Survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa.

Background: Diabetic neuropathy is a very common complication of diabetes mellitus. Thus, measuring the incidence of diabetic neuropathy is a key element in tracking the progress of epidemics of diabetes mellitus and an indication of early accessibility for healthcare in terms of type 2 diabetic patients. Objective: To assess survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa from June 25 to August 25, 2023. Methods: An institutional-based retrospective follow-up study design was used among newly diagnosed type 2 diabetic patients at hospitals of Addis Ababa. A chart review tool that contains socio-demographic, clinical, and comorbidity characteristics, biochemical characteristics, and the status of type 2 patients was used. A cleaned data was exported from Epi-data manager 4.6 version to SPSS version 25 for analysis. Bivariate Cox regression analysis was done to identify predictors of diabetic neuropathy at a 95% confidence level. Result: A total of 414 type 2 diabetic patients were included in the study. Of these, 97 (23.4%) developed diabetic neuropathy. Variables like having hypertension (AHR 11.25, 95% CI 3.73-33.93), anemia (AHR 4.18, 95% CI 1.78-9.82), high-density lipoprotein < 40 mg/dl (AHR 5.07, 95% CI 1.38-18.67), high creatinine level (AHR 14.67, 95% CI 4.27-50.40), diabetic retinopathy (AHR 4.32, 95% CI 1.32-14.18), and diabetic nephropathy (AHR 2.50, 95% CI 1.09-6.57) were associated with the incidence of diabetic neuropathy. The mean time to develop diabetic neuropathy was 4.94 years, CI (4.50-5.38), and the mean survival time was 6.61 years. Conclusion: The incidence of diabetic neuropathy was high relative to other studies. Variables like having hypertension, anemia, high-density lipoprotein, high creatinine level, diabetic retinopathy, and diabetic nephropathy were predictors of diabetic neuropathy. The mean time to develop diabetic neuropathy was 5 years, with a survival mean time of 7 years.

Ambulance service satisfaction level and associated factors among service users in Addis Ababa, Ethiopia.

INTRODUCTION: Pre-hospital ambulance service is the most important part of healthcare service. Client satisfaction with the service indicates the degree of adaptation to the appropriate quality and quantity of services. Patients' dissatisfaction with the service can affect their expectations of the overall services that they will receive later in the definitive care facility. However, it is not a well-addressed area in developing countries, including Ethiopia. OBJECTIVE: This study aimed to identify the ambulance service satisfaction level and associated factors among service users in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted in five governmental hospitals in Addis Ababa city. A face-to-face exit interview technique was employed on a total of 410 consecutively selected participants using a pretested tool developed from similar sources. The cleaned data was entered into the Epi-Data Manager 4.6 version and then exported to SPSS version 26 for analysis. The dependent variable was dichotomized into satisfied and unsatisfied to compute bivariate logistic regression. In the multivariate logistic regression model, predictors with a p-value < 0.05 at the 95% CI were considered to have a significant association. RESULT: A total of 410 respondents were included in the study. The mean of participants' responses regarding ambulance personnel, call operator, treatment on the scene, and ambulance subscale was 3.64, 3.48, 3.40, and 3.43, respectively. The study found that only 21.5% of participants were satisfied by the ambulance service they received. There was a statistically significant association between ambulance service satisfaction and age (AOR = 3.52, 95% CI: 1.01-12.36), monthly income (AOR = 3.13, 95% CI: 1.41-6.94), ambulance response time (AOR = 10.33, 95% CI: 2.09-51.06), type of ambulance used (AOR = 4.55, 95% CI: 2.19-9.43), and previous ambulance usage (AOR = 2.33, 95% CI: 1.34-4.05). CONCLUSION: The study found a low level of satisfaction among ambulance users. The findings suggest that ambulance personnel performance is a key determinant of user satisfaction, while treatment at the scene and in the ambulances, and call operator areas require improvement. Age, monthly income, ambulance response time, type of ambulance, and previous ambulance use also influenced satisfaction. Improving the quality of services, reducing response time, and ensuring call operators are trained are vital steps to enhance satisfaction.

Pattern and Outcomes of Fall Injuries and Associated Factors in Emergency Department at Addis Ababa Burn, Emergency and Trauma Hospital.

INTRODUCTION: Fall injuries are an important public health concern and remain a growing health problem globally. Falls are predicted to rise in rank compared to other causes of death, to become the 17th leading cause of death by 2030 unless necessary intervention is given. PURPOSE: This study was aimed to assess the pattern, outcomes of fall injuries, and associated factors. METHODS: A cross-sectional study design was employed to review a patient's registration chart from January 1, 2019 to December 31, 2019. Data were collected using a structured checklist developed from previous similar studies. The checked data were entered into Epi data 4.1 versions. Then, it was exported to SPSS 25 versions for analysis. Data were analyzed using descriptive statistics and logistic regression. In the multivariate logistic regression predictors having a P-value < 0.05 were considered to be statistically associated. RESULTS: A total of 331 patients' charts were reviewed. The most common outcome of falling injury was alive 284 (85.8%) while death accounts for 47 (14.2%). Among injured body parts, extremity accounts for around one-fourth, 88 (26.6%), followed by head injury 68 (20.5%). In multivariate logistic regression, those patients aged ≥65 years had 6.15 times more likely to die than those patients aged between 15 and 30 years (AOR 6.15; 95% CI 2.82-14.37, P=0.015), and participants with comorbidity were 1.6 times more likely to die than to be discharged (AOR 1.60; 95% CI, 1.01-5.09, P=0.005) due to falling injury, whereas patient's occupation, marital status, and sex had no significant association with outcomes of a fall injury. CONCLUSION: The most common outcomes of fall injury were discharged with improvement even though there was a high death rate. Extremity injuries were the most common pattern of injury. Fall is high-risk mortality in the older age group. Furthermore, patient with comorbidity, fall from height and injury to spinal cord and poly-trauma is more likely to die relative to other patients.