Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals.

INTRODUCTION: Dietary management is considered to be one of the cornerstones of diabetes care. Improvement of dietary practice alone can reduce glycosylated hemoglobin (HbA1c) by an absolute 1 to 2% with the greatest impact at the initial stages of diabetes. METHODS: Data from Hospital based cross sectional study were used to assess the level of dietary adherence and its determinants among diabetic patients. The morisky 8 item medication adherence scale was used to develop 10 item tool for evaluation of dietary adherence. Multiple logistic regression was conducted to identify factors which affect dietary adherence and variables with P vale < 0.05 were considered statistically significant. RESULTS: More than half of 303 participants (55.7%) were found to be non-adherent to the recommended dietary approach. Gathering with family and friends and eating out were the major reasons for not being compliant with the recommended regimen. Attending diabetic nutrition education (AOR=2.8 95% C 1.97, 5.61) and having the disease for more than 10 years (AOR 2.9 95% CI 1.32, 5.84) were statistically significant with adherence to dietary recommendation. CONCLUSION: Non-adherence to recommended dietary practice was observed in more than fifty percent of patients; it is therefore a major public health problem. Attending diabetic nutrition education and length of diabetes greater than 10 years were the factors associated with adherence to dietary recommendation. This findings indicate that it is important to design strategies to help patients understand their dietary regimens and improve their adherence.

Burden, risk factors and outcomes of hyperemesis gravidarum in low-income and middle-income countries (LMICs): systematic review and meta-analysis protocol.

INTRODUCTION: Hyperemesis gravidarum (HG) is a pregnancy condition characterised by excessive nausea and vomiting resulting in dehydration, weight loss and serious adverse pregnancy outcomes including termination of pregnancies. Even though evidence in low-income and middle-income countries (LMICs) is limited, the prevalence of HG in pregnancy ranges from 0.3% to 10.8%. With this systematic review and meta-analysis, we aim to determine the prevalence/burden, risk factors, and maternal and perinatal outcomes of HG in LMICs. METHODS: PubMed, CINAHL, EMBASE, EBSCO, Ovid maternity and infant care databases, Cochrane Database of Systematic Reviews, Web of Science and SCOPUS databases will be searched. Reference lists of selected articles will be assessed in order to identify other potential studies of interest. Observational studies and (non) randomised controlled trials conducted from January 2000 to September 2018 in LMIC will be included. A weighted inverse-variance meta-analysis using fixed-effects and random-effects model will be done to generate a pooled estimate. Funnel plot and Egger's regression statistical test will be applied to check publication bias. Heterogeneity among studies will be checked using Τ2 to determine dispersion. Moreover, meta-regression analysis will be performed to investigate the source of heterogeneity. STATA V.14 will be used to analyse the data. ETHICS AND DISSEMINATION: Formal ethical approval and patient consent are not required; as primary data collection will not be employed. The result will be published in a peer-reviewed scientific journal and will be presented at scientific conferences and public press. PROSPERO REGISTRATION NUMBER: CRD42018096284.

Biomedical and public health reviews and meta-analyses in Ethiopia had poor methodological quality: overview of evidence from 1970 to 2018.

OBJECTIVES: The aims of this overview are to assess the trend of narrative and systematic reviews in Ethiopia, examine their methodological quality, and suggest future directions for improvement. STUDY DESIGN AND SETTING: All narrative reviews and systematic reviews with or without a meta-analysis on topics associated with Ethiopia irrespective of the place of publication and authors' affiliation were included. The International Narrative Systematic Assessment for narrative reviews and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews with or without a meta-analysis were used for quality appraisal. Fisher's exact test at the P-value threshold of 0.05 was used to investigate associated factors of methodological quality. RESULTS: Of 106 articles reviewed, 54 (50.9%) were narrative reviews, 17 (16%) were systematic reviews, and 35 (33.1%) were systematic reviews with meta-analyses. Among 48 systematic reviews with or without meta-analysis, only five (10.4%) registered their protocol, four (8.3%) justified the selection of the study design for inclusion, and none of them reported sources of funding for the primary studies. Overall, 55.3% of narrative reviews and 75% of systematic reviews with or without meta-analysis had poor methodological quality. CONCLUSIONS: Although publication rate of narrative and systematic reviews has risen in Ethiopia, half of the narrative reviews and three-quarters of the systematic reviews had poor methodological quality.