BackgroundIn spite of the availability and accessibility of HIV testing opportunities and efforts, people are being late to test in the course of HIV infection. Late diagnosis leads to late anti-retroviral therapy initiation which in turn results in poor treatment outcome and prognosis of the disease. The aim of this study was to determine the prevalence and predictors of late HIV diagnosis among HIV-infected patients in South Tigray Zone, Ethiopia.MethodsA facility based cross sectional study was conducted among HIV positive patients from February 1-30, 2014 in Southern Tigray, Ethiopia. Multistage sampling technique was employed to select the study participants. Data were collected by reviewing patient medical card and interviewing using structured questionnaire. Data were entered using Epi-Data version 3.1 and analyzed using SPSS version 20.0. Both bivariate and multivariate logistic regressions were modeled to evaluate the association of predictors with late diagnosis of HIV infection.ResultsOut of 789 study participants, 68.8 % of them were late for HIV diagnosis. Feeling healthy (65.7 %), fear of stigma and discrimination (32.4 %) and using traditional treatment (1.5 %) were reported as the main reasons for late HIV diagnosis. Use of Khat [AOR = 3.27, 95 % CI (1.75, 6.13)], bed ridden functional status [AOR = 2.66, 95 % CI (1.60, 4.42)], ambulatory functional status [AOR = 1.56, 95 % CI (1.03, 2.35)] and Muslim religion [AOR = 2.26, 95 % CI (1.13, 4.49)] were significantly associated with late presentation for HIV diagnosis.ConclusionsHigh prevalence of late HIV diagnosis was recorded in Southern Tigray Zone, Ethiopia. Public health educations and campaigns targeted at improving early diagnosis and prognosis of people living with HIV/AIDS in Southern Tigray, Northern Ethiopia should be underway.
Introduction. Irrational prescribing is a major cause for irrational drug use. Bad prescribing habits lead to ineffective and unsafe treatment, exacerbation or prolongation of illness, distress and harm to the patient, and higher costs. Incidence of irrational prescribing practice cannot be reduced without a critical intervention by assessing the causes. Objectives. The objective of this study was to assess drug prescription pattern, using WHO prescribing indicators, in OPD at Mekelle General Hospital (MGH) Methodology. The study was conducted at Mekelle General Hospital (MGH), Mekelle, Northern Ethiopia, from December 2016 to April 2017. A descriptive cross-sectional, retrospective hospital-based study design was used to assess prescriptions at OPD in MGH from 01 January to 31 December 2016. A systematic random sampling technique was used to select prescriptions at the time of data collection. Result. 384 prescriptions were analyzed. 751 medications were prescribed from which 679 (90.4%) were with their generic name, 225 (58.6%) prescriptions contained antibiotics, 162 (42.2%) prescriptions were encountered with injection, and 648 (86.3%) encountered from the hospital list of medicine. Conclusion. In general, average number of drugs per encounter, generic prescribing, and the use of EDL/formulary of the hospital to prescribe drugs reviewed in this study were totally out of the recommended values and hence inappropriate. The study also revealed overprescribing of both antibiotics and injections.
Introduction. Irrational medicine use is a global problem, and one of its manifestation is inappropriate prescribing that occurs when medicines are not prescribed in accordance with the guideline. Objective. The aim of the study was to assess prescription completeness and drug use pattern of the hospital using the WHO core drug use indicators. Methods. 1000 prescriptions were collected retrospectively from prescriptions written for 1 year from outpatient pharmacies of the hospital. Exit interview was employed to assess patient care indicators. The health facility indicators were checked by assessing the presence of drug formulary and availability of key medicines at the facility. Data were analyzed using SPSS version 20. Results. It was found that only name of the patients was filled in all the prescriptions. Other informations were below the standard. The average number of drugs per prescription was 1.65. Percentages of encounter by generic name, with antibiotic and injections, were 85.78%, 41%, and 25%, respectively. The percentage of drugs prescribed from an essential drug list was 98.48%. The mean consultation time and dispensing time were 14.49 and 2.16 minutes, respectively. More than half patients had knowledge on drug dispensed to them (68%). The percentage of drugs actually dispensed was 65%, but none of the drugs dispensed were adequately labelled. A copy of EDL and 84% of the key drugs were available in the hospital. Conclusion. From the results of our study, it can be concluded that all prescriptions were not complete, and except the average number of drugs prescribed per encounter, the other drug use pattern indicators were out of the WHO recommendation. Therefore, effective intervention program, like training, for promotion of rational drug use practice was recommended.
Ensete ventricosum (Welw.) cheeseman which belongs to the family of Musaceae is one of the main sources of starch in Ethiopia. This study aimed at evaluating epichlorohydrin cross-linked enset starch as a drug release sustaining excipient in microsphere formulations of theophylline. Extracted enset starch was cross-linked using epichlorohydrin as a cross-linking agent. The effect of cross-linker concentration, cross-linking duration, and cross-linking temperature on the degree of cross-linking and release rate of microspheres prepared by emulsion solvent evaporation method was investigated using the two-level full factorial design. Accordingly, the concentration of epichlorohydrin and duration of cross-linking were the most significant factors affecting both the degree of cross-linking and drug release rate. Thus, the effects of these two factors were further studied and optimized using the central composite design. As per the numerical method of central composite design, the optimal points were obtained at epichlorohydrin concentration of 13.70% and cross-linking time of 3.82 h. Under these optimal conditions, the model predicts the degree of cross-linking of 74.70% and drug release rate of 28.00 h1/2. The validity of these optimal points was confirmed experimentally. The microspheres of the optimum formulation also exhibited minimum burst release with sustained release for 12 h. Besides, the optimized formulation followed the Higuchi square root kinetic model with non-Fickian diffusion release mechanism. The finding of this study suggested that cross-linked enset starch can be used as an alternative drug-release-sustaining pharmaceutical excipient in microsphere formulation.
Introduction Drug information center (DIC), in most cases, is part and parcel of pharmacy service established as a unit that deals with offering recent, balanced, truthful facts about drugs to the public, patients, and health care professionals. Objective To assess the query receiving and response trends by the drug information centers (DICs) found in main university affiliated teaching health care institutes in Ethiopia. Settings The drug information centers located in Mekelle, Gondar, Jimma, Tikur Anbessa Specialized University Hospitals, and St. Peter Public Hospital, Ethiopia. Methods It employed analytical, descriptive (cross-sectional), and retrospective methods. The study was performed from June to August, 2015. All the available documented data were gathered with the help of checklist and questionnaire (self-administered). Results A total of 439 queries submitted to the DICs during their active service period were included in this study of which 407 were found to be suitable for this assessment. The highest inquiries had come from public hospitals (60 %) from health care workers (95.1 %), out of which pharmacists were the highest (63.57 %) submitters, followed by health care students (12.7 %). The major purposes of query submission were to improve treatment outcome of patients (33.9 %) and then to update the knowledge (25.1 %) although 39.3 % of the queries did not document it. The most common requests concern drug interaction (19.7 %) followed by therapeutic use (17.8 %) and the major pharmacological group is about antimicrobials (23.3 %) followed by antihypertensives (11.4 %). Web sites (31.4 %) were the most highly used references followed by Micromedex (19.0 %). Conclusion The assessment of the DICs had shown that it is feasible to establish and develop DIC services in a developing country setting, Ethiopia. The study found that most of the common queries deal with drug interaction, therapeutic use, and general product information (most commonly about antimicrobials).
The faba bean is among the major grain legumes cultivated in Ethiopia and is used extensively as a break crop in the highlands. Although a blanket application of DAP (diammonium phosphate) at the rate of 100 kg · ha−1 has been practised in faba bean production in the country, this was not based on research results. In addition, little information is available on the response of the crop to N and P fertilizers under diverse environmental conditions. Hence, field experiments were carried out at three locations in 1991, seven locations during 1992 and 1993 and at one location in both 1993 and 1995 to determine faba bean response to N and P fertilization. Five levels of N (0, 9, 18, 27 and 36 kg N · ha−1 as urea) in factorial combinations with four levels of P (0, 23, 46 and 69 kg P2O5 · ha−1 as TSP [triple super phosphate]) were studied in a randomized complete block design with four replications in the first year. In the remaining years four levels of N (0, 18, 27 and 36 kg N · ha−1 as urea) in factorial combinations with four levels of P (0, 23, 46 and 92 kg P2O5 · ha−1 as TSP) were used in a randomized complete block design with three and four replications at one and seven locations, respectively. Results indicated that a positive linear response of faba bean seed yield was noted at all locations (except Debre Zeit and Burkitu) to P fertilization, while a significant quadratic response was also found at Holetta. In addition, plant height, above ground biomass and number of pods per plant were positively influenced by P application while the effect of N on these was mostly nonsignificant. Faba bean seed yield response to N was noted at only two out of eight locations; in most cases, nonsignificant and inconsistent seed yield responses to N fertilization were obtained. There was nonsignificant N × P rate interaction. In conclusion, we do not recommend supplemental N application to faba bean at six out of eight locations but we recommend the application of P fertilizer to faba bean at almost all locations (with the exception of Debre Zeit) and for other soils deficient in available P. Further work is recommended on the determination of critical levels for soil‐available P, below which P fertilization should be practised for optimum faba bean seed yield.
Introduction Orally disintegrating tablet (ODT) is a dosage form that overcomes the problem of swallowing which is prevalent in about 35% of the general population. Co-trimoxazole (CTX) is given for patients with HIV for the prophylaxis of opportunistic infection (OI), commonly for pneumocystis carinii pneumonia. It was reported that CTX was associated with a 25–46% reduction in mortality among individuals infected with HIV in sub-Saharan Africa. Esophageal candidiasis which usually comes along with HIV/AIDS is one of AIDS defining illness affecting up to 1 in 5 of people with AIDS. This opportunistic illness is manifested by painful or difficulty of swallowing. In this respect, CTX ODT offer the advantages of both liquid dosage forms in terms of easy swallowing thereby improve patient compliance and solid dosage forms in terms of dose uniformity, stability, lower production, and transportation costs. The objective of this study was to formulate, characterize and optimize CTX ODT which could overcome swallowing problem and improve patient compliance. Co-trimoxazole ODTs were prepared by direct compression technique using a semi synthetic super disintegrant (crospovidone) along with other excipients. Two taste masking techniques were employed, addition of sweetening agent, and solid dispersion by using a pH sensitive polymer, Eudragit E-100 at different ratios (1:1, 1:2 and 1:3). Taste masking was determined by comparing taste threshold value and in vitro drug release. Preliminary study was used to investigate the effect of crospovidone, compression force (CF) and Hydroxypropyl cellulose (HPC) on disintegration time, friability and wetting time (WT). Factorial design was used as it enables simultaneous evaluation of formulation variables and their interaction effect. From the preliminary study, the factors that were found significant were further optimized using central composite design. Design-Expert 8.0.7.1 software was employed to carry out the experimental design. The bitterness threshold concentration of Trimethoprim was found to be 150 μg/ml and the in vitro drug release of the three batches of drug to polymer ratio (F1:1, 1:2 and 1:3) was 2.80±0.05, 2.77±0.00 and 2.63±0.00 respectively. From the optimization study, the optimal concentration for the superdisintegrant was 8.60% w/w and a CF of 11.25 KN which gave a rapid disintegration and WT of 13.79 and 23.19 seconds respectively and a friability of 0.666%. Conclusion In this study, co-trimoxazole ODT was formulated successfully. Central composite design was effectively used to model and optimize friability, DT and WT. The method was found effective for estimating the effect of independent variables on the dependent variables by using polynomial equation and surface plots. Optimization of the response variables was possible by using both numerical and graphical optimization and the predicted optimal conditions were confirmed experimentally and were found to be in good agreement within 5% of the predicted responses. The results of the study showed that CTX ODT had significantly rapid disintegration, less than 1% friability and enhanced dissolution profiles. The successful formulation of CTX ODT can solve difficulty of swallowing of conventional tablets for some group of patients which are unable to swallow solid oral dosage form.
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