Diabetes in Ethiopia: A systematic review of prevalence, risk factors, complications, and cost

Bishu, Kinfe G.; Jenkins, Carolyn; Yebyo, Henock; Atsbha, Merhawit; Woldearegay, Tewolde Wubayehu; Gebregziabher, Mulugeta

doi:10.1016/j.obmed.2019.100132

Cited by 76 publications

(91 citation statements)

References 39 publications

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“…The possible explanations for the observed association in the current study might be due to high prevalence of underlying diseases and the immune-suppressive effects of these diseases. In Ethiopia, a meta-analysis of studies showed high burden (6.5%) of diabetes mellitus [ 51 ]. Besides, another meta-analysis in other setting (North America, Europe, Latin America, and the Caribbean) reported immune-suppression as risk factor for HCAI [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

et al. 2020

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Background Healthcare-associated infection is a global threat in healthcare which increases the emergence of multiple drug-resistant microbial infections. Hence, continuous surveillance data is required before or after patient discharge from health institutions though such data is scarce in developing countries. Similarly, ongoing infection surveillance data are not available in Ethiopia. However, various primary studies conducted in the country showed different magnitude and determinants of healthcare-associated infection from 1983 to 2017. Therefore, this systematic review and meta-analysis aimed to estimate the national pooled prevalence and determinants of healthcare-associated infection in Ethiopia. Methods We searched PubMed, Science Direct, Google Scholar, and grey literature deposited at Addis Ababa University online repository. The quality of studies was checked using Joanna Brigg’s Institute quality assessment scale. Then, the funnel plot and Egger’s regression test were used to assess publication bias. The pooled prevalence of healthcare-associated infection was estimated using a weighted-inverse random-effects model meta-analysis. Finally, the subgroup analysis was done to resolve the cause of statistical heterogeneity. Results A total of 19 studies that satisfy the quality assessment criteria were considered in the final meta-analysis. The pooled prevalence of healthcare-associated infection in Ethiopia as estimated from 18 studies was 16.96% (95% CI: 14.10%-19.82%). In the subgroup analysis, the highest prevalence of healthcare-associated infection was in the intensive care unit 25.8% (95% CI: 3.55%-40.06%) followed by pediatrics ward 24.16% (95% CI: 12.76%-35.57%), surgical ward 23.78% (95% CI: 18.87%-29.69%) and obstetrics ward 22.25% (95% CI: 19.71%-24.80%). The pooled effect of two or more studies in this meta-analysis also showed that patients who had surgical procedures (AOR = 3.37; 95% CI: 1.85–4.89) and underlying non-communicable disease (AOR = 2.81; 95% CI: 1.39–4.22) were at increased risk of healthcare-associated infection. Conclusions The nationwide prevalence of healthcare-associated infection has remained a problem of public health importance in Ethiopia. The highest prevalence was observed in intensive care units followed by the pediatric ward, surgical ward and obstetrics ward. Thus, policymakers and program officers should give due emphasis on healthcare-associated infection preventive strategies at all levels. Essentially, the existing infection prevention and control practices in Ethiopia should be strengthened with special emphasis for patients admitted to intensive care units. Moreover, patients who had surgical procedures and underlying non-communicable diseases should be given more due attention.

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Section: Discussionmentioning

confidence: 99%

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

et al. 2020

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“…1 A systematic review indicates the prevalence of diabetes in Ethiopia ranged from 2.0% to 6.5% with a low of 2% in smaller rural areas. 3 Diabetes mellitus is associated with bladder dysfunction, glycosuria, and low immunity, all of which predispose an individual to urinary tract infection (UTI). The risk of developing UTI in diabetic patients is higher compared to non-diabetics.…”

Section: Introductionmentioning

confidence: 99%

<p>Bacterial Profiles and Their Associated Factors of Urinary Tract Infection and Detection of Extended Spectrum Beta-Lactamase Producing Gram-Negative Uropathogens Among Patients with Diabetes Mellitus at Dessie Referral Hospital, Northeastern Ethiopia</p>

Alemu¹,

Belete²,

Gebre-Selassie³

et al. 2020

DMSO

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Purpose: To determine the bacterial profile with its associated risk factors and to identify extended spectrum beta-lactamase producing Gram-negative bacterial uropathogens among diabetic patients at Dessie Referral Hospital, Northeastern Ethiopia. Materials and Methods: A hospital-based cross-sectional study was conducted from May to September 2018. A total of 336 diabetic patients were included using a simple random sampling technique. A structured questionnaire was used to collect socio-demographic and risk factor-related data. A 10-mL mid-stream urine specimen was collected and transported to the microbiology laboratory for culture, antimicrobial susceptibility testing, and detection of ESBL-producing bacteria. The data were entered into SPSS version 22, and descriptive statistics, bivariate and multivariate logistic regression analyses were performed. A p-value ≤0.05 with a 95% confidence interval was considered for statistical significance. Results: Among 336 diabetic patients, the overall prevalence of UTI was 11.6%. The predominant bacterial isolate was Escherichia coli 12/39 (30.8%), followed by Klebsiella pneumoniae 11/ 39 (28.2%) and coagulase-negative staphylococci 7/39 (17.9%). Gram-negative isolates showed 100% resistance to ampicillin, whereas Gram-positive isolates showed a high level of resistance to penicillin and tetracycline. Moreover, MDR was observed among 18 (46.2%) of the isolates and 2 of the isolated Gram-negative bacteria were ESBL producers. Being illiterate (AOR=7.226, 95% CI: (1.478, 35.340), p<0.015), having current symptoms of UTI (AOR = 2.702, 95% CI: (1.102, 6.624), p=0.030), and blood glucose level ≥126 mg/dl (AOR = 2.940, 95% CI: (1.080, 8.005), p=0.035) were significantly associated with the occurrence of bacterial UTI. Conclusion: The overall prevalence of significant bacteriuria (11.6%) in this study was comparable with some studies in Ethiopia and relatively lower than others. A moderately higher rate of resistance to the commonly used antimicrobial agents was noticed for both Gram-negative and Gram-positive isolates. Health information dissemination should be given about UTI, glycemic control, and habit of drug use for diabetes mellitus patients.

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“…In Ethiopia, the prevalence was dramatically increasing from 3.8% to 5.2%. 1,2 Diabetes mellitus (DM) is a serious global public health problem that affects the whole life of the people in terms of their biological, psychological, and social effects. The cost of paying for diabetes is rising dramatically due to complications ranging from an increased risk of heart attacks, strokes, and amputations to blindness and kidney damage.…”

Section: Introductionmentioning

confidence: 99%

<p>Perceived Self-Efficacy and Associated Factors Among Adult Patients with Type 2 Diabetes Mellitus at Public Hospitals of Western Ethiopia, 2020</p>

Oluma

Abadiga

Mosisa

et al. 2020

PPA

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Background: Diabetes Mellitus is a chronic disease and can be self-managed using five treatment approaches, including education, medical nutrition therapy, physical exercise, pharmacological intervention, and blood sugar monitoring. Improvement of patient compliance and self-efficacy are critical points that impact the self-care behavior in patients with type two diabetes mellitus in order to limit the morbidity and promote glycemic control. Therefore, the present study successfully assesses the effect of perceived self-efficacy and associated factors among patients with diabetes mellitus at public hospitals of western Ethiopia. Methods: The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p <0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine factors associated with perceived self-efficacy by considering adjusted odds ratio at CI 95% and the significance level was set at p <0.05. Results: Out of 423 participants sampled, 398 participated in the study giving a response rate of 94.1%. The level of perceived good self-efficacy among diabetes patients was 52.5%. Being married (AOR=1.611, 95% CI = 1.003, 2.587), home blood glucose test (AOR=3.359, 95% CI = 1.912,5.903), doing exercise (AOR=11.412, 95% CI = 2.488,52.346), having good appetite (AOR=2.587, 95% CI = 1.454,4.606), having special diet (AOR=4.902, 95% CI= 1.202, 19.992), and good self-care behavior (AOR=10.320, 95% CI= 5.657, 18.824) were significantly associated with good self-efficacy. Conclusion: The level of perceived self-efficacy was high. Home blood glucose tests, good self-care behavior, married, doing exercise, good appetite, having a special diet were significantly associated with high perceived self-efficacy. The national policymaker focused on patients' behavioral change to develop perceived self-efficacy for confidently managing the disease.

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Diabetes in Ethiopia: A systematic review of prevalence, risk factors, complications, and cost

Cited by 76 publications

References 39 publications

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

<p>Bacterial Profiles and Their Associated Factors of Urinary Tract Infection and Detection of Extended Spectrum Beta-Lactamase Producing Gram-Negative Uropathogens Among Patients with Diabetes Mellitus at Dessie Referral Hospital, Northeastern Ethiopia</p>

<p>Perceived Self-Efficacy and Associated Factors Among Adult Patients with Type 2 Diabetes Mellitus at Public Hospitals of Western Ethiopia, 2020</p>

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