Assessment of subclinical left ventricular systolic and diastolic dysfunction in patients with type 2 diabetes mellitus under follow-up at Tikur Anbessa specialized hospital, Ethiopia: a case-control study.

BACKGROUND: Individuals with diabetes mellitus are at increased risk of cardiovascular diseases, which in turn are the most common cause of morbidity and mortality in the diabetic population. A peculiar feature of cardiovascular diseases in this population is that they can have significant cardiac disease while remaining asymptomatic. There is a paucity of data regarding subclinical cardiac imaging features among diabetic adults in Africa, particularly in Ethiopia. This study was conducted to compare the magnitude and spectrum of left ventricular systolic and diastolic dysfunction among asymptomatic type 2 diabetic adults versus a normotensive, non-diabetic control group and to evaluate the determinants of left ventricular diastolic and systolic dysfunction. METHODS: This was a case-control study conducted at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A standard transthoracic echocardiography was done for all study participants with type 2 diabetes mellitus and their normotensive and non-diabetic controls. Structured questionnaires were used to collect demographic and clinical characteristics and laboratory test results. Statistical analysis was done using the SPSS 25.0 software. The data was summarized using descriptive statistics. Bivariate and multivariate analysis was performed to determine the association between variables and echocardiographic parameters. The strength of statistical association was measured by adjusted odds ratios and 95% confidence intervals, with significant differences taken at p < 0.05. RESULTS: We analyzed age- and sex-matched 100 participants in the study (diabetic) group and 200 individuals in the control group. Left ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic adults than their sex and age matched controls. Among diabetic individuals, ages of 60 years and above, dyslipidemia, use of Metformin and Glibenclamide, high serum triglyceride level, presence of neuropathy and use of statins correlated significantly with the presence of left ventricular diastolic dysfunction. Chronic kidney disease and neuropathy were determinants of left ventricular systolic dysfunction. CONCLUSION: Left ventricular systolic and diastolic dysfunction were significantly more prevalent among diabetic patients than their sex- and age-matched controls in our study. We recommend early screening for subclinical left ventricular dysfunction, especially in the elderly and in those with chronic kidney disease, dyslipidemia, and microvascular complications such as neuropathy.

Assessment of Trend, Indication, Complications, and Outcomes of Pacemaker Implantation in Adult Patients at Tertiary Hospital of Ethiopia: Retrospective Follow Up Study.

Background: A pacemaker is a device implanted in the chest to help people with symptomatic bradycardia and life-threatening irregular rhythm. However, it is also associated with many complications. Therefore, this study evaluated pacemaker-related complications and factors associated with them, as there is little data on pacemaker-related complications in sub-Saharan Africa and Ethiopia. Methods: The study was conducted on 118 patients over 18 years old who had pacemakers implanted between 2017 and 2022 at Tikur Anbessa Comprehensive Specialized Hospital in Addis Ababa, Ethiopia who were reviewed by the authors from September 2022 to December 2022. Sociodemographic factors, clinical characteristics, and complications data were extracted using a structured questionnaire by retrospective review of patient records. The chi-square test or Fisher's exact test was performed to evaluate factors associated with complications. Results: The median age of patients was 60.5 years (IQR = 15 years), with men accounting for 50.8% of patients. Hypertension was the most common comorbidity (64.2%). Symptomatic grade 3 AV block was the most common indication (78.8%) for pacemaker implantation. With a mean follow-up of 3.92 ± 1.94 years, 15.3% of patients had complications. Pneumothorax, pocket site infection, and lead dislodgement were the most common complications occurring in 2.54% of patients each. Patient age during surgery (p-value = 0.02), patient gender (p-value = 0.04), pacemaker implanting team (p-value = 0.01), and adherence to follow-up (p-value = 0.04) are related to pacemakers-related complications. Conclusion: Pacemaker implantation is associated with many complications. Pneumothorax, pacemaker pocket infection, and lead dislodgement were the most common complications. Patient age at pacemaker implantation, patient gender, pacemaker implanting team, and follow-up compliance were factors associated with pacemaker-related complications. Skill development through specialized training and compliance counseling may improve outcomes for patients who have complications related to pacemaker implanting team and poor adherence to follow.

Risk perceptions and attitudinal responses to COVID-19 pandemic: an online survey in Ethiopia.

BACKGROUND: Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia. METHODS: An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used. RESULTS: A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05). CONCLUSIONS: Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.