Level of knowledge, attitude, and practice on modern contraceptive method and its associated factors among housemaids living in Debre Tabor town, northwest Ethiopia: a community-based cross-sectional study.

BACKGROUND: Contraception is widely recognized as an effective technique for avoiding unplanned pregnancies and sexually transmitted diseases. Promoting contemporary contraceptive methods would minimize the number of unplanned pregnancies and the high number of maternal fatalities connected with unsafe abortions. OBJECTIVE: This study aims to assess the level of knowledge, attitude, and practice of modern contraceptive methods and its associated factors among housemaid residents of Debre Tabor Town, northwest Ethiopia: METHODS: A structured questionnaire supplemented with face-to-face interviews was used to conduct a community-based cross-sectional study with 423 housemaids' women of reproductive age in Debre Tabor City. The data were analyzed using descriptive analysis, binary analysis, and multivariable logistic regression. RESULTS: A 12.8% of respondents in this study used modern contraceptive methods. A 44.68% of study participants had good knowledge of modern contraceptive methods, and 36.40% had a positive attitude towards them. Housemaids' older age, urban location, educational status, work experience, and family situation were found to be positive predictors of a good understanding of current contraceptive techniques. Housemaids' older age, urban residence, educational level, work experience, family situation, and first sex before now are all positive predictors of a positive attitude and good practices. CONCLUSIONS: Housemaids' knowledge, attitude, and practice of modern contraceptive methods were influenced by a variety of socio-demographic factors. As a result, housemaids should be educated about modern contraceptive methods by the health sector and other stakeholders to improve their knowledge, attitude, and practices.

Cognitive functioning and its associated factors among breast cancer patients on chemotherapy at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia: an institution-based comparative cross-sectional study.

BACKGROUND: Breast cancer is the second leading cause of cancer in the world. It is the commonest type of cancer in Ethiopia. Cognitive problems are common among breast cancer patients. The study aimed to assess cognitive functioning and its associated factors among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2020. METHODS: Institution-based comparative cross-sectional study was conducted. Study subjects were 117 breast cancer patients on chemotherapy and 117 women without breast cancer who volunteered for the study. Data was collected from May-June 2020. The Mini-mental status exam (MMSE) was used to assess cognitive functioning. Data were entered into Epi Data version 4.6.0.2 and analyzed using STATA version 14 software. Univariable and multivariable linear regression model was fitted to identify factors associated with cognitive functioning. A two-tailed p-value less than 0.05 was used to declare statistical significance. RESULTS: Among the total breast cancer patients 41.9% were diagnosed with earlier sage of the diseases (stage I and II), while the rest 58.1% were diagnosed with stage III and stage IV breast cancer. A significant difference in the MMSE score was observed among breast cancer patients and controls (19.76 ± 5.29, 25.18 ± 4.68 p <  0.0001) respectively. In multivariable linear regression analysis being non-breast cancer (Adjusted beta coefficient (Adj.ß.coff). = 3.34, 95% CI (1.92-4.76) p <  0.001), hemoglobin gm/dl (Adj.ß.coff =0.34, 95% CI (0.04-0.63) p = 0.02), and primary education (Adj.ß.coff =2.98 95%CI (1.16-4.96) p = 0.001) secondary level and more education (Adj.ß.coff = 5.47, 95%CI (3.51-7.28) p < 0.001) were significantly associated with MMSE cognitive score. CONCLUSION: Breast cancer patients had lower mean MMSE scores when compared to non-breast cancer women. Higher hemoglobin level and higher level of education increase the MMSE cognitive score. Clinicians should incorporate routine screening of cognitive functioning for breast cancer patients and further study is required to evaluate cognitive impairment among breast cancer patients in Ethiopia.

Coverage of azithromycin mass treatment for trachoma elimination in Northwestern Ethiopia: a community based cross-sectional study.

BACKGROUND: Mass drug administration with antibiotics predominantly with azithromycin is one of the four arms of the SAFE strategy. The elimination of ocular chlamydial infection is only achieved as long as the azithromycin mass treatments (AMT) are given frequently enough and at a high enough coverage. This study was conducted to assess the coverage of azithromycin mass treatment and its determinants in Awi Zone, Northwestern Ethiopia. METHODS: House to house survey using a structured questionnaire was done between July 7 to July 25, 2013. Coverage is defined as the proportion of individuals in the eligible population who actually ingested the Azithromycin during the Campaign. RESULTS: A total of 1267 households were enrolled in the survey in which 5826 eligible members were living in these households. Almost half (54.6%) of the community members who were eligible for all six campaigns had participated in more than three campaigns of azithromycin mass treatment. The overall average self-reported coverage of the azithromycin mass treatment (AMT) in all six campaigns was 62.8% (64% in rural vs. 61.6% urban). On average, each eligible person had taken the drug 3.77 times. The rural residents were significantly more likely to have received treatment during the last round of AMT in 2012 {AOR = 2.35; 95% CI [1.80-3.06]}. Azithromycin uptake status of female household heads was less than the corresponding male household heads {AOR = 0.41; 95% CI [0.24-0.72]}. Household heads' awareness about trachoma (AOR = 2.55; 95% CI [1.19-5.44]) and AMT {AOR = 7.19; 95% CI [3.27-15.82]} had positive association with acceptability. CONCLUSION: The overall average AMT coverage was found to be low. There was low coverage of the treatment in the urban community as compared to the rural residents. Misconceptions of household heads about trachoma and azithromycin have negatively affected the coverage. Further work on why female household heads are associated with higher risk of non-participation in AMT is warranted. Strengthening awareness creation and consideration of additional campaigns is essential.

Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

BACKGROUND: Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. METHODS: A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. RESULTS: A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. CONCLUSION: Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to institutionalize the service is minimal. Thus, concerted efforts need to be exerted to promote the service through organizing awareness forums as well as revisiting the curriculum.

Prevalence and predictors of dyslipidemia among HAART treated and HAART naive HIV positive clients attending Debre Tabor Hospital, Debre Tabor, Ethiopia.

Background: Highly active anti-retroviral therapy has been reported to be associated with a number of side effects in human immunodeficiency virus patients among which dyslipidemia isa common metabolic disorder. Methods: A Hospital based comparative cross-sectional study among 228 HIV positive patients was conducted from July to August 2020. Socio-demographic and clinical data were collected using structured questionnaires. Fasting venous blood sample was collected and analyzed for Lipid profiles. EDTA sample was analyzed for CD4+ T cell determination. Anthropometric measurement was done. Data were analyzed using SPSS version 22. Independent t-test was done. Logistic and binary regression was done. Result: A total of 228 HIV patients were enrolled in the study. Prevalence of dyslipidemia in HAART naive and HAART treated patients was 61 (53.5%) and 84 (73.7%), respectively. The prevalence of Total Cholesterol ≥200 mg/dl was 50% and 30%; High density lipoprotein cholesterol <40 mg/dl was 43.8% and 36%; Low density lipoprotein cholesterol ≥130 mg/dl was 48.3% and 28.1%; and Triglyceride ≥ 150 mg/dl 59.6% and 39% among HAART treated and HAART naive, respectively. Age greater than 40 years (AOR = 3.27, 95% C.I: 1.47-7.25), blood pressure ≥140/90 (AOR = 16.13, 95% C.I: 5.81-44.75), being on HAART (AOR = 2.73, 95% C.I: 1.35-5.53) and body mass index >25 kg/m2 (AOR = 1.92, 95% C.I: 1.20-4.81) were identified as determinants of dyslipidemia. Conclusion: The mean value of lipid profile was significantly higher among HAART treated as compared to those HAART naive HIV positive clients.

Concomitant Use of Herbal and Conventional Medicines among Patients with Diabetes Mellitus in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study.

INTRODUCTION: The majority of the population in developing countries including Ethiopia still relies on traditional medicines (TMs). Patients with chronic illness like diabetes mellitus (DM) are dissatisfied with conventional medicines and thus are more likely to simultaneously use herbal medicines (HMs). However, such practice could result in potential herb-drug interaction. This study aimed to identify the commonly used HMs among patients with DM and determine the magnitude of concomitant use of herbal and conventional antidiabetic medicines. METHOD: A health facility-based cross-sectional study design was employed using both quantitative and qualitative data collection methods to determine the magnitude of concomitant use. Patients with DM and prescribers from four public hospitals were the study population for the quantitative and qualitative study, respectively. Simple descriptive statistics were used to describe variables for the quantitative data, and content analysis had been conducted manually for qualitative data. RESULT: Out of 791 respondents, 409 (51.7%) used traditional medicine at least once in their life time, and 357 (45.1%) used traditional medicine in the last six months prior to data collection. A majority (288 (80.7%)) of the respondents used HMs after starting the conventional antidiabetic medicines within the last six months. Moringa stenopetala, Thymus vulgaris, Trigonella foenum-graecum, Nigella sativa, and Allium sativum were among the frequently mentioned HMs. Prescribers were requesting patients' HM use when they saw sign of liver toxicity and skin disease, and they were not documenting their history in the patient's chart. CONCLUSION: Concomitant use of herbal and conventional antidiabetic medicines was a common practice. Cognizant of its potentially serious herb-drug interactions, efforts should be made to improve awareness and knowledge of healthcare providers about HM potential effects. Further studies on dose, frequency, duration, and modes of interaction are recommended.

Physicians' utilization of microbiologic reports and determinants of their preference to order culture in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

OBJECTIVE: The main aim of the study was to assess physicians' utilization of microbiologic reports and determinants of their preference in ordering microbiologic culture among patients with systemic bacterial infection at Tikur Anbessa Specialized Hospital. RESULTS: Of the total 369 patients observed, 91 (24.7%) had microbiologic reports (culture and gram stain). About 12% of the patients had culture reports of which majority (77.8%) were available after 72 h of the initial antibiotic start. Antimicrobial susceptibility test was done for 83.3% of the positive cultures. Although 99.5% of the patients were initially placed on empiric therapy, adjustment was done in 114 (30.9%) of the patients. Among these patients with adjusted therapy, changes were unrelated to microbiologic reasons in 103 (90.4%) patients. None of these changes were for the reason of streamlining therapy. Prolonged hospital stay (AOR = 2.9, 95% CI 1.2-6.7), senior physician consultation (AOR = 4.1, 95% CI 1.1-17.7) and suspicion of new site of infection (AOR = 2.6, 95% CI 1.1-6.2) were positive independent predictors for physicians' preference in ordering culture.

Cosmetics Use-Related Adverse Events and Determinants Among Jigjiga Town Residents, Eastern Ethiopia.

INTRODUCTION: Non-medicated cosmetics use is very common among the Ethiopian population. However, little is known about these products' related adverse events. The aim of this study was to assess the prevalence and determinants of cosmetics-related adverse events among Jigjiga Town residents, Eastern Ethiopia. METHODS: A community-based cross-sectional study design was conducted in May and June 2014. Semi-structured interviews were used to collect cosmetics use pattern and related adverse events. For assessing determinants, logistic regression was used and statistical significance was set at p < 0.05. RESULTS: Overall, 600 participants were approached with a 93% response rate. Ninety-three percent (n = 521) of them reported the use of cosmetics at least once within 2 weeks prior to this study, and of these, 229 (44%) used traditional herbal cosmetics along with modern cosmetics. A total of 342 (61%) reported experiencing adverse events of which the most common reported were: allergic reactions, 149 (36%); the appearance of acne, 66 (16%); and hirsutism, 52 (12.5%). The occurrence of cosmetics-related adverse events were significantly associated with the number of cosmetics used per day, the frequency of use, mixing of different types of cosmetics together, and mixing of cosmetics with water or saliva. CONCLUSION: A higher proportion of cosmetic users reported experiencing at least one adverse event. The number of cosmetic products and frequency of use were important predictors for experiencing adverse events. This implies the need to consider safety concerns related to cosmetic use. Approaches to address such issues may include awareness creation programs and promoting the concept of cosmetovigilance among cosmetic sellers, users, and other stakeholders.

Attitude and satisfaction of health care providers towards clinical pharmacy services in Ethiopia: A post-deployment survey.

BACKGROUND: Clinical pharmacy service has evolved steadily over the past few decades and is contributing to the 'patient care journey' at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers' perception and satisfaction towards the service. METHODS: A cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools. RESULTS: Majority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70-90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience. CONCLUSIONS: A large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.