR1 activity were not influenced by the polymorphisms which we studied.
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Mekashaw, Ewunetie, Birhanu Demeke, and Mesfin Haile. "Recognition of symptoms, mitigating mechanisms and self-care experiences of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia." Emerald Open Research 3 (August 24, 2021): 14. http://dx.doi.org/10.35241/emeraldopenres.14312.2.
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Background: Compliance of patients with self-care practices is the mainstay of measures to manage diabetes. This study explored self-care practices of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia. Methods: The study employed an interpretive phenomenological approach using purposive sampling. The data were collected from 24 (11 males and 13 females) participants (July 2019 to January 2020) using in-depth interviews till theoretical saturation. The data were analyzed thematically and organized using QDA Miner Lite v2.0.8. Results: The findings were categorized into: labeling diabetes, self-care maintenance experiences, recognition of symptoms, and mitigating mechanisms of symptoms. The self-care maintenance practice of patients was linked with diet input preferences and the effectiveness level of insulin. What guides the self-care behavior was the patients’ preferentiality of strictly adhering to their preferred dietary inputs. Barley and wheat were the most common preferential and non-preferential inputs, respectively. The patients strictly adhered to insulin treatment because they found it effective. The most common hyperglycemia symptoms to be managed by taking an additional dose of insulin, were frequent urination, increased thirst, and their consequences (dehydration). Excessive sweating (initial), shivering (middle), and falling (final), respectively in severity, were the most common symptoms of hypoglycemia which were perceived to be treated with sweet snacks. Originality: To our knowledge, this is the first research in Ethiopia to investigate the self-care experiences of type 2 diabetes patients receiving insulin using an interpretive phenomenological approach.
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Mekashaw, Ewunetie, Birhanu Demeke, and Mesfin Haile. "Recognition of symptoms, mitigating mechanisms and self-care experiences of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia." Emerald Open Research 3 (July 28, 2021): 14. http://dx.doi.org/10.35241/emeraldopenres.14312.1.
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Background: Compliance of patients with self-care practices is the mainstay of measures to manage diabetes. This study explored self-care practices of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia. Methods: The study employed an interpretive phenomenological approach using purposive sampling. The data were collected from 24 (11 males and 13 females) participants (July 2019 to January 2020) using in-depth interviews till theoretical saturation. The data were analyzed thematically and organized using QDA Miner Lite v2.0.8. Results: The findings were categorized into: labeling diabetes, self-care maintenance experiences, recognition of symptoms, and mitigating mechanisms of symptoms. The self-care maintenance practice of patients was linked with diet input preferences and the effectiveness level of insulin. What guides the self-care behavior was the patients’ preferentiality of strictly adhering to their preferred dietary inputs. Barley and wheat were the most common preferential and non-preferential inputs, respectively. The patients strictly adhered to insulin treatment because they found it effective. The most common hyperglycemia symptoms to be managed by taking an additional dose of insulin, were frequent urination, increased thirst, and their consequences (dehydration). Excessive sweating (initial), shivering (middle), and falling (final), respectively in severity, were the most common symptoms of hypoglycemia which were perceived to be treated with sweet snacks. Originality: To our knowledge, this is the first research in Ethiopia to investigate the self-care experiences of type 2 diabetes patients receiving insulin using an interpretive phenomenological approach.
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Tariku, Mandaras, Demeke Demilew, Tolesa Fanta, Meskerem Mekonnen, and Dessie Abebaw Angaw. "Insight and Associated Factors among Patients with Schizophrenia in Mental Specialized Hospital, Ethiopia, 2018." Psychiatry Journal 2019 (November 17, 2019): 1–5. http://dx.doi.org/10.1155/2019/2453862.
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Background. Insight is the degree of the patient’s awareness and understanding of their attributions, feelings, behavior and disturbing symptoms. Majority of the patients with schizophrenia have poor insight and insight is an important prognostic indicator in schizophrenia to enhance treatment compliances and reducing the risks of clinical deterioration. The main objective of this study was to assess insight and its associated factors among patients with schizophrenia at mental specialized hospital in Ethiopia. Methods. Institutional based cross-sectional study was conducted from May to June 2018 Mental Specialized Hospital among 455 patients with schizophrenia. Insight was measured by an abridged version of Scale to assess unawareness of mental disorder. Positive and Negative Syndrome Scale, Calgary depressive scale, Oslo social support scale was used to identify factors associated with insight. Simple and multiple linear regression analysis were used to assess associated factors of insight in the participants. Results. The mean score of insight was 13.66 (95% CI 13.27, 14.04). Age at first onset of illness, duration of treatments, depressive symptoms were inversely associated with mean insight score; whereas unemployed, positive and negative syndrome, previous hospitalization, >=2 episodes were positively associated with mean insight score. Conclusion. Nearly half of the study participants were scored above the mean insight score so, the clinicians and psychotherapists should have to work together to improve insight among patients with schizophrenia.
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Weldegebreal, Asgedom Solomon, Fekadu Tezeta, Atey Tesfay Mehari, Wubetu Gashaw, Kassa Tesfaye Dessale, and Niriayo Yirga Legesse. "Assessment of drug therapy problem and associated factors among adult hypertensive patients at Ayder comprehensive specialized hospital, Northern Ethiopia." African Health Sciences 19, no. 3 (November 6, 2019): 2571–79. http://dx.doi.org/10.4314/ahs.v19i3.33.
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Background: Drug-therapy problems(DTPs) among hypertensive patients can result in patient’s morbidity and mortality. The main aim of this study was to assess drug therapy problem and associated factors among <="" span="" style="font-family: hypertensive patients.Methods: A hospital based cross sectional study was conducted. The data was collected from patients’ medical charts and through interview. Drug therapy problem was categorized according to Cipolle methods of DTP classification. Thedata was analyzed using the Statistical Package for the Social Sciences (SPSS), version 21.Results: A total of 241 patients were studied. The mean number of antihypertensive medications prescribed were 1.41±0.53. A total of 357 drug therapy problems(DTPs) were identified. From the patients studied,134(55.6%) had at least one evidence of drug therapy problem. Non adherence was the most commonly identified drug therapy problem occurred in (143(59.3%)) patients. Substance use (AOR=0.445, 95% CI= 0.227-0.870, p=0.018) and comorbidity (AOR= 2.099, 95% CI= 1.192-3.694, p=0.010) werethe predictors of DTP.Conclusion: More than half of the participants had evidence of onset drug therapy problem. Thus efforts that could boost antihypertensive compliance and minimizes substance use should be adopted to reduce patients’s drug therapy problems.Keywords: assessment, drug, therapy, problem, Ethiopia.
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Jemal, Suoud. "Knowledge and Practices of Hand Washing among Health Professionals in Dubti Referral Hospital, Dubti, Afar, Northeast Ethiopia." Advances in Preventive Medicine 2018 (November 22, 2018): 1–7. http://dx.doi.org/10.1155/2018/5290797.
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Introduction. Nosocomial infections due to poor hand hygiene are a major cause of increasing morbidity, mortality, and health care costs among hospitalized patients worldwide. Hand hygiene is mandatory to prevent the transmission of health care associated infections especially where infectious diseases are common like Sub-Saharan Africa. Hand washing compliance among health professionals in general is unacceptably low especially in developing countries like Ethiopia. Method. Institution-based cross-sectional study design was used to assess the knowledge and practice of hand washing among health professionals working in Dubti Referral Hospital. Structured self-administered pretested questionnaires were used. The data obtained were analyzed using SPSS version 23. Result. Out of 91 respondents, majority, 60 (65.9%), of them were knowledgeable and 31 (34.1%) were not knowledgeable. However, the majority of health professionals, 51 (56.0%), had poor practice and 40 (43.0%) of them had good practice of hand washing. Conclusion. Majority of health professionals were knowledgeable. However, they had poor practice of hand washing.
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Kassaw, Chalachew, Elias Tesfaye, Shimelis Girma, and Liyew Agenagnew. "Perceived Patient Satisfaction and Associated Factors among Psychiatric Patients Who Attend Their Treatment at Outpatient Psychiatry Clinic, Jimma University Medical Center, Southwest Ethiopia, Jimma, 2019." Psychiatry Journal 2020 (March 5, 2020): 1–10. http://dx.doi.org/10.1155/2020/6153234.
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Background. In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic. Methods. Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P<0.05) was used to identify the association between the outcome and independent variable. Result. 414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%–51.2%). Being male (β=−0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β=−1.250, 95% CI (-1.765, -0.735)), living in a rural area (β=−1.358, 95% CI (-1.687, -1.030)), having a diagnosis of major depressive disorder (β=1.719, 95% CI (1.332, 2.106)) and bipolar disorder (β=1.203, 95% CI (0.890, 1.516)), far in distance from the hospital (β=−3.250, 95% CI (-4.662, -2.450)), having a history of current substance use (β=−1.719, 95% CI (-2.015, -1.423)), longer in waiting time (β=−3.853, 95% CI (-4.701, -2.205)), and strong social support (β=0.456, 95% CI (0.231, 0.654)) were variables significantly associated with patient satisfaction. Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.
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Aynalem, Getasew Amogne, Tadesse Alemu Bekele, Tirhas Tadesse Berhe, and Getabalew Endazenew. "Factors affecting adherence to lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019." SAGE Open Medicine 9 (January 2021): 205031212110125. http://dx.doi.org/10.1177/20503121211012523.
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Introduction: Adherence to lifestyle modification in addition to medication adherence is very important in preventing complications. Nevertheless, lifestyle modification guidelines are not widely followed by patients with hypertension. The objective of the study was to explore the predictors of compliance with lifestyle modification among patients with hypertension at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2019. Method: A descriptive cross-sectional study design was used. A total of 384 patients with hypertension were included in this study. A systematic sampling method was used to select study participants. The data were collected through an interview method by using a structured questionnaire. The data were entered and analyzed using SPSS. Each variable was summarized using summary statistics. To measure the association between lifestyle modification and its predictors, a bivariate and multivariate logistic regression model was used. P-value < 0.05, odds ratio (OR), and 95% confidence interval (CI) were used to determine statistical significance, direction, and strength of association. Results: Two hundred six (53.6%) patients with hypertension had poor adherence to the recommended lifestyle modification. Male patients with hypertension were more adherent to lifestyle modification compared with female patients (adjusted OR (AOR) = 0.60, 95% CI: 0.39–0.92). The rate of poor adherence was 1.86 times higher among patients with hypertension diagnosis of <5 years compared with patients with hypertension diagnosis of ⩾5 years(AOR = 1.86, 95% CI: 1.19–2.89). Patients who were adherent to their medication were 2.13 times to have poor adherence to lifestyle modification compared with medication non-adherent patients (AOR = 2.13, 95% CI: 1.38–3.27). Conclusion: High proportions of patients with hypertension were non-adherent to lifestyle modification. Sex, age, duration of the disease, and medication adherence were significantly associated with lifestyle modification adherence. Close follow-up of female patients, the elderly, and patients with a short duration of hypertension is recommended.
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Kassie, Belayneh Ayanaw, Aynishet Adane, Eskeziaw Abebe Kassahun, Amare Simegn Ayele, and Aysheshim Kassahun Belew. "Poor COVID-19 Preventive Practice among Healthcare Workers in Northwest Ethiopia, 2020." Advances in Public Health 2020 (October 16, 2020): 1–7. http://dx.doi.org/10.1155/2020/7526037.
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Background. The novel coronavirus disease (COVID-19) pandemic outbreak affects the global social, economic, and political context and becomes a significant threat to healthcare providers who are among the exposed groups to acquire and transmit the disease while caring and treating patients. It is crucial to comply with prevention recommendations so as to stay safe and protected. Therefore, this study aimed to assess COVID-19 preventive practice and associated factors among healthcare workers in Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 630 healthcare workers in Northwest Ethiopia from March to April 2020. A multistage sampling technique was used to select study participants. A pretested and structured self-administered questionnaire was used to collect data. The data were entered using Epi Info 7 and analyzed using STATA 16 statistical software. Both bivariate and multivariable logistic regression analyses were employed to identify associated factors. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine independent predictors of COVID-19 preventive practice. In multivariable analysis, a variable with a P value of less than 0.05 was considered as statically significant. Result. Among 630 healthcare workers participated in the study, the overall good preventive practice towards COVID-19 was found to be 38.73% (95% CI: 34.8, 42.5). Being a male healthcare provider (AOR = 1.48; 95% CI: 1.02, 2.10), having work experience of 6–10 years (AOR = 2.22; 95% CI: 1.23, 4.00), and having poor attitude towards COVID-19 (AOR = 2.22; 95% CI: 1.03, 2.22) were found to be significantly associated with poor COVID-19 preventive practice among healthcare workers. Conclusion. Overall compliance towards COVID-19 preventive practice among healthcare workers was found to be low. Multiple education and training platforms with focus on COVID-19 preventive measures and adequate personal protective equipment and supplies should be provided for healthcare providers.
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Baye, Assefa Mulu, Andualem Ababu, Regasa Bayisa, Mahdi Abdella, Edessa Diriba, Minyechel Wale, and Muluken Nigatu Selam. "Perspectives of compounding pharmacists on alcohol-based hand sanitizer production and utilization for COVID-19 prevention in Addis Ababa, Ethiopia: A descriptive phenomenology study." PLOS ONE 16, no. 4 (April 29, 2021): e0250020. http://dx.doi.org/10.1371/journal.pone.0250020.
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Background Globally, the safety of patients and healthcare providers is at risk due to health care-associated infections (HCAIs). World Health Organization and the Centers for Disease Control and Prevention recommend using alcohol-based hand rub (ABHR) for hand hygiene in healthcare settings to prevent HCAIs. Irrational use of ABHR will have undesirable consequences including wastage of products, exposure of healthcare providers to infections and emergence of microbial resistance to the alcohol in hand sanitizers. This study aimed to explore the perspective and experiences of compounding pharmacists on production and utilization of ABHR solution for coronavirus disease in 2019 (COVID-19) prevention in public hospitals of Addis Ababa, Ethiopia. Methods A descriptive qualitative study using in-depth interview of 13 key-informants serving as compounding pharmacists in public hospitals of Addis Ababa, Ethiopia, was conducted. The study participants were identified and selected by purposive sampling. All transcribed interviews were subjected to thematic analysis and transcripts were analyzed manually. Findings The compounding pharmacists in this study had a mean age of 30.6 (±3.1) years and nine of the thirteen participants were men. Ten participants believed that the compounding practice in their respective sites followed the principles of good compounding practice. More than half of the participants did not believe that ABHR products were used rationally in health facilities. They argued that users did not have enough awareness when and how to use sanitizers. Most of the interviewees reported that compounding personnel had no formal training on ABHR solution production. Study participants suggested incentive mechanisms and reimbursements for experts involved in the compounding of ABHR solutions. Conclusion Three of the compounding pharmacists indicated that ABHR production in their setting lack compliance to good compounding practice due to inadequate compounding room, quality control tests, manpower and equipment. Despite this, most study participants preferred the in-house ABHR products than the commercially available ones. Thus, training, regular monitoring and follow-up of the hospital compounding services can further build staff confidence.
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Angaw, Dessie Abebaw, Lemma Derseh Gezie, and Berihun Assefa Dachew. "Standard precaution practice and associated factors among health professionals working in Addis Ababa government hospitals, Ethiopia: a cross-sectional study using multilevel analysis." BMJ Open 9, no. 10 (October 2019): e030784. http://dx.doi.org/10.1136/bmjopen-2019-030784.
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ObjectivesOccupational exposure to blood and body fluids is a major risk factor for the transmission of infections to health professionals in developing countries like Ethiopia. The aim of this study was to assess standard precaution practices (SPPs) and its associated factors among health professionals working at Addis Ababa government hospitals.MethodsA cross-sectional study was conducted on 772 health professionals working at eight government hospitals in Addis Ababa, 2015. The multistage sampling technique was used to select study participants. Health professionals who were directly participating in screening, diagnosis, treatment and follow-ups of patients were studied. SPPs by health professionals were determined by a self-rated response to a 30-item Likert scale. A respondent would be graded as ‘good’ compliant for the assessment if they scored at least the mean of the total score, or would be considered as poor compliant if they scored less. To take the hierarchical structure of the data into account during analysis, multilevel binary logistic regressions were used. The intraclass correlation coefficient was calculated to evaluate whether variations in score were primarily within or between hospitals.ResultOut of the participants, 50.65% had good SPPs. At the individual level, attitude, age and educational status were found to be important factors of SPPs. Controlling individual-level factors, applying regular observations (adjusted OR (AOR) 1.82; 95% CI 1.2 to 2.76), providing sufficient materials (AOR 1.53; 95% CI 1.03 to 2.28) and weak measures on reported incidences (AOR 0.49; 95% CI 0.30 to 0.8) were also hospital-level factors associated with SPPs.ConclusionSPPs in the healthcare facilities were found to be so low that both patients and health professionals were at a significant risk for infections. The finding suggests the need for optimising individual-level and hospital-level precautionary practices.
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Assefa, Nega, Abdramane Soura, Elena C. Hemler, Michelle L. Korte, Dongqing Wang, Yasir Y. Abdullahi, Bruno Lankoande, et al. "COVID-19 Knowledge, Perception, Preventive Measures, Stigma, and Mental Health Among Healthcare Workers in Three Sub-Saharan African Countries: A Phone Survey." American Journal of Tropical Medicine and Hygiene 105, no. 2 (August 11, 2021): 342–50. http://dx.doi.org/10.4269/ajtmh.20-1621.
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ABSTRACT. The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented public health crisis globally. Understanding healthcare providers’ (HCPs’) knowledge and perceptions of COVID-19 is crucial to identifying effective strategies to improve their ability to respond to the pandemic in sub-Saharan Africa. A phone-based survey of 900 HCPs in Burkina Faso, Ethiopia, and Nigeria (300 per country) was conducted to assess knowledge, perceptions, COVID-19 prevention measures, stigma, and mental health of HCPs. Modified Poisson regression models were used to evaluate predictors of knowledge, perceptions, and prevention measures; adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) were calculated. Three-fourths of the HCPs had adequate knowledge, and over half had correct perceptions of risk and high levels of self-reported prevention measures. The majority of the HCPs (73.7%) reported self-perceived social stigma. There was relatively low prevalence of depression (6.6%), anxiety (6.6%), or psychological distress (18%). Compared with doctors, being a nurse was associated with lower levels of knowledge (ARR: 0.83; 95% CI: 0.77–0.90) and was also negatively associated with having correct perceptions toward COVID-19 (AOR: 0.82; 95% CI: 0.73–0.92). HCPs treating COVID-19 patients had higher likelihood of having high levels of prevention measures (AOR: 1.37; 95% CI: 1.23–1.53). Despite high levels of knowledge among HCPs in sub-Saharan Africa, there is a need to improve COVID-19 perceptions and compliance with prevention measures as well as address social stigma toward HCPs to better ensure their safety and prepare them to deliver health services.
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Madia, A., M. Soprana, A. Mele, C. Kadhim, N. Binello, A. Lanzafame, M. S. Cori, C. Battistella, G. Azzimonti, and G. Putoto. "Type 2 Diabetes Mellitus in urban and rural districts in the area of Wolisso Hospital, Ethiopia." European Journal of Public Health 30, Supplement_5 (September 1, 2020). http://dx.doi.org/10.1093/eurpub/ckaa165.816.
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Abstract The prevalence of Diabetes Mellitus has been rapidly growing in developing countries, both in urban and rural contexts. Ethiopia has the largest diabetes population in sub-Saharan Africa (2.6 million adult people). At Wolisso Hospital, a collaboration is underway between Doctors with Africa CUAMM and the local Association of Diabetic Patients, with the aim of guaranteeing the correct monitoring and treatment of the disease. Between December 2018 and May 2019, 244 diabetic patients were visited in a dedicated outpatient room in Wolisso Hospital; in 55 selected patients (type 2 Diabetes Mellitus, ≥ 2 visits in the 6 months, on insulin therapy), a further set of variables was measured, including: modality of insulin storage, monthly glycemic measurements, compliance with prescribed therapy, glycemic control, knowledge of glycemic target. Based on their urban or rural provenience, patients were split in two groups (27 urban, 28 rural). The χ2-test was used to determine significance. P ≤ 0.05 was considered statistically significant. A statistically significant difference was reported for the following variables: availability of a fridge for insulin storage (51.9% urban vs 21.4% rural, p = 0.039), compliance with prescribed therapy (63.0% urban vs 35.7% rural, p = 0.043), prevalence of hypertension (55.6% urban vs 28.6% rural, p = 0.043), alcohol consumption (32.1% rural vs 11.1% urban, p = 0.018). 13/27 urban patients and 21/28 rural patients reported that they stored insulin in the sand. No substantial variation between the groups is observed for BMI, glycemic control, number of monthly glycemic measurements and knowledge of glycemic target. The differences highlighted between type 2 diabetic patients from urban and rural districts of the area of Wolisso suggest that these populations probably have different features and risk factors; this consideration may be useful in the organization of specific public health interventions aimed at addressing the issue in the different settings. Key messages The prevalence of Diabetes Mellitus has been rapidly growing in developing countries, both in urban and rural contexts. The differences highlighted between type 2 diabetic patients from urban and rural districts of the area of Wolisso suggest that these populations probably have different features and risk factors.
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Y, Gebre, Zemene A, Fantahun A, and Aga F. "Assessment of Treatment Compliance and Associated factors among Cervical Cancer Patients in Tikur Anbessa specialized hospital, Oncology unit, Ethiopia 2012." International Journal of Cancer Studies & Research, March 2, 2015, 67–74. http://dx.doi.org/10.19070/2167-9118-1500010.
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Getnet, Fentabil, Meaza Demissie, Alemayehu Worku, Tesfaye Gobena, Rea Tschopp, Alinoor Mohamed Farah, and Berhanu Seyoum. "Challenges in delivery of tuberculosis Services in Ethiopian Pastoralist Settings: clues for reforming service models and organizational structures." BMC Health Services Research 21, no. 1 (June 30, 2021). http://dx.doi.org/10.1186/s12913-021-06662-3.
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Abstract Background The End-TB strategy aims to see a world free of tuberculosis (TB) by the coming decade through detecting and treating all cases irrespective of socioeconomic inequalities. However, case detections and treatment outcomes have not been as they should be in Somali pastoral settings of Ethiopia. Hence, this study aimed to explore the challenges that hinder the delivery and utilization of TB services in pastoral areas. Methods A qualitative study was conducted between December 2017 and October 2018 among pastoralist patients with delay of ≥2 months in seeking healthcare, healthcare providers and programme managers. Data were collected from different sources using 41 in-depth interviews, observations of facilities and a review meeting of providers from 50 health facilities. The data were transcribed, coded and analyzed to identify pre-defined and emerging sub-themes. ATLAS.ti version 7.0 was used for coding data, categorizing codes, and visualizing networks. Results Poor knowledge of TB and its services, limited accessibility (unreachability, unavailability and unacceptability), pastoralism, and initial healthcare-seeking at informal drug vendors that provide improper medications were the key barriers hindering the uptake of TB medical services. Inadequate infrastructure, shortage of trained and enthused providers, interruptions of drugs and laboratory supplies, scarce equipment, programme management gaps, lack of tailored approach, low private engagement, and cross-border movement were the major challenges affecting the provision of TB services for pastoral communities. The root factors were limited potential healthcare coverage, lack of zonal and district TB units, mobility and drought, strategy and funding gaps, and poor development infrastructure. Conclusion In pastoral settings of Ethiopia, the major challenges of TB services are limited access, illicit medication practices, inadequate resources, structural deficits, and lack of tailored approaches. Hence, for the pastoral TB control to be successful, mobile screening and treatment modalities and engaging rural drug vendors will be instrumental in enhancing case findings and treatment compliance; whereas, service expansion and management decentralization will be essential to create responsive structures for overcoming challenges.
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Emishaw, Solomon. "Compliance with Anti-Hypertensive Treatment and Associated Factors among Hypertensive Patients on Follow-Up in Jimma University Specialized Hospital, Jimma, South West Ethiopia: A Quantitative Cross- Sectional Study." Journal of Hypertension- Open Access 03, no. 05 (2014). http://dx.doi.org/10.4172/2167-1095.1000174.
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