Erectile dysfunction and associated factors among patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia. A cross-sectional study design.

Background: The global prevalence of erectile dysfunction among patients with diabetes is high. It is the most underestimated problem but has a great physical, psychological, and social impact on the individual with the disease, family, and society in general. Thus, this study aimed to assess the magnitude of erectile dysfunction and associated factors among patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted on selected 210 adult male patients with diabetes attending follow-up at a public hospital, Harar, Eastern Ethiopia, from 1 February to 30 March 2020. Simple random sampling was used to select study participants. A pre-tested interviewer-administered structured questionnaire was used to collect the data. The data were entered to EpiData version 3.1 and exported to SPSS version 20 for analysis. Bivariate and multivariable binary logistic regression were carried out, and a P-value of <0.05 was taken as statistically significant. Result: A total of 210 adult male patients with diabetes participated in the study. The overall magnitude of erectile dysfunction was 83.8%, with 26.7% suffering from mild, 37.5% mild to moderate, 29% moderate, and 6.8% severe erectile dysfunctions. Age 46-59 years [adjusted odds ratio (AOR): 2.560; 95% confidence interval (CI) (1.73, 6.53)], age ≥ 60 years [AOR: 2.9; 95% CI (1.48, 5.67)], and poor glycemic control [AOR: 2.140; 95% CI (1.9, 7.44)] were significantly associated with erectile dysfunction among patients with diabetes. Conclusion: The present study revealed a high magnitude of erectile dysfunction among population with diabetes. The age categories of 46-59 and ≥60 and having poor glycemic control were the only variables significantly associated with erectile dysfunction. Thus, routine screening and management for erectile dysfunction in patients with diabetes should be part of routine medical care particularly for adult male patients and those with poor glycemic control.

Diabetes Concordant Comorbidities and Associated Factors Among Adult Diabetic Out-Patients at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a Cross-Sectional Study.

BACKGROUND: Nowadays diabetic comorbidities constitute a major public health problem in Ethiopian context. However, there is a dearth in epidemiology and risk factors of diabetic comorbidity in Ethiopia, particularly in the study setting. Therefore, this study was conducted to determine the prevalence and identify factors associated with concordant diabetic comorbidities among diabetic out-patients at Hiwot Fana Specialized University Hospital (HFSUH), EasternEthiopia. METHODOLOGY: A hospital-based cross-sectional study was conducted by reviewing medical record charts of adult diabetic outpatients. Bivariable and multivariable logistic regression analysis was carried out by using STATA version 16.0. To measure the strength of association an Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used. Moreover, variables with p-value ≤ 0.05 were considered as statistically significant with the outcome variable. RESULTS: In this study, it is found that the overall prevalence of concordant comorbidity among adult diabetic out-patients was 55.8% (95% CI: 50.3-61.3). Moreover, more than two-third of patients, 72.73% were diagnosed for type two diabetic mellitus (T2DM). Among specified comorbidities about 42.3% were hypertension, 21.63% were obesity, and 13% were multi-morbidity. Age ≥ 55 years (AOR: 7.52, 95% CI: 1.24, 45.75), T2DM (AOR: 9.01, 95% CI: 1.50, 54.04), 2-5 years duration of treatments (AOR: 0.23, 95 CI: 0.078, 0.691), and poor glycemic control (AOR: 4.4 1, 95% CI: 2.34, 8.32) were factors significantly associated with concordant diabetic comorbidity. CONCLUSION: From the study conducted, the higher prevalence of concordant comorbidity among diabetic patients was investigated. Furthermore, older in age, T2DM, prolonged duration of treatment, and poor glycemic control were factors associated with diabetic comorbidities. Early detection and appropriate treatment of diabetic comorbidities are very important for better patient's quality of life and functionality.

Cardiovascular diseases risk factors among adult diabetic patients in eastern Ethiopia.

OBJECTIVE: The aim of this study was to determine the magnitude of cardiovascular disease risk factors among adult diabetic patients at Hiwot Fana Specialized University Hospital and Jugal Hospital, eastern Ethiopia. METHODS: An institutional based cross sectional study was conducted on a total of 416 study participants (age ≥18 years) from February to March 2017. Data were collected using: structured questionnaires, measurements of weight, height, and blood pressure, and laboratory examination of blood lipids (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein cholesterol) and fasting blood glucose. Data were analyzed using SPSS version 16.0 software packages. The association of cardiovascular disease risk factors with diabetes type, age, and sex was assessed by chi-square test. RESULT: The mean age of study participants was 52 years and 44% were male. Dyslipidemia (90.6%), physical inactivity (76%), and hypertension (62.7%) were the most common cardiovascular disease risks factors identified among diabetic patients. It was also observed that 68.5% of the study participants had uncontrolled blood glucose level. Hypertension was significant in patients over 65 compared to those ≤65 years of age (p < 0.023). Females were considered to be significantly physically inactive compared to males (p < 0.001). CONCLUSION: Dyslipidemia is the most common risk factor of CVD in individuals with Types 1 and 2 diabetes mellitus. Identification and treatment of lipid abnormalities is very important. Controlling hypertension among older patients and lifestyle modification among female diabetic patients are also recommended.

Magnitude and associated factors of diabetes mellitus and hypertension among adult HIV-positive individuals receiving highly active antiretroviral therapy at Jugal Hospital, Harar, Ethiopia.

BACKGROUND: People with HIV infection are at increased risk of noncommunicable diseases (NCDs). Diabetes mellitus (DM) and hypertension are recognized as the major NCDs. Except few findings in general population, there is no well-documented evidence on the magnitude of NCDs and associated factors among HIV-positive patients. PURPOSE: The aim of this study was to determine the magnitude and associated factors of DM and hypertension among adult HIV-positive subjects receiving highly active antiretroviral therapy (HAART). METHODS: A hospital-based cross-sectional study was conducted from February to April at Jugal Hospital, Harar, Eastern Ethiopia. Sociodemographic and anthropometric data and blood pressure (BP) were collected by senior clinical nurses. A total of 5 mL of venous blood was collected. Serum glucose and lipid profile were measured using the Autolab 18 clinical chemistry analyzer. Data were analyzed using STATA version 13. RESULTS: A total of 425 HIV-infected individuals taking HAART of age ranging from 18 to 68 years were included. The prevalence of DM and hypertension were 7.1% (95% CI: 4.9-9.9) and 12.7% (95% CI: 9.8-16.2), respectively. Increased blood triglyceride (adjusted odds ratio [AOR] =4.7, 95% CI: 1.7-13.1), high BP (AOR =3.3, 95% CI: 1.1-9.5), and high baseline body mass index (BMI) (AOR =8.7, 95% CI: 2.4-31.8) were significantly associated with DM. In contrast, raised waist-hip ratio (AOR =4.6, 95% CI: 1.6-13.3), raised blood glucose (AOR =3.5, 95% CI: 1.1-11.4), increased total cholesterol (AOR =3.9, 95% CI: 1.3-11.9), high current BMI (AOR =3.8, 95% CI: 1.5-9.6), drinking alcohol (AOR =3.4, 95% CI: 1.5-8.1), CD4 count <500 cell/mL (AOR =2.7, 95% CI: 1.3-5.6), and longer duration of HAART (AOR =2.3, 95% CI: 1.1-5.1) were significantly associated with hypertension. CONCLUSION: DM and hypertension were frequent among HIV patients on HAART, and they were linked to the well-known risk factors. Therefore, regular screening and monitoring of DM and hypertension before and after the initiation of HAART is of paramount importance.

Prevalence of rheumatic heart disease among school children in Ethiopia: A multisite echocardiography-based screening.

BACKGROUND: Auscultation-based surveys in Ethiopia conducted in the late 1990's reported a rural prevalence of 4.6/1000 and an urban prevalence of 6.4/1000 of rheumatic heart disease (RHD). With echo-based screening, we aimed to estimate the national prevalence of RHD in school children by taking school-based samples from six regions across the country using the 2012 World Heart Federation echocardiographic criteria. PATIENTS AND METHODS: We conducted a cross-sectional echocardiographic screening of RHD in school children aged 6-18years from 28 randomly selected primary and secondary schools found in six different geographic regions of Ethiopia. We used the standardized WHF echocardiographic criteria. RESULTS: A total of 3238 children (48.5% females) were screened. The mean age was 13.2±3.2years. Of these, 44 patients (1.4%) met the WHF criteria for definite RHD, while 15 (0.5%) met the criteria for borderline disease, yielding a prevalence of 19 [13.9-23.4, 95% CI] cases per 1000 school children between the ages of 6-18years. The majority of those who tested positive were girls (26/44). The prevalence was lowest in children aged 6-9years and otherwise uniformly distributed across ages 10-18years. Definite RHD involved the mitral valve in 42 subjects, 39 of whom had mitral regurgitation and 3 with mitral stenosis. The aortic valve was affected in 6 children. The ratio of definite to borderline cases was 2.9. CONCLUSION: This study demonstrated a consistent pattern of high prevalence of asymptomatic RHD with definite disease predominating over borderline involvement across six regions of Ethiopia.

Factors affecting adherence to antiretroviral treatment in harari national regional state, eastern ethiopia.

Background. The efficacy of antiretroviral treatment (ART) depends on strict adherence to the regimen, but many factors have been identified for nonadherence. Method. To identify the factors for non-adherence to ART, a cross-sectional study was conducted on people living with human immunodeficiency virus (HIV) and attending the ART service at Hiwot Fana and Jugal hospitals; it was done from October to December, 2010. Adherence was defined as taking 95% of the prescribed doses in the week before the survey. Data were collected using a standard interview questionnaire and were analyzed using SPSS Version 16. Result. Among the 239 study participants, the magnitude of adherence to ART in the week before interview was 87%. The main reasons for nonadherence were forgetting (47.2%), traveling (18.9%), and being busy doing other things (15.1%). There was not any independent predicator identified for adherence to ART. Conclusion. Compared to other similar studies in Ethiopia, in this study a high adherence rate was found. Forgetfulness was the most common reason for the nonadherence. Therefore, the ART counseling needs to give emphasis to using memory aids. In addition, a further study on adherence rate and its determinants with multiple adherence measurements is recommended.