Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: a cross-sectional study.

BACKGROUND: End-Stage Kidney Disease, the most severe form of chronic kidney disease, is fatal if not treated by renal replacement therapy. Thus, patients with End-Stage Kidney Disease depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health-related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries. METHODS: A hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients who were on hemodialysis in five randomly selected public and private hospitals (n = 125) were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life questionnaire. Clinical data were extracted from the patients' medical charts. HRQOL was categorized as low, if the overall mean score was ≤ 50, or as high, if the overall mean score was > 50. Factors associated with lower HRQOL were identified by multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR) and its respective 95 % confidence interval. RESULTS: The mean age of the study participants (n = 125) was 50.33 years (± 15.07) and more than two-thirds (68.8 %) of the participants were males. The mean score of HRQOL was 49.08 ± 11.09, with 48.0 % (95 % CI: 42.2 - 54.5 %) of them had lower HRQOL. Unemployed patients (aOR = 2.40, 95 % CI: 1.10-5.90) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95 % CI: 1.07-3.83) had lower HRQOL. Elderly patients had higher odds of having lower mean score on the burden of kidney disease (aOR = 2.07; 95 % CI 1.18-4.13) as compared to the younger patients. CONCLUSIONS: Nearly half of the patients with ESKD on hemodialysis had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Elderly patients had lower mean score of burden of kidney disease. Therefore, quality of life of patients with chronic dialysis should be given special attention during the patients' care. Measures should be taken by the government to ensure accessibility and affordability of the hemodialysis services in the country.

Nutritional status among orphans and vulnerable children aged 6 to 59 months in Addis Ababa, Ethiopia: a community-based cross-sectional study.

BACKGROUND: Childhood undernutrition is a global problem contributing to more than a third of under-five mortality. Orphans and vulnerable children (OVC) fare worse than children living with their parents. However, the nutritional and healthcare needs of OVC are under-recognized in Ethiopia. METHODS: A community-based cross-sectional study was conducted among OVC aged 6 to 59 months. Multi-stage sampling technique was applied to select the households and eligible children included in the study (n = 584). An interviewer-administered questionnaire and anthropometric measurements were carried out. The proportions of stunting, wasting and underweight were determined based on the WHO Z-score cut-off. Factors associated with stunting were identified by Multivariable binary logistic regression analysis. RESULTS: The prevalence of stunting, wasting and underweight were 35.1% (95% CI; 31.3-39.1%), 4.7% (95% CI; 3.2-6.7%) and 12.0% (95% CI; 9.6-14.9%), respectively. Stunting was significantly associated with initiation of complementary feeding after 12 months of age (AOR = 3.61; 95% CI 1.16-14.11), household food insecurity (AOR = 1.90; 95% CI 1.10-3.17), unplanned pregnancy (AOR = 1.90; 95% CI 1.03-3.42), age ≥ 2 years (AOR = 1.80; 95% CI 1.25-2.67), caretaker's age ≤ 25 years (AOR = 1.50; 95% CI 1.03-2.16) and employment of the caretaker (AOR = 1.50; 95% CI 1.03-2.26). CONCLUSION: The prevalence of all forms of undernutrition among OVC was significantly higher than the national estimate that has been reported by consecutive Ethiopian Demographic and Health Surveys (EDHS). Policy makers and programmers working on nutritional interventions should give due emphasis to address the unmet need of OVC and focus on interventions which enhance household food security and caretaker's awareness on child feeding and pregnancy planning.

Prevalence And Predictors Of Opportunistic Infections Among HIV Positive Adults On Antiretroviral Therapy (On-ART) Versus Pre-ART In Addis Ababa, Ethiopia: A Comparative Cross-Sectional Study.

PURPOSE: Data comparing the burden of the opportunistic infections among the Pre-ART and On-ART HIV-infected patients in Ethiopia are scarce. Therefore, this study aimed to compare the prevalence and predictors of opportunistic infections in Pre-ART and On-ART HIV-infected patients. METHODS: A comparative cross-sectional study was conducted among adult patients infected with HIV and who were on Pre-ART or On-ART and followed up from 2012 to 2016 in Zewditu Memorial Hospital, Addis Ababa. Those patients who were infected with HIV, but not eligible for ART were categorized under Pre-ART follow-up (n=192) and those patients who started taking ART were categorized under the On-ART follow-up group (n=192). Patients were included in the study by using simple random sampling technique from the list of the patients registered in the ART follow-up database. The presence of opportunistic infections along with clinical findings and baseline laboratory data was extracted from the ART follow-up database and the medical records of the patients using a standardized checklist. Factors associated with the development of opportunistic infections were analyzed using multi-variable binary logistic regression analysis. RESULTS: The overall prevalence of opportunistic infections was found to be 33.6% (95% CI; 28.9-38.5). The prevalence of opportunistic infections among the Pre-ART group (38%) was higher than On-ART group (29.2%) (P-value = 0.04). Pulmonary tuberculosis was the most common opportunistic infection observed in both Pre-ART and On-ART groups. Being in the WHO clinical Stage III (AOR = 2.1; 95% CI 1.1-3.9) or Stage IV (AOR = 3.6; 95% CI 1.7-7.7) were independent predictors for the development of opportunistic infections. CONCLUSION: The prevalence of opportunistic infections among the HIV-infected patients who were in Pre-ART was higher than On-ART group. This finding reinforces the need for early initiation of ART for HIV-infected patients irrespective of their CD4 counts.

Glycemic Index and Load of Selected Ethiopian Foods: An Experimental Study.

BACKGROUND: Determining the glycemic index and load of foods has significant impact on meal planning for diabetes. However, there is no data on the glycemic index (GI) and glycemic load (GL) of Ethiopian foods. Therefore, the aim of this study was to analyze the glycemic index and glycemic load of Teff Injera, Corn Injera, and White Wheat Bread. METHODS: Experimental study design was conducted among selected healthy adults. Teff Injera, Corn Injera, and White Wheat Bread were selected as test foods for the study, and glucose was used as the reference food. The postprandial glucose concentrations in the blood were recorded at 0, 15, 30, 45, 90, and 120 minutes. The relative glycemic index of each food was calculated, and the presence of statistical difference in glycemic index among the three foods was analyzed. RESULTS: The mean age of the participants was 23 years (±1.6 years). The glycemic indexes of Teff Injera, White Wheat Bread, and Corn Injera were 36 (low), 46 (low), and 97 (high), respectively, and the glycemic loads were 7 (low), 14 (moderate), and 22 (high), respectively. There was a significant difference in glycemic index and load among the three food items (p < 0.001). Teff Injera had a much lower glycemic index and load compared with Corn Injera (p < 0.001) and White Wheat Bread (p = 0.03). CONCLUSIONS: Teff Injera and White Wheat Bread have low glycemic index and are recommended to be consumed by diabetic patients, whereas Corn Injera has high glycemic index and is not recommended for diabetic patients. Therefore, Teff Injera should be considered globally in the dietary modification programs for diabetes.