Self-care practice and associated factors among hypertensive follow-up patients at East Gojam zone public hospitals, North West Ethiopia, 2021

Uncontrolled hypertension leads to cardiovascular complications and organ damage. Self-care practice is crucial for the prevention and management of hypertension by improving quality of life, preventing complications and decreasing health care expenditure. The study aimed to assess self-care practice and its associated factors among hypertensive follow up patients at East Gojjam Zone public hospitals; in Northwest Ethiopia. Quantitative cross-sectional study design and qualitative phenomenological approach were applied. The quantitative result was supported by in-depth interview. Out of 480 patients included in the study, 49% have good self-care practices. Out of the total participants 44.6% have poor in antihypertensive medication adherence, 92.5% have low in diet management, 82.8% were poorly practiced physical activity and 62.5% poor practice to weight management. Participants who cannot read and write (AOR = 3.1, 95% CI: 1.6-5.9), and have no comorbidity (AOR = 0.4, 95% CI: 0.2-0.6), uncontrolled blood pressure status (AOR = 2.1, 95% CI: 1.2-3.6), poor social support status (AOR = 2.5, 95% CI: 1.5-4.3) and unfavorable attitude (AOR = 3.1, 95% CI: 1.9-5.2) are the factors for poor self-care practice. During interview; family meal preparation habits, inadequate information about self-care practice during follow-up time, inconvenient working environment, pressure during social events to share food, negligence, and poor self-efficacy were highly described as challenges for practicing and sustaining self- care. The level of hypertension self-care practices was found to be low. Therefore, hypertension self-care practices should be strengthened throughout their follow-up time, and creating awareness in the community is highly encouraged.

Mortality rate and predictors among patients with breast cancer at a referral hospital in northwest Ethiopia: A retrospective follow-up study

BACKGROUND

Breast cancer is one of the common global health concerns that affects2.1 million women each year and causes the highest number of cancer-related morbidity and mortality among women. The objective of this study was to determine the mortality rate and its predictors among breast cancer patients at the referral hospitals, in northwest Ethiopia.

METHODS

A retrospective follow-up study was conducted on breast cancer patients registered between February 01, 2015 and February 28, 2018. They were selected by simple random sampling using computer-generated method and followed until February 29, 2020, in Amhara region referral hospital. A pre-tested data extraction checklist was used to collect data from the registration book and patient medical records. The collected data were entered into Epi-Data version 3.1 and exported to STATA version 14 for analysis. The mortality rate by person-year observation was computed. The Kaplan-Meier survival curve with the log-rank test was used to estimate the survival probabilities of the patients. Bivariate and multivariate Cox regression model was used to identify predictors of mortality.

RESULTS

The overall mortality rate of breast cancer was 16.9 per 100 person-years observation. The median survival time was 38.3 (IQR: 26.23, 49.4) months. Independent predictors of breast cancer mortality was; Clinical stage IV and stage III (aHR:10.44,95% CI: 8.02,11.93 and aHR: 9.43, 95% CI: 6.29,11.03respectively), number of positive lymph node in the category of 10 and more and number of positive lymph node within the category of 4-9 (aHR:12.58, 95%CI: 5.2, 30.46 and aHR: 4.78, 95% CI: 2.19, 10.43respectively), co-morbidities (aHR:1.5, 95%CI: 1.01,2.21), Postmenopausal (aHR:2.03,95% CI: 1.37, 3), histologic grade III (aHR:2.12, 95% CI: 1.26,3.55) and not received hormonal therapy (aHR: 2.19, 95%CI: 1.52,3.15) were independent predictors of mortality.

CONCLUSION

The overall mortality rate was 16.9 per 100 person-years. The finding was higher compared to high-income countries. Advanced clinical stage, co-morbidities, menopausal status, and hormonal therapy are the significant predictors of mortality. Early detection and treatment of breast cancer is needed to reduce the mortality rate.

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east Gojjam zone referral hospitals, northern Ethiopia, 2019

Background

Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1–10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%).

Objective

We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019.

Methods

An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.

Result

Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors.

Conclusion

Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.