RESUMEN
Background: Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia. Chronic hyperglycemia causes vascular complications, mortality, and life-threatening disabilities in low-income countries including Ethiopia. Glycemic control status in diabetic patients is crucial to maintain the blood glucose level at the optimal level and to reduce the risk of diabetes-related complications and mortality. However, there is limited data on poor glycemic control status and its associated factors among diabetic patients in southern Ethiopia, particularly in the study area. Thus, this study aimed to determine glycemic control status and its associated factors using glycated hemoglobin among adult diabetic patients at Nigist Elleni Mohammad Memorial Referral Hospital, Hossana, southern Ethiopia. Materials and methods: A facility-based cross-sectional study was conducted from May 1 to June 30, 2020. A systematic random sampling technique was used to recruit 307 diabetic patients at follow-up. Interviewer administered questionnaire was used to collect data on sociodemographic, clinical, and behavioral characteristics. Five milliliters of venous blood samples were collected to determine lipid profiles and hemoglobin A1C. Lipid profiles and hemoglobin A1C were measured by Cobas c311 analyzer. The data were analyzed by SPSS version 20. Bivariable and multivariable logistic regression were used to determine associated factors with poor glycemic control status. P-value <0.05 was considered statistically significant. Result: The overall prevalence of poor glycemic control among the study participants based on hemoglobin A1C ≥7% was 82.4%. Having a history of diabetic complications (AOR: 7.09, 95%CI: 1.72-29.16), duration of diabetes ≥7 years (AOR: 4.09, 95%CI: 1.38-12.08), insulin and oral hypoglycemic agents (AOR: 0.106 95%CI: 0.02-0.44), lack of self-glucose monitoring (AOR: 8.27, 95%CI: 1.61-42.46), lack of physical exercise (AOR: 5.5, 95%CI: 1.6-18.9) and dyslipidemia (AOR: 2.74, 95%CI: 1.12-6.66) were significantly associated with poor glycemic control. Conclusion: A high prevalence of poor glycemic control status (82.4%) was observed among diabetic patients in this study area, and disease-related factors like duration of diabetes, complication, treatment type and lack of self-glucose monitoring, physical exercise, and dyslipidemia were identified as factors significantly associated with poor glycemic control status. The finding of the current study should be taken into account to conduct a strategic and timely intervention on significantly associated factors to delay diabetic complications and to improve the health outcome of diabetic patients. Routine screening and monitoring of dyslipidemia and providing health education on behavioral factors were the necessary measures that should be conducted to reduce the burden of poor glycemic control status among diabetic patients.
Asunto(s)
Glucemia , Hemoglobina Glucada , Control Glucémico , Humanos , Estudios Transversales , Etiopía/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Hemoglobina Glucada/análisis , Glucemia/análisis , Diabetes Mellitus/epidemiología , Diabetes Mellitus/sangre , Anciano , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/sangre , Factores de Riesgo , PrevalenciaRESUMEN
The data presented in this article show changes in land use/land cover and fragmentation of land at a landscape level for a period of 45 years (1973-2018) in Ambo district of the central highlands of Ethiopia. Data generated from satellite images of Multispectral Scanner (MSS), Enhanced Thematic Mapper (ETM) and Operational Land Image (OLI) with path/raw value of 181/54, 169/54 and169/54 for each images respectively were analyzed by Arc GIS 10.1 software using a standard method. The precision of the images were verified by data collected from ground control points by using Geographic Positioning System (GPS) receiver. A raster data of LULC was used as an input in to FRAGSTAT software to analyze fragmentation at the landscape level. The data presented in this article showed that cultivated land and settlement increased by 45.7% (376.5ha/yr) and 111% (78.3ha/yr) for 1973-2018 periods respectively. Forest land, shrub land and bare land shrunk by 38% (147.5ha/yr), 17.1% (88.5ha/yr) and 63.9% (218ha/yr) respectively over the periods considered. Transition matrix indicated that 64781.86ha of land unchanged over the years (1973-2018). Number of patches increased by 143% while largest patch index increased by 226% in the years (1973-2018). In contrast, however, Aggregation index has shown a negative value (9.3%) and other metrics such as SIDI (12) and IJI (8.1) has shown an overall decreasing trend.