Background Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria. Methods Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping. Results The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13–17%, I2 = 77.94%, p < 0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38–45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18–26%), Staphylococcus aureus, 15% (95% CI 12–18%), Staphylococcus saprophytic, 12% (95% CI 6–18%) Proteus mirabilis, 7% (95% CI 4–10%), Enterococcus species, 6% (0–12%), Pseudomonas aeruginosa, 4% (2–6%), Citrobacter species, 4% (95% CI 2–4%), Group B streptococcus, 3% (1–5%), and Enterobacter species, 2% (1–4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76–91%), 78% (95% CI 66–90%), 89% (95% CI 83–96%), and 78% (95% CI 67–88%), respectively. Conclusion The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.

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Background Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia. Methods A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value < 0.05 was considered statistically significant. Results Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline-directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI). Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in-hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients. Conclusion In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.

Purpose: Despite the increasing burden of metabolic syndrome (MS) and ischemic heart disease in sub-Saharan Africa, data on the prevalence of MS among patients with acute coronary syndrome (ACS) from the regions are limited. Hence, this study is aimed to evaluate the prevalence and impact of MS on 30-day all-cause mortality in patients hospitalized with ACS. Patients and Methods: We prospectively assessed 176 ACS patients, who were admitted to two tertiary hospitals in Ethiopia. MS was diagnosed based on a harmonized definition of MS. In-hospital major adverse cardiovascular events (MACE) and 30-day mortality were recorded. Multivariable cox-regression was used to identify predictors of 30-day mortality. Results: Among 176 ACS patients enrolled, 62 (35.2%) had MS. Majority of the patients (62.5%) were male with the mean age of 56±11.9 years. ACS patients with MS were older, presented with atypical symptoms, and they had history of hypertension, diabetes, dyslipidemia and coronary artery disease compared to those without MS. MS was also significantly associated with in-hospital MACE (30.6% vs 17.5%; p= 0.046) and 30-day mortality [adjusted hazard ratio (AHR) = 3.25, 95% CI=1.72-6.15]. The other significant predictors of 30-day mortality were pre-hospital delay >12h (HR= 4.32, 95% CI=1.68-11.100), killip class ≥2 (HR=10.7, 95% CI= 2.54-44.95), and ejection fraction <40 (HR= 2.59 95% CI=1.39-4.84). Conclusion:The prevalence of MS among patients with ACS in Ethiopia is high. MS was significantly associated with high in-hospital MACE and it was an independent predictor of 30-day mortality. Initiating appropriate strategies on MS prevention and timely diagnosis of MS components could decrease the burden of ACS and improve patient's outcome.

Background Drug-related problems are associated with high mortality, complications, prolonged hospital stay, compromised quality of life, and increased healthcare costs. This problem is high in patients hospitalized with chronic conditions such as heart failure. However, there are limited studies conducted on this area, particularly in Ethiopia. Objective To evaluate drug-related problems, their predictors, and clinical pharmacist intervention among hospitalized heart failure patients at Jimma Medical Center, Ethiopia. Methods and participants A prospective interventional study was conducted among hospitalized heart failure patients from September 30, 2020, to May 28, 2021, at Jimma Medical Center. Drug-related problems were sorted based on the Pharmaceutical Care Network Europe drug classification tool version 9.0. Patient's specific data were collected using a structured questionnaire. Data was analyzed using statistical software package version 23.0. Multivariate logistic regression analysis was used to identify independent predictors of drug-related problems occurrence and statistical significance was considered at a p value < 0.05. Results A total of 237 heart failure patients were included in this study. The mean (SD) age was 49.06 + 17.79. About two-thirds (66.2%) of study patients had at least one drug-related problem during their hospital stay. A total of 283 drug-related problems were identified among 157 patients. Treatment effectiveness-related problem (55.48%) was the most common observed drug-related problem. The independent predictors of drug-related problems were khat chewing [AOR = 3.25, 95% CI = (1.46–7.23)], hospital stay > 18 days [AOR = 3.77, 95% CI = (1.93–7.37)]; presence of comorbid condition [AOR = 2.59, 95% CI = (1.35–4.96)] and polypharmacy [AOR = 2.94, 95% CI = (1.54–5.61)]. Conclusion The prevalence of drug-related problems was high among hospitalized heart failure patients in the study area. Chewing khat, prolonged hospital stay, comorbidity, and polypharmacy were the predictors of drug-related problems. Hence, to overcome these problems, clinical pharmacists, physicians, and other health professionals have to work in collaboration.

Objective Incidence and clinical outcomes of medication prescribing errors are common and potentially more harmful in the pediatric population than in the adult population. Hence, this study was aimed to assess the prevalence and types of medication prescribing errors in the pediatric wards of Nekemte Referral Hospital (NRH). Results Of 384 pediatric patients included in the study, 241 (63%) were males and 116 (30.21%) of them were aged between 1–3 years. About 241 (62.76%) of the patients were treated based on empirical diagnosis and only 10 (2.60%) pediatrics had co-morbid disease. The most category of medication prescribing error was dosing error 251 (48.6%) followed by incorrect drug selection 98 (19.0%). Being critically ill (AOR = 5.31, 95% CI = 1.80–12.31, p = 0.003), route of administration via IV (AOR = 3.98, 95% CI = 1.85–11.15, p = 0.011) and via IV + IM route (AOR = 2.22, 95% CI = 1.05–9.25, p = 0.045) as well as 4–6 medications per patient (AOR = 3.10, 95% CI = 3.43–12.42, p = 0.012) and > 6 medications per patient (AOR = 7.23, 95% CI = 3.91–21.45, p < 0.001) were independent predictors of medication prescribing errors. Antibiotics were the most common classes of drugs responsible for prescribing errors.

Background Heart failure is a global pandemic, as it affects approximately 64.34 million people worldwide with a $346.17 billion global economic burden. The prevalence of heart failure has increased from 43.4 to 46.5% in the last 10 years in lower and middle-income countries. Most of the studies conducted in Ethiopia were retrospective cross-sectional, with limited study participants, and conducted in a single setting that commonly addresses the prevalence and pattern of heart failure rather than clinical outcome, associated factors, and specific management in different areas. Hence, this study aimed to assess management, clinical outcomes and their predictors among heart failure patients admitted to tertiary care hospitals in Ethiopia. Methods A prospective observational study design was conducted on heart failure patients admitted at two tertiary care hospitals in Ethiopia from September 2020 to May 2021. Using semi-structured questionnaires relevant data were collected from patients’ medical records and face-to-face interviewing. Data were analyzed using SPSS version 23.0. A multivariate Cox regression model was performed to identify independent predictors of 90-day all-cause mortality. Variables with P values < 0.05 were considered statistically significant. Results Out of 283 patients enrolled in this study, 52.3% were male and the mean (± SD) age was 52.4 ± 17.9 years. The most common medications prescribed during hospitalization and discharge were diuretics (98.9% vs 95.6%), angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (48.8% vs 67.3%), and beta-blockers (46.6% vs 64.7%), respectively. In the present study, the 90-day all-cause mortality was 10.2%. Hypertension (HR = 3.7, 95% CI 1.2–11.6), cardiogenic shock (HR = 8.7, 95% CI 3.2–20.8), alcohol drinking (HR = 2.8, 95% CI 1.1–7.8), absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers (HR = 0.02, 95% CI 0.0–0.2), and reduced ejection fraction (HR = 1.5, 95% CI 1.1–3.8) were predictors of 90-day all-cause mortality. Conclusion High 90-day all-cause mortality was observed among heart failure patients in the present study. In the current study, the majority of heart failure patients were treated with diuretics. Alcohol drinking, hypertension, cardiogenic shock, reduced ejection fraction, and absence of angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs were predictors of poor treatment outcomes for whom restriction of alcohol consumption, early management of hypertension, reduced ejection fraction, cardiogenic shock, and providing angiotensin I converting enzyme inhibitors/angiotensin II receptor blockers drugs for all heart failure patients would be recommended to improve these poor treatment outcomes.

Background: Despite the fact that the burden, risk factors, and clinical characteristics of acute coronary syndrome (ACS) have been studied widely in developed countries, limited data are available from sub-Saharan Africa. Therefore, this study aimed at evaluating the clinical characteristics, treatment, and 30-day mortality of patients with ACS admitted to tertiary hospitals in Ethiopia.Methods: A total of 181 ACS patients admitted to tertiary care hospitals in Ethiopia were enrolled from March 15 to November 15, 2018. The clinical characteristics, management, and 30-day mortality were evaluated by ACS subtype. The Cox proportional hazards model was used to determine the predictors of 30-day all-cause mortality. A p-value &lt; 0.05 was considered statistically significant.Results: The majority (61%) of ACS patients were admitted with ST-segment elevation myocardial infarction (STEMI). The mean age was 56 years, with male predominance (62.4%). More than two-thirds (67.4%) of patients presented to hospital after 12 h of symptom onset. Dyslipidemia (48%) and hypertension (44%) were the most common risk factors identified. In-hospital dual antiplatelet and statin use was high (&gt;90%), followed by beta-blockers (81%) and angiotensin-converting enzyme inhibitors (ACEIs; 72%). Late reperfusion with percutaneous coronary intervention (PCI) was done for only 13 (7.2%), and none of the patients received early reperfusion therapy. The 30-day all-cause mortality rate was 25.4%. On multivariate Cox proportional hazards model analysis, older age [hazard ratio (HR) = 1.03, 95% CI = 1.003–1.057], systolic blood pressure (HR = 0.99, 95% CI = 0.975–1.000), serum creatinine (HR = 1.32, 95% CI = 1.056–1.643), Killip class &gt; II (HR = 4.62, 95% CI = 2.502–8.523), ejection fraction &lt;40% (HR = 2.75, 95% CI = 1.463–5.162), and STEMI (HR = 2.72, 95% CI = 1.006–4.261) were independent predictors of 30-day mortality.Conclusions: The 30-day all-cause mortality rate was unacceptably high, which implies an urgent need to establish a nationwide program to reduce pre-hospital delay, promoting the use of guideline-directed medications, and increasing access to reperfusion therapy.