Project description:BackgroundThe goals of glycemic management for patients with diabetes are to prevent or delay complications and optimize quality of life. However, in clinical practice, the recommended glycemic control target is difficult to achieve. Therefore, it is important to identify factors that influence the outcomes of glycemia to improve the quality of diabetic management. The study aimed to evaluate the level and factors associated with glycemic control among type 2 diabetic outpatients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.MethodsA hospital-based cross-sectional study was conducted among systematically selected 325 patients with type 2 diabetes who attended diabetic clinics at Tikur Anbessa Specialized Hospital. Pretested, structured, and interviewer-administered questionnaires were used to collect sociodemographic and diabetes-related information from March 1 to May 30, 2021. HbA1c was used to assess glycemic control according to the HbA1c target of < 7% ('good' control) as recommended by the American Diabetes Association for non-pregnant adults. The HbA1c level in the range of 7-8% was defined as 'inadequate' control and 'poor' at levels > 8%. Data entry and analysis were performed using SPSS v26. Multivariate logistic regression analysis was used to identify determinants of glycemic control.ResultsThe median level of HbA1c of the participants was 8.4% (IQR 6.8-10.1). And approximately three-quarters (73.8%) of the patients had inadequate and poor glycemic control (HbA1c ≥ 7%). Older age (AOR: 2.46, 95% CI: 1.28-6.01), DM duration of > 10 years (AOR: 3.15, 95% CI: 2.22-6.54), insulin therapy (AOR: 3.07, 95% CI: 2.10-6.12), poor diet compliance (AOR: 1.97, 95% CI: 1.28-3.52) and failure to set goals for glycemic control (AOR: 3.42, 95% CI: 2.17-5.97) were factors associated with inadequate and poor glycemic control.ConclusionsThe study revealed that a significant number of diabetic patients had inadequate and poor glycemic control levels. And this was associated with older age, longer duration of DM, insulin therapy, poor diet compliance, and failure to set control goals. This requires a focus on the associated factors identified and tailored management mechanisms to maintain good glycemic control.

Project description:BackgroundBreast cancer is the most common cancer affecting women in Ethiopia with increasing burden, and chemotherapy treatment produces a detrimental effect on individual wellbeing. Since last few years quality of life has been the primary goal of cancer treatment, yet little research has been conducted on quality of life of breast cancer patients under chemotherapy.ObjectiveTo determine the quality of life and associated factors among patients with breast cancer under chemotherapy at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia.MethodsInstitution based cross-sectional study was conducted on 404 patients with breast cancer, who took at least one cycle of chemotherapy treatment using face to face interview at oncology unit of Tikur Anbessa specialized hospital day care center from February to April 2018. The validated Amharic version of European organization for research and treatment of cancer core 30 (EORTC QLQ-C30) and quality of life questionnaire specific to breast (QLQ-BR23) was used to measure health related quality of life. Both descriptive and inferential statistics were used. For the purpose of interpretation quality of life score was dichotomized in to two using the calculated mean score, which is 53 as a cutoff point, then, bi-variable and multivariable logistic regression was used to describe association between dependent and independent variables. Hence, patients who score above 53 for quality of life were considered to have good quality of life.ResultOf the total sample, overall response rate was 99.77%. The average quality of life score of patients with breast cancer under chemotherapy treatment was 52.98 (SD = 25.61). Majority of patients had scored poor in emotional functioning, sexual functioning, and financial difficulties. Educational status of college and above, being divorced, higher household income, higher scores of physical and social functioning were associated with significantly improved (better) quality of life. Lower scores of fatigue, insomnia, financial difficulties and systemic therapy side effects all were associated with better scores of quality of life of breast cancer patients. Whereas, patients receiving < = 2 cycles of chemotherapy had significantly lower scores of quality of life.Conclusion and recommendationQuality of life of breast cancer patients under chemotherapy treatment is poor in comparison with the reference data and international findings. Therefore, quality of life assessment should be incorporated in patient's treatment protocol. And financial aids may significantly improve the quality of life of breast cancer patients under chemotherapy treatment.

Project description:BACKGROUND:Tuberculosis remains a major public-health problem in the world, despite several efforts to improve case identification and treatment compliance. It is well known cause of ill-health among millions of people each year and ranks as the second leading cause of death from infectious disease worldwide. Despite implementation of the World health organization recommended strategy, the reductions in the incidence of TB have been minimal in high burden countries. OBJECTIVES AND METHODS:A case control study was carried out to assess the risk factors of TB, where cases were newly registered bacteriologically confirmed pulmonary TB patients with age greater than 15 years who present at twenty health centres in Addis Ababa. Controls were age and sex matched attendees who presented in the same health centers for non-TB health problems. RESULTS:A total of 260 cases and 260 controls were enrolled in the study and 45.8% of cases and 46.2% of controls were in the 26-45 years age bracket. According to the multivariable logistic regression analysis, seven variables were found to be independent predictors for the occurrence of TB after controlling possible confounders. Patients who live in house with no window or one window were almost two times more likely to develop tuberculosis compared to people whose house has multiple windows (AOR = 1.81; 95% CI:1.06, 3.07). Previous history of hospital admission was found to pose risk almost more than three times (AOR = 3.39; 95% CI: 1.64-7.03). Having a household member who had TB was shown to increase risk of developing TB by three fold (AOR = 3.00; 95% CI: 1.60, 5.62). The study showed that illiterate TB patients were found to be more than twice more likely to develop TB compared to subjects who can atleast read and write (AOR, 95% CI = 2.15, 1.05, 4.40). Patients with household income of less than 1000 birrs per month were more than two times more likely to develop TB compared to those who had higher income (AOR = 2.2; 95% CI: 1.28, 3.78). Smoking has also been identified as important risk factor for developing TB by four times (AOR = 4.43; 95% CI: 2.10, 9.3). BCG was found to be protective against TB reducing the risk by one-third (AOR = 0.34; 95% CI: 0.22, 0.54). CONCLUSION:This study showed that TB is more common among the most agile and economically active age group, and number of windows, history of hospital admission, a household member who had TB, illiteracy, low household income and smoking and lack of BCG scar were identified as independent risk factors. Therefore it is imperative that the TB control effort need a strategy to address socio economic issues such as poverty, overcrowding, smoking, and infection control at health care facilities level is an important intervention to prevent transmission of TB within the facilities.

Project description:The COVID-19 pandemic continues to grow around the world and has caused enormous mortality and morbidity. The severity and mortality of coronavirus disease are associated with various comorbidities. The infection fatality rate was reported to be inconsistent with different studies. Therefore, the aim of this study was to assess the magnitude and factors associated with mortality among patients admitted to Eka Kotebe General Hospital, Addis Ababa, Ethiopia. An institutional-based cross-sectional study was conducted at Eka Kotebe General Hospital among patients who were admitted for COVID-19 from January 15, 2021, to June 30, 2021. A total of 393 records of patients were selected by simple random sampling. Data was extracted from compiled data forms where available information was already tabulated. Data was entered and analyzed using SPSS version 25. The determinant factors associated with mortality among COVID-19 patients were identified using bivariate and multivariable logistic regression analysis. A statistical association was declared with multivariable logistic regression using a 95% confidence interval and a P-value of less than 0.05. The proportion of COVID-19 mortality among patients admitted to Eka Kotebe General Hospital was 8.1% (95% CI (5.4-10.8%)). Age >50 years [AOR = 7.91; 95% CI (2.34-25.70)], being male [AOR = 2.09; 95% CI (1.20-3.65)], having diabetes mellitus [AOR = 2.64; 95% CI (1.30-5.35)], having hypertension [AOR = 2.67; 95% CI (1.22-5.88)] and having chronic kidney disease [AOR = 12.04; 95% CI (4.03-14.22)] were determinant factors of COVID-19 mortality. The current study findings revealed that COVID-19 mortality was high among hospitalized COVID-19 patients. Furthermore, age, gender, diabetes mellitus, hypertension, and chronic kidney disease were discovered to be independent predictors of COVID-19 mortality. Therefore, older COVID-19 patients and those with established comorbidities such as hypertension, diabetes, and end-stage renal disease should receive comprehensive preventative efforts, including vaccination.

Project description:BACKGROUND:Suicide which is considered a psychiatric emergency, is a serious cause of mortality worldwide. Youth living with HIV/AIDS (YLWHA) have higher rates of suicidal behavior than the general public. This study aimed to assess the magnitude and associated factors of suicide ideation and attempt among the Human Immune deficiency Virus (HIV) positive youth attending anti-retroviral therapy (ART) follow up at St. Paul`s hospital Millennium Medical College and St. Peter`s specialized hospital, Addis Ababa, Ethiopia. METHODS:In this cross-sectional study, 413 HIV positive youth were recruited for interviews, using the systematic random sampling technique. The Composite International Diagnostic Interview (CIDI) was used to assess suicide. PHQ-9, the Oslo social support and HIV perceived stigma scale instruments were used to assess the factors. We computed bivariate and multivariable binary logistic regressions to assess factors associated with suicidal ideation and attempt. Statistical significance was declared at P-value <0.05. RESULT:The magnitude of suicidal ideation and attempts were found to be 27.1% and 16.9%, respectively. In the multivariate analysis, female sex (adjusted odd ratio(AOR) = 3.1, 95% CI, 1.6-6.0), family death (AOR = 2.1, 95%CI 1.15-3.85), WHO clinical stage III of HIV (AOR = 3.1 95% CI 1.3-7.35), WHO clinical stage IV of HIV (AOR = 4.76, 95%CI, 1.3-7.35), co-morbid depression (AOR = 7.14, 95%CI, 3.9-12.9), and perceived HIV stigma (AOR = 4.2, 95%CI, 2.27-8.2) were significantly associated with suicidal ideation, whereas female sex (AOR = 4.12, 95%CI, 1.82-9.78), opportunistic infections (AOR = 3.1, 95%CI, 1.6-6.04), WHO clinical stage III of HIV (AOR = 3.1 95%CI 1.24-7.81), co-morbid depression (AOR = 5.6 95% CI, 2.8-11.1), and poor social support (AOR = 3.4, 95%CI, 1.2-9.4) were statistically significant with suicidal attempt. The result suggests that the magnitude of suicidal ideation and attempts among HIV positive youth were high. We recommend that clinicians consider youth with comorbid depression, perceived HIV stigma and poor social support.

Project description:Background:Anemia is a common finding in cancer, which is caused by many factors. It is a major cause of morbidity in cancer patients, worsens disease status and impairs treatment outcome; however, little is known about the prevalence of anemia and associated factors among cancer patients during diagnosis in developing countries like Ethiopia. In response to this, we have conducted research with the aim of assessing the prevalence of anemia and associated factors among newly diagnosed patients with solid malignancy at Tikur Anbessa Specialized Hospital (TASH), Radiotherapy center, Addis Ababa, Ethiopia. Methods:Descriptive cross-sectional study was conducted from April to May 2014. A total of 422 newly diagnosed patients with solid malignancy attending Radiotherapy center, TASH were enrolled to assess anemia prevalence and associated factors. Data were coded, entered and analyzed using SPSS version16. Using logistic regression, chi squares, Odds ratio and 95% confidence intervals were computed to measure strength of association between variables. p-value?<?0.05 was taken as statistically significant. Result:Out of 422 respondents, 285 (68%) were females and 153 (36%) of respondents fell into 35-49 age group with age range between 18 and 80?years and the median age of 45. Magnitude of solid cancers was gynecologic (28.9%), breast (22.7%), nasopharyngeal carcinoma (NPC) (7.6%), colorectal (7.1%), sarcoma (6.9%), head and neck (4.5%), thyroid (3.3%), hepatoma (1.9%), and others (17.1%). The overall prevalence of anemia across different tumor was 23% and higher anemia prevalence was noted in gynecologic (37.7%) and colorectal carcinomas (26.7%). The majority of the anemic patients (68%) remained untreated for anemia. The mean trigger hemoglobin for transfusion was 7.7?g/dl. About 83.5% of anemia was mild to moderate type. Performance status (AOR?=?3.344; 95% CI 1.410-7.927) and bleeding history (AOR?=?3.628; 95% CI 1.800-7.314) showed statistically significant association with occurrence of anemia with p-value?<?0.05. Conclusion:Among solid cancers, gynecologic cancer remained the dominant one. Anemia prevalence was 23% in general, in which gynecologic and colorectal cancers were more prevalent. ECOG performance status and bleeding history showed a statistically significant association with the occurrence of anemia.

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Magnitude Of Glycemic Control And Its Associated Factors Among Patients With Type 2 Diabetes At Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

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