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Ayenew W, Tessema TA, Anagaw YK, Siraj EA, Zewdie S, Simegn W, Limenh LW, Tafere C, Yayehrad AT. Prevalence and predictors of self-medication with antibiotics in Ethiopia: a systematic review and meta-analysis. Antimicrob Resist Infect Control 2024; 13:61. [PMID: 38853267 PMCID: PMC11163721 DOI: 10.1186/s13756-024-01417-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/29/2024] [Indexed: 06/11/2024] Open
Abstract
INTRODUCTION Antibiotic self-medication is a global public health concern contributing to antibiotic resistance. This systematic review and meta-analysis aim to assess the prevalence of antibiotic self-medication and its associated factors in Ethiopia. METHODS A comprehensive search of electronic databases was conducted from MEDLINE (PubMed), Scopus, Google Scholar and Web of Science to identify relevant studies published between 2000 and 2024. Adult households, undergraduate university students and health care professionals who had taken antibiotics without a prescription in the household setting were included in this review. The primary outcome of this review is antibiotic self- medication. The random-effects model was used to estimate pooled prevalence rates. The outcome measure was analyzed with STATA version 17 software. RESULTS A total of nine studies were included in the Meta-analysis, comprising a sample size of 5908 participants. The pooled prevalence of antibiotic self-medication among Ethiopians was found to be 46.14 with 95% Confidence Interval [35.71, 56.57]. The most frequently used classes of self-medicated antibiotics were penicillins, followed by tetracyclines. Community pharmacies were the source of information that individuals utilized. The most common reported reasons for antibiotic self-medication include previous experience of treating a similar illness, to save cost, lack of time and avoiding waiting time for medical services. Participants having less than high school educational level was the most commonly reported factor associated with self-medication antibiotics. CONCLUSION Antibiotic self-medication is a prevalent practice in Ethiopia. This underscores the need for targeted interventions such as educating people about the risks associated with using antibiotics without medical guidance, which results in a reduction in antibiotic resistance.
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Affiliation(s)
- Wondim Ayenew
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Ayalew Tessema
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeniewa Kerie Anagaw
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ebrahim Abdela Siraj
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Segenet Zewdie
- Department of Social and Administrative Pharmacy, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chernet Tafere
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashagrachew Tewabe Yayehrad
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
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Mehrabani S, Shoaei N, Shateri Z, Askarpour M, Nouri M, Keshani P, Honarvar B, Homayounfar R. Consumption of ultra-processed foods could influence the metabolic syndrome odds: A cross-sectional study. Food Sci Nutr 2024; 12:2567-2577. [PMID: 38628179 PMCID: PMC11016394 DOI: 10.1002/fsn3.3938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 04/19/2024] Open
Abstract
Metabolic syndrome (MetS) prevalence has augmented globally during recent decades. Over the past years, the consumption of ultra-processed foods (UPFs) has grown significantly worldwide. So, the present research investigated the association between UPFs and MetS in an Iranian sample. This cross-sectional research was conducted on people (n = 8841) in the Fasa cohort study, Fars province, Iran. The participants' dietary consumption over a year, UPF consumption, and MetS diagnosis were evaluated through a 125-item modified food frequency questionnaire, the NOVA food group classification, and the Adult Treatment Panel III of the National Cholesterol Education Program, respectively. The association between the quartiles (Q) of UPF intake and the odds of MetS was estimated using the backward LR method of multivariate analysis. In the multivariate model, after adjusting potential confounders, the association between UPF intake and the odds of MetS was significant (Q4: odds ratio (OR = 3.27; 95% confidence interval (CI): 2.76-3.89). Also, the odds of increasing triglycerides (TG), blood pressure, and fasting blood sugar (FBS) and decreasing high-density lipoprotein cholesterol (HDL-C) were significantly higher in the last quartile compared to the first quartile of UPFs (TG: OR = 1.71; 95% CI: 1.49-1.97, blood pressure: OR = 1.53; 95% CI: 1.30-1.79, FBS: OR = 1.30; 95% CI: 1.10-1.54, and HDL-C: OR = 1.22; 95% CI: 1.08-1.39). The current research found a relationship between UPF intake and MetS and its components, indicating a diet-containing UPFs can be related to the occurrence of noncommunicable diseases.
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Affiliation(s)
- Sanaz Mehrabani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Department of Clinical Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Niloofar Shoaei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, Faculty of MedicineIlam University of Medical SciencesIlamIran
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutritional Sciences and DieteticsShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
| | - Mehran Nouri
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
- Students' Research Committee, School of Nutrition and Food ScienceShiraz University of Medical SciencesShirazIran
- Department of Community Nutrition, School of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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Chekol YM, Merid MW, Tesema GA, Tesfie TK, Tebeje TM, Gelaw NB, Gebi NB, Seretew WS. Development and Validation of a Risk Prediction Model to Estimate the Risk of Stroke Among Hypertensive Patients in University of Gondar Comprehensive Specialized Hospital, Gondar, 2012 to 2022. Degener Neurol Neuromuscul Dis 2023; 13:89-110. [PMID: 38116193 PMCID: PMC10728309 DOI: 10.2147/dnnd.s435806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
Background A risk prediction model to predict the risk of stroke has been developed for hypertensive patients. However, the discriminating power is poor, and the predictors are not easily accessible in low-income countries. Therefore, developing a validated risk prediction model to estimate the risk of stroke could help physicians to choose optimal treatment and precisely estimate the risk of stroke. Objective This study aims to develop and validate a risk prediction model to estimate the risk of stroke among hypertensive patients at the University of Gondar Comprehensive Specialized Hospital. Methods A retrospective follow-up study was conducted among 743 hypertensive patients between September 01/2012 and January 31/2022. The participants were selected using a simple random sampling technique. Model performance was evaluated using discrimination, calibration, and Brier scores. Internal validity and clinical utility were evaluated using bootstrapping and a decision curve analysis. Results Incidence of stroke was 31.4 per 1000 person-years (95% CI: 26.0, 37.7). Combinations of six predictors were selected for model development (sex, residence, baseline diastolic blood pressure, comorbidity, diabetes, and uncontrolled hypertension). In multivariable logistic regression, the discriminatory power of the model was 0.973 (95% CI: 0.959, 0.987). Calibration plot illustrated an overlap between the probabilities of the predicted and actual observed risks after 10,000 times bootstrap re-sampling, with a sensitivity of 92.79%, specificity 93.51%, and accuracy of 93.41%. The decision curve analysis demonstrated that the net benefit of the model was better than other intervention strategies, starting from the initial point. Conclusion An internally validated, accurate prediction model was developed and visualized in a nomogram. The model is then changed to an offline mobile web-based application to facilitate clinical applicability. The authors recommend that other researchers eternally validate the model.
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Affiliation(s)
- Yazachew Moges Chekol
- Department of Health Information Technician, Mizan Aman College of Health Science, Mizan Aman, Ethiopia
| | | | | | - Tigabu Kidie Tesfie
- Department of Public Health, Debre Markos University, Debre Markos, Ethiopia
| | - Tsion Mulat Tebeje
- Department of Epidemiology and Biostatistics, Dilla University, Dilla, Ethiopia
| | | | | | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
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Banham D, Karnon J, Brown A, Roder D, Lynch J. The fraction of life years lost after diagnosis (FLYLAD): a person-centred measure of cancer burden. Popul Health Metr 2023; 21:14. [PMID: 37704992 PMCID: PMC10500871 DOI: 10.1186/s12963-023-00314-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cancer control initiatives are informed by quantifying the capacity to reduce cancer burden through effective interventions. Burden measures using health administrative data are a sustainable way to support monitoring and evaluating of outcomes among patients and populations. The Fraction of Life Years Lost After Diagnosis (FLYLAD) is one such burden measure. We use data on Aboriginal and non-Aboriginal South Australians from 1990 to 2010 to show how FLYLAD quantifies disparities in cancer burden: between populations; between sub-population cohorts where stage at diagnosis is available; and when follow-up is constrained to 24-months after diagnosis. METHOD FLYLADcancer is the fraction of years of life expectancy lost due to cancer (YLLcancer) to life expectancy years at risk at time of cancer diagnosis (LYAR) for each person. The Global Burden of Disease standard life table provides referent life expectancies. FLYLADcancer was estimated for the population of cancer cases diagnosed in South Australia from 1990 to 2010. Cancer stage at diagnosis was also available for cancers diagnosed in Aboriginal people and a cohort of non-Aboriginal people matched by sex, year of birth, primary cancer site and year of diagnosis. RESULTS Cancers diagnoses (N = 144,891) included 777 among Aboriginal people. Cancer burden described by FLYLADcancer was higher among Aboriginal than non-Aboriginal (0.55, 95% CIs 0.52-0.59 versus 0.39, 95% CIs 0.39-0.40). Diagnoses at younger ages among Aboriginal people, 7 year higher LYAR (31.0, 95% CIs 30.0-32.0 versus 24.1, 95% CIs 24.1-24.2) and higher premature cancer mortality (YLLcancer = 16.3, 95% CIs 15.1-17.5 versus YLLcancer = 8.2, 95% CIs 8.2-8.3) influenced this. Disparities in cancer burden between the matched Aboriginal and non-Aboriginal cohorts manifested 24-months after diagnosis with FLYLADcancer 0.44, 95% CIs 0.40-0.47 and 0.28, 95% CIs 0.25-0.31 respectively. CONCLUSION FLYLAD described disproportionately higher cancer burden among Aboriginal people in comparisons involving: all people diagnosed with cancer; the matched cohorts; and, within groups diagnosed with same staged disease. The extent of disparities were evident 24-months after diagnosis. This is evidence of Aboriginal peoples' substantial capacity to benefit from cancer control initiatives, particularly those leading to earlier detection and treatment of cancers. FLYLAD's use of readily available, person-level administrative records can help evaluate health care initiatives addressing this need.
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Affiliation(s)
- David Banham
- School of Public Health, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
- Wardliparingga Aboriginal Health Research, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Research, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
| | - David Roder
- School of Health Sciences, Cancer Research Institute, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia
| | - John Lynch
- School of Public Health, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
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Alamnia TT, Sargent GM, Kelly M. Patterns of Non-Communicable Disease, Multimorbidity, and Population Awareness in Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study. Int J Gen Med 2023; 16:3013-3031. [PMID: 37465551 PMCID: PMC10351527 DOI: 10.2147/ijgm.s421749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
Objective Ethiopia, like other developing countries, is going through an epidemiological transition, and high rates of non-communicable diseases (NCDs) are having a significant impact on the health system; however, there is limited evidence about community level NCD prevalence, multimorbidity, and population awareness that could inform targeted interventions and policy responses. This study aimed to identify factors associated with NCD prevalence, multimorbidity, and population awareness of NCDs in Bahir Dar, Northwest Ethiopia. Methods A community-based cross-sectional survey was conducted with 417 randomly sampled adults. We performed descriptive and logistic regression analyses to evaluate associations between NCD prevalence (cardiovascular diseases, diabetes, cancer, chronic respiratory diseases, chronic kidney disease, and hypertension) multimorbidity (2 or more NCDs) and demographic, socioeconomic, individual risk factors, anthropometrics, knowledge, and attitude. Results This study reveals that 24% of participating adults have an NCD, and 8% have multimorbidity. One-third (34.5%) have some NCD knowledge, and 75% consider NCDs more dangerous than communicable diseases. We find low NCD prevalence in participants: younger than 40 years of age (AOR 0.17, 95% CI 0.07 to 0.39); with normal body mass index (AOR 0.27, 0.10 to 0.77) and; with a family history of NCD (AOR 7.7, 4.2 to 14.1). Multimorbidity is lower in young adults (AOR 0.08, 0.03 to 0.26). NCD knowledge is higher in men (AOR 1.76, 1.06 to 2.93) and employed adults (AOR 2.91, 1.52 to 5.57), and NCD attitude in normal-weight adults (AOR 3.23, 1.42 to 7.39). Conclusion This study reveals a high prevalence of NCD and overall low NCD awareness in the population. Age above 40 years, family history of NCD, and weight in the obese category are significant predictors of NCD prevalence. These findings can help health professionals, health offices, and concerned stakeholders to plan targeted health interventions to reduce NCDs in the population.
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Affiliation(s)
- Tilahun Tewabe Alamnia
- College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ginny M Sargent
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Misgana S, Asemahagn MA, Atnafu DD, Anagaw TF. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia, a retrospective follow-up study. Eur J Med Res 2023; 28:227. [PMID: 37430339 DOI: 10.1186/s40001-023-01192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Globally, one in three adults has hypertension, a condition that causes 51% of all deaths from stroke. Stroke is becoming a major public health problem and the most common cause of morbidity and mortality among non-communicable diseases in the world and Ethiopia. Therefore, this study assesses the incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia 2021. METHODS A hospital-based retrospective follow-up study design was used, simple random sampling technique was used to select 583 hypertensive patients that had follow-up registration between January 2018 and December 30th, 2020. Data were entered into Epi-data version 3.1 and exported to STATA version 14. The adjusted hazard ratio for each predictor with a 95% confidence interval was calculated using the Cox proportional hazards regression model, and a P-value ≤ 0.05 was used to denote statistical significance. RESULTS From 583 hypertensive patients 106(18.18%) [95% CI 15-20] were developed stroke. The overall incidence rate was 1 per 100 person-years (95% CI 0.79-1.19). Comorbidities (Adjusted hazard ratio(AHR): 1.88, 95% CI 1.0-3.5), stage two hypertension (AHR = 5.21, 95%CI 2.75-9.8), uncontrolled systolic blood pressure (AHR: 2, 95% CI 1.21-354), uncontrolled diastolic blood pressure (AHR:1.9, 95% CI 1.1-3.57), alcohol consumption (AHR = 2.04, 95%CI 1.2-3.49), age 45-65 (AHR = 10.25, 95%CI 7.47-11.1); and drug discontinuation (AHR = 2.05,95% CI 1.26-3.35) were independent predictors for the incidence of stroke among hypertensive patients. CONCLUSION The incidence of stroke among hypertensive patients was high and various modifiable and non-modifiable risk factors highly contributed to its incidence. This study recommends early screening of blood pressure, giving priority to comorbid patients and patients with advanced stage hypertension, and giving health education about behavioral risks and drug adherence.
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Affiliation(s)
- Solomon Misgana
- Amhara Regional Health Beauro,Bahir Dar, Bahir Dar, Ethiopia
| | - Mulusew Andualem Asemahagn
- School of Public health, College of Medicine and Health Science Bahir Dar University, Bahir Dar, Ethiopia
| | - Desta Debalkie Atnafu
- Department of Health System Management and Health Economics, School of Public health, College of Medicine and Health Science Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public health, College of Medicine and Health Science Bahir Dar University, 079, Bahir Dar, Ethiopia.
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Ambaw Kassie G, Alemu A, Yosef Gebrekidan A, Asmare Adella G, Eshetu K, Wolie Asres A, Sisay Asgedom Y. Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:278. [PMID: 37244992 PMCID: PMC10225092 DOI: 10.1186/s12872-023-03300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/13/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Hypertension is a major public health problem, resulting in 10 million deaths annually. Undiagnosed hypertension affects more people than ever before. It is more likely to be linked to severe hypertension, which can lead to stroke, cardiovascular disease, and ischemic heart disease. Thus, this systematic review and meta-analysis aimed to synthesize the prevalence of undiagnosed hypertension and its associated factors in Ethiopia. METHODS Databases, such as Medline/PubMed, Google Scholar, Science Direct, AJOL, and the Cochrane Library, were systematically searched to find potential studies published until December 2022. A Microsoft Excel spreadsheet was used to enter the extracted data. The pooled prevalence of undiagnosed hypertension and its associated factors was estimated using a random effect model. I2 statistics and the Cochrane Q-test were used to assess statistical heterogeneity across the studies. Begg's and Egger's tests were performed to identify possible publication bias. RESULTS A total of ten articles with 5,782 study participants were included in this meta-analysis. In the random effects model, the pooled prevalence of undiagnosed hypertension was 18.26% (95% CI = 14.94-21.58). Being older (OR = 3.8, 95% CI = 2.56, 5.66), having a body mass index > 25 kg/m2 (OR = 2.71, 95% CI = 2.1, 3.53), having a family history of hypertension (OR = 2.22, 95% CI = 1.47, 3.36), and having DM comorbidity (OR = 2.44, 95% CI = 1.38, 4.32) were significantly associated with undiagnosed hypertension. CONCLUSION In this meta-analysis, the pooled prevalence of undiagnosed hypertension was found to be high in Ethiopia. Being older, having a BMI > 25 kg/m2, having a family history of hypertension, and having DM comorbidity were found to be risk factors for undiagnosed hypertension.
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Affiliation(s)
- Gizachew Ambaw Kassie
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Afework Alemu
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Abiyot Wolie Asres
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Agyemang-Pambour B, Osei I, Boateng-Osei EA, Kwarteng A, Dzomeku V. Prevalence and risk factors of hypertension among public servants in Ejisu-Juaben municipality, Ghana. BMC Res Notes 2023; 16:77. [PMID: 37189186 PMCID: PMC10186681 DOI: 10.1186/s13104-023-06349-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES We determined the prevalence and risk factors of hypertension among public servants of Ejisu Juaben municipality. RESULTS The overall prevalence of hypertension was 29.3% (95%CI:22.5-36.1%) and only 8.6% of the participants were aware of their hypertensive status. Respondents who were > 40 years were twice as likely to develop hypertension compared to those who were ≤ 40 years [adjusted odds ratio (AOR) = 2.37, 95% confidence interval (CI) 1.05-5.32]. Those who were married were 2.54 times more likely to be hypertensive compared with those unmarried [AOR = 2.54, 95%CI: 1.06-6.08]. Compared to health workers, Judicial and Security service workers were almost five times more likely to be hypertensive [AOR = 4.77, 95%CI: 1.20-18.96]. Being overweight [AOR = 2.25, 95%CI: 1.06-6.41] and obese [AOR = 4.80, 95%CI: 1.82-12.91] was associated with increased odds of hypertension. The prevalence of hypertension among the participants in this study is high. Employee wellness programs are needed at workplaces and the Ghana Health Service must adopt targeted intervention programs such as regular screening for non-communicable diseases and promotion of physical activities at the workplace.
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Affiliation(s)
- Bernice Agyemang-Pambour
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Osei
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, PO Box 273, Banjul, West Africa, The Gambia.
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | | | - Alexander Kwarteng
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Veronica Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mehar P, Bera R, Swarnim S, Mishra D. Composition of Common Junk Food Items and Their Contribution to the Dietary Requirement of Children and Adolescents. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2839-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Dasgupta P, Harris VM, Garvey G, Aitken JF, Baade PD. Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review. Front Oncol 2022; 12:968400. [PMID: 36185181 PMCID: PMC9521397 DOI: 10.3389/fonc.2022.968400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/31/2022] [Indexed: 11/14/2022] Open
Abstract
Background While cancer survival among Aboriginal and Torres Strait Islander peoples has improved over time, they continue to experience poorer cancer survival than other Australians. Key drivers of these disparities are not well understood. This systematic review aimed to summarise existing evidence on Aboriginal and Torres Strait Islander cancer survival disparities and identify influential factors and potential solutions. Methods In accordance with PRISMA guidelines, multiple databases were systematically searched for English language peer-reviewed articles on cancer survival by Aboriginal and Torres Strait Islander status published from 1/1/2008 to 4/05/2022. Observational studies presenting adjusted survival measures in relation to potential causal factors for disparities were included. Articles were screened independently by two authors. Included studies were critically assessed using Joanna Briggs Institute tools. Results Thirty population-based and predominantly state-level studies were included. A consistent pattern of poorer unadjusted cancer survival for Aboriginal and Torres Strait Islander peoples was evident. Studies varied widely in the covariates adjusted for including a combination of socio-demographics, cancer stage, comorbidities, and treatment. Potential contributions of these factors varied by cancer type. For lung and female breast cancer, adjusting for treatment and comorbidities reduced the survival disparity, which, while still elevated was no longer statistically significant. This pattern was also evident for cervical cancer after adjustment for stage and treatment. However, most studies for all cancers combined, or colorectal cancer, reported that unexplained survival disparities remained after adjusting for various combinations of covariates. Conclusions While some of the poorer survival faced by Aboriginal and Torres Strait Islander cancer patients can be explained, substantial disparities likely to be related to Aboriginal determinants, remain. It is imperative that future research consider innovative study designs and strength-based approaches to better understand cancer survival for Aboriginal and Torres Strait Islander peoples and to inform evidence-based action.
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Affiliation(s)
- Paramita Dasgupta
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Veronica Martinez Harris
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Joanne F. Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute for Resilient Regions, University of Southern Queensland, Brisbane, QLD, Australia
| | - Peter D. Baade
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
- Centre for Data Science, Faculty of Science, Queensland University of Technology, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
- *Correspondence: Peter D. Baade,
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Quantifying the number of deaths among Aboriginal and Torres Strait Islander cancer patients that could be avoided by removing survival inequalities, Australia 2005–2016. PLoS One 2022; 17:e0273244. [PMID: 36026498 PMCID: PMC9417002 DOI: 10.1371/journal.pone.0273244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background While Aboriginal and Torres Strait Islander peoples have poorer cancer survival than other Australians, absolute measures of survival disparities are lacking. This study quantified crude probabilities of deaths from cancer and other causes and estimated the number of avoidable deaths for Aboriginal and Torres Strait Islanders if these survival disparities were removed. Methods Flexible parametric relative survival models were used to estimate reported measures for a population-based cohort of 709,239 Australians (12,830 Aboriginal and Torres Strait Islander peoples), 2005–2016. Results Among Aboriginal and Torres Strait Islander peoples, the 5-year crude probability of cancer death was 0.44, while it was 0.07 for other causes of death. These probabilities were 0.07 and 0.03 higher than among other Australians, respectively. Magnitude of these disparities varied by cancer type and ranged for cancer deaths from <0.05 for pancreatic, prostate and uterine cancers to 0.20 for cervical and head and neck cancers. Values for disparity in other causes of death were generally lower. Among an average cohort of Aboriginal and Torres Strait Islander peoples diagnosed per year over the most recent five-year diagnosis period (2012–2016, n = 1,269), approximately 133 deaths within 5 years of diagnosis were potentially avoidable if they had the same overall survival as other Australians, with 94 of these deaths due to cancer. The total number of avoided deaths over the entire study period (2005–2016) was 1,348, with 947 of these deaths due to cancer. Conclusions Study findings suggest the need to reduce the prevalence of risk factors prevalence, increase screening participation, and improve early detection, diagnosis and treatment rates to achieve more equitable outcomes for a range of cancer types. Reported measures provide unique insights into the impact of a cancer diagnosis among Aboriginal and Torres Strait Islander peoples from a different perspective to standard relative survival measures.
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12
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Cummings JR, Lipsky LM, Schwedhelm C, Liu A, Nansel TR. Associations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth. Int J Behav Nutr Phys Act 2022; 19:61. [PMID: 35619114 PMCID: PMC9137185 DOI: 10.1186/s12966-022-01298-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive intake of ultra-processed foods, formulated from substances extracted from foods or derived from food constituents, may be a modifiable behavioral risk factor for adverse maternal and infant health outcomes. Prior work has predominately examined health correlates of maternal ultra-processed food intake in populations with substantially lower ultra-processed food intake compared to the US population. This longitudinal study investigated relations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth in a US cohort. METHODS Mothers in the Pregnancy Eating Attributes Study were enrolled at ≤12 weeks gestation and completed multiple 24-Hour Dietary Recalls within six visit windows through one-year postpartum (458 mothers enrolled, 321 retained at one-year postpartum). The NOVA (not an acronym) system categorized food and underlying ingredient codes based on processing level. Maternal anthropometrics were measured throughout pregnancy and postpartum, and infant anthropometrics were measured at birth and ages 2 months, 6 months, and 1 year. Maternal cardiometabolic markers were analyzed from blood samples obtained during the second and third trimesters. RESULTS Holding covariates and total energy intake constant, a 1-SD greater percent energy intake from ultra-processed foods during pregnancy was associated with 31% higher odds of excessive gestational weight gain (p = .045, 95% CI [1.01, 1.70]), 0.68±0.29 mg/L higher c-reactive protein during pregnancy (p = .021, 95% CI [0.10, 1.26]), 6.7±3.4% greater gestational weight gain retained (p = .049, 95% CI [0.03, 13.30]), and 1.09±0.36 kg greater postpartum weight retention (p = .003, 95% CI [0.38, 1.80]). No other significant associations emerged. CONCLUSIONS Ultra-processed food intake during pregnancy may be a modifiable behavioral risk factor for adverse maternal weight outcomes and inflammation. Randomized controlled trials are needed to test whether targeting ultra-processed food intake during pregnancy may support optimal maternal health. TRIAL REGISTRATION Clinicaltrials.gov. Registration ID - NCT02217462 . Date of registration - August 13, 2014.
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Affiliation(s)
- Jenna R Cummings
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Carolina Schwedhelm
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.
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Essa E, Shitie D, Yirsaw MT, Wale MZ. Undiagnosed hypertension and associated factors among adults in Debre Markos town, North-West Ethiopia: A community-based cross-sectional study. SAGE Open Med 2022; 10:20503121221094223. [PMID: 35558191 PMCID: PMC9087240 DOI: 10.1177/20503121221094223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Globally, hypertension is an important risk factor for cardiovascular diseases and all-cause mortality. Despite this high public health burden, no community-based evidence regarding the magnitude and related factors of hypertension has been reported in the study area. Objective: The aim of this study was to determine the prevalence and associated factors of undiagnosed hypertension in Debre Markos town, North-West Ethiopia, 2020. Method: A community-based cross- sectional study design was conducted from January to March 2020. Socio-demographic and behavioral characteristics of the participants were collected using interviewer-administered semi-structured questionnaires. Physical measurements including body mass index, waist circumference, and blood pressure were collected using standardized measuring instruments. Statistical analysis was collected using SPSS version 21 software. Univariate logistic regression model was used to present the results. The p value less than 0.05 in a multivariable analysis was considered statistically significant at 95% confidence interval. Results: From a total of 630 samples, 600 participants, 270 (45%) males and 330 (55%) females with a mean age of 36.32 ± 12.48 years, were participated giving a response rate of 95.2%. The prevalence of undiagnosed hypertension among adults was 12.7%. Of these, 5.5% were males and 7.2% were females. Factors including age (above 60 years) (adjusted odds ratio = 2.92, 95% confidence interval (1.05, 8.06), p = 0.03), body mass index (overweight and obese) (adjusted odds ratio = 3.85, 95% confidence interval (2.16, 6.87), p < 0.01), fatty diet consumption (adjusted odds ratio = 1.88, 95% confidence interval (1.03, 3.42), p = 0.04), family history of hypertension (adjusted odds ratio = 2.21, 95% confidence interval (1.04, 4.69), p = 0.04) were significantly associated with hypertension. Conclusion: The prevalence of undiagnosed hypertension among adults was found to be remarkable. Therefore, a community-based health education and hypertension screening strategies are needed to prevent the problem early in life in Debre Markos town and the nation at large.
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Affiliation(s)
- Enatnesh Essa
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Dessalegn Shitie
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mesenbet Terefe Yirsaw
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Mengistu Zelalem Wale
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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Clèries R, Buxó M, Vilardell M, Ameijide A, Martínez JM, Font R, Marcos-Gragera R, Puigdemont M, Viñas G, Carulla M, Espinàs JA, Galceran J, Izquierdo Á, Borràs JM. No Excess Mortality up to 10 Years in Early Stages of Breast Cancer in Women Adherent to Oral Endocrine Therapy: A Probabilistic Graphical Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063605. [PMID: 35329292 PMCID: PMC8950380 DOI: 10.3390/ijerph19063605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/04/2023]
Abstract
Breast cancer (BC) is globally the most frequent cancer in women. Adherence to endocrine therapy (ET) in hormone-receptor-positive BC patients is active and voluntary for the first five years after diagnosis. This study examines the impact of adherence to ET on 10-year excess mortality (EM) in patients diagnosed with Stages I to III BC (N = 2297). Since sample size is an issue for estimating age- and stage-specific survival indicators, we developed a method, ComSynSurData, for generating a large synthetic dataset (SynD) through probabilistic graphical modeling of the original cohort. We derived population-based survival indicators using a Bayesian relative survival model fitted to the SynD. Our modeling showed that hormone-receptor-positive BC patients diagnosed beyond 49 years of age at Stage I or beyond 59 years at Stage II do not have 10-year EM if they follow the prescribed ET regimen. This result calls for developing interventions to promote adherence to ET in patients with hormone receptor-positive BC and in turn improving cancer survival. The presented methodology here demonstrates the potential use of probabilistic graphical modeling for generating reliable synthetic datasets for validating population-based survival indicators when sample size is an issue.
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Affiliation(s)
- Ramon Clèries
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
- Department de Ciències Clíniques, Universitat de Barcelona, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-260-74-17
| | - Maria Buxó
- Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain; (M.B.); (R.M.-G.)
| | | | - Alberto Ameijide
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - José Miguel Martínez
- Department de Estadística i Investigació Operativa, Universitat Politècnica de Catalunya (EDIFICI H), Diagonal 647, 08028 Barcelona, Spain;
- Grupo de Investigación en Salud Pública, Universidad de Alicante, 03690 Alicante, Spain
| | - Rebeca Font
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
| | - Rafael Marcos-Gragera
- Institut d’Investigació Biomèdica de Girona (IDIBGI), C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Girona, Spain; (M.B.); (R.M.-G.)
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
- Facultat de Medicina, Universitat de Girona (UdG), 17071 Girona, Spain
- Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Montse Puigdemont
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
| | - Gemma Viñas
- Servei d’Oncología Médica, Institut Català d’Oncología, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain;
| | - Marià Carulla
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - Josep Alfons Espinàs
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
| | - Jaume Galceran
- Registre de Càncer de Tarragona, Servei d’Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus (IISPV), 43204 Reus, Spain; (A.A.); (M.C.); (J.G.)
| | - Ángel Izquierdo
- Registre de Cáncer de Girona-Unitat d’Epidemiologia, Institut Català d’Oncología, 17005 Girona, Spain; (M.P.); (Á.I.)
- Grup d’Epidemiologia Descriptiva, Genètica i Prevenció del Càncer de Girona-IDIBGI, 17005 Girona, Spain
- Servei d’Oncología Médica, Institut Català d’Oncología, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain;
| | - Josep Maria Borràs
- Hospitalet de Llobregat Avenue Gran Vía 199-203, 08908 Barcelona, Spain; (R.F.); (J.A.E.); (J.M.B.)
- Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Avenue Gran Via de l’Hospitalet, 199-203-1a Planta, 08908 Barcelona, Spain
- Department de Ciències Clíniques, Universitat de Barcelona, 08907 Barcelona, Spain
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Aschalew A, Kebed RA, Demie TG, Weldetsadik AY. Assessment of level of asthma control and related factors in children attending pediatric respiratory clinics in Addis Ababa, Ethiopia. BMC Pulm Med 2022; 22:70. [PMID: 35197032 PMCID: PMC8865488 DOI: 10.1186/s12890-022-01865-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background Asthma is a common airways disease with significant morbidity and mortality in all ages. Studies of pediatric asthma control and its determinants yielded variable results across settings. However, there is paucity of data on asthma control and its factors in Ethiopian children. We aimed to assess the level of asthma control and the related factors in children attending pediatric respiratory clinics at three tertiary hospitals in Addis Ababa.
Methods We conducted a cross-sectional study from March 1 to August 30, 2020 using standardized questionnaires and review of patient’s charts. Data was analyzed using SPSS software for window version 26. Results A total of 105 children (56.2% male) were included in the study. The mean age (± SD) and age at Asthma diagnosis (± SD) were 6 (± 3.3) and 4 (± 2.8) respectively. Uncontrolled asthma was present in 33 (31%) of children. Comorbidities (Atopic dermatitis and allergic Rhinitis (AOR = 4.56; 95% CI 1.1–18.70; P = 0.035), poor adherence to controller medications (AOR = 3.23; 95% CI 1.20–10.20; P = 0.045), inappropriate inhaler technique (AOR = 3.48; 95% CI 1.18–10.3; P = 0.024), and lack of specialized care (AOR = 4.72; 95% CI 1.13–19.80; P = 0.034) were significantly associated with suboptimal asthma control. Conclusion One-third of children attending pediatric respiratory clinics in Addis Ababa had uncontrolled Asthma. Treatment of comorbidities, training of appropriate inhaler techniques, optimal adherence to controllers, and proper organization of clinics should be emphasized to improve asthma control among children.
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Affiliation(s)
| | - Rahel Argaw Kebed
- Pediatric Pulmonary and Critical Care, Addis Ababa University, Addis Ababa, Ethiopia
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Belay M, Oumer A, Abdureshid N, Ale A. Overnutrition and Associated Factors Among High School Adolescents in Mid COVID-19 Pandemic in Ethiopia: Neglected Public Health Concern. Adolesc Health Med Ther 2022; 13:1-14. [PMID: 35082546 PMCID: PMC8784252 DOI: 10.2147/ahmt.s349189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adolescent overnutrition is becoming a global public health problem, increasing at an alarming rate in developing countries. Overnutrition increases the risks of serious diet-related chronic diseases, including type 2 diabetes, hypertension, cardiovascular disease, and stroke. However, there is limited evidence on the magnitude and risk factors of overnutrition in the study area. OBJECTIVE To determine the magnitude of overnutrition and associated factors among school adolescents in Dire Dawa, Eastern Ethiopia. METHODS A cross-sectional study was conducted from May to June 2021 among 498 adolescent students selected using a multi-stage sampling procedure. A systematic random sampling technique was employed. Self-administered questionnaires, including food frequency and anthropometric measurement, were used to collect the data. The BMI-for-age Z score was calculated using the WHO Anthro-Plus. A binary logistic regression model was fitted with an odds ratio, and 95% confidence levels. Statistical significance is declared at a p-value below 0.05. RESULTS A total of 498 (98.4%) were included with the overall prevalence of overnutrition of 26.1% (95% CI: 22.3-29.9), where 23.7% and 2.4% had overweight and obesity, respectively. Being female (AOR = 3.32; 95% CI: 1.65-6.63), attending at private school (AOR = 4.97; 95% CI: 1.72-14.35), having sweet food preferences (AOR = 6.26; 95% CI: 3.14-12.5), snacking (AOR = 3.05; 95% CI: 1.11-8.36), sedentary behavior (AOR = 3.20; 95% CI: 1.67-6.09), and eating while watching TV (AOR= 2.95; 95% CI: 1.47-5.95) were significantly associated with overnutrition. CONCLUSION Overnutrition is a major emerging public health problem in eastern Ethiopia. School type, sex, sweet food preferences, habits of snacking, sedentary behaviors, and eating while watching TV were significantly associated with overnutrition. Therefore, public health strategies to curb overweight and obesity among high school adolescents are urgently needed in order to reduce the prevalence and its adverse complications.
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Affiliation(s)
- Michael Belay
- Department of public health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Abdu Oumer
- Department of public health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Neil Abdureshid
- Department of Midwifery and College Quality Improvement Coordinator, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Ahmed Ale
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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Simegn W, Moges G. Antibiotics Self-Medication Practice and Associated Factors Among Residents in Dessie City, Northeast Ethiopia: Community-Based Cross-Sectional Study. Patient Prefer Adherence 2022; 16:2159-2170. [PMID: 35999841 PMCID: PMC9393019 DOI: 10.2147/ppa.s370925] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Taking antibiotics without prescription would result in the emergency of antibiotics resistance. The aim of this study was to assess antibiotics self-medication practice and associated factors among residents in Dessie City, Ethiopia. METHODS A community-based cross-sectional was employed from June to July 2021. A total of 407 participants have been selected from each Kebele by stratified and systematic random sampling techniques. The collected data were checked, translated and exported into SPSS version 26. Results were organized using frequency and percentage tables. Bi-variate and multi-variable logistic regressions were used to test the association of independent variables with antibiotics self-medication practice. RESULTS Four hundred and seven participants enrolled with a response of 96.7%. One hundred and fifty-two (37.3%) were females, and 115 (28.3%) respondents have taken antibiotics in the last 6 months. The prevalence of antibiotics self-medication practice was 55.3% (95% CI: 50.6-60.2). Amoxicillin (45%), Ciprofloxacin (36%), and Amoxicillin with clavulanic acid (24%) were commonly used antibiotics. Cough (34.4), fever (30.7), cold and flu (29.0), diarrhea (21.9) and headache (18.7) were the most reported conditions that necessitate antibiotics self-medication. Educational level (8-10 grade) (AOR = 4.10, 95% CI: 1.28, 13.12), using mass media as a source of information (AOR = 2.23, 95% CI: 1.24, 4.27), relying on previous experience for source of information (AOR = 2.02, 95% CI: 1.23, 3.31), having awareness of antibiotics resistance (AOR = 2.45, 95% CI: 1.34, 4.50) and good knowledge of antimicrobial resistance (AOR = 1.81, 95% CI: 1.11, 2.97) were significantly associated with antibiotics self-medication practice. CONCLUSION Antibiotics self-medication practice among residents was high. Educational status, using mass media and previous experiences as sources of information on antibiotics, having awareness of antibiotics resistance, and knowledge of antimicrobial resistance were significantly associated with self medication of antibiotics. Attention should be given by the stakeholders to reduce self medication practice with antibiotics.
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Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Wudneh Simegn, Email
| | - Getachew Moges
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Comparison of adult and pediatric pilocytic astrocytomas using competing risk analysis: A population-based study. Clin Neurol Neurosurg 2021; 212:107084. [PMID: 34875553 DOI: 10.1016/j.clineuro.2021.107084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Pilocytic astrocytoma(PA) is a relatively benign tumor occurring primarily in the pediatric population. Comparison of characteristics and survival of this tumor between adult and pediatric patients in a single, population-based study is yet to be performed. OBJECTIVE We aimed to directly compare the characteristics and survival of pilocytic astrocytoma between pediatric and adult patients in a single, population-based study. METHODS We utilized the SEER database using data from 1983 to 2016. All patients with histologically confirmed, intracranial pilocytic astrocytoma were included and divided into a pediatric(age<18 years) or adult group. Due to lower risk of tumor-specific-mortality, we utilized a competing risk analysis to account for mortality from other causes. Univariable and multivariable competing risk analysis(CRA) was performed, and sub-distribution hazard ratio(SHR) or adjusted SHR(aSHR) was reported. RESULTS A total of 4357 patients comprised the final cohort, with 3014(69.2%) pediatric patients. As compared to the pediatric group, adult patients were predominantly White(p < 0.01), with PA less likely fully resected(p = 0.01), smaller tumor size(p < 0.01), and were less often located in the cerebellum(p < 0.01). Multivariable CRA revealed a worse prognosis for the adult group(p < 0.01), regional or distal extension(p < 0.01), and non-cerebellar locations including frontal(p < 0.01), parietal(p < 0.01), ventricular(p < 0.01) or brainstem(p < 0.01). Improved prognosis was seen with more recent year-of-diagnosis(2003-2016, p = 0.03), gross-total/total resection(p < 0.01), and biopsy only patients(p = 0.02). CONCLUSIONS Pilocytic astrocytomas in adult patients have a worse prognosis than pediatric patients. Cumulative incidence of cancer-specific-mortality is higher in adults when adjusted for other factors. PAs with regional or distal extension and non-cerebellar locations carry worse outcomes. Surgery remains an effective treatment and GTR/TR should be achieved when possible.
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Canidate SS, Schrimshaw EW, Schaefer N, Gebru NM, Powers N, Maisto S, Parisi C, Leeman RF, Fields S, Cook RL. The Relationship of Alcohol to ART Adherence Among Black MSM in the U.S.: Is it Any Different Among Black MSM in the South? AIDS Behav 2021; 25:302-313. [PMID: 34741688 PMCID: PMC8610946 DOI: 10.1007/s10461-021-03479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2021] [Indexed: 11/30/2022]
Abstract
Alcohol-using Black MSM (Men who have sex with men) are disproportionately impacted by HIV in the U.S.-particularly in the southern U.S.-despite the availability of antiretroviral therapy (ART). The purpose of this study was to summarize the current evidence on alcohol use and ART adherence among Black MSM in the U.S. and in the South and to identify future research needs. A systematic review was conducted using eight databases to identify relevant peer-reviewed articles published between January 2010 and April 2021. The authors also snowballed remaining studies and hand-searched for additional studies. Including both quantitative and qualitative studies, five published studies examined alcohol and ART adherence among Black MSM in the U.S. The search identified 240 articles, the study team reviewed 114 in full-text and determined that only five met the inclusion criteria. Three of the five included studies identified alcohol use as a barrier to ART adherence. In conclusions, the general lack of literature on HIV disparities among alcohol-using Black MSM in the U.S. (specifically in the South) indicates a critical need for research on this population's unique risks and needs to inform the development of tailored interventions.
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Affiliation(s)
- Shantrel S Canidate
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610-0182, USA.
| | - Eric W Schrimshaw
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL, 32827, USA
| | - Nancy Schaefer
- UF Health Science Center Libraries, University of Florida, Gainesville, FL, 32610, USA
| | - Nioud Mulugeta Gebru
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA
| | - Noelani Powers
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610-0182, USA
| | - Stephen Maisto
- Department of Psychiatry, College of Arts and Sciences, Syracuse University, Syracuse, NY, 13244, USA
| | - Christina Parisi
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610-0182, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, 06511, USA
| | - Sheldon Fields
- College of Nursing, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Robert L Cook
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL, 32610-0182, USA
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Merera AM. Determinants of acute respiratory infection among under-five children in rural Ethiopia. BMC Infect Dis 2021; 21:1203. [PMID: 34847859 PMCID: PMC8631694 DOI: 10.1186/s12879-021-06864-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In low- and middle-income nations, acute respiratory infection (ARI) is the primary cause of morbidity and mortality. According to some studies, Ethiopia has a higher prevalence of childhood acute respiratory infection, ranging from 16 to 33.5%. The goal of this study was to determine the risk factors for acute respiratory infection in children under the age of five in rural Ethiopia. METHODS A cross-sectional study involving 7911 children under the age of five from rural Ethiopia was carried out from January 18 to June 27, 2016. A two stage cluster sampling technique was used recruit study subjects and SPSS version 20 was used to extract and analyze data. A binary logistic regression model was used to identify factors associated with a childhood acute respiratory infection. The multivariable logistic regression analysis includes variables with a p-value less than 0.2 during the bivariate logistic regression analysis. Adjusted odds ratios were used as measures of effect with a 95% confidence interval (CI) and variables with a p-value less than 0.05 were considered as significantly associated with an acute respiratory infection. RESULTS The total ARI prevalence rate among 7911 under-five children from rural Ethiopia was 7.8%, according to the findings of the study. The highest prevalence of ARI was found in Oromia (12.8%), followed by Tigray (12.7%), with the lowest frequency found in Benishangul Gumuz (2.4%). A multivariable logistic regression model revealed that child from Poor household (AOR = 2.170, 95% CI: 1.631-2.887), mother's no education (AOR = 2.050,95% CI: 1.017-4.133), mother's Primary education (AOR = 2.387, 95% CI:1.176-4.845), child had not received vitamin A (AOR = 1.926, 95% CI:1.578-2.351), child had no diarrhea (AOR = 0.257, 95% CI: 0.210-0.314), mothers not working (AOR = 0.773, 95% CI:0.630-0.948), not stunted (AOR = 0.663, 95% CI: 0.552-0.796), and not improved water source (AOR = 1.715, 95% CI: 1.395-2.109). Similarly, among under-five children, the age of the child, the month of data collection, anemia status, and the province were all substantially linked to ARI. CONCLUSIONS Childhood ARI morbidity is a serious health challenge in rural Ethiopia, according to this study, with demographic, socioeconomic, nutritional, health, and environmental factors all having a role. As a result, regional governments, healthcare staff, and concerned groups should place a priority on reducing ARI, and attempts to solve the issue should take these variables into account.
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Affiliation(s)
- Amanuel Mengistu Merera
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
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21
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Tilahun AG, Kebede AM. Maternal minimum dietary diversity and associated factors among pregnant women, Southwest Ethiopia, 2021. BMC Nutr 2021; 7:66. [PMID: 34706770 PMCID: PMC8555354 DOI: 10.1186/s40795-021-00474-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inadequate dietary diversity intake during pregnancy increases risks of intrauterine growth restriction, abortion, low birth weight, preterm birth, prenatal and infant mortality,and morbidity and has long-lasting health impacts. Dietary diversity during pregnancy promotes the health status of the mother and her fetus. This study aimed to assess the magnitude of minimum dietary diversity and associated factors among pregnant women attending antenatal care. METHODS A facility-based cross-sectional study was conducted among 274 pregnant women who attended antenatal care at Wacha primary hospital from January to February 2021. A systematic sampling method was used to select the study participants. The data were collected through face-to-face interviews using a structured and semi-structured questionnaire. Bivariate logistic regression was done to identify factors associated with maternal dietary diversity. Finally, multivariate logistic regression was done, and variables that showed P values of < 0.05 were considered statistically significant. RESULT The magnitude of minimum dietary diversity was 51% (95% CI: 44.5, 56.7). The mean (±SD) minimum dietary diversity score was 4.5 (± 1.268) with a minimum of 1 anda maximum of 8 food groups consumed out of ten food groups. Age fewer than 25 years (AOR 4.649; 95% CI; 1.404, 15.396), and the age group between 25 to 34 years (AOR 3.624; 95% CI: 1.315, 10.269), husband age group of 26 to 34 years (AOR 2.238; 95% CI; 1.028,4.873), and 35 to 44 years (AOR 3.555; 95% CI; 1.228,10.292) and nutrition awareness of women (AOR 2.182; 95% CI; 1.243, 3.829) were significantly associated with minimum dietary diversity. CONCLUSION The consumption of minimum dietary diversity of the pregnant mothers was found to be low. Women aged less than 25 and age between 25 to 34 years, husband's age between 26 to 34 and 35 to 44 years, and nutrition awareness were the factors significantly associated with minimum dietary diversity. Therefore, providing nutrition education and counseling service warranted to promote maternal dietary diversity.
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Affiliation(s)
- Abel Girma Tilahun
- Department of Reproductive Health and Human Nutrition, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
| | - Abebaw Molla Kebede
- Department of Reproductive Health and Human Nutrition, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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22
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Addressing Competing Risks When Assessing the Impact of Health Services Interventions on Hospital Length of Stay. Epidemiology 2021; 32:230-238. [PMID: 33284168 DOI: 10.1097/ede.0000000000001307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although hospital length of stay is generally modeled continuously, it is increasingly recommended that length of stay should be considered a time-to-event outcome (i.e., time to discharge). Additionally, in-hospital mortality is a competing risk that makes it impossible for a patient to be discharged alive. We estimated the effect of trauma center accreditation on risk of being discharged alive while considering in-hospital mortality as a competing risk. We also compared these results with those from the "naive" approach, with length of stay modeled continuously. METHODS Data include admissions to a level I trauma center in Quebec, Canada, between 2008 and 2017. We computed standardized risk of being discharged alive at specific days by combining inverse probability weighting and the Aalen-Johansen estimator of the cumulative incidence function. We estimated effect of accreditation using pre-post, interrupted time series (ITS) analyses, and the "naive" approach. RESULTS Among 5,300 admissions, 12% died, and 83% were discharged alive within 60 days. Following accreditation, we observed increases in risk of discharge between the 7th day (4.5% [95% CI = 2.3, 6.6]) and 30th day since admission 3.8% (95% CI = 1.5, 6.2). We also observed a stable decrease in hospital mortality, -1.9% (95% CI = -3.6, -0.11) at the 14th day. Although pre-post and ITS produced similar results, we observed contradictory associations with the naive approach. CONCLUSIONS Treating length of stay as time to discharge allows for estimation of risk of being discharged alive at specific days after admission while accounting for competing risk of death.
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Fanta K, Daba FB, Tegene E, Melaku T, Fekadu G, Chelkeba L. Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study. BMC Emerg Med 2021; 21:41. [PMID: 33789565 PMCID: PMC8010978 DOI: 10.1186/s12873-021-00433-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia. Methods A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value < 0.05 was considered statistically significant. Results Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction (STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guideline-directed medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%), beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI). Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause in-hospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients. Conclusion In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-021-00433-3.
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Affiliation(s)
- Korinan Fanta
- Department of Clinical Pharmacy, Institute of Health, Jimma University, P.O.Box: 378, Jimma, Oromia, Ethiopia.
| | - Fekede Bekele Daba
- Department of Clinical Pharmacy, Institute of Health, Jimma University, P.O.Box: 378, Jimma, Oromia, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Tsegaye Melaku
- Department of Clinical Pharmacy, Institute of Health, Jimma University, P.O.Box: 378, Jimma, Oromia, Ethiopia
| | - Ginenus Fekadu
- Department of clinical pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.,School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New territory, Hong Kong
| | - Legese Chelkeba
- Department of Pharmacology and Clinical Pharmacy, Collage of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
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24
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Gutema BT, Chuka A, Ayele G, Estifaons W, Melketsedik ZA, Tariku EZ, Zerdo Z, Baharu A, Megersa ND. Tobacco use and associated factors among adults reside in Arba Minch health and demographic surveillance site, southern Ethiopia: a cross-sectional study. BMC Public Health 2021; 21:441. [PMID: 33663469 PMCID: PMC7934440 DOI: 10.1186/s12889-021-10479-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 02/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Tobacco use is one of the world-leading preventable killers. There was a varied prevalence of tobacco use and cigarette smoking across different areas. The aim of the study was to assess the prevalence and factors associated with current tobacco use among adults residing in Arba Minch health and demographic surveillance site (HDSS). METHODS A community-based cross-sectional study was conducted among adults residing in Arba Minch HDSS in 2017. The estimated sample size was 3368 individuals which were selected by simple random sampling techniques using Arba Minch HDSS dataset. Data collection tools were obtained from the WHO STEPwise. Current use of tobacco, which defined as the current use of smoked and/or smokeless tobacco, was considered as the dependent variable. A binary logistic regression model was used to identify candidate variables for the multivariable logistic regression model. An adjusted odds ratio (AOR) at a p-value of less than 0.05 was used to determine a statistically significant association between independent and dependent variables. RESULT The prevalence of tobacco use among adults was 20.2% (95% CI: 18.9-21.6%). The current use of smoked and smokeless tobacco were 17.1% (95%CI: 15.8-18.4%) and 9.7% (95%CI: 8.8-10.8%), respectively. The current use of tobacco was significantly associated with sex (female [AOR 0.54; 95%CI: 0.42-0.68] compared to men), age group (35-44 [AOR 1.57; 95%CI: 1.14-2.17], 45-54 [AOR 1.99; 95%CI: 1.45-2.74], and 55-64 [AOR 3.26; 95%CI: 2.37-4.48] years old compared to 25-35 years old), physical activity (moderate physical activity level [AOR 0.65; 95%CI: 0.44-0.96] compared with low) and residency (highland [AOR 4.39; 95% CI: 3.21-6.01] compared with at lowlander). Also, heavy alcohol consumption (AOR 3.97; 95% CI: 3.07-5.12), and Khat chewing (AOR 3.07(95%CI: 1.64-5.77) were also associated with the use of tobacco among the study participants. CONCLUSION Nearly one in five adults used tobacco currently in the study area, which is more than the national reports. Interventions for the reduction of tobacco use need to give due attention to men, older adults, uneducated, poor, and highlanders.
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia.
- Arba Minch Health and Demographic Surveillance Site (HDSS), Arba Minch, Ethiopia.
| | - Adefris Chuka
- CARE Ethiopia Hawassa Project Office, Hawassa, Ethiopia
| | - Gistane Ayele
- School of Public Health, Arba Minch University, P.O.Box 21, Arba Minch, Ethiopia
- Arba Minch Health and Demographic Surveillance Site (HDSS), Arba Minch, Ethiopia
| | | | | | | | - Zerihun Zerdo
- Arba Minch Health and Demographic Surveillance Site (HDSS), Arba Minch, Ethiopia
- Department of Medical Laboratory Science, Arba Minch University, Arba Minch, Ethiopia
| | - Alazar Baharu
- Arba Minch Health and Demographic Surveillance Site (HDSS), Arba Minch, Ethiopia
- Department of Computer Science, Arba Minch University, Arba Minch, Ethiopia
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25
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Wondimu W, Girma B. Challenges and Silver Linings of COVID-19 in Ethiopia -Short Review. J Multidiscip Healthc 2020; 13:917-922. [PMID: 32982268 PMCID: PMC7502404 DOI: 10.2147/jmdh.s269359] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/17/2020] [Indexed: 01/07/2023] Open
Abstract
Difficult situations bring not only challenges but also fruitful opportunities. The pandemic of COVID-19 by itself and the related governmental or individual level measures have their own challenges and opportunities to the community, which even might be directly or indirectly related to the control and prevention of the pandemic. The silver linings of the pandemic of COVID-19 should be uncovered to encourage the community not only to focus on the black side of the disease but also to enjoy the opportunities. This can contribute to facilitate the control of the disease and avoid the related panics. In this review, we have discussed the challenges of COVID-19 in Ethiopia in terms of health, economy, and social life, and the silver linings in terms of research opportunities, technological transformation, reading culture, and family discussion. The literatures used in this review were published and unpublished articles, reports, and working papers from Google Scholar, PubMed, MedRxiv, BioRxiv, and official websites of national and international organizations.
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Affiliation(s)
- Wondimagegn Wondimu
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia
| | - Bethlehem Girma
- Department of Health Extension Program, Mizan Aman Health Science College, Mizan Aman, Ethiopia
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26
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Wright CM, Nowak AK, Halkett G, Moorin RE. Incorporating competing risk theory into evaluations of changes in cancer survival: making the most of cause of death and routinely linked sociodemographic data. BMC Public Health 2020; 20:1002. [PMID: 32586298 PMCID: PMC7318745 DOI: 10.1186/s12889-020-09084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Relative survival is the most common method used for measuring survival from population-based registries. However, the relative survival concept of ‘survival as far as the cancer is concerned’ can be biased due to differing non-cancer risk of death in the population with cancer (competing risks). Furthermore, while relative survival can be stratified or standardised, for example by sex or age, adjustment for a broad range of sociodemographic variables potentially influencing survival is not possible. In this paper we propose Fine and Gray competing risks multivariable regression as a method that can assess the probability of death from cancer, incorporating competing risks and adjusting for sociodemographic confounders. Methods We used whole of population, person-level routinely linked Western Australian cancer registry and mortality data for individuals diagnosed from 1983 to 2011 for major cancer types combined, female breast, colorectal, prostate, lung and pancreatic cancers, and grade IV glioma. The probability of death from the index cancer (cancer death) was evaluated using Fine and Gray competing risks regression, adjusting for age, sex, Indigenous status, socio-economic status, accessibility to services, time sub-period and (for all cancers combined) cancer type. Results When comparing diagnoses in 2008–2011 to 1983–1987, we observed substantial decreases in the rate of cancer death for major cancer types combined (N = 192,641, − 31%), female breast (− 37%), prostate (− 76%) and colorectal cancers (− 37%). In contrast, improvements in pancreatic (− 15%) and lung cancers (− 9%), and grade IV glioma (− 24%) were less and the cumulative probability of cancer death for these cancer types remained high. Conclusion Considering the justifiable expectation for confounder adjustment in observational epidemiological studies, standard methods for tracking population-level changes in cancer survival are simplistic. This study demonstrates how competing risks and sociodemographic covariates can be incorporated using readily available software. While cancer has been focused on here, this technique has potential utility in survival analysis for other disease states.
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Affiliation(s)
- Cameron M Wright
- Health Economics and Data Analytics, Faculty of Health Sciences, School of Public Health, Curtin University, Kent St, Bentley, 6102, Western Australia. .,School of Medicine, College of Health & Medicine, University of Tasmania, Churchill Avenue, Hobart, Tasmania, 7005, Australia.
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, 6009, Western Australia.,School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Kent St, Bentley, 6102, Western Australia
| | - Georgia Halkett
- Midwifery and Paramedicine, Faculty of Health Sciences, School of Nursing, Curtin University, Kent St, Bentley, 6102, Western Australia
| | - Rachael E Moorin
- Health Economics and Data Analytics, Faculty of Health Sciences, School of Public Health, Curtin University, Kent St, Bentley, 6102, Western Australia.,Centre for Health Services Research, Faculty of Medicine, Dentistry and Health Sciences, School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia
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27
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Negesa LB, Magarey J, Rasmussen P, Hendriks JM. Cardiovascular risk behaviour is an emerging health issue in developing countries: a cross-sectional study. Eur J Cardiovasc Nurs 2019; 18:679-690. [PMID: 31269808 DOI: 10.1177/1474515119861772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Low and middle-income countries are facing a high burden of cardiovascular disease while there is limited availability of resources and evidence to educate and modify lifestyle behaviours in the population as well as to guide policy making. AIM The goal of the present study was to quantify the prevalence of different cardiovascular risk behaviours among patients with known cardiovascular conditions in a developing country. METHODS A hospital-based cross-sectional survey was conducted in two referral hospitals in eastern Ethiopia. Outpatients who had a confirmed diagnosis of cardiovascular disease were recruited for the study. Data were collected through face-to-face interviews with patients using validated tools. RESULTS A total of 287 cardiovascular disease patients was recruited, of which 56.4% were women and 90.2% were urban residents. Most patients had inadequate consumption of fruit and vegetables, 51.6% were physically inactive, 20% were current khat chewers, 19% were current alcohol drinkers and only 1% were current smokers. Approximately one-third (30%) of the patients had one of these risk behaviours, more than half (51.9%) had two, 15% had three and 3.1% had four risk behaviours. The majority (70%) of the patients had multiple (more than two) risk behaviours. The prevalence of multiple risk behaviours did not significantly vary with sex, residence and educational level differences (P>0.05). CONCLUSION Cardiovascular disease patients continue to follow unhealthy lifestyles although they attend follow-up care with a specific focus on risk management. The findings of this study provide evidence for policy makers that health services reform is required to promote healthy lifestyle behaviours for the patients.
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Affiliation(s)
- Lemma B Negesa
- Adelaide Nursing School, The University of Adelaide, Australia.,College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Judy Magarey
- Adelaide Nursing School, The University of Adelaide, Australia
| | | | - Jeroen Ml Hendriks
- Centre for Heart Rhythm Disorders, Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Australia.,Department of Medical and Health Sciences, Linköping University, Sweden
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28
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Diaz A, Baade PD, Valery PC, Whop LJ, Moore SP, Cunningham J, Garvey G, Brotherton JML, O’Connell DL, Canfell K, Sarfati D, Roder D, Buckley E, Condon JR. Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012). PLoS One 2018; 13:e0196764. [PMID: 29738533 PMCID: PMC5940188 DOI: 10.1371/journal.pone.0196764] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/19/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women. METHODS Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+), for Indigenous women compared to non-Indigenous women. RESULTS Of 4,467 women, Indigenous women (4.4%) compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0%) and lower five-year cause-specific survival (60.2% vs. 76.6%). Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality) when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4), indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality. CONCLUSIONS Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted. IMPACT The results highlight the need for cancer care guidelines and multidisciplinary care that can meet the needs of complex patients. Also, primary and acute care services may need to pay more attention to Indigenous Australian women who may not obviously need it (i.e. those without comorbidity).
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Affiliation(s)
- Abbey Diaz
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Peter D. Baade
- Cancer Council Queensland, Spring Hill, Queensland, Australia
| | - Patricia C. Valery
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Lisa J. Whop
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Suzanne P. Moore
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Julia M. L. Brotherton
- Victorian Cytology Service, Carlton, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Dianne L. O’Connell
- Cancer Council NSW, Cancer Research Division, Kings Cross, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Canfell
- Cancer Council NSW, Cancer Research Division, Kings Cross, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Prince of Wales Clinical School, University of NSW, Sydney, New South Wales, Australia
| | | | - David Roder
- Cancer Epidemiology & Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - Elizabeth Buckley
- Cancer Epidemiology & Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - John R. Condon
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
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