Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

Assessment of Risk Factors for Advanced Open Angle Glaucoma Presentation among Patients Visiting Jimma University Medical Center, Jimma, Ethiopia

Glaucoma is the predominant cause of irreversible blindness, particularly the late presentation. The purpose of this study is to identify the risk factors associated with late presentation in Jimma University Medical Center METHODS: A case-control study was done among patients newly diagnosed to have open angle glaucoma (of any type) at Jimma University Medical Center from July 2014 ­ January 2019. Cases were patients/eyes diagnosed to have any type of open angle glaucoma with advanced glaucomatous disc features, whereas controls were patients diagnosed with early and moderate stages of glaucoma. RESULTS: There were 205 (116 cases and 89 controls) participants. The mean age of the participants at the time of diagnosis was 58.3±13.4yrs. Family history of blindness, presenting IOP, type of glaucoma and age were independently associated with late presentation. Patients with family history of blindness had late advanced glaucoma five times higher than those with no family history of blindness. The presence of late glaucoma among patients with presenting intra ocular pressure < 30mmHg is lower than those having ≥30mmHg (Adjusted Odds Ratio= 0.136). Primary open-angle glaucoma patients were less likely to present with advanced glaucoma than pseudo exfoliative glaucoma patients (Adjusted Odds Ratio=0.39). The chance of presenting with late glaucoma was increased by 3.4% for every one-year increment of age. CONCLUSIONS: Presence of family history of blindness, high presenting intraocular pressure, pseudo exfoliative glaucoma and old age are risk factors for late presentation of glaucoma

The Quality of Medical RecordsManagementin Public Health Facilities inthe Jimma Zone, Oromia Regional state, Southwest Ethiopia

Background:Comprehensive medical records are the cornerstones forthe quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and plans for care. The study aimed to assess the quality of medical records in public health facilities in the Jimma Zone.Methods:A facility-based cross-sectional study design supplemented by a qualitative method was employed from May 30 -July 29, 2020. A total of 384 medical records were reviewed from 36 facilities using afacility inventory checklist. EPIData 3.1 software was used to enter the quantitative data, which wasthen analyzed using SPSS 23, and descriptive statistics were used to present the results. A thematic analysis approach was used for qualitative datawhich wasfinally triangulated with the quantitative data.Result:384medical records were reviewed from thirty-six public health facilities in the Jimma Zone with a 100% retrieval rate. Among the 36 health facilities, only one hada printer in the record room and three (8%) hadtracer cards. On completeness of the medical records, mode of arrival and date of birth were the least recoded data elements (17% and 5%), respectively.Conclusion:The majority of health facilities hada shortage of trained and qualified recording personnel in the medical record units. The majority of medical records had poor completeness in terms of administrative, clinical, financial, and legal data. The overall quality of medical records in public health facilities in the Jimma Zone was low as per the standard of health facility requirements. It was recommended to have qualified medical record unitpersonnel and to standardize the unitin order to improve the quality of medical records. [Ethiop. J. Health Dev. 2022;36(SI-1)]

Household Readiness to Care for Mild and Asymptomatic COVID-19 Cases at Home, Southwest Ethiopia: A Community-based CrossSectional Stud

BACKGROUND: Corona virus disease (COVID-19) continued with its notorious effects overwhelming health institutions. Thus, home-based identification and care for asymptomatic and mild cases of COVID-19 has been recommended. Therefore, the objective of this study was to assess the level of household readiness for caring asymptomatic and mild cases of COVID-19 at home. METHODS: A community-based cross-sectional study was conducted from March-June 2021 on randomly selected 778 households. Data entry and analysis were carried out using EpiData and SPSS version 25, respectively. Multivariable logistic regression was modeled to identify independent predictors of community readiness. RESULTS: Overall readiness of the community was very low (43.8%). Factors positively affecting household readiness were male household heads (AOR = 1.6; 95%CI: 1.05, 2.45), primary (AOR=2.0; CI:.62, 1.59) and higher (AOR = 1.90; 95%CI: 1.04, 3.45) educational level of the respondents, number of rooms within household (AOR = 1.22; CI: 1.03, 1.46), having additionally house (AOR = 2.61; CI: 1.35, 5.03), availability of single use eating utensils (AOR = 2.76; 95%CI: 1.66, 4.56), availability of community water supply (AOR = 8.21; 95% CI: 5.02, 13.43), and community participation and engagement (AOR = 2.81; 95% CI: 1.93, 4.08) in accessing transport, water and sanitation. CONCLUSIONS: The community was less prepared in terms of housing, infection prevention, water and sanitation. Considering alternative options including universal coverage of vaccine is important; designed behavioral change communications can enhance community participation and engagement in improving access to transport, water and sanitation to reduce risk of infections

Always, better control-vital, essential and non-essential matrix analysis of pharmaceuticals inventory management at selected public health facilities of Jimma zone southwest Ethiopia: facility based cross sectional study design

Background:Always, better control(ABC)-vital, essential and non-essential (VEN) matrix analysis has a key role in assisting decisions making in medicine selection, purchasing and inventory management and hence help in reducing cost, identifying medicine use problems and improve efficiency in the pharmaceutical supply system. Studies on analysis of pharmaceuticals expenditures throughout the country were very limited, in Jimma zone no studies found yet. The objective of the study was, therefore, to analyze pharmaceuticals based on cost and criticality aspects and identify those which require stringent managerial control at selected public health facilities of Jimma zone Southwest Ethiopia. Methods:Health facility-based, cross-sectional, study design using a quantitative method in which ABC, VEN and ABC-VEN matrix analysis techniques were utilized to analyse pharmaceutical inventory management system at selected public health facilities of Jimma zone. Results:The ABC analysis shows that class A items accounted for 53(15.3%), whereas class B and C items accounted for 72(20.8%) and 221(63.8%) number of items at selected public health facilities of Jimma zone. VEN analysis showed that 132 items (59.7%) were categorized as vital and consumes 61.4% ($248,372) of the annual pharmaceuticals expenditures (APE). Whereas, 55 items (24.8%) and 34 items (15.3%) were categorized under essential and less/non-essential with a total APE of 31.1% ($126,020) and 7.4%($30,008)respectively. From ABC-VEN matrix analysis, the majority of items were category I pharmaceuticals.Conclusions:Majority of items at a selected public health facility were category I and most of the category I pharmaceuticals, in turn, were Class A and V items which require great attention for their control and availability

Drug use evaluation of cotrimoxazole prophylaxis in people living with human immunodeficiency virus/acquired immune deficiency syndrome at Jimma University Specialized Hospital, Jimma, South West of Ethiopia, 2013.

Background: Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to advice optimal patient outcomes. Pneumocystis carinii pneumonia (PCP) is the most common acquired immune defi ciency syndrome (AIDS) defi ning illness. Antibiotics being the most commonly prescribed group of drugs the problem of its overuse are a global phenomenon. Cotrimoxazole (CTX) preventive therapy (CPT) was shown effectively prevents PCP in patients with clinical evidence of immune suppression. CTX has been widely used as a treatment for common infections in many resource limited areas and as a result, CTX resistance among these pathogens has increased dramatically. In response to these problems, this study aims to evaluate the use CTX prophylaxis for opportunistic infections in human immunodefi ciency virus (HIV) patients at Jimma University Specialized Hospital (JUSH). Methods: The study was done with retrospective cross-sectional review of medical records of HIV patients who have been on CTX prophylaxis in the hospital during September 11, 2012-September 10, 2013. To maintain the validity of data, the whole 135 patient cards were included in the study within the specifi ed period. Data were collected from January 16, 2013 to February 15, 2013 using structured data collection format. Results: From the study subjects, 82 (60.74%) were females 85.93% of patients were used appropriate dose of CPT and 13.3% patients use CTX against contraindication. Regarding to adverse drug reactions (ADRs), 3.7% of patients were developed rash while 2.2% cases were developed nausea during the follow-up period of CPT. However, only 5.9% patients have documented information about ADR of CPT. On the top of this, CD4 count and hemoglobin test were done for 82.96%, 64.4% patients respectively during initiation of CPT. However, renal function tests were performed only for 2.96% of patients while initiating CPT. Conclusion: The use of CPT for people living with HIV/AIDS was found to be good in JUSH with regard to initiation and dosage. However, the practice of discontinuation of CTX, documentation of ADRs and follow-up for adverse effects of CTX should be improved by proper implementation and adhering to the national guideline of CPT.

Barriers to access: availability and affordability of essential drugs in a retail outlet of a public health center in south western Ethiopia.

Essential drugs (EDs) satisfy the priority health care needs of a population and their availability and affordability at all times is crucial for provision of complete health service. The study aimed to assess availability and affordability of treatment cost for common diseases in Jimma Health Center (JHC). A cross sectional study was conducted using structured data abstraction form for exit interviews and checklists. Only 128 (55.65%) EDs were available. The average price for commonly used drugs per recommended dose for an individual patient in JHC Pharmacy, Ethiopian Red Cross (ERC) Pharmacy and Private Pharmacies were $0.65, $0.62 and $0.94 respectively. Affordability of medications was significantly associated with age, marital status, occupational status, gross monthly income and number of economically dependent family members (p<0.005). 58.07% of the respondents bought drugs from JHC pharmacy, while the rest bought drugs from ERC pharmacy and private retail outlets. In this study 47.83%, 33.54% and 18.63% of the respondents said that the drugs are not affordable, fairly affordable and affordable respectively. Low availability of EDs forced patients to purchase drugs from private pharmacies, go to informal sector or forgo treatment. Considering proportion of total household income spent on health care, costs of treatment seem unaffordable.