Incidence and determinants of nosocomial infection among hospital admitted adult chronic disease patients in University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2016-2020.

Background: Nosocomial infections are major public health problem which affects more than 100 million patients each year globally. This leads to prolonged hospital stays, a high mortality rate, and a vast financial burden to the healthcare system as well as the patients. This study aimed to find out the incidence of nosocomial infections and determinant factors among admitted adult chronic illness patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods: An institutional-based retrospective follow-up study design was employed among 597 respondents. The secondary data was collected from April 15 to May 15, 2021. A computer-generated random sampling technique was used to select a total of 599 patients using Open-epi software. Structured checklists were used to collect data. For data entry and analysis Epi-Data version 4.6 and STATA 16 were used respectively. To identify statistically significant variables Cox-regressions (univariable and multivariable) were performed. To declare statistically significant variables based on p < 0.05 in the multivariable Cox-regression model, adjusted hazard ratio with 95% CI was used. Results: A total of 597(99.6%) adult chronic illness patients were included in the study. Of these, 53 (8.88%) participants developed nosocomial infections and the incidence rate of nosocomial infection was 6.6 per 1,000 person-days observation. In this study, not taking antibiotics (AHR = 2.74, 95% CI: 1.49, 5.04), using mechanical ventilation (AHR = 2.67, 95% CI: 1.36, 5.26), being on urinary catheter (AHR = 4.62, 95% CI: 2.22, 9.65), being on intravenous catheter (AHR = 3.42, 95% CI: 1.22, 9.61) and length of hospital stay >20 days (AHR = 2.66, 95% CI: 1.43, 4.94) were significantly associated with nosocomial infections. Conclusions: The findings have indicated that the incidence of nosocomial infection was low. No taking antibiotics, intravenous insertion, mechanical ventilation, length of hospital stay, and urinary catheterization were the predictors for the development of nosocomial infection. Therefore, we recommend that the healthcare providers need to give emphasis on infection prevention and control in the institution on these factors that have a significant effect on nosocomial infection.

Outcomes and Predictors of Severe Community-acquired Pneumonia Among Adults Admitted to the University of Gondar Comprehensive Specialized Hospital: A Prospective Follow-up Study.

Background: Severe community-acquired pneumonia is a common life-threatening infection with a high rate of unfavorable outcome. This study aimed to assess the outcomes and predictors of hospitalized severe community-acquired pneumonia patients at University of Gondar comprehensive specialized hospital. Methods: A prospective follow-up study was conducted at University of Gondar comprehensive specialized hospital from May 1 to September 31, 2021. The data was collected by reviewing patients' charts and interviewing the patients themselves. Descriptive statistics, binary and multivariable logistic regression analysis were performed accordingly. Variables with p-value <0.2 on binary logistic regression were analyzed using multivariable logistic regression and variables with p<0.05 were considered to have significant association. Results: A total of 239 admitted patients with severe community-acquired pneumonia were enrolled in the study. An unfavorable outcome was observed in 105 (44%) patients; 24.27% was in-hospital all-cause mortality, 12.5% was nonresolution, 5.8% was complicated cases, and 1.26% were gone against medical care for poor prognosis. After analyzing multivariable logistic regression, confusion (OR= 4.84; 95%CI: 1.47-15.88), anemia (OR= 2.36; 95%CI: 1.01-5.52), leukopenia (OR=4.38; 95%CI: 1.26-15.25), leukocytosis (OR=3.15; 95%CI: 1.23-7.96), elevated creatinine (OR=5.67; 95%CI: 1.72-18.65), intubation (OR=7.27; 95%CI: 1.58-33.37) and antibiotic revision during treatment for a different reason (OR=0.02; 95%CI: 0.01-0.07) were variables significantly associated with unfavorable outcome. Conclusion: Unfavorable outcome was high among hospitalized severe community acquired pneumonia patients, and confusion, elevated creatinine, anemia, leukopenia, leukocytosis, intubation during admission, and antibiotic revision during the course were independent predictors associated significantly with the unfavorable outcome. It is important to consider the development of a treatment protocol for the hospital and to further research incorporating the microbiologic profile of the patients.

High burden of depression among cancer patients on chemotherapy in University of Gondar comprehensive hospital and Felege Hiwot referral hospital, Northwest Ethiopia.

INTRODUCTION: Cancer, the most stressful event a person may experience often triggers depression. Depression among these groups of people, in turn, affects chemotherapy adherence, length of hospitalization, quality of life and cancer treatment outcome. Even though the problem is enormous studies that address it are limited. Therefore this study was conducted to determine the prevalence of depression and associated factors among cancer patients on chemotherapy in Felege-Hiwot referral hospital and University of Gondar referral hospital, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted from April to May 2019. A total of 302 cancer patients on chemotherapy were included. Depression was assessed using the patient health questionnaire (PHQ-9). Binary logistic regression was used to select variables and determine Crude Odds Ratio (COR). Variables with P value < 0.2 were entered into multivariable logistic regression. Adjusted Odds Ratio (AOR) with 95% confidence intervals for variables with P-value < 0.05 was estimated to show factors affecting depression among cancer patients. The fitness of the model was checked by using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: The prevalence of depression among cancer patients on chemotherapy was 70.86% (95% CI: 65.38, 75.92). Educational status of college and above (AOR = 0.1, 95% CI: 0.02, 0.43), Jobless (AOR = 0.15, 95% CI: 0.04, 0.58), Underweight(AOR = 2.39, 95% CI: 1.10, 5.19)chemotherapy duration ≥ 6 months or more (AOR = 2.36, 95% CI: 1.16, 4.79) were notably associated with depression. CONCLUSION: The burden of depression among cancer patients in this study was high. We recommend concerned bodies working to curve the problem to intervene based on the identified risk factors. Improving educational status, reducing work stress and maintaining normal weight would reduce depression.