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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SUBMITTER: yohannes tekalegn
PROVIDER: S-BSST118 | biostudies-other |
REPOSITORIES: biostudies-other
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Project description:Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetic cases live in low and middle income countries. Glycemic control is the most important predictor for diabetic related complications and deaths. Identifying factors associated with glycemic control help health care providers and patients to work in the areas that reduce risks of diabetic related complications and deaths.The aim of this study is to assess the magnitude and factors associated with glycemic control among type 2 diabetic patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.Hospital-based cross sectional study was conducted on 412 type 2 diabetic patients who were attending in diabetic clinics at Tikur Anbessa Specialized Hospital. Data were collected through structured interview questionnaire, and data abstraction format to collect information from each patient's medical records from March to April, 2015. Data were entered and analyzed using SPSS version 20 statistical software. Both descriptive and inferential statistics were used to determine magnitude of glycemic control and factors associated with poor glycemic control.Median age of participants was 52 years old (IQR = 40-60 years old). From the study participants,51.7% were females. Median duration of living with diabetes since diagnosis was 10 years (IQR: 5-16 years). About 80% of the respondents had uncontrolled fasting blood glucose level. The factors which are significantly associated with poor glycemic control were longer duration of diabetes (AOR = 2.72 95%CI:1.16-6.32), and being on insulin therapy (AOR = 3.01 95% CI: 1.5-5.9).A high proportion of patients had poor glycemic control. Longer duration of the disease, and being on drug regimen of insulin were associated with poor glycemic control. Appropriate attention should be given to patients with longer duration of disease and those who are on insulin therapy.
| S-EPMC5837131 | biostudies-literature
Project description:ObjectivesTo assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.DesignInstitution-based cross-sectional study design.SettingAmanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.ParticipantsWe recruited about 418 participants using systematic sampling technique for an interview during the study period.MeasurementData were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.ResultsThe magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.ConclusionsOne in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.
| S-EPMC8076922 | biostudies-literature
Project description:BACKGROUND:Cancer of the cervix is the most frequent cancer among women in Ethiopia. The disease burden and its treatment adversely affects patients' health-related quality of life (HRQoL). We aimed to investigate the HRQoL and its predictors among cervical cancer patients in Ethiopia. METHODS:A hospital-based cross-sectional study was conducted from January to June 2018 at the oncology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 404 cervical cancer patients were interviewed using validated Amharic version of the European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), cervical cancer module (EORTC QLQ-CX24), and Euro Quality of Life Group's 5-Domain Questionnaires 5-Levels (EQ-5D) questionnaires. ANOVA test was used to determine the effect of patients' characteristics on mean scores of the different domains of HRQoL and stepwise multivariable logistic regression was performed to identify predictors of HRQoL. Coefficients of level-specific utility values obtained from a hybrid regression model for the Ethiopian general population were used to compute utility. RESULTS:The mean age of patients was 52.1 ± 10.4 years and 379 (93.8%) of the patients were receiving service at the outpatient clinic. About one-third (35%) of patients were diagnosed with stage IV cervical cancer. Mean global health status/QoL, mean utility and visual analog scale scores were 48.3 ± 23.77, 0.77 and 65.7 ± 20.83, respectively. Physical functioning (AOR = 4.98, 95% CI:2.16-11.49), emotional functioning (AOR = 5.25, 95% CI:2.26-12.17), pain (AOR = 5.79, 95% CI:2.30-14.57), and symptom experience (AOR = 4.58, 95% CI:1.95-10.79) were associated with patients' HRQoL. CONCLUSIONS:Cervical cancer significantly affects patient's HRQoL and hence, efforts to improve HRQoL should be commenced especially in terms of physical and emotional functioning, pain, and symptom experience.
| S-EPMC7076924 | biostudies-literature
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.
| S-EPMC6754151 | biostudies-literature
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.
| S-EPMC6445425 | biostudies-literature
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.
| S-EPMC6830816 | biostudies-literature
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.
| S-EPMC6855075 | biostudies-literature
Project description:BackgroundHemoglobin A1C (HbA1c) is the predominant hemoglobin found in HbA1 fractions. A1c assay is the recommended assay for diagnosing diabetes and any condition that changes red cell turnover such as Iron deficiency Anemia (IDA), will lead to spurious A1C results. Therefore, the present study was aimed at determining the effect of IDA on HbA1c in diabetic patients attending Black Lion Specialized Teaching Hospital, Addis Ababa, Ethiopia.MethodsA facility based comparative cross sectional study was conducted on 174 diabetic patients (87 with IDA and 87 without IDA) from April to July 2016. Socio demographic data and clinical conditions were collected using structured questionnaire. Venous blood was collected for performing Complete blood count (CBC) using Cell dyn 1800 hematology analyzer; Serum ferritin, performed by COBAS INTEGRA 400/800 Chemistry analyzer and HbA1c tests, performed by COBAS C 111 analyzer. Data was analyzed using SPSS version 21 software. Pearson's correlation, chi-square, and independent t-tests were calculated. The data was presented as mean?±?SD. A P-value of <?0.05 was taken as statistically significant.ResultsMean hemoglobin (Hgb), hematocrit (HCT), Mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC) were lower in IDA group compared to non-IDA diabetic patients. HbA1c (%) level was significantly lower in IDA group (6.18?±?1.57) compared with the non-IDA diabetic patients (7.74?±?1.81) (p <?0.05).ConclusionHbA1c is significantly lower in diabetic patients with IDA compared to the non-IDA diabetic patients. Therefore, the authors believe that monitoring these patients using only HbA1c could be misleading, hence physicians and health care providers should take this into account before making any therapeutic decision. Detailed examination including large number of participants employing advanced laboratory techniques is recommended.
| S-EPMC6327502 | biostudies-literature
Project description:BackgroundSubjective wellbeing (SWB) is a self-reported positive life judgment and good feeling. RHD, rheumatic heart disease, is a long-term sequel of single or recurrent acute rheumatic fever. There are no studies that assessed SWB in RHD patients. We aimed to assess SWB among RHD subjects enrolled in chronic care at Tikur Anbessa Specialized Hospital (TASH), Ethiopia.MethodsThis observational cross-sectional study employed a validated Amharic WHO-5 wellbeing index to assess SWB. Sociodemographic and clinical data were collected using structured questionnaire. RHD subjects aged 9 years and above were included. Factors associated with SWB were assessed using logistic regression models.ResultsThe study included 384 subjects, females 68.2% (262). Children, < 18 years, constituted one third of study subjects, 32.8% (126). Moderate and severe echocardiographic RHD dominated, 85.9% (330) with no associated comorbidity, 84.4% (324). Only 17.2% (66) had surgical or device intervention. Poor SWB was documented in 9.6% of study subjects (95% CI: 6.88-13.04). On multivariable regression, those with younger age RHD diagnosis, < 20 years, had almost three times higher odds of poor SWB, adjusted odds ratio (aOR) 2.69(95% CI: 1.30-5.58, P 0.008). Those with monthly family income of < 1000 Ethiopian Birr had three times higher odds of poor SWB, aOR 2.97(95% CI: 1.24-7.1, P 0.014). Study subjects who had good medication adherence had reduced odds of poor SWB, aOR 0.37(95% CI: 0.18-0.77, P 0.028). Those who received psychologic support from their families also had reduced odds of poor SWB, aOR 0.26(95% CI: 0.11-0.64, P 0.003).ConclusionPoor SWB was documented in one-tenth of RHD patients. Family income, younger age at RHD diagnosis, medication adherence and psychological support predicted poor SWB. Poor SWB has to be considered and assessed among RHD patients particularly among those with younger age at RHD diagnosis and poor family income. Further mixed studies are recommended to assess how medication adherence and psychological supports associate with positive SWB among RHD patients.
| S-EPMC8684619 | biostudies-literature
Project description:BackgroundUrinary tract infections are the most common causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of gram-negative bacteria causing urinary tract infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of bacterial isolates related to urinary tract infections among cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.Methods and materialsHospital based prospective cross-sectional study was conducted for three months from January to March 2018 in tertiary care hospital located in the capital city of the country. Gram-negative bacteria isolated from urine specimens from hospitalized patients with cancer were characterized using standard microbiological methods. Modified Kirby-Bauer disk diffusion technique was applied for antimicrobial susceptibility testing in accordance with CLSI 2019 criteria.ResultsOf totally 292 urine samples tested, eighteen (6.3%) were culture positive cases, Escherichia coli (44.4%) was the highest proportion isolated uropathogen followed by Klebsiella pneumoniae (22.2%) and Citrobacter diversus (16.7%). The antibiotic susceptibility results showed meropenem and nitrofurantoin as the most effective antibiotics for E. coli, K. pneumoniae, and Citrobacter diversus isolates. The rate of multidrug resistant (MDR) isolates were 33.3% (6/18), and meropenem and nitrofurantoin were the most effective antibiotic against MDR isolates.ConclusionThe study findings showed a significant distribution of MDR gram-negative bacteria which may increase the burden of urinary tract associated infections in cancer patients. Carbapenem (meropenem) can be considered as effective agents to treat MDR cases in our region.
| S-EPMC7728278 | biostudies-literature