Determinants of Diabetic Nephropathy among Diabetic Patients in General Public Hospitals of Tigray, Ethiopia, 2018/19.

BACKGROUND: Diabetic nephropathy is real damage resulting from having uncontrolled diabetes mellitus. Unmanaged diabetic nephropathy is one of the most leading causes of kidney failure. There is a scarcity of information on the determinants of diabetic nephropathy among diabetes mellitus patients in Ethiopia. Identification of the determinants can help devise a strategy to properly address the disease and its consequences. Therefore, this study was designed to assess the determinants of diabetic nephropathy among diabetes mellitus patients. METHODS: Unmatched case-control study design with 168 cases and 672 controls with a mean age of 45.18 and 62.12, respectively, participated in the study. An interviewer-administered questionnaire was employed for data collection, and a systematic sampling technique was used to select the study participants. Data were entered into Epi data and exported to SPSS for data clarification and analysis. Binary logistic regression analysis was carried out to check the level of association between diabetic nephropathy and the independent variables. RESULTS: Comorbidity (AOR: 4.96 at 95 CI: 1.77-13.87), hypertension (AOR: 6.33, 95% CI: 2.51-16.02), poor glycemic control (AOR: 3.27, 95% CI: 1.31, 8.21), age (AOR: 1.14, 95%: 1.09-1.19), duration with diabetes mellitus since diagnosis (AOR: 1.83, 95 CI: 1.62-2.06), and nonadherence to diabetic medication (AOR: 3.3, 95% CI: 1.34, 8.15), diet (AOR: 5.96, 95%: 1.92-18.54), and exercise (AOR: 5.60, 95% CI: 1.94-16.21) were the determinants of diabetic nephropathy. CONCLUSION: Adherence to medication, diet, and exercise should be empowered to achieve glycemic control and to prevent diabetic nephropathy. More attention has to be also given for old aged diabetic patients, long duration since diagnosis of diabetes mellitus, hypertension, and other comorbidities.

Hypoglycemia Prevention Practice and Associated Factors among Diabetic Patients on Follow-Up at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018.

BACKGROUND: Hypoglycemia is an acute medical situation that occurs when blood glucose level falls below 70 mg/dl. Although prevention of hypoglycemia is one cornerstone in the management of diabetes mellitus, its prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. METHODS: Hospital-based cross-sectional study design was employed from March 1 to April 1, 2018, in the central zone of Tigray regional state of Ethiopia. A total of 272 diabetes mellitus patients selected by a systematic random sampling method were included in the study. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for further analysis. The binary logistic regression model (AOR, 95% CI, and p value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. RESULTS: The mean age of respondents was 43.62 years, and about 100 (63.2%) participants had good hypoglycemia prevention practice. Good knowledge on hypoglycemia (AOR = 10.34; 95% CI [5.41, 19.89]), having a glucometer at home (AOR = 3.02; 95% CI [1.12, 8.12]), favorable attitude towards diabetes mellitus (AOR = 2.36 CI [1.26, 4.39]), and being governmental employee (AOR = 5.19, 95% CI [1.63, 16.58]) were positive predictors of good hypoglycemia prevention practice. However, being divorced (AOR = 0.13, 95% CI [0.32, 0.53]) was found negatively associated with good hypoglycemia prevention practice. CONCLUSION: Only two-thirds of the study participants were found to have good hypoglycemia prevention practices. Healthcare personnel and Ethiopian diabetic association should promote patients' attitude towards DM and knowledge on hypoglycemia by strengthening information, education, and communication program. Stakeholders should also try to provide glucometers to diabetic patients.

Self-care practices and associated factors among adult hypertensive patients in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018.

OBJECTIVES: To assess self-care practices and associated factors among hypertensive patients in Ayder Comprehensive Specialized Hospital 2017/2018. RESULT: Good self-care practice was found only among 20.3% of respondents. Adherence to not smoking, anti-hypertensive medication, alcohol abstinence, dietary management, physical exercise and weight management was found to be 99.1%, 74.10%, 67.20%, 63.10%, 49.4% and 40.6% respectively. Sex (AOR = 2.254, 95% CI 1.092-4.653), age (AOR = 3.265, 95% CI 1.030-10.355), educational status (AOR = 4.205, 95% CI 1.304-13.559), disease duration (AOR = 3.124, 95% CI 1.204-8.105), BP status (AOR = 2.728, 95% CI 1.256-5.926) and knowledge (AOR = 6.196, 95% CI 2.906-13.214) showed significant statistical association with self-care practice.

Uncontrolled hypertension and associated factors among adult hypertensive patients in Ayder comprehensive specialized hospital, Tigray, Ethiopia, 2018.

BACKGROUND: Despite the availability and improvement in diagnostic and therapeutic interventions with proven benefits in reducing cardiovascular morbidity and mortality, control rates of hypertension remain poor and grossly inadequate. Around one billion individuals are living with uncontrolled hypertension globally. Uncontrolled hypertension among hypertensive patients on treatment in Ethiopia ranges from 11.4 to 69.9%. Therefore, the aim of this study was to determine the magnitude and associated factors of uncontrolled hypertension among hypertensive patients in Ayder comprehensive specialized hospital, Tigray, Ethiopia 2018. METHODS AND MATERIALS: Hospital-based cross-sectional study design was conducted from February 16-April 30/2018. Simple random sampling method was used to select 320 participants. Data was collected using interviewer administered standard structured questionnaire. Self-care practice measuring tool was adopted from hypertension self-care activity level effects (H-scale). Data was entered to and cleaned by Epi Info version 7 and it was exported to SPSS version 22 for analysis. Binary logistic regression model (AOR, 95% CI and p-value < 0.05) was used to determine the predictors of uncontrolled hypertension. RESULT: From the total respondents, 164 (51.2%) were females. The mean age of the respondents was 53.83 + 14.52 years. Prevalence of uncontrolled hypertension was found 52.5%. Overweight (AOR = 4.527, 95% CI: 2.247-9.123), co-morbidity (AOR = 2.112, 95% CI: 1.218-3.662), non-adherence to anti-hypertensive medication (AOR = 2.062, 95% CI: 1.030-4.129), non-adherence to physical activity (AOR = 1.931, 95% CI: 1.074-3.470) and non-adherence to alcohol abstinence (AOR = 2.093, 95% CI: 1.109-3.948) are independent predictors of uncontrolled hypertension. CONCLUSION: the prevalence of uncontrolled hypertension is high. Patients' adherence to antihypertensive medication, physical exercise and alcohol abstinence should be maximized. Weight reduction and early identification and management of co-morbidities are also crucial.