Prevalence of Hypertension and Associated Factors among the Outpatient Department in Akaki Kality Subcity Health Centers, Addis Ababa, Ethiopia

In-hospital mortality and its predictors among adult stroke patients admitted in Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia

Introduction

Stroke is the second-leading global cause of death next to ischemic heart disease. The burden of stroke mortality, morbidity, and disability is increasing across the world. In Ethiopia, evidence on the survival status of adult stroke patients is insufficient. The purpose of this study is to estimate in-hospital mortality and its predictors among adult stroke patients.

Methods

Institution-based retrospective follow-up study was conducted on adult stroke patients who were admitted to Debre Markos Comprehensive Specialized Hospital from 1 November 2015 to 31 October 2020. Through simple random sampling, 382 patient charts were selected from 1125 stroke patients for 5 years follow-up period. Data were entered using EpiData™ version 4.1 and exported to Stata/SE™ version 14 for cleaning, coding, categorizing, and analysis. Predictor variables were selected using 95% confidence interval with a corresponding adjusted hazard ratio.

Results

In this study, 219 (57.33%) males and the mean (standard deviation) age of 57.65 ± 14.3 years. The in-hospital mortality rate of stroke was 12.8%; the median (interquartile range) time to mortality and Glasgow Coma Scale were 7 (4-13) days and 14 (11-15), respectively. The incidence of in-hospital mortality was 29/1000, 11/1000, 8/1000, and 13.6/1000 person-days in the first, second, third, and end of follow-up weeks, respectively. Pneumonia (adjusted hazard ratio = 3.51 (95% confidence interval = 1.86, 6.61)), hemorrhagic stroke (adjusted hazard ratio = 2.03 (95% confidence interval = 1.03, 3.99)), moderate impairment Glasgow Coma Scale (9-12) (adjusted hazard ratio = 2.16 (95% confidence interval = 1.08, 4.29)), severe impairment Glasgow Coma Scale (3-8) (adjusted hazard ratio = 2.38 (95% confidence interval = 1.01, 5.67)), history of hypertension (adjusted hazard ratio = 2.01 (95% confidence interval = 1.08, 3.74)), and increased intracranial pressure (adjusted hazard ratio = 2.12 (95% confidence interval = 1.10, 4.07)) were statistically significant predictors for in-hospital mortality.

Conclusion

In-hospital mortality of stroke was relatively high, and the median time to mortality was 8 days. Pneumonia, hemorrhagic stroke, Glasgow Coma Scale, history of hypertension, and increased intracranial pressure were identified predictors.

Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis

OBJECTIVES

Non-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults.

RESEARCH DESIGN AND METHODS

This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings.

RESULTS

From 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years.

CONCLUSIONS

A signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.

Behavioral and Sociodemographic Determinants of Hypertension and Its Burden among Bank Employees in Metropolitan Cities of Amhara Regional State, Ethiopia

Background

Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Bank workers are at higher risk of hypertension because of their work sedentary characteristics. However, little is known about the prevalence and determinants of hypertension among this group of population. Therefore, this study aimed to assess the prevalence and associated factors of hypertension among bank employees in metropolitan cities in Amhara Regional State of Ethiopia.

Method

An institution-based cross-sectional study was conducted among 368 bank employees. A simple random sampling technique was used to select participants. A pretested self-administered questionnaire and biophysical measurements were employed to collect the data. Descriptive statistics and logistic regression analyses were done to summarize the data and identify factors associated with hypertension, respectively.

Result

The overall prevalence of hypertension among bank employees was 52.4% (95% CI: 47.2, 57.7). Increased age (AOR = 1.1, 95% CI: 1.03, 1.11), male sex (AOR = 2.5, 95% CI: 1.2, 5.1), overweight (AOR = 2.7, 95% CI: 1.5, 5.2), obesity (AOR = 5.6, 95% CI: 2.0, 11.3), moderate/high physical activity (AOR = 0.36, 95% CI: 0.2, 0.62), daily fruit intake (AOR = 0.1, 95% CI: 0.04, 0.3), stressful life event experience (AOR = 1.8, 95% CI: 1.01, 3.4), family history of hypertension (AOR = 2.8, 95% CI: 1.5, 5.4), and poor knowledge of CVDs (AOR = 2.4, 95% CI: 1.2, 4.8) were significantly associated with hypertension.

Conclusion

The prevalence of hypertension among bank workers was very high. Increased age, male sex, overweight and obesity, daily fruit intake, moderate/high physical activity, the experience of stressful events, familial history of hypertension, and poor CVDs knowledge were associated with hypertension. Thus, raising awareness about cardiovascular disorders and behavior change interventions that enhance bank workers' engagement in physical exercise, screening behavior, and a healthy diet is urgently required for this group of population.