ObjectiveUncontrolled asthma negatively impacts patients, families, and the community. The level of symptom control among asthmatics in Ethiopia has not been well studied. We investigated the level of asthma control and risk factors for poor asthma control in clinic patients seen in the largest public hospital in Ethiopia.ResultsIn this cross-sectional study, we studied all 182 consecutive subjects with a physician diagnosis of asthma who were seen in chest clinic at Tikur Anbessa Specialized Hospital between July and December 2015. Of the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years and the median duration of asthma was 20 ± 12.7 years. One hundred and seventeen subjects (64.3%) had nighttime awakening due to asthma. Fifty-eight (31%) were not using controller medications and 62 (34.6%) had improper inhaler technique. Only 44 (24.2%) subjects had well-controlled asthma. On multivariate analysis, variables associated with uncontrolled asthma included: use of biomass fuel for cooking, longer duration of asthma (> 30 year), incorrect inhalation technique, and asthma exacerbation in the last 12 months. Most asthmatics attending in the largest public hospital in Ethiopia, had uncontrolled asthma. Several risk factors for poor asthma control were identified. Improved asthma control is possible through directed interventions.
Globally, non-communicable diseases (NCDs) are increasing in people living with HIV (PLHIV). Pulmonary hypertension (PH) is a rare NCD in PLHIV with a reported prevalence of < 1%. However, data on PH in PLHIV from Africa are scarce and are non-existent from Ethiopia. This study aimed to examine the prevalence and severity of echocardiographic PH and risk factors associated with PH in PLHIV in Ethiopia. A total of 315 consecutive adult PLHIV followed at the Tikur Anbessa Specialized Hospital HIV Referral Clinic were enrolled from June 2018 to February 2019. Those with established PH of known causes were excluded. A structured questionnaire was used to collect data on demographics, respiratory symptoms, physical findings, physician-diagnosed lung disease, and possible risk factors. PH was defined by a tricuspid regurgitant (TR) velocity of â¥2.9m/sec on transthoracic echocardiography. A TR velocity ⥠3.5, which translates into a PAP/RVSP of ⥠50mmHg, was considered moderate to severe PH. The mean age of the participants was 44.5+9.8 years and 229 (72.7%) were females. PH was diagnosed in 44 (14.0%) of participants, of whom 9 (20.5%) had moderate to severe disease. In those with PH, 17 (38.6%) were symptomatic: exertional dyspnea, cough, and leg swelling were seen in 12 (27.3%), 9 (20.5%) and 4 (9.1%), respectively. There was no significant difference in those with PH compared to those without the disease by gender, cigarette smoking, previous history of pulmonary TB treatment, physician-diagnosed COPD or bronchial asthma, duration of ART therapy or anti-retroviral regimen type. PH looks to be a frequent complication in PLHIV in Ethiopia and is often associated with significant cardiopulmonary symptoms. Further studies using right heart catheterization are needed to better determine the etiology and prevalence of PH in PLHIV in Ethiopia compared to other countries.
Many African countries have extremely low ratios of physicians to population, and there are very, very few specialists. This leaves most patients without access to specialised care, and importantly also leaves many countries with insufficient expertise to properly evaluate the burden of illness and the needs of the population overall. The challenges to training a specialised physician workforce in resource-limited settings are many, and they go far beyond the (relatively simple) task of transmission of clinical skills. We initiated a capacity-building programme to train pulmonary physicians in Ethiopia, a country of 105 million persons with a high burden of lung disease that had no prior existing training programme in pulmonary medicine. Using volunteer faculty from the USA and Europe, we have provided high-quality training and established a cohort of pulmonary specialists there. We have identified several components of training that go beyond clinical skills development but which we feel are crucial to sustainability. These components include the delineation of viable career pathways that allow professional growth for subspecialist physicians and that support the permanent establishment of a local faculty; the development of important non-clinical skills, including leadership and pedagogical techniques; training in clinical research methodologies; and the development of mechanisms to amplify the impact of a still relatively small number of specialised physicians to address the needs of the population generally. Our programme, the East African Training Initiative, has successfully addressed many of these challenges and we hope that it can be replicated elsewhere.
Background: Voluntary testing and counseling (VCT) is the process by which an individual undergoes confidential counseling, to enable the individual arrive at an informed choice with respect of learning his or her HIV status and advice on taking the appropriate action. It is vitally important and one of the national strategy to control HIV/AIDS epidemics in the general population and is internationally acknowledged as essential strategy for HIV prevention and entry point to HIV/ AIDS care. HIV/AIDS is a disease which affects the human immune system caused by infection with human immune deficiency virus. According to Ministry of Health, in Ethiopia the highest prevalence of HIV is seen in the age group 15-24 years. Objective: This study aimed to assess knowledge, attitude and practice towards HIV voluntary testing and counseling among undergraduate at the Wachemo University, southern Ethiopia. Methods: Institutional based cross-sectional study design was conducted at Wachemo University from February 10 to February 30/2018.Multistage sampling method was used to enroll students from different faculties. Main outcome measures included level of knowledge, attitude and practice of VCT for HIV. Results: A total of 623 students participated in the study yields the response rate of 100%. The majority, (91.2%) of respondents were heard about voluntary counseling and testing of HIV. More than half, (63.0%) of the students disagreed that voluntary counseling and testing of HIV service in the campus is not functional and not giving service appropriately. The majorities, (93.4%) of the study participants were knowledgeable about voluntary testing and counseling of HIV; and 491 (78.8%) of the study participants had positive attitude towards voluntary testing and counseling of HIV. However, only one thirds (36.7%) of the respondents had practiced voluntary testing and counseling of HIV. Conclusion: Despite high knowledge and favorable attitude towards VCT, more than half of the respondents (63.3%) don’t experienced HIV test, for the following reason: Fear of positive result (32.4%), stigmatization (15.9%), while (30.7%) being sure of not having HIV.
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