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1.
Front Med (Lausanne) ; 11: 1345144, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38646554

RESUMO

Introduction: Pharmacological stress ulcer prophylaxis (SUP) has been recommended for many years to reduce the risk of clinically significant upper gastrointestinal (GI) bleeding caused by stress ulcers (SUs). Stress-related ulcer bleeding in surgical patients significantly increases morbidity and mortality. Therefore, preventing stress-induced hemorrhage is the most appropriate measure for patients who are at increased risk. However, the inappropriate use of SUP has increased in recent years, and its use in Ethiopian surgical patients has not been well studied. Objective: The aim of this study was to assess the appropriateness of SUP use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital (DBUHGH), Ethiopia. Methods: We randomly selected 230 patients from the whole cross-sectional group of all surgical patients at DBUHGH from 1 February to 30 June 2023. The risk of stress ulcer (SU) development was assessed using the modified American Society of Health-System Pharmacists (ASHP) guidelines. For data analysis, we used SPSS version 25. Results: The mean age of study participants was 47.2 years (SD ± 20.4), and out of the total of 230, 130 (56.5%) were women. Approximately 66% of study participants took inappropriate SUP based on ASHP guidelines criteria. The most commonly used drug class for SUP was histamine-2 receptor blockers 115 (50%). Study participants who have a Charlson Comorbidity Index Score of moderate and GI bleeding have been significantly associated with the inappropriate use of SUP. Conclusion: In our study, inappropriate SUP use was common in the surgical ward of DBUHGH. This may be an area that requires further and more focused working together among clinical pharmacists and medical professionals in an institution-specific SUP protocol that aids clinicians in identifying appropriate candidates for SUP medication.

2.
Am J Trop Med Hyg ; 105(6): 1476-1482, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34670193

RESUMO

Countries across West Africa began reporting COVID-19 cases in February 2020. By March, the pandemic began disrupting activities to control and eliminate neglected tropical diseases (NTDs) as health ministries ramped up COVID-19-related policies and prevention measures. This was followed by interim guidance from the WHO in April 2020 to temporarily pause mass drug administration (MDA) and community-based surveys for NTDs. While the pandemic was quickly evolving worldwide, in most of West Africa, governments and health ministries took quick action to implement mitigation measures to slow the spread. The U.S. Agency for International Development's (USAID) Act to End NTDs | West program (Act | West) began liaising with national NTD programs in April 2020 to pave a path toward the eventual resumption of activities. This process consisted of first collecting and analyzing COVID-19 epidemiological data, policies, and standard operating procedures across the program's 11 countries. The program then developed an NTD activity restart matrix that compiled essential considerations to restart activities. By December 2020, all 11 countries in Act | West safely restarted MDA and certain surveys to monitor NTD prevalence or intervention impact. Preliminary results show satisfactory MDA program coverage, meaning that enough people are taking the medicine to keep countries on track toward achieving their NTD disease control and elimination goals, and community perceptions have remained positive. The purpose of this article is to share the lessons and best practices that have emerged from the adoption of strategies to limit the spread of the novel coronavirus during MDA and other program activities.


Assuntos
Anti-Infecciosos/uso terapêutico , COVID-19/epidemiologia , Administração Massiva de Medicamentos , Programas Nacionais de Saúde/organização & administração , Doenças Negligenciadas/terapia , SARS-CoV-2 , África Ocidental , Anti-Infecciosos/administração & dosagem , Humanos , Programas Nacionais de Saúde/normas , Guias de Prática Clínica como Assunto , Fatores de Risco , Fatores de Tempo , Clima Tropical , Estados Unidos , United States Agency for International Development
3.
BMC Res Notes ; 11(1): 696, 2018 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-30286801

RESUMO

OBJECTIVE: The main objective of this study was to assess time to death and associated risk factors among tuberculosis (TB) patients. RESULTS: A total of 769 TB patients were studied and of those, 87 (11.3%) patients died. All of the deaths occurred within 7 months of anti-tuberculosis therapy. Extra-pulmonary TB (AHR = 17.376, 95% CI; 3.88-77.86, p < 0.001) as compared to pulmonary TB and cotrimoxazole prophylaxis therapy (CPT) (AHR = 0.15, 95% CI; 0.03-0.74, p = 0.02) were found to be the predictors of mortality. We noticed higher rates of mortality. Extra-pulmonary TB patients have high risk and TB-HIV co-infected patients who received CPT have low risk of death. Improving early diagnosis of extra-pulmonary TB and early CPT initiation of TB-HIV co-infected patients could minimize patient's mortality.


Assuntos
Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico , Tuberculose/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores de Tempo , Adulto Jovem
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