Burden and predictors of heart failure treatment outcomes in Ethiopia: A systematic review and meta-analysis protocol

BACKGROUND

Heart failure is an important global health problem which is associated with high mortality. Uncontrolled heart failure leads to hospitalization and reduction in quality of life. Therefore, the study aimed to assess the treatment outcome such as improved, death, hospitalization, and self-discharges without improvement and associated factors in heart failure patients admitted to south western Ethiopian hospitals.

METHODS

We will use databases such as PubMed, Science Direct, HINARI, Scopus and Google Scholar. The final systematic review and meta-analysis will contain papers that fulfill the eligible criteria. A systematic data extraction check list will be used to extract the data, and STATA version 14 will be used for the analysis. Heterogeneity is evaluated using the I2 tests and the Cochrane Q test statistic. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test are utilized. The sensitivity analysis and subgroup analysis will be done for studies having heterogeneity. The Joanna Briggs institute meta-analysis of statistics assessment and review instrument (JBI- MAStARI) will be used for quality assessment.

DISCUSSION

This protocol is expected to provide adequate evidence on the burden of poor heart failure treatment outcome that includes self-discharge, developing complication and finally leads to death in acute and chronic heart failure patients in Ethiopia. Furthermore, to enrich our estimation, we also intended to assess the associated factors of poor treatment outcome. Therefore, our review will call for government and non-government interventions in reducing the mortality associated with heart failure.

Men's sexual desire, and why women often don't recognize it? Prevalence of erectile dysfunction and associated factors among diabetes mellitus patients attending Mettu Karl Comprehensive Specialized Hospital: A cross-sectional study

Objective

The study aimed to assess the magnitude and predictors of erectile dysfunction at Mettu Karl Comprehensive Specialized Hospital.

Methods

Male diabetic patients visiting chronic care follow-up at Mettu Karl Comprehensive Specialized Hospital were face-to-face interviewed as part of a retrospective cross-sectional study from April 6, 2022 to May 6, 2022. SPSS version 21 for Windows was used to enter and analyze the data for the descriptive statistics. Following that, a binary logistic regression and a multivariate logistic regression model were used. Based on a p-value of 0.05, variables that had an independent link with sexual dysfunction were found. The adjusted odds ratio and its associated 95% confidence interval were also used to analyze the direction and intensity of the link.

Results

A total of 307 diabetic men participated in the study, with a mean age of (52.74, 16.16) and a mean duration of (5.94, 2.974). In this study, 252 people (82.1%) experienced erectile dysfunction, with mild, moderate, and severe cases represented by 30%, 38%, and 14.1% of respondents, respectively. There were statistically significant associations between erectile dysfunction and age (adjusted odds ratio: 4.8, 95% confidence interval: 1.27-18.32), type of diabetes (adjusted odds ratio: 5.8, 95% confidence interval: 1.96-17.73), and comorbidities (adjusted odds ratio: 0.32, 95% confidence interval: 0.15-0.71).

Conclusion

This study showed that the prevalence rate of erectile dysfunction is high in Mettu Karl Comprehensive Specialized Hospital. Age, type of diabetes mellitus, and the presence of comorbidity were factors associated with erectile dysfunction. Therefore, assessment and management of erectile dysfunction in the diabetic clinic should be part of routine medical care during follow-up visits with diabetic patients.

Tracheal Intubation-related adverse events in pediatrics anesthesia in Ethiopia

BACKGROUND

Tracheal intubation is a common intervention for many pediatric surgical patients. Even though it can be lifesaving, it carries a risk of morbidity and even mortality. Evidence is lacking regarding the adverse events related to pediatric intubation in Ethiopia. This study is aimed to assess the scale of tracheal intubation-related adverse events with its associated factors in pediatrics surgical patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

METHODS

An Institutional-based cross-sectional study was conducted on 310 pediatric surgical patients who underwent major surgery from December 30, 2019, to February 30, 2020. All pediatrics patients scheduled for surgery under general anesthesia in the study period were included in this study. Data with complete information were entered into Epi Info version 7 and exported to SPSS version 22 for analysis. Descriptive statistics, bivariate, and multivariable logistic regression were computed to identify factors associated with tracheal intubation-related adverse events. The level of statistical significance was declared at a P-value of less than .05.

RESULT

In this study, the overall incidence of tracheal intubation-related adverse events in pediatrics patients was 36.5%. Being a neonate (AOR = 4.13, 95% CI: 1.26-13.49), emergency surgery (AOR = 3.39, 95% CI: 1.41-8.13), difficult intubation (AOR, 4.08, 95% CI: 1.01-7.50), intubation without using premedication (AOR = 1.75, 95% CI: 1.45-10.83), intubation without using muscle relaxant (AOR = 1.81; 95% CI: 1.10-8.14), and tracheal intubation attempted more than three times (AOR = 3.92, 95% CI: 0.16-7.39) were identified as independent predictors of tracheal intubation-related adverse events.

CONCLUSION AND RECOMMENDATIONS

The incidence of tracheal intubation-related adverse events in pediatric surgical patients is high. Anesthesia professionals should be vigilant and have a preplanned strategy to avoid intubation-related adverse events, especially in high-risk patients. The use of difficult airway algorithms, oxygen saturation monitoring, and training in simulation room are very important strategies to help reduce patient harm.