Assessment of psychotropic medications prescribing pattern in Gebretsadik Shawo General Hospital, South West Ethiopia.

Introduction: due to the widespread prescription of antipsychotic medications, their usage is cumulative. Evidence on the trends of medication use in Ethiopia and other parts of the world is lacking. The scant information on prescription trends and medication usage suggests that drug use is generally not sensible in both industrialized and emerging nations. So, the aim of this study was to assess the psychotropic medications prescribing pattern in Gebretsadik Shawo General Hospital, South West Ethiopia. Methods: from June 1st to July 31st, 2019, a cross-sectional study on prescriptions for psychiatric drugs was conducted at Gebretsadik Shawo General Hospital. Using systematic random sampling, prescription records were obtained from the pharmacy dispensing book. Version 21 of the statistical program for social science was used to code and analyze the data. Results: the study included 355 prescription records containing psychotropic drugs in total. The bulk of those taking the psychotropic medication were aged 20 to 49. The most often administered classes of drugs remained antipsychotic, followed by tricyclic antidepressants, antiepileptics, anxiolytics/sedatives, anticholinergic and selective serotonin reuptake inhibitors. The most often ordered antipsychotic medication, which included 102 (23.18%) medications, was chlorpromazine. Tricyclic antidepressants, which included 56 medicines (12.73%) and 24 medications (5.45%), included amitriptyline and imipramine. Conclusion: the results of this investigation showed that psychiatrists preferred traditional psychotropic medications, such as Antipsychotic tricyclic, antidepressants (TCAs) and phenothiazines, in high amounts possibly because these medications were readily available in this hospital and their prices suited patients' needs. Health care workers' interdisciplinary relationships and coherence would improve for the benefit of patients and services of higher quality.

Willingness, Attitude, and Associated Factors towards Adverse Drug Reaction Reporting among Healthcare Providers in Mizan Tepi University Teaching Hospital, Southwest Ethiopia.

Background: An adverse drug reaction (ADR) is harm that arises from the use of a drug. Adverse drug reactions have a huge impact on the health system since they result in drug-related morbidity and mortality as well as indirect costs such as loss of productivity at work. Reporting of adverse drug reactions to a relevant authority is one of the methods of enhancing medication safety; however, underreporting of adverse drug reactions by health workers is a major challenge in enhancing medicines safety. The aim of this study was to assess the willingness, attitude, and associated factors of healthcare providers towards ADRs reporting at Mizan Tepi University Teaching Hospital (MTUTH). Methods: A cross-sectional mixed method was conducted among healthcare providers working in Mizan Tepi University Teaching Hospital from August to September 2021. A total of 190 healthcare providers and five key informants were participated in the study. The quantitative data were collected using self-administered structured questionnaires, and for the qualitative study, data from the key informant interviews were collected using a semistructured questionnaire containing open-ended questions. The collected data were coded, entered, and analyzed using a Statistical Package for Social Sciences (SPSS, version 21). Furthermore, the logistic regression model was fitted to see the association between attitude items and demographic characteristics. Variables with P value <0.05 were considered as statistically significant. Analysis of the qualitative data was done by sorting the data into categories and examining the emerging themes. Results: The majority of individuals in the study (81.6%) were willing to report adverse drug reactions. High percent (57.9%) of the study participants knew how to report ADR to responsible body and 66 (34.7%) of the study participants believe that ADR reporting is the responsibility of all healthcare professionals. 86 (45.3%) of respondents encountered ADR cases during their professional career. It was found that the majority of participants (53.7%) had a positive attitude toward ADR reporting. The professional distribution and work experiences of healthcare professionals had a significant impact on their attitude toward ADR reporting (P < 0.05). Conclusion: A large percentage of study subjects were willing to report adverse drug reactions to the appropriate authorities. The majority of healthcare providers were found to have a good attitude towards ADR reporting. Professional distribution and work experiences were significantly associated with attitude of healthcare providers towards ADR reporting. In order to improve the ADR reporting practices of the healthcare professionals and increase the ADR reporting load at the national level, the national regulatory body should collaborate with health facilities.

Health Care Providers' Knowledge, Attitude and Practice Toward Counterfeit Medicines in Mizan-Tepi University Teaching Hospital, South West Ethiopia: A Cross-Sectional Study.

There is a paucity of evidence-based information regarding healthcare professionals' awareness and views toward counterfeit medicines in developing countries. Therefore; this is aimed to assess health care providers' knowledge, attitude, and practice toward counterfeit medicines in Mizan-Tepi University Teaching Hospital, South West Ethiopia. A cross-sectional study was conducted among health care providers working in Mizan-Tepi University Teaching Hospital from December 2020 to January 2021. A total of 171 health care providers participated in the study. Data were collected through self-administered structured questionnaires developed by reviewing similar surveys with some modifications. The data analyzed using a Statistical Package for Social Sciences (SPSS, version 21). Variables with P value <.05 were considered as statistically significant. Large proportions of the study participants (84.2%) have information on counterfeit drugs and 15.8% of them described counterfeit medicine as product with toxic impurities. 50.3% of them were able to distinguish a counterfeit drug from the genuine drug. 8.2% of the participants demonstrated that counterfeit medicine can be identified by physical observation of labeling, color appearance and packaging. 61.4% of the study respondents revealed that strong legal action can prevent circulation of counterfeit medicine. Professional distribution was significantly associated with the attitude of health care providers toward counterfeit medicines (P < .05). Accordingly, public health officers and midwifery health care providers were more likely to have poor attitude toward counterfeit medicines (AOR = 6.09, CI (1.798-20.69) and (AOR = 3.98(1.54-10.25)) respectively as compared to nurses. This study demonstrated the importance of awareness creation to all health care providers. Drug regulatory bodies and concerning bodies must play an active role in designing appropriate program and policy to enhance health professionals' knowledge and attitude toward CFM. There is also a need of empowering the practitioners in identifying counterfeit drugs by simple observations.

Evaluation of Policy Governing Herbal Medicines Regulation and Its Implementation in Ethiopia.

Background: Ethiopia is one of the world's oldest countries, with a fascinating history of herbal medicine. However, there is a lack of evidence for the regulatory framework for herbal medicines and its implementation. Thus, the aim of this study was to evaluate the policy governing herbal medicines regulation and its implementation in Ethiopia. Methods and Materials: An archival review, a semi-structured interview with key informants, a cross-sectional study involving traditional healers, and an institution-based cross-sectional survey were conducted from June 15, 2020 to December 25, 2020. The qualitative data was transcribed using Microsoft Word 10, whereas the quantitative data was recorded and analyzed using SPSS 20 computer statistical software. The study's findings are summarized using descriptive statistics. In addition, multiple logistic regressions were performed to identify factors affecting regulation of herbal medicine (HM) in Ethiopia. Variables with p<0.05 were considered potential predictors. Results: According to all key informants, Ethiopia has yet to adopt distinct policies and laws on herbal medicine that may provide an independent regulatory framework. Similarly, the majority of respondents in an institution-based survey indicated that there were no defined policies (n=52, 57.3%), laws (n=53, 59.6%), or registration systems (n=67, 75.3%) for herbal medicine. However, traditional healers claimed that they are licensed by either the Woreda Health Bureau (n=21, 95.5%) or the Regional Health Bureau (n=1, 4.5%) to legally practise traditional herbal medicine. Besides, no traditional healer is licensed by Ethiopian Food and Drug Administration (EFDA) or Ministry of Health. Conclusion: Ethiopia has yet to adopt distinctive herbal medicine policies and laws to provide an independent herbal regulatory system. Despite the fact that the EFDA has a mandate for herbal medicine regulation, traditional healers are licensed by the woreda and regional health bureaus, thus more investigation is needed.

Rational Dispensing of Oral Dosage Forms of Medicines to Children and Its Associated Factors in South West Ethiopia.

Introduction: Obstacles encountered when maintaining excellent dispensing practices for children include a lack of age-appropriate dosage forms, a shortage of medications in appropriate strengths for children, a lack of appetizing drugs, and a lack of competence in pediatric pharmacy. These difficulties contribute to ineffective dispensing procedures and an urgent need to study whether oral dose forms of medications are dispensed to children in a rational way. Objective: The purpose of this study is to evaluate the rational dispensing of oral dosage forms of medicines to children, as well as the factors that influence this practice. Methods: Using validated indicators, a cross-sectional study design was utilized to analyze the rational dispensing practice of oral dosage forms of medicines administered to children under the age of 12 years in seven pharmacies and two drug stores over a one-month period. Results and discussions: Out of 810 medicines, 11.7% and 4% were irrationally manipulated, 5.8% and 1.8% needed manipulation, 3.7% and 0.2% were alternatively dispensed, 8.8% and 7.5% of the medicines had correct advice on their label and also 745 medicines were adequately labeled in the hospital and the selected drug stores. In this study, 92% of medicines were adequately labeled and had sufficient advice on their labels, 15.3% of medicines were irrationally manipulated and around 7.7% of the dosage forms needed manipulation during dispensing. The type of medicine retail outlet had a significant effect on the percentage of instances where alternative solid oral dosage forms were dispensed (p = 0.003), the percentage of dosage forms were adequately labeled (p = 0.008), and the percentage of dosage forms were irrationally manipulated before dispensing (p = 0.001). Conclusion: The rational dispensing practice of oral dosage forms of medicines was relatively poor and there is room for improvement.

Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia: A cross-sectional study.

ABSTRACT: The use of Antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. The therapy restores immune function and reduces HIV-related adverse outcomes. However, treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. Thus, this study aimed to assess anti-retroviral treatment failure and associated factors among HIV patients on the first line ART at Mizan-Tepi University Teaching Hospital. A cross-sectional study was undertaken among adult patient who have been on ART and attending ART Clinic of Mizan-Tepi University Teaching Hospital from September 2014 to September 2018. Data were collected retrospectively by reviewing patients' medical charts using a standard structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of anti-retroviral treatment failure, multiple stepwise backward logistic regression analysis were done. P value < .05 was considered as statistically significant. Among 221 patients included in the study, 118 (53.39%) were females. The mean weight of study participants at ART initiation was 57.04 kg. Of the 221 patients on the first line ART, 10 (4.5%) experienced treatment failure. Of these patients, 5 (50%) and 3 (30%) experienced virological failure and clinical failure, respectively. Functional status (AOR: 3, CI: [1.13-6.5], P < .001) and low baseline CD4 cell count (AOR: 4.3, CI: [3.4-10.6], P < .0001) were found to be an independent predictors of treatment failure. The rate of first-line ART treatment failure in the study setting was substantial. Functional status and low baseline CD4 cell count were found to be an independent predictors of virological, clinical and immunological failure. Therefore, more attention should be given for the lifestyle of pateints' on ART and maximize virological tests for monitoring treatment failures.

Patients' Adherence to Anti-diabetic Medications and Associated Factors in Mizan-Tepi University Teaching Hospital: A Cross-Sectional Study.

INTRODUCTION: A number of medications have been demonstrated to lower blood glucose. However, current-day management has failed to achieve and maintain the optimal glycemic level for diabetic patients. Patients' non-adherence is among the most contributing factors. Therefore, the aim of this study was to explore the prevalence of non-adherence to anti-diabetic medications and associated factors. METHODS: A hospital based cross-sectional study was conducted from November 2020 to January 2021. A systematic random sampling technique was used. Data were collected by structured questionnaire adapted from different literatures. Then, data were entered into SPSS version 25 and analyzed. To determine the association of dependent and independent variables, multiple logistic regression was done. P-value <.05 was considered statistically significant. RESULTS: A total of 275 study participants were interviewed with a response rate of 100%. From this 53.8% were females, 59.3% were in the age group of 41-60 years, 35.3% were college/university graduates and 79.3% were not using social drugs. One hundred eighty-seven (68%) of them were adherent to their anti-diabetic medication. Factors found to be significantly associated with anti-diabetic medication adherence were age >60 years (AOR = .276, 95% CI = .124-.611) attending higher education (AOR = 6.203, 95% CI = 1.775-21.93), retired (AOR = 7.771, 95% CI = 1.458-41.427), housewife (AOR = 7.023, 95% CI = 1.485-33.215), average monthly income 1001birr-2000 birr (AOR = .246, 95% CI = .067-.911) and social drug use (AOR = 3.695, 95% CI = 1.599-8.542). Forgetfulness, not affording, side effects, misunderstanding of instructions, and poly-pharmacy were identified reasons for non-adherence. CONCLUSIONS AND RECOMMENDATIONS: Patients' adherence to anti-diabetic medications in the current study is sub-optimal. Age, monthly income, level of education, occupational status, and social drug use were associated with adherence. Forgetfulness, not affording, and side effects were reasons identified to contribute to non-adherence. Therefore, adherence counseling, use of alarms, and the way to mitigate non-affordability, including anti-diabetic medications into a program drug should be considered.

Medication Counseling Practices in Medicine Retail Outlets Found in Bench Sheko Zone, Southern Nations, Nationalities, and Peoples' Region, South West Ethiopia.

OBJECTIVE: The objectives of this research were to investigate pharmacy professionals' counseling practices as well as to evaluate pharmacy professionals' counseling skills and the content of counseling services provided to patients visiting medicine retail outlets. METHODS: A facility-based observational cross-sectional study was used to assess medication counseling practice by pharmacy professionals. Data were gathered through an observation and a semi-structured questionnaire. Epi data version 4.0.2 was used to enter data, which was subsequently exported to SPSS version 21.0 for analysis. ANOVA and post hoc statistical analyses were used to investigate the association between independent and dependent variables; and a 0.05 p-value was considered. RESULTS: This study has a total of 105 pharmacy professionals that were included in the analysis. The majority of those who responded were between the ages of 25 and 29. The most common drug information offered by pharmacy staff to patients was frequency of administration (90%), length of therapy (90%), and unit dose dispensed, according to the current study (86%). Pharmacy professionals' age was significant on components of counseling practice as on mentioning the name of drugs during dispensing the medication (p=0.000), the route of administration (p=0.000), a drug dose (p=0.003), frequency of drug administration (p=0.016), proper medicine storage (p=0.024), type of dosage form (p=0.025), and duration of treatment (p=0.012). In comparison with the other age groups, an age greater than 40 years was significant on components of counseling practice (p=0.001) as a factor associated with penurious counseling practice than the other groups. CONCLUSION: This study shows that counseling practice is still quite low in comparison to what is expected. Some of the issues that affect counseling include a high patient load, the lack of a private counseling room, a lack of updated drug knowledge, and a lack of experience were factors that influence counseling.

Corrigendum to "Organochlorine pesticide residues in tea and their potential risks to consumers in Ethiopia" [Heliyon 7 (7) (July 2021) e07667].

[This corrects the article DOI: 10.1016/j.heliyon.2021.e07667.].

Organochlorine pesticide residues in tea and their potential risks to consumers in Ethiopia.

Tea is the most frequently consumed drink in the sphere; next to the water. However, tea can be contaminated by different pesticides particularly those outdated pesticides which have been familiar as one of the main difficulties in Ethiopia and contaminate the food commodities. From a study done in south west of Ethiopia, Dichlorodiphenyltrichloroethane (DDT) and endosulfan were detected in commonly consumed food items. Therefore, the main aim of this study was to analyze the residue of organochlorine pesticides (OCPs) in tea collected from the market and assessing their risks to consumers. 19 different tea samples were randomly collected from supermarkets in Jimma town and Addis Ababa city. In the analytical procedure, QuEChERS (Quick, Easy, Cheap, Rugged, and Safe) method was applied for the extraction of tea samples. The finding of the study revealed that, five OCPs (aldrin, γ-chlordane, DDT, endrin, and dibutylchlorepoxide) were detected at a concentration of 0.1465, 0.167, 0.2044, 0.3067 and 0.4089 mg kg-1 in domestic tea, respectively, while endosulfan sulfate, methoxychlor, and heptachlor epoxide were detected at a concentration of 0.258, 0.458 and 1.427 mg kg-1 in imported tea samples respectively. From the pesticides detected, the mean concentration of DDT (0.292-0.825 mg kg-1) is above the Maximum Residue Limits (MRLs) established by China (0.2 mg kg-1). The estimated daily intake (EDI) of γ-chlordane and endrin were above the acceptable daily intakes (ADIs), this indicates that there is a health risk for tea consumers. The detection of pesticide residues in tea reveals that there is the widespread use of OCPs in the study area for agricultural purposes or as vector control. Therefore, strict regulation of pesticides during production, importing, sale, and application in the field is important for Ethiopia.

Assessment of Psychological Distress and Associated Factors among Hospitalized Patients During the COVID-19 Pandemic at Selected Hospitals in Southwest Ethiopia.

BACKGROUND: The aim of this study was to assess the prevalence of psychological distress and associated factors among hospitalized patients during the COVID-19 pandemic at three selected hospitals in southwest Ethiopia. METHODS: An institution-based cross-sectional study design was conducted among hospitalized patients during the COVID-19 pandemic at Mizan-Tepi University Teaching Hospital, Tepi General Hospital, and Gebre Tsadik Shawo General Hospital, southwest Ethiopia from May 10 to August 10, 2020. Sample size was computed using a single-proportion formula, and systematic sampling was employed to recruit study participants. Data were collected using a structured interviewer-administered questionnaire. Psychological distress was assessed with the Kessler Psychological Distress Scale, which has been validated in Ethiopia. SPSS 21.0 was used for analysis. Descriptive statistics were calculated to characteristize the study population. Predictors of psychological distress were identified by logistic regression analyses. RESULTS: Among the 337 study participants enrolled, about 41% were aged 25-34 years. The overall prevalence of psychological distress was 57.9% (95% CI 52.8%-63.5%). Being female (AOR 3.69, 95% CI 2.08-6.55), having high (AOR 5.45, 95% CI 2.35-12.66) and medium perceived life threat (AOR 3.37, 95% CI 1.75-6.48), poor (AOR 3.97, 95% CI 1.70-9.29) and moderate social support (AOR 3.17, 95% CI 1.36-7.41), and current khat use (AOR 4.16, 95% CI 1.67-10.35) were statistically associated with psychological distress during the COVID-19 pandemic at P value <0.05. CONCLUSION: The prevalence of psychological distress was high among hospitalized patients during the COVID-19 pandemic. The study findings highlight the need to develop psychological support strategies to improve mental health and psychological resilience.

Determination of Pesticide Residues in Food Premises Using QuECHERS Method in Bench-Sheko Zone, Southwest Ethiopia.

Pesticides are risk factors in human life causing chronic human health effects. They are commonly used across the globe to enhance human endeavors. In Ethiopia, pesticides are widely used by local farmers and governmental organizations for pest control purpose. Pesticide residues in food items have been a concern to the consumers and environment they live in. Therefore, this study was aimed at determining the amount of organochlorine and organophosphate pesticide residues in cereal crops in Bench-Sheko Zone, Ethiopia. A cross-sectional laboratory-based study design was employed to determine the amount of pesticide residues. The samples were extracted using a Quick, Easy, Cheap, Effective, Rugged and Safe (QuEChERS) extraction and clean up method. Finally, the extracted samples were injected into gas chromatography tandem mass spectrometer and the types and concentrations of pesticide residues were analyzed. The highest concentration of endosulfan sulfate (0.076 mgkg-1) was detected in rice, followed by dimethoate (0.068 mgkg-1) and p,p'-DDE (0.087 mgkg-1) in sorghum and common millet, respectively, in the samples obtained from the Gurafarda site.The highest concentration of p,p'-DDT (0.133 mgkg-1) was detected in common millet, followed by aldrin (0.082 mgkg-1) and dimethoate (0.077 mgkg-1) in sorghum and common millet, respectively, in the samples obtained from the North Bench site. In addition, aldrin detected in rice, sorghum, and common millet obtained from the three sites was a residue of above the maximum residual limits set by Codex Alimentarius regulations and European Union. The finding shows that an indication of the widespread use of pesticides in cereal crops.

Adverse Drug Reaction and Its Predictors Among Psychiatric Patients Taking Psychotropic Medications at the Mizan-Tepi University Teaching Hospital.

INTRODUCTION: Psychotropic medications are crucial in the treatment of a variety of psychiatric disorders. Use of second-generation antipsychotics (SGA) has been associated with many adverse events. Assessment and monitoring of ADRs is required to develop appropriate interventional strategies to manage, prevent and minimize the risks of undesirable effects and thus improve quality of life and adherence, avoid relapse, and reduce treatment costs. OBJECTIVE: The objectives of this study were to assess adverse drug reactions and its predictors in psychiatric patients taking psychotropic medications from the outpatient pharmacy of MTUTH. METHODS: A cross-sectional study design was conducted using a structured questionnaire interviewing a psychiatric patient. One way ANOVA and bivariate logistic regression was computed for all independent variables to identify variables that fit for multivariate logistic regression. A p-value less than 0.05 was considered significant. RESULTS AND DISCUSSIONS: A total of 101 patients (91.8%) experienced one or more types of ADR in the current study. There was a statistically significant relationship between ADRs management and age, marital status, educational status, occupation, and monthly income of the study participants. The odds of having experienced autonomic adverse drug reactions experience among respondents aged 30 years and older higher than those under 30 years. Participants taking multiple medications were more likely to face psychiatric adverse drug reactions compared to those taking a single medication. Patients taking multiple psychotropic medications were ten times more likely to develop autonomic adverse drug reactions compared to those taking a single drug. CONCLUSION: The study revealed a moderate incidence of ADR in patients attending the psychiatric OPD. Age and number of antipsychotics were predictors of ADR (autonomic and psychiatric). This study revealed that there is a gap in the role of clinicians in the monitoring and reporting of ADRs.

Ethnobotanical Assessment and Physicochemical Properties of Commonly Used Medicinal Plants in Jimma Zone, Southwest Ethiopia: Traditional Healers Based Cross-Sectional Study.

BACKGROUND: The demand for traditional herbal medicine is increasing and about 85% of the world population use herbal medicines for the prevention and treatment of diseases. More than 62.5% of the forest areas in Ethiopia are found in the southwest region, which have been used as a source of traditional medicine to treat different human and livestock ailments. The aim of this study was the investigation of the ethnobotanical and physicochemical properties of commonly used medicinal plants in Jimma zone, southwest Ethiopia. MATERIALS AND METHODS: A cross-sectional study was conducted in the district of Jimma zone from June 1 to 30, 2017. The ethnobotanical data were collected from traditional healers through semi-structured questionnaires. Specimens collected from various habitats were taken into Jimma University, Herbarium laboratory, dried, and prepared using standard herbarium specimen techniques for identification. Physicochemical analysis was done for selected medicinal plants. RESULTS: A total of 72 medicinal plants categorized under 61 genera and 39 families were stated by the respondents for the treatment of different human and livestock ailments. Herbs constitute the largest category (28 species, 38.89%) followed by shrubs (21 species, 29.17%), trees (20 species, 27.78%) and climbers (3 species, 4.17%). Leaves (39.19%) were the most commonly used plant parts followed by roots (27%) and seeds (10.81%). Traditional healers reported processing remedies mainly through crushing (46.91%), powdering (18.52%), pounding (11.11%), and pressing (9.88%). The water-soluble extractive value of the selected medicinal plants were between 1.825 to 18.507%w/w and the alcohol-soluble extractive value were between 0.143 to 1.107%w/w. The moisture content (%LOD) of Barleria argentea Balf. f. was higher than the recommended standard which consisted of 21.063%w/w and followed by high %LOD of Crateva adansonii D.C. Prodr (8.143%w/w) and Euphorbia abbyssinica J.F. Gmel. (16.347%w/w). The highest total ash value was registered in Dioscorea quartiniana A.Rich. species which consisted of 18.563%w/w and followed by Crateva adansonii D.C. Prodr (16.033%w/w) and Barleria argentea Balf. f. (15.648%w/w). High acid-insoluble ash value (7.227%w/w) and water-soluble ash (6.731%w/w) was recorded in Euphorbia abbyssinica J.F. Gmel. CONCLUSION: The study revealed that the water-soluble extractive value of the selected medicinal plants indicates the presence of water-soluble components such as sugar, acids, and inorganic compounds. In the future, these characters can be used to check the genuine nature of the crude drug; thus, it plays an important role in preventing the possible steps of adulteration.