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Background: Globally, about 18 million people died from cardiovascular diseases (CVDs) in 2019, over three-quarters in developing countries. Non-adherence to medication in CVD patients causes hospitalization, worsened symptoms, higher healthcare costs, and more emergency visits. Hence, this study aimed to assess treatment satisfaction and medication adherence and predictors in heart failure (HF) patients attending Debre Berhan Comprehensive Specialized Hospital (DBCSH), Ethiopia. Methods: A hospital-based cross-sectional study was undertaken at the medical referral clinic of DBCSH. A total of 344 ambulatory HF patients who visited the medical care of the DBCSH medical referral clinic during the study period were included. Treatment satisfaction was assessed using a self-administered Medicine Questionnaire (SATMED-Q). Relationships between predictor variables and treatment satisfaction were determined using one-way analysis of variance (ANOVA) and an independent t-test. Medication adherence was determined using the Morisky Green Levin Medication Adherence Scale (MGLS). Results: Participants with drug-drug interactions (DDIs) were approximately 38% less likely to adhere to medication compared to their counterparts (AOR = 0.62, 95% CI: 0.54–0.71). Additionally, participants who had taken five or more drugs were approximately 68% less likely to adhere to medication compared to those who had taken only one drug (AOR = 0.32, 95% CI: 0.2–0.51). The correlation between medication adherence and drug-drug interactions remains a possible pseudo-correlation via the number of medications taken. There was a noteworthy positive correlation (rs = 0.34, p = 0.027) between participants’ treatment adherence and treatment satisfaction. Conclusion: The rate of treatment satisfaction and treatment adherence among HF patients was 67.6% and 60.9%, respectively. The presence of DDI and the number of drugs were identified as predictors to medication adherence. [ABSTRACT FROM AUTHOR]

Introduction: Though drugs play indispensable role in the treatment of cervical cancer, they are associated with medication-related problems (MRPs). Hence, the present study was aimed to investigate MRPs among patients with cervical cancer. Methods: A hospital-based retrospective study was employed at the oncology center of University of Gondar Comprehensive Specialized Hospital. All patients with cervical cancer diagnosis from January 1, 2016 to December 31, 2020, were included. Stata version 16/MP for Windows was used for description and analysis. Logistic regression analysis was employed. Results: A total of 124 patients with cervical cancer were included. Paclitaxel and cisplatin (69.4%) combination were the most widely used treatment regimen. MRPs were found in 59.7% patients, with a mean of 2.22 ± 1.13. Subtherapeutic dose (24.4%), the need for additional drug therapy (22.6%), and adverse drug reactions (22%) were the most prevalent MRPs. Being >50 years (adjusted odds ratio (AOR) = 15.37, 95% confidence interval (CI) = 2.25–105.09, p = 0.005), treated with ≥5 medications (AOR = 7.00, 95% CI = 2.65–18.49, p < 0.001), and being stage III (AOR = 15.43, 95% CI = 2.92–81.47, p = 0.001) and stage IV (AOR = 8.41, 95% CI = 1.35–52.44, p = 0.023) were independent predictors of MRPs. Conclusion: More than half of patients with cervical cancer had one or more MRPs. Being older, patients taking polypharmacy, stage III and IV patients were significantly associated with the development of MRPs. As most of the cervical patients experienced one or more MRPs, clinical pharmacy service should be strengthened to optimize drug therapy to reduce unwanted adverse events. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate community pharmacists' knowledge of opioid-containing medications and their attitude toward opioid use problems. Materials and methods: A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1– 30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants' knowledge and attitudes. Results: Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor's degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76– 40.35) and 9.93 (1.04– 85.33) for bachelors and postgraduates respectively and age 1.45 (1.20– 1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20– 17.90) and 4.29 (1.23– 15.05)] for 5– 9 years and ≥ 10 years respectively and education level [AOR (95% CI): 4.08 (1.40– 11.93) for bachelors and 6.40 (1.42– 28.96)] for postgraduates were linked to attitude. Conclusion: A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information. [ABSTRACT FROM AUTHOR]

Introduction: Data on colorectal cancer (CRC) patients' thorough management practices and medication-related harms (MRH) are scarce. This study's aim was to investigate the MRHs in patients receiving CRC chemotherapy at the comprehensive specialized hospital of the University of Gondar (UoGCSH). Methods: A registry-based retrospective cohort study was conducted on CRC patients at the UoGCSH during 2017-2021. From February to May 2022, medical records were reviewed using a pretested data collection tool to collect socio-demographic and disease-related characteristics, MRHs, and medication regimens. MRHs occurrence and adverse drug reactions (ADRs) severity were assessed using standard guidelines and protocols. Version 16/MP of STATA for Windows was used for the analysis. Independent predictors of MRHs were investigated using logistic regression analysis. A p-value =0.05 was used to determine an independent variable's statistical significance. Results: One hundred forty three CRC patients were included, with a mean age of 49.9 ± 14.5 years. About 32.9% and 33.6% had stage II and III cancer, respectively. Significant patients had co-morbidities (15.4%) and complications (13.3%). Fluorouracil (5-FU)-based regimens were given to more than half (56%) of the patients. MRHs were found in 53.1% of the patients, with a mean of 2.45 ± 1.37 MRHs. The most common MRHs were the need for additional drug therapy, sub-therapeutic dose, DDIs, and ADRs. Being on stage IV (AOR = 27.7, 95% CI = 3.85-199.38, p = 0.001), having co-morbidity (AOR = 7.42, 95% CI = 1.80-30.59, p = 0.018) and having complication (AOR = 11.04, 95% CI = 1.72-70.95, p = 0.011) and treated with five or more drugs (AOR = 2.54, 95% CI = 1.07-6.07, p = 0.035) were independent predictors of MRHs. Conclusion: A fluorouracil-based treatment regimen was most frequently used. MRHs were found in nearly half of CRC patients. Furthermore, MRHs were significantly associated with cancer stage, comorbidity and complication status, and the number of medications used. Because MRHs are common, improving clinical pharmacy services is critical for optimizing drug therapy in CRC patients. [ABSTRACT FROM AUTHOR]

Background: Health economic evaluation identifies, measures, values, and compares alternative strategies to efficiently allocate scarce resources. The validity, methodological quality, and generalizability of economic evaluations must be assessed, as poorly designed studies can lead to incorrect conclusions. Therefore, this study aimed to evaluate the quality and characteristics of published economic evaluations done in Ethiopia, using the Quality of Health Economics Studies (QHES) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) instruments. Methodology: Various electronic databases were searched using different keywords. We included only original studies conducted in Ethiopia that evaluated the cost and consequences of at least two health interventions. Abstracts, treatment guidelines, reviews, expert opinions, and studies that included other countries were excluded. Two reviewers independently evaluated each study using the QHES and CHEERS instruments and any disagreements were then resolved by a third reviewer. Result: The study included 21 studies published between 2002 and 2021. HIV was the most frequently evaluated medical condition, examined in four (19.06%) of the 21 studies. Seventeen of the studies (80.95%) compared healthcare services or programs, while the other four examined pharmaceutical products. Cost-utility analysis was the economic evaluation technique used in 14 studies (66.67%). Of the studies that disclosed their funding sources, foreign institutions were involved in funding 71.43% of them. Disability-adjusted life-year (DALY) was an outcome metric used in nine (42.86%) studies. The average QHES score of the studies was 82%. Fourteen studies had QHES scores of ≥75% and two had scores of <50%. The studies evaluated using the CHEERS instrument ranged in quality from 42.9% to 92.9%, with an average of 78.23%. Conclusion: Our study revealed that Ethiopia lacks health economic evaluations, particularly on non-communicable diseases. This indicates that the economic evaluation of healthcare interventions in Ethiopia is still in its early stages. Additionally, Ethiopian institutions have played a very limited role in funding research, highlighting the importance of active participation from local institutions. [ABSTRACT FROM AUTHOR]

Micronutrient deficiency has serious consequences across all ages worldwide, particularly in sub-Saharan Africa. Poor micronutrient (MN) consumption among children remains a major public health concern in many countries. Low literacy, poor diets, a lack of access to healthcare, and insufficient agricultural productivity made proper micronutrient consumption difficult, despite numerous interventions. Thus, this research aimed to determine the adequate intake of MNs among 6–23 months of age children in sub-Saharan Africa. Initially, a two-stage stratified sampling technique was applied for the selected recent demographic and health survey data. The data source was the (2015–2020) standard demographic and health surveys (DHS) among 20 Sub-Saharan African countries. Micronutrient intake status (the outcome variable) was determined using either food rich in Vitamin A or iron consumed within the previous 24 hr or multiple micronutrient powder or iron supplementation within the previous 07 days or vitamin A supplementation or deworming within 06 months. A generalized linear mixed model based on Modified Poisson regression and robust error variance was used to identify factors associated with children's adequate micronutrient intake. An adjusted Prevalence Ratio (aPR) with a 95% confidence interval was used to identify factors, strength and direction of the association. The total samples of 65,187 children aged 6–23 months were included. Of all, 73.99% (95% CI: 73.65, 74.32) of children had adequate intake of micronutrients. Maternal education (primary (aPR = 1.04, 95% CI: 1.02, 1.06) and secondary (aPR = 1.07, 95% CI: 1.04, 1.09)), father's education (primary (aPR = 1.03, 95% CI: 1.01, 1.05) and secondary (aPR = 1.04, 95% CI: 1.02, 1.06)), occupational status of the mother (aPR = 1.04, 95% CI: 1.02, 1.06), pregnancy interval (aPR = 0.97, 95% CI: 0.95, 0.99), exclusive breastfeeding status (aPR = 0.83, 95% CI: 0.82, 0.85), birthweight (average (aPR = 1.03, 95% CI: 1.01, 1.05) and larger than average (aPR = 1.04, 95% CI: 1.02, 1.06)), multiple/twin at birth (aPR = 0.94, 95% CI: 0.91, 0.98), child age (aPR = 1.22, 95% CI: 1.19, 1.25), number of children in home (aPR = 1.02, 95% CI: 1.01, 1.03), ANC utilization (aPR = 1.20, 95% CI: 1.15, 1.27), place of birth (AOR = 0.93, 95% CI: 0.91, 0.95), rich households (aPR = 1.03, 95% CI: 1.01, 1.05), and countries from Central (aPR = 1.07, 95% CI: 1.04, 1.09), South Africa (aPR = 1.07, 95% CI: 1.03, 1.11), and West African (aPR = 0.95, 95% CI: 0.92, 0.99) were associated with level of micronutrients intake status. The prevalence of adequate intake of MN was considerable. Variables at the child, family and community levels were associated with adequate intake of micronutrients. Consequently, stakeholders' involvement is required in healthcare and community settings. [ABSTRACT FROM AUTHOR]

Introduction: In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer. Methods: A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed. Results: A total of 184 cervical cancer patients were included, with a mean age of 50.2± 10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32± 1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78– 10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28– 6.99, p = 0.011), being treated with ≥ 5 medications (AOR = 5.1, 95% CI = 2.38– 10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02– 0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01– 0.32, p = 0.003). Conclusion: Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs. [ABSTRACT FROM AUTHOR]

Many endoparasites are still considered neglected tropical illnesses. The term "endoparasites" refers to infections caused by both helminths and protozoa. In many places in Ethiopia, particularly Debre Tabor, epidemiological data on the prevalence and associated variables of endoparasites among under-five children is unavailable. Thus, the aim of this study was to gather baseline data on the prevalence of endoparasites and their associated variables among under-five children who visited the Debre Tabor comprehensive specialized hospital in Northwest Ethiopia. A hospital-based quantitative cross-sectional study was used. The study was carried out from May 1 to November 30, 2021. Study participants were selected by a systematic sampling technique. The stool specimen was examined for the presence of different stages of intestinal parasites (adult, trophozoite, larvae, cysts, and ova) using direct wet mount, modified formal-ether sedimentation, and modified Ziehl–Neelsen methods. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The data was summarized using frequency tables and a bar chart. The adjusted odds ratio and p value <0.05 were used to declare the final association. In the present study, a total of 258 under-five children and their mothers/guardians were involved in the study, with a response rate of 100%. More than half of the respondents, 137 (53.10%), were females, and 159 (61.63%) were in the age group of 24 to 59 months. The overall prevalence of one or more endoparasites among under-five children was 45 (17.44%). Multivariate logistic regression analysis showed that health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with childhood endoparasites. The present study demonstrated a higher prevalence of endoparasites among under-five children. Health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with endoparasites. Thus, strengthening health education about food, personal, and environmental hygiene for both children and their mothers/guardians is crucial. [ABSTRACT FROM AUTHOR]

Background: Different evidence suggested that couples often disagree about the desirability of pregnancy and the use of contraceptives. Increased women's decision-making on contraceptives is identified as a key solution that can change the prevailing fertility and contraceptive utilization pattern in SSA. Therefore, this study aimed to determine determinants of contraceptive decision-making among married women in Sub-Saharan Africa.Methods: The data source of this study was the standard demographic and health survey datasets of 33 Sub-Saharan Africa countries. Reproductive age group women aged (15-49 years) currently married who are not pregnant and are current users of contraceptive preceding three years the survey was included from the individual record (IR file) file between 2010 and 2018. Since the outcome variable is composed of polychotomous categorical having multiple-choice, the Multinomial logistic regression (MNLR) model was applied.Results: A total of 76,516 married women were included in this study. Maternal age 20-35 and 36-49 years were more likely to had decision making on contraceptive use in both women-only and joint (women and husband/partner category (referance = husband/partner) (RRR = 1.2; 95% CI = 1.05-1.41, RRR = 1.18; 1.04-1.33 and RRR = 1.38; 95% CI = 1.17-1.61, RRR = 1.27; 1.11-1.47)] respectively. Married women with higher education were more likely to decide by women-only category on contraceptive use (referance = husband/partner) (RRR = 1.26; 95% CI = 1.06-1.49). Women only decision-making to use contraceptives relative to the husband/partner only decreases by a factor of 0.86 (95% CI = 0.80-0.93) among rural than urban residences. Women only or joint decision making to use contraceptives was 1.25 and 1.35 times more likely relative to husband/partner decision making respectively among women who had work than that of had no work. The relative risk of women's decision to use family planning relative to husband increased among couples who had a marital duration of ≥ 10 years (RRR = 1.14; 95% CI = 1.06-1.22). But it has no significant effect on joint decision making. Respondents found in the richest wealth index category increase the relative risk of joint decision-making relative to husband/partner (RRR = 1.33; 95% CI = 1.20-1.47) compared to the poorest category.Conclusions: Decision-making to use contraceptives among married women varies greatly by socio-demographic characteristics. The finding of this study showed that women's age, women educational status, residence, duration of the marriage, family economy, and country income were significantly associated with contraceptive decision-making. Therefore to promote ideal family planning decision making, there is a need to formulate policies and design programs that target women's socio-demographic characteristics and modern contraceptive interventions should be promoted by considering empowering women on decision making. [ABSTRACT FROM AUTHOR]

Introduction: By measuring patients' satisfaction, providers can gain insight into several elements of health care services, including the effectiveness of their care and the level of empathy they exhibit. The aim of this study was to assess patient satisfaction with pharmaceutical services and associated factors in public hospitals located in Northwestern Ethiopia. Methods: An institution-based quantitative cross-sectional study was used. The study was carried out in an outpatient pharmacy from January 1–June 30, 2021. Participants were selected by a systematic sampling technique. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The findings were presented using descriptive statistical methods. To find factors linked to satisfaction, binary logistic regression was used. Results: The final analysis included a total of 401 samples. More than half of the participants (229, or 55.1%) were female. The overall mean score of satisfaction was 30.6 out of a maximum of 100 scores. By taking this mean score as a cut-off point, 204 (50.9%) of the study participants had satisfaction with the outpatient pharmacists' service. Participants' responses scored on the uncomfortable and inconvenient waiting areas [AOR = 0.31; 95%CI, (0.13, 0.49)] were found to be negatively associated with the level of patients' satisfaction. Also, the unavailability of medications [AOR = 0.12; 95%CI, (0.02, 0.37)] was negatively associated with the respondent satisfaction. Uncomfortable and inconvenient private counseling areas [AOR = 1.37; 95%CI, (0.79, 4.42)] showed a negative association with their satisfaction. Conclusion: Patients' satisfaction levels with pharmacy service were found to be greater than 50%. The socio-demographic characteristics of patients have no association with their level of satisfaction, but their perception of uncomfortable private counseling areas and waiting areas was negatively associated with their satisfaction. [ABSTRACT FROM AUTHOR]

Background: Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. There are disproportional survivals among children in the world. Therefore, the study aimed to assess the Survival status of under-five mortality and determinants in Sub-Saharan African Countries using the recent DHS data.Methods: The data was retrieved from the birth record file from the standard Demographic and Health Survey dataset of Sub-Saharan Africa countries. Countries that have at least one survey between 2010 and 2018 were retrieved. Parametric shared frailty survival analysis was employed.Results: A total of 27,221 (7.35%) children were died before celebrating their fifth birthday. Children at an early age were at higher risk of dying and then decrease proportionally with increased age. The risk of death among rich and middle family were lowered by 18 and 8% (AHR =0.82, 95% CI: 0.77-0.87) and (AHR = 0.92, 95% CI: 0.87-0.97) respectively, the hazard of death were 11, 19, 17, 90 and 55% (AHR = 1.06, 95% CI: 1.00-1.12), (AHR = 1.11,95%CI:1.04-1.19), (AHR = 1.17, 95% CI:1.12-1.23), (AHR = 1.90, 95%CI: 1.78-2.04) and (AHR = 1.55, 95% CI:1.47-1.63) higher than among children in rural, use unimproved water, delivered at home, born less than 18 months and between 18 and 23 months birth intervals respectively. The hazard of death was 7% among females and low birth weights (AHR = 0.93, 95%CI: 0.90 - 0.97) and (AHR = 0.93 95%CI: 0.89-0.97) respectively. There was also a significant association between multiple births and birth orders (AHR = 2.11, 95%CI: 2.51 - 2.90), (AHR = 3.01, 95%CI: 2.85-3.19) respectively.Conclusions: Death rate among under-five children was higher at an early age then decreases as age advanced. Wealth status, residence, water source, place of delivery, sex of the child, plurality, birth size, preceding birth interval, and birth order were the most predictor variables. The health care program should be designed to encourage a healthy family structure. The health care providers should intervene in the community to inspire maternal health services. [ABSTRACT FROM AUTHOR]

Background. The prevalence and incidence rate of epilepsy were found to be higher in low- and middle-income countries. Uncontrolled epilepsy has a high risk of disability, stigma, discrimination, human rights violations, and premature death. The available studies of controlled seizure in Ethiopia have showed inconsistent results which calls for systematic review and meta-analysis. Therefore, this review intended to show the pooled prevalence of controlled seizure among people with epilepsy receiving antiepileptic drugs at outpatient department. Methods. A systematic literature search was conducted using PubMed/Medline, Science Direct, PsycINFO, Hinnarri databases, and Google Scholar for grey literatures. Data were extracted with structured format prepared using Microsoft Excel and exported to Stata/MP 16.0 software for analyses. The I 2 test was used to check the heterogeneity between primary studies with a corresponding 95% confidence interval (CI). Results. A total of 23 primary studies were included in the review showing the pooled prevalence of controlled seizure to be 46% (95% CI: 35, 56). A subgroup analysis of the primary studies showed a considerable variation in magnitude of seizure freedom by study regions, age groups, and seizure-free period. The highest prevalence was found in Addis Ababa 52% (95% CI: 29, 75), pediatric patients 77% (95% CI: 71, 83), and a seizure-free period of less than six months 58% (95% CI: 32, 83). On the other hand, the lowest prevalence of controlled seizure was found in Tigray 27% (95% CI: 11, 65), adult patients 43% (95% CI: 32, 54), and a seizure-free period of six or more 41% (95% CI: 32, 51). Higher frequency of seizure before treatment (2.23, 95% CI: 1.15, 3.31) and medication nonadherence (2.7, 95% CI: 1.25, 4.15) had statistically significant association with uncontrolled seizure. Conclusion. In this review, the prevalence of controlled seizure was found to be low. This warrants that clinicians should give more focus to epileptic patients regarding monitoring and evaluation of treatment outcome of epilepsy and factors that affect seizure control in routine clinical services. The use of standardized definition of controlled seizure, designing strategies to identify pharmacoresistant epilepsy and its treatment, and increasing medication adherence are recommended in Ethiopia. The review protocol has been registered with PROSPERO registration number CRD42021215302. [ABSTRACT FROM AUTHOR]

Background: Sleep is a physiologic necessity for all humankind. Pregnant women, in particular, need adequate sleep to develop their fetuses as well as save energy required for delivery. A change in sleep quality and quantity is the most common phenomena during pregnancy due to mechanical and hormonal factors. However, there is a scarcity of data about poor sleep quality and its associated factors among pregnant mothers in Ethiopia. Therefore, this study aims to determine the prevalence of poor sleep quality and its associated factors among pregnant mothers at Wadila primary hospital, Ethiopia. Methods: Institution based cross-sectional study design was employed on 411 pregnant mothers. Data were collected using a pre-tested interviewer administered questionnaire. SPSS Version 23 for Windows software was used for data analyses. Bivariate analysis was conducted to detect the association between dependent and independent variables, and to choose candidate variables (p < 0.25) for multivariate logistic regression. Statistical significance was set at p-value <0.05. Results: A total of 411 participants were included in the study making a response rate of 97.4%. Overall, 68.4% of participants found to have poor sleep quality (PSQI>5). Age of the mother [age 20–30 years; AOR = 4.3 CI (1.8, 9.9), p = 0.001, and age >30 years; AOR = 4.7 CI (1.6, 13.9) p = 0.005], gestational age [second trimester, AOR = 2.46, CI (1.2, 4.9), p = 0.01 and third trimester, AOR = 7.5, CI (3.2, 17.8), p = 0.000] and parity [multiparous women; AOR = 2.1(1.24, 3.6) p = 0.006] were predictor variables for poor sleep quality among pregnant mothers. Conclusion: More than two-third of pregnant mothers had poor sleep quality. Advanced maternal age, increased gestational age and multiparty are found to be predictors of poor sleep quality in pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Inappropriate drug utilization may reduce the best possible benefits of drug therapy, and patients may not be cured, they may be exposed to toxicity, and medications may be wasted. The aim of this study is to assess household-level drug utilization practices and their associated factors. Methods: A cross-sectional community-based study was conducted from January 15 to March 15, 2020. In total, 847 households selected by stratified multistage sampling were visited. Bivariate and multivariable analyses for association were carried out using a binary logistic regression model. The statistical significance of an association was confirmed at p< 0.05. Results: Of the total 847 households, 378 (44.6%) were found to store drugs at home at the time of datacollection. In the 371 households that allowed observation of the drugs stored, a mean of 2.51 (SD=1.68) drugs per household was found; 40.2% of stored medicines were not in use at the time of the study. The prevalences of medication hoarding, sharing, and allopathic self-medication were 20.4%, 26.3%, and 43.8%, respectively. Higher monthly income and the presence of a child aged under 5 years were significantly associated with drug hoarding. The presence of an elderly person aged above 65 years and the presence of a family member with chronic illness were significantly associated with drug hoarding and sharing. Families with higher educational status were less likely to hoard and share medicines. The presence of stored drugs at home was significantly associated with the practice of self-medication. Conclusion: A high prevalence of inappropriate drug utilization was observed. Factors such as the presence of a family member with chronic illness, elderly people, and children under 5, higher income, and the presence of stored drugs were significantly associated with inappropriate drug utilization. Families of higher educational status were less likely to hoard and share medicines. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D status is related to risks of influenza and respiratory tract infections. Vitamin D has direct antiviral effects primarily against enveloped viruses, and coronavirus is an enveloped virus. The 2019 coronavirus disease had a high mortality rate and impacted the whole population of the planet, with severe acute respiratory syndrome the principal cause of death. Vitamin D can adequately modulate and regulate the immune and oxidative response to infection with COVID-19. The goal of this systematic review was thus to summarize and decide if there were a link between vitamin D status and COVID-19 infection and prognosis. Methods: The protocol of this study is documented in the Prospero database and can be accessed with the protocol number CRD42020201283. PubMed and Google Scholar were used for a literature search from August 2020 to September 2020. We restricted the year of publication of reviewed articles to 2019– 2020, and the selected language was English. Studies that used secondary data, feedback, or analysis of reviews were removed. To assess the standard of studies included, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method was used. Results: Of the nine studies reviewed, seven (77.8%) showed that COVID-19 infection, prognosis, and mortality were correlated with vitamin D status. Conclusion: Most of the articles reviewed showed that blood vitamin D status can determine the risk of being infected with COVID-19, seriousness of COVID-19, and mortality from COVID-19. Therefore, maintaining appropriate levels of Vitamin D through supplementation or natural methods, eg, sunlight on the skin, is recommended for the public to be able to cope with the pandemic. [ABSTRACT FROM AUTHOR]

Background: Happiness is the most indicator of good quality of life particularly for pregnant women. Reduced happiness of pregnant women can result in reduced maternal health services utilization and can result in adverse newborn and maternal outcomes. Assessing the level of happiness and its factors are important for pregnant women and the next generation. Hence, the current research paper aimed to assess the level of happiness and its associated factors among pregnant women who attended antenatal care follow-up in South Gondar Zone Hospitals. Methods: Institution-based cross-sectional study was carried out from September 2018 to February 2019 among 1606 expectant pregnant women in the last 6 months. The Oxford Happiness Questionnaire (OHQ) was used as a measure of the degree of happiness and used four as average person score. Besides, bivariate, multivariable logistic analyses were deployed to identify associations. Results: A total of 1606 pregnant women were participating in this study. The prevalence of low level of pregnancy happiness in this study was 24% (95% CI: 20.7 − 26.6). Mothers who exposed to unintended pregnancy (AOR; 1.94, CI 95% 1.86– 4.52), reported intimate partner violence (AOR; 2.42, 95% CI 1.67– 3.54) and being in the third trimester (AOR; 1.89 95% CI 1.19– 3.01) were the most predictor variables with the low level of happiness. Conclusion: Approximately one-fourth of the pregnant women had a low level of pregnancy happiness. Mothers who were exposed to unintended pregnancy encountered intimate partner violence, who were in the third trimester were the most significant variables associated with a low level of happiness. Governmental and non-governmental organizations work on women's reproduction rights and the zonal health department with local health offices should educate on the prevention of intimate partner violence and unintended pregnancy and its consequences and also empower women to cope with changes and challenges of pregnancy and childbirth. [ABSTRACT FROM AUTHOR]

Medication-related problems (MRPs) are an important healthcare problem. This study aimed at reviewing the published literature in Ethiopia to estimate the prevalence of MRPs and to summarize associated factors. A comprehensive systematic search was conducted in PubMed, EMBASE, CINAHL, Scopus, Google Scholar, and Google databases from inception to April 2020. Articles that addressed MRPs were eligible for inclusion. Article screening, data extraction, and study quality analysis were performed independently by two reviewers. Studies targeting specific disease condition were considered as specific, while the remaining were nonspecific. The prevalence of MRPs was then computed in medians and interquartile ranges (IQR), while associated factors were summarized in a table. Of the thirty-two studies included in this review, the majority of them (n = 24) targeted MRPs, while the remaining studies (n = 8) investigated adverse drug reactions (ADRs). Studies varied in the study design, study population, and definition of MRPs and ADRs used. The overall median prevalence was 70.8% (IQR = 61.0-80.2) with a range of 16.0% to 88.7%. The median prevalence of MRPs in specific and nonspecific patients was 71.2% (IQR = 60.7-71.2) and 69.3% (IQR = 60.7-82.0), respectively. In addition, a median of 36.6% (IQR = 10.0-85.7) of patients experienced ADRs. Indication-related and effectiveness-related MRPs were commonly reported in both specific and nonspecific patients, while noncompliance MRPs were more prevalent among specific patients than nonspecific patients. Increasing age, presence of co-morbidity, and an increasing number of drugs were the commonly identified contributing factors of MRPs. The review showed that more than two-thirds of the study participants developed MRPs. Hence, an integrated approach should be designed to improve the optimal use of pharmacotherapy to reduce the burden of MRPs. Further, future research should be undertaken to prepare cost-effective and efficient prevention mechanisms to reduce or halt the development of MRPs. [ABSTRACT FROM AUTHOR]

Background: Globally, pre-school children are the most at-risk population groups for vitamin A deficiency (VAD). The 2009 World Health Organization (WHO) report stated that one-third (190 million) of pre-school children worldwide are deficient in vitamin A. Both clinical and subclinical VAD have been a long-standing problem in developing countries. In Ethiopia, VAD was recognized as a public health problem 4– 5 decades before. Since then, researches conducted in other parts of the country still showed varied and high prevalence, which is 2– 8 times higher than WHO cut-off points. This community-based study was therefore conducted on pre-school children of rural kebeles in Farta district to determine the prevalence of clinical VAD (Bitot's spot and night blindness) and associated factors. Methods: A community-based cross-sectional mixed quantitative and qualitative study was conducted. Randomly selected 588 pre-school children participated in the study. The clinical aspect of the study investigated the presence of Bitot's spots on the children's eye with the aid of a magnifying loop and torch. Data on the history of night blindness were obtained from mothers/caregivers by using WHO standard questions. The qualitative study data were obtained via a key informant interview with the mothers/caregivers whose child has clinical VAD. Quantitative data were entered using Epi Data statistical software and analysed by using SPSS version 20 statistical software package. A bivariable logistic regression was employed, and variables that showed significant association with clinical VAD (P < 0.2) were entered a multivariable logistic regression model to identify independent predictors of clinical VAD. Results: The prevalence of Bitot's spot and night blindness was 0.8% and 1.2%, respectively. Pre-school children who were from highland (AOR: 3.71; 95% CI: 1.01– 13.68), a mother having antenatal care (ANC) visit during pregnancy of a child (AOR: 8.63; 95% CI: 2.58– 28.79), family monthly income (AOR: 8.63; 95% CI: 2.58– 28.79) and handwashing frequency were found to be determinants of VAD (p < 0.05). Conclusion: Clinical vitamin A deficiency in the study area is of public health concern because the prevalence of Bitot's and night blindness was above the WHO threshold level. Accordingly, effective preventive measures should be designed to reduce VAD prevalence. [ABSTRACT FROM AUTHOR]

aimed to assess the prevalence of SSIs and surgical antibiotic prophylaxis practice, and identifying the gap in practicing prophylactic surgical antibiotic use. Methods: A retrospective cross-sectional study design was conducted on randomly selected 281 participants who fulfilled the inclusion criteria. Appropriateness of surgical antibiotic prophylaxis was assessed by clinical pharmacists based on the standard treatment guideline. Descriptive and multivariate logistic regression analyses were performed in SPSS version 25. Statistical significance was set at p < 0.05. Results: The overall prevalence of SSI was 19.6% (95% CI: 19– 20.2). Majority of surgical patients (88.6%) got surgical antibiotic prophylaxis. Ceftriaxone and metronidazole (45.4%), and ceftriaxone (33.3%) were the most frequently used prophylactic antibiotics. Presence of comorbidity (AOR=9.18, 95% CI: 5.17– 17.9, p< 0.001), contaminated (AOR=6.01, 95% CI: 1.77– 16.8, p=0.019) and dirty (AOR=7.20, 95% CI: 1.23– 12.1, p=0.029) wound classes, devoid of prophylactic antibiotics (AOR=6.63, 95% CI: 0.89– 19.3, p=0.006), the timing of prophylactic antibiotic administration between 1 hour and 2 hours before incision (AOR=8.2, 95% CI: 4.34– 18.1, p=0.001), and 48 hours duration of surgical antimicrobial prophylaxis (AOR=7.20, 95% CI: 1.23– 28.17, p=0.027) were significantly associated with the development of SSIs. Conclusion: The prevalence of SSI was relatively high despite most surgical patients were given prophylactic antibiotics. The presence of comorbidity, contaminated and dirty wound classes, devoid of prophylactic antibiotics, administering prophylactic antibiotics between 1 hour and 2 hours before incision, and 48 hours duration of surgical antibiotic prophylaxis were significantly associated with SSIs. [ABSTRACT FROM AUTHOR]

aimed to assess diabetes self-care predictors among patients with T2DM patients at Dubti and Assaita hospitals in northeastern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 403 patients with T2DM who followed-up in northeastern Ethiopia's Dubti and Assaita hospitals. Data were analyzed using SPSS version-22.0 after the data were entered, sorted and cleaned. Multiple stepwise backward logistic regression analysis was done for a P value of < 0.25 to identify the independent predictors of self-care practice. Results: In the present study, males comprised 62% of the sex category. Overall, 63.8% of the study participants had adequate self-care practice, while 36.2% had inadequate self-care practice. Being younger age (AOR 2.27, 95% CI 1.27– 4.07, P= 0.005), monthly income status with low (AOR 3.08, 95% CI 1.08– 8.78, P= 0.04), average (AOR 2.43, 95% CI 1.15– 5.09, P= 0.02) and high (AOR 2.68, 95% CI 1.03– 6.99, P= 0.04), treated with oral hypoglycemic agents (OHA) (AOR 0.22, 95% CI 0.05– 0.95, P = 0.04) and insulin (AOR 0.18, 95% CI 0.04– 0.75, P= 0.01), having social support (AOR 3.09, 95% CI 1.76– 5.4, P ≤ 0.01) and diabetic education from health professionals (AOR 5.53, 95% CI 1.92– 15.93, P= 0.001) and media (AOR 2.63, 95% CI 1.47– 4.7, P = 0.001) were the independent predictors of self-care practice. Conclusion: In this study, the practice of self-care found to be sub-optimal among patients with T2DM. Independent predictors of self-care practice were age, monthly income, treatment regimen, social support, and diabetic education. Therefore, a suitable approach should be built to improve self-care practice with diabetes. [ABSTRACT FROM AUTHOR]

Emerging evidence shows that the recent pandemic of coronavirus disease 19 (COVID-19) is characterized by coagulation activation and endothelial dysfunction. This increases the risk of morbidity, mortality and economic loss among COVID-19 patients. Therefore, there was an urgent need to investigate the extent and risk factors of thromboembolism among COVID-19 patients. English-language based databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane library) were exhaustively searched to identify studies related to prevalence of thromboembolism among hospitalized COVID-19 patients. A random-effects model was employed to estimate the pooled prevalence of thromboembolism. The pooled prevalence of thrombotic events was computed using STATA 16.0 software. Heterogeneity analysis was reported using I2. A total of 19 studies with 2,520 patients with COVID-19 were included. The pooled prevalence of thrombotic events of hospitalized patients with COVID-19 was 33% (95% CI: 25-41%, I2 = 97.30%, p < 0.001) with a high degree of heterogeneity across studies. Elevated D-dimer hospitalized in the intensive care unit and being under mechanical ventilation were the most frequently associated factors for the development of thrombotic events. The pooled prevalence of thrombotic events in COVID-19 patients was 33%. The prevalence of thrombotic event is variables on the basis of study design and study centers. Several risk factors such as, elevated D-dimer, hospitalized in the intensive care unit and being under mechanical ventilation, were the most frequently reported risk factors identified. Therefore, healthcare professionals should consider these risk factors to optimally manage thromboembolism in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life (QoL) is increasingly being considered as an important measure of how disease affects patients’ lives, especially for long-term diseases like chronic kidney disease (CKD). Even though there is no statistically significant association between stages of CKD and QoL, it is decreased in patients with early stages of the disease. Hence, this study aimed to assess QoL and its predictors among patients with CKD at Tikur Anbessa Specialized Hospital (TASH). Methods: A cross sectional study was conducted at the nephrology clinic of TASH. A total of 256 patients were recruited through systematic random sampling. Data were collected using the Medical Outcomes Study Short Form 36-Items (SF-36). The data were entered into Epi Info 7.2.2.2 and analyzed using SPSS version 20.0 statistical software. Descriptive statistics like frequency, percent, mean and standard deviation were used to summarize patients’ baseline characteristics. Student’s unpaired t-test and ANOVA were conducted to compare two groups and more than two groups in the analysis of QoL, respectively. Multivariable linear regression was employed to investigate the potential predictors of QoL. Results: Quality of life was decreased in all stages of CKD. A reduction in physical functioning (p = 0.03), bodily pain (p = 0.004), vitality (p = 0.019) and social functioning (p = 0.002) was observed progressively across stages of CKD. High income status and greater than 11g/dl hemoglobin level were found to be predictors of all high score SF-36 domains. High family income (β 15.33; 95%CI: 11.33–19.33, p<0.001), higher educational status (β 7.9; 95%CI: 4.10–11.66, p<0.001), and hemoglobin ≥11g/dl (β 8.36; 95%CI: 6.31–10.41, p<0.001) were predictors of better QoL in the physical component summary, whereas absence of CKD complications (β 2.75; 95%CI: 0.56–4.94, p = 0.014), high family income (β 10.10; 95%CI: 5.10–15.10, p<0.001) and hemoglobin ≥11g/dl (β 4.54, 95%CI: 2.01–7.08, p = 0.001) were predictors of better QoL in the mental component summary. Conclusion: In this setting, QoL decreased in CKD patients in the early stages of the disease. Study participants with low income and hemoglobin level were considered to have worse quality of life in both physical and mental component summaries. [ABSTRACT FROM AUTHOR]

Background. Adverse effects from antiretroviral therapy (ART) have an impact on quality of life and medication adherence. There is no clear understanding of how people manage the adverse effects of ART. The individual taking medications which cause serious adverse effects may choose to stop or reduce the medications to relieve the adverse effects. Hence, this study was aimed at assessing coping strategies for adverse effects of ART among adult human immunodeficiency virus (HIV) patients. Methods. A cross-sectional study was conducted at HIV clinic of University of Gondar Referral Hospital (UoGRH). A total of 394 study participants were recruited by systematic random sampling. Data were collected through interviewing patients. Data were entered to Epi-Info 3.5.4 and analyzed using SPSS-20.0. Descriptive statistics were used to summarize patient's sociodemographic data and the adverse effects of their ART regimen. Binary and multivariate logistic regressions were used to investigate the potential predictors of nonadherence coping strategies. Results. The majorities of study participants were females (66%) and aged between 35 and 44 years (38.1%). The major adverse effects reported by the participants were headache (48.2%) followed by fatigability (18%) and loss of appetite (17.5%). Coping strategies used by HIV patients for adverse effect of ART were positive emotion coping strategy (91.1%), social support seeking (76.6%), taking other medications (76.6%), information seeking (48.7%), and nonadherence (35.5%). Younger age (AOR = 29.54, 95% CI = 2.49–35.25, p = 0.007), low level of education (AOR = 5.70, 95% CI = 2.16-15.05, p < 0.001), and living far from the health institution (AOR = 2.68, 95% CI = 1.29–5.57, p = 0.008) were associated with nonadherence coping strategy to relieve the adverse effects of ART. Conclusion. The present study revealed that positive emotion coping was the most commonly used strategy. Age, level of education, and distance from health institution were the predictors of nonadherence coping strategy. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the management practice, medication adherence, and factors affecting medication adherence in CKD patients at Tikur Anbessa Specialized Hospital (TASH). Methods. A cross-sectional study was conducted at the nephrology clinic of TASH. A total of 256 CKD (stages 1 and 2=50, stage 3=88, stage 4=55, and stage 5=63) patients were recruited through systematic random sampling. Data were collected from medical records and interviewing patients. The rate of adherence was determined using 8-item Morisky medication adherence scale. The data were analyzed using SPSS version 20.0 statistical software. Univariate and multivariate binary logistic regression were used to investigate the potential predictors of medication nonadherence. Results. About 57.3% of diabetes mellitus with hypertension were treated with combination of insulin and ACEI based regimens. Other cardiovascular comorbidities were predominantly treated with Acetyl Salicylic Acid in combination with β-blocker. Only 61.3% (stages 1 and 2=70%, stage 3=73.9%, stage 4=54.5%, and stage 5=43%) of the study population were adherent to their treatment regimens. Forgetfulness (79.8%) was the major reason for medication nonadherence. Patients who had an average and high monthly income were 4.14 (AOR=4.14, 95% CI: 1.45-11.84, p=0.008) and 6.17 times (AOR=6.17, 95% CI: 1.02-37.46, p=0.048) more likely to adhere as compared to those who had very low income. Patients who were prescribed with ≥5 drugs were 0.46 times (AOR= 0.54, 95% CI: 0.27-1.10, p=0.049) less likely to adhere compared to their counterpart. Patients who were students, drivers, or teachers working in private school were about 7.46 times (AOR=7.46, 95% CI: 1.49-37.26, p=0.014) more likely to adhere compared with patients who were farmers. Conclusion. Insulin and ACEIs based regimens were the most frequently used regimens in the treatment of diabetes mellitus and hypertension comorbidities. Very low income, increased number of prescribed medications, and being a farmer were the predictors of medication nonadherence. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease (CKD) has a complicated interrelationship with other diseases and major risk factor for cardiovascular disease. Therapeutic management for CKD patients is complicated due to co-morbidities and dominant risk factors of CKD. Non-adherence to treatment is an increasing problem for patients with CKD and it has not been extensively studied in patients with CKD. Hence, the present study was carried out to assess the management practice, medication adherence and factors affecting medication adherence in CKD patients at Tikur Anbessa Specialized Hospital (TASH). Methods: A hospital-based cross-sectional study was conducted at the nephrology clinic of TASH. A total of 256 patients were recruited through systematic random sampling. Data were collected from medical records and interviewing patients. The degree of adherence was determined using eight-item Morisky Medication Adherence Scale. The data were entered into Epi Info 7.2.2.2 and analyzed using SPSS version 20.0 statistical software. Descriptive statistics such as frequency, percent, mean and standard deviation were used to summarize patients’ baseline characteristics. Univariable and multivariable binary logistic regression were used to investigate the potential predictors of medication non-adherence. Results: About 55% patients with hypertension only were treated with non-angiotensin converting enzyme inhibition based regimens; 57.3% of diabetes mellitus with hypertension treated with combination of insulin and ACEI based regimens. About three-fourth of patients with anemia and osteodystrophy complications were treated with iron preparations and calcium based phosphate binder. Only 61.3% of the study population were adherent to their treatment regimens. Forgetfulness (79.8%) was the major reason for medication non-adherence. Patients who had an average and high monthly income were 4.14 (AOR = 4.14, 95% CI: 1.45–11.84, p = 0.008) and 6.17 times (AOR = 6.17, 95% CI: 1.02–37.46, p = 0.048) more likely to adhere as compared to those who had very low income. Patients who were prescribed with ≥5 drugs were 0.46 times (AOR = 0.54, 95% CI: 0.27–1.10, p = 0.049) less likely to adhere compared to their counterpart. Patients who were students, drivers, teachers working in private school were about 7.46 times (AOR = 7.46, 95% CI: 1.49–37.26, p = 0.014) more likely to adhere compared with patients who were farmers. Conclusion: Insulin and ACEIs based regimens were the most frequently used regimens in the treatment of diabetes mellitus and hypertension co-morbidities. Very low income, increased number of prescribed medications and being a farmer were the predictors of medication non-adherence. [ABSTRACT FROM AUTHOR]