Magnitude and predictors of poor glycemic control in patients with diabetes at Jimma Medical Center, Ethiopia.

Despite the development of new medications over the past decade to aid in the control of blood glucose, most diabetic patients often do not reach recommended glycemic targets of glycated hemoglobin (HbA1C) < 7% in daily clinical practice because of many contributing factors. This study was designed to assess the magnitude and predictors of poor glycemic control among adult diabetic patients on ambulatory chronic care follow-up at Jimma Medical Center. A cross sectional study was conducted on 307 adult diabetic patients between January 2 and April 30, 2022. Representative samples were selected using a systematic random sampling technique. Predictors of poor glycemic control were assessed using a binary and multi variable logistic regression. Data analysis was performed using Statistical Package for Social Science version 25 and R in the R studio environment. A total of 307 adult diabetic patients were included in the study making a response rate of 93%. Out of 307 adult diabetic patients, majority (62.5%) were males. Mean age of the patients was 48.91 ± 15.68 years. The majority, 221 (72%), of patients had poor glycemic control. Non-adherence of patients to medications (AOR = 3.36, 95% CI 1.16-9.72, p = 0.04), no formal education (AOR = 3.84, 95% CI (1.06-13.93, p = 0.04), therapeutic inertia (AOR = 3.16, 95% CI 1.61-6.20, p = 0.001) and poor diabetic knowledge (AOR = 4.79, 95% CI 1.56-14.68, p = 0.006) were found to be independent predictors of poor glycemic control. Nearly three fourth of diabetic patients in the present study had poor glycemic control and were at higher risk of developing diabetic complications or already developed it. These results highlight the need for appropriate management of patients focusing on adherence to medications, education, therapeutic inertia and diabetic knowledge to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

Treatment Outcomes and Determinants of Eclampsia and Severe Preeclampsia Among Pregnant Women Admitted to Selected Tertiary Hospitals in Ethiopia: A Cohort Study.

BACKGROUND: Eclampsia contributes to 12% of all maternal deaths worldwide during pregnancy. Again, women with severe preeclampsia and eclampsia had a three to 25-fold increased risk of severe complications. Therefore, this study was aimed to determine treatment outcomes and determinants of eclampsia and severe preeclampsia among pregnant women admitted to selected tertiary hospitals. METHODS: A prospective cohort study was conducted on 217 women with eclampsia or severe preeclampsia from April 1 to October 30, 2019. Data were collected from patients' chart, questionnaire-based interviews at baseline and telephone interviews during follow-up. Then, the collected data were entered into EpiData 3.1 and exported to SPSS 21.0 for final analysis. Kaplan-Meier (log rank test) and Cox regression were employed to compare baseline survival experience and to adjust for the predictors of clinical outcomes, respectively. RESULTS: Of 217 women, 80.2% of them developed maternal complications, while nine (4.2%) women died. Determinant factors of maternal complications were linked with eclampsia case (AHR: 1.98; 95%CI: 1.28-3.06; P=0.002), lack of ANC follow-up (AHR: 1.75; 95%CI: 1.22-2.51; P=0.002), presence of maternal leukocytosis (AHR: 1.53; 95%CI: 1.12-2.09; P=0.008), elevated serum creatinine (AHR: 1.51; 95%CI: 1.05-2.17; P=0.02), and maternal age of 20-35 years (AHR: 0.61; 95%CI: 0.41-0.90; P=0.01). CONCLUSION: Despite improved survival of women with preeclampsia/eclampsia, different complications that they experienced remained serious problems. We suggest strategies that comprise frequent ANC follow-up and check-up for women with leukocytosis and kidney impairment so as to optimally prevent and treat eclampsia and preeclampsia during pregnancy.

Drug-related problem and its predictors among pediatric patients with infectious diseases admitted to Jimma University Medical Center, Southwest Ethiopia: Prospective observational study.

BACKGROUND: Drug-related problem is any event involving drug therapy that may interfere in a patient's desired clinical outcome. It has been pointed out that hospitalized pediatric patients are particularly prone to drug-related problems. Thus, this study aimed to assess drug-related problems and its predictors among pediatric patients diagnosed with infectious diseases admitted to Jimma University Medical Center, Southwest Ethiopia. METHODOLOGY: A prospective observational study was conducted among pediatric patients with infectious diseases admitted to the Jimma University Medical Center. Drug-related problems were classified based on Cipolle, Morley, and Strand's drug-related problems classification method. The patient's specific data were collected using a structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug-related problems occurrence, multiple stepwise backward logistic regression analysis was done. Statistical significance was considered at a p-value < 0.05. RESULTS: Of the total 304 participants, 226 (74.3%) of them had at least one drug-related problem during their hospital stay. A total of 356 drug-related problems were identified among 226 patients. Anti-infective medication was the major class of drug involved in drug-related problems. Noncompliance (28.65%) and dose too low (27.53%) were the most common type of drug-related problems identified. Presence of disease comorbidity (adjusted odds ratio = 3.39, 95% confidence interval = 1.89-6.08), polypharmacy (adjusted odds ratio = 3.16, 95% confidence interval = 1.61-6.20), and more than 6 days stay in hospital (adjusted odds ratio = 3.37, 95% confidence interval = 1.71-6.64) were independent predictors for the occurrence of drug-related problems.. CONCLUSION: Drug-related problems were high among pediatric patients with infectious disease in the study setting. The presence of comorbidity, polypharmacy, and prolonged hospital stay were predictors of drug-related problems in this finding. Therefore, to prevent these problems, the collaboration of clinical pharmacists, pediatricians, and other health care professionals is needed during the provision of pharmaceutical care.