Antibiotics prescribing practice among patients with urinary tract infection at outpatient department, the case of Dilchora referral hospital, Eastern Ethiopia: an institutional retrospective cross-sectional study.

BACKGROUND: Inappropriate prescription of antibiotics is a global public health challenge. Widespread use, misuse, or inappropriate prescribing has resulted in unnecessary expenditure on drugs, raised risk of adverse reactions, the development of antimicrobial resistance, and increment in health care costs. There is a limited practice in rational prescribing of antibiotics in the management of Urinary tract infection (UTI) in Ethiopia. OBJECTIVE: To assess antibiotic prescribing practice in the treatment of patients with UTI at outpatient department (OPD), Dilchora referral hospital, Eastern Ethiopia. METHODS: A retrospective cross-sectional study was conducted from January 7 to March 14, 2021. Data were collected from 600 prescription papers using systematic random sampling method. World Health Organization's standardized core prescribing indicators was used. RESULTS: A total of 600 prescriptions containing antibiotics prescribed for patients with UTIs were observed during the study period. Of these, 415 (69.19%) were females and 210 (35%) were in the age group of 31-44 years. The number of generic drugs and antibiotics prescribed per encounter was 1.60 and 1.28, respectively. The percentage of antibiotics per prescription was found to be 27.83%. About 88.40% of antibiotics were prescribed by generic names. Fluoroquinolones were the most frequently prescribed class of drugs for the treatment of patients with UTIs. CONCLUSION: The prescribing practice of antibiotics in patients with UTIs was found to be good as the drugs were prescribed in generic name.

Asymptomatic Bacteriuria, antimicrobial susceptibility pattern and associated risk factors among pregnant women attending antenatal care in Assosa General Hospital, Western Ethiopia.

BACKGROUND: Asymptomatic bacteriuria is a common problem in pregnant women and about 40% of women with untreated asymptomatic bacteriuria during pregnancy develop pyelonephritis, which might lead to low birth weight, premature rupture of membranes, and preterm labour. Therefore, this study aimed to assess the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates among pregnant women attending the antenatal care of Assosa general hospital, western Ethiopia. METHODS: A facility-based cross-sectional study was conducted from January to February 2019. Two hundred and eighty-three pregnant women with no symptoms of urinary tract infections participated in the study. Bacterial isolates were identified as per the standard bacteriological procedure using colony characteristics, Gram-staining, and series of biochemical tests. Antimicrobial susceptibility test was carried out by Kirby- Bauer disk diffusion technique on Muller-Hinton agar medium and the diameter of zone of inhibition was interpreted according to Clinical Laboratory Standard Institute guidelines. RESULTS: The overall prevalence of asymptomatic bacteriuria among pregnant women in this study was 13.78% (i.e. 39 out of 283 urine samples were positive for bacterial isolates). E. coli was the most predominant isolate (53.8%) followed by K. pneumoniae (17.95%), S. aureus (15.4%), and coagulase-negative staphylococci (12.8%). Gram-negative bacteria were highly resistant to tetracycline (96.4%), and ampicillin (90.5%). CONCLUSION: Significant bacteriuria was observed in asymptomatic pregnant women. A large number of the bacterial isolates were resistant to the commonly used antimicrobial drugs.

Potential adverse drug events and its predictors among hospitalized patients at medical center in Ethiopia: a prospective observational study.

Potential adverse drug event (PADE) is a medication error with the potential to cause associate degree injury however that does not cause any injury, either due to specific circumstances, chance, or as a result of the error being intercepted and corrected. This study aimed to assess the incidence, contributing factors, predictors, severity, and preventability of PADEs among hospitalized adult patients at Jimma Medical Center. A prospective observational study was conducted among hospitalized adult patients at a tertiary hospital in Ethiopia. Logistic regression was performed to identify factors predicting PADE occurrence. P-value < 0.05 was considered for statistical significance. A total of 319 patients were included. About 50.5% of them were females. The mean ± SD age of the participants was 43 ± 17.6 years. Ninety-four PADEs were identified. Number of medications (adjusted OR = 5.12; 95% CI: 2.01-13.05; p = 0.001), anticoagulants (adjusted OR = 2.51; 95% CI: 1.22-5.19; p = 0.013), anti-seizures (adjusted OR = 21.96; 95% CI: 6.57-73.39; p < 0.0001), anti-tuberculosis (adjusted OR = 2.2; 95% CI: 1.002-4.59, p = 0.049), and Elixhauser comorbidity Index ≤ 15 (adjusted OR = 6.24; 95% CI: 1.48-26.25, p = 0.013) were independent predictors of PADEs occurrence. About one-third of patients admitted to the hospital experienced PADEs.

Identification and resolution of drug-related problems among diabetic patients attending a referral hospital: a prospective observational study.

BACKGROUND: People living with diabetes are more vulnerable to drug-related problems due to the presence of multiple diseases. This study aimed to identify drug-related problems and contributing factors among diabetic patients. METHODS: This study used a prospective observational study design. The study was conducted among diabetic patients during follow-up at Mettu Karl Referral Hospital from 15 April to 09 August 2019. The consecutive sampling was utilized to collect data. The identification of drug-related problems was performed using the Pharmaceutical Care Network Europe version 8.03. Following data collection, data were entered into Epidata manager version 4.4.2 and exported to the SPSS version 24.0 for analysis. Multivariable logistic regression analysis was done to identify predictors of drug-related problems. RESULTS: A total of 330 people with diabetes were included in the study, among whom 279 (84.5%) had at least one drug-related problem. A total of 455 drug-related problems were identified. Effects of drug treatment not being optimal (52.7%) and untreated symptoms or indications (30.1%) were the most commonly identified drug-related problems. About 865 interventions were provided for identified drug-related problems and 79.8% was accepted. Diabetes duration [Formula: see text] years [AOR = 2.02; 95% CI (1.06, 3.85); p = 0.033] and the presence of comorbidity [AOR: 2.33; 95% CI (1.18, 4.60); p = 0.015] were factors identified as predictors of drug-related problems. CONCLUSION: The present study identified that drug-related problems are common among diabetic patients. Effects of drug treatment not being optimal and untreated symptoms or indications were the most commonly identified drug-related problems. Longer diabetes duration and the presence of comorbidities were predictors of drug-related problems.

Severity and Mortality Associated with Steroid Use among Patients with COVID-19: A Systematic Review and Meta-Analysis.

BACKGROUND: There are controversial suggestions about steroid use to treat patients infected with COVID-19. Conclusive evidence regarding the use of steroids to treat COVID-19 is still lacking. This meta-analysis aimed to determine the mortality and severity associated with corticosteroid therapy compared to noncorticosteroid treatment in patients with COVID-19. METHODS: The information was collected from electronic databases: PubMed, CINAHL, the Cochrane Library, clinicaltrials.gov, and Google scholar through January 30, 2021. Risk ratios (RRs) with 95% confidence intervals (CIs) were performed using random effect models. Endnote citation manager software version X9 for Windows was utilized to collect and organize search outcomes (into relevant and irrelevant studies) and to remove duplicate articles. RESULTS: Thirty-two studies were included in the meta-analysis, including 14,659 COVID-19 patients. No significant differences in mortality between the steroid and nonsteroid treatment groups (RR = 0.95; 95% CI: 0.80-1.13; p = 0.57). There was no significant reduction in mortality in critically ill COVID-19 patients treated with corticosteroid (RR = 0.89; 95% CI: 0.62-1.27; p = 0.52). Significant differences were observed in severe disease conditions between the steroid and nonsteroid treatment groups (RR = 1.10; 95% CI, 1.03-1.19, p = 0.007). CONCLUSION: There was no significant difference in all-cause mortality between the steroid and nonsteroid treatment users' of COVID-19 patients. There was no significant reduction of all-cause mortality in critically ill COVID-19 patients treated with corticosteroids.

Dental caries and associated factors in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results. OBJECTIVE: This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia. METHODS: Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I2 test were performed respectively. A random effects model meta-analysis was accustomed to estimate the pooled burden of dental caries. RESULTS: The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest. CONCLUSION: Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.

Prevalence, Patterns and Predictors of Chronic Complications of Diabetes Mellitus at a Large Referral Hospital in Ethiopia: A Prospective Observational Study.

PURPOSE: Diabetes mellitus complications are responsible for increased disability, morbidity, and mortality. This study aimed to assess prevalence, patterns, and predictors of chronic complications of diabetes among people with diabetes. PATIENTS AND METHODS: The study was conducted using a prospective observational study design which was done on people with diabetes attending the ambulatory clinic of Mettu Karl Referral Hospital. The data were collected using a consecutive type of sampling technique from April 15 to August 9, 2019. The data were entered into Epidata manager version 4.4.2. Logistic regression analysis was done to identify predictors of chronic complications of diabetes. RESULTS: A total of 330 participants were included in this study. The mean age of participants was 49.9±14.2, and 156 (47.3%) were 41 to 60 years old. About 127 (38.5%) had one or more chronic complications. The predictors of chronic diabetes complications were resident in urban areas [AOR: 1.94; 95% CI: (1.17, 3.20); p = 0.010], duration of diabetes 10 years [AOR: 2.05, 95% CI: (1.21, 3.47); p = 0.007], hypertension [AOR: 4.19; 95% CI: (2.54, 6.91); p < 0.001] and poor glycemic control [AOR: 2.82; 95% CI: (1.53, 5.21); p = 0.001]. CONCLUSION: Almost two-fifth of the study participants had chronic complications of diabetes. Residents in urban areas, longer duration of diabetes, hypertension and poor glycemic control were predictors of chronic diabetes complications. It is important to achieve good glycemic control and manage comorbid diseases like hypertension to minimize the risk of chronic diabetes complications.

Adverse Drug Events and Contributing Factors Among Hospitalized Adult Patients at Jimma Medical Center, Southwest Ethiopia: A Prospective Observational Study.

BACKGROUND: Adverse drug events (ADEs) are common complications of clinical care resulting in significant morbidity, mortality, and high clinical expenditure. Population-level estimates of inpatient ADEs are limited in Ethiopia. OBJECTIVE: This study aimed to assess the incidence, contributing factors, severity, and preventability of ADEs among hospitalized adult patients at Jimma Medical Center, Ethiopia. METHODS: A prospective observational study design was conducted among hospitalized adult patients at tertiary hospital in Ethiopia. A structured data collection tool was prepared from relevant literatures for data collection. Data were analyzed using statistical software. Logistic regression was performed to identify factors contributing to ADE occurrence. P values < 0.05 were considered statistically significant. RESULTS: A total of 319 patients were included with follow-up period of 5667 person-days. About 50.5% were women. The mean (SD) age of patients was 43 (17.6) years. One hundred sixteen ADEs were identified with the incidence of 36.4 (95% CI, 30.1-43.6) per 100 admissions and 20.5 (95% CI, 16.9-24.6) per 1000 person-days. Antituberculosis agents (adjusted odds ratio [aOR] = 2.52; 95% CI, 1.06-5.98; P = 0.036), disease of the circulatory system (aOR = 2.67; 95% CI, 1.46-4.89; P = 0.001), disease of the digestive system (aOR = 2.84; 95% CI, 1.45-5.57; P = 0.002), being on medication during admission (aOR = 3.09; 95% CI, 1.77-5.41; P < 0.001), and hospital stay more than 2 weeks (aOR = 3.93; 95% CI, 1.39-11.12; P = 0.010) were independent predictors of ADE occurrence. CONCLUSIONS: One in every 4 patients admitted to the hospital experienced ADEs during their hospital stay. Most ADEs were moderate in severity. About two-thirds of the ADEs identified were deemed probably or definitely preventable. Therefore, it is high time to reinforce large-scale efforts to redesign safer, higher quality health care systems to adequately tackle the problem.

Glycemic Control and its Predictors among Adult Diabetic Patients attending Mettu Karl Referral Hospital, Southwest Ethiopia: A Prospective Observational Study.

INTRODUCTION: The current estimate is that 463 million people worldwide have diabetes. In 2017, an estimated 5 million (9.9%) deaths worldwide among adults were caused by diabetes. The burden of disease associated with uncontrolled diabetes is substantial in terms of mortality and cardiovascular disease. The aim of this study was to assess glycemic control level and its predictors among adult patients with diabetes. METHODS: A prospective observational study was conducted among patients with diabetes during follow-up at an ambulatory clinic of Mettu Karl referral hospital from 15 April to 09 August 2019. The consecutive sampling method was used to collect data, following which the data were entered into Epidata manager version 4.4.2 and exported to the SPSS version 24.0 statistical software package for analysis. Logistic regression analysis was performed to identify predictors of poor glycemic control. Variables whose significance level was < 0.05 (p value) were considered to be predictors of poor glycemic control. RESULTS: A total of 330 diabetic patients were included in the study, among whom 240 (72.7%) had poor glycemic control. The predictors of poor glycemic control in the multivariate logistic regression analysis were overweight [adjusted odds ratio (AOR) 4.07; 95% confidence interval (CI) 1.60, 10.36; p = 0.003], obesity (AOR 4.39; 95% CI 1.59, 12.14; p = 0.004), higher estimated glomerular filtration rate (eGFR) (AOR 2.34; 95% CI 1.23, 4.44; p = 0.010), type 1 diabetes (AOR 3.22; 95% CI 1.58, 6.55; p = 0.001), poor diet adherence (AOR 6.95; 95% CI 3.63, 13.32; p < 0.001) and non-adherence to medications (AOR 5.82; 95% CI 2.77, 12.26; p < 0.001). CONCLUSION: Almost three-quarters of the study population of diabetic patients had poorly controlled blood sugar. Overweight, obesity, higher eGFR, type 1 diabetics, poor adherence to diet recommendation and non-adherence to medications were independent predictors of poor glycemic control. Educational strategies should focus on improving adherence to the recommended diet and medication(s), achieving weight control and optimizing glycemic control.