ObjectivePharmacists monitor diabetic patients more often than any other healthcare providers. It is important that they have appropriate counseling practice on diabetes mellitus management. The aim of this study is to assess the counseling practice of community pharmacists for diabetes mellitus patients in Addis Ababa, Ethiopia.ResultsAmong 300 community pharmacy professionals, 58.3% were male. Nearly half of the community pharmacy professionals delivered appropriate counselling service on the appropriate time to administer each oral anti-diabetic drug and missed oral dose. Only 15.3% of the community pharmacy professionals gave proper counselling on the importance of continuous screening for nephropathy, retinopathy, and neuropathy.
Purpose Rubbing the hands with alcohol-based handrub (ABHR) is globally recommended as the preferred approach to prevent healthcare-associated infections in most routine encounters with patients, except in cases handwashing with soap and water is advised. Inappropriate utilization of ABHR could have detrimental effects, most importantly during the coronavirus disease (COVID-19) pandemic, which include exposure of healthcare professionals to healthcare-associated infections and the development of resistant microorganisms. In a hospital setting, the utilization of ABHR among frontline healthcare workers including pharmacy professionals is low. Therefore, the purpose of this study was to explore the current practice of hand rubbing among pharmacy professionals in public hospitals of Addis Ababa during the pandemic of COVID-19. Methods The study was a cross-sectional study using a self-reported questionnaire conducted among pharmacy professionals in public hospitals found in Addis Ababa from 10th May to 9th June, 2020 to recognize ABHR utilization rate. Data were collected on a sample of 384 pharmacy professional by a self-administered questionnaire. Data analysis was done using software for the statistical package for social science version 25.0. To identify the significant predictors of ABHR utilization practice bivariable and multivariable logistic regressions were carried out. Crude odds ratio and adjusted odds ratio with 95% confidence interval were calculated to determine the predictors. Results Out of 384 participants, three hundred and four participants were included in the final analyses after the exclusion of incomplete responses. Female participants represented 41.4% of the study participants. More than half (58.9%) of the pharmacy professionals had sufficient knowledge on ABHR utilization for COVID-19 prevention. Similarly, 56.6% of pharmacy professionals had positive attitude towards ABHR for COVID-19 prevention. But only 35.9% of the study participants had good ABHR utilization practice. Conclusion Despite the modest level of knowledge and attitude towards ABHR, pharmacy professionals’ utilization practice of ABHR for COVID-19 prevention was found to be suboptimal. Provision of ABHR solutions through hospitals and increasing the awareness of pharmacy professionals on ABHR needs to be encouraged.
Background The use of herbal medicine is common among HIV/AIDS patients due to chronic nature of the disease. However, the data are scarce on the extent of herbal medicine use and associated factors among HIV/AIDS patients while on antiretroviral therapy (ART) in Ethiopia. Purpose To assess the extent of herbal medicine use and associated factors among people living with HIV/AIDS on ART in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods A cross-sectional study design was conducted from February to June 2019. Patients were interviewed face to face using a structured questionnaire. Binary analysis using a chi-square test was used to determine the independent association of herbal medicine use to demographic and clinical characteristics, and multivariate analysis using binary logistic regression was done to identify predictability of herbal medicine use adjusted for other factors. Results A total of 318 participants were included in this study of which 26.1% of patients have used herbal medicines while on ART. The common herbal medicines used by participants were garlic ( Allium stadium ) 37.35% and Damakase ( Ocimum lumiifolium ) 22.9%. Most participants (60%) used herbal medicine for the treatment of opportunistic infections. The independent predictors for herbal medicine use were female gender (P=0.04; AOR 1.99, 95% CI 1.02–3.88), age above 60 (P=0.046; AOR 2.79, 95% CI 1.02–7.65), history of experiencing OIs (p=0.02; AOR 2.02, 95% CI 1.12–3.65) and developing side effects from ART (p=0.001; AOR 2.80, 95% CI 1.55–5.10). Conclusion A considerable proportion of HIV/AIDS patients used herbal medicine concomitantly with ART at TASH, Ethiopia. The determinant factors for use of herbal medicine were female gender, age above 60, experiencing OIs and developing side effects from ART.
Introduction: Malaria is one of the infectious diseases with substantial risks for pregnant women, the fetus and the newborn child. Thus, prevention and treatment of malaria with safe and effective drugs is of paramount importance. Pregnant women are mostly excluded from clinical trials, and systematic approaches of pharmacovigilance in pregnancy are limited. This means the safety and efficacy of antimalarial agents during pregnancy are unclear. Purpose: This study was designed to carry out a systematic review and aggregate data metaanalysis of literature published on efficacy and safety of artemisinin-based combination therapy (ACT) for uncomplicated malaria in pregnant women. Methods: A search of literature published between 1998 to 2020 on efficacy and safety of artemisinin-based combination therapy (ACT) in pregnant women was made using Cochrane Library, Medline and the Malaria in Pregnancy Consortium Library. Data were extracted independently by two reviewers, and any discrepancies were resolved by consensus. Metaanalysis was carried out using Open Meta-Analyst software. Random effects model was applied, and the heterogeneity of studies was evaluated using Higgins I 2 . Results: Twenty-four studies that fulfilled the inclusion criteria were included in the final assessment. Overall, days 28 to 63 malaria treatment success rate was 96.1%. Overall days 28 to 63 cure rates for AL, AS+AQ, AS+MQ, DHA+PQ, AS+ATQ+PG and AS+SP were 95.1%, 92.2%, 97.0%,94.3%, 96.5% and 97.4%, respectively. Comparison of ACTs with non-ACTs revealed that the risk of treatment failure was substantially lower in patients treated with ACTs than with non-ACTs (risk ratio 0.20, 95% C.I. 0.09-0.43). The overall prevalences of miscarriage, stillbirth and congenital anomalies were 0.3%, 2.1% and 1.0%, respectively, and found to be comparable among various ACTs. There was comparable tolerability across ACTs during pregnancy. Conclusion: ACTs demonstrated a high cure rate, safety and tolerability against Plasmodium falciparum infection in pregnant women. The higher treatment success and comparable tolerability could be used as an input for decision makers to support the continued usage of ACTs for treatment of uncomplicated falciparum malaria in pregnant women.
Background: According to the World Health Organization (WHO), alcohol-based hand rubs (ABHRs) are regarded as the "gold standard" for hand disinfection in healthcare facilities. Local production of ABHRs in health facilities is recommended by WHO due to its availability and affordability reasons. However, fire hazard is a concern in health facilities during ABHRs production, storage, or use from dispensers. Objective: To evaluate the preparedness of public hospitals found in Addis Ababa, Ethiopia towards potential fire hazards during ABHR production and storage practices. Methods: A cross-sectional observational study was applied. An assessment checklist was used for evaluating public hospitals' measures taken for the potential fire hazards during ABHR production and storage practice. Statistical Package for Social Sciences (SPSS) version 23 was used for data entry and analysis. Results: Out of the 13 public hospitals observed in the study, fire extinguishers were not available in more than half of the hospitals' (7 hospitals) compounding premises. Also, 57.1% of the hospitals without fire extinguishers were manufacturing beyond the WHO 50 liters limit of ABHR solution at once under such unfavorable conditions. Moreover, ethanol and the oxidizing agent hydrogen peroxide were not stored separately in eight hospitals. Conclusion: None of the hospitals were found to be well prepared for the potential risk of fire associated with ABHR solution production and storage practice. Generally, the practices taken by the studied hospitals for preventing the fire risk and minimizing the damage if fire hazards occurred during ABHR production and storage were not satisfactory. On the safety and precautions measures taken for the risk of fire, Tikur Anbessa Specialized Hospital (TASH), Amanuel Mental Specialized Hospital (AMSH), and Eka Kotebe General Hospital (EKGH) showed a relatively better preparedness compared to others. ABHR solutions should be manufactured and stored in a way that limits the risk of ignition and follows standard fire safety measures.
Background: Skin diseases are among the major contributors of disease burden in Ethiopia affecting individuals of all age. Extemporaneous compounding of topical medications serves as a necessary option to treat skin diseases when manufactured medications could not meet specific patient needs. Different classes of drugs are commonly used for the treatment of dermatologic diseases. Failure to periodically assess the prescribing pattern and patient needs may lead to inappropriate planning and implementation that ultimately compromise the service. Periodic prescription analysis for compounded medications helps to monitor the prescription pattern with respect to medication selection, disease condition, dosage form types and other relevant parameters. The current study was conducted to analyze the pattern of compounding prescriptions for dermatologicals in ALERT hospital. Methods: A cross-sectional design was conducted by retrospectively evaluating compounding prescription records of January and July, 2021. A total of 460 prescriptions in the hospital community pharmacy were systematically selected. Data related to disease pattern, product selection and dosage form type were extracted and analyzed. Data analysis was done using software for the statistical package for social science version 25.0. Results: A total of 441 prescriptions containing dermatological products for compounding were analyzed. Most patients were female (62.8%) and aged 30-64 years (44.0%). Psoriasis (36.2%), acne vulgaris (15.3%), and rosacea (13.4%) were the top 3 skin diseases for which the compounding preparations were prescribed. Salicylic acid (38.0%) was the most frequently prescribed drug followed by betamethasone (20.2%); while white petrolatum (47.2%) was the most common diluting agent used for compounding. Conclusion: Psoriasis was the major dermatologic disease for compounding prescriptions and salicylic acid was the most frequent product used in compounding for treatment of the prescribed skin diseases.
Background: Adverse drug reactions (ADR) are a major clinical problem accounting for significant hospital admission rates, morbidity, mortality, and health care costs. One-third of people with diabetes experience at least one ADR. However, there is notable interindividual heterogeneity resulting in patient harm and unnecessary medical costs. Genomics is at the forefront of research to understand interindividual variability, and there are many genotype-drug response associations in diabetes with inconsistent findings. Here, we conducted a systematic review to comprehensively examine and synthesize the effect of genetic polymorphisms on the incidence of ADRs of oral glucose-lowering drugs in people with type 2 diabetes.Methods: A literature search was made to identify articles that included specific results of research on genetic polymorphism and adverse effects associated with oral glucose-lowering drugs. The electronic search was carried out on 3rd October 2020, through Cochrane Library, PubMed, and Web of Science using keywords and MeSH terms.Result: Eighteen articles consisting of 10, 383 subjects were included in this review. Carriers of reduced-function alleles of organic cation transporter 1 (OCT 1, encoded by SLC22A1) or reduced expression alleles of plasma membrane monoamine transporter (PMAT, encoded by SLC29A4) or serotonin transporter (SERT, encoded by SLC6A4) were associated with increased incidence of metformin-related gastrointestinal (GI) adverse effects. These effects were shown to exacerbate by concomitant treatment with gut transporter inhibiting drugs. The CYP2C9 alleles, *2 (rs1799853C>T) and *3 (rs1057910A>C) that are predictive of low enzyme activity were more common in subjects who experienced hypoglycemia after treatment with sulfonylureas. However, there was no significant association between sulfonylurea-related hypoglycemia and genetic variants in the ATP-binding cassette transporter sub-family C member 8 (ABCC8)/Potassium Inwardly Rectifying Channel Subfamily J Member 11 (KCNJ11). Compared to the wild type, the low enzyme activity C allele at CYP2C8*3 (rs1057910A>C) was associated with less weight gain whereas the C allele at rs6123045 in the NFATC2 gene was significantly associated with edema from rosiglitazone treatment.Conclusion: In spite of limited studies investigating genetics and ADR in diabetes, some convincing results are emerging. Genetic variants in genes encoding drug transporters and metabolizing enzymes are implicated in metformin-related GI adverse effects, and sulfonylurea-induced hypoglycemia, respectively. Further studies to investigate newer antidiabetic drugs such as DPP-4i, GLP-1RA, and SGLT2i are warranted. In addition, pharmacogenetic studies that account for race and ethnic differences are required.
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