Prevalence of anti-seizure medication nonadherence and its associated factors, among people with epilepsy in North Shewa, Ethiopia, 2021.

BACKGROUND: Epilepsy is a worldwide neurologic illness, characterized by recurrent unprovoked epileptic seizures and can affect people of all age groups. Patients who are receiving drug therapy for chronic diseases, such as epilepsy, must fit complex medication regimens into their everyday routines. Managing medication schedules may pose a significant burden on patients' lives. Anti-seizure medication choices should therefore be tailored to patients' factors that may limit medication use. The study aimed to determine the prevalence and Predictors of anti-seizure medication nonadherence among patients with epilepsy. METHODOLOGY: An institutional-based cross-sectional study was conducted among 352 people with epilepsy who were selected by systematic random sampling method at government hospitals in North Shewa Ethiopia. Data were collected by reviewing patients' charts and interviewing people with epilepsy by using structured and pretested questionnaires. Data obtained were encoded into EPI-INFO software and exported to SPSS version 25 for analysis. Logistic regression was employed to assess independent factors associated with medication non-adherence. RESULT: The prevalence of anti-seizure medication non-adherence was 40%. Being female [AOR = 3.37, 95%, CI: 1.84, 6.18], Divorced [AOR = 9.13, 95%, CI: 1.80, 46.34], Being jobless [AOR = 7.33, 95%, CI: 3.24, 16.56], Perceived poor social support [AOR = 2.73, 95%, CI: 1.28, 5.82], perceived stigma [AOR = 5.07, 95%, CI: 2.40, 10.68], polytherapy [AOR = 2.23, 95%, CI: 1.06, 4.71], drug side effects[AOR = 6.03, 95%, CI: 3.17, 11.45], buying medications [AOR = 5.81, 95%, CI: 3.63,16.79] and duration of stay on treatment [AOR = 4.31, 95%, CI: 1.863, 9.97] were significant predictors of anti-seizure medication non-adherence. CONCLUSION: Non-adherence to anti-seizure medication among people with epilepsy in the study area was relatively higher as compared with study reports from different parts of the country. Health and clinical, socio-economy, and patients' psychological mindset were among the determinant factors affecting the consistency of epilepsy treatment adherence. Enhanced professional, health education for patients as well as for society and financial support, are basic pillars to reduce the constraints of effective treatment.

Effect of malaria and HIV/AIDS co-infection on red blood cell indices and its relation with the CD4 level of patients on HAART in Bench Sheko Zone, Southwest Ethiopia.

BACKGROUND: Malaria and HIV/AIDS are the two most common infections in sub Saharan Africa (SSA) and worldwide. HIV infected individuals in malaria endemic areas experience severe malaria episodes. The immunological basis of this clinical observation is unclear and the hematologic abnormalities such as anemia in malaria and HIV co infected patients were inconsistent from studies in the past. Ethiopia's three-fourth of the landmass is malarious and HIV prevalence is high that significantly affect RBC indices and other hematologic profiles. OBJECTIVE: This study aimed to compare RBC indices and anemia in HIV patients' co-infected with malaria and those HIV patients without malaria and correlates these with CD4 level. METHODS: A comparative cross-sectional study was employed on 103 malaria-HIV/AIDS co infected (MHC) and 103 HIV patients without malaria on HAART of the same ART centers in Bench Sheko Zone. Data was collected by structured questionnaire and blood samples were collected from both groups for malaria test and RBC indices measurement. Data was entered and checked in Epi-data and exported to IBM SPSS version 21 software packages for analysis. RESULTS: There were significant differences in Mean±SD of RBC indices between the two groups (P<0.001). RBC, Hgb, HCT and MCV were lower in MHC patients. In total study participants, significant positive correlation was observed between CD4 count with MCV, CD4 count with MCH and CD4 count with anemia. In the group of malaria-HIV co-infected, CD4 count with RBC and CD4 count with Hgb and in HIV without malaria CD4 count with MCV, CD4 count with MCH and CD4 count with MCHC were positively correlated. Overall anemia prevalence was 45.1%. Anemia prevalence in MHC (Malaria-HIV co-infected) was 63.4%. Anemia prevalence distribution among sex showed that 61.3% in female sex and anemia prevalence distribution among CD4 group showed 55.9% in patients with CD4 count of ≤500 cells/µl. Anemia in MHC patients was higher in those with CD4 count of ≤500 cells/µl (59.3%) while in OH (Only HIV infected) anemia prevalence was similar in those with CD4 count of ≤500 and ≥500 cells/µl (50%). There is significant difference in anemia in MHC and OH infected with different CD4 group (P<0.01). CONCLUSION: There was a difference in RBC indices in both groups; RBC, Hgb, HCT and MCV were lower in MHC patients. There was positive correlation between CD4 counts with some RBC indices in combined both groups. However, there was positive correlation between CD4 counts with RBC and Hgb in malaria-HIV co-infected. The combined prevalence of anemia was higher and anemia in MHC was greater than OH infected patients.

Prevalence of pneumonia and its determinant factors among under-five children in Gamo Zone, southern Ethiopia, 2021.

Background: Pneumonia, which is a form of acute lower respiratory tract infection, affects the lung parenchyma and destructs alveolar air space. Pneumonia is the leading cause of morbidity and mortality in under-five children. It was estimated that pneumonia kills 900,000 under-five children each year worldwide. Approximately 172 deaths per 1,000 live births occur in sub-Saharan African countries, with pneumonia being the major cause. This study aimed to assess the prevalence and determinant factors of pneumonia inunder-five children in southern Ethiopia. Methodology: An institutional cross-sectional study was employed. A total of 239 child-caregiver pairs were included. Data were collected by trained nurses using a semi-structured questionnaire. The collected data were checked for completeness, coded and entered into EPI data version 4.6, and exported to SPSS version 25 for analysis. Results were reported as the mean, frequency, and percentile. Logistic regression was employed to assess statistically significant predictors of pneumonia. Variables with a p-value <0.05 were considered statistically significant factors of pneumonia. Result: The prevalence of pneumonia in the study area was 30%. Among the factors assessed, place of food cooking-inside the living room [adjusted odd ratio (AOR) = 5.79, 95% confidence interval (CI): 2.47-13.58], nonexclusive breastfeeding (AOR = 3.26, 95% CI: 1.42-7.52), vitamin A supplementation status (AOR = 5.62, 95% CI: 2.65-11.94), and vaccination status (AOR = 3.59, 95% CI: 1.49-8.66) were significantly associated with the occurrence of pneumonia in under-five children. Conclusion: This study showed that the prevalence of pneumonia was relatively higher in Arba Minch town than other parts of the country. Place of food cooking, nonexclusive breastfeeding, vitamin A supplementation status, and vaccination status of children were significant factors of pneumonia among under-five children. Enhancing caregivers'/mothers' awareness of predicted factors was needed to reduce the incidence of childhood pneumonia and to enhance children's quality of health.

Glycemic Control, Diabetes Complications and Their Determinants Among Ambulatory Diabetes Mellitus Patients in Southwest Ethiopia: A Prospective Cross-Sectional Study.

BACKGROUND: Over the past two decades, the prevalence of diabetes has increased faster in low- and middle-income countries than in high-income countries. Regardless of the instant growth in the prevalence of diabetes in Ethiopia, up-to-date data regarding glycemic control and related complications of diabetes is inadequate. This study aimed to identify glycemic control and chronic complications and their determinants among ambulatory diabetic patients at Mizan-Tepi University Teaching Hospital (MTUTH). METHODS: We conducted facility-based cross-sectional study from February 25 to March 25, 2019, at Mizan-Tepi University Teaching Hospital. Patients' demographic data, diabetes complications, and treatments were collected using pretested questionnaire and data abstraction format. Data was entered by using Epidata manager 4.0.2.101, and statistical analysis was done by SPSS version 21. Bivariate logistic regression was done to see the association between independent variables and glycemic control and complication. Multivariable logistic regression analyses using backward selection were done to identify the predictors of poor glycemic control and complication at a P-value of <0.05. RESULTS: One hundred ambulatory diabetic patients were included in this study. The mean duration of diabetes and the mean age of the participants were 3.95±5.85 and 46.66±15.53 years, respectively. About 71 (71%) of the studied diabetic patients had uncontrolled fasting blood glucose (FBG) level. More than half of the diabetic patients (59%) developed chronic complications of diabetes. Low medication adherence (adjusted odds ratio (AOR)=11.78, 95%CI: 1.09-17.17) and inappropriate doses in the first, second, and third clinic visits (AOR=7.70, 95%CI: 1.79-33.01; AOR=8.09, 95%CI: 1.90-34.33; AOR=4.34, 95%CI: 1.09-17.17), respectively, were independent predictors of uncontrolled FBG. No variable was found to be an independent predictor of chronic diabetic complication on multivariable logistic regression analyses. CONCLUSION: Poor glycemic control and diabetes complications among ambulatory diabetic patients were high. Low medication adherence and inappropriate doses in the first, second, and third clinic visits were independent predictors of poor glycemic control.