Background. Diabetes mellitus is a major chronic illness in Africa that requires lifelong lifestyle interventions and pharmacological therapy. Lifestyle change is the most important aspect of diabetes care and includes diabetes self-management education and support, medical nutrition therapy, physical activity, smoking cessation counseling, and psychosocial care. Purpose. The purpose of this project was to review published articles that investigate lifestyle and dietary pattern interventions for diabetes prevention and management in Africa. Barriers to lifestyle interventions and strategies to overcome the barriers are also reviewed in this study. Methods. The article search was conducted in an electronic database search of PubMed, Google Scholar, and Cochrane Library. Studies were included if they were published between 2011 and 2019, if they were conducted in an African country, and were written in the English language. Results. Articles reviewed included several that examined the basic lifestyle and dietary pattern changes for all patients diagnosed with type 2 diabetes, on self-care behavior of type 2 diabetes patients, on the cost of diabetes in Africa, and on barriers for adherence to lifestyle and dietary changes in Africa, with strategies to address those barriers. Conclusion. Lifestyle interventions including regular physical exercise, weight management, and adherence to health care professionals’ recommendations on a healthy diet are the cornerstone in the prevention and management of diabetes in Africa. The main barriers to adherence were both systemic (population changes, poor access, western cultural influences, and low-quality healthcare) and personal (poverty and cost, educational status, and perceptions about the disease) in nature. The strategies for the barriers include health education programs, advocacy, and capacity building.
ObjectivesTo assess the prevalence of antenatal depression and factors associated with antenatal depression among pregnant women in Aneded woreda, Northwest Ethiopia, 2019. A community based- cross sectional study was conducted in Aneded woreda among 7 kebles’ of North-West, Ethiopia from March 16 to April 23, 2019. A total of 342 pregnant women were recruited using simple random sampling.ResultThe prevalence of antenatal depression was 15.20%. Urban residence [AOR = 6.8; 95% CI (1.97, 23.32)], marital status of being unmarried [AOR = 5.1; 95% CI (1.79, 14.63)], occupation of being government employee [AOR = 8.8; 95% CI (2.06, 37.12)] and merchant [AOR = 3.7; 95% CI (1.27, 10.91)], prim gravid [AOR = 5.3; 95% CI (2.03, 13.82)], not attend ANC follow up [AOR = 8.7; 95% CI (3.46, 21.79)], intimate partner violence [AOR = 4.5; 95% CI (1.28, 15.52)], unplanned pregnancy [AOR = 6.2; 95% CI (2.37, 16.06)], and substance use [AOR = 5.6; 95% CI (2.12, 14.92)] were significantly factors. Strengthen the risk prevention activities so important to tackle the problem of antenatal depression.
Background Depression is a major public health problem among cancer patients undergoing chemotherapy. It compromises patient outcomes, resulting in higher rates of mortality. Currently, there are little data on the prevalence of depression in Sub-Sharan countries. Therefore, the current study was done to assess the prevalence of depression among adult cancer patients and its associated factors in Ethiopia. Method An institutional based cross-sectional study was conducted among 420 adult cancer patients from 1st March to April 30, 2021. Systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9. The collected data were coded and entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis. Bivariate binary logistic regression was performed to select factors that will be included in multivariate analysis, and variables with a p-value < 0.05 were included in multivariate analysis. In multivariate analysis, odds ratios and their 95% confidence intervals were computed and variables with p-value < 0.05 were considered to declare a significant association. Results In this study, the prevalence of depression was 33.1% (95% CI = 0.2858, 0.3761). Minimal symptoms of depression, minor depression, moderate depression, moderate severe depression, and severe depression were found to be 272 (64.8%), 9 (2.1%), 104 (24.8%), 28 (6.7%), and 7 (1.7%), respectively. Those cancer patients who had unemployed status, sacked from jobs, and had stage IV cancer were most likely to develop depression, whereas patients who completed primary education, colon, prostate and cervical cancer were less likely to have depression. Conclusion Depression is found to be a major public health concern for adult cancer patients in Ethiopia. To reduce the occurrence of depression among cancer patients, special attention is needed.
Background Dyslipidemia represents significant health care concerns in patients taking antiretroviral therapy due to their association with cardiovascular disease risk. There is limited data regarding the effects of boosted atazanavir (ATV/r) treatment in the lipid profiles of Ethiopian HIV patients. Thus, this study compares the mean values of lipid profile differences of HIV patients on ATV/r-based regimen compared to efavirenz (EFV)-based regimen, while the background is Tenofovir Disoproxil Fumarate/lamivudine. Materials and Methods A comparative hospital-based cross-sectional study was conducted among adult HIV-infected patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia, from July–September 2017. An equal number of EFV and ATV/r-treated patients (n=90 each) receiving for 1-year and over were included in the study. Serum total cholesterol (TC), triglyceride (TG), gigh-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Data comparison used chi-square test, Student’s t -test and Mann–Whitney U -test. Multivariate logistic regression analysis and p -value<0.05 were used to identify associated factors of serum lipid profiles. Results In the present study, the ATV/r-treated group results were significantly higher in the median values of TG [207 (56–1094) vs 145 (42–768) mg/dL; p =0.001] and the mean value of TG/HDL-c (6.6 vs 4.4; p =0.001) as compared to the EFV-treated group. The EFV-treated group showed significantly higher in the mean value of HDL-c (44.7 vs 38.7 mg/dL; p =0.001) as compared to the ATV/r-treated group. Body mass index was associate with LDL and HDL. CD4 was associated with TC. Current antiretroviral therapy was associated with TG. Duration of HIV since first diagnosis and duration of ART were associated with HDL. Conclusion ATV/r is associated with elevated in TG and TG/HDL-C, but low HDL as compared to EFV. Differences in LDL or HDL that were found were of unclear clinical significance. The long-term significance is unknown.
Background Globally, type 2 diabetes has become increasing. As little is known about the effect of educational intervention on this population, this systematic review and meta-analysis evaluated the effectiveness of mobile phone text message reminders versus usual care to improve medication adherence among type 2 diabetes mellitus patients. Methods PubMed, Google Scholar, Cochrane Library, Scopus, and African Journals Online, were searched. A random-effects model was employed to estimate combined effect sizes. Subgroup analyses were employed to investigate possible sources of heterogeneity between studies. The overall certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results A total of 9 trials with 1,121 participants were included in the review. The pooled estimated impact of mobile phone text message reminders on medication adherence was (SMD: 0.36; 95%CI; 0.14, 0.59) compared to usual care groups among patients with type 2 diabetes mellitus. In addition, subgroup analyses revealed greater medication adherence levels in those studies with intervention durations of more than six months and with self-report/refill adherence scale measurement (SMD: 0.21; 95%CI: 0.02, 0.40) and (SMD: 0.45; 95%CI: 0.22, 0.68), respectively. Conclusion Mobile phone text messages can potentially lead to improved medication adherence levels in patients with Type 2 diabetes despite heterogeneity across the studies. Therefore, mobile phone text messaging when delivered in addition to usual care, have the potential to produce significant improvements in medication adherence.
Background: Dyslipidemia represent significant health care concerns in Human immune deficiency virus (HIV) infected patients taking highly active antiretroviral therapy due to their association with cardiovascular disease risk. There is limited data regarding the effects of boosted atazanavir (ATV/r) treatment in the lipid profiles of Ethiopian HIV patients. Thus, this study compares the lipid profile changes of HIV patients on ATV/r-based regimen compared to efavirenz (EFV)-based regimen, while the background nucleos/tide backbone is optimized.Materials and methods: A comparative Hospital based cross-sectional study was conducted among adult HIV-infected patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia, from July-September 2017. Equal number of EFV and ATV/r-treated patients (n = 90 each) taking for one year and above were included in the study. Serum lipid parameters (triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C)) were measured using fully automated mind ray, Chemistry analyzer. Data comparison used chi-square test, Student t-test and Mann-Whitney U test. Multivariate regression analysis and p-value<0.05 was used to identify associated factors of serum lipid profiles.Results: In the present study ATV/r-treated group resulted significantly higher in the median values of TG [207 (56-1094) vs. 145(42-768) mg/dL; p=0.001] and the mean value of TG/HDL-C ratio (6.6 vs. 4.4; p=0.001) as compared to EFV-treated group. EFV-treated group showed significantly higher in the mean value of HDL-C (44.7 vs. 38.7mg/dL; p= 0.001) as compared to ATV/r-treated group. No significant difference was found in TC (p=0.5), LDL-C (p=0.6), TC/HDL-C (p=0.5) and LDL-C/HDL-C (p=0.1) between EFV and ATV/r-treated patients. In ATV/r-treated patients, CD4 count and body mass index (BMI) was significantly associated with TC. In EFV-treated patients, BMI was significantly associated with increased serum LDL-C and TC in female participants.Conclusion: In conclusion, ATV/r raises TG and TG/HDL-C while, HDL-C was higher in EFV than ATV/r-treated group. Both groups have less atherogenic lipid profiles in terms of TC/HDL-C and LDL/HDL-C.
Background: Utilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. Results: Utilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age [AOR= 3.67; 95% CI; 1.36-9.95], knowledge[AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN. Conclusion: This study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age , knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which increase utilization of LLITN. Key words : LLITN utilization, pregnant women, malarious kebeles, Awable, Ethiopia
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