The magnitude and associated factors of anxiety and depression among non-communicable chronic disease patients during COVID-19 pandemic in a resource-limited setting.

Objective: To assess the magnitude and associated factors of depression and anxiety among chronic disease patients during the COVID-19 pandemic at the University of Gondar Comprehensive and Specialized Hospital, Northwest Ethiopia 2021. Methods: A cross-sectional study was done from June 1 to August 30, 2021 among non-communicable chronic disease patients. A systematic random sampling technique was used to collect data from 400 patients. Data were entered into EPI Info and to SPSS version 23 for analysis. Descriptive data analysis was done and bivariable and multi-variable logistic regression was used to identify factors. Variables with a p-value of 0.05 were considered statically significant. Results: The mean age of the respondents was 51.3 ± 0.8 years. The prevalence of anxiety and depression among non-communicable chronic disease patients was 17.9% (95%CI 14.2, 21.7) and 16.3% (95%CI 12.6, 20.1)) respectively. Being female (AOR = 2.56, 95% CI: 1.21, 5.41), divorced (AOR = 3.42, 95% CI: 1.02-11.50), and ever cigarette smoking (AOR = 5.00, 95% CI: 1.66-14.90) were significantly associated with depression. Whereas, ever cigarette smoking (AOR = 2.74, 95% CI: 1.04, 7.21), number of closed contacts (AOR = 1.16, 95% CI: 1.03, 1.31), and poor social support (AOR = 2.98, 95% CI: 1.16, 7.65) were significantly associated with the anxiety. Conclusion: The magnitude of depression and anxiety was high. Thus, appropriate action should be taken to identify those patients and integration of psychiatric care into the usual care of non-communicable chronic disease patients is vital.

Angiotensin-Converting Enzyme Inhibitor Dose Optimization and Its Associated Factors at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.

Introduction: Angiotensin-converting enzyme inhibitors dose optimizations (ACEIs) are essential to boost the treatment outcome in heart failure patients (HF) with reduced ejection fraction. Therefore, the main purpose of this study was to evaluate dose optimization and associated factors of ACEIs among HF patients. Method: An institutional-based retrospective study was conducted on 256 study participants from May 20 to August 30, 2020 in ambulatory care clinic at Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling method was carried out to select study participants. Data were collected from the patient interview and the review of medical records. Epidata and SPSS version 22 were used for data entry and analysis. A bivariate logistic regression analysis was done to determine the association of independent variables with a dose optimization of ACEIs. Results: The mean age of the subjects in the study was 53.82 years with a standard deviation (SD) of 17.067 and more than half of (60.9%) the patients were unable to read and write. Among participants who were receiving ACEIs, only 30.6% were taking an optimal dose. Age ≥65 years (AOR 5.04 (2.81-12.56)) and a dose of furosemide ≥40 mg (AOR, 2.62 (1.28-16.74)) were significantly associated with the suboptimal dose of ACEIs. Conclusion: Only one-third of patients received the optimum dose of ACEIs. Older age and dose of furosemide greater >40 mg were significantly associated with suboptimal dosing of ACEIs. Therefore, more attention must be given to older patients with HF in order to optimize the dose of ACEIs administered.

Comparative analysis of the effectiveness of narrow-spectrum versus broad-spectrum antibiotics for the treatment of childhood pneumonia.

OBJECTIVES: The main objective of this study was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalized with community-acquired pneumonia (CAP) at the University of Gondar Referral Hospital, Gondar, Ethiopia. METHODS: Institutional-based retrospective chart review was conducted at the University of Gondar Referral Hospital (GURH) pediatrics ward from 1 February 2016 to 30 April 2016. The collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were done to present the basic features and summary of the data set. In addition, binary logistics and multivariable logistic regression analysis were conducted to test for an association between the dependent and independent variables. A P value of <0.05 was taken to declare statistical significance at a 95% confidence interval. RESULT: A total of 147 patients with CAP were included in the study. Seven different treatment regimens were employed for the 147 children hospitalized. About 63 (42.9%) of the study participants received a narrow-spectrum antibiotic and 84 (57.1%) received a broad-spectrum antibiotic. There was no significant difference between the broad and narrow spectrum treatment groups in main treatment outcomes. The median length of stay (LOS) for the study population was 3 days. The median LOS was shorter among those receiving narrow-spectrum therapy compared with those receiving broad-spectrum therapy. Treatment dose and duration of therapy were significantly associated with treatment outcome (P < 0.0001 and P = 0.003), respectively. CONCLUSION: The effectiveness of narrow-spectrum therapy is similar to that of broad-spectrum therapy for children hospitalized with CAP. Treatment regimens for children with community-acquired pneumonia should be selected based on their safety profile and their tendency for antibiotic resistance.