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Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study.

ABSTRACT: Objective: Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia.

Methods: Data from a total of 872 randomly sampled adults aged 25-64?years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value?
Results: 14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25-64?years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55?years (adjusted odds ratio?=?2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio?=?2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio?=?1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio?=?0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio?=?0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus.

Conclusion: The prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55?years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient's adherence to medications and promote diabetes self-care management.

SUBMITTER: Ayele BH

PROVIDER: S-EPMC7686592 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study.

Ayele Behailu Hawulte BH Roba Hirbo Shore HS Beyene Addisu Shunu AS Mengesha Melkamu Merid MM

SAGE open medicine 20201120

<h4>Objective</h4>Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia.<h4>Methods</h4> ...[more]

PMID: 33282310

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Project description:BackgroundBurnout is a syndrome of emotional exhaustion, low personal accomplishment and depersonalization experienced by a health professional and it is more common in nurses due to high workload and job stress that is mostly caused by working proximity to patients and taking care of them. Burnout compromises the provision of quality health care. Despite this, there is no information in Ethiopia on burnout among nurses in study area.ObjectivesTo determine the magnitude of burnout and associated factors among nurses working in public hospitals of Harari regional state and Dire Dawa administration, eastern Ethiopia, February 1-29, 2020.MethodsInstitutional based quantitative cross-sectional study was employed from February 1-29 among 412 randomly selected nurses who have been working in hospitals for the last 6 months. Simple random sampling method was employed and data was collected by self-administered, standardized, reliable and valid, questionnaire (Maslachs Burnout Inventory- Human Services Survey). Data was entered into EpiData Version 3.1 and exported to statistical package for social science version 20 for analysis. All covariate with P-value less than 0.25 in bivariable analysis were candidate for multivariable analysis. Level of statistical significance was declared at p-value < 0.05.ResultsAmong 412 nurses taking part in this study, 183(44.4%) of nurses with 95% CI, had experienced burnout. Married marital status [AOR:2.3,95%CI:(1.2-4.3)], poor current health status [AOR:4.8, 95% CI:(1.1-21.4)] and fair current health status [AOR:12, 95% CI:(4.5-32)], working greater than eight hour per-day[AOR:0.52, 95%CI:(0.29-0.92)], intention to leave a job [AOR:0.48,95%CI:(0.2-0.88), being working in emergency room [AOR:0.3,95%CI:(0.1-0.98)] and using a different medication related to work related health problems were factors associated with nurses' burnout.ConclusionThe nurses' burnout in this study is high and it is attributed by marriage, perceiving health status as poor and fair, whereas, having the intention to leave job, being working in emergency room and using a medication in relation to work related health problems reduced risk of developing burnout. So, the concerned bodies should provide trainings which focus on stress copying mechanisms and assertiveness program.

Project description:Introduction: Health care workers are at the frontline of the response against the COVID-19 outbreak. Poor preparedness and infection prevention practices among health care workers compound the hazard and occurrence of COVID-19 hospital transmission. Thus, the study aimed to assess preparedness toward COVID-19 pandemics and associated factors among health care workers in Hospitals of Eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted from 20 June to July 10 2020. A simple random sampling technique was used to select 423 health care workers. Data were collected using a structured self-administered questionnaire and analyzed using SPSS Version 23. Bivariate and multivariable logistic regression was conducted to identify factors associated with the outcome variable, and statistical significance was declared at a p-value less than 0.05. Results: This study revealed that the proportion of health care workers’ preparedness toward the COVID-19 pandemic was 40.9% (95% CI: 36.2–45.9). Working in a public hospital (AOR = 2.7, 95% CI: 1.6–4.3), being unafraid of transmitting COVID-19 to patients (Adjusted odds ratio/AOR = 4.6, 95% CI: 2.2–10.0), feeling safe at the workplace (AOR = 3.3, 95% CI: 1.7–6.4)), satisfied with the infection control policy (AOR = 6.0, 95% CI: 2.3–15.0), and not feeling anxious about the likelihood of COVID-19 spread (AOR = 2.1, 95% CI: 1.3–3.4) were significantly associated with COVID-19 preparedness. Conclusion: The majority of the health care workers were not prepared for COVID-19 pandemics. Feeling safe at the workplace scared of transmitting COVID-19 to patients, satisfied with the infection control policy, and feeling anxious concerning the likelihood of COVID-19 were factors associated with health care workers’ preparedness to COVID-19. The current awareness creation training, including motivational and psychological preparation for all health care workers, is mandatory, regardless of their profession or working place.

Project description:IntroductionMore than two-thirds of the pregnant women in Africa have at least one antenatal care contact with a health care provider. However, to achieve the full life-saving potential that antenatal care promises for women and babies, four visits providing essential evidence-based interventions - a package often called focused antenatal care are required. Hence, identifying the factors associated with dropout of maternal health care utilization would have meaningful implications. The study aimed to assess antenatal care dropout and associated factors among mothers delivering in the public health facilities of Dire Dawa town, Ethiopia.MethodsFacility-based cross-sectional study was conducted from January 1 to 30, 2020. Proportionate sampling and simple random sampling techniques were used to select 230 women. Data were collected using a structured and pretested interview administered questionnaire during delivery. The data were entered into Epidata version 3.1 and analyzed using SPSS version 20. A binary logistic regression model with a 95 % confidence interval was used to analyze the results. Bivariable analysis (COR [crude odds ratio]) and multivariable analysis (AOR [adjusted odds ratio]) was used to analyze the results. From the bivariable analysis, variables with a p-value < 0.25 were entered into the multivariable logistic regression analysis. From the multivariable logistic regression analysis, variables with a significance level of p-value < 0.05 were taken as factors independently associated with ANC dropout.ResultThe proportion of antenatal care dropouts was 86 (37.4 %) (95 % CI: 31.3-43.9). In logistic regression analyses, those who had no past antenatal care follow up were more likely to have ANC dropout (AOR = 7.89; 95 % CI: 2.109-29.498) and those who had no professional advice were more likely to have antenatal care dropout (AOR = 4.64 95 % CI: 1.246-17.254).ConclusionsThis study indicates that a high number of women had antenatal care dropout. Having no past ANC follow-up and professional advice were the major factors of ANC service utilization dropout. Hence, giving more information during the ANC visit is important to reduce the dropout rate from the maternity continuum of care.

Project description:IntroductionPost cesarean section surgical site infection increases both the duration of a patient's hospital stay and unplanned hospital costs. It can delays recovery, prolongs hospitalization, necessitates readmission, and adds to hospital bills and other morbidities as well as mortalities.MethodFacility-based case-control study was conducted from 1st March to 20th April, 2019 among all the mother records enrolled from 1st January to 31st December, 2018 at Public hospitals in Dire Dawa administration. The records of the mothers' who had post-cesarean section surgical site infection (119) was extracted by a census and every three consecutive controls (357) for each case were collected by trained data collectors using a structured data extraction tool. Variables which had p-value <0.25 in bivariate analysis were considered as candidates for multivariable analysis. Statistical significance was declared at P-value ≤0.05 with adjusted odd ratio and 95% confidence interval in the multivariable logistic regression model.ResultAge 20-34 years (AOR:5.4; 95%CI:2.35,12.7), age >35 years (AOR:8.9; 95%CI:1.8,43.9), ≥4 per vaginal examinations (AOR: 4.2; 95%CI:2.16,8.22), current history of Chorioamnionitis (AOR:5; 95%CI:1.05,23.9), previous history of cesarean section (AOR:6.2; 95%CI: 2.72,14.36), provision of antibiotics prophylaxis (AOR:3.2; 95%CI:1.81,5.62), perioperative HCT level <30% (AOR:6.9; 95%CI:3.45,14.1) and duration of rupture of membrane >12 hours (AOR:5.4; 95%CI:1.84,15.87) were the independent determinants of post-cesarean section surgical site infection.ConclusionIncreased in age of the mother, higher number of per vaginal examination, having a history of chorioamnionitis, having previous history of cesarean section, not receiving antibiotics prophylaxis, lower perioperative hematocrit level and longer duration of rupture of membrane were statistically significant in multivariable analysis. Therefore; emphasis should be given for mothers who have higher age category, previous cesarean scar and history of choriamnionitis. In addition; provision of antibiotics should be comprehensive for all mothers undergoing cesarean section.

Project description:BackgroundUnmet need for family planning is a measure of the gap between women's contraceptive behavior and their fertility desires. It should be measured among different population groups to effectively implement public health interventions. Thus, this study aimed to determine the magnitude of unmet need for family planning and associated factors among HIV- positive women in Dire Dawa city Anti-retroviral treatment (ART) clinics, Eastern Ethiopia.MethodsWe carried out a facility-based cross-sectional study (March-June 2020) among 409 married women aged 15-49 on ART, using systematic random sampling. A face-to-face interview was done using a structured questionnaire. Bivariable and multivariable logistic regression was done to identify factors associated with unmet need for family planning.ResultsOverall, 33% [95% confidence interval (CI): 28.9-37.9] of the respondents had unmet need for family planning. Woman's residing in a rural area (adjusted odds ratio (AOR): 2.41 [95% CI: 1.24-4.67]), woman's not attained formal education (AOR: 4.14 [95% CI: 1.73-9.93]) and attaining primary education (AOR: 2.97 [95% CI: 1.54-5.74]), poor knowledge (AOR: 2.87 [95% CI: 1.52-5.40]), and unfavorable attitude towards family planning (AOR: 2.21 [95% CI: 1.12-4.34]), clients not satisfied with family planning service (AOR: 6.34 [95% CI: 3.31-12.15]), the woman not having decision making power on family planning (AOR:3.97 [95% CI: 2.14-7.38]) and not getting family planning counseling in ART clinics (AOR: 2.87 [95% CI: 1.54-5.35]) were positively associated with having unmet need for family planning.ConclusionThis study indicates there a high unmet need for family planning among married HIV-positive women. Factors like a place of residence, educational status of women, knowledge and attitude towards family planning, client satisfaction with FP service, women decision-making power, and FP counseling service in ART. Therefore, we recommend that the concerned bodies should collaborate with ART clinics to design interventions that enhance access to family planning programs to combat the high unmet need for family planning among HIV-positive women.

Project description:IntroductionPressure ulcer is one of the major challenges in hospitals; which endanger patient safety, prolonging hospital stay and contributed to disability and death. Data regarding to pressure ulcer prevention practice are very important to take action. However in Ethiopia, there are limited researches that have been conducted and there is clearly paucity of information on this regard. Hence, this study aimed to assess pressure ulcer prevention practice and associated factors among nurses in public hospitals of Eastern Ethiopia.MethodsA cross-sectional study was conducted among randomly selected 422 nurses who were working in the public hospitals of Eastern Ethiopia. Data were collected from the 1st February to the 1st March 2018 using pretested structured self-administered questionnaire and observational checklist. The collected data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Pressure ulcer prevention was determined based on mean calculation; a result above the mean value was categorized as good pressure ulcer prevention practice, and a P-value of <0.05 was considered to declare a result as statistically significant.ResultsIn this study 51.9% (95% CI: 47.1%, 56.4%) of nurses were reported that they have good pressure ulcer prevention practice. On observation 45.2% of nurses were practicing proper pressure ulcer prevention activities. Pressure ulcer prevention practice were statistically associated with nurses with bachelor degree and above qualification level (AOR = 1.7, 95% CI: 1.02, 2.83), availability of pressure-relieving devices (AOR = 2.2, 95% CI: 1.34, 3.63), being satisfied with their job (AOR = 1.65, 95% CI: 1.09, 2.52) and good knowledge (AOR = 2.3, 95% CI: 1.48, 3.55).ConclusionsIn this study the self-reported practice and results from observation was substantially low. Continuing education and training should be considered for nurses to enhance their practice regarding pressure ulcer prevention practice.

Dataset Information

Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study.

Publications

Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study.

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