Concordance between modification of diet in renal disease, chronic kidney disease epidemiology collaboration and Cockcroft-Gault equations in patients with chronic kidney disease at St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia.

BACKGROUND: The most commonly used glomerular filtration rate estimating equations for drug dosing are Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. However there is still a concern about whether to use MDRD and CKD-EPI interchangeably with CG for drug dosage adjustment. METHODS: The study was initiated to determine the concordance between MDRD, CKD-EPI and CG equations and associated factors in patients with chronic kidney disease at Saint Paul's Hospital Millennium Medical College (SPHMMC). This was a cross sectional study which involved patient chart review and physicians self-administered questionnaire. Serum creatinine level ≥ 1.2 mg/dL was used as a cutoff point in pre-selection of patients. The correctness of the drug dose prescribed for the level of renal function were compared to the drug database (Lexi-Comp) available through Up-to-date version 21.2. RESULTS: Among the total of 422 patients, 249 (59%) were males. Mean age of patients was 46.09 years. The use of MDRD equation for drug dose adjustment by physicians working in the renal clinic of SPHMMC was six out of nine physicians. The Pearson correlation coefficient between the CG with MDRD and CKD-EPI equations was r = 0.94, P < 0.001 and r = 0.95, P < 0.001, respectively. The concordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories was 73.7%, Kappa = 0.644 and 74.9%, Kappa = 0.659, respectively. Concordance between the CG with MDRD and CKD-EPI equations for the drug dosing recommendation was 89.6%, kappa = 0.782 and 92%, kappa = 0.834, respectively. Age > 70 years was associated with discordance between CG and MDRD equations for drug dosing recommendation whereas serum creatinine 1.2-3.5 mg/dL, weight < 61 Kg and age > 70 years were associated with discordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories. However, none of the factors associated with discordance between CG and CKD-EPI for drug dosing. CONCLUSION: MDRD equation can be used interchangeably with CG equation for drug dosing recommended in all adult patients between the age of 18 and 70 years. CKD-EPI can be used interchangeably with CG in all adult Ethiopian patients with CKD.

COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia.

BACKGROUND: To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town. PATIENTS AND METHODS: Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used. RESULTS: The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge. CONCLUSION: The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.