ABSTRACT
Background: Diabetic neuropathy is a very common complication of diabetes mellitus. Thus, measuring the incidence of diabetic neuropathy is a key element in tracking the progress of epidemics of diabetes mellitus and an indication of early accessibility for healthcare in terms of type 2 diabetic patients. Objective: To assess survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa from June 25 to August 25, 2023. Methods: An institutional-based retrospective follow-up study design was used among newly diagnosed type 2 diabetic patients at hospitals of Addis Ababa. A chart review tool that contains socio-demographic, clinical, and comorbidity characteristics, biochemical characteristics, and the status of type 2 patients was used. A cleaned data was exported from Epi-data manager 4.6 version to SPSS version 25 for analysis. Bivariate Cox regression analysis was done to identify predictors of diabetic neuropathy at a 95% confidence level. Result: A total of 414 type 2 diabetic patients were included in the study. Of these, 97 (23.4%) developed diabetic neuropathy. Variables like having hypertension (AHR 11.25, 95% CI 3.73-33.93), anemia (AHR 4.18, 95% CI 1.78-9.82), high-density lipoprotein < 40 mg/dl (AHR 5.07, 95% CI 1.38-18.67), high creatinine level (AHR 14.67, 95% CI 4.27-50.40), diabetic retinopathy (AHR 4.32, 95% CI 1.32-14.18), and diabetic nephropathy (AHR 2.50, 95% CI 1.09-6.57) were associated with the incidence of diabetic neuropathy. The mean time to develop diabetic neuropathy was 4.94 years, CI (4.50-5.38), and the mean survival time was 6.61 years. Conclusion: The incidence of diabetic neuropathy was high relative to other studies. Variables like having hypertension, anemia, high-density lipoprotein, high creatinine level, diabetic retinopathy, and diabetic nephropathy were predictors of diabetic neuropathy. The mean time to develop diabetic neuropathy was 5 years, with a survival mean time of 7 years.
ABSTRACT
Introduction: Mortality in the emergency department is still high in developing countries with resources scarce. Most of emergency department mortality occurred within the first three days; the majority of these deaths are avoidable with proper intervention. Therefore, the purpose of this study was to assess the mortality risks and therapeutic benefits of early and late death. Methods: Case-control study approach with 87 cases and 174 controls (case to control ratio of 1:2) was used on 261 study participants. Data were extracted from the patient charts using a pretested extraction tool. Then, checked data were entered into Epi-data manager 4.6 versions and analyzed using SPSS 25 versions. Binary logistic regression was used to construct bivariate and multivariable analyses following the descriptive analysis. Finally, a predictor variable in the multivariate logistic regression was deemed to have a significant association if its P-value was less than 0.05 at a 95% confidence level. Results: Patients who were triaged into the red zone had a 2.3-fold greater risk of dying early than those who were placed in another triage category [(AOR=2.3; 95% CI: 1.10, 5.55) P=0.001]. Besides, having cardiovascular disease (AOR=4.79; 95% CI: 1.73, 13.27), age ≥65 years [(AOR=3.2; 95% CI: 1.74, 7.23) P=0.003)], having rural residency (AOR=6.57; 95% CI: 1.39, 31.13), and having been diagnosed with respiratory failure [(AOR=3.2; 95% CI: 1.04, 7.69), P=0.013)] were associated with early mortality. Conclusion: The common causes of early mortality were respiratory failure, cardiovascular disease, and road traffic accident. Being aged, having rural residence, being triaged into red zone, and diagnosed for respiratory failure and cardiac failure increase early mortality compared with late death.
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Objective: This study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia. Methods: A facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval. Results: This study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36; p = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99; p = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10; p = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85; p = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86; p = 0.043; 95% confidence interval (3.99, 8.703)). Conclusion: The intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women's intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.
ABSTRACT
Background: The majority of homeless women (75%) do not wish to have or delay a pregnancy during this difficult time, yet many do not use contraception in developing countries. In Ethiopia, there is limited evidence of unmet need for family planning in settings where homelessness is on the increase. This study aims to assess the unmet need for family planning services among homeless women and identify associated factors in Jimma Town, southwestern, Ethiopia. Methods: A community-based cross-sectional study was conducted on May 3rd and 4th, 2021. The complete enumeration was done to include 206 homeless women. Epidata version 3.1 data entry and exported to SPSS version 20 were used for analysis. Bivariate and multivariable logistic regressions were used to identify factors associated with the unmet need for family planning. Associated factors were determined by a 95% confidence interval of AOR and P-value <0.05 in the multivariable model. Results: The unmet need for family planning among homeless women was 47.3% [95% CI (38.2, 49.7)]. Being with a disability; [(AOR: 4.10, 95% CI (1.73-9.56), visited by a health care provider in the last 12 months; [(AOR: 0.25, CI (0.09-0.65)], and a number of living children; [(AOR: 0.42, CI (0.18-96)] were significantly associated with an unmet need for family planning. Conclusion: The unmet need for family planning methods among homeless women was high compared to the national standard of unmet need for family planning, being with a physical disability, visited by a health care provider in the last twelve months, and having a number of living children contributed to the unmet need for family planning. Therefore, health care professionals should focus on providing health education on family planning among these women at the grass-root level to reduce the unmet need for family planning among these women.
ABSTRACT
Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity globally. This is due to the increasing prevalence of modifiable CVDs risk factors. Hence, the study was aimed to identify knowledge and unhealthy behaviors that contribute to CVD among diabetes mellitus patients. An institutional-based cross-sectional study design was employed among diabetes mellitus patients. A close-ended questionnaire developed from up-to-date similar literature was pretested and face-to-face interview techniques were used to collect data. Checked data were entered into the Epidata 4.1 versions. Then, descriptive and bivariate logistic regression was done using SPSS 25 versions. Of the study participants included in the study, 318, more than half of them, 167(52.5%), were aged ≥45 years and 187(58.8%) of them were females. Among the study participants, more than half, 198(62.3%), had good Knowledge of modifiable CVDs risk factors. Most of the study participants identified consuming foods rich in fats instead of vegetables and fruits 198(62.3%), followed by physical inactivity 196(61.6%) as a risk factor for CVD. Regarding CVDs prevention practice, 175(55.0%) of the patients had a good practice. More than three-fourths, 267(84.0%), practice avoiding foods rich in fats and, sugar, and cigarette smoking 250(78.6%). Predictors like educational status, college and above (AOR 2.68; 95% CI 1.14-6.27), and urban residence area (AOR 1.94; 95% CI 1.09-3.15) were associated with knowledge of CVDs risk factors. While sex, marital status monthly income, and age of the participants had no association with knowledge and prevention practice of modifiable CVDs risk factors. The study participants' knowledge and prevention practice of modifiable cardiovascular disease risk factors was satisfactory, even though continuous awareness creation is required to lower CVD mortality and morbidity burdens. Educational status and residence are of the study participants affect the knowledge and prevention practice modifiable of cardiovascular disease risk factors.
