Patients' knowledge on cardiovascular risk factors and associated lifestyle behaviour in Ethiopia in 2018: A cross-sectional study.

BACKGROUND: Cardiovascular disease (CVD) is posing a major public health challenge globally. Evidence reports significant gaps in knowledge of cardiovascular risk factors among patients with CVD. Despite the growing burden of cardiovascular disease in developing countries, there is limited data available to improve the awareness of this area, which is crucial for the implementation of prevention programs. METHODS: A cross-sectional survey was conducted in two referral hospitals in Eastern Ethiopia from June-September 2018. Outpatients with a confirmed diagnosis cardiovascular conditions were eligible for participation in the study. A convenience sampling technique was used. The primary outcome of the study was knowledge of cardiovascular risk factors among patients with cardiovascular disease. The knowledge of cardiovascular disease risk factors was measured using a validated instrument (heart disease fact questionnaire). A score less than 70% was defined as suboptimal knowledge. Multivariable linear regression was used to examine the relationship between knowledge of cardiovascular risk factors and explanatory variables. RESULTS: A total of 287 patients were enrolled in the study. Mean age was 47±11yrs and 56.4% of patients were females. More than half of patients (54%) had good knowledge on cardiovascular risk factors (scored>70%), whilst 46% demonstrated suboptimal knowledge levels in this area. Urban residency was associated with higher cardiovascular risk factors knowledge scores, whereas, never married and no formal education or lower education were identified as predictors of lower knowledge scores. There was no statistically significant association between knowledge of cardiovascular risk factors and actual cumulative risk behaviour. CONCLUSION: Almost half of CVD patients in Ethiopia have suboptimal knowledge regarding cardiovascular risk factors. Residence, education level and marital status were associated with knowledge of cardiovascular risk factors. Implementation of innovative interventions and structured, nurse-led lifestyle counselling would be required to effectively guide patients in developing lifestyle modification and achieve sustainable behaviour change.

Breast cancer screening practice and its associated factors among women in Kersa District, Eastern Ethiopia.

INTRODUCTION: Breast cancer is one of the most common cancers and cause of death among women globally. Mortality due to breast cancer was higher in lower (LMICs) and middle-income countries than high income countries (HICs) mostly due to lack of timely detection and treatment. There was limited evidence related to breast cancer screening practice among women in Eastern Ethiopia. Therefore, the aim of this study was to assess breast cancer screening practice and its associated factors among women in this area. METHODS: A community based descriptive cross-sectional study design was conducted among 422 randomly selected women in Kersa district, Eastern Ethiopia using systematic sampling. Data were collected using pretested interviewer administered questionnaire. Logistic regression was used to analyse the association between the dependent and independent variables. RESULTS: The overall breast cancer screening practice among women was 6.9%. Women with the age of 26 years and above were 2.3 times more likely to have breast cancer screening practice as compared to women with age of 20-25 years (AOR=2.3; 95% CI: 1.4, 3.7), and women who had good knowledge on breast cancer risk factors were 3.4 times more likely to had breast cancer screening as compared to their counterpart (AOR=3.4; 95% CI: 1.3, 9.4). The women who had ever heard about breast cancer screening were 2.8 times more likely to have breast cancer screening as compared to those who had never heard about breast cancer screening (AOR=2.8; 95% CI: 1.2, 6.5). CONCLUSION: The overall breast cancer screening practice was very low among women in the study area. Age and women's knowledge towards breast cancer risk factors and breast cancer screening information were identified as important factors for breast cancer screening practice.

Cardiovascular risk behaviour is an emerging health issue in developing countries: a cross-sectional study.

BACKGROUND: Low and middle-income countries are facing a high burden of cardiovascular disease while there is limited availability of resources and evidence to educate and modify lifestyle behaviours in the population as well as to guide policy making. AIM: The goal of the present study was to quantify the prevalence of different cardiovascular risk behaviours among patients with known cardiovascular conditions in a developing country. METHODS: A hospital-based cross-sectional survey was conducted in two referral hospitals in eastern Ethiopia. Outpatients who had a confirmed diagnosis of cardiovascular disease were recruited for the study. Data were collected through face-to-face interviews with patients using validated tools. RESULTS: A total of 287 cardiovascular disease patients was recruited, of which 56.4% were women and 90.2% were urban residents. Most patients had inadequate consumption of fruit and vegetables, 51.6% were physically inactive, 20% were current khat chewers, 19% were current alcohol drinkers and only 1% were current smokers. Approximately one-third (30%) of the patients had one of these risk behaviours, more than half (51.9%) had two, 15% had three and 3.1% had four risk behaviours. The majority (70%) of the patients had multiple (more than two) risk behaviours. The prevalence of multiple risk behaviours did not significantly vary with sex, residence and educational level differences (P>0.05). CONCLUSION: Cardiovascular disease patients continue to follow unhealthy lifestyles although they attend follow-up care with a specific focus on risk management. The findings of this study provide evidence for policy makers that health services reform is required to promote healthy lifestyle behaviours for the patients.

Prevalence and associated factors of common mental disorders among adult patients attending HIV follow up service in Harar town, Eastern Ethiopia: a cross-sectional study.

BACKGROUND: In developed countries, there are well documented mental health impacts of HIV/AIDS and patients' quality of life. Acquiring HIV/AIDS can be a serious psychological trauma and can predispose a person to different mental disorders. Co-occurring mental illness complicates diagnosis, help-seeking, quality of care provided, treatment outcomes and adherence. However, in Ethiopia, studies about mental health problems in HIV/AIDS treatment settings are limited. The purpose of the current study is to determine the prevalence and associated factors of common mental disorders among adult HIV/AIDS patients undergoing HIV service in Harar town, eastern Ethiopia. Conducting this study is important as baseline information for the concerned stakeholders including health professionals and policymakers and in general to improve the quality of care for HIV/AID patients. METHODS: Institution based cross-sectional study was conducted. We collected data from 420 adult patients through a face to face interviewing technique using a standardized questionnaire and review of medical records. Bivariable and multivariable (binary logistic regression) analyses were used to check the association between common mental disorders (CMDs) and independent variables. Variables which have a p-value < 0.05 during bivariable regression were entered into multivariable (binary logistic regression) and finally which have a p-value of < 0.05 under multivariable (binary logistic regression) were identified as statistically significant association at 95% of confidence interval. RESULTS: All 420 patients were interviewed providing response rate 100%. The result revealed that (28.1%; 95% CI; 26.14, 30.06) of HIV/AIDS patients had CMD. In the final model, stage 4 HIV/AIDS (Adjusted Odds Ratio 3.37, 95% CI: 1.45, 7.83), family history of mental illness (AOR 2.65, 95% CI: 1.26, 5.54) and current drinking alcohol (AOR 5.1, 95% CI: 2.04, 12.79) were found having statistically significant association with CMD. CONCLUSIONS: This study investigated the prevalence and associated factors of CMD among adults living with HIV/AIDS. HIV/AIDS stage, having family history of mental illness and current drinking alcohol were the main identified associated factors of CMD. These factors are important for the hospitals and other concerned bodies for providing prevention and appropriate intervention of common mental disorders among HIV/AIDS patients.

Undernutrition and associated factors among adults human immunodeficiency virus positive on antiretroviral therapy in hospitals, East Hararge Zone, Oromia, Ethiopia: A cross-sectional study.

OBJECTIVE: The aim of the study was to assess undernutrition and factors associated with, among people living with human immunodeficiency virus (HIV) and on antiretroviral therapy (ART). METHODS: Facility-based cross-sectional study design was implemented. Data were collected using pretested structured questionnaire at ART service site. Basic descriptive statistics were computed. Bivariate and multivariate logistic regression analyses were used to assess the association between outcome variable and explanatory variables. RESULTS: The prevalence of undernutrition (body mass index [BMI] ≤18.5 kg/m2) among patients on ART was 30%. The mean BMI was 20.3 with standard deviation ± 2.9 kg/m2. Undernutrition was significantly associated with CD4 (200-500) (adjusted odds ratio [AOR] = 0.576, 95% confidence interval [CI]: 0.338, 0.979) and CD4 >500 (AOR = 0.431, 95% CI: 0.239-0.778), duration on ART >12 months (AOR = 0.466, 95% CI: 0.224, 0.966), unable to get nutritional care and support (AOR = 2.188, 95% CI: 1.349, 3.549), diarrhea (AOR = 1.641, 95% CI: 1.036, 2.6), khat chewing (AOR = 0.589, 95% CI: 0.377, 0.92), and severe food insecurity (AOR = 1.594, 95% CI: 1.008, 2.521). CONCLUSIONS: Our study provides a unique insight into prevalence and associated factors of undernutrition which greatly affect ART outcomes. The study revealed that the undernutrition was found to be high and its problem in HIV-positive patients are interworsen. Diarrhea, severe food insecurity, nutritional care and support, khat chewing, CD4 >200/µl, and duration on ART >12 months were independently associated with undernutrition. Comprehensive nutritional assessment during follow-up and routine nutritional supplement therapy for undernutrition in conjunction with early start on ART need to be initiated.

Adherence to recommended lifestyle modifications and factors associated for hypertensive patients attending chronic follow-up units of selected public hospitals in Addis Ababa, Ethiopia.

INTRODUCTION: One of the most prevalent noncommunicable diseases is hypertension (HTN). The availability of effective antihypertensive medications does not result in the expected outcomes in terms of controlling blood pressure. The rationale for these and other findings of uncontrolled HTN points toward poor adherence. The most neglected causes of uncontrolled HTN are unhealthy lifestyles. Few studies have been conducted to show the gap and magnitude of self-management adherence. OBJECTIVE: This study aimed to assess adherence to recommended lifestyle modifications of hypertensive patients undergoing follow-up at chronic follow-up units of public health hospitals in Addis Ababa, Ethiopia, 2016. METHODS: Institutional-based cross-sectional study was conducted in four public health hospitals which were selected by drawing lots. Systematic random sampling was used to select study subjects. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between lifestyle modification and independent variables were ana-lyzed using bivariate and multivariate logistic regression analysis. The study was conducted from February 15, 2016 to April 15, 2016. RESULTS: The study included 404 respondents with a 97% response rate; 210 (52%) were male and the mean age was 54.00±10.77 years. The respondents' adherence to lifestyle modifications was 23%. The lifestyle adherence was found to be better in females, patients who had comorbidities, and had been knowledgeable about the disease and was poor among young adult respondents. CONCLUSION: The rates of adherence to lifestyle changes were generally found to be low. Educational sessions that especially focus on lifestyle modifications and ongoing support for patients should be designed and studies which assess all the components of self-management should be conducted for comparison among different subgroups.