SummaryBackgroundEfforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment.MethodsWe measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.FindingsThe global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level...

Background There is an alarming rise of chronic kidney disease prevalence globally associated with significant morbidity and mortality necessitating special attention as one of the major growing public health problems. Medication-related problems are common in hospitalized patients including chronic kidney disease and may lead to increase hospital stay and health care cost and augment the risk of morbidity and mortality. Objective To determine prevalence of medication-related problems and associated factors among chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Methods A hospital-based prospective observational study was conducted among 103 chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, and laboratory results were collected through review of patients' medical charts. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 21.0. Univariate and multivariate logistic regression was utilized to assess the associations between dependent and independent variables. Statistical significance was considered at p value <0.05. Results Out of 103 chronic kidney disease patients, 81 (78.6%) of patients had MDRs, on average 1.94 ± 0.873 per patient. The rate of overall MRPs was 30.95 per 100 medication orders. The most common MRPs among CKD patients were need additional drug therapy (62 (31%)), nonadherence (40 (20%)), and dose too low (36 (18%)). The most common cause of need additional drug therapy (52 (26%)) was untreated medical conditions; nonadherence (19 (9.5%)) was mostly due to that the patient/caregiver forgets to take/give the medication, and dose too low (29 (14.5%)) was mostly due to that the dose is too low to produce the desired response. Polypharmacy (AOR = 4.695, 95% CI: 1.370–16.091), number of comorbidities (AOR = 3.616, 95% CI: 1.015–1.8741), and stage of CKD (AOR = 3.941, 95% CI: 1.221–12.715) were independent predictors for MRPs. Conclusions We have demonstrated that medication-related problems are high among chronic kidney disease patients. Marital statuses, stage of CKD, polypharmacy, and comorbidity were independent predictors for MRPs. Interdisciplinary health professionals should work to decrease the high prevalence of MRPs among chronic kidney disease patients.

Background. There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as one of the major public health problems. The burden of CKD disproportionately impacts low-income countries like Ethiopia where hypertension and diabetes mellitus, the two most important risk factors for CKD growth rate, are greatest. Objective. The aim of this study is to assess patient awareness, prevalence, and risk factors of chronic kidney disease among hypertensive and diabetes mellitus patients. Methods. Hospital based cross-sectional study design was conducted at Jimma University Medical Center among adult (≥18 years) hypertensive and diabetes mellitus patients. Informed written consent was obtained from each participant and data was collected by interview and chart review; blood and urine samples were collected for CKD screening. Glomerular filtration rate (GFR) was estimated from serum creatinine using CKD epidemiology collaboration (CKD-EPI) equation, and CKD was defined using estimated GFR (e-GFR) and albuminuria. Multivariate logistic regression was used to identify independent predictors of CKD and p-value <0.05 considered statistically significant. Result. Mean (±SD=standard deviation) age of participants was 54.81 ± 12.45 years and 110 (52.9%) of them were male. Only 59 (28.4%) of the participants had awareness about CKD and its risk factors. The prevalence of CKD was 26% (95% CI; 20.3%-31.8%). Factors associated with chronic kidney disease were uncontrolled blood pressure (adjusted odds ratio (AOR)=2.22,95% CI=1.01-4.76), fasting blood sugar ≥ 150 mg/dl, (AOR=3.70,95% CI=1.75-7.69), angiotensin converting enzyme inhibitors (ACEIs) nonusers, (AOR=4.35 ,95% CI=1.96-10.0), poor knowledge of CKD (AOR=3.69, 95% CI=1.48-9.20), and long duration of hypertension (AOR=4.55, 95%CI=1.72-11.11). Conclusion. Our study found out low level of patient awareness and high prevalence of CKD. The predictors of CKD were uncontrolled blood pressure, fasting blood sugar> 150 mg/dl, long duration of hypertension, ACEIs nonusers, and poor knowledge about CKD.

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Background The lack of organ donors has become a limiting factor for the development of organ transplantation programs. Many countries are currently facing a severe shortage of organs for transplantation. Medical students, as future doctors can engage in the role of promoting organ donation by creating awareness and motivating the community to donate their organs besides their voluntary organ donation. The aim of this study is to assess the knowledge, attitude and willingness of undergraduate medical students’ towards organ donation at Jimma University. Methods A cross-sectional study was conducted among 320 medical students from year I to internship using questionnaire in order to assess their knowledge, attitude and willingness regarding organ donation. Data collected was entered using epidata and analyzed using Statistical Package for Social Sciences (SPSS) software version 20. Results Mean (±SD = standard deviation) age of participants was 23.48 ± 17.025 years. 57.8% of the study subjects were male. There was a statistically significant interaction effect between gender and year of study on the combined knowledge questions (dependent variables) F(25,062) = 1.755,P = 0.014, Wilk’s Λ = .033. Variables which were related to a positive attitude towards organ donation were: being of the male sex (Odds Ratio = 1.156); having awareness about organ donation (Odds Ratio = 2.602); not having a belief on the importance of burying intact body (Odds Ratio = 5.434); willingness to donate blood (Odds Ratio = 4.813); and willingness to donate organ (Odds Ratio = 19.424). Conclusion High level of knowledge but low level of positive attitude and willingness was noticed among the study participants toward organ donation.