BackgroundDiabetes is increasing at an alarming rate throughout the world, and ~80% of diabetics live in developing countries. Similar to the rest of sub-Saharan African countries, Ethiopia is experiencing a significant burden of diabetes, with increased prevalence, complications, and mortality, as well as life threatening disabilities. Reasons for poor glycemic control among type 2 diabetes patients are complex and multivariable. Hence, this study aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients.MethodA hospital-based cross-sectional study was conducted among type 2 diabetic patients attending the diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose levels of the last three clinic visits were obtained and the mean fasting blood glucose measurement was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable P<0.05 was considered statistically significant.ResultsOut of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of patients was 43±12.4 years and 154 (67.5%) were found to not be following their general dietary program correctly. Nearly one third, 73 (32%), of patients never attended diabetic education and 52 (22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148 (64.9%), of patients had poor blood glucose control. Age 40–60 years (AOR=2.01, 95% CI=0.04–0.06, P=0.044), being illiterate (AOR=3.12, 95% CI=1.52–8.50, P=0.001), having informal education only (AOR=2.28, 95% CI=2.14–32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR=3.94, 95% CI=1.51–27.83, P=0.012), inadequate physical exercise (AOR=3.19, 95% CI=1.05–19.84, P=0.019), and smoking (AOR=4.51, 95% CI=0.00–0.50, P=0.022) were independent predictors of poor glycemic control on multivariable logistic regression analysis.ConclusionNearly two-thirds of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment, and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education, and barriers of glycemic control should be explored with further research.

ObjectiveSelf-medication is defined as use of medicines to treat self-recognized illnesses. It is widely used in Ethiopia. However, its extent of use is unknown among health professionals. This study aimed to assess prevalence and reasons of self-medication with modern medicines among health professionals. A cross-sectional study was conducted on the health professionals, working in the public health facilities. Data were collected from March to May, 2016 using semi-structured questionnaire. Data were entered and analyzed using statistical package for the social sciences. A chi square test was used as test of significance at 95% of confidence interval.ResultsA total of 154 health professionals were enrolled, with 53% were being females. The finding revealed that prevalence of self-medication with modern medicines was 67.5%. Financial constraints (32.5%) and familiarity with medicines (24%) were the major reasons of self-medication. It also showed that self-medication with modern medicines was significantly associated with marital status (χ2 = 19.57, P = 0.00). Analgesics (53%) and antibiotics (36%) were the most commonly used categories of medicines. Self-medication with modern medicines was highly practiced among health professionals. Financial constraints and familiarity with medicines were the two major reasons of practicing.

BackgroundHuman Immunodeficiency Virus (HIV) is one of the main causes of morbidity and mortality; because of this it continues to be a major global public health concern. It has believed to kill more than 34 million lives so far. Sub Saharan Africa constitutes about 70% of people living with HIV among the 37 million on the globe. This region, accounted for more than two third of the global new HIV infections and about 15 million (40%) were receiving antiretroviral therapy (ART) at the end of 2014 throught the world. ART has fundamentally changed the treatment of HIV and transformed this infection from a disease of high mortality to chronic and medically managed disease. The issues of drug induced toxicities & complexity of current highly active antiretroviral therapy (HAART) regimens has remained of great concern. The aim of this study was to determine factors leading to antiretroviral regimen changes among HIV/AIDS Patients in the study area.MethodsA facility based retrospective cross-sectional study was conducted from April 28, 2017 to May 30, 2017 in the ART clinics of east and west Wollega zone health institutions using a pre-tested data collecting form and chart review. The sample included the 243 patients whose medication had been switched.ResultsMajority 145 (59.67%) of the patients had been on ART for > 10 years duration. More than half 126(51.9%) of the patients had received tuberculosis (TB) treatment and almost three out of five patients (57.2%) had received isoniazid & cotrimoxazole prophylaxis. The most common reason for regimen change was peripheral neuropathy 146(60.1%) and the most common medication for this reason was stavudine, lamivudine and neverapine based 108(44.44%).ConclusionsThe number of patients who changed ARV drug in our resource constrained setting present a challenge to the restricted treatment choices that we currently own. Less toxic and better-tolerated HIV treatment options should be available and used more frequently.

No abstract

No abstract

Background: Tuberculosis (TB) has existed for millennia and remains a major global health problem. Although it may be assumed that in general health care workers (HCWs) know about MDR-TB and its implications, several studies from around the globe have found that HCWs do not always exhibit sufficient knowledge, positive attitudes, and acceptable practices regarding preventing and treating MDR-TB. Methods: A cross sectional study was conducted by means of self-administered semi structured questionnaires that was provided to health care workers of NRH from March 10 to April 2, 2017. Using convenient sampling technique, from 155 health professionals’ 140 individuals returned the questionnaires. The data was analyzed using SPSS version 20. Descriptive statistics was used to determine frequency and percentage. Chi-square test was used to identify the relationships between dependent and independent variables (P<0.05 and 95% CI). Results: The mean age of participants was 30.76+6.42 years. About 56.4% of the participants were males and majority of participants were Nurses (42.2%). Greater than half (59.3%) of respondents had good level of knowledge about MDR-TB and the overwhelming majority of them held positive attitude (60.7%) towards patients with MDR-TB. Overall 21%, 55%, 72.1% of respondents reported that they had their own copy of MDR-TB management guidelines, used the protective masks and were individually involved in educating patients about MDR-TB respectively. Respondents who had good knowledge about MDR-TB significantly wore their Protective masks than those with insufficient knowledge which was statistically significant (P=0.01). Based on the assessed level of knowledge, respondents with good level of knowledge reported they referred to the manual more than those with insufficient level (30.1% versus 19.3%, P=0.172). Conclusion: The finding indicates that the level of knowledge about MDR-TB did not influence the attitude and practices of respondents towards patients suffering from MDR-TB. Contrary to this good knowledge was positively associated with safer practices such as using protective masks, educating patients, and referring to the MDRTB guidelines manual. This situation needs to be remedied by making the guidelines available to all healthcare workers in Ethiopia.

Background: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics’ lives in developing countries. Similar to the rest of sub Saharan African countries, Ethiopia is experiencing significant burden of diabetes with increased prevalence, complications and mortality as well as life threatening disabilities. Reasons for poor glycemic control in type 2 diabetes are complex and multivariable. Hence, this study was aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. Method: A hospital based cross sectional study was conducted on type 2 diabetic patients attending diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose of last three clinic visits were obtained and the mean fasting blood glucose measurements was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable with P< 0.05 was considered statistically significant. Result: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of participants was 43±12.4 years and 154(67.5%) were found not following their general dietary program correctly. Nearly one third, 73(32%) of participants never attended diabetic education and 52(22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148(64.9%) of patients had poor blood glucose control. Age range of 40-60 years (AOR=2.01, 95% CI 0.04-0.06, P=0.044), being illiterate (AOR = 3.12, 95 % CI 1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI 2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR = 3.94, 95 % CI 1.51-27.83, P=0.012), inadequate physical exercise (AOR = 3.19, 95 % CI 1.05-19.84, P=0.019), smoking (AOR = 4.51, 95 % CI 0.00-0.50, p=0.022) were independent predictors of poor glycemic control up on a multivariable logistic regression analysis. Conclusion: Nearly two third of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education as well as barriers of glycemic control should be explored with further research.

No abstract