Incidence and predictors of diabetes mellitus among severe COVID-19 patients in western Ethiopia: a retrospective cohort study

Background: Evidence reported a high occurrence of diabetes mellitus (DM) during the time of COVID-19. This study aimed to assess the incidence of DM and its predictors among severe COVID-19 patients admitted to the treatment centre of Wollega University Referral Hospital (WURH), western Ethiopia. Methods: A facility-based retrospective cohort study was conducted among severe COVID-19 patients diagnosed using the rRT-PCR from September 30, 2020, to June 10, 2021. EpiData version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with DM. A multivariable Cox regression model with 95% CI and adjusted hazard ratio (AHR) was used to identify a significant predictor of the incidence of DM at p-value < 0.05. Results: A total of 304 patient cards with complete data were included in the final analysis. The mean age of the participants was 43.3 (SD ± 16.9) years. Of the total 304 patients admitted with severe COVID-19, 14.5% were newly diagnosed with DM with an overall incidence rate of 13.7 per 1 000 person days' observation (PDO). The median time to occurrence of DM was 11 days (95% CI 7, 13) days. Age > 41 years (AHR = 2.54, 95% CI 1.15, 5.57), living in urban (AHR = 2.49, 95% CI 1.12, 5.52) and loss of appetite (AHR = 2.24, 95% CI 1.16, 4.34) increased the hazard of DM incidence, while presenting to the health facility after two days of clinical manifestation (AHR = 0.49, 95% CI 0.23, 0.96) decreased the risk of developing DM. Conclusions: The incidence rate of DM among patients admitted with severe COVID-19 in the study area was found to be 13.7 per 1 000 person days' observation. Higher age, urban residence, early presentation to a health facility and loss of appetite were independent predictors of DM incidence. Therefore, we recommend early detection of DM and frequent monitoring of blood glucose for patients diagnosed with COVID-19. [ FROM AUTHOR] Copyright of Journal of Endocrinology, Metabolism & Diabetes of South Africa is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Acute respiratory distress syndrome among patients with severe COVID-19 admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia.

BACKGROUND: Acute respiratory distress syndrome is a life-threatening condition that has a significant effect on the occurrence of morbidity and mortality among patients with severe Coronavirus disease 2019 (COVID-19). To the best of researchers' knowledge, there is no Study on ARDS of COVID-19 in Ethiopia. Therefore, this study aimed to identify the prevalence of ARDS and associated factors among severe COVID-19 patients at Wollega University Referral Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted from September 20, 2020, to June 10, 2021. Real-Time Reverse transcription-polymerase Chain Reaction (rRT-PCR) test was used to test Patients for COVID-19. Epi-data version 3.2 was used for data entry, and the final data analysis was through STATA version 14. After checking the assumption P-value<0.25 in the bivariable analysis was used to select a candidate variable for multi-variable analysis, and a p-value of <0.05 was used to declare statistical significance. RESULTS: In this study, the prevalence of ARDS was 32%. Almost all the patients had the clinical feature of cough (93.7%), followed by shortness of breath (79.9%), fever (77.7%), and headache (67%). Age older than 65 years (AOR = 3.35, 95%CI = 1.31, 8.55), male gender (AOR = 5.63, 95%CI = 2.15, 14.77), and low oxygen saturation level (AOR = 4.60, 95%CI = 1.15, 18.35) were the independent predictors of ARDS among severe COVID-19 patients. CONCLUSION: The prevalence of ARDS among patients with severe COVID-19 was high in the study area. Therefore, elders and patients with critical conditions (low oxygen saturation) better to get special attention during COVID-19 case management to enhance good care and monitoring of the patients.

Incidence and predictors of death from COVID-19 among patients admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia: A retrospective cohort study.

INTRODUCTION: Currently, COVID-19 contributes to mortality and morbidity in developed as well as in developing countries since December 2019. However, there is scarcity of evidence regarding the incidence and predictors of death among patients admitted with COVID-19 in developing country including Ethiopia, where the numbers of deaths are under-reported. Hence, this study aimed to assess the incidence and predictors of death among patients admitted with COVID-19 in Wollega University Referral Hospital (WURH), western Ethiopia. METHODS: An institution based retrospective cohort study design was conducted among 318 patients admitted with COVID-19 in WURH treatment center. Patients who were tested positive for COVID-19 by using rRT-PCR test and admitted with the diagnosis of severe COVID-19 cases from September 30, 2020 to June 10, 2021 were a source population. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with mortality from COVID-19. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of mortality from COVID-19 at p-value < 0.05. RESULTS: A total of 318 patients were included in final analysis with mean age of 44 (SD±16.7) years and about two third (67.9%) were males. More than half (55.7%) of patients had no comorbidity on admission. The majority, 259 (81.45%) of patients recovered from COVID-19 and 267 (84%) of patients were censored at the end of follow up. The incidence rate of mortality was 14.1 per/1000 (95%CI: 10.7, 18.5) person days observation. Age ≥ 59 years (AHR: 5.76, 95%CI: 2.58, 12.84), low oxygen saturation (AHR: 2.34, 95% CI: (2.34, 4.17), and delayed presentation (AHR: 5.60, 95%CI: 2.97, 10.56) were independent predictors of mortality among COVID-19 patients. CONCLUSION: The mortality rate of COVID-19 pandemic was high in the study area, and most of death was happened during the first 10 days. Being old age, low oxygen saturation and delayed presentation were factors which predict mortality due to COVID-19. Hence, strengthening the health care delivery system to satisfy the need of the patients should get due attention to reduce the incidence of mortality from COVID-19 cases.

Attitude of health professionals towards COVID-19 vaccination and associated factors among health professionals, Western Ethiopia: A cross-sectional survey.

INTRODUCTION: Even though people of the world were eagerly waiting for the hope of vaccine development, vaccine hesitancy is becoming the top concern in both developed and developing countries. However, there is no adequate evidence regarding the attitude and perception of health professionals towards the COVID 19 vaccine in resource-limited settings like Ethiopia. The aim of this study was to assess health professionals' attitudes and perceptions towards COVID 19 vaccine in Western Ethiopia. METHODS: An institution-based cross-sectional study was conducted among health care workers found in Nekemte town from April 14-21, 2021. A total of 439 health professionals present on duty during the study period was included in the study. The data were collected by using self-administered questionnaire. Epidata version 3.2 was used for data entry, and STATA version 14 was used for data analysis. The binary logistic regression model was employed to determine factors associated with the attitude towards COVID-19 vaccination. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared at a 5% level (p-value < 0.05). RESULT: A total of 431 health professionals participated in the study yielding a response rate of 98.1%. The results indicated that 51.28% (95%CI: 45.12%, 57.34%) of health professionals had a favorable attitude towards COVID-19 vaccination. Having good knowledge about the COVID-19 vaccine (AOR = 0.38, 95%CI: 0.22, 0.64, P-value <0.001) was negatively associated with unfavorable attitude towards COVID-19 vaccine, whereas age less than 30 years (AOR = 2.14, 95%CI:1.25,3.67, P-value <0.001), working in a private clinic (AOR = 7.77, 95% CI: 2.19, 27.58, P-value <0.001) and health center (AOR = 2.45, 95%CI: 1.01, 5.92, P-value = 0.045) were positively associated with unfavorable attitude towards COVID-19 vaccine. CONCLUSION AND RECOMMENDATION: In general, the attitude and perception of health care professionals toward the COVID-19 vaccine in the study area were unsatisfactory. Knowledge about the COVID-19 vaccine, age of health care workers, and place of work are the factors which affects attitude towards COVID-19 vaccine. Thus, we recommend the media outlets and concerned bodies to work to develop trust among the public by disseminating accurate and consistent information about the vaccine.

ART Adherence Among People Living with HIV Seeking Services from Public Health Facilities in Western Ethiopia.

BACKGROUND: The burden of COVID-19 is more severe among the elderly and patients affected with chronic medical conditions like diabetes, cardiovascular diseases, and HIV/AIDS. There is no study regarding the level of adherence to antiretroviral therapy (ART) during the time of COVID-19 in Ethiopia. So, this study aimed to assess the level of HIV positive patient's adherence to ART treatment and associated factors in Nekemte public health facilities, Western Ethiopia. METHODS: This study was conducted in Nekemte public health facilities, Western Ethiopia from August 1, 2020 to September 30, 2020. A facility-based cross-sectional study was employed among HIV positive patients on ART treatment. A single proportion formula was used to calculate a sample size of 384 . A systematic random sampling technique was employed to select the sample population. Face-to-face interview questionnaires were used during data collection. A binary logistic regression model was fitted to identify factors associated with dependent factor, and an adjusted odds ratio (AOR) was used to estimate the strength of the association between dependent and independent variables. RESULTS: A total of 361 HIV positive patients have participated in the study, yielding a response rate of 94%. The mean age of the participants was 33.8 (SD ±9.8) years. Seventy-seven (21.3%) HIV-positive patients had not adhered to ART follow-up. The study found that living in rural areas (AOR=3.37, 95% CI=1.80-6.24), age less than 25 years (AOR=3.41, 95% CI=1.26-9.21), and substance use (AOR=5.42, 95% CI=1.8-16.29) were independent predictors of poor adherence to ART. CONCLUSION: Generally, non-adherence to antiretroviral treatment among people living with HIV during the pandemic outbreak was high in the study area. A home-based delivery of ART treatment and improving retention mechanism during pandemics is highly recommended for concerned bodies. In addition, counseling on avoidance of substance use should be strengthened to increase retention on treatment.

Knowledge, Attitude and Practice Toward Corona virus Infection Among Pregnant Women Attending Antenatal Care at Public Hospitals in Three Wollega Zones, Ethiopia.

BACKGROUND: Pregnancy is an immune-suppressed state which makes pregnant women generally more susceptible to COVID-19 infection and severe illness. Extensive precautions have been recommended to avoid exposure to the virus. Knowledge and attitude toward the disease play an integral role in readiness to accept public health measures. This study aimed to assess the knowledge, attitude and practice towards COVID-19 among pregnant women attending antenatal clinics in three Wollega zones, Ethiopia. METHODS: Institution-based cross-sectional study was employed among 415 pregnant women attending antenatal care at public hospitals in three Wollega zones, Ethiopia from July to August 2020. The data were collected using an interviewer-administered structured questionnaire. The level of knowledge was assessed using 12 multiple choice questions; the score of above or equal to mean was considered as adequate knowledge. Binary logistic regression was performed and the adjusted odds ratio with P-value ≤0.05 at 95% CI was taken as statistically significant. RESULTS: This study indicates that more than two-thirds (75.4%; 95% CI: 71.1-79.3%) and 43.6% of the pregnant women had adequate knowledge and good practice about the coronavirus pandemic, respectively. The pregnant women who attended secondary school and above and were urban residents were more likely to have good knowledge, AOR = 2.99 (1.7-5.0) and 1.6 (1.2-2.7), respectively. Maternal age ≤ 25 yearsand being an urban resident were the two predictors of good practice of preventive measures, AOR = 1.7 (1.2-2.6) and 2.3 (1.3-4.0), respectively. CONCLUSIONS AND RECOMMENDATIONS: The target population demonstrated acceptable knowledge and poor practice toward COVID-19. Health-care providers should give more attention to educating pregnant women at any point of contact; legal enforcement should be implemented to improve practice of preventive measures. Special consideration should be given to those who are from rural areas, and to less-educated pregnant women.