Pharmacotherapy Pattern and Treatment Outcomes of Stroke Patients Admitted to Jimma University Medical Center, Ethiopia

Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study

Purpose

Despite the existence of effective medications, pulmonary tuberculosis (PTB) remains a significant global public health concern, The evaluation and feedback of national TB control programs are crucial, requiring diligent monitoring of TB treatment outcomes and analysis of the factors influencing these outcomes. This study aims to provide valuable insights into the challenges faced by TB patients, which can inform better strategies for treatment and management in the future.

Patients and Methods

We conducted a study in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA), from January 1, 2018 to December 31, 2023. The study was a registry-based retrospective cohort study. Patients' data were sourced from the National Tuberculosis Registry database of Saudi Arabia. Treatment outcomes were determined as either success or failure, considering clinical evaluation, changes in chest X-rays, and the results of subsequent sputum examinations during follow-up. To evaluate the data, SPSS version 28.0 was used.

Results

A total of 427 PTB patients participated in the study. The results show successful treatment outcomes among 88.5% of patients. Among the patients, males exhibited a higher likelihood of treatment failure as compared to females (aOR 1.3; 95%Cl 1.2-1.5, p < 0.001). Patients with positive sputum smear (aOR 1.3; 95%Cl 1.1-1.3 p < 0.00) and the presence of cough were associated with an increased risk of treatment failure (aOR1.5; 95%Cl 1.1-1.4, p < 0.001).

Conclusion

This study shows that the percentage of unsuccessful treatment outcomes is high, ie, 11.5%, due to patients' deaths and loss to follow-up. Enhanced supervision and treatment monitoring for tuberculosis patients at high risk of treatment failure can lead to improved treatment success rates in Saudi Arabia.

Treatment outcomes, types, risk factors, and common manifestations of stroke among admitted stroke patients in Ethiopia: Systematic review and meta-analyses

INTRODUCTION

Stroke is the sudden onset of a reduced cerebral perfusion-related localized or widespread neurologic impairment. The two main causes of poor treatment outcomes are uncontrolled blood pressure and hospital arrival delays. Identifying the risk factors, types of stroke presentation, and treatment options might be used in the prevention, early detection, and management of stroke to provide the best care to patients.

OBJECTIVE

This systematic review and meta-analysis aimed to assess the treatment outcomes, types, and risk factors of stroke patients in Ethiopia.

METHODS

A variety of databases were searched, including African Journals Online (AJOL), Google Scholar, Scopus, EMBASE (Ovid), and HINARI, and published and unpublished articles from the Ethiopian Universities repository. To pool the outcome variables, a weighted inverse variance random-effects model at 95% Cl was employed. Heterogeneity and publication bias were assessed using Cochrane I2 statistics and Egger's test with funnel plot, respectively. A subgroup analysis was conducted based on sample size, case definition, and region to detect source of heterogeneity.

RESULT

This study contained data from 26 studies, involving 6291 study participants, from different regions of Ethiopia. Out of 19 articles with I2 = 96.1%, p<0.001, the pooled prevalence of improved stroke treatment outcome was 47.50% (95% CI: 40.20-54.80), while the prevalence of mortality was 18.95% (95% CI: 15.62-22.29) from 19 articles with I2 = 87.9%, p<0.001. In Ethiopia, ischemic stroke accounted for 59.34% of all stroke cases (95% CI: 53.73-64.95). Among risk factors, substance abuse ranked second at 36.58% (95% CI: 25.22-47.93), after hypertension at 50.90% (95% CI: 43.77-56.27). According to the findings, hemiparalysis or hemiplegia was mentioned as a frequent clinical sign associated with stroke (56.87%) (95% CI: 45.65-68.06).

CONCLUSION

The improved treatment outcome was not satisfactory, and the most common type of stroke was an ischemic stroke. Hypertension was the most common risk factor, followed by substance use. As a result, there should be a strengthening of post-stroke care and the creation of awareness about the risk factors and clinical manifestations for prevention and early detection of stroke in Ethiopian people.

Clinical characteristics and short-term outcomes of adult stroke patients admitted to Jimma Medical Center, Ethiopia: a prospective cohort study

Introduction

sub-Saharan African countries are facing a rapid increase in stroke incidence and mortality. However, there is a paucity of clinical studies on the burden of stroke and its short-term outcomes. Hence, this study is aimed at evaluating risk factors, clinical characteristics, management, and 28-day clinical outcomes among stroke patients.

Methods

a prospective observational study was conducted at Jimma Medical Center, Ethiopia from July 2020 to January 31^st, 2021. All adult patients diagnosed with stroke were enrolled consecutively and followed for 28 days starting from admission. Data were analyzed using SPSS version 23 and Multivariable cox regression was used to identify factors associated with 28-day all-cause mortality.

Results

among 153 patients enrolled in this study, 127 (83%) had brain CT-scan and hemorrhagic stroke accounts for 66 (52%). About half 81 (53%) of the participants were male and the mean age was 57 years. Regarding in-hospital management, antihypertensive, statins, and aspirin was given to 80 (52%), 72 (47%), and 68 (44%) patients respectively. The overall in-hospital mortality rate was 26 (17%) and the all-cause 28-day mortality rate was 39 (25.5%). Rural residence [adjusted Hazard Ratio (aHR): 2.93, 95% Confidence Interval (CI): 1.46-5.81], aspiration pneumonia (aHR= 6.57, 95% CI=3.16-13.66) and increased intracranial pressure (aHR= 3.27, 95% CI=1.56-6.86) were associated with 28-day mortality.

Conclusion

the patients admitted to the hospital with stroke diagnosis had high short-term mortality. Strategies focused on increasing timely arrival and evidence-based management of stroke and its complications could improve stroke patient outcomes.