Dataset Information

Time to acute kidney injury and its predictors among newly diagnosed Type 2 diabetic patients at government hospitals in Harari Region, East Ethiopia.

ABSTRACT:

Background

Incidence of Acute Kidney Injury (AKI) among Type 2 diabetic patients is significantly increasing. But, earlier studies has focused on the admitted patients which may hide the true nature of the Acute Kidney Injury among Type 2 Diabetic (T2D) patients. So, this study was conducted to determine the time to Acute Kidney Injury and its predictors among Type 2 Diabetic patients in Harari Region, East Ethiopia.

Methods

We conducted a retrospective cohort study among type 2 diabetic patients who had been receiving treatment at government hospitals of Harari region, Ethiopia from 2013 to 2017. We extracted data from patients' medical records. We estimated incidence rate and compared survival curves between different exposure groups using Kaplan-Meier and log-rank test. Weibull regression model was fitted to the data to identify the predictor variables. Variables with p-value <0.05 were considered statistically significant.

Results

Overall, 14.5% (95%CI: 11.7-17.9) of the study population developed acute kidney injury, with median survival time of 57 months. The significant predictors were physical activity [Adjusted Time Ratio (ATR):95%CI; 0.6 (0.49-0.75)], congestive heart failure [ATR:95%CI; 0.84 (0.71-0.99)], chronic kidney disease [ATR:95%CI; 0.77(0.65-0.91)], hypertension [ATR:95%CI; 0.78(0.65-0.91)], obesity [ATR:95%CI; 0.84(0.74-0.96)], diabetic nephropathy [ATR:95%CI; 0.80(0.65-0.98)], diuretics & beta blockers [ATR:95%CI; 0.85(0.74-0.97)], and delay of follow-up [ATR:95%CI; 0.97(0.96-0.98)].

Conclusions

Incidence of acute kidney injury was high in our study area. Hence, identification and controlling of comorbidities along with regular monitoring of kidney function are needed to prevent or delay the risk of acute kidney injury in type 2 diabetic patients.

SUBMITTER: Regassa LD

PROVIDER: S-EPMC6497261 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Time to acute kidney injury and its predictors among newly diagnosed Type 2 diabetic patients at government hospitals in Harari Region, East Ethiopia.

Regassa Lemma Demissie LD Gete Yigzaw Kebede YK Mekonnen Fantahun Ayenew FA

PloS one 20190502 5

<h4>Background</h4>Incidence of Acute Kidney Injury (AKI) among Type 2 diabetic patients is significantly increasing. But, earlier studies has focused on the admitted patients which may hide the true nature of the Acute Kidney Injury among Type 2 Diabetic (T2D) patients. So, this study was conducted to determine the time to Acute Kidney Injury and its predictors among Type 2 Diabetic patients in Harari Region, East Ethiopia.<h4>Methods</h4>We conducted a retrospective cohort study among type 2 d ...[more]

PMID: 31048925

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Project description:BackgroundDiabetic ketoacidosis (DKA) is a morbid complication of Type 1 diabetes mellitus(T1DM), and its occurrence at diagnosis has rarely been studied in Ethiopia, despite the many cases seen in the pediatric population.ObjectiveThe aim of this study was to know the prevalence of DKA among patients with newly diagnosed diabetes mellitus and identify avoidable risk factors.MethodThis institution-based retrospective cross-sectional study was conducted from December 1, 2018 to December1, 2022. Newly diagnosed T1DM under 15 years were included in the study. DKA and the new diagnosis of type 1 DM were defined based on the 2022 ISPAD and other international guidelines. A data collection form was used to collect sociodemographic and clinical data. Descriptive, bivariate, and multivariate logistic regression analyses were conducted to identify the risk factors.ResultAmong the 61 newly diagnosed T1DM pediatric patients admitted, DKA was the initial presentation in 37 patients, accounting for 60.7% of the cases. The mean age at diagnosis was 8 (±3.85) years, with females being more affected. Clinical presentation revealed vomiting accompanied by signs of dehydration (32.4%), with polyuria, polydipsia and weight loss (26.2%) being the most common symptoms. The presence of adequate knowledge of signs and symptoms of DM (AOR = 0.07, 95%CI 0.019-0.0897, P value 0.017) and a family history of DM (AOR = 0.129 95%CI 0.019-0.897, P value 0.039) were protective factors against DKA as the initial diagnosis of DM. Moreover, new-onset type 1 DM without DKA was 1.5 times higher in children from families with a high monthly income (AOR = 1.473, 95% CI 0.679-3.195 p value 0.000) compared to those from families with low income. The presence of an infection prior to DKA (AOR = 11.69,95%CI 1.34-10.1,P value 0.026) was associated with the diagnosis of DKA at the initial presentation of DM.ConclusionA high number of children present with diabetic ketoacidosis (DKA) at the initial diagnosis of diabetes mellitus (DM), which is associated with inadequate knowledge of the signs and symptoms of DM as well as the masking effect of concomitant infections in these children. Healthcare professionals should endeavor to suspect and screen children. Continuous awareness creation of DM is encouraged to diagnose diabetes mellitus earlier and to decrease the prevalence of DKA as an initial presentation.

Project description:IntroductionDiabetic foot disease is a growing major public health problem and the leading cause of prolonged hospital admission, health-related costs, and reduced quality of life for diabetes patients. This study aimed to determine the prevalence of diabetic foot ulcers (DFU) and its associated factors among type 2 diabetes patients in Harari Region, East Ethiopia.MethodsAn institution-based retrospective study was conducted from 28 March to 30 April 2018, among type 2 diabetes patients diagnosed between 1 January 2013 and 31 December 2017, at three government hospitals of Harari Region. Data were collected using a standard checklist format. Data were entered into Epi Info Version 7 and analyzed using SPSS 24. Binary and multiple logistic regression models were used to determine the associated factors. Odds ratio with 95% confidence intervals was used to determine level of association.ResultA document of 502 type 2 diabetes patients was reviewed and included in the final analysis in this study. The prevalence of DFU among type 2 diabetes patients was 21.1%. Being currently married decreased the odds of DFU by 60% (adjusted odds ratio = 0.40; 95% confidence interval: 0.17-0.96). Factors associated with increased diabetes ulcers chance were physical inactivity 2.29 (adjusted odds ratio = 2.29; 95% confidence interval: 1.17-4.48), starting treatment with insulin 4.43 times (adjusted odds ratio = 4.43; 95% confidence interval: 1.84-10.67), obesity 27.76 (adjusted odds ratio = 27.76; 95% confidence interval: 13.96-55.23), delay to start follow-up 2.22 (adjusted odds ratio = 2.22; 95% confidence interval: 1.03-4.82), history of infection 3.50 (adjusted odds ratio= 3.50; 95% confidence interval: 1.83-6.69), and hypertension 3.99 (adjusted odds ratio = 3.99; 95% confidence interval: 2.08-7.65).ConclusionThe prevalence of DFU among type 2 diabetes is substantially high as more than one in five patients have this complication. Moreover, marital status, physical activity, baseline medication, obesity, delay for follow-up, infection history, and hypertension were significantly associated with the development of DFU.

Project description:BackgroundErectile dysfunction is a common problem among patients with diabetes, often going undiagnosed and having a significant negative impact on their health. This condition necessitates accurate evaluation and early intervention. However, there is an inconsistent explanation of factors and limited evidence on the prevalence of erectile dysfunction among patients with diabetes in eastern Ethiopia. Thus, this study aimed to determine the prevalence of erectile dysfunction and its associated factors among patients with diabetes in public hospitals in the Harari Region, eastern Ethiopia.MethodsA cross-sectional study was conducted involving 339 randomly selected participants. Data were collected using the Kobo Toolbox with standardized questionnaires administered by interviewers, along with a review of the patients' medical records. Data analysis was performed using Stata version 14. The Poisson regression model with robust variance estimate was fitted to examine the association of the independent variables and erectile dysfunction. An adjusted prevalence ratio (APR) with 95% confidence intervals was reported. Statistical significance was declared at the p-value < 0.05.ResultThe prevalence of erectile dysfunction was 78.28% (95% CI 73-83). Age 35-45 years [APR = 1.38; 95% CI: 1.03-1.84], and > 45 years [APR = 1.58; 95% CI 1.17-2.13], depression [APR = 1.41; 95% CI 1.06-1.86], current khat use [APR = 1.14; 95% CI 1.00-1.28], low social support [APR = 1.70; 95% CI 1.09-2.65] and medium social support [APR = 1.79; 95% CI 1.16-2.78] were factors significantly associated with erectile dysfunction.ConclusionsMore than three-fourths of the participants had erectile dysfunction. Significant factors associated with erectile dysfunction included age 35 years and above, depression, current hat use, and low and medium social support level. The management of erectile dysfunction should be integrated into routine medical care in diabetic follow-up clinics, with special attention for those participants aged 35 years and above, who have depression, currently use Khat, and have low-level social support.

Project description:IntroductionThe quality of nursing care has been evaluated using patient perception. Patients' participation in nursing care and decision-making is regarded as a prerequisite for effective clinical practice; however, poor communication can lead to incorrect diagnosis and delayed, or ineffective medical treatment.ObjectivesThis study sought to assess admitted adult patients' perceptions of, and factors influencing, nurse communication at public hospitals in Harar, eastern Ethiopia.MethodsFacility-based cross-sectional study was conducted among 377 admitted adult patients in Harar Town public Hospitals from 15 April to 30 May 2020. A proportionate stratified sampling technique was used to select the study participants. A pretested and structured questionnaire was used to collect data through a face-to-face interview and which were entered into EpiData and analyzed using SPSS. Bivariate and multivariate logistic regression analyses were conducted, odds ratio and confidence intervals were calculated and statistical significance was declared at p < 0.05.ResultsThis study outlined that the overall prevalence of good perception toward nurses' communication was 41.9% (95% confidence interval = 37.1%, 46.9%). Patients whose age group were 26-35 years (adjusted odds ratio = 0.46 (95% confidence interval: 0.24, 0.86), Being female patients (adjusted odds ratio = 1.89; 95% confidence interval: 1.20, 2.98), admitted in private room (adjusted odds ratio = 3.25; 95% confidence interval: 1.91, 5.51), patients who have family support (adjusted odds ratio = 2.56; 95% confidence interval: 1.16, 3.64), urban residence (adjusted odds ratio = 0.65; 95% confidence interval: 0.02, 0.66) and language difference (adjusted odds ratio = 0.61; 95% confidence interval: 0.40, 0.94) were statistically significant.ConclusionThis study pointed out that less than half of the study participants had good perceptions toward nurses' communication. As a result, increasing the number of health care providers who speak the same language as the patients and communication and behavioral change training must be prioritized.

Project description:BACKGROUND:Diabetes Mellitus recognized as one of the emerging public health problems in developing countries. Self-monitoring needs to be individualized and should assist people with diabetes. This study aimed to assess the predictors of self-management practices among diabetic patients attending hospitals in western Oromia, Ethiopia. METHODS:A facility-based cross-sectional study was conducted from November 2017 to February 2018 in hospitals located in western Oromia, Ethiopia. An interview was made with a total of 400 diabetic patients attending the diabetes center and admitted to ward in the study hospitals. The data were entered into Epi Info software version 3.5.4. Data analysis was made using a statistical package for the social sciences (SPSS) version 20. Odds ratio (OR) was used to show the association. The statistical significance was considered at P<0.05, and potential confounding variables were controlled using logistic regression. The analyzed data were presented in texts and tables. RESULTS:From a total of 398 interviewed patients, 129 (32.4%) practiced diabetes self-management. About 63.6% of the study participants' self-management practice was good. Most 103 (79.84%) of those who practiced self-management were presented with one of diabetes mellitus-related complications. Logistic regression analysis results showed that merchants were about six times higher in self-management practice [AOR of 5.945 (1.177-30.027 at 95% CI)] and those having family support in diabetes practiced self-management 2.87 times than others [AOR of 2.835 (1.386-5.801 at 95% CI)]. CONCLUSIONS:Compared to the findings of previous studies, diabetes self-management practices of the participants was good. The study participants regular physical activity, food intake, medication adherence, and foot self-examination were moderate. Two variables, being a merchant and having family support were found to be the predictors of self-management practices. Predictors of self-management should be considered to boost self-management practice.

Project description:BackgroundBurnout is a syndrome of emotional exhaustion, low personal accomplishment and depersonalization experienced by a health professional and it is more common in nurses due to high workload and job stress that is mostly caused by working proximity to patients and taking care of them. Burnout compromises the provision of quality health care. Despite this, there is no information in Ethiopia on burnout among nurses in study area.ObjectivesTo determine the magnitude of burnout and associated factors among nurses working in public hospitals of Harari regional state and Dire Dawa administration, eastern Ethiopia, February 1-29, 2020.MethodsInstitutional based quantitative cross-sectional study was employed from February 1-29 among 412 randomly selected nurses who have been working in hospitals for the last 6 months. Simple random sampling method was employed and data was collected by self-administered, standardized, reliable and valid, questionnaire (Maslachs Burnout Inventory- Human Services Survey). Data was entered into EpiData Version 3.1 and exported to statistical package for social science version 20 for analysis. All covariate with P-value less than 0.25 in bivariable analysis were candidate for multivariable analysis. Level of statistical significance was declared at p-value < 0.05.ResultsAmong 412 nurses taking part in this study, 183(44.4%) of nurses with 95% CI, had experienced burnout. Married marital status [AOR:2.3,95%CI:(1.2-4.3)], poor current health status [AOR:4.8, 95% CI:(1.1-21.4)] and fair current health status [AOR:12, 95% CI:(4.5-32)], working greater than eight hour per-day[AOR:0.52, 95%CI:(0.29-0.92)], intention to leave a job [AOR:0.48,95%CI:(0.2-0.88), being working in emergency room [AOR:0.3,95%CI:(0.1-0.98)] and using a different medication related to work related health problems were factors associated with nurses' burnout.ConclusionThe nurses' burnout in this study is high and it is attributed by marriage, perceiving health status as poor and fair, whereas, having the intention to leave job, being working in emergency room and using a medication in relation to work related health problems reduced risk of developing burnout. So, the concerned bodies should provide trainings which focus on stress copying mechanisms and assertiveness program.

Project description:BackgroundGood-quality antenatal care improves maternal health in the least developed countries. This study was aimed at assessing the quality of antenatal care and associated factors among pregnant women attending hospitals in the Sidama Region, Southern Ethiopia.MethodA facility-based cross-sectional study was conducted from 1 February to 30 April 2020 among 372 pregnant women. A two-stage sampling technique-the first stage, selection of health facilities; the second stage, selection of respondents-was used. Trained data collectors administered exit interviews. Data were entered into EPI Info 7 and analyzed using IBM SPSS version 25. Quality of care was assessed using a validated questionnaire containing 68 attributes of quality. Good quality of care was determined by the proportion of respondents who scored ⩾80% of 68 variables. Bivariable and multivariable logistic regressions were used in the analysis. The outputs were presented using an adjusted odds ratio with 95% confidence intervals.ResultsThis study revealed that 41.2% (95% confidence interval: 36.2%-46.2%) of pregnant women had received good-quality antenatal care. Increased odds of the utilization of quality antenatal care were observed among women who lived in urban areas (adjusted odds ratio = 4.32, 95% confidence interval: 2.58-7.21), attained primary education and more (adjusted odds ratio = 2.68, 95% confidence interval: 1.60-4.48), earned a monthly income >3000 Ethiopia Birr (US$93.3) (adjusted odds ratio = 3.86, 95% confidence interval: 2.28-6.51), and visited hospitals for antenatal care ⩾4 times (adjusted odds ratio = 3.68, 95% confidence interval: 2.21-6.10).ConclusionsThe proportion of women who received good-quality antenatal care was low. Good quality care was associated with residence, education status, income level, and frequency of antenatal care visits. Training care providers, strengthening counseling, and promoting women's economic empowerment to improve the utilization of quality antenatal care are recommended.

Dataset Information

Time to acute kidney injury and its predictors among newly diagnosed Type 2 diabetic patients at government hospitals in Harari Region, East Ethiopia.

Background

Methods

Results

Conclusions

Publications

Time to acute kidney injury and its predictors among newly diagnosed Type 2 diabetic patients at government hospitals in Harari Region, East Ethiopia.

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