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Getachew M, Lerdal A, Småstuen MC, Eshete MT, Desta T, Lindberg MF. Modifiable factors associated with a consistently high acute pain trajectory after surgical treatment of traumatic fractures in Ethiopia: a multi-center prospective cohort study. J Orthop Surg Res 2023; 18:288. [PMID: 37038171 PMCID: PMC10084616 DOI: 10.1186/s13018-023-03770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND In Ethiopia, little is known about postoperative pain trajectories and possible predictive factors associated with them in patients undergoing surgery following traumatic fractures. METHODS This multi-center prospective observational cohort study included surgical candidates for traumatic fractures (n = 218). Worst pain intensity was measured with an 11-point numeric rating scale on the first 4 postoperative days and day of hospital discharge. Growth mixture modeling was used to identify subgroups of patients based on their pain trajectories, and logistic regression models to quantify associations between pain trajectories and demographic, clinical, psychological, and life style factors. RESULTS Two postoperative pain trajectory subgroups were identified: rapid pain relief (48% of included individuals) and consistently high pain (52% of included individuals). Sub-analysis stratified by cause of injury demonstrated that higher preoperative pain was an independent risk factor for consistently high postoperative pain regardless of the patient's injury type: traffic accident (OR = 1.48, 95% CI 1.23-1.79), machine/tool injury or conflict (OR = 1.58, 95% CI 1.11-2.26), or fall (OR = 1.47, 95% CI 1.08-1.99). Moreover, longer surgical time was a risk factor for consistently high postoperative pain among patients who had a fall-related injury (OR = 1.02, 95% CI 1.00-1.03). In contrast, among patients with a traffic-related injury, receiving a nerve block was a protective factor (OR = 0.19, 95% CI 0.04-0.87) compared with general anesthesia. CONCLUSION Higher preoperative pain and longer surgical time were associated with a consistently high acute postoperative pain trajectory. Clinicians may use these potentially modifiable factors to identify patients at risk for consistently high pain during the early postoperative period.
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Affiliation(s)
- Mestawet Getachew
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Research and Administration, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Research and Administration, Lovisenberg Diaconal Hospital, Oslo, Norway
- Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Million Tesfaye Eshete
- Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tilahun Desta
- Department of Orthopedics and Traumatology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Maren Falch Lindberg
- Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
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Melaku T, Assefa D, Gashe F, Getachew M, Kabeta T, Mekonnen Z. Impact of COVID-19 pandemic on the availability of maternal and child health products and childhood vaccines. J Pharm Policy Pract 2023; 16:35. [PMID: 36864509 PMCID: PMC9979878 DOI: 10.1186/s40545-023-00541-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND In many low- and middle-income countries, the 2019 novel coronavirus (COVID-19) has challenged efforts to ensure access to and availability of quality maternal, newborn, and child health (MCH) services and essential MCH commodities. OBJECTIVES This study evaluated the impact of COVID-19 pandemic on the availability of maternal and child health products and childhood vaccines at selected health facilities in Ethiopia. METHODS We have prospectively assessed 28 maternal-child health products and 14 childhood vaccines and accessories, which are listed in the Ethiopian national essential medicines list. Data were collected from 5 hospitals located in the Jimma zone of Oromia regional state in the southwestern part of Ethiopia. We extracted data on drug availability, and order fill rates for these pharmaceutical products between May 2019 and August 2020. RESULTS The overall mean availability of selected maternal and child health products was 43.2%. It was 52.9% (range 21.0-63.6%) prior COVID-19 and 42.6% (range 19-56.4) during COVID-19 time. The average monthly orders fill rates of hospitals for the selected products ranged from 39 to 79%. Before COVID-19 the average order fill rate was near 70% of total orders placed by the hospitals. However, immediately after the COVID-19 case notification in Ethiopia, the percentage of order filled correctly in items and quantities began decreasing. CONCLUSION This study illustrates that the availability of key essential medicines for maternal and child health in the study area was low. The overall stock-out situation of MCH products has worsened during COVID-19 compared to pre-COVID-19 pandemic. None of the surveyed MCH products met the ideal availability benchmark of 80% in the public hospitals. To allow governments to guarantee these products are constantly available and affordable, a variety of policy frameworks and choices addressing inevitable epidemics should exist.
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Affiliation(s)
- Tsegaye Melaku
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Desta Assefa
- grid.411903.e0000 0001 2034 9160School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fanta Gashe
- grid.411903.e0000 0001 2034 9160School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- grid.411903.e0000 0001 2034 9160School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Temesgen Kabeta
- grid.411903.e0000 0001 2034 9160Department of Health Policy and Management, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- grid.411903.e0000 0001 2034 9160School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Sefera B, Getachew M, Babu Y, Bekele F, Fanta K. Drug-related problems and its predictors among hospitalized heart failure patients at Jimma Medical Center, South West Ethiopia: prospective interventional study. BMC Cardiovasc Disord 2022; 22:418. [PMID: 36123632 PMCID: PMC9487104 DOI: 10.1186/s12872-022-02859-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background Drug-related problems are associated with high mortality, complications, prolonged hospital stay, compromised quality of life, and increased healthcare costs. This problem is high in patients hospitalized with chronic conditions such as heart failure. However, there are limited studies conducted on this area, particularly in Ethiopia. Objective To evaluate drug-related problems, their predictors, and clinical pharmacist intervention among hospitalized heart failure patients at Jimma Medical Center, Ethiopia. Methods and participants A prospective interventional study was conducted among hospitalized heart failure patients from September 30, 2020, to May 28, 2021, at Jimma Medical Center. Drug-related problems were sorted based on the Pharmaceutical Care Network Europe drug classification tool version 9.0. Patient's specific data were collected using a structured questionnaire. Data was analyzed using statistical software package version 23.0. Multivariate logistic regression analysis was used to identify independent predictors of drug-related problems occurrence and statistical significance was considered at a p value < 0.05. Results A total of 237 heart failure patients were included in this study. The mean (SD) age was 49.06 + 17.79. About two-thirds (66.2%) of study patients had at least one drug-related problem during their hospital stay. A total of 283 drug-related problems were identified among 157 patients. Treatment effectiveness-related problem (55.48%) was the most common observed drug-related problem. The independent predictors of drug-related problems were khat chewing [AOR = 3.25, 95% CI = (1.46–7.23)], hospital stay > 18 days [AOR = 3.77, 95% CI = (1.93–7.37)]; presence of comorbid condition [AOR = 2.59, 95% CI = (1.35–4.96)] and polypharmacy [AOR = 2.94, 95% CI = (1.54–5.61)]. Conclusion The prevalence of drug-related problems was high among hospitalized heart failure patients in the study area. Chewing khat, prolonged hospital stay, comorbidity, and polypharmacy were the predictors of drug-related problems. Hence, to overcome these problems, clinical pharmacists, physicians, and other health professionals have to work in collaboration.
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Affiliation(s)
- Birbirsa Sefera
- Department of Pharmacy, College of Health Science, Mettu University, Mettu, Oromia, Ethiopia.
| | - Mestawet Getachew
- School of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Oromia, Ethiopia
| | - Yadeta Babu
- Department of Pharmacy, College of Health Science, Mettu University, Mettu, Oromia, Ethiopia
| | - Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mettu University, Mettu, Oromia, Ethiopia
| | - Korinan Fanta
- School of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Oromia, Ethiopia
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4
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Mohammed M, Bayissa B, Getachew M, Adem F. Drug-related problems and determinants among elective surgical patients: A prospective observational study. SAGE Open Med 2022; 10:20503121221122438. [PMID: 36093421 PMCID: PMC9459467 DOI: 10.1177/20503121221122438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 08/05/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives The aim of this study was to assess drug-related problems and determinants among elective surgical patients admitted to Jimma University Medical Center. Methods A hospital-based prospective observational study was conducted at Jimma University Medical Center, from April 10 to July 10, 2018. Data were collected through patients' interview and physicians' medication orders and charts review using pre-tested questionnaire and data abstraction formats. Drug-related problems were assessed for each patient using drug-related problem classification tool. Data were analyzed using Statistical Package for Social Science for windows; version 21.0. The predictors of drug-related problems were determined by multivariable logistic regression analysis. A p-value of less than or equal to 0.05 was considered to be statistically significant. Results Of the total 141 participants, 98 (69.5%) of them had at least one drug-related problem during their hospital stay. A total of 152 drug-related problems were identified among 141 elective surgical patients. The most common identified drug-related problems were indication-related problems (39%) followed by effectiveness-related problems (21%) and safety-related problems (21%). The presence of complication (adjusted odds ratio = 2.90, 95% confidence interval (1.302, 3.460)), American Society of Anesthesiologists Physical Status ⩾ 2 (adjusted odds ratio = 6.01, 95% confidence interval (1.0011, 9.500)), and postoperative antibiotics (adjusted odds ratio = 6.027, 95% confidence interval (1.594, 22.792)) were independent predictors of drug-related problems. Conclusion The prevalence of drug-related problems is high among elective surgical patients. The indication-related problems were the most common category of drug-related problem identified among elective surgical patients. The presence of complication, American Society of Anesthesiologists Physical Status ⩾ 2, and postoperative antibiotics were the independent predictors of drug-related problems.
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Affiliation(s)
- Mesud Mohammed
- Department of Pharmacy, School of Medicine, Madda Walabu University, Goba, Ethiopia
| | - Bodena Bayissa
- School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- School of Pharmacy, Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Fuad Adem
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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Getachew M, Lerdal A, Småstuen MC, Gay CL, Aamodt A, Tesfaye M, Lindberg MF. Worst pain intensity and opioid intake during the early postoperative period were not associated with moderate-severe pain 12 months after total knee arthroplasty - a longitudinal study. Scand J Pain 2022; 23:364-371. [PMID: 35938939 DOI: 10.1515/sjpain-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES There are several known predictors of pain after total knee arthroplasty (TKA). However, it is unclear whether acute postoperative pain intensity and postoperative opioid intake are associated with pain 12 months after TKA. Thus, the aim of this study was to assess whether worst pain intensity and opioid intake during the early postoperative period are associated with moderate-severe pain 12 months after TKA. METHODS A total of 202 patients undergoing primary TKA between October 2012 and September 2014 were prospectively enrolled. Age, sex, contralateral knee pain, BMI, physical status and opioid intake were collected preoperatively. Ketamine and daily opioid intake were collected on postoperative days (POD) 0-3. Using the Brief Pain Inventory, patients' "worst pain intensity" was measured preoperatively, on POD 0-4, and 12 months after TKA. Two logistic regression models evaluated the independent association of early postoperative pain intensity (model 1) and postoperative opioid intake (model 2) with moderate-severe pain 12 months after TKA, adjusting for possible confounders. RESULTS In total, 187 patients with data at the 12 month postoperative follow-up were included in this analysis. Pain intensity on POD2 and POD3, as well as preoperative pain and BMI, were significantly associated with pain at 12 months in univariate models. However, in multivariable models adjusted for preoperative pain and BMI, neither pain intensity on POD 0-4 (model 1) nor opioid intake on POD 0-3 (model 2) were associated with pain at 12 months. Preoperative pain was still significant in both models, but BMI remained significant only in model 2. CONCLUSIONS Worst pain intensity and opioid intake during the early postoperative period were not associated with moderate-severe pain 12 months after TKA when controlling for potential confounders. More research is needed to confirm these findings.
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Affiliation(s)
- Mestawet Getachew
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.,Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Scociety, Faculty of Medicine, University of Oslo, Oslo, Norway.,Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway.,Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Caryl L Gay
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Arild Aamodt
- Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Million Tesfaye
- Department of Anesthesiology, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Maren Falch Lindberg
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
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Mitiku P, Scholten JN, Getachew M, Mulder C. 3HP almost doubled the uptake of TB preventive treatment among PLHIV. Int J Tuberc Lung Dis 2022; 26:381-382. [PMID: 35351249 DOI: 10.5588/ijtld.22.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- P Mitiku
- IMPAACT4TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia
| | - J N Scholten
- Technical Division, KNCV Tuberculosis Foundation, The Hague, the Netherlands
| | - M Getachew
- HIV and Viral Hepatitis Prevention and Control, Disease Prevention and Control Directorate, Ministry of Health, Addis Ababa, Ethiopia
| | - C Mulder
- Technical Division, KNCV Tuberculosis Foundation, The Hague, the Netherlands
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Getachew M, Yeshigeta R, Tiruneh A, Alemu Y, Dereje E, Mekonnen Z. Soil-Transmitted Helminthic Infections and Geophagia among Pregnant Women in Jimma Town Health Institutions, Southwest Ethiopia. Ethiop J Health Sci 2021; 31:1033-1042. [PMID: 35221621 PMCID: PMC8843140 DOI: 10.4314/ejhs.v31i5.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022] Open
Abstract
Background Pregnancy is a key step for human's reproduction and continuity of generation. Pregnant women are among at risk groups for the infection of soil-transmitted helminths (STHs). STHs are highly prevalent in low- and middle-income countries due to the deprived environmental sanitation and personal hygiene. Eating soil (geophagia) is also commonly practiced by pregnant women, particularly in developing countries. The aim of this study was to determine the prevalence of STHs and geophagia, and to assess associated factors among pregnant women in Jimma, Southwest Ethiopia. Methods A cross sectional study was conducted among 407 pregnant women attending antenatal care (ANC) at different health facilities located in Jimma Town. Data related to sociodemographic and geophagia practice was collected using a structured questionnaire and STH infections status was determined by using McMaster technique. Results A total of 407 pregnant women were included in this study. The overall prevalence of any STHs was 19.7% (80/407). Ascaris lumbricoides was the most prevalent 45(56.2%), followed by Trichuris trichiura 19(23.8%) and hookworms 12(15%). There were 4(5%) of double infection with A. lumbricoides and T. trichiura. Overall, 71 (17.4%) of the pregnant women responded to practice geophagia. STHs infection was significantly higher among geophagic pregnant women (p<0.01) and pregnant women who practiced geophagia were 3 times more likely (OR 2.9, 95% CI 1.3–4.2) to have the STHs compared to non-geophagic. Out of those who claimed soil eating habits, 59.1% preferred reddish soil type. Geophagia practice was significantly higher during the third trimester as compared to first and second (p<0.05). Conclusion Geophagia is a risky behavior and this study showed a significant association of geophagia practice with STH infections, although the causal relation could not be established.
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Affiliation(s)
| | - Ruth Yeshigeta
- School of Medical Laboratory Sciences, Institute of Health, Jimma University
| | - Abebaw Tiruneh
- School of Medical Laboratory Sciences, Institute of Health, Jimma University
| | - Yonas Alemu
- School of Medical Laboratory Sciences, Institute of Health, Jimma University
| | - Eden Dereje
- Molecular Biology Research Center, Jimma University
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University
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Geiger M, Hockenhull J, Buller H, Kedir MJ, Engida GT, Getachew M, Burden FA, Whay HR. Comparison of the socio-economic value and welfare of working donkeys in rural and urban Ethiopia. Anim Welf 2021. [DOI: 10.7120/09627286.30.3.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Donkeys (Equus asinus) are widely used throughout Ethiopia and play essential roles in a variety of everyday and income-generating tasks for the people that use them. The challenges faced by people and their working equids vary across communities and geographic locations. This
may have implications for how donkeys are perceived by the people they work for, the roles they fulfil and ultimately their welfare. Two complementary methodological approaches were used in this study to explore the socio-economic value of donkeys for their owners and the welfare of the donkeys
in rural and urban Ethiopia. Using a questionnaire, donkey owners were asked about their donkeys, their attitudes and beliefs related to donkey use and ownership, and the role donkeys played in their lives. Animal-based welfare assessments were also conducted on a sample of donkeys from different
locations, with the overarching aim of the study to investigate differences in use, beliefs, and donkey welfare between rural and urban locations. In both rural and urban locations, working donkeys are critical for their owners' income-generating activity and therefore their livelihoods. The
work they undertake differs substantially between locations, as does their welfare. Work in each setting presents its own challenges and these are reflected in the behaviour and physical health of the donkeys. Rural donkeys showed more apathetic behaviour, a higher ectoparasite burden and
greater evidence of tethering/hobbling. Urban donkeys were more alert and had a wider range of body condition scores. The findings highlight marked differences in the role and welfare of donkeys between different areas within the same country, demonstrating the importance of understanding
the context, both from the perspective of humans and working equids, prior to staging interventions intended to benefit either party.
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Sahilu T, Getachew M, Melaku T, Sheleme T. Adverse Drug Events and Contributing Factors Among Hospitalized Adult Patients at Jimma Medical Center, Southwest Ethiopia: A Prospective Observational Study. Curr Ther Res Clin Exp 2020; 93:100611. [PMID: 33296443 PMCID: PMC7689274 DOI: 10.1016/j.curtheres.2020.100611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/18/2020] [Indexed: 12/20/2022] Open
Abstract
Background Adverse drug events (ADEs) are common complications of clinical care resulting in significant morbidity, mortality, and high clinical expenditure. Population-level estimates of inpatient ADEs are limited in Ethiopia. Objective This study aimed to assess the incidence, contributing factors, severity, and preventability of ADEs among hospitalized adult patients at Jimma Medical Center, Ethiopia. Methods A prospective observational study design was conducted among hospitalized adult patients at tertiary hospital in Ethiopia. A structured data collection tool was prepared from relevant literatures for data collection. Data were analyzed using statistical software. Logistic regression was performed to identify factors contributing to ADE occurrence. P values < 0.05 were considered statistically significant. Results A total of 319 patients were included with follow-up period of 5667 person-days. About 50.5% were women. The mean (SD) age of patients was 43 (17.6) years. One hundred sixteen ADEs were identified with the incidence of 36.4 (95% CI, 30.1-43.6) per 100 admissions and 20.5 (95% CI, 16.9-24.6) per 1000 person-days. Antituberculosis agents (adjusted odds ratio [aOR] = 2.52; 95% CI, 1.06-5.98; P = 0.036), disease of the circulatory system (aOR = 2.67; 95% CI, 1.46-4.89; P = 0.001), disease of the digestive system (aOR = 2.84; 95% CI, 1.45-5.57; P = 0.002), being on medication during admission (aOR = 3.09; 95% CI, 1.77-5.41; P < 0.001), and hospital stay more than 2 weeks (aOR = 3.93; 95% CI, 1.39-11.12; P = 0.010) were independent predictors of ADE occurrence. Conclusions One in every 4 patients admitted to the hospital experienced ADEs during their hospital stay. Most ADEs were moderate in severity. About two-thirds of the ADEs identified were deemed probably or definitely preventable. Therefore, it is high time to reinforce large-scale efforts to redesign safer, higher quality health care systems to adequately tackle the problem.
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Affiliation(s)
- Tamiru Sahilu
- Department of Pharmacy, College of Health Science, Assosa University, Assosa, Ethiopia
| | - Mestawet Getachew
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tsegaye Melaku
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tadesse Sheleme
- Department of Pharmacy, College of Public Health and Medical Science, Mettu University, Metu Zuria, Ethiopia
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10
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Getachew M, Lerdal A, Småstuen MC, Gay CL, Aamodt A, Tesfaye M, Lindberg MF. High levels of preoperative pain and fatigue are red flags for moderate-severe pain 12 months after total knee arthroplasty-A longitudinal cohort study. Musculoskeletal Care 2020; 19:186-192. [PMID: 33085181 PMCID: PMC8247059 DOI: 10.1002/msc.1522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/27/2022]
Abstract
Background Moderate/severe pain after total knee arthroplasty (TKA) is a poor surgical outcome. Many studies have identified preoperative risk factors of pain after TKA, but studies of the joint contributions of co‐occurring symptoms are lacking. Methods Patients undergoing primary TKA (n = 202) were enrolled in a longitudinal cohort study. Preoperatively, patients completed questionnaires measuring demographics and symptoms (pain, fatigue, sleep problems and depression). Pain was re‐assessed 12 months after TKA. Logistic regression analysis was used to compute the probabilities of moderate‐severe pain at 12 months based on preoperative symptom levels, and results were combined into a risk matrix. Results More than one‐third (40%) of patients (n = 187) reported moderate‐severe pain after TKA. Among preoperative risk factors included in the logistic regression analyses were age, sex, pain, fatigue, sleep problems and depression. Adjusting for possible confounders, fatigue (p = 0.02) and pain (p = 0.01) were significant risk factors for moderate‐severe pain at 12‐months follow‐up and were retained in the final risk matrix. The co‐occurrence of high‐preoperative fatigue and pain scores resulted in 57% estimated probability of moderate‐severe pain at 12 months. Similarly, the co‐occurrence of low‐preoperative fatigue and pain scores resulted in 14% estimated probability of moderate‐severe pain 12 months after TKA. Conclusion The combination of high fatigue and pain scores prior to surgery was a key risk factor for moderate‐severe pain 12 months after TKA. Mapping of these factors could be used preoperatively to identify patients who are at risk to experience a poor outcome of TKA.
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Affiliation(s)
- Mestawet Getachew
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Research and Administration, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Research and Administration, Lovisenberg Diaconal Hospital, Oslo, Norway.,Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Caryl L Gay
- Department of Research and Administration, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Family Health Care Nursing, University of California, San Francisco, California, USA
| | - Arild Aamodt
- Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Million Tesfaye
- Department of Anesthesiology, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Maren Falch Lindberg
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway
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11
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Hailu BY, Berhe DF, Gudina EK, Gidey K, Getachew M. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. BMC Geriatr 2020; 20:13. [PMID: 31931723 PMCID: PMC6958579 DOI: 10.1186/s12877-020-1413-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/03/2020] [Indexed: 01/09/2023] Open
Abstract
Background Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients often excluded from premarketing trials that can further increase the occurrence of DRPs. This study aimed to identify drug related problems and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods A prospective interventional study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR] = 4.350, 95% C.I: 1.212–9.260, p = 0.020) and number of comorbidities (AOR = 1.588, 95% C.I: 1.029–2.450, p = 0.037). Conclusions Drug related problems were substantially high among geriatric inpatients. Patients with polypharmacy and co-morbidities had a much higher chance of developing DRPs. Hence, special attention is needed to prevent the occurrence of DRPs in these patients. Moreover, clinical pharmacists’ intervention was found to reduce DRPs in geriatric inpatients. The prescriber acceptance rate of clinical pharmacists’ intervention was also substantially high.
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Affiliation(s)
- Berhane Yohannes Hailu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Derebew Fikadu Berhe
- Department of Pharmacology and Toxicology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Esayas Kebede Gudina
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mestawet Getachew
- Department of clinical pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
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Mekonnen Z, Getachew M, Bogers J, Vercruysse J, Levecke B. Assessment of seasonality in soil-transmitted helminth infections across 14 schools in Jimma Town, Ethiopia. Pan Afr Med J 2019; 32:6. [PMID: 31068999 PMCID: PMC6492303 DOI: 10.11604/pamj.2019.32.6.16085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/11/2018] [Indexed: 12/22/2022] Open
Abstract
Introduction Up to date, the frequency of preventive chemotherapy based on the prevalence is the only strategy in the control programmes of soil-transmitted helminths (STHs). However, prevalence of STHs may be affected by climatic and/or seasonal changes, particularly when these are important determinants of transmission of STH infections. Our objective was to describe the prevalence and infection intensity and seasonal variation (mainly dry vs rainy season) of any STHs among school age children. Methods Assessment of infection intensity and prevalence of STHs was carried out during dry season (February-March, 2012) and end of rainy season (September-October, 2012) across 14 primary schools in Jimma Town, Jimma, Ethiopia. A total of 1,680 school children (840 in each season) were included. All stool samples were processed by the McMaster egg counting method. Odds of infection and intensity was performed to assess any differences in prevalence and infection intensity between the schools and the two seasons. The pooled odd ratio and their 95% confidence interval was also computed and presented using the "metafor" package of the statistical software R. The level of significance was declared at p < 0.05. Results Infections with any STH were observed in 824/1,680 (49.0%) subjects. T. trichiura was the most prevalent (35.5%), followed by A. lumbricoides (23.4%) and hookworms (9.9%). Among the schools there were a huge variation in prevalence, ranging from 16.7% to 68.3% for any STH, 6.7% to 39.2% for A. lumbricoides, 10.8% to 55.0% for T. trichiura and 0 % to 28.3% for hookworms. A significant difference in prevalence (for T. trichiura) and in infection intensity (for A. lumbricoides and T. trichiura) across seasons was observed. Generally, STH infections were more prevalent in the dry season (52.4%) compared to the rainy season (45.7%) and as well intensity of all three STH infections was higher in the dry season. Conclusion Our data suggested that there were huge variation in STH prevalence among schools and a significant difference in infection intensity and prevalence across seasons. This in turn might limits how national governments and international organizations define and target resources to combat the disease burden due to STH infection. Long term studies are needed to confirm the influence of seasonal factors and related ecological, environmental and socio-economic factors.
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Affiliation(s)
- Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Johannes Bogers
- Applied Molecular Biology Research (AMBIOR) Group, Antwerp University, Antwerp, Belgium
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, University of Ghent, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, University of Ghent, Belgium
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Getachew M, Tewelde T. Cosmetic Use and Its Adverse Events among Female Employees of Jimma University, Southwest Ethiopia. Ethiop J Health Sci 2018; 28:717-724. [PMID: 30607088 PMCID: PMC6308756 DOI: 10.4314/ejhs.v28i6.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/13/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cosmetics is applied to human body for cleansing, beautifying, promoting attractiveness or altering appearance. Cosmetics is causing alarming adverse events to its users, yet evidence about its magnitude and cosmetic use among female employees in Ethiopia is limited. Therefore, this study was aimed at determining cosmetic use and its adverse events among female employees of Jimma University. METHOD A cross-sectional study was done among female employees from December 2016 to January 2017. Samples of 426 participants were selected using stratified simple random sampling from all colleges, and data were collected using self-administered questionnaire. Descriptive statistics was used to compute proportions and logistic regression to assess the determinants of cosmetics-related adverse events. RESULT A total of 387 females were participated, making a 90.8% response rate. The majority (80.1%) were using at least one cosmetic product, and 39.0% of them were between 25-29 years. The majority (86.6%) of the respondents used toothpaste, lotion, lipstick, or eye makeup. Cosmetics related adverse events were experienced by 19.0% of the respondents primarily on face and hairs. Lotion and hair cosmetics were the primary perceived causes of adverse events. Employees who had monthly income between 1000 and 3000 ETB (AOR=3.4; 95% CI: 1.4-8.4), above 3000 ETB (AOR=4.7; 95% CI: 1.8-12.2) and those who used traditional cosmetics (AOR=4.5; 95% CI: 2.1-9.6) were more likely to develop adverse events. CONCLUSION A significant proportion of the users suffered from cosmetics related adverse events. The female employees have to be aware of the rational cosmetics utilization practices to minimize adverse events.
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Affiliation(s)
| | - Tsegaye Tewelde
- Department of Epidemiology, Institute of Health, Jimma University, Ethiopia
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Bekele A, Gebreselassie N, Ashenafi S, Kassa E, Aseffa G, Amogne W, Getachew M, Aseffa A, Worku A, Raqib R, Agerberth B, Hammar U, Bergman P, Aderaye G, Andersson J, Brighenti S. Daily adjunctive therapy with vitamin D 3 and phenylbutyrate supports clinical recovery from pulmonary tuberculosis: a randomized controlled trial in Ethiopia. J Intern Med 2018; 284:292-306. [PMID: 29696707 PMCID: PMC6202271 DOI: 10.1111/joim.12767] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Immunotherapy using vitamin D (vitD3 ) and phenylbutyrate (PBA) may support standard drug regimens used to treat infectious diseases. We investigated if vitD3 + PBA enhanced clinical recovery from pulmonary tuberculosis (TB). METHODS A randomized controlled trial was conducted in Addis Ababa, Ethiopia. Patients with smear-positive or smear-negative TB received daily oral supplementation with 5000 IU vitD3 and 2 × 500 mg PBA or placebo for 16 weeks, together with 6-month chemotherapy. Primary end-point: reduction of a clinical composite TB score at week 8 compared with baseline using modified intention-to-treat (mITT, n = 348) and per-protocol (n = 296) analyses. Secondary end-points: primary and modified TB scores (week 0, 4, 8, 16, 24), sputum conversion, radiological findings and plasma 25(OH)D3 concentrations. RESULTS Most subjects had low baseline plasma 25(OH)D3 levels that increased gradually in the vitD3 + PBA group compared with placebo (P < 0.0001) from week 0 to 16 (mean 34.7 vs. 127.4 nmol L-1 ). In the adjusted mITT analysis, the primary TB score was significantly reduced in the intervention group at week 8 (-0.52, 95% CI -0.93, -0.10; P = 0.015) while the modified TB score was reduced at week 8 (-0.58, 95% CI -1.02, -0.14; P = 0.01) and 16 (-0.34, 95% CI -0.64, -0.03; P = 0.03). VitD3 + PBA had no effect on longitudinal sputum-smear conversion (P = 0.98). Clinical adverse events were more common in the placebo group (24.3%) compared with the vitD3 + PBA group (12.6%). CONCLUSION Daily supplementation with vitD3 + PBA may ameliorate clinical TB symptoms and disease-specific complications, while the intervention had no effect on bacterial clearance in sputum.
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Affiliation(s)
- A Bekele
- Department of Internal Medicine, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - N Gebreselassie
- Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.,Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - S Ashenafi
- Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - E Kassa
- Department of Internal Medicine, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - G Aseffa
- Department of Radiology, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - W Amogne
- Department of Internal Medicine, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - M Getachew
- Department of Internal Medicine, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - A Worku
- Department of Public Health, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - R Raqib
- Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - B Agerberth
- Clinical Microbiology, Department of Laboratory Medicine (Labmed), Karolinska Institutet, Stockholm, Sweden
| | - U Hammar
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - P Bergman
- Clinical Microbiology, Department of Laboratory Medicine (Labmed), Karolinska Institutet, Stockholm, Sweden
| | - G Aderaye
- Department of Internal Medicine, Faculty of Medicine, Black Lion University Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - J Andersson
- Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.,Division of Infectious Diseases, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - S Brighenti
- Center for Infectious Medicine (CIM), F59, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
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Bekana T, Mekonnen Z, Zeynudin A, Ayana M, Getachew M, Vercruysse J, Levecke B. Comparison of Kato-Katz thick-smear and McMaster egg counting method for the assessment of drug efficacy against soil-transmitted helminthiasis in school children in Jimma Town, Ethiopia. Trans R Soc Trop Med Hyg 2016; 109:669-71. [PMID: 26385937 DOI: 10.1093/trstmh/trv073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is a paucity of studies that compare efficacy of drugs obtained by different diagnostic methods. METHODS We compared the efficacy of a single oral dose albendazole (400 mg), measured as egg reduction rate, against soil-transmitted helminth infections in 210 school children (Jimma Town, Ethiopia) using both Kato-Katz thick smear and McMaster egg counting method. RESULTS Our results indicate that differences in sensitivity and faecal egg counts did not imply a significant difference in egg reduction rate estimates. CONCLUSION The choice of a diagnostic method to assess drug efficacy should not be based on sensitivity and faecal egg counts only.
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Affiliation(s)
- Teshome Bekana
- Department of Biomedical Science, Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Ghent University, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Ghent University, Belgium
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Belew S, Getachew M, Suleman S, Mohammed T, Deti H, D'Hondt M, Wynendaele E, Mekonnen Z, Vercruysse J, Duchateau L, De Spiegeleer B, Levecke B. Assessment of Efficacy and Quality of Two Albendazole Brands Commonly Used against Soil-Transmitted Helminth Infections in School Children in Jimma Town, Ethiopia. PLoS Negl Trop Dis 2015; 9:e0004057. [PMID: 26406600 PMCID: PMC4583991 DOI: 10.1371/journal.pntd.0004057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/14/2015] [Indexed: 11/30/2022] Open
Abstract
Background There is a worldwide upscale in mass drug administration (MDA) programs to control the morbidity caused by soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis) available on the local market in Ethiopia. Methodology/Principal Findings A randomized clinical trial was conducted according to the World Health Organization (WHO) guidelines to assess drug efficacy, by means of egg reduction rate (ERR), of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%), but showed poor efficacy against T. trichiura (~20%). For hookworms, Ovis was significantly (p < 0.05) more efficacious compared to Bendex (98.1% vs. 88.7%). Assessment of the physicochemical quality of the drugs revealed a significant difference in dissolution profile, with Bendex having a slower dissolution than Ovis. Conclusion/Significance The study revealed that differences in efficacy between the two brands of albendazole (ABZ) tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before conducting efficacy assessment in any clinical trials to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a factor of reduced drug efficacy other than anthelminthic resistance. Overall, this paper demonstrates that “all medicines are not created equal”. Soil-transmitted helminths (STHs) infect millions of children worldwide. To fight STH, large-scale de-worming programs are implemented in which anthelmintic drugs (either albendazole (ABZ) or mebendazole (MEB)) are administered. However, there is a wide range of other brands, which are even more accessible, but for which the efficacy and quality remain poorly explored. We evaluated efficacy against STHs and quality of two ABZ brands commonly available on the local markets in Ethiopia (Bendex and Ovis). Both brands showed high efficacy against roundworm infections and poor efficacy against whipworms. However, for hookworm infections, Bendex was significantly less efficacious than Ovis. In terms of drug quality, a significant difference was observed in the dissolution profile, with Bendex having a significantly slower dissolution rate than Ovis. Since dissolution behavior is critical for a drug to be appropriately absorbed into the helminth (through host-blood and/or parasite-cuticle) and produce therapeutic efficacy, the poor dissolution of Bendex compared to Ovis can explain the observed difference in efficacy against hookworms. Our results emphasize the importance of periodically assessing of drug quality to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a potential factor of reduced drug efficacy other than drug resistance.
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Affiliation(s)
- Sileshi Belew
- School of Pharmacy, Jimma University, Jimma, Ethiopia
- Drug Quality and Registration Group, Department of Pharmaceutical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Gent, Belgium
| | - Mestawet Getachew
- Jimma University Specialized Hospital, Jimma University, Jimma, Ethiopia
| | - Sultan Suleman
- School of Pharmacy, Jimma University, Jimma, Ethiopia
- Drug Quality and Registration Group, Department of Pharmaceutical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Gent, Belgium
| | | | | | - Matthias D'Hondt
- Drug Quality and Registration Group, Department of Pharmaceutical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Gent, Belgium
| | - Evelien Wynendaele
- Drug Quality and Registration Group, Department of Pharmaceutical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Gent, Belgium
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luc Duchateau
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Bart De Spiegeleer
- Drug Quality and Registration Group, Department of Pharmaceutical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Gent, Belgium
- * E-mail: (BDS); (BL)
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- * E-mail: (BDS); (BL)
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Dana D, Mekonnen Z, Emana D, Ayana M, Getachew M, Workneh N, Vercruysse J, Levecke B. Prevalence and intensity of soil-transmitted helminth infections among pre-school age children in 12 kindergartens in Jimma Town, southwest Ethiopia. Trans R Soc Trop Med Hyg 2014; 109:225-7. [PMID: 25371496 DOI: 10.1093/trstmh/tru178] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pre-school age children (preSAC) remain difficult to reach in mass drug administration (MDA) programmes to control soil-transmitted helminth (STH) infections. Kindergartens provide a unique platform to increase the coverage of MDA in preSAC in Ethiopia, but surveys assessing STHs among preSAC in kindergartens are scarce. METHODS We report the prevalence and intensity of STH infections among 622 preSAC in 12 kindergartens in Jimma, Ethiopia. RESULTS STHs were found in all kindergartens, with prevalence exceeding 50% in 8 kindergartens. The majority of the infections were of low intensity. CONCLUSIONS This study highlights the importance of kindergartens as an additional opportunity for MDA in Ethiopia.
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Affiliation(s)
- Daniel Dana
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Daniel Emana
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Mestawet Getachew
- Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Netsanet Workneh
- Department of Paediatrics, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
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Peachey L, Pinchbeck G, Scantlebury C, Tefera G, Getachew M, Etana D, Burden F, Trawford A, Matthews J, Hodgkinson J. The evaluation of African and UK bioactive plant extracts for the control of equid gastrointestinal nematodes. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2012.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Getachew M, Alemseged F, Abera M, Deribew A. Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia. ETHIOP J HEALTH DEV 2011. [DOI: 10.4314/ejhd.v24i3.68388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Getachew M, Innocent GT, Trawford AF, Reid SWJ, Love S. Epidemiological features of fasciolosis in working donkeys in Ethiopia. Vet Parasitol 2010; 169:335-9. [PMID: 20138432 DOI: 10.1016/j.vetpar.2010.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 12/22/2009] [Accepted: 01/05/2010] [Indexed: 12/01/2022]
Abstract
A cross-sectional coprological survey in the tropical regions of Ada, Akaki, Bereh and Boset, and a retrospective post-mortem investigation were conducted to study the epidemiology of fasciolosis in working donkeys in Ethiopia. Faecal samples from 803 donkeys were collected, and the number of liver flukes recovered from 112 donkeys at post-mortem between 1995 and 2004 were analysed. There was a high prevalence of fasciolosis irrespective of the age of the donkeys. The overall prevalence of the infection was 44.4% in coprologically examined donkeys, and the prevalence in the donkeys examined post-mortem was 41.9%. The infection prevalence was significantly higher in Bereh and Ada regions than in Akaki and Boset regions. Bereh with 72.6% and Boset with 21.5% showed a significantly higher and lower infection prevalence, respectively, than the rest of the regions (P<0.001). There was no significant difference between different age groups of donkeys in the infection prevalence (P>0.05) but infection intensity was significantly higher in donkeys 8 years old and above (P<0.0001). Both Fasciola hepatica and Fasciola gigantica were identified.
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Affiliation(s)
- M Getachew
- Faculty of Veterinary Medicine, Addis Ababa University, Donkey Health and Welfare Project - Donkey Sanctuary, P.O. Box 34, Debre Zeit, Ethiopia.
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Getachew M, Trawford A, Feseha G, Reid SWJ. Gastrointestinal parasites of working donkeys of Ethiopia. Trop Anim Health Prod 2009; 42:27-33. [PMID: 19548106 DOI: 10.1007/s11250-009-9381-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 06/03/2009] [Indexed: 11/24/2022]
Abstract
The general prevalence and population composition of gastrointestinal and pulmonary helminths of working donkeys were studied. For the purpose 2935 working donkeys were coprologically examined for nematode and cestode, and 215 donkeys for trematode infections. Seven donkeys that died due to various health problems or were euthanased on a welfare ground were necropsied and the parasites were recovered and identified to the species level. The study was conducted during the periods 1996-1999.Coprological examination revealed 99% strongyle, 80% Fasciola, 51% Parascaris, 30% Gastrodiscus, 11% Strongyloides westeri, 8% cestodes and 2% Oxyuris equi infection prevalence. Over 55% of donkeys had more than 1000 eggs per gram of faeces (epg). Forty two different species of parasites consisting of 33 nematodes, 3 trematodes, 3 cestodes and 3 arthropod larvae were identified from postmortem examined donkeys. Among the nematodes 17 species of Cyathostominae and 7 species of Strongylinae were identified. Other parasites identified include, Habronema muscae, Draschia megastoma, Trichostrongylus axei, Strongyloides westeri, Anoplocephala perfoliata, Anoplocephala magna, Anoplocephaloides (Paranoplocephala) mamillana, Parascaris equorum, Fasciola hepatica, Fasciola gigantica, Gastrodiscus aegyptiacus, Dictyocaulus arnfieldi, Oxyuris equi, Probstmayria vivipara, Gasterophilus intestinalis, Gasterophilus nasalis, Rhinoestrus uzbekistanicus and Setaria equina. This study revealed that working donkeys in Ethiopia are infected with a range of helminths and arthropod larvae, which are representatives of the important pathogenic parasites found in equids worldwide.
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Affiliation(s)
- M Getachew
- Faculty of Veterinary Medicine, Addis Ababa University, Donkey Health and Welfare project-Donkey Sanctuary, P.O. Box 34, Debre Zeit, Ethiopia.
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Getachew M, Feseha G, Trawford A, Reid SWJ. A survey of seasonal patterns in strongyle faecal worm egg counts of working equids of the central midlands and lowlands, Ethiopia. Trop Anim Health Prod 2008; 40:637-42. [PMID: 18975128 DOI: 10.1007/s11250-008-9142-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2007] [Accepted: 02/11/2008] [Indexed: 10/22/2022]
Abstract
A study was conducted for two consecutive years (1998-1999) to determine the seasonal patterns of strongyle infection in working donkeys of Ethiopia. For the purpose 2385 donkeys from midland and lowland areas were examined for the presence of parasitic ova. A hundred percent prevalence of strongyle infection with similar seasonal pattern of strongyle faecal worm egg output was obtained in all study areas. However, seasonal variations in the number of strongyle faecal worm egg output were observed in all areas. The highest mean faecal worm egg outputs were recorded during the main rainy season (June to October) in both years in all areas. Although an increase in the mean strongyle faecal egg output was obtained in the short rainy season (March-April) followed by a drop in the short dry season (May), there was no statistically significant difference between the short rainy season and long dry season (Nov-Feb) (P > 0.05). A statistically significant difference however, was obtained between the main rainy season and short rainy season, and between the main rainy season and dry season (P < 0.05). Based on the results obtained it is suggested that the most economical and effective control of strongyles can be achieved by strategic deworming programme during the hot dry pre-main rainy season (May), when the herbage coverage is scarce and helminthologically 'sterile', and the arrested development of the parasites is suppose to be terminating. This could insure the greatest proportion of the existing worm population to be exposed to anthelmintic and also reduces pasture contamination and further infection in the subsequent wet season.
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Affiliation(s)
- M Getachew
- Faculty of Veterinary Medicine, Addis Ababa University, Donkey Health and Welfare Project-Donkey Sanctuary, P.O. Box 34, Debre Zeit, Ethiopia.
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