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BACKGROUND: Epilepsy is a major public health problem affecting 70 million people worldwide. 90% of global people with epilepsy were living in developing regions like Ethiopia. Due to the lack of clear guidelines for treatment selection and the difficulty of individualizing care in resource-poor settings, achieving seizure control can be challenging. Seizure control status among epileptic patients is affected by different factors. Accordingly, this study aimed to assess the magnitude of uncontrolled seizures and associated factors among people with epilepsy attending the outpatient clinic of Jimma Medical Center, Southwest Ethiopia. METHODS: A hospital-based retrospective chart review and a respective patient interview conducted among people with epilepsy from October 2020 to June 2021. Sociodemographic, behavioral-related factors, medication adherence, and medication belief were obtained through patient interviews. Seizure control status in the last two years before the study period was retrospectively evaluated and recorded from the charts. Data were entered into Epi Data manager version 4.6 and then exported to SPSS version 23.0 for analysis. A backward logistic regression analysis was done to identify factors associated with uncontrolled seizures. RESULTS: From a total of 314 medical charts reviewed, 149(47.5 %) of patients were with uncontrolled seizures. 28.7 %,12.8 %, and 6 % of the patients experienced 1-5,6-10, and >10 seizure episodes during the last two years respectively. Comorbidity [adjusted odds ratio [(AOR): 2.13, 95 % confidence interval (CI):1.26-3.58], nonadherence [AOR: 2.41, 95 %CI: 1.46-3.9], possible adverse drug reaction (ADR) [AOR:1.79, 95 %CI: 1.107-3.01], and drug interaction [AOR: 3.06, 95 %CI: 1.24-7.57] were associated with an uncontrolled seizure. CONCLUSION AND RECOMMENDATION: Our study showed that a substantial proportion of the patients were with uncontrolled seizures. Epileptic patients with comorbidities, nonadherence, adverse drug reactions, and drug interactions were more prone to have uncontrolled seizures. Hence, to overcome these problems, strategies like community-based education, treatment intensification, and routine assessment of adverse drug reactions and drug interaction may help to improve seizure control status.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Epilepsia , Humanos , Estudos Retrospectivos , Etiópia/epidemiologia , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Hospitais de EnsinoRESUMO
BACKGROUND: Drug-related problems are associated with high mortality, complications, prolonged hospital stay, compromised quality of life, and increased healthcare costs. This problem is high in patients hospitalized with chronic conditions such as heart failure. However, there are limited studies conducted on this area, particularly in Ethiopia. OBJECTIVE: To evaluate drug-related problems, their predictors, and clinical pharmacist intervention among hospitalized heart failure patients at Jimma Medical Center, Ethiopia. METHODS AND PARTICIPANTS: A prospective interventional study was conducted among hospitalized heart failure patients from September 30, 2020, to May 28, 2021, at Jimma Medical Center. Drug-related problems were sorted based on the Pharmaceutical Care Network Europe drug classification tool version 9.0. Patient's specific data were collected using a structured questionnaire. Data was analyzed using statistical software package version 23.0. Multivariate logistic regression analysis was used to identify independent predictors of drug-related problems occurrence and statistical significance was considered at a p value < 0.05. RESULTS: A total of 237 heart failure patients were included in this study. The mean (SD) age was 49.06 + 17.79. About two-thirds (66.2%) of study patients had at least one drug-related problem during their hospital stay. A total of 283 drug-related problems were identified among 157 patients. Treatment effectiveness-related problem (55.48%) was the most common observed drug-related problem. The independent predictors of drug-related problems were khat chewing [AOR = 3.25, 95% CI = (1.46-7.23)], hospital stay > 18 days [AOR = 3.77, 95% CI = (1.93-7.37)]; presence of comorbid condition [AOR = 2.59, 95% CI = (1.35-4.96)] and polypharmacy [AOR = 2.94, 95% CI = (1.54-5.61)]. CONCLUSION: The prevalence of drug-related problems was high among hospitalized heart failure patients in the study area. Chewing khat, prolonged hospital stay, comorbidity, and polypharmacy were the predictors of drug-related problems. Hence, to overcome these problems, clinical pharmacists, physicians, and other health professionals have to work in collaboration.
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Insuficiência Cardíaca , Qualidade de Vida , Catha/efeitos adversos , Estudos Transversais , Etiópia/epidemiologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Humanos , Estudos ProspectivosRESUMO
BACKGROUND: The human immune virus or acquired immune deficiency syndrome, is a major threat to the health of millions of people worldwide. In Ethiopia, there were more than a million people living with HIV/AIDS. The continuous and appropriate use of condoms, particularly among those who have HIV-positive clients, is essential to a comprehensive and long-term approach to avoiding HIV and other STIs as well as unintended pregnancy. But irregular condom use is regularly reported. There is inconsistent reports of the prevalence and correlates of frequent condom use in Ethiopia. This study's goal is to provide an overview of the most recent research on magnitude condom use among people living with HIV in Ethiopia. METHODS: Four databases of PubMed, Science Direct, Scopus, and Google Scholar were used. Finally, 10 studies that satisfied the eligibility criteria were included in the systematic review and meta-analysis. The data were collected using a methodical checklist for data extraction, and STATA 14 was utilized for the analysis. The consistent condom use was reported as use of condom in every sexual encounter preceding the study. The prevalence of consistent condom usage among HIV/AIDS patients was calculated by dividing the total number of patients who regularly used condoms by the total number of HIV/AIDS patients and multiplying that result by 100. The factors associated with a consistent use of condom were described using the pooled odds ratio (OR) and calculated based on binary outcomes from the included primary studies. The statistical significance was determined based on the correlation factor as their confidence level should not include 1. Subgroup analyses by region and publication years were carried out by using a random-effects model. The STATA commands of metan magnitude semagnitude, random xlab(.1,5,10) lcols (authors) by (variables)texts(120) xsize(18) ysize (14) were used to carried out the subgroup analysis. To assess the presence of publication bias, funnel plot, Egger test and Begg's test at 5% significant level were computed. The asymmetry of funnel plot and the Egger test and Begg's test P value of 0 >0.5 showed the absence of publication bias. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. RESULT: The pooled magnitude of consistent condom use was 50.56% (95%CI: 38.09-63.02). The predictors of consistent condom use includes urban residence (AOR = 3.46; 95% CI: 2.24-5.35), marital status (AOR = 0.33; 95% CI: 0.18-0.61), and HIV disclosure status (AOR = 5.61;95%CI: 2.29-13.73). CONCLUSION: Half of the HIV/AIDS patients in our study regularly used condoms. According to this study, urban residency, disclosure status, and marital status were all associated with consistent condom use among HIV/AIDS patients. Therefore, health education about condom use should be provided to married couples and people living in rural regions. In addition, disclosing HIV status and the necessity of constant condom usage would be crucial for consistent condom use.
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Preservativos , Infecções por HIV , Humanos , Etiópia/epidemiologia , Preservativos/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Feminino , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Masculino , Prevalência , Sexo Seguro/estatística & dados numéricosRESUMO
The human papillomavirus is known to cause cervical and anogenital cancer and benign anogenital and cutaneous warts. Both males and females can contract the virus during sexual intercourse and skin-to-skin contact. Communities in low- and middle-income countries, including Africa, are particularly suffering from human papillomavirus-related diseases, mainly cervical cancer. Vaccination is the most economical and efficient prevention strategy to control human papillomavirus-related diseases. Undoubtedly, to control all types of human papillomavirus-related morbidity and mortality, the entire at-risk, sexually active population needs to be vaccinated regardless of their sex. However, the vaccination program, particularly in Africa, the world's most resource-limited region, is habitually limited to the female population, considering only the burden of cervical cancer. We think that it is impossible to fully mitigate the human papillomavirus infection by vaccinating only the female population, while males can carry and pass the virus. In addition, marginalizing males from this program seems to violate gender inequality and their sexual and reproductive health rights. Hence, we voice the need for global and local governments to consider and customize human papillomavirus vaccination programs for the male population. Also, it is better to consider the male population in different research studies regarding human papillomavirus-related malignant and benign conditions.
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Even though COVID-19 vaccinations must be effective and safe to stop the pandemic, vaccine skepticism is growing everywhere. One of the challenges to world health today is vaccine hesitancy, which results from peoples' refusal to accept the vaccine. The author found that the estimated willingness to accept COVID-19 vaccine was 28.4%. Globally, a people's perceptions and beliefs may have an impact on how well they accept the COVID-19 vaccine. Peoples who have a negative attitude toward vaccinations may be reluctant to get vaccinated. The author recommends the increasing awareness level of the COVID-19 vaccine to increase the vaccine acceptance rate. Therefore, healthcare workers should provide continuous and updated information on the COVID-19 vaccine to increase the awareness level of the communities.
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BACKGROUND: Heart failure is an important global health problem which is associated with high mortality. Uncontrolled heart failure leads to hospitalization and reduction in quality of life. Therefore, the study aimed to assess the treatment outcome such as improved, death, hospitalization, and self-discharges without improvement and associated factors in heart failure patients admitted to south western Ethiopian hospitals. METHODS: We will use databases such as PubMed, Science Direct, HINARI, Scopus and Google Scholar. The final systematic review and meta-analysis will contain papers that fulfill the eligible criteria. A systematic data extraction check list will be used to extract the data, and STATA version 14 will be used for the analysis. Heterogeneity is evaluated using the I2 tests and the Cochrane Q test statistic. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test are utilized. The sensitivity analysis and subgroup analysis will be done for studies having heterogeneity. The Joanna Briggs institute meta-analysis of statistics assessment and review instrument (JBI- MAStARI) will be used for quality assessment. DISCUSSION: This protocol is expected to provide adequate evidence on the burden of poor heart failure treatment outcome that includes self-discharge, developing complication and finally leads to death in acute and chronic heart failure patients in Ethiopia. Furthermore, to enrich our estimation, we also intended to assess the associated factors of poor treatment outcome. Therefore, our review will call for government and non-government interventions in reducing the mortality associated with heart failure.
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Insuficiência Cardíaca , Qualidade de Vida , Humanos , Etiópia/epidemiologia , Insuficiência Cardíaca/terapia , Metanálise como Assunto , Prevalência , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto , Resultado do TratamentoRESUMO
Intraventricular hemorrhage (IVH) is one of the medical issues that preterm infants are susceptible to as a result of their difficulty adjusting to life outside the womb. It is bleeding into the ventricular system from the germinal matrix, a highly cellular and vascular tissue that is only seen in preterm newborns and ruptures easily. The study aims to assess the magnitude and associated factors of IVH in preterm neonates. Methods: A hospital-based cross-sectional study was conducted at Tibebe Ghion Specialized Hospital (TGSH) from 14 March 2022 to 15 August 2022. The neonatal referral form, the mother's medical file, an in-person interview with the mother, and bedside cranial sonography were used to collect clinical data. After data were entered into Epi Info and exported to Scientific Program for Social Science (SPSS), analysis was carried out using binary and multivariable logistic regression. Results: The overall magnitude of IVH in preterm newborns among preterm neonates admitted to TGSH was 53 (27.04%) (95% CI: 20.9-32.2%). In the multivariable logistic regression analysis, a birth weight of between 1500 and 2000 g (OR: 0.38, 95% CI: 0.18-0.79) were negative, and those neonates with gestational age between 28 and 32 weeks (OR: 2.14, 95% CI: 1.04-4.41) were positively associated with the occurrence of IVH. Conclusion: The study discovered that the magnitude of IVH is slightly higher than that of prior studies done in different parts of the world, and those neonates delivered at early gestational ages and those with very low birth weight have a higher incidence of IVH. Both guardians and health providers should give more attention to those neonates born at an early gestational age and with small birth weight.
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INTRODUCTION: Childhood vaccination is a cost-effective public health intervention to reduce child mortality and morbidity. But, vaccination coverage remains low, and previous similar studies have not focused on machine learning algorithms to predict childhood vaccination. Therefore, knowledge extraction, association rule formulation, and discovering insights from hidden patterns in vaccination data are limited. Therefore, this study aimed to predict childhood vaccination among children aged 12-23 months using the best machine learning algorithm. METHODS: A cross-sectional study design with a two-stage sampling technique was used. A total of 1617 samples of living children aged 12-23 months were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 70% and 30% of the observations were used for training, and evaluating the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. All the included algorithms were evaluated using confusion matrix elements. The synthetic minority oversampling technique was used for imbalanced data management. Informational gain value was used to select important attributes to predict childhood vaccination. The If/ then logical association was used to generate rules based on relationships among attributes, and Weka version 3.8.6 software was used to perform all the prediction analyses. RESULTS: PART was the first best machine learning algorithm to predict childhood vaccination with 95.53% accuracy. J48, multilayer perceptron, and random forest models were the consecutively best machine learning algorithms to predict childhood vaccination with 89.24%, 87.20%, and 82.37% accuracy, respectively. ANC visits, institutional delivery, health facility visits, higher education, and being rich were the top five attributes to predict childhood vaccination. A total of seven rules were generated that could jointly determine the magnitude of childhood vaccination. Of these, if wealth status = 3 (Rich), adequate ANC visits = 1 (yes), and residency = 2 (Urban), then the probability of childhood vaccination would be 86.73%. CONCLUSIONS: The PART, J48, multilayer perceptron, and random forest algorithms were important algorithms for predicting childhood vaccination. The findings would provide insight into childhood vaccination and serve as a framework for further studies. Strengthening mothers' ANC visits, institutional delivery, improving maternal education, and creating income opportunities for mothers could be important interventions to enhance childhood vaccination.
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Algoritmos , Cobertura Vacinal , Feminino , Humanos , Criança , Etiópia , Estudos Transversais , Aprendizado de Máquina , DemografiaRESUMO
BACKGROUND: Heart failure is the leading cause of hospital stays, medical expenses, and fatalities, and it is a severe problem for worldwide public health. Successful heart failure therapy requires a high level of self-care as well as devotion to different elements of the treatment plan. Despite the positive effects of heart failure self-care on health outcomes, many heart failure patients engage in insufficient self-care behaviors. Additionally, conflicting information has been found regarding the prevalence and predictors of self-care behaviors in Ethiopia. As a result, this review's objective is to provide an overview of the most recent studies on Ethiopian heart failure patients' self-care practices. METHODS: We have used four databases such as PubMed, Science Direct, Scopus and Google Scholar. Eventually, the final systematic review and meta-analysis contained eleven papers that matched the eligibility requirements. A systematic data extraction check list was used to extract the data, and STATA version 14 was used for the analysis. Heterogeneity was evaluated using the I2 tests and the Cochrane Q test statistic. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test were utilized. RESULT: The pooled magnitude of adherence to self-care was 35.25% (95%CI: 27.36-43.14). The predictors of good adherence to self-care behavior includes heart failure knowledge (odds ratio = 5.26; 95% CI, 3.20-8.65), absence of depressive symptoms (odds ratio = 3.20;95% CI,1.18-8.70), higher level of education (AOR = 3.09;95%CI,1.45-6.61), advanced New York Heart Association (NYHA) class (odds ratio = 2.66; 95% CI, 1.39-5.07), absence of comorbidity(odds ratio = 2.92; 95% CI,1.69-5.06) and duration of heart failure symptoms(odds ratio = 0.37; 95% CI, 0.24-0.58). CONCLUSION: The extent of self-care behavior adherence is shown to be low among heart failure patients. This study showed a positive relationship between self-care behavior and factors such as proper understanding of heart failure, the absence of co-morbidity, depression, higher levels of education, a longer duration of heart failure symptoms, and advanced classes of heart failure disease. Therefore, a continuous health education should be given for patients to enhance their understanding of heart failure. Besides, special attention should be given for patients having co-morbidity and depressive symptom.
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Cardiopatias , Insuficiência Cardíaca , Terapia Ocupacional , Humanos , Etiópia/epidemiologia , Autocuidado , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Antiarrítmicos , Cardiotônicos , DiuréticosRESUMO
Background: Non-adherence to anti-epileptic drugs (AEDs) was the most common drug therapy issue that hampered epileptic patients' treatment success. As a result, the barriers to patients adhering to their treatment should be investigated in depth in order to prevent poor treatment outcomes. Methods: A hospital-based cross-sectional study was conducted on epileptic patients who had followed up at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Data collection was done through patient interview and medical charts review. Hill-Bone Compliance to High Blood Pressure Therapy Scale was used to measure medication adherence. The data were analyzed using SPSS version 23 after data were entered by Epi Info7.2.1. The multivariable logistic regressions were utilized and P < 0.05 was used to declare association. Results: Over the study period, more than half of the participants 172 (57.7%) were males, and the median age of participants was 29 years. The magnitude of non-adherence to ant-epileptic drugs (AEDs) was 120 (40.27%). The results of multivariable analysis revealed that patients who had experienced the medication side effects, adjusted odds ratio (AOR) = 2.199; 95% CI: 1.21, 4.00, P = 0.010, a poly-pharmacy, adjusted odds ratio (AOR) = 5.166; 95% CI: 2.63, 10.14, P = <0.001 and the presence of a co-morbidity, adjusted odds ratio (AOR) =3.70; 95% CI: 2.058, 6.65, P = <0.001 were the predictors of medication non-adherence. Conclusion: The magnitude of non-adherences to AEDs was found to be high. Phenobarbitone was the most prescribed AEDs. The number of medications taken by the patients, the presence of co-morbidity and the occurrence of medication side effects had a significant association with non-adherence to AEDs. Therefore, the pharmaceutical care in general and drug information services in particular should be established to enhance medication adherence in our study area.
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Objective: The study was aimed to assess the magnitude and associated factors of 2-year seizure-free status of epileptic patients at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Methods: A retrospective cross-sectional study was conducted at MKCSH from 12 February 2020 to 11 August 2020. Treatment outcome was measured in terms of seizure control status and seizure frequency. Accordingly, good treatment outcome was declared if the patients had a 2-year seizure-free status and poor if the patient had episodes of seizure in the last 2 years. The pharmaceutical care network Europe guideline was used to assess the presence of medication-related problems. Multivariable logistic regression was used to analyze the variables by using crude odds ratio (COR) and adjusted odds ratio (AOR) with 95% confidence interval (CI). Finally, the predictors of epilepsy treatment outcome were declared if a P-value was ⩽0.05. Results: Over the study period, more than half of the participants (172 (57.7%)) were males. The median age of participants was 29 and majorly distributed to 18-30 classes. More than one-fourth of the patients were suffering from absent seizure 85 (28.5%) and general tonic-clonic seizure 83 (27.9%). The most commonly prescribed medication was Phenobarbitone which accounts 34 (11.41%), whereas Valproic acid 8 (2.68%) was the least prescribed. Overall, less than half 131 (43.96%) of patients developed poor treatment outcomes. The predictors of treatment outcomes were having head the injury (AOR = 5.7; 95% CI: 3.18, 10.31), family history of epilepsy (AOR = 5.6; 95% CI: 3.07, 10.46) and the presence of drug therapy problems (AOR = 5.2; 95% CI: 2.79, 9.69). Conclusion: The magnitude of poor epilepsy treatment outcome was found to be high. The predictors of epilepsy treatment outcome were the history of head injury, family history of epilepsy and drug therapy problems. Therefore, to improve the treatment outcome of epileptic patients, health care providers should pay close attention to the identified factors. Besides this, the clinical pharmacy service should be implemented to minimize any medication-related problems.
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Introduction: The COVID-19 vaccine is a key intervention toward containing the pandemic. Vaccines are thought to be a form of defense. One of the major challenges to managing the COVID-19 pandemic is the uncertainty or willingness to accept vaccinations. Our study aimed willingness to get the COVID-19 vaccine and the factors that influence it in Mettu Woreda, Ilu Ababor Zone, Ethiopia. Methodology: Cross-sectional study design was conducted from August 1, 2021, to September 1, 2021, among rural residents of Mettu woreda's of Ilu Ababor Zone, Oromia, Ethiopia. The semi-structured data collection format was prepared to assess the magnitude of the communities' acceptance of the COVID-19 vaccine. A multivariable logistic regression analysis was used to determine the predictors of communities' acceptance of the COVID-19 vaccine at 95% CI. Results: Of 350 participants from the study area, 59% of them were males and 41% females. Less than one-third (29.8%) of participants were willing to accept the COVID-19 vaccine. The results multivariable logistic regression revealed that the age group of ≥50 years (OR=0.29; 95% CI: -3.1-0.34) as compare with the 18-29 years, low monthly income (OR=0.85; 95% CI: -0.74-2.33), low perception level (OR=0.35; 95% CI: -2.03-0.24), government unemployed (OR=0.86; 95% CI: -0.72-0.1), low Level of acceptance (OR=0.72; 95% CI: -0.67, 0.08) and unwillingness to test COVID-19 (OR=0.13; 95% CI: -4.47, 0.58) were predictors of willingness to receive COVID-19 vaccine. Conclusion: Less than one-third of the study, participants were willing to accept the COVID-19 vaccine. The likelihood of Willingness to accept the COVID-19 vaccine was low in the study area. Overall; low education, low vaccination perception, low income, jobless occupation, older age, and unwillingness to test for COVID-19 were associated with greater willingness to take the COVID-19 vaccine and are significantly associated with willingness to get the COVID-19 immunization.
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BACKGROUND: Despite appropriate treatment of epilepsy, the treatment outcome is poor in developing country. Therefore, the study was aimed to identify the magnitude and associated factors of epileptic patients at ambulatory clinic of south western Ethiopian hospital. METHODS: A hospital-based cross-sectional study was conducted on epileptic patients who had follow-up at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Data collection was done through patient interview and medical charts review. The pharmaceutical care network Europe foundation classification system was used to assess the drug therapy problem and Naranjo algorithm of adverse drug reaction was employed to identify the probability of adverse drug reaction. The data were analyzed by SPSS version 23 after data were entered by Epidemiological Information (Epi Info) 7.2.1. The multivariable logistic regressions were utilized and P < 0.05 was used to declare association. RESULTS: Over the study period, more than half of the participants 172(57.7%) were males. The magnitude of drug-related problems was found to be 164(55.0%). Among epileptic patients about 323 drug-related problems (DRPs) were identified on average, 1.084 drug-related problems (DRPs) per patient. The widely occurred types of drug-related problems were needs additional drug therapy 72(22.29%), dose too low 52(16.09%) and dose to high which accounts 50(15.48%). Regarding the predictors of drug-related problems, being a female (AOR = 3.57, 95% CI:1.85-6.88, P ≤ 0.001), having frequent seizures (AOR = 2.47, 95% CI%:1.33-4.61, P = 0.004) and the presence of poly-pharmacy (AOR = 3.57, 95% CI: 1.49-8.5, P = 0.004) were predictors of drug-related problems. CONCLUSION: More than half of the patients had a drug therapy problem. Number of medications taken by the patients, gender and the seizure frequency had a significant association with occurrence of drug therapy problems (DTPs). Therefore, the pharmaceutical care in general and drug information services in particular should be established to hinder any undesirable medication effects in our study area.
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Triple-negative breast cancer (TNBC) is associated with an increased risk of early recurrence and distant metastasis, as well as the development of therapeutic resistance and poor prognosis. TNBC is characterized by a wide range of genetic, immunophenotypic, morphological, and clinical features. TNBC is coined to describe cancers that lack estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). As a result, hormonal or trastuzumab-based treatments are ineffective in TNBC patients. TNBCs are biologically aggressive, and despite some evidence that they respond to treatment better than other forms of breast cancer, the prognosis remains poor. This is attributed to a shorter disease-free interval in adjuvant and neoadjuvant settings, as well as a more aggressive metastatic course. TNBC has a lot of clinical ramifications. In terms of new treatment methods, TNBC has lagged behind other types of breast cancer. There are not many options for treating this form of breast cancer because it is progressive. Many effective treatments for most breast cancers block the growth-stimulating effects of ER, PR, and/or HER2, leaving TNBC with few choices. Finding new and effective treatment options for TNBC remains a critical clinical need. To develop more effective drugs, new experimental approaches must be tested in patients with TNBC.
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Background: Although the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone. Methods: A facility-based unmatched case-control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95% confidence interval were declared as statistically significant with outcome variable. Results: A total of 168 (163) respondents participated in the study, with a response rate of 97%. The mean (+SD) age of the respondents was 31.36 ± 5.916. Regarding the educational status of respondents about 36 (64.3%) of cases and 90 (84.1%) of controls have formal education, and about 42 (75%) of cases' husbands and 97 (90.65%) of controls' husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation. Conclusion: The findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended regular follow-up and treating side effects are very important to sustain intrauterine device utilization.
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Objective: The study aimed to assess the magnitude and predictors of erectile dysfunction at Mettu Karl Comprehensive Specialized Hospital. Methods: Male diabetic patients visiting chronic care follow-up at Mettu Karl Comprehensive Specialized Hospital were face-to-face interviewed as part of a retrospective cross-sectional study from April 6, 2022 to May 6, 2022. SPSS version 21 for Windows was used to enter and analyze the data for the descriptive statistics. Following that, a binary logistic regression and a multivariate logistic regression model were used. Based on a p-value of 0.05, variables that had an independent link with sexual dysfunction were found. The adjusted odds ratio and its associated 95% confidence interval were also used to analyze the direction and intensity of the link. Results: A total of 307 diabetic men participated in the study, with a mean age of (52.74, 16.16) and a mean duration of (5.94, 2.974). In this study, 252 people (82.1%) experienced erectile dysfunction, with mild, moderate, and severe cases represented by 30%, 38%, and 14.1% of respondents, respectively. There were statistically significant associations between erectile dysfunction and age (adjusted odds ratio: 4.8, 95% confidence interval: 1.27-18.32), type of diabetes (adjusted odds ratio: 5.8, 95% confidence interval: 1.96-17.73), and comorbidities (adjusted odds ratio: 0.32, 95% confidence interval: 0.15-0.71). Conclusion: This study showed that the prevalence rate of erectile dysfunction is high in Mettu Karl Comprehensive Specialized Hospital. Age, type of diabetes mellitus, and the presence of comorbidity were factors associated with erectile dysfunction. Therefore, assessment and management of erectile dysfunction in the diabetic clinic should be part of routine medical care during follow-up visits with diabetic patients.
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Background: Diabetic foot ulcer (DFU) is one of the main complications of diabetes mellitus associated with major morbidity and mortality. DFU is the major cause of infection and lower extremity amputations in diabetic patients. Despite this, there was a scanty finding on associated factors of foot ulcer among diabetes mellitus. Methods: Facility-based cross-sectional study was conducted among diabetes mellitus patients at BGH from August 1, 2021 - 30, 2021. The validated tool of the Nottingham Assessment of Functional Footcare (NAFF) was used to assess the diabetic foot self-care practice. Multivariate logistic regression was used to analyze the associations between the dependent variables and independent variables. Data were analyzed using a statistical package for social science (SPSS version 23). Results: A total of 162 respondents with a response rate of 100% have participated in the study. Of the respondents, 88 (54.3%) were females and the mean and SD of the age were 35.8 and 12.70. The prevalence of diabetic foot ulcers in our study area was 24(14.81%). The results of the multivariable logistic regression analysis revealed that being a male (AOR = 2.143; 95% CI: 0.691-6.65), poor diabetic foot care practice (AOR = 3.761; 95CI: 1.188-11.90), and having a co-morbidity (AOR = 2.507; 95CI: 3.270-5.95)were more likely to experience a diabetic foot ulcer than their counterparts. Conclusion: The prevalence of diabetic foot ulcers among diabetic patients in BGH was found to be high. The presence of comorbidity, being a male, and foot care practice were factors that predict the occurrences of diabetic foot ulcers. Therefore, the ongoing medical education on the foot care practices should be given to diabetes mellitus patients.
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Objectives: Insufficient nutrition can predisposes women to infection, pregnancy losses, preeclampsia and anaemia as well birth of underweight baby whose survival is threatened. Therefore, this study was aimed to assess pregnant mothers' nutrition knowledge, attitude, practice and associated factors. Methods: A multicenter cross-sectional study was conducted among 378 participants who were selected using a systematic random sampling technique. Quantitative data were collected using a structured and interviewer-administered questionnaire, which consisted of questions on sociodemographic features, obstetrics characteristics and pregnant women's nutrition knowledge, attitude and practice. Data entry and analysis were done using Statistical Package for the Social Sciences statistical version 23. Binary logistic regression analysis was done to identify associated factors. All variables with p-value of < 0.23 in bivariate analysis were included in multivariate analysis, and finally, statistical significance was declared at p-value < 0.05 with 95% confidence interval. Result: From 378 women participated, a total of 231 (61.1%) respondents were in age range of 25-34 years. About 148 (39.1%) of women were not knowledgeable, 153 (40.5%) had an unfavourable attitude, and 47.7% had poor dietary practice. Knowledge (adjusted odds ratio = 4.5; 95% confidence interval: 2.88, 10.06, p = 0.03), attitude (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.04) and practice (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.036) were all significantly associated with maternal education. Regarding their occupation, merchant women were seven times (adjusted odds ratio = 7.02; 95% confidence interval: 2.88, 17.09, p = 0.01) more likely to have knowledge and government employees were six times (adjusted odds ratio = 6.05; 95% confidence interval: 3.58, 13.05, p = 0.04) more likely to be knowable than housewives. Moreover, multiparous women were 4.77 times (adjusted odds ratio = 4.77; 95% confidence interval: 1.15, 8.66, p = 0.002) more likely to be knowledgeable compared to primigravida women. Monthly income was also associated to attitude (adjusted odds ratio = 0.45, 95% confidence interval: 0.10, 1.66, p = 0.03). Women who had a favourable attitude were five times (adjusted odds ratio = 5.25; 95% confidence interval: 2.36, 9.62, p = 0.04) more likely to have good nutritional practices during pregnancy. Conclusion: Pregnant women's knowledge, attitude and practice towards nutrition in this area were low. The educational status of women was associated with knowledge; attitude and practice. Likewise, occupation and parity were associated with knowledge; and attitude was also found to be a determinant factor of nutritional practice. Therefore, community nutritional education and antenatal nutritional counselling need to be strengthened in the area.
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Objective: Cervical cancer is the fourth most common gynaecological cancer in the world. Its incidence and burden are high in developing regions, especially in sub-Saharan Africa. The World Health Organization plans to increase vaccination, screening, and treatment of cases to 90%, 70%, and 90%, respectively, in developing countries by 2030. Therefore, the aim of this study was to assess knowledge, attitudes, and practices of cervical cancer screening and predictors among female healthcare providers. Methods: Institution-based cross-sectional survey was done from 4 March to 20 April 2019. The data were collected using a structured questionnaire. The data were entered into EpiData version 3.1 and analysed with SPSS version 25. Logistic regression analysis was used to identify associations. After controlling for confounders, an independent association was declared at a p-value of 0.05 with a 95% confidence interval. Results: Of a total of 404 participants, half were nurses. One hundred seventy-seven (43.8%) had adequate knowledge, 124 (30.7%) had a favourable attitude, and 35 (8.7%) had regular screening practice. The availability of trained personnel in the health facility and regular screening were variables associated with knowledge. Participants' attitude was shown association with profession, level of education, and knowledge. Moreover, knowledge of the causes of cervical cancer and knowledge of screening were variables significantly associated with screening practice. Conclusion and recommendations: Unfortunately, there is low adequate knowledge, low favourable attitude, and irregular screening practice of cervical cancer in the study area. Despite their own effects, their knowledge and attitude may affect the vast majority of their clients. Therefore, this finding calls for prompt action, such as training for participants to increase awareness, to shape their attitudes, and to increase the uptake of screening services.
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Worldwide, the magnitudes of neonatal mortality are estimated to be about 3 million due to insufficient care. The burden of neonatal mortality is high in Ethiopia as compared to high and middle-income countries. The study aimed to assess the neonatal care practice and associated factors among mothers of infants 0-6 months old in Northern Shewa, Ethiopia. A community-based cross-sectional study design was undertaken on a mother living in the North Shewa zone from September 2019 to June 2020. Neonatal care practice was assessed by World Health Organization (WHO) minimum neonatal care package indicators. Over the study period, a total of 245 (62.0%) mothers had a good neonatal care practice. Being urban areas [AOR 5.508, 95% CI 2.170, 13.984], having ANC follow-up [AOR 3.042, 95% CI 1.031, 12.642], lack of adequate information [AOR 0.123, 95% CI 0.054, 0.282] and post-natal care (PNC) [AOR 5.779, 95% CI 2.315, 14.425] were predictors of good neonatal care practice. In our study, there was moderate neonatal care practice among mothers. Therefore, all elements of neonatal care packages should be studied at large.