Factors associated with hypertension among diabetic patients in Gamo Zone, Southern Ethiopia, 2021: case-control study.

The prevalence of hypertension in diabetic patients is nearly twice that of non-diabetic patients. The presence of both hypertension and diabetes accelerates complications and raises the risk of death. Thus, identifying determinants of hypertension in diabetic patients is critical for preventing the development of devastating acute and chronic complications, as well as diabetes-related death. Methods and materials: A case-control study was carried out in public hospitals of Gamo Zone, Southern Ethiopia. To select study participants, a systematic random sampling technique was used. The KOBO toolbox was used to collect data, which was then exported to the IBM SPSS version 25 software package for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with hypertension in diabetes patients, and variables in the multivariable logistic regression analysis with a P value less than 0.05 were declared significantly associated at a 95% CI. Results: In this study, age greater than or equal to 50 years [adjusted odd ratio (AOR)=4.08, 95% CI (1.41, 11.82)], higher body mass index [AOR=3.23, 95% CI (1.40, 7.66)], and higher waist to hip ratio [AOR=2.15, 95% CI (1.12, 4.13)] were significantly associated with hypertension in diabetic patients. Conclusions: This study found that factors associated with hypertension among diabetic patients included older age (>50 years), a high waait to st#to#hip ratio, and a higher body mass index. The concerned health authorities and healthcare providers in the study area should focus on those identified factors to prevent hypertension among diabetic patients.

Factors associated with poor glycemic control among adult patients with type 2 diabetes mellitus in Gamo and Gofa zone public hospitals, Southern Ethiopia: A case-control study.

BACKGROUND: Diabetes mellitus is a serious global public health problem that affects the whole life of people in terms of their biological, psychological, and social effects. Complications and death from diabetes occur from poorly controlled blood glucose levels. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess factors associated with poor glycemic control among type2 diabetes patients in public hospitals of Gamo and Gofa zone southern, Ethiopia, 2021. METHODS: An institution-based unmatched case-control study was employed among 312 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identify factors associated with poor glycemic control using IBM SPSS version 25. The strength of association was assessed by using an Adjusted odds ratio (AOR) with a 95% confidence interval (CI). RESULT: Factors associated with poor glycemic control based on multivariable analysis were, having comorbidity (AOR = 2.35, 95% CI (1.39-3.95)), adhering to dietary recommendations (AOR = 0.31, 95% CI (089-0.51)), poor social support (AOR = 3.31, 95% CI (1.59-6.85)), physical exercise (AOR = 1.86 95% CI (1.11-3.12)), and having poly-pharmacy (AOR = 2.83, 95% CI (1.39-5.74)). CONCLUSION AND RECOMMENDATION: This study indicated a significant association of comorbidity, physical exercise, poly-pharmacy, low social support, and adherence to dietary recommendations with poor glycemic control. We suggest that the health care providers and concerned bodies encourage patients to have regular check-ups and work on providing necessary social support.

Magnitude and factors associated with musculoskeletal disorder among patients with diabetes attending chronic care at Arba Minch General Hospital, Arba Minch, southern Ethiopia, 2021: a cross-sectional study.

OBJECTIVE: This study aimed to assess the prevalence and determinants of musculoskeletal disorders (MSDs) among patients with diabetes in southern Ethiopia. DESIGN: Facility-based cross-sectional study. SETTING: Data collected from 1 March 2021 to 30 August 2021 at Arba Minch General Hospital. PARTICIPANTS: Three hundred and sixty-five patients with diabetes attending care at Arba Minch General Hospital. MAIN OUTCOME MEASURES: The magnitude and determinants of the MSDs. RESULTS: The prevalence of MSDs among patients with diabetes was 23.29% (95% CI 19.00 to 27.76). The likelihood of developing MSDs was 6.8 times higher among women than men (AOR=6.787, 95% CI 2.08 to 22.19). Rural participants were about 2.4 times (AOR=2.38, 95% CI 1.06 to 5.33) more likely to develop MSDs as compared with urban participants. Participants aged >50 years were 5.9 times more likely to develop MSDs as compared with those aged ≤50 years (AOR=5.864, 95% CI 2.663 to 12.914). The odds of developing MSDs was 6.2 times (AOR=6.247, 95% CI 1.158 to 33.702) and 5.5 times (AOR=5.451 95% CI 1.174 to 25.312) higher among participants who attended primary and secondary education as compared with those who attended college and above, respectively. Participants with cardiovascular disease were 3.9 times more likely to develop MSDs as compared with their counterparts (AOR=3.854, 95% CI 1.843 to 8.063). CONCLUSIONS: This study showed that age, sex, educational status, place of residence and cardiovascular disease were found to be determinants of MSDs. Thus, clinical and public health interventions working on diabetes mellitus should consider these determinants.

Assessment of quality of care provided to adults with type 2 diabetes mellitus at public hospitals in Gamo Gofa zone, Southern Ethiopia: Facility based Cross-Sectional study.

PURPOSE: Proactive management of type 2 diabetes is important for restoring beta-cell function and improving sustained blood glucose control. Evidence on quality of diabetes care in Ethiopia is inadequate. METHOD: Facility-based cross-sectional study was conducted to assess level of quality of care provided to adult type 2 diabetes patients at three public hospitals in Gamo Gofa Zone, Southern Ethiopia. RESULTS: A total of 210 adult type 2 diabetes patients were included. The mean age of patients was 44.1 ± 9.94 years. Fifty-one (24.3%) of patients adhered to prescribed medicines. Sixty-seven (31.9%) patients could benefit from neuropathy screening and referral. Diabetes-specific evidence-based guidelines, operational plan to reduce overweight and obesity were not available. There was no periodic lipid profile, renal function and glycated haemoglobin testing. Sixty-three (30%) patients achieved fasting blood glucose (FBG) level. Only 41 (19.5%) achieved the recommended target value for composite intermediate outcomes. All three sub-components of quality care structure, process and outcome (SPO) were below the agreed minimum score and the quality of care provided to adult type 2 diabetes was poor. Only 41 (19.5%) achieved agreed quality indicator targets for type 2 diabetes (fasting blood glucose blood pressure and low-density lipoprotein cholesterol). CONCLUSION: The quality of care provided to adult type 2 diabetes patients was poor particularly in areas such as availability of evidence-based guidelines, operational plan to reduce obesity, monitoring of lipid profile and glycaemic control. Therefore, developing strategies for addressing structure, process and outcome-related gaps by involving all stakeholders is critical for improving the quality of care provided to these patients.

Methicillin-resistant Staphylococcus aureus colonization among medicine and health science students, Arba Minch University, Ethiopia.

Individuals with Methicillin-Resistant Staphylococcus aureus (MRSA) colonized nasal cavities were at greater risk of developing the infection and can serve as potential reservoirs of transmission. Aim of this study is to determine the extent of nasal carriage and associated factors linked to MRSA in medical and health science students of Arba Minch University (AMU), Ethiopia, who are much prone. An institution based cross-sectional study was conducted at AMU from 01st August through 30th November, 2020 by means of a systematic sampling technique using a structured questionnaire. Nasal swabs samples were collected and S. aureus were identified following standard microbiological methods. Methicillin resistance was tested using cefoxitin disk and antimicrobial susceptibility tests were performed by Kirby-Bauer disk diffusion. Biofilm forming ability was phenotypically detected by micro-titer plate assay. Descriptive statistics and multivariable logistic regression analysis were done by Statistical Package for Social Service (SPSS) version 25. The overall prevalence of Staphylococcus aureus and MRSA were 27.1% (70/258) and 7.4% (19/258) respectively. Methicillin-Resistant S. aureus carriage were higher among medical interns, 16.9% (11/65). Isolates in general were co-resistant to antibiotics, such as trimethoprim-sulfamethoxazole (63.2%) and tetracycline (48.4%). Multidrug resistance (MDR) were observed among 52.6% (10/19) of the isolates. Besides, 31.4% (6/19) of MRSA were biofilm producers and all of them were MDR. Multivariable analysis showed that mean exposure for > 2 years to hospital settings [p = 0.048, AOR: 4.99, 95% CI 1.01-24.66] and the habit of sharing clothing and sports equipment [p = 0.017, AOR: 5.43, 95% CI 1.35-21.83] were statistically significant. The overall prevalence of nasal colonized MRSA among students were comparatively lower than that observed in other studies done in Ethiopia itself. An alarming factor is that, 60% of MDR-MRSA were biofilm producers.

Prevalence and Associated Factors of Carpal Tunnel Syndrome Among Diabetic Patients in Arba Minch General Hospital, South West Ethiopia, 2021.

Purpose of the Study: This study aimed to assess the prevalence of carpal tunnel syndrome and associated factors among diabetic patients in Arba Minch General Hospital, Southwest Ethiopia. Carpal tunnel syndrome (CTS) is the second most common cause of absence from work which causes functional loss of the hands and leads to disability. However, it is understudied among diabetic patients in Ethiopia. Patients and Materials: An institution-based cross-sectional study was conducted from May 1 to October 1, 2021. Systematic random sampling method was used to select 353 study participants. CTS-6 Evaluation tool was applied to assess carpal tunnel syndrome. The data was coded and entered into Epi-Data version 3.1 statistical packages and exported to SPSS version 25 for analysis. Binary logistic regression model was applied to assess the association between outcome variable and independent variables. Odds ratio (OR) with 95% CI and p-values <0.05 were used to identify significantly associated factors with an outcome variable. Results: The study was conducted among 353 diabetic patients. The cumulative prevalence of carpal tunnel syndrome among diabetes was 3.1%. CTS was statistically significantly associated with high body mass index; AOR=0.34 (0.12, 0.97, 95% CI) (p=0.04. Majority of participants 322 (91.2%) had type 2 DM. Mean fasting blood sugar level ± standard error of study participants was 157.52 ± 1.91 mg/dl. Conclusion: The prevalence of carpal tunnel syndrome was relatively low. High body mass index (BMI) was significantly but negatively associated with carpal tunnel syndrome compared to diabetic patients with normal BMI. Diabetic patients with normal BMI should be screened for CTS for early management of the disease and prevention of further complications. Further investigations are recommended.

Knowledge, Perception and Preparedness Related to COVID-19 among Adult Rural Population in Konso, Southern Ethiopia.

BACKGROUND: According to the world health organization, the COVID-19 outbreak has currently affected millions of people worldwide. Since the start of the pandemic in China, everything countries have thrown at the virus turned unsuccessful. As there is no established vaccine to halt the virus transmission, it might be very difficult for developing countries like Ethiopia even after vaccine development. Thus, focusing on improving knowledge, perception, and preparedness related to the virus might be very vital. METHODS: A community-based cross-sectional survey was conducted using the questionnaire applied in most countries which is suitable to apply in the Konso zone in South Nations Nationalities Region (SNNPR) from April.2020 to July 2020. Data were collected, cleaned, coded, checked, and entered into Epi Info and then exported and analyzed in STATA 15. We fitted a binary logistic regression model. Categorical variables were presented using figure tables, and proportion and for continuous variables, mean and standard deviation were used. The results were also presented using Adjusted Odds Ratio (AOR) with 95% CI. RESULTS: From 636 respondents expected, 615(97%) were participated and possessed the knowledge of 39%, and 64% perception and preparedness each. Measurements related to the policy and interventions like restrictions to movement, self-isolation, wearing a face mask, & the need for more tests was not supported by most participants. CONCLUSION: The poor knowledge, perception, and preparedness were correlated with the unavailability of water and electricity, less education, and informal source of information which could be improved through area appropriate health education interventions.

Establishing an Ultrasound Screening Protocol for Chronic Liver Disease with a Handheld Device: A Pilot Project in Southern Ethiopia.

Chronic liver disease (CLD) poses significant challenges in the developing world. The prevalence of this problem and the health burden on local health services are not well understood. The diagnosis and monitoring of CLD are difficult in these settings because of limited access to expensive imaging with limited mobility and/or liver biopsy. The aim of this project was to develop and implement an efficient evidence-based robust ultrasound protocol for the assessment of chronic liver disease using a hand-held ultrasound device that could be effectively used in the developing world. A protocol was established using scoring systems that have established accuracy for the diagnosis of hepatic fibrosis/cirrhosis and hepatic steatosis. Included in the protocol was the identification of hepatic masses, portal venous enlargement, hepatic size and splenic size. Hepatic steatosis was common, identified in 46 of 94 participants (49%). Hepatic fibrosis was observed in only 13 of 94 participants (14%). A significant limitation of the methodology was the inability to validate the results with biopsy or other forms of cross-sectional imaging. The protocol was successfully implemented in a community in a rural setting in South Ethiopia with a mean examination time of around 6 min. It is feasible to use handheld ultrasound for the screening of CLD in remote settings. This project provides an evidence-based framework for further studies in this area.

Morphometric assessment of spleen dimensions and its determinants among individuals living in Arba Minch town, southern Ethiopia.

INTRODUCTION: The spleen is a vital lymphoid soft organ that demands constant attention from the clinical point of view. It is a multi-dimensional organ that enlarges in its all dimensions during some disease condition. The detection of the spleen by palpation is not an indicator of an enlarged spleen because normal spleen may be palpable. Therefore, this study aimed to assess the morphometry of spleen dimensions and its determinants among individuals living in Arba Minch town by sonographic examinations. METHODS AND MATERIALS: Community-based cross-sectional study was conducted in Arba Minch town from February 1 to March 30, 2020. Seven hundred and eight study participants were selected using a multi-stage systematic random sampling technique. Data were checked for completeness, edited, coded and entered into Epi-Data version 3.1 and exported to STATA software version 16 for analysis. RESULT: The mean splenic length, width, thickness and volume were 10.24 cm, 4.79 cm, 3.93 cm, and 109.34 cm3, respectively. The mean spleen length, width, thickness and volumes among males were 10.64 cm, 4.92 cm, 4.05 cm and 119.81 cm3 and among females were 9.75 cm, 4.63 cm, 3.78 cm and 96.50 cm3 respectively. As age increased by one year the mean spleen length, width, thickness and volume was decreased by 0.032 cm, 0.018 cm 0.004 cm and 0.012 cm respectively. As height increased by 1 cm the mean spleen width and volume were increased by 0.096 cm and 0.052 cm respectively. As we go from male to female the mean spleen length decreased by 0.294 cm. CONCLUSION: The spleen dimensions were higher in males than females. Splenic length was determined by age & sex, the spleen width was determined by age & height, the spleen volume was determined by age & height and the spleen thickness was determined by age.

Sero-prevalence and risk factors for hepatitis B virus infection among the consumers of the alcoholic beverage, cheka in Konso zone, southwestern Ethiopia.

INTRODUCTION: Hepatitis B virus (HBV) is a hepatotropic and partially double stranded deoxyribonucleic acid (DNA) virus that causes the immune-mediated killing of infected liver cells. It is a public health conundrum due to its considerable morbidity and mortality. Cheka is a cereal and vegetable-based fermented beverage that is consumed as a key dietary component in the southwestern parts of Ethiopia. This study was aimed to assess the seroprevalence of hepatitis B surface antigen (HBsAg) and associated risk factors among cheka consumers in the Konso community, southwest of Ethiopia. METHODS: A community-based cross-sectional study was conducted in a total of 633 cheka consumers between October 01, 2018, and May 31, 2019. The socio-demographic characteristics and associated factors were collected using a pre-tested semi-structured questionnaire. HBV infection was screened using immune-chromatographic strip tests and positive results were further confirmed with ELISA. RESULTS: The prevalence of HBV was found to be 18.2% (95% CI, 15.1-21.5). Gender (male) (AOR = 1.757:95% CI, 1.009-3.059), age (35-44 yrs), (AOR = 4.123:95% CI, 1.718-9.892), nature of the job (daily laborer) (AOR = 4.551:95% CI, 1.115-18.57), awareness about the transmission of the disease (AOR = 2.056:95% CI, 1.074-3.934) and previous history of contacts with patients having liver diseases (AOR = 2.496:95% CI, 1.187-5.248) were identified as factors which are being significantly associated with the HBV infection. CONCLUSIONS: Very high endemic levels of HBV infection are identified in the study. Male participants of age between 35 and 44 years, who are daily laborers and are aware of HBV transmission, with a previous history of contacts with patients having liver diseases were even at higher risk of HBV infection. The need for more research to find the links between cheka consumption and other mechanisms of HBV cross-infection in these communities is indicated.