Assessment of knowledge, attitude, and practice on substandard and counterfeit pharmaceutical products among pharmacy professionals in Gondar City, North-West Ethiopia.

INTRODUCTION: The circulation of substandard and counterfeit pharmaceutical products on the national and international markets has increased. Different studies revealed that there is limited information about pharmacy professionals' awareness of substandard and counterfeit pharmaceutical products. Therefore; the aim of the present study was to assess the pharmacy professionals' knowledge, attitude, and practice of substandard and counterfeit pharmaceutical products. METHODS: A cross-sectional study was conducted to assess the knowledge, attitude, and practice of pharmacy professionals about substandard and counterfeited pharmaceutical products in Gondar City, North-West Ethiopia. Data were collected through a self-administered, structured questionnaire using the Kobo tool. SPSS version 27 was used for the analysis. To assess the association of factors with pharmacy professionals' practice towards substandard and counterfeit medicines, we conducted univariate and multivariate logistic regression analysis. RESULTS: A total of 170 respondents participated in the study. The highest numbers of participants (71.8%) were in the age group of 18-30 years. Only 10.6% of them reported purchasing medicines regularly. Of total, 31 (18.24%) of respondents had a good knowledge and more than one-third 60 (35.29%) of the respondents had a good level of practice. Multivariate logistic regression analysis results revealed that some socio-demography and attitude (AOR = 0.473 (0.225-0.995) were associated with the practice of pharmacy professionals towards substandard and counterfeit medicines. CONCLUSION: In general, less than one-quarters of the respondents had a good knowledge and more than one-thirds of the respondents had a good level of practice. However, half of the respondents had a positive attitude.

Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: Multicenter cross-sectional study.

Background: Hyperemesis gravidarum is one of the problems encountered among pregnant women due to persistent and excessive vomiting starting before the end of the 22nd week of gestation. The current study aimed to assess the prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia. Methods: A multi-facility-based cross-sectional study was conducted at comprehensive specialized hospitals from 1st June 2022 to 30th July 2022. The data were entered using EPI Data Version 4.6 statistical software and analyzed using SPSS Version 26. Descriptive statistics such as frequency, mean, and percentage were calculated. Univariable and multivariable binary logistic regression analyses were carried out to identify the associated factors of hyperemesis gravidarum. Results: In all, 404 study participants were enrolled. About 16.8% of pregnant women were found to have hyperemesis gravidarum. Age < 20 year (AOR = 3.170; 95% CI: 1.119, 8.980), study participants who cannot read and write (AOR = 5.662; 95% CI: 2.036, 15.7470), grade 1-8 (AOR = 4.679; 95% CI: 1.778, 12.316), and grade 9-10 (AOR = 8.594; 95% CI: 3.017, 24.481), being housewife (AOR = 6.275; 95% CI: 1.052, 37.442), living in urban area (AOR = 2.185; 95% CI: 1.035, 4.609), having previous hyperemesis gravidarum (AOR = 2.463; 95% CI: 1.210, 5.012), having family history of hyperemesis gravidarum (AOR = 2.014; 95% CI: 1.002, 4.047), unplanned pregnancy (AOR = 2.934; 95% CI: 1.030, 8.351), having recent abortion (AOR = 2.750; 95% CI: 1.010, 7.483), and gravidity (AOR = 1.956; 95%CI: 1.023, 3.737) were factors associated with hyperemesis gravidarum. Conclusion: The prevalence of hyperemesis gravidarum is higher. Low maternal age, lower educational level, being a housewife, being an urban resident, having previous hyperemesis gravidarum, having a family history, having an unplanned pregnancy, and having a recent abortion were significantly associated with hyperemesis gravidarum.

Prevalence and predictors of self-medication with antibiotics in Ethiopia: a systematic review and meta-analysis.

INTRODUCTION: Antibiotic self-medication is a global public health concern contributing to antibiotic resistance. This systematic review and meta-analysis aim to assess the prevalence of antibiotic self-medication and its associated factors in Ethiopia. METHODS: A comprehensive search of electronic databases was conducted from MEDLINE (PubMed), Scopus, Google Scholar and Web of Science to identify relevant studies published between 2000 and 2024. Adult households, undergraduate university students and health care professionals who had taken antibiotics without a prescription in the household setting were included in this review. The primary outcome of this review is antibiotic self- medication. The random-effects model was used to estimate pooled prevalence rates. The outcome measure was analyzed with STATA version 17 software. RESULTS: A total of nine studies were included in the Meta-analysis, comprising a sample size of 5908 participants. The pooled prevalence of antibiotic self-medication among Ethiopians was found to be 46.14 with 95% Confidence Interval [35.71, 56.57]. The most frequently used classes of self-medicated antibiotics were penicillins, followed by tetracyclines. Community pharmacies were the source of information that individuals utilized. The most common reported reasons for antibiotic self-medication include previous experience of treating a similar illness, to save cost, lack of time and avoiding waiting time for medical services. Participants having less than high school educational level was the most commonly reported factor associated with self-medication antibiotics. CONCLUSION: Antibiotic self-medication is a prevalent practice in Ethiopia. This underscores the need for targeted interventions such as educating people about the risks associated with using antibiotics without medical guidance, which results in a reduction in antibiotic resistance.

Food adulteration: Causes, risks, and detection techniques-review.

Food adulteration is the intentional addition of foreign or inferior substances to original food products for a variety of reasons. It takes place in a variety of forms, like mixing, substitution, hiding poor quality in packaging material, putting decomposed food for sale, misbranding or giving false labels, and adding toxicants. Several analytical methods (such as chromatography, spectroscopy, electronic sensors) are used to detect the quality of foodstuffs. This review provides concise but detailed information to understand the scope and scale of food adulteration as a way to further detect, combat, and prevent future adulterations. The objective of this review was to provide a comprehensive overview of the causes, risks, and detection techniques associated with food adulteration. It also aimed to highlight the potential health risks posed by consuming adulterated food products and the importance of detecting and preventing such practices. During the review, books, regulatory guidelines, articles, and reports on food adulteration were analyzed critically. Furthermore, the review assessed key findings to present a well-rounded analysis of the challenges and opportunities associated with combating food adulteration. This review included different causes and health impacts of food adulteration. The analytical techniques for food adulteration detection have also been documented in brief. In addition, the review emphasized the urgency of addressing food adulteration through a combination of regulatory measures, technological advancements, and consumer awareness. In conclusion, food adulteration causes many diseases such as cancer, liver disease, cardiovascular disease, kidney disease, and nervous system-related diseases. So, ensuring food safety is the backbone of health and customer satisfaction. Strengthening regulations, taking legal enforcement action, enhancing testing, and quality control can prevent and mitigate the adulteration of food products. Moreover, proper law enforcement and regular inspection of food quality can bring about drastic changes.

Assessment of prescription completeness and drug use pattern using WHO prescribing indicators in private community pharmacies in Addis Ababa: a cross-sectional study.

BACKGROUND: Healthcare systems in both developing and developed countries were not free from prescription errors. One of the effects of prescription errors is irrational prescribing. According to the estimation of the World Health Organization (WHO), greater than 50% of medicines are prescribed and dispensed irrationally. On the other hand, research on drug use patterns in the private healthcare sector is scarce. This study aimed to assess prescription Completeness and Drug use Pattern using WHO prescribing indicators in Private Community Pharmacies in Lemi-Kura sub-city. METHODS: Based on the WHO prescribing indicators, a retrospective cross-sectional technique was employed to examine the completeness and drug-prescription patterns. The study was conducted from April to May 2021. Prescriptions, kept for 1 year that was prescribed from March 2020 to March 2021, by private healthcare sectors, were analyzed. A systematic random sampling technique was employed to select prescriptions obtained from private health facilities. Data were analyzed using SPSS® version 26.0 software. RESULTS: Of a total of 1000 prescriptions, 1770 drugs were prescribed and the average number of drugs per prescription was 1.77. Prescriptions for two drugs account for 38% of these, while prescriptions for three drugs account for 15%. Age, sex, and card number were written on 99.0%, 99.2%, and 41.8% of prescriptions, respectively. The patient's name was written on every prescription. Even though the availability of other therapeutic information on the prescription made it appear greater, only 44.2% of prescriptions included the dosage form of medications. The generic name was used for the majority of the medications (67.8%). Furthermore, assuming that each prescription was for a single patient, 71% of patients received antibiotics, and 2% received injectable medicines. The National List of Essential Medicines-Ethiopia was used in 99.6% of the prescriptions. CONCLUSIONS: On the basis of the finding of this study, the prescribing and prescription completeness indicator showed deviation from the standard recommended by WHO. This situation could be critical since a similar pattern is reported from public healthcare sectors, which might imply the extent of non-adherence to WHO core drug use standards. Consequently, it could play a considerable role in increasing prescription errors in Ethiopia. Hence, in-service training for prescribers should be provided to improve adherence to basic prescription writing.

Assessment of Knowledge, Attitudes, and Practices of Traditional Healers toward Dosage Forms and Routes of Administration: A Cross-Sectional Study in Ethiopia.

Methods: A cross-sectional study design was conducted on 70 traditional healers from June 1, 2022 to July 25, 2022. The data were collected through structured questionnaires. The data were checked for completeness and consistency and then entered into SPSS version 25.0 for analysis. The results were presented with frequencies and percentages. The association between sociodemographic factors and traditional healers' knowledge of dosage forms and route of administration was determined using the Pearson's chi-squares test. A statistically significant difference was declared if the p value was 0.05 or lower. Results: Most (58.1%) traditional healers had information on dosage forms, especially about solid, semisolid, and liquid dosage forms. In addition, 33 (53.2%) traditional healers had information about rectal, nasal, and oral route of administration. All traditional healers had practiced different dosage forms and route of administration both individually and in combination earlier to date. More than half of the participants agreed on the need for different dosage forms and route of administration. This study result also showed that most (72.6%) traditional healers had gaps in sharing experiences and information with other healers and health professionals. Conclusions: The current study revealed that solid, semisolid, and liquid were the most frequently formulated dosage forms with oral, rectal, and nasal route of administration by traditional healers. The practice of checking the status of the formulations was poor. Traditional healers had a good attitude towards the need for different dosage forms and route of administration. The stakeholders should provide continuous training and exchange of experiences between traditional healers and healthcare professionals to improve the knowledge of traditional healers for appropriate use of dosage forms and route of administration.

Nonadherence to antiasthmatic medications and its predictors among asthmatic patients in public hospitals of Bahir Dar City, North West Ethiopia: using ASK-12 tool.

BACKGROUND: Globally, adequate asthma control is not yet achieved. The main cause of uncontrollability is nonadherence to prescribed medications. OBJECTIVES: The objective of this study is to assess asthmatic patients' non-adherence to anti-asthmatic medications and the predictors associated with non-adherence. METHODS: An institution-based cross-sectional study was conducted in three governmental hospitals in Bahir Dar city from September 5 to December 12, 2021. The data was collected using the Adherence Starts with Knowledge-12 tool (ASK-12). Systematic random sampling was applied to select study participants. Bivariable and multivariable logistic regression analyses were used to identify predictors of non-adherence. All statistical tests were analyzed using STATA version 16. P-values less than 0.05 were considered statistically significant. RESULTS: A total of 422 asthmatic patients were included in the study. Most of the study participants (55.4%) did not adhere to their prescribed anti-asthmatic medicines. The educational status of the study participants (AOR = 0.03, 95% CI = 0.00-0.05), family history of asthma (AOR = 0.13, 95% CI = 0.04-0.21), and disease duration that the patients were living with (AOR = 0.01, 95% CI = 0.00-0.01) were the predictors of non-adherence to anti-asthmatic medications. CONCLUSIONS: The level of nonadherence to treatment among patients with asthma was high. Religion, educational status of study participants, family history of asthma, and duration of the disease were the predictors of non-adherence of asthmatic patients to their antiasthmatic medications. Therefore, the Ministry of health, health policy makers, clinicians, and other healthcare providers should pay attention to strengthening the adherence level to antiasthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to anti-asthmatic medications.

Antimalarial activity of the 80%methanol extract and solvent fractions of Cucumis ficifolius A. rich roots against Plasmodium berghei in mice.

Ethnopharmacological relevance: Malaria is still a known health threat, especially in parts of sub-Saharan Africa. It is one of the frequently mentioned issues with hospital admission and outpatient care in Ethiopia. Cucumis ficifolius A. Rich roots are historically used in Ethiopia to treat meningitis, inflammation, and malaria. However, the antimalarial activity of this plant has not been scientifically studied so far. Aim of the study: This study aimed to determine the in vivo antimalarial activity of 80% methanol extract and solvent fractions of the roots of Cucumis ficifolius against Plasmodium berghei infection in mice. Methods: The in vivo antimalarial activity of the 80% methanol extract and solvent fractions of Cucumis ficifolius A. Rich was evaluated by standard chemo suppressive, curative and repository tests using Plasmodium berghei (ANKA strain) in Swiss albino mice at doses of 100, 200 and 400 mg/kg/day. The level of parasitemia, survival time, variation in weight, rectal temperature, and packed cell volume of mice were determined to establish the activity of the extracts. Result: The 80% methanol extract of Cucumis ficifolius A. Rich roots had a promising suppression of parasitemia at 400 mg/kg with a chemosuppression value of 65.21 ± 1.20%. Among the solvent fractions, the chloroform fraction showed the highest antimalarial activity in the four-day suppressive test with a chemosuppression value of 55.9 ± 0.28%, followed by the n-butanol (42.9 ± 0.24%), and aqueous (40.57 ± 0.52%) fractions at a dose of 400 mg/kg. The highest survival times were observed with crude extract (15.4 ± 0.24 days) at 400 mg/kg, and chloroform fraction (13.4 + 0.24 days), though all extracts increased survival time. Conclusion: The findings of the present study collectively indicate the root extract of Cucumis ficifolius has a promising antiplasmodial activity which substantiates the traditional claim of the plant.

Treatment Outcomes of the Acute Coronary Syndrome Among Patients Attending St. Paul Hospital.

Background: Acute coronary syndrome (ACS) patients need intense therapy and diagnostic evaluation for improved treatment. In Ethiopia, where patient deaths and hospital stays are rising, the ACS treatment is thought to be not very effective. Methods: A retrospective cross-sectional study was conducted at St. Paul Hospital. The data were collected from patients medical records using a structured data abstraction checklist from 2018 to 2020. The data was entered, analyzed, and interpreted using SPSS version 24 software. Results: Of 157 ACS patients, 69 (43.9%) had a STEMI diagnosis. Age was 63.69 years on average (SD: 8.23). The typical amount of time between the onsets of ACS symptoms to hospital presentation was 79.3 hours (3.3 days). For 104 (66.2%) patients, hypertension was the main risk factor for the development of ACS. Killip class III and IV patients made up about 3.8% of the ACS patients at St. Paul hospital. An EF of less than 40% was present in 36.3% of patients. Loading doses of aspirin (90.4%), anticoagulants (14%), beta-blockers (82.8%), statins (86%), clopidogrel (7.6%), and nitrates (2.5%) are among the medications taken inside hospitals. Of 157 ACS patients, 6 (3.8%) patients with medical records examined died while receiving treatment in the hospital, while 151 (96.2%) patients were discharged alive. Conclusion: STEMI was the most common diagnosis for ACS patients at St. Paul Hospital. The two main hospital events for these patients were CHF and cardiogenic shock.

Assessment of community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer health promotion services: a cross-sectional study.

INTRODUCTION: The role of community pharmacy professionals has been expanded to patient care and health promotion service globally. However, in Ethiopia, there is a scanty of data on the issue, although the country is dealing with a double burden of non-communicable and communicable diseases. OBJECTIVES: This study aimed to assess community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer extended services for health promotion in Injibara town, Amhara, Ethiopia. METHODS: A cross-sectional study was conducted among licensed and registered community pharmacy professionals working in Injibara town from June 25 to July 10, 2022. A structured self-administered questionnaire was used to collect data. The data were presented using descriptive statistics. The data were analyzed using STATA version 16 software. RESULTS: A total of 24 community pharmacy professionals were involved in the study, with a response rate of 92.3%. Approximately 91.7% of them were involved in health promotional services. Of them, 54.1% were willing and strongly believed that their involvement in health promotion services would have a positive impact on promoting health. A total of 60.9% of the community pharmacy professionals reported that they were very involved in family planning and alcohol consumption counseling. Different barriers to not providing health promotion services were also cited. CONCLUSIONS: Majority of community pharmacy professionals in this study is involved in health promotional services but there are also barriers on their involvement. Therefore, governmental strategies to overcome the barriers that hamper their involvement should be designed.

Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia.

BACKGROUND: Co-infection with HIV challenges treatment of tuberculosis (TB) and worsens the outcome. This study aimed to assess the outcome of TB treatment and its predictors among HIV infected patients at Mizan-Tepi University Teaching Hospital (MTUTH), Ethiopia. METHODS: Medical records of 188 TB/HIV co-infected patients who attended the TB clinic of MTUTH from September 2012 to December 2015 were reviewed from March 14 to April 1, 2016. The primary endpoints of the study were treatment outcome of TB and its predictors. Data were analyzed by Statistical Package for Social Sciences version 21. Multivariable binary logistic regression analysis was carried out to identify predictors of treatment outcome. Statistical significance was considered at p-value <0.05. RESULT: The treatment outcomes of TB patients included in this study were 18 (9.57%) cured, 20 (10.64%) defaulted, 24 (12.77%) died, 39 (20.74%) completed the treatment, and 87 (46.28%) transferred out. A successful treatment outcome was achieved in 57 (30.32%) patients. Initial World Health Organization (WHO) clinical stage III (COR: 2.60; 95%CI: 1.17-5.76) and stage IV (COR: 4.00; 95%CI: 1.29-12.40) were associated with unfavorable outcome. Both WHO stages (III, IV) at the time of HIV diagnosis were independent predictors of poor treatment outcome (AOR: 3.08; 95%CI: 1.14-8.38; AOR: 5.80; 95%CI: 1.36-24.71 respectively). However, smear positive TB was an independent predictor of a favorable treatment outcome (AOR: 2.50; 95%CI: 1.13-5.51). CONCLUSION: This study revealed that treatment outcome of TB patients was unsatisfactory, which signals a need for improved care. Advanced WHO clinical stages were predictors of poor outcome, while smear positive TB favors good outcome.