Assessment of traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia

CONTEXT

Although pharmaceutical equipment and medical supplies play a vital role in the quality of traditional medicines, they have not received much attention from stakeholders and researchers nationally and internationally.

OBJECTIVE

This study assesses traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia.

MATERIALS AND METHODS

A quantitative cross-sectional study was conducted on 70 traditional healers. The data were collected using an interview-based questionnaire. The collected data were checked and entered into Statistical Package for Social Sciences version 25.0 for analysis. The results were presented as percentages. The association between socio-demographic characteristics and traditional healers' knowledge of pharmaceutical equipment and medical supplies was examined using Pearson's Chi-squares test.

RESULTS

About 90% of traditional healers had information about pharmaceutical equipment and medical supplies, and currently 80% of them used different pharmaceutical equipment and medical supplies individually and in combination with traditional equipment. Although most traditional healers used different pharmaceutical equipment and medical supplies, only 13.3% of them used equipment and supplies a day. Only 15% of traditional healers continuously cleaned their equipment. None of the socio-demographic variables were significantly associated to the knowledge of pharmaceutical equipment and medical supplies.

DISCUSSION AND CONCLUSIONS

Pharmaceutical equipment and medical supplies used by traditional healers was inconsistent, mainly associated with their habit of using self-prepared and home-available equipment. Moreover, the checkup status of compounding equipment was poor. As Traditional healers provide high-patient care services, emphasis should be given to improving their preparation and treatment strategies.

Tuberculosis treatment outcomes and associated factors among tuberculosis patients treated at healthcare facilities of Motta Town, Northwest Ethiopia: a five-year retrospective study

Tuberculosis (TB) remains a significant public health concern, particularly in low-resource settings. The treatment outcome is a crucial indicator of the effectiveness of TB treatment programs. Assessing the current treatment outcome and its associated factors is essential for improving patient care and reducing the spread of TB. Therefore, this study aimed to assess TB treatment outcomes and their associated factors among TB patients who received treatment at public healthcare facilities in Motta Town, Northwest Ethiopia. A facility-based retrospective cross-sectional study design was employed in two TB treatment centers in Motta town from January 2017 to December 2021. The study participants were all patients diagnosed with TB who received treatment. A p-value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance. A total of 362 TB patients were included in the study. The overall treatment success rate was 88.4% (95% CI 85.1, 91.7). Male gender (AOR = 2.40, 95% CI 1.16, 4.98), normal nutritional status (AOR = 3.11, 95% CI 1.33, 7.25), HIV negative status (AOR = 3.35, 95% CI 1.31, 8.60), and non-presumptive drug resistance to TB (AOR = 3.72, 95% CI 1.74, 7.98) were significantly associated with successful TB treatment outcomes (p < 0.05). In the current study, nine out of ten study participants had successful TB treatment outcome rates. Male gender, normal nutritional status, non-presumed drug resistance to TB, and HIV-negative status were significantly associated with successful TB treatment outcomes. By taking risk factors associated with poor treatment outcomes like those found in this study into account, patient management and treatment can be optimized. Sufficient TB control measures for populations are imperative and could significantly reduce the nation's total TB burden.

Patients' Preference for Pharmaceutical Dosage Forms: Does It Affect Medication Adherence? A Cross-Sectional Study in Community Pharmacies

Background

Dosage forms (DF), which are primarily divided into solid, semisolid, liquid, and gaseous, are among the different factors that influence drug adherence. Thus, the purpose of this study was to evaluate how patients' preferences for pharmaceutical DF affected their adherence to medication in community pharmacies in Gondar town.

Methods

A cross-sectional study on community pharmacies was carried out from June 25 to July 27, 2023. The statistical package for social sciences, version 26, was used for data analysis. Factors associated with patient medication discontinuation were found using both bivariate and multivariate logistic regressions.

Results

According to our study, the majority of respondents (42.4%) preferred tablet DF. Most respondents (63.9%) DF preference was affected by the size of the medication, in which small-sized were most preferable (59.6%). The oral route of administration was the most preferable (71.2%). The majority of the respondents (59.9%) had a history of discontinuation of medicines. Being male (AOR=2.21, 95% CI: 1.29, 3.79), living in rural areas (AOR=1.98, 95% CI: 1.03, 3.83), types of DF (AOR=4.59, 95% CI: 1.28, 16.52), high frequency of administration (AOR=2.22, 95% CI: 1.08, 4.57), high cost of medication (AOR=3.09, 95% CI: 1.69, 5.68), getting some improvement from illness (AOR=3.29, 95% CI: 1.10, 9.87), and high number of drugs (AOR=3.29, 95% CI: 1.67, 13.85) were significantly associated with medication discontinuation.

Conclusion

Our findings showed that tablet dosage forms, oral routes of administration, and once-daily taking of medicines were the most preferred by our respondents. Being male, living in rural areas, types of DF, high frequency of administration, high cost of medication, getting some improvement from illness, and high number of drugs were significantly associated with medication discontinuation. This provides an insight into what to consider when prescribing medicine to enhance patients' adherence and overall therapeutic outcomes.

Knowledge and Attitudes of Graduating Medical, Pharmacy, and Nursing Students Toward Geriatric Care at the College of Medicine and Health Sciences, University of Gondar, North West Ethiopia

Background

The education and training of health professions students in geriatric care is critical to their future clinical practice. However, the knowledge and attitude of health science students toward geriatric care are barely studied in Ethiopia.

Objective

This study aimed to assess the knowledge and attitude of graduating medical, pharmacy, and nursing (MPN) students towards geriatric care at the College of Medicine and Health Sciences, University of Gondar, North West Ethiopia.

Methods

A cross-sectional study was conducted among 301 graduating MPN students using stratified random sampling from June 30, 2022, to July 30, 2022. The data was collected by using previously validated self-administered structured questionnaires and analyzed using SPSS version 26. Both descriptive and inferential statistics were done. A statistical significance was declared at a p-value < 0.05.

Results

The majority of graduating MPN students had either neutral (70.76%) or positive (16.28%) attitudes towards older people; however, a greater amount (88%) of them had poor knowledge of geriatric care. The knowledge of female students was significantly less favorable than the knowledge of male students (p-value < 0.001). The knowledge and attitudes of pharmacy and nursing students were significantly lower than medical students (p-value < 0.001). The attitude mean rank score of students aged ≤25 years was significantly lower than students aged >25 years (p-value < 0.001).

Conclusion

The majority of graduating MPN students had poor knowledge despite having either a neutral or positive attitude toward geriatric care. Female students had lower knowledge scores than male students. Similarly, pharmacy and nursing students had lower knowledge and attitude scores than medical students, and the attitude score of students aged ≤ 25 years was lower than students aged >25 years. Their respective departments should implement a strategy to improve the knowledge of MNP students.

Determine the perceived level of involvement and factors affecting diabetes management by community pharmacy professionals at drug retails in northwestern amhara region, Ethiopia

Background

Pharmacists in community drug retail outlets (CDROs) have significant involvement in diabetes prevention and management by providing more direct interventions in medication education, preventive measures, and disease management. This study examined the perceived level of involvement of community pharmacy professionals (CPPs) in diabetes management at CDROs in Northwest Ethiopia.

Methods

A multicenter cross-sectional study was conducted among CPPs in Northwest Ethiopia between September 1 and 30, 2022. The Statistical Package for Social Science (SPSS) version 26 was used to analyzed the data, which had been gathered using a self-administered structured questionnaire. An independent sample t-test and one-way ANOVA were used to examine the mean perceived involvement score difference between CPPs. The association between CPPs' involvement and other sociodemographic variables was examined using linear regression analysis. At a 95% confidence interval (CI), a p-value <0.05 was considered statistically significant.

Results

The study included 184 (94.3%) of 195 CPPs approached. The overall mean perceived involvement score of CPPs in diabetes management was 3.80 ± 0.63 out of 5. CPPs with a bachelor's degree or higher [β = 3.065, 95% CI: 2.704, 3.641; p < 0.001], CPPs with a higher monthly income (≥5000 ETB) [β = 0.242, 95% CI: 0.112, 0.596; p = 0.034], and those who provided more than 8 hours of service per day [β = 0.163, 95% CI: 0.051, 0.332; p = 0.043] had higher perceived involvement in the management of diabetes compared with their counterparts.

Conclusions

This study found that most CPPs had a high level of perceived involvement in diabetes management. Higher educational backgrounds, a higher monthly salary, and working longer hours were associated with an increased level of perceived involvement. Promoting the educational background of CPPs may be crucial to enhance their active involvement in the management of diabetes.

Assessment of pain management adequacy among hospitalized pediatric patients: institutional-based cross-sectional study

Background

As the evidence showed, despite the magnitude of the effects that pain can have on a child, it is often inadequately assessed and treated. However, whether pain is adequately treated or not, evidence is lacking in the study setting.

Objectives

This study assessed pain management adequacy among hospitalized pediatric patients at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.

Methods

An institution-based cross-sectional study was conducted among pediatric patients admitted to the University of Gondar Comprehensive and Specialized Hospital between June and August 2021. Eligible patients were enrolled in the study using consecutive sampling techniques. Data were collected using a structured interview-based questionnaire and a review of the patient's medical records that were prepared after reviewing earlier studies. Pain management adequacy was determined using the pain management index (PMI) score. Statistical Software for Social Sciences (SPSS) version 22 was used for data entry and analysis. Descriptive statistics such as frequencies, percentages, and means with standard deviation were used to describe the respective variables. Logistic regression was used to assess predictor variables of pain management adequacy. A p-value <0.05 at a 95% CI was considered statistically significant.

Results

Of the 422 participants enrolled in the study, most (58.1%) were males, with a mean age of 3.9 ± 0.8 years. Pain medication was prescribed to 62.8% (95% CI: 57.3-68.2) of the participants. About 63.3% (95% CI: 58.8%-68%) received inadequate analgesics. The type of painkillers administered also did not match the severity of the pain. Pediatric patients less than 1 month and between 1 month and 1 year (AOR = 2.891, 95% CI: 1.274-12.899 and AOR = 2.657, 95% CI: 1.350-5.175), respectively, and patients with severe and moderate levels of pain (AOR = 3.448, 95% CI: 1.902-6.251 and AOR = 5.345, 95% CI: 1.956-9.828), respectively, were found to have inadequate pain medication compared with their counterparts.

Conclusion

This study revealed that pain was hardly managed based on its severity. Overall, two-thirds of pediatric patients received inadequate pain medication. This indicates majority of patients experienced pain did not manage appropriately.

Evaluation of Antibiotics Residues in Milk and Meat Using Different Analytical Methods

Veterinary drugs are pharmacologically and biologically active chemical agents. At present, veterinary drugs are extensively used to prevent and treat animal diseases, to promote animal growth, and to improve the conversion rate of feed. However, the use of veterinary drugs in food-producing animals may leave residues of the parent compounds and/or their metabolites in food products resulting in harmful effects on humans. To ensure food safety, sensitive and effective analytical methods have been developing rapidly. This review describes sample extraction and cleanup methods, and different analytical techniques are used for the determination of veterinary drug residues in milk and meat. Sample extraction methods, such as solvent extraction, liquid-liquid extraction, and cleanup methods such as dispersive solid-phase extraction and immunoaffinity chromatography, were summarized. Different types of analytical methods such as microbial, immunological, biosensor, thin layer chromatography, high-performance liquid chromatography, and liquid chromatography-tandem mass spectrometry were discussed for the analysis of veterinary drug residues in animal-derived foods. Liquid chromatography-tandem mass spectrometry is the most widely used analytical technique for the determination of antibiotic drug residues. This is due to the powerful separation of LC and accurate identification of MS, and LC-MS/MS is more popular in the analysis of veterinary drug residues.

Assessment of Knowledge, Attitudes, and Practices of Traditional Healers toward Dosage Forms and Routes of Administration: A Cross-Sectional Study in Ethiopia

Methods

A cross-sectional study design was conducted on 70 traditional healers from June 1, 2022 to July 25, 2022. The data were collected through structured questionnaires. The data were checked for completeness and consistency and then entered into SPSS version 25.0 for analysis. The results were presented with frequencies and percentages. The association between sociodemographic factors and traditional healers' knowledge of dosage forms and route of administration was determined using the Pearson's chi-squares test. A statistically significant difference was declared if the p value was 0.05 or lower.

Results

Most (58.1%) traditional healers had information on dosage forms, especially about solid, semisolid, and liquid dosage forms. In addition, 33 (53.2%) traditional healers had information about rectal, nasal, and oral route of administration. All traditional healers had practiced different dosage forms and route of administration both individually and in combination earlier to date. More than half of the participants agreed on the need for different dosage forms and route of administration. This study result also showed that most (72.6%) traditional healers had gaps in sharing experiences and information with other healers and health professionals.

Conclusions

The current study revealed that solid, semisolid, and liquid were the most frequently formulated dosage forms with oral, rectal, and nasal route of administration by traditional healers. The practice of checking the status of the formulations was poor. Traditional healers had a good attitude towards the need for different dosage forms and route of administration. The stakeholders should provide continuous training and exchange of experiences between traditional healers and healthcare professionals to improve the knowledge of traditional healers for appropriate use of dosage forms and route of administration.

Clinical and economic impact of adverse drug reactions in hospitalised patients: prospective matched nested case-control study in Ethiopia

OBJECTIVES

The purpose of this study was to assess the clinical and economic impact of adverse drug reactions (ADRs) among patients admitted to the University of Gondar Comprehensive Specialized Hospital (UoGCSH).

DESIGN AND SETTING

A prospective nested case-control study was conducted at the UoGCSH among admitted adult patients with (cases) and without ADRs (controls) between May and October 2022.

PARTICIPANTS

All eligible adult patients admitted in the medical ward of the UoGCSH during the study period were included in this study.

MAIN OUTCOME MEASURES

The outcome variables were the clinical and economic outcomes. Length of hospital stay, visits to intensive care units (ICU) and in-hospital mortality were used to measure and compare clinical outcomes in patients with and without ADRs. The economic outcome was also assessed using direct medical-related costs and compared for the two groups. Paired samples t-test and McNemar tests were used to compare measurable outcomes between the two groups. A p value <0.05 at the 95% CI was considered statistically significant.

RESULTS

Out of a total of 214 eligible enrolled patients, 206 (103 with and 103 without ADRs) with a 96.3% response rate were included in the cohort. The length of hospital stay was much longer in patients with ADRs than without ADRs (19.8 vs 15.2 days, p<0.001). Similarly, ICU visits (11.2% vs 6.8%, p<0.001) and in-hospital mortality (4.4% vs 1.9%, p=0.012) were significantly higher in patients with ADRs compared with those without ADRs. Patients with ADRs were significantly charged with higher direct medical costs compared with those without ADRs (6237.2 vs 5256.3 Ethiopian birr; p<0.001).

CONCLUSION

This study concluded that ADRs had a significant impact on patients' clinical and medical costs. Healthcare providers should strictly follow the patients to minimise ADR-related clinical and economic adverse outcomes.

Are pediatrics taking the prescribed tablet dosage form? Practices of off-label tablet modification in pediatric wards: A prospective observational study

Tablet manipulation (modification) is a practice where the licensed tablet product is customized into reduced fractions of doses or changed into dispersions using solvents because of suitable dose for paediatrics and neonates are frequently unavailable. As a result, unlicensed dosage form frequently used after manipulation, outside what is approved by drug regulatory authorities.

Objective

To assess the practice of off-label tablet manipulation in pediatric and neonatal wards at selected public hospitals in Ethiopia.

Methods

A prospective, direct observational approach was used to investigate the frequency, nature and appropriateness of tablet manipulations in neonatal and pediatrics patients of two public hospitals of Ethiopia from April 12, to June 30, 2021.

Results

During the study period a total of 303 tablet manipulations were observed. Two hundred nine (69%) of tablets were dispensed to pediatric patients to be taken after split into lower strengths. The remaining nighty four (31%) tablets were manipulated into dispersion using 0.9% normal saline as a main solvent. Interestingly, 48 (15.8%) of tablet manipulations into dispersions involved practically insoluble drugs whose manipulation may probably affect their bioavailability. In 12.5% (12/94) dispersion manipulations, large undissolved fractions were observed during administration through naso-gastric tubes. The most commonly manipulated tablets were drugs for central nervous system (n = 135, 44.6%) followed by cardiovascular drugs (n = 85, 28%).

Conclusions

and recommendations: The study revealed the off-label use of tablets for pediatrics age groups is very common in Ethiopia. Evidence-based guidelines for tablet manipulations should be practiced to improve the safety of paediatric drug use. As for policy implication, this study concurs with previous scientific recommendations that manufacturers introduce a wide range of dosage forms to reduce the need for manipulations.

Extent of cardiovascular medications dispensing practice without a prescription: Self-reported and simulated patient-based study at community pharmacies in Northwest Ethiopia

BACKGROUND

Critical actions are required for the proper administration of medications to patients with cardiovascular diseases. However, there has been an increase in irrational use of cardiovascular drugs. The purpose of this study was to determine the extent of non-prescription cardiovascular medicine dispensing practices at community drug retail outlets (CDROs) in Gondar, Northwest Ethiopia.

METHODS

A cross-sectional survey and simulated patient-based visits were employed at the CDROs in Gondar City, Northwest Ethiopia between June 1 and July 20, 2022. The cross-sectional component that assessed the self-reported practices used a standardized self-reported questionnaire. A simulated patient (SP) case scenario, using different tracer prescriptions only for cardiovascular medications, allowed for the observation of real-world dispensing procedures. SPSS version 22 was used for the data entry and analysis.

RESULTS

The cross-sectional study approached 76 CDROs, and 71 of them agreed to take part (93.4% response rate). More than half of the respondents (53.5%) were males, with a mean (SD) age of 33.5 ± 9.1 years. Overall, the current self-reported survey showed that 59.2% of the participants provided cardiovascular drugs without a prescription. A total of 213 simulated visits were conducted. Considering all SP scenarios, the percentage of cardiovascular drugs dispensed without a prescription increased to 88.7%. Besides, more than 90% of pharmacists did not demand the SP to have a prescription, did not advise them to visit doctors or clinics, and did not inquire as to whom the medication was required.

CONCLUSION

A significant proportion of CDROs dispensed cardiovascular medications without a prescription. The findings highlight the disparity between self-reported and actual CDRO practices. Additionally, nearly all of the CDROs approached made it simple to obtain cardiovascular medications. Stakeholders could adherently follow the CDROs' practices to improve their proper dispensing procedures.

Ethnobotanical uses, phytochemistry and biological activity of the genus Euclea: A review

Euclea (Ebenaceae) is a genus of flowering shrubs and trees widely distributed in Africa, the Comoro Islands, and Arabia. This review aimed to evaluate the ethnobotanical uses, phytochemistry, and biological activities of the genus Euclea on available research reports. This was achieved through PubMed, Medline, Google Scholar, Science Direct, Taylor and Francis Online, Wiley Online Library which provides access to scientific and medical research. The extensive literature survey revealed that plants that belong to this genus are used as folkloric medicine for the treatment of diabetes mellitus, toothache, diarrhea, cancer, malaria, leprosy, and genital and oral diseases in the case of HIV/AIDS-related diseases. To date, more than 40 secondary metabolites have been isolated and identified from these plants, especially from E natalensis and E. divinorum. Among these, naphthoquinones, terpenes, and flavonoids are potential secondary metabolites with profound biological activities. Euclea plant extracts and their bioactive compounds possess outstanding pharmacological properties, especially antimalarial, antidiabetic, anticancer, antimicrobial, and antioxidant properties.

Assessment of community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer health promotion services: a cross-sectional study

INTRODUCTION

The role of community pharmacy professionals has been expanded to patient care and health promotion service globally. However, in Ethiopia, there is a scanty of data on the issue, although the country is dealing with a double burden of non-communicable and communicable diseases.

OBJECTIVES

This study aimed to assess community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer extended services for health promotion in Injibara town, Amhara, Ethiopia.

METHODS

A cross-sectional study was conducted among licensed and registered community pharmacy professionals working in Injibara town from June 25 to July 10, 2022. A structured self-administered questionnaire was used to collect data. The data were presented using descriptive statistics. The data were analyzed using STATA version 16 software.

RESULTS

A total of 24 community pharmacy professionals were involved in the study, with a response rate of 92.3%. Approximately 91.7% of them were involved in health promotional services. Of them, 54.1% were willing and strongly believed that their involvement in health promotion services would have a positive impact on promoting health. A total of 60.9% of the community pharmacy professionals reported that they were very involved in family planning and alcohol consumption counseling. Different barriers to not providing health promotion services were also cited.

CONCLUSIONS

Majority of community pharmacy professionals in this study is involved in health promotional services but there are also barriers on their involvement. Therefore, governmental strategies to overcome the barriers that hamper their involvement should be designed.

Perceived stress and associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic: A cross-sectional study

Background

During extensive outbreaks of infectious diseases, people who are impacted, particularly the subgroups of the community who are at an increased risk of mental health problems, may experience increased stress and mental health difficulties. University students are one such susceptible population and are prone to experiencing high levels of stress as compared with the general population. Therefore, this study aimed at assessing perceived stress and identifying its associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among university students in Ethiopia from 30 May to 30 June 2021. Students were asked to fill out an online survey on Google Forms that included consent, sociodemographic information, the UCLA-8 Loneliness Scale, the standard validated stress scale (PSS-10) questionnaire, and the three-item Oslo Social Support Scale (OSSS-3) to assess social support. The collected data were exported to SPSS 26. Descriptive and analytical statistics were carried out. Binary and multiple logistic regression analyses were performed to find associated factors, and variables with a p-value of 0.05 were considered statistically significant variables.

Results

A total of 426 university students were included in the survey, among whom 268 (62.9%) were male participants. The age of the participants ranged from 18 to 37 years. Health-related departments accounted for 37.1% of the participants, while non-health-related departments accounted for 62.9%. The prevalence of stress was 18.3% in the study population. In this study, extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy to prevent COVID-19, and loneliness were significantly associated with perceived stress.

Conclusion

Stress was prevalent among university students in Ethiopia during the late stage of the COVID-19 pandemic. Extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy, and loneliness were identified as factors for stress. Therefore, we suggest that universities should provide opportunities for safe social connection, counseling, and guidance for students.

Assessment of prescribing errors reported by community pharmacy professionals

Background

Medication errors have serious consequences for patients’ morbidity and mortality. The involvement of pharmacy professionals in the prescribing and dispensing procedure allowed the detection of a range of drug-related problems in addition to identification by prescribers. They are often the first point of contact in the healthcare system in identifying prescribing errors and intervening in these errors by dealing with the prescribers and the patients.

Objectives

This study aimed to assess prescribing errors reported by community pharmacy professionals in Gondar Town, North West Ethiopia.

Methods

A self-administered cross-sectional survey was employed from February 29 to June 23, 2020, to collect data on prescribing errors reported by community pharmacy professionals. All community pharmacy professionals found in Gondar town were included. Community pharmacy professionals who were ill at the time of study and who had less than 6 months of work experience were excluded.

Results

Seventy-four pharmacy professionals participated in the study with a response rate of 93.6%. The overall prevalence of prescribing errors was 75.1% (95% CI 71.08–78.70). Of these errors, drug selection was the most common (82.4%), followed by errors of commission (79.7%) and errors of omission (78.4%). Antibiotics (63.5%) were commonly involved in prescribing errors, followed by analgesics (44.5%) and antipsychotics (39.5%).

Conclusion

The findings of this study revealed a high prevalence of prescribing errors in Gondar, Ethiopia. Drug selection was the most prescribed error, followed by errors of commission. Stakeholders should design interventions such as training, integrating prescribers with clinical pharmacists and supervising interns by seniors. Large-scale studies that include potential factors of prescribing problems are recommended for future researchers.

Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia

Background

Medication nonadherence in patients with chronic diseases, particularly in type 2 diabetes mellitus (T2DM) with comorbidity, has continued to be the cause of treatment failure. The current study assessed medication adherence and its impact on glycemic control in T2DM patients with comorbidity.

Methods

An institutional-based multicenter cross-sectional study was conducted among T2DM patients with comorbidity at the selected hospitals in Northwest Ethiopia. Medication adherence was measured using a structured questionnaire of the General Medication Adherence Scale (GMAS). A logistic regression model was used to identify predictors of the level of medication adherence and glycemic control. P < 0.05 at 95% confidence interval (CI) was statistically significant.

Results

A total of 403 samples were included in the final study. This study showed that more than three-fourths (76.9%) of the participants were under a low level of medication adherence. Source of medication cost coverage [AOR = 10.593, 95% CI (2.628–41.835; P = 0.003], monthly income (P < 0.00), self-monitoring of blood glucose (SMBG) practice [AOR = 0.266, 95% CI (0.117–0.604); P = 0.002], number of medications [AOR = 0.068, 95% CI (0.004–0.813); P = 0.014] and medical conditions [AOR = 0.307, 95% CI (0.026–0.437); P = 0.018] were found to be significant predictors of medication adherence. Significantly, majority (74.7%) of participants had poor levels of glycemic control. Patients who had a high level of medication adherence [AOR = 0.003, 95% CI (0.000–0.113); P = 0.002] were found less likely to have poor glycemic control compared with patients who were low adherent to their medications.

Conclusion

The current study concluded that medication adherence was low and significantly associated with poor glycemic control. Number of medical conditions and medications were found to be associated with medication adherence. Management interventions of T2DM patients with comorbidity should focus on the improvement of medication adherence.

COVID-19 vaccine hesitancy among health professionals in a tertiary care center at the University of Gondar Specialized Hospital, Ethiopia: A cross-sectional study

Background

COVID-19 is a highly communicable disease that can be transmitted from animal-to-human and human-to-human contacts. It is still now a major global threat for which vaccination remains the ultimate solution to protect it, especially healthcare professionals are the first frontiers to fight against the COVID-19 virus which makes them at higher risk of this disease. Therefore, to reduce the spread of COVID-19, we need to improve the acceptance of COVID-19 vaccines is crucial. The aim of this study was to assess the vaccine hesitancy of the COVID-19 vaccine among health professionals who worked at the University of Gondar Specialized Hospital.

Methods

A cross-sectional survey was conducted between 1 May and 10 June 2021. And the data were analyzed using Statistical Package for Social Sciences version 26. A chi-square test was conducted and to assess the associations between socio-demographic characteristics, perceived risk of COVID-19, attitude, and acceptance of COVID-19 vaccine, a p-value of less than 0.05 was considered to declare statistical significance.

Results

We surveyed 319 health professionals with a response rate of 67.87%. Of these, 74.9% (239) were male, and 81.2% (259) of health professionals were perceived exposed to COVID-19 without testing. 87.7% of respondents would like to vaccinate their parents. 66.2% (208) of them have accepted the COVID-19 vaccine. 54.85% (175) of health professionals had a good attitude and 45.8% (146) of health professionals were received the first-round COVID-19 vaccine.

Conclusion

This study showed that more than 60% of health professionals had good acceptance of COVID-19 vaccination during the pandemic period. Regarding vaccine safety profile may reduce the vaccination in the future. To increase vaccine uptake in response to the COVID-19 pandemic, COVID-19 vaccination programs should be redesigned to remove barriers to vaccine acceptance. Knowledge and attitude toward the COVID-19 vaccine should be promoted.

Availability of Essential Antidotes and the Role of Community Pharmacists in the Management of Acute Poisoning: A Cross-Sectional Study in Ethiopia

Background

Morbidity and mortality related to acute poisoning is a major public health issue in both developing and developed countries. Community pharmacists have a crucial role in ensuring drug availability, increasing drug safety, counseling patients, overdose risk reduction and management, and provision of appropriate drug information. This study aimed to assess the availability of necessary antidotes in community pharmacies in Gondar and Bahir-Dar cities, Ethiopia, and the role of community pharmacists in the management of acute poisoning.

Methods

A cross-sectional survey was conducted in Gondar and Bahir-Dar cities. A self-administered, structured questionnaire was used for data collection and Statistical Package for Social Sciences (SPSS) version 24.0 was used for data analysis. Chi-square analysis was computed to identify the associated factors with a confidence interval of 95% and a P value less than .05 was used as a cut-point for statistical significance.

Results

Out of 101 community pharmacies invited to participate in the study, 80 of them completed the survey with a response rate of 79.2%. The overall mean antidote availability score was .59 (SD = .837), which falls within the definition of Poor availability. None of the pharmacies had kept all of the antidotes, and the maximum number of an antidote kept by a single pharmacy was 7 out of nineteen essential antidotes surveyed. The most commonly reported reason for the unavailability of essential antidotes was stock was not ordered (56.3%) followed by stock ordered but not delivered from suppliers (wholesalers) (20.0%). More than 3 fourth of the respondents (83.8%) had poor knowledge about the antidotes for the common poisonings.

Conclusion

There was a significantly very low availability of essential antidotes in the community pharmacies. Strategies should be implemented to improve pharmacist’s knowledge about antidotes, and management of poisoning emergencies through on-job training and provision of reference materials.

Compliance of Private Pharmacy Retail Outlets to Narcotic Drug Regulations in Ethiopia: A Cross-Sectional and Simulated Client Study Method

Background:

Inappropriate use of narcotic drugs is a growing worldwide health challenge. The problem is even worse in Sub-Saharan Africa where organized supply chain regulations on dispensing and stock management are poor for controlling these global challenges.

Methods:

A mixed method, descriptive cross-sectional and simulated client study design was used from September 10, 2020 to November 26, 2020 to assess the extent of utilization and compliance of narcotic drug dispensing in private pharmacy retail outlets of Gondar and Bahir Dar town of Amhara region, Ethiopia. A total of 107 private pharmacy outlets were on duty. But in simulated study, purposive sampling is a method that prioritizes study units having the data of interest.

Results:

A total of 107 private pharmacy retails outlets were included in the survey. The average compliance to the controlled prescription regulation of Ethiopia in all pharmacy outlets (107) of the five drugs were calculated and found to be poor, 23.9% (SD = 18.3%). Compliance to strong narcotics is extremely low, 3.3 % for pethidine and 8% for morphine. Religion of the professionals has significant association with compliance to the prescription of narcotic drugs (p < .001).

Discussion:

In the era of narcotic epidemics, as a result of growing global inappropriate use of controlled drugs, the finding of this study gives an insight for a serious and strict regulation in managing and controlling the overall distribution of the narcotic drugs.

Conclusions:

The compliance of the private retail pharmacies of Ethiopia to the regulation of controlled drugs is low.

Impact of Personal, Cultural and Religious Beliefs on Medication Adherence among Patients with Chronic Diseases at University Hospital in Northwest Ethiopia

BACKGROUND

Subjective beliefs about chronic disease conditions and their drug management are among factors determining adherence to medications that are amenable to interventions. Patient-level factors such as personal, cultural, and religious beliefs about diseases, and medication use may have a significant impact on medication adherence. The purpose of this study was to assess the impact of personal, cultural and religious beliefs on medication adherence behavior among patients with chronic follow-up.

PATIENTS AND METHODS

An institutional-based cross-sectional study design was conducted among chronic ambulatory patients from July to August 2021. The data was collected through an interviewer administered questionnaire. Initially stratified sampling technique was used to include proportional participants from different disease conditions, and systematic random sampling was employed to enroll eligible patients from each subgroup. Descriptive statistics such as frequencies and percentages were computed for categorical variables and mean with (standard deviation ±SD) used for continuous variables. Logistic regression model was employed to determine variable with poor adherence. A 95% confidence interval with P-value ≤0.05 was used to declare statically significance.

RESULTS

Among the 404 participants, more than half (51%) were males. The mean (±SD) age of the patients was 47.8 ± 14.8 years. Patients with strong belief in the harm of medications were found 4 times more likely to have poor medication adherence than those with weak belief in the harm of medications (AOR = 4.027, 95% CI:1.232-13.161, P = 0.021). In contrast, having strong personal belief regarding the necessity of medications were found to be less likely to have poor medication adherence (AOR = 0.368, 95% CI: 0.220-0.615, P < 0.001).

CONCLUSION

This study generalized that most of the patients were poor adherent to their medications. Personal beliefs were found to influence medication adherence of the patients. Future studies could be needed to explore and identify how these factors affect patients' medication adherence.

In vivo hypoglycemic, antihyperglycemic and antidyslipidemic effects of the solvent fractions of Hagenia abyssinica leaves in mice

Background

Hagenia abyssinica leaves have been used traditionally for the management of different diseases including diabetes mellitus (DM) although the antidiabetic effect of different solvent fractions of hydromethanol H. abyssinica leaf extract has not been scientifically studied. Thus, this study was conducted to investigate the in vivo hypoglycemic, antihyperglycemic and antidyslipidemic effects of the solvent fractions of Hagenia abyssinica leaf extract.

Methods

The antidiabetic effect of the solvent fractions was evaluated in normal, oral glucose loaded and streptozotocin-induced diabetic mice. Hypoglycemic, antihyperglycemic, antidyslipidemic activities and effect on body weight change were evaluated after administration of three different doses of the solvent fractions (100, 200, and 400 mg/kg). One-way ANOVA followed by Tukey's post hoc test was used for data analysis, and p<0.05 was considered as statistically significant.

Results

The crude hydromethanol extract of H. abyssinica leaves did not show any sign of toxicity at the dose of 2000 mg/kg in mice. In normoglycemic mice, both aqueous and ethyl acetate fractions of H. abyssinica leaves showed significant (P<0.05) hypoglycemic activity. In oral glucose loaded mice, the two doses of the aqueous fraction, 200 mg/kg (p<0.05) and 400 mg/kg (p<0.001), showed a significant antihyperglycemic effect at 60 and 120 minute post-oral glucose loading while the ethyl acetate fraction showed significant antihyperglycemic effect at 60 (P<0.05 for 200 mg/kg and P<0.001 for 400 mg/kg) and 120 min (P<0.01 for 400 mg/kg) post-oral glucose loading. In single dose-treated diabetic mice, all doses of the solvent fractions caused a significant (P<0.05) reduction in blood glucose level except 100 mg/kg of the aqueous and chloroform fractions. Additionally, repeated daily treatment with the aqueous fraction significantly reduced hyperglycemia, body weight loss, and improved dyslipidemia of diabetic mice.

Conclusion

This study has revealed that the solvent fractions of H. abyssinica leaves possess in vivo blood-glucose-lowering activities on normal, oral glucose loaded, and streptozotocin-induced diabetic mice. Additionally, the aqueous fraction prevented diabetic body weight loss and dyslipidemia in mice after repeated daily dose administration.

Availability and Utilization of World Health Organization Recommended Priority Life-Saving Medicines for Under Five-Year-Old Children in Gondar Town, Ethiopia: A Cross-Sectional Study

BACKGROUND

Globally, more than eight million under-five children die every year because of diseases that could be treated or prevented with drug therapy. Thus, this study aimed to evaluate the utilization and availability of the World Health Organization (WHO) suggested priority life-saving medicines for under-five-year-old children in Gondar town.

METHODS

Institutional-based cross-sectional survey was conducted from March 2020 to May 2020 in public health centers of Gondar town. Data entry and validation were performed in EpiData 3.1 and exported to SPSS version 20 for descriptive analysis like frequency, percentage, mean, standard deviation, and median.

RESULTS

The availability of zinc phosphate and oral rehydration salt for the diarrheal cases was 57.14% and 85.71%, respectively. The availabilities of amoxicillin dispersible tablet and gentamicin injection for the treatments of pneumonia cases were 71.43% and 42.85%, respectively, and the availability of paracetamol tablet was high (85.71%). The availabilities of artemether/lumefantrine tablet and artesunate rectal were ranged between fairly high (57.1%) to very low (28.5%), respectively, and the availabilities of zidovudine/lamivudine/nevirapine-based antiretroviral regimen was 100%, a utilization for this regimen was high (96.29%). Two (3.70%) of the surveyed cases were utilized lopinavir/ritonavir-based regimen. The utilization of priority medicines was low for pain management and pneumonia which was 18.5% and 48.18%, respectively.

CONCLUSION

The study concluded that medicine was not consistently available throughout public health centers in Gondar town. Thus, this finding suggests the integration of WHO-recommended life-saving priority medicines into the essential drug management systems and health unit logistics to raise their utilization and availability.

Impact of COVID-19 on Pharmaceutical Care Services and the Role of Community Pharmacists: A Multi-Center Cross-Sectional Study in Ethiopia

Objectives

The current study aimed at assessing the impact of COVID-19 on pharmaceutical care services and the role of community pharmacists.

Methods

A cross-sectional study was conducted from May 1st to June 7, 2020, on community pharmacies in Bahir Dar and Gondar cities, Ethiopia. Descriptive statistics and Chi-square test were conducted. A P-value of less than 0.05 was considered to declare statistical significance at a 95% Confidence interval (CI).

Results

A total of 101 community pharmacies were approached (one pharmacist per pharmacy), and 80 of them had completed the survey. From the total pharmacies, 78.8% of them had encountered a shortage of pharmaceutical products. Chi-square test revealed that there was a significant difference (P = 0.036) in the shortage of personal protection equipment between Gondar and Bahir Dar cities. Face mask 55 (77.4%) followed by hand glove 15 (21.1%) were the most commonly reported personal protective equipment's in short supply.

Conclusion

Strategies should be in place to improve the availability and affordability of various essential pharmaceuticals to mitigate the spread of the disease and prevent other complications.

Health professional's exposure, attitude, and acceptance of drug promotion by industry representatives: A cross-sectional study in Ethiopia

Interactions between pharmaceutical companies and health care providers have long been an area of interest from ethical as well as scientific grounds. The information provided by those companies must be scientifically accurate and fair. The current study aimed to investigate the exposure, attitude, and training background of medical doctors and pharmacy professionals regarding drug promotional activities, and assess their acceptance of promotional gifts provided by pharmaceutical sales representatives. A cross-sectional study was conducted on medical doctors and pharmacy professionals working at Bahir Dar and Gondar cities, Amhara regional state, Ethiopia. Data were collected using a self-administered structured questionnaire and Statistical Package for Social Science (SPSS) version 26 was used for analysis. A Chi-square test was computed to investigate the presence of an association between the dependent and independent variables. A p-value of less than 0.05 was considered to declare significance at a 95% Confidence Interval (CI). A total of 105 health professionals, 81 pharmacy professionals, and 24 medical doctors have participated in the study. Above two-thirds of the respondents (69.5%) agreed that most talks sponsored by drug companies were helpful and educational. On the other hand, 39% of the respondents agreed and 47.6% disagreed that receiving gifts from pharmaceutical representatives will increase the chance that they will eventually sell or recommend the drug company's products. The majority of the study participants (81%) preferred drug samples and stationery as appropriate gifts by pharmaceutical sales representatives. Significant gaps were found regarding the training of health professionals about the ethics of drug marketing and how to deal with pharmaceutical representatives. Policies aiming at restricting health care provider's contacts with pharmaceutical companies during residency training along with incorporating gift restriction policies could bring significant improvements.

Availability and Utilization of the WHO-Recommended Lifesaving Medicines for Under-Five Children at University of Gondar Comprehensive Specialized Hospital, Amhara Region, Ethiopia

According to the World Health Organization report, 5.4 million under-five children died, which is similar to under-five mortality rate of 39 deaths per 1000 live births. This rate is higher in sub-Saharan Africa with 76 deaths per 1000 live births. More than 1 out of every 2 deaths is because of diseases that can be managed with drug of low-cost and high quality. Institutional-based cross-sectional survey was conducted from January to February 2021, at the University of Gondar Comprehensive Specialized Hospital. Statistical Package for the Social Sciences software version 24 was used for data analysis. The results were presented using Figures, tables, and texts according to the nature of the data. The overall average availability of priority medicines was 75% on the day of visit and the average stock-out duration in the last 6 months was 23.85 days. Availability and utilization of priority medicines for the management of antiretroviral infections, Vitamin A deficiency, malaria, and diarrheal cases were high, whereas availability and utilization of suggested medication for neonatal sepsis were very low. A significant proportion of priority diseases was managed by non-priority medications. Medicines supply sources of the country, ministry of health, policymakers as well as facility managers should work in collaboration toward ensuring sustainable and consistent availability of priority medicines through the country. Continues in-service training of healthcare professionals is also mandatory to update themselves with newly developed guidelines, standards, and recommendations.

COVID-19: What should health professionals know? Assessment of Knowledge, attitude, and practice of community pharmacists in a developing country

BACKGROUND

Healthcare professionals are the primary frontiers of the fight against every public health threat. These had made them vulnerable to various infectious agents, with many reports of morbidity and mortality also being evident.

OBJECTIVES

The current study aimed to assess the knowledge, attitude, and practice toward COVID-19 among community pharmacists in Gondar town, Ethiopia.

METHODS

A cross-sectional study was conducted. A structured, self-administered questionnaire was used for data collection, and the collected data were coded, validated, and analyzed using SPSS version 26. Quantitative data were summarized using means and standard deviations, while frequencies and proportions were used to summarize categorical data. A chi-square test was used to assess an association between the different variables, and a P-value of less than 0.05 was considered to declare statistical significance at a 95% confidence interval.

RESULTS

A total of 46 community pharmacy professionals had participated in the study. The main sources of information about COVID-19 were news media 29 (63%), followed by social media 24 (52.2%). The mean knowledge score was 8.15 (standard deviation: 1.86), and among the total study participants, 29 (63%) were found to have good knowledge about COVID-19. The mean attitude score was 31.52 (standard deviation: 4.288). Only 30.4% of the study participants were found to have a good practice toward the prevention of COVID-19. Chi-square results showed that having a good knowledge of COVID-19 was significantly associated with practice (P = 0.035).

CONCLUSION

Significant gaps were identified concerning community pharmacy professional's knowledge of COVID-19 and their practice toward prevention of the disease. Strategies should be implemented to equip community pharmacy professionals with all necessary information about COVID-19 through continuous training programs and other virtual platforms.

Utilization Pattern of Long-Acting and Permanent Family Planning Methods and Associated Factors: A Community-Based Cross-Sectional Study in Ethiopia

Background

Long-acting and permanent family planning methods (LAPMs) are modern contraceptive methods that can prevent pregnancy for greater than one year and include long-acting reversible contraceptive methods (LARCs) (Intrauterine device and subdermal implants), and permanent contraceptive methods (Tubal ligation and Vasectomy). The current study aimed to assess the utilization pattern of long-acting and permanent contraceptive methods and factors associated with their utilization in Lay-Armachiho district, Amhara regional state, Ethiopia.

Methods

A community-based cross-sectional study was conducted. Data were collected by using an interview method and the collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Both binary logistics and multivariable logistic regression analyses were used to analyze predictive variables with the utilization of contraceptives. A 95% confidence interval (CI) and a P-value of <0.05 were used to declare statistical significance.

Results

A total of 460 women have participated in the study. The proportion of women that utilize long-acting and permanent contraceptives was found to be 65.4%. Educational statuses, residence, attitude towards long-acting contraceptives, discussion, and joint decision-making with their spouse were factors significantly associated with the utilization of long-acting contraceptive methods.

Conclusion

The current study showed that there is high utilization of LAPMs. Women’s attitude, educational status, residency, frequent discussions, and a joint decision with their partners about LAPMs were significantly associated with the utilization of long-acting and permanent contraceptives. There is a significant impact of husbands (sexual partners) on the utilization and choice of contraceptive methods by women.

Healthcare professionals' knowledge, attitude and practice towards adverse drug reaction (ADR) reporting at the health center level in Ethiopia

Background Adverse drug reactions (ADRs) are major health problems which are of global concern. Spontaneous reporting of adverse drug reactions constitutes a crucial contribution to patient care. Objective The purpose of this study was to assess the knowledge, attitudes, and practices of healthcare professionals towards adverse drug reaction reporting. Setting Health care professionals in Gondar, Ethiopia. Methods A cross-sectional study was conducted from March to May 2017. Data were collected through self-administered questionnaires. The collected data were analyzed using SPSS version 20. Binary logistic regression analysis was performed to distinguish factors that affect adverse drug reaction reporting. A p value < 0.05 was considered as a statistically significant. Main outcome measure Factors affecting adverse drug reaction reporting of health care professionals. Results Of 102 healthcare professionals included in this study, 61 (59. 8%) were nurses, 16 (15.7%) health officers, and 25 (24.5%) pharmacy professionals. Nearly 48 (47%) study participants had an inadequate level of knowledge towards adverse drug reaction reporting. The majority of participants 88 (86.3%) had a positive attitude, while more than half (51%) of study participants did not report the adverse drug reaction they encountered. Participants who had not taken adverse drug reaction reporting training (p = 0.037), health officers (p = 0.019), and nurse professionals (p = 0.001) showed a statistically significant association with an inadequate level of knowledge. Conclusion Even though the majority of healthcare professionals had a positive attitude, they had an inadequate level of knowledge and practice towards adverse drug reaction reporting.