Publications by authors named "Firomsa Bekele"

24 Publications

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Treatment Strategies Against Triple-Negative Breast Cancer: An Updated Review.

Breast Cancer (Dove Med Press) 2022 11;14:15-24. Epub 2022 Jan 11.

School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.

Triple-negative breast cancer (TNBC) is associated with an increased risk of early recurrence and distant metastasis, as well as the development of therapeutic resistance and poor prognosis. TNBC is characterized by a wide range of genetic, immunophenotypic, morphological, and clinical features. TNBC is coined to describe cancers that lack estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). As a result, hormonal or trastuzumab-based treatments are ineffective in TNBC patients. TNBCs are biologically aggressive, and despite some evidence that they respond to treatment better than other forms of breast cancer, the prognosis remains poor. This is attributed to a shorter disease-free interval in adjuvant and neoadjuvant settings, as well as a more aggressive metastatic course. TNBC has a lot of clinical ramifications. In terms of new treatment methods, TNBC has lagged behind other types of breast cancer. There are not many options for treating this form of breast cancer because it is progressive. Many effective treatments for most breast cancers block the growth-stimulating effects of ER, PR, and/or HER2, leaving TNBC with few choices. Finding new and effective treatment options for TNBC remains a critical clinical need. To develop more effective drugs, new experimental approaches must be tested in patients with TNBC.
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http://dx.doi.org/10.2147/BCTT.S348060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760999PMC
January 2022

Adherence to Adjuvant Hormonal Therapy and Associated Factors Among Women with Breast Cancer [Letter].

Authors:
Firomsa Bekele

Patient Prefer Adherence 2021 21;15:2845-2846. Epub 2021 Dec 21.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

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http://dx.doi.org/10.2147/PPA.S351766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710078PMC
December 2021

"Loss of a limb is not loss of a life". Knowledge and attitude on diabetic foot ulcer care and associated factors among diabetic mellitus patients on chronic care follow-up of southwestern Ethiopian hospitals: A multicenter cross-sectional study.

Ann Med Surg (Lond) 2021 Dec 5;72:103140. Epub 2021 Dec 5.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

Background: Diabetic foot ulcer (DFU) is a full-thickness wound penetrating through the dermis located below the ankle in a diabetes patient. The incidence of diabetic foot ulcers has increased due to the worldwide prevalence of diabetic mellitus (DM) and the poor knowledge and attitude of diabetic foot self-care. Therefore, the study was aimed to assess the knowledge and attitude on diabetic foot ulcers and associated factors among diabetic mellitus patients of southwestern Ethiopian hospitals.

Methods: A multicenter cross-sectional study design was used. All diabetic patients fulfilling the inclusion criteria and treated as outpatient in the study period from August 9, 2021 to September 5, 2021 G was interviewed through a semi-structured questionnaire at Bedele General Hospital and Mettu Karl Comprehensive Specialized Hospital. Data was analyzed using a statistical package for social science (SPSS 23 version).

Result: Out of 387 diabetic patients, 234(60.5) were male and 266(68.7%) were married. The mean age of the participants was 41.73(SD ± 15.637) years and the majority 87(22.5) of the patients age were greater than 55 years. A total of 11(28.7%) patients had a diabetes mellitus duration between 5 and 10 years and more than half 213(55%) of the patients had a co-morbidity. Regarding the diabetic foot care, a total of 180(46.5%) and 257(66.4%) of the patients had good knowledge and attitude, respectively. Educational level(AOR = 2.705(1.380-5.299), P = 0.004) and age[AOR = 1.254(0.768-2.048), P = 0.017] were the predictors of knowledge. Monthly income (AOR = 2.879(1.043-7.944), P = 0.041), educational level (AOR = 2.415(1.121-5.20), P = 0.024), previous information (AOR = 4.022(2.311-7.000), P < 0.001) and previous history of foot ulcers (AOR = 1.976(1.126-3.466), P = 0.018) were factors associated with the attitude of diabetic foot ulcer.

Conclusion: More than half of the study participants had poor knowledge while the majority of them had a good attitude. Educational level and age were significantly associated with knowledge. Monthly income, educational level, previous information, and previous history of foot ulcers were predictors of attitude towards diabetic foot care. Therefore, the health care providers should provide diabetic foot care education to reduce further complications of foot ulcers. Besides this, special attention should be given to patients who developed diabetic foot ulcers and have low socio-economic status.
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http://dx.doi.org/10.1016/j.amsu.2021.103140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661129PMC
December 2021

Patients' Satisfaction with Pharmaceutical Care and Associated Factors [Letter].

Authors:
Firomsa Bekele

Patient Prefer Adherence 2021 3;15:2703-2704. Epub 2021 Dec 3.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

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http://dx.doi.org/10.2147/PPA.S350401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651090PMC
December 2021

An up to date on clinical prospects and management of osteoarthritis.

Ann Med Surg (Lond) 2021 Dec 19;72:103077. Epub 2021 Nov 19.

School of Pharmacy, Institute of Health Science, Jimma University, Jimma, Ethiopia.

The rising prevalence of osteoarthritis (OA) in the general population has necessitated the development of novel treatment options. It is critical to recognize the joint as a separate entity participating in degenerative processes, as well as the multifaceted nature of OA. OA is incurable because there is currently no medication that can stop or reverse cartilage or bone loss. As this point of view has attracted attention, more research is being directed toward determining how the various joint components are impacted and how they contribute to OA pathogenesis. Over the next few years, several prospective therapies focusing on inflammation, cartilage metabolism, subchondral bone remodelling, cellular senescence, and the peripheral nociceptive pathway are predicted to transform the OA therapy landscape. Stem cell therapies and the use of various biomaterials to target articular cartilage (AC) and osteochondral tissues are now being investigated in considerable detail. Currently, laboratory-made cartilage tissues are on the verge of being used in clinical settings. This review focuses on the update of clinical prospects and management of osteoarthritis, as well as future possibilities for the treatment of OA.
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http://dx.doi.org/10.1016/j.amsu.2021.103077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626656PMC
December 2021

Patients' Acceptance of COVID-19 Vaccine: Implications for Patients with Chronic Disease in Low-Resource Settings.

Patient Prefer Adherence 2021 16;15:2519-2521. Epub 2021 Nov 16.

Department of Oromo Folklore and Literature, College of Social Science, Mettu University, Mettu, Ethiopia.

Coronavirus disease 2019 (COVID-19) has become a major global health challenge, with high morbidity and mortality. Despite different vaccines being produced around the globe, the spread of the virus is still uncontrolled. In particular, the shortage of vaccines in low-income countries is one of the key factors hindering efforts to reduce the spread of the virus. Even though evidence has been provided by different responsible bodies, there are still multiple beliefs and misconceptions about COVID-19 vaccination that have not yet been addressed. Nowadays, vaccine hesitancy is one of the top ten threats to global health, arising from the unwillingness of chronic patients to receive the vaccine. Chronic disease patients in low-resource settings are fearful of taking the vaccine because of a shortage of information about the COVID-19 vaccine. Therefore, the acceptance of the COVID-19 vaccine among chronic disease patients should be studied more widely in low-resource settings.
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http://dx.doi.org/10.2147/PPA.S341158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613934PMC
November 2021

Treatment outcome and associated factors of bacterial meningitis at pediatric wards of southwestern Ethiopian hospital: a prospective observational study.

J Pharm Health Care Sci 2021 Nov 15;7(1):41. Epub 2021 Nov 15.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

Background: Meningitis is a common infectious cause of morbidity and mortality in pediatric age-groups. Acute bacterial meningitis is considered a medical emergency, because it is a life-threatening infection that requires immediate treatment. Therefore the study was aimed to assess the magnitude and predictors of poor treatment outcome among pediatric patients admitted to Bedele General Hospital.

Methods: A prospective observational study was conducted at pediatric wards of Bedele General Hospital from February 12, 2020 to August 11, 2020. Lumbar puncture, in the absence of contraindications, was performed under aseptic conditions for all patients with suspected bacterial meningitis to collect cerebrospinal fluid specimen. Multivariable logistic regression was used to determine the predictors of poor treatment outcome.

Result: Of the 196 pediatric patients involved, 112(57.1%) were male and the mean and standard deviation of their age was 6.09 ± 4.46. Regarding to their clinical profile, a total of 101(51.5%) were completely immunized and 115(58.7%) were given corticosteroid during their treatment. In our study the most frequently occurred clinical manifestation of meningitis was fever 164(83.67%), neck rigidity149 (76.02%), and irritability 122(62.24%). Regarding to their pharmacotherapy, the most commonly prescribed antibiotics were Ampicillin 104(24.82%), and Gentamycin 102(24.34%). The magnitude of good treatment outcome was 132(67.35%) whereas 64(32.65%) were poorly controlled. The presence of comorbidity (AOR = 3.64, 95CI%:1.83-7.23,P = < 0.001),corticosteroid use (AOR = 2.37, 95CI%:1.17-4.81,P = 0.017) and oxygen administration (AOR = 3.12, 95CI%: 1.34-7.25, P = 0.008) was a predictor of meningitis treatment outcome.

Conclusion: The treatment outcome of meningitis was good in of two-third of the patients. It was found that the presence of comorbidity, the administration of oxygen and use of corticosteroid was predictors of the treatment outcomes of bacterial meningitis in children. Therefore, in patients with these factors, appropriate meningitis treatment should be encouraged and locally applicable treatment guidelines should be prepared to improve patient outcome. Finally, the meningitis patients should be given corticosteroid and oxygen as treatment and special attention should be given for patients having co-morbidities.
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http://dx.doi.org/10.1186/s40780-021-00224-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591840PMC
November 2021

Attitude Towards COVID-19 Vaccination Among Healthcare Workers: A Systematic Review.

Infect Drug Resist 2021 21;14:3883-3897. Epub 2021 Sep 21.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

Introduction: Availability and accessibility of a safe COVID-19 vaccine do not necessarily guarantee an effective means to mitigate the pandemic. However, the fragile hero's or health care worker's attitude toward the vaccine is of paramount importance to promote its acceptance. So, the current review aims to provide the latest assessment of healthcare workers' attitudes toward the COVID-19 vaccination and its contributing factor worldwide.

Methods: Peer-reviewed surveys in English indexed via an electronic database in Google Scholar, Science Direct and PubMed were systematically searched. The review was carried out per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-2009) and registered on PROSPERO (CRD42021265534).

Results: Originally 8039 articles were searched from three databases PubMed, Science direct, and Google scholar. Finally, 24 studies met the inclusion criteria and made the root for the estimates of the attitude of COVID -19 vaccinations. In about two-thirds of the studies, respondents showed a positive attitude (≥50%) toward COVID-19 vaccination. However, in about one-quarter of the studies, a negative attitude (<50%) against vaccination was reported. Factors related to the attitude of healthcare workers toward COVID-19 vaccination include age, sex, profession, concerns about the safety of vaccines and fear of COVID-19, trust in the accuracy of the measures taken by the government, flu vaccination during the previous season, comorbid chronic illness, history of recommendation, and depression symptoms in the past week.

Conclusion: Although most studies report that healthcare workers have a positive attitude toward COVID-19 vaccination, quite a few surveys mention negative attitudes towards the use of vaccines, which may reflect missed opportunities or challenges for the international efforts aimed at mitigating the pandemic. Still, we need to continue to make more efforts to change the attitudes of the uncertain healthcare workers to increase the uptake of the vaccine and deal with the multi-faceted impact of infection.
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http://dx.doi.org/10.2147/IDR.S332792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464326PMC
September 2021

"Childrens are not just "little adults". The rate of medication related problems and its predictors among patients admitted to pediatric ward of southwestern Ethiopian hospital: A prospective observational study.

Ann Med Surg (Lond) 2021 Oct 7;70:102827. Epub 2021 Sep 7.

Department of Statistics, College of Natural and Computational Science, Mettu University, Mettu, Ethiopia.

Background: The rate of medication related problems is high in developing countries due to the complexity of pediatrics medication management. Pediatric population should have their own dosage regimens. The pediatric dosage regimens were derived from the adult dose that might lead to sudden reach of sub or supra-therapeutic doses. As the result, the medication therapy management is difficult in this populations. Despite this, a scanty of studies were conducted on medication related problems among pediatric populations. Therefore, this study examined the prevalence and risk factors for the occurrence of the medication related problems among patients admitted to pediatric ward of Mettu karl referral hospital.

Patients And Methods: The pediatric population who were received the pharmacotherapy for their disease was observed and followed for the occurrences of medication related problems at pediatric wards of Mettu karl referral hospital from February 12, 2020 to February 24, 2021. Patients whose age was less than or equal to 18 years and who were on drug therapy or who needs drug therapy during study period were included. The possibility of adverse drug reactions developed from the drug was assessed by using the Naranjo scale. Multivariable logistic regression analysis was used to determine the predictors of medication related problems.

Result: Over the study period, a total of 189 pediatric populations were included. Among these, 115 (60.8%) were males, and the mean age of the patients was 1.4339 ± 0.864 years. The mediciation related problems was found among 121(64.01%) of pediatric patients. Among seven types of drug therapy problems unnecessary drug therapy, need additional drug therapy, ineffective drug therapy and dose too high were the most predominantly occured DRP that accounted 74 (27.72%), 67 (25.09%), 43 (16.10%), 36 (13.48%), respectively. The mean number of hospital stay was 4.29 days with minimum and maximum stay of 2 and 9 days and antibiotics 364(51.3%) were the most common class of drugs that was associated with drug related problems. Being a neonate (AOR = 1.48, 95CI%: 1.69-7.42, P = <0.001), hospital stay greater than or equal to seven days (AOR = 1.98, 95CI%: 2.471-12.644, P = 0.016), and the presence of co-morbidity(AOR = 2.507, 95CI%: 3.270-4.949, P = 0.080) were the predictors of the medication related problems.

Conclusion: The prevalence of medication-related problems in pediatrics patient was found to be high. Being neonatal, prolonged hospital stay and the presence of a multiple disease were the predictors of medication-related problems in pediatric patients. Therefore special attention should be given for newborns, prolonged hospital stay and patients having co-morbidity. Besides this, the drug information service and the patients round activity should be started by clinical pharmacist to decrease the occurences of any preventable medication related problems.
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http://dx.doi.org/10.1016/j.amsu.2021.102827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435910PMC
October 2021

Impact of COVID-19 pandemic on chronic diseases care follow-up and current perspectives in low resource settings: a narrative review.

Int J Physiol Pathophysiol Pharmacol 2021 15;13(3):86-93. Epub 2021 Jun 15.

School of Pharmacy, Institute of Health Sciences, Wollega University Nekemte, Ethiopia.

Coronavirus is a respiratory disease that spreads globally. The severity and mortality risk of the disease is significant in the elderly, peoples having co-morbidities, and immunosuppressive patients. The outbreak of the pandemic created significant barriers to diagnosis, treatment and follow-up of chronic diseases. Delivering regular and routine comprehensive care for chronic patients was disrupted due to closures of healthcare facilities, lack of public transportation or reductions in services. The purpose of this narrative review was to update how patients with chronic care were affected during the pandemic, healthcare utilization services and available opportunities for better chronic disease management during the pandemic in resources limited settings. Moreover, this review may call to the attention of concerned bodies to make decisions and take measures in the spirit of improving the burden of chronic diseases by forwarding necessary recommendations for possible change and to scale up current intervention programs.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310882PMC
June 2021

Prevalence and associated factors of the psychological impact of COVID-19 among communities, health care workers and patients in Ethiopia: A systematic review.

Ann Med Surg (Lond) 2021 Jun 25;66:102403. Epub 2021 May 25.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

Introduction: The mental health effects of coronavirus is found to be high in health care professionals, patients and communities. Therefore, this review tried to summarize the prevalence and associated factors of the psychological impact of COVID-19 among the health care workers (HCWs), patients and communities in Ethiopia.

Methods: The studies from Medline via PubMed, Science Direct, and Google Scholar were searched from February 17 to March 17, 2021. PRISMA-2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was used to conduct this review.

Result: Initially, 2190 publications were obtained from three databases (PubMed, Science Direct, and Google Scholar). Finally, 9 articles that fulfilled eligible criteria were included in the review. Among different types of mental health impacts stress was reported that lies in the range from 18% to 100%, anxiety was reported from 27.7% to 100%, depression was from 12.4% to 55.7%. Several factors were associated with negative psychological impacts of COVID-19 among health care workers, patients and communities such as level of education, occupation, gender, age, marital status, presence of co-morbidity, lack of social support, personal/family exposure, their attitude, income level, family size, presence of respiratory symptoms, substance use, area of residence, and lack of protective equipment.

Conclusion: There was overall high psychological impact of COVID-19 pandemic among healthcare workers, communities, and patients. The most common indicators of psychological impact reported across studies were anxiety and stress. Therefore, online psychotherapy and cognitive behavioral and mindfulness-based therapies should be provided through smartphone applications to minimize psychological impacts of COVID-19.
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http://dx.doi.org/10.1016/j.amsu.2021.102403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146265PMC
June 2021

Magnitude and determinants of the psychological impact of COVID-19 among health care workers: A systematic review.

SAGE Open Med 2021 25;9:20503121211012512. Epub 2021 Apr 25.

Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia.

Introduction: The mental health of the health care professionals is more likely to be affected by the coronavirus disease-19 compared to the general population. Accordingly, the current study aimed to summarize the magnitudes and determinants of the psychological impact of coronavirus among health care professionals.

Methods: The studies from Medline via PubMed, Science Direct, and Google Scholar were searched from 5 September to 19 October 2020. The review was conducted as per PRISMA-2009 (Preferred Reporting Items for Systematic Reviews and Meta-analyses).

Result: Initially, 6316 articles were searched from three databases (PubMed, Science Direct, and Google Scholar). Finally, 20 articles were filtered to be included in our review. Among different types of psychological impact, stress was reported that lies within the range from 5.2% to 100%, anxiety was reported from 11.1% to 100%, depression was from 10.6% to 58%, and insomnia was from 28.75% to 34%. Several factors were related to the negative psychological state of health care workers due to coronavirus disease-19 like educational level, occupation, gender, age, working environment, work experience, legal status, ethnicity, psychological comorbidity, social support, personal/family exposure, and feeling of health care providers.

Conclusion: The most common psychological impacts among health care workers were anxiety and stress. Besides different sociodemographic factors that determine the psychological impacts, front-line health care workers and participants having psychological comorbidity have a high risk of negative psychological state impacts as compared to their counterparts. Therefore, special attention should tend to health care workers directly involved in the prevention and management of coronavirus disease-19 and having a different risk of mental health condition.
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http://dx.doi.org/10.1177/20503121211012512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082979PMC
April 2021

Magnitude and determinants of drug-related problems among patients admitted to medical wards of southwestern Ethiopian hospitals: A multicenter prospective observational study.

PLoS One 2021 16;16(3):e0248575. Epub 2021 Mar 16.

Department of Pharmacy, Institute of Health Science, Wollega University, Nekemte, Ethiopia.

Background: Drug-related problem (DRP) is an event involving drugs that can impact the patient's desired goal of therapy. In hospitalized patients, DRPs happen during the whole process of drug use such as during prescription, dispensing, administration, and follow-up of their treatment. Unrecognized and unresolved DRPs lead to significant drug-related morbidity and mortality. Several studies conducted in different hospitals and countries showed a high incidence of DRPs among hospitalized patients. Despite the available gaps, there were scanties of studies conducted on DRPs among patients admitted to medical wards in Ethiopia. Therefore, this study assessed the magnitude of drug-related problems and associated factors among patients admitted to the medical wards of selected Southwestern Ethiopian hospitals.

Patients And Methods: A multicenter prospective observational study was conducted at medical wards of Mettu Karl Hospital, Bedele General Hospital and Darimu General Hospital. Adult patients greater than 18 years who were admitted to the non-intensive care unit (ICU) of medical wards and with more than 48 h of length of stay were included. Identified DRPs were recorded and classified using the pharmaceutical care network Europe foundation classification system and adverse drug reaction was assessed using the Naranjo algorithm of adverse drug reaction probability scale. Hill-Bone Compliance to High Blood Pressure Therapy Scale was used to measure medication adherence. Multivariable logistic regression was used to analyze the associations between the dependent variable and independent variables.

Result: Of the 313 study participants, 178 (56.9%) were males. The prevalence of actual or potential DRPs among study participants taking at least a single drug was 212 (67.7%). About 125 (36.63%) patients had one or more co-morbid disease and the average duration of hospital stay of 7.14 ± 4.731 days. A total of 331 DRPs were identified with an average 1.06 DRP per patient. The three-leading categories of DRPs were unnecessary prescription of drugs 92 (27.79%), non-adherence (17.22%) and dose too high (16.92%). The most common drugs associated with DRPs were ceftriaxone (28.37%), cimetidine (14.88%), and diclofenac (14.42%). The area of residence (AOR = 2.550, 95CI%: 1.238-5.253, p = 0.011), hospital stay more than 7 days (AOR = 9.785, 95CI%: 4.668-20.511, p≤0.001), poly pharmacy (AOR = 3.229, 95CI%: 1.433-7.278, p = 0.005) were predictors of drug-related problem in multivariable logistic regression analysis.

Conclusion: The magnitude of drug therapy problems among patients admitted to the medical wards of study settings was found to be high. Therefore, the clinical pharmacy services should be established in hospitals to tackle the DTPs in this area. Additionally, healthcare providers of hospitals also should create awareness for patients seeking care from health facilities of the importance of rational drug usage.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248575PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7963049PMC
October 2021

Drug-related problems among patients with infectious disease admitted to medical wards of Wollega University Referral Hospital: Prospective observational study.

SAGE Open Med 2021 22;9:2050312121989625. Epub 2021 Jan 22.

Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.

Introduction: Drug-related problems can affect the treatment outcomes of hospitalized patients and outpatients that lead to morbidity and mortality. Despite this, there were scanty of studies among patients with infectious diseases in Ethiopia. As the result, this study was tried to assess the magnitude and determinants of drug therapy problems among infectious disease patients admitted to the medical wards of Wollega University Referral Hospital.

Methods: A prospective observational study was conducted from May to August 2019. The prevalence and types of drug- related therapy problems were studied using the Pharmaceutical Care Network Europe Foundation classification system, and adverse drug reaction was assessed by using the Naranjo algorithm. Multivariable logistic regression analysis was used to determine the predictors of drug-related problems, and a significant association was declared if p-value < 0.05.

Result: Of the 172 study participants, 106 (61.6%) were males, and the patient's mean age was 39.1 ± 14.31 years. Over the study period, 123 (71.51%) patients had drug-related problems. Need for additional drug therapy was the widely occurred drug-related problem that accounts for 107 (22.77%), and the most common drug-associated with the drug therapy problem was ceftriaxone (77 (44.77%)). This inappropriate use of ceftriaxone might be due to the preference of physicians to prescribe this broad spectrum antibiotic in which it was prescribed for the majority of the infectious disease etiology. Polypharmacy (adjusted odds ratio (AOR) = 2.505, 95% confidence interval (CI): 1.863-11.131), length of hospital stay ⩾ 7 days (AOR = 4.396, 95% CI: 1.964-7.310), and presence of co-morbidity (AOR = 2.107, 95% CI: 1.185-4.158, p = 0.016) were determinants of drug-related problems.

Conclusion: The magnitude of drug-related problems was found to be high. Hence, the clinical pharmacy service should be established to tackle inappropriate indications, ineffective drug therapy, and adverse drug events in the study area.
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http://dx.doi.org/10.1177/2050312121989625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841694PMC
January 2021

Impact of HIV status and predictors of successful treatment outcomes among tuberculosis patients: A six-year retrospective cohort study.

Ann Med Surg (Lond) 2020 Dec 15;60:531-541. Epub 2020 Nov 15.

School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Tuberculosis (TB) remains a major global public health problem. Hence, the study aimed to assess the impact of human immune virus (HIV) status and predictors of successful treatment outcomes of TB patients enrolled at Nekemte specialized hospital. An institution-based retrospective cohort study was conducted and the data analyzed using SPSS version 24.0. A multivariable logistic regression model was fitted to identify the association between treatment outcome and potential predictor variables. The association was calculated using the Adjusted Odds ratio (AOR) and the statistical significance was considered at p < 0.05. Out of the total 506 study participants, 50.2% of them were males. The overall treatment success rate was 81.4% and 58.06% among HIV co-infected TB patients. Female sex (AOR = 2.01, 95%CI: 1.04-16.11), age 25-34 years (AOR = 3.982, 95%CI: 1.445-10.971), age 35-49 years (AOR = 5.392, 95%CI: 1.674-17.368), high school educational level (AOR = 5.330, 95% CI: 1.753-16.209), urban residence (AOR = 3.093, 95%CI: 1.003-9.541) and HIV negative (AOR = 10.3, 95%CI, 3.216-32.968) were positively associated with favorable TB treatment outcome. Whereas, being single (AOR = 0.293, 95%CI: 0.1-0.854), smear-negative pulmonary TB (AOR = 0.360, 95%CI: 0.156-0.834), extra-pulmonary TB (AOR = 0.839, 95%CI: 0.560-0.955) and retreatment case (AOR: 0.54, 95%CI: 0.004-0.098) were negatively associated with successful treatment outcome. The treatment success rate of TB patients was lower than World Health Organization target set of 85%. The increased unsuccessful outcome among TB/HIV patients requires urgent public health interventions to improve the evaluation policy and control framework.
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http://dx.doi.org/10.1016/j.amsu.2020.11.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704363PMC
December 2020

Patterns and associated factors of COVID-19 knowledge, attitude, and practice among general population and health care workers: A systematic review.

SAGE Open Med 2020 11;8:2050312120970721. Epub 2020 Nov 11.

Department of Nursing, College of Health Science, Selale University, Fiche, Ethiopia.

Introduction: Coronavirus disease 2019 is a pandemic disease, requiring persons around the world to take immediate action to reduce the risk of infection. This study was aimed to summarize the patterns and determinants of coronavirus disease 2019 knowledge, attitude, and practice among general populations and health workers.

Methods: A cross-sectional study from PubMed, HINARI, and Scopus were searched from March 16 to July 30, 2020. The review was done in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses-2009.

Result: We found 56 articles upon the initial search. Finally, 21 studies were filtered to be studied in this systematic review. Overall, the majority of the articles that were previously published had good knowledge about coronavirus disease 2019 that lies in the ranges from 40% to 99.5%. A good attitude lies in the ranges from 70% to 97.1%. Among impact of coronavirus disease 2019 on mental health, only anxiety was reported that ranges from 24.6% to 96.3%. We found the variable practice towards combating coronavirus disease 2019. Several factors were associated with poor knowledge, attitudes, and practice skills regarding the pandemic of coronavirus disease 2019 such as level of education, occupation, income, gender, age, residence, work experience, religion, having media, marital status, and race.

Conclusion: The majority of the articles that were previously published had found good knowledge and attitude about coronavirus disease 2019 and variable reports for practice to combat the disease. Most of them were severely worried about the disease. Therefore, the mental effect of the coronavirus disease 2019 should be studied at large, and every country should implement the strategy to combat the disease to increase the level of practice.
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http://dx.doi.org/10.1177/2050312120970721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675903PMC
November 2020

Amputation rate of diabetic foot ulcer and associated factors in diabetes mellitus patients admitted to Nekemte referral hospital, western Ethiopia: prospective observational study.

J Foot Ankle Res 2020 Nov 4;13(1):65. Epub 2020 Nov 4.

School of Pharmacy, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.

Background: Diabetes foot ulcer is a devastating and much-feared complication of diabetes. Diabetes foot ulcerations which developed gangrene can take weeks or months to heal and can sometimes not heal at all so that amputation for non-traumatic causes is a frequent outcome in the diabetic foot. Despite this, there is no finding on predictors of the amputation rate of diabetes foot ulcers in Ethiopia. Hence this study was aimed to identify factors associated with the amputation rate of diabetes foot ulcer patients in Nekemte referral hospital.

Patients And Methods: A prospective observational study was conducted among adult diabetes foot ulcer patients admitted to Nekemte referral hospital from March 15 to June 15, 2018. A pus swab was obtained from the ulcers before any ulcer cleaning to conduct gram staining. The primary outcome was the amputation rate. Cox regression analysis was used to estimate the hazard ratios and time from study entry to healing was evaluated as censored event times by Kaplan-Meier curves.

Result: Over the study period, 115 diabetes foot ulcer patients were admitted to the NRH; of these patients, 64(55.65%) were males while the mean age of participants was 44.4 ± 14.7. A total of 34(29.57%) of the diabetes foot ulcer were overweight and 16(13.91%) were obese while the mean ± standard deviation of body mass index (BMI) was 24.94 ± 3.69 kg/m2 and a total of 56(48.69%) diabetic foot ulcer had a diabetic complication. Of patients with diabetic foot ulcer, 35(30.43%) were undergone lower extremity amputations (LEA). Patients who were prescribed with inappropriate antibiotics were unlikely to heal. A total of 18(46.15%) of the patients who were taken inappropriate antibiotics were healed whereas 21(53.85%) were not healed (P = 0.017). Besides, the higher the Wagner grade, the worse the outcome of healing. A total of 19(21.84%) and 16(57.14%) of patients with grade < 4 and grade ≥ 4, respectively, did not heal (P = 0.005).

Conclusion: The amputation rate of diabetes foot ulcers was rapid for patients prescribed inappropriate antibiotics and higher grades of the foot ulcer. Therefore, the presence of clinical pharmacists plays a pivotal role to promote the appropriate use of antibiotics and besides the daily care, special attention should be given for patients having an advanced grade of diabetes foot ulcer.
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http://dx.doi.org/10.1186/s13047-020-00433-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640406PMC
November 2020

Clinical Presentation of Patients Infected with Coronavirus Disease 19: A Systematic Review.

Infect Dis (Auckl) 2020 10;13:1178633720952076. Epub 2020 Sep 10.

Department of Pharmacy, College of Public Health and Medical Science, Mettu University, Mettu, Ethiopia.

Background: The coronavirus disease-19 has been labeled a pandemic by World Health Organization. By virtue of its highly contagious attribution, this virus has spread across over the world and the numbers are still rapidly increasing. Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 are occurring in several countries. The aim of this systematic review was to summarize clinical presentations of this newly emerging coronavirus disease.

Methods: A systematic review of published articles was conducted using databases such as PubMed, Scopus, and Google Scholar. A search was conducted on 18 to 25 April 2020. Search terms included "novel coronavirus," "2019 novel coronavirus," "Coronavirus disease 2019," "COVID-19," "severe acute respiratory syndrome coronavirus 2." The studies published in the English language and their full texts available were included. The eligible study designs were cross-sectional, case-control, cohort, and case series.

Results: Thirty (30) studies which contain 4829 participants were included in this review. From included studies, the age of infected patients were found in range 0.25 to 94 years. The main clinical symptoms of COVID-19 patients were fever (77.6%), cough (64.8%), fatigue (27.2%), dyspnea (21.2%) and sputum production (18.0%).

Conclusion: This systematic review identified that fever, cough, fatigue, and dyspnea were the most common reported clinical features of coronavirus disease 19. Understanding of the clinical spectrum and impact of this novel disease is important for all individuals, especially for healthcare workers to manage and prevent it.
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http://dx.doi.org/10.1177/1178633720952076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495523PMC
September 2020

Adherence to Anti-Tuberculosis Treatment Among Pediatric Patients at Nekemte Specialized Hospital, Western Ethiopia.

Patient Prefer Adherence 2020 24;14:1259-1265. Epub 2020 Jul 24.

Department of Obstetrics and Gynecology, School of Medicine, Institute of Health Science, Wollega University, Nekemte, Ethiopia.

Background: Non-adherence to tuberculosis treatment is the most challenging and hindering factor for successful tuberculosis therapy. The long duration of tuberculosis treatment and the undesirable effects of anti-tuberculosis drugs result in non-adherence to treatment among pediatric patients. Hence, this study was aimed to evaluate pediatrics adherence status among tuberculosis pediatric patients on anti-tuberculosis treatment at Nekemte Specialized Hospital.

Methods: A health facility-based cross-sectional study design was used to recruit pediatric TB patients who were receiving their treatment between February 15 and March 15, 2019. Adherence to tuberculosis therapy was evaluated using data obtained from face-to-face interviews of their respective caregivers. The collected data were entered into EPI-manager 4.0.2 software and analyzed using SPSS version 24. Logistic regression was used to analyze the variables and variables with p-value <0.05 had a statistically significant association with the adherence to anti TB treatment.

Results: Among 202 participants involved in the study, 120 (59.4%) of them were males and 119 (58.9%) were in the age category of 11-15 years. A total of 166 (82.2%) of the patients had extra-pulmonary tuberculosis and 174 (86.1%) of them were in the intensive phase. Of the pediatric tuberculosis patients, 48 (73.3%) of them have adhered to the treatment regimen. Female gender [AOR: 3.3, 95% CI: 1.52-7.2], younger age (0-5 years) [AOR: 5.96 95% CI: 1.81-19.6], living in urban area [AOR: 3.73, 95% CI: 1.67-8.36], and patients who did not experience side effect [AOR: 2.87, 95% CI: 1.41-5.81] were predictors of good adherence to tuberculosis treatment up on multivariable logistic regression analysis.

Conclusion: The level of adherence observed in our study area was low. Age, sex, residence, and side effect experience showed an association with tuberculosis treatment adherence. Therefore, health care providers should educate all patients with tuberculosis before the initiation of anti-tuberculosis treatment.
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http://dx.doi.org/10.2147/PPA.S258292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386810PMC
July 2020

Drug Use Evaluation of Beta-Blockers in Medical Wards of Nedjo General Hospital, Western Ethiopia.

Cardiovasc Ther 2020 22;2020:2509875. Epub 2020 May 22.

Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal Srinagar, 190006 Jammu and Kashmir, India.

Introduction: Beta-blocker use evaluation is a performance method that focuses on the evaluation of beta-blocker use processes to achieve optimal patient outcomes. Several studies conducted in different hospitals revealed a high incidence of inappropriate prescription of beta-blockers among hospitalized patients. Therefore, it is important to identify inappropriate beta-blocker prescribing since they may increase the risk of hospitalizations. Despite this, there was no study conducted related to drug use evaluation of beta-blockers in Nedjo general hospital (NGH). Thus, this study was aimed at assessing the use evaluation of beta-blockers in medical wards of NGH.

Methods: A retrospective cross-sectional study was conducted at medical wards of NGH from January 1, 2016, to December 31, 2017.

Results: Out of the total of 149 medical record of patients that contains beta-blockers, 84 (56.37%) were males and about one-third (31.54%) of the patients ages were between 41 and 50 years. Propranolol was the most commonly prescribed beta-blocker (62.76%), and 94.56% of beta-blockers were prescribed with correct indication. There were about 51%, 46.31%, 64.43%, and 46.98% of beta-blockers prescribed with the correct dose, duration, frequency, and route of administration, respectively. Regarding the routes of administration, 70 (46.98%) of them were prescribed with the correct route. Most drugs interacting were propranolol with cimetidine 26 (68.42%), and the most frequent condition for which beta-blockers were prescribed was hypertension (32.89%).

Conclusion: Overall, there was an inappropriate use of beta-blockers in terms of dosage and durations. So, prescribers of NGH should strictly adhere to the national treatment guideline when prescribing medications. Additionally, drug information centers have proved useful and effective in promoting rational drug use. Hence, it should be recommended for general use.
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http://dx.doi.org/10.1155/2020/2509875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284961PMC
July 2020

Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia.

Integr Blood Press Control 2020 21;13:49-61. Epub 2020 Apr 21.

Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopa.

Background: Hypertension is the leading cause of morbidity and mortality among non-communicable diseases. The rate of blood pressure (BP) control among hypertensive patients is poor and the reasons for poor control of BP remain poorly understood globally. Therefore, this study aimed to assess the magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Nekemte referral hospital (NRH).

Methods: A hospital-based cross-sectional study was conducted from February to April 2018 at NRH. BP control status was determined by the average consecutive BP recordings across the 3 months. The data was entered and analyzed using SPSS version 20.0 and p-value <0.05 was considered statistically significant.

Results: Out of 297 study participants included, the majority were females, 181 (60.9%), and the mean age of the patients was 59.4 ±10.4 years. About half, 137 (46.12%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin-converting enzyme inhibitors (88.2%). The mean of systolic blood pressure was 132.41± 15.61mmHg, while the mean of diastolic blood pressure was 84.37± 9.32 mmHg. The proportion of participants with optimally controlled BP was 63.6% and 36% were adherent to their medications. Male sex (Adjusted Odd Ratio [AOR]: 1.89, 95% CI: 1.09-4.84), illiteracy (AOR= 1.56, 95% CI: 1.22-6.78), duration of hypertension diagnosis > 10 years (AOR= 2.01, 95% CI: 1.04-16.11), non-adherence (AOR= 3.14, 95% CI: 1.35-10.76) and lack of physical exercise (AOR= 2.8, 95% CI: 1.16-6.74) were positively associated with uncontrolled BP status. Whereas age older than 55 years (AOR= 0.38, 95% CI: 0.11-0.92) was negatively associated with uncontrolled BP.

Conclusion: BP control was relatively achieved in about two-third of pharmacologically treated patients. We recommend better health education and care of patients to improve the rate of BP control status.
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http://dx.doi.org/10.2147/IBPC.S245068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183335PMC
April 2020

Risk factors and outcomes of diabetic foot ulcer among diabetes mellitus patients admitted to Nekemte referral hospital, western Ethiopia: Prospective observational study.

Ann Med Surg (Lond) 2020 Mar 18;51:17-23. Epub 2020 Jan 18.

Department of Nursing, College of Health Science, Selale University, Fiche, Ethiopia.

Objectives: Diabetic foot ulcer is one of the complications of diabetes mellitus. The diabetic patients with foot infections especially gangrene require long-term hospitalization and carry the risk of limb amputation. Despite these challenges, there are a scarce studies done on risk factors and no finding on outcomes of diabetic foot ulcers in Ethiopia.

Patients And Methods: A prospective observational study was conducted among diabetes patients with diabetic foot ulcer at Nekemte referral hospital from March 15 to June 15, 2018.

Results: Of the 115 diabetes foot ulcer patients admitted to Nekemte referral hospital, 64(55.65%) were males and the mean age of participants was 44.4 ± 14.7 years. Fifty-eight (50.43%) of the patients had chronic health problems and 56(48.69%) had diabetic complications. Of patients with complications, 35(30.43%) were undergone amputations. Diabetic foot ulcer grade ≥4  =  inappropriate antibiotics use ( =  overweight ( =  obesity (AOR = 3.020; 95% CI: 2.556, 16.397), poor blood glucose control  =  and neuropathy  =  were predictors of amputation up on multivariable logistic regression analysis.

Conclusion: Blood glucose level, higher body mass index, inappropriate antibiotics use, neuropathy and advanced grade of diabetic foot ulcer were independent predictors of amputation. Thus, special emphasis for patients having neuropathy and advanced grade of diabetic foot ulcer as well as weight reduction, managing hyperglycaemia, and appropriate antibiotics prescription practice would decrease untoward effects of diabetic foot ulcer.
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http://dx.doi.org/10.1016/j.amsu.2020.01.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992950PMC
March 2020

Management protocols and encountered complications among stroke patients admitted to stroke unit of Jimma university medical center, Southwest Ethiopia: Prospective observational study.

Ann Med Surg (Lond) 2019 Dec 15;48:135-143. Epub 2019 Nov 15.

Department of Nursing, Institute of Health Science, Wollega University, Nekemte, Ethiopia.

Objectives: The number of stroke patients receiving recombinant tissue plasminogen activator (r-tPA) in developing world is extremely low. Pre-hospital delay, financial constraints and lack of infrastructure are the main barriers. Additionally, various medical, neurological and psychological complications are allied to stroke patients after the acute attack. Hence, the study was aimed to identify management protocols and encountered complications among stroke patients admitted to stroke unit of Jimma university medical center (JUMC).

Patients And Methods: Prospective observational study was conducted at stroke unit of JUMC from March 10 to July 10, 2017. All eligible consecutive stroke patients of ≥18 years were included. Data was entered to Epi data version 3.1 and analyzed using SPSS version 20.

Results: A total of 116 eligible stroke patients were followed with mean age of 55.14 ± 14.04 years and males comprised of 62.9%. Using world health organization (WHO) criteria, 60 (51.7%) patients had ischemic while 56 (48.3%) had hemorrhagic stroke. During admission, 93 (80.2%) patients had developed at least one complication. The most complication was brain edema (increased intracranial pressure) detected in about one third of the patients (30.2%) followed by urinary incontinence (28.4%) and aspiration pneumonia (19.8%). Almost half of the patients (52.5%) had at least one past medication history. During hospitalization, 111(95.7%) of patients had received at least one medication and the median start time of the medications after hospital arrival was 15 h. The most common medication given for the patients during hospitalization were antiplatelets and statins for 63 (54.3%) patients. During discharge, about 78 (67.2%) patients had received medications and antihypertensives were the prominent medications prescribed for half of the discharged patients.

Conclusion: Both neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.
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http://dx.doi.org/10.1016/j.amsu.2019.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880120PMC
December 2019

Patterns and epidemiology of acute poisoning in Ethiopia: systematic review of observational studies.

Arch Public Health 2018 2;76:34. Epub 2018 Jul 2.

1School of pharmacy, Department of Clinical pharmacy, College of Health Sciences, Jimma University, Jimma, Ethiopia.

Background: Acute poisoning is a common reason for emergency department visit and hospitalization worldwide with major morbidity and mortality. The burden of poisoning exposures in Africa is a significant public health concern, but only 10 of 58 countries have poisons information centers (PICs).

Objective: The primary intention of our current review is to explore and summarize the published evidence on the patterns and epidemiology of poisoning in Ethiopia.

Method: PubMed and Scopus were searched for primary, case series and human studies for publications from inception to July 2017. A manual search for additional relevant studies using references from retrieved articles was also performed. Only studies that reported acute poisoning in both pediatric and adult patients were included. From the screened articles, data were extracted for baseline characteristics and relevant end points such as case fatality rate, time for health institution presentation and length of hospital stay.

Result: Initial entry and search resulted in the retrieval of 332 articles. Finally, 9 studies comprised of 4763 participants were included in this current review. In 78% of the studies included in this review, acute poisoning is reported to be more prevalent in females. Acute poisoning was revealed to be prevalent in less than 30 years old. Organophosphates and household cleaning agents were the predominant agents of acute poisoning. Intentional poisoning was identified responsible for the majority of acute poisoning cases and factors such as psychiatric problems, and quarrel were identified as the underlying reasons for poisoning. Time of presentation to health institution after poisoning, length of hospital stay and case fatality rate were reported and lies in the ranges between 0.2 h-24 h, 0.5 days-17.7 days and 0-14.8%, respectively.

Conclusion: The occurrence of acute poisoning was higher in females and common in less than 30 years of age, making this a real public health burden in Ethiopia. Psychiatric problems, quarrel and substance abuse were identified as the most common reasons for acute poisoning. Awareness creation how to handle chemicals and prescribed drugs and psychiatric consultations should be in place for the community.
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http://dx.doi.org/10.1186/s13690-018-0275-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027736PMC
July 2018
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