Background The annual number of surgical operations performed is increasing throughout the world. With this rise in the number of surgeries performed, so too, the challenge of effectively managing postoperative pain. In Africa, there are scanty data available that make use of multi-center data to characterize the quality of postoperative pain management. In this study using a longitudinal data, we have attempted to characterize the quality of postoperative pain management; among patients scheduled for major elective orthopedic, gynecologic and general surgery. Methods This prospective longitudinal study evaluated the quality of postoperative pain management in patients undergoing elective general, gynecologic, and orthopedic surgery. We quantified the prevalence of moderate to severe postoperative pain with the International Pain Outcome Questionnaire and the corresponding adequacy of treatment with the pain management index. At four time points after surgery, we estimated pain severity, its physical and emotional interference, and patient satisfaction. Results Moderate to severe postoperative pain was present in 88.2% of patients, and pain was inadequately treated in 58.4% of these patients. Chronic pain (β = 0.346, 95% CI: 0.212, 0.480) predicted patients’ worst pain intensity. Gender was not associated with the worst pain intensity or percentage of time spent in severe pain. Patient’s pain intensity did not predicted the level of satisfaction. Conclusions The prevalence of moderate to severe postoperative pain and its functional interference is high in Ethiopian patients. The treatment provided to patients is inadequate and not in line with international recommendations and standards.

BackgroundPostoperative pain remains a challenge in the developed world, but the consequences of inadequately treated postoperative pain are particularly severe in low- and middle-income countries. Since 2011, reports have drawn attention to the poor quality of postoperative pain management in Ethiopia; however, our multicenter qualitative study was the first to attempt to understand the factors that are barriers to and facilitators of quality pain managment in the country. To this aim, the study explored the perspectives of patients, healthcare professionals, and hospital officials. We expected that the results of this study would inform strategies to improve the provision of quality pain management in Ethiopia and perhaps even in other low- and middle-income countries.MethodsThis study used a qualitative, descriptive approach in which nine healthcare professionals, nine patients, and six hospital officials (i.e. executives in a managerial or leadership position in administration, nursing, or education) participated in face-to-face, semi-structured interviews. Thematic data analysis was conducted, and patterns were explained with the help of a theoretical framework.FindingsThe barriers identified ranged from healthcare professionals’ lack of empathy to a positive social appraisal of patients’ ability to cope with pain. They also included a lack of emphasis on pain and its management during early medical education, together with the absence of available resources. Enhancing the ability of healthcare professionals to create favorable rapport with patients and increasing the cultural competence of professionals are essential ingredients of future pain education interventions.ConclusionsBarriers to and facilitators of postoperative pain management do not exist independently but are reciprocally linked. This finding calls for holistic and inclusive interventions targeting healthcare professionals, patients, and hospital officials. The current situation is unlikely to improve if only healthcare professionals are educated about pain physiology, pharmacology, and management. Patients should also be educated, and the hospital environment should be modified to provide high-quality postoperative pain management.

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IntroductionExcellence in anesthesia education has been advocated to meet the current and future needs of society. Universities play a key role in creating a conducive climate for learning and facilitating the development of expected competencies among graduates. This study assessed students’ learning approaches and their relationship with their academic achievement at two selected public universities in Ethiopia.Materials and methodsA cross-sectional study was conducted on 123 anesthesia students. All 3rd- and 4th-year students were recruited for the study. Study Skills Inventory for Students (ASSIST) was used to assess students’ learning approaches. Perceived performance, cumulative grade point average (cGPA), and 100 MCQ items were used to assess academic achievement. Data were entered into Epi-data and exported to SPSS for statistical analysis. An independent t-test was used to determine the presence of a difference in academic achievement across learning approaches. Bivariate and multivariable linear regressions were fitted to assess the association of students’ characteristics and learning approaches with their academic achievement. A P-value of less than 0.05 was used to declare the statistical significance.ResultThere were no statistically significant differences between the groups on most of the learning approaches and academic achievement measures. In multivariable linear regression, university entrance exam results, students’ perception of the definition of learning, and a deep approach to learning were found to be the predictors of students’ academic achievement (β = 0.004 and P = 0.03, β = 0.14 and P = 0.015, and β = 0.13 and P = 0.023), respectively.ConclusionIn this study, students mainly follow deep approaches to learning, and there were no statistically significant differences between the groups on most of the learning approach measures and academic achievements. Entrance exam results, positive perception of the definition of learning, and a deep approach to learning were found to be positive predictors of academic achievement. Emphasis has to be given to improving students’ learning approaches for better academic achievement and success.

Background Excellence in Anesthesia education has been advocated to meet the current and future needs of the society. Educational environment plays significant role in determining students’ learning and academic achievement. This study assessed the perception of Anesthesia students on their educational environment and it association with their academic achievement at Debre Tabor University and University of Gondar. Methods A comparative cross-sectional study design was employed on 3rd and 4th year students. Dundee Ready Educational Environment Measure (DREEM) was used to assess students’ perception on their educational environment. Perceived performance, Cumulative Grade Point Average (CGPA) and 100 MCQ items were used to assess the academic achievement of the students. An independent t-test was used to assess the differences in the perception of educational environment and academic achievements. Bivariate and multivariable linear regressions were fitted to assess the relationship between perception on educational environment and academic achievement. A P-value of less than 0.05 was used to declare the statistical significance. Result A total of 123 students (91 from University of Gondar and 32 from Debre Tabor University) were participated on this study. The study showed no statistically significant differences between the groups on the perception of students on the educational environment on DREEM total and subscale scores, and academic achievements. However, there were statistically significant differences in some items of the educational environment measures. On multivariable linear regression; entrance exam result, students’ perception of teachers, students’ academic self –perception and students’ social self-perception showed positive correlation with students’ academic achievement (ß = 0.003 & P = 0.04, ß = 0.009 & P = 0.9, ß = 0.06 & P = 0.42, ß = 0.06 & P = 0.39, ß = 0.14 & P = 0.015 and ß = 0.13 & P = 0.023) respectively. Conclusion The perception of students on the educational environment was found to be more positive and there was no statistically significant differences in total and domains of DREEM scores and academic achievement of students between the two institutions. Entrance exam result and more positive perception of the educational environment were positively associated with academic achievement of students.

Background. In resource-constrained countries, accurate diagnosis of Helicobacter pylori infection remains a challenge. This study aimed to assess the clinical utility of locally available serological and stool antigen test kits in the management of people with suspected H. pylori infection in Ethiopia. Methods. A community-based cross-sectional study was conducted with apparently healthy adults and children living in southwest Ethiopia. Participants were interviewed for dyspepsia symptoms and related clinical conditions. H. pylori infection was examined using commercially available serological and stool antigen tests. The association between H. pylori tests and dyspepsia symptoms was analyzed using logistic regression models. Results. Out of 1392 participants included in the final analysis, 49.1% and 6.5% tested positive for H. pylori infection with serology and stool antigen test kits, respectively. Participants reporting epigastric symptoms in the past three months (AOR = 1.93, 95% CI = 1.28–2.91) and those with recent dyspepsia treatment (AOR = 1.51, 95% CI = 1.05–2.18) were likely to have positive serology test. However, no association between dyspepsia symptoms and H. pylori stool antigen positivity was observed in our study. Conclusion. ccurate detection of H. pylori infections using commercially accessible diagnostics remains difficult in Ethiopia. With these methods, it will be hard to ensure adequate diagnosis and early treatment of H. pylori infection, as well as rational antibiotic use.

The pain status of hospitalized pediatric patients in Ethiopia remains unstudied. This hospital based prospective survey assessed 162 children for pain before, at and after admission using previously validated age specific pain assessment tools. Sociodemographic, clinical and treatment profile of patients were abstracted from charts and interview. The aim was to describe the prevalence, severity, documentation and treatment of pain at Jimma University Hospital during April 1 to May 25, 2013. At admission moderate to severe pain prevalence was 90.1% at admission. Analgesics were prescribed for 44 of the children only, while 2 received combination of paracetamol and Tramadol. Only 11.1% of the patients were brought within the first 24 hrs of the onset of pain. There were no any pre-procedure (pre-emptive) analgesics given to all infants and children. Despite this, pain was assessed and documented for 47.5% of the children. The prevalence of pain in pediatrics was quite high and was under assessed, undertreated and undocumented. A further research might explore the impact of the gaps observed at the level of assessment, documentation and treatment of pain.

Background The annual number of surgical operations performed is increasing throughout the world. With this rise in the number of surgeries performed, so too, the challenge of effectively managing postoperative pain. Healthcare professionals and patients in education might help in controlling postoperative pain effectively. However, data from low-income countries investigating the impact of educational intervention on postoperative pain are very scanty, and reports from the developed settings are inconclusive. The study has investigated the impact of preoperative patient education and health care professionals education on improving the quality of postoperative pain management; in patients scheduled for major elective orthopedic, gynecologic and general surgery; as measured by patient-reported outcomes. Methods This was a quasi-experimental, non-equivalent control group design with before and after measures. We have recruited 700 consecutive patients; who are eighteen years or more, scheduled for general, orthopedic and gynecologic surgery. Outcome measures were patient-reported outcomes (postoperative pain intensity, pain interference, and perception of care) and adequacy of pain management used. Results Generally, no significant difference was observed in most outcome measures except for the worst level of pain, least level of pain, patient participation in decision making and feeling of drowsiness between the treatment and control group. Conclusion Results of this study contained very important information in understanding the effectiveness of educational interventions in the postoperative setting. The treatment was successful in increasing patients participation in decision making, as anticipated. However, its impact on decreasing pain intensity was only noted at the last measurement point after surgery.