Project description:BackgroundUndernutrition is a common comorbidity in chronic kidney disease patients which augments the progression of the disease to an end-stage renal disease, renal dysfunction and related morbidity and mortality. However, in Ethiopia, there is a dearth of research evidence in this regard. Therefore, this study aimed to assess the magnitude of undernutrition and its associated factors among adult chronic kidney disease patients.MethodsAn institution-based cross-sectional study was conducted in selected hospitals of Addis Ababa from May to August 2018. Data were collected by structured and pretested questionnaires. Patients' charts were reviewed from their medical profiles. Body mass index was calculated from anthropometric measurements using calibrated instruments. Serum albumin level was determined by reference laboratory standard procedure. Data were entered into Epi- data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were calculated and presented by tables, graphs and texts. Binary and multivariable logistic regression analyses were computed and the level of statistical significance was declared at p-value <0.05.ResultsFrom the total sample size of 403 participants, 371 were involved in the study. The prevalence of undernutrition (BMI<18.5) among adult chronic kidney disease patients was 43.1% (95% CI: 38%-48%). Undernutrition (BMI<18.5) was significantly higher among patients with diabetic nephropathy [AOR = 2.00, 95% CI, 1.09-2.66], serum albumin value less than 3.8g/dl [AOR = 4.21: CI, 2.07-5.07], recently diagnosed with diabetes mellitus [AOR = 2.36, 95% CI, 1.03-3.14] and stage V chronic kidney disease [AOR = 3.25:95% CI, 1.00-3.87].ConclusionUndernutrition in chronic kidney disease patients was significantly higher among patients with diabetic nephropathy, patients on stage V chronic kidney disease, recently diagnosed with diabetes mellitus and serum albumin value less than 3.8g/dl.
Project description:ObjectiveThis study was conducted to assess the magnitude and contributing factors of medication administration errors among nurses in federal hospitals in Addis Ababa, Ethiopia.DesignA hospital-based cross-sectional study design was employed. Data on medication administration and associated factors were collected using a structured self-administered questionnaire. Multivariable binary logistic regression analysis was done to identify factors associated with medication administration errors on the basis of adjusted OR with 95% CI and a p value less than 0.05.SettingThis study was conducted in federal hospitals in Addis Ababa, Ethiopia.ParticipantsFour hundred and twenty-three randomly selected nurses participated.Outcome measuresThe primary outcome variable is medication administration error, which was ascertained using the following errors: wrong medication, wrong dose, wrong time, wrong route, wrong patient, wrong drug preparation, wrong advice, wrong assessment and wrong documentations.ResultsA total of 59.9% (95% CI: 55.0% to 64.8%) of the nurses in the federal hospitals in Addis Ababa committed one or more medication administration errors in the last 12 months prior to the survey. The most commonly reported medication errors were wrong time (56.8%), wrong documentation (33.3%), wrong advice (27.8%) and wrong dose (20.1%). Medication administration errors among nurses were significantly associated with short work experience (adjusted OR (AOR): 6.48, 95% CI: 1.32 to 31.78), night shift work (AOR: 5.0, 95% CI: 1.82 to 13.78), absence of on-the-job training (AOR: 3.16, 95% CI: 1.67 to 6.00), unavailability of medication administration guidelines in wards (AOR: 2.07, 95% CI: 1.06 to 4.06) and interruptions during medication administration (AOR: 2.42, 95% CI: 1.30 to 4.49).ConclusionIt was found that a high proportion of nurses in federal hospitals committed medication administration errors. Short work experience, night shift work, absence of on-the-job training, unavailability of medication administration guidelines and interruptions during medication administration explained the high magnitude of medication administration errors.
Project description:BackgroundJob dissatisfaction issues and health workers' intention to leave is an increasing problem that threatens the function of the health care sector worldwide, especially in developing countries, including Ethiopia. As part of future evidence, this study was intended to assess nurses' job satisfaction and intention to leave their current work and its associated factors in federal public hospitals in Addis Ababa, Ethiopia.MethodAn institutional based cross-sectional study design was used to conduct the study. A simple random sampling technique was employed to select 408 nurses from selected federal hospitals in Ethiopia. Self-administered questionnaire was used to collect the data. Logistic regression was employed to identify the predictor variables with consideration of statistical significance at P <0.05 adjusted odds ratios calculated at 95% CIs.ResultThe magnitudes of job satisfaction and intention to leave their current job among nurses in this study were 47.7% and 80.6%, respectively. Salary is imbalanced with demands [AOR = 2.85 (1.24, 6.57)], managers who have no personal plan for developing skills [AOR = 3.74 (1.58, 8.87)], stressful jobs [AOR = 0.28 (0.11, 0.71)], health problems are a reason for having thoughts about changing jobs [AOR = 3.02 (1.17, 7.79)], and a lack of development [AOR = 4.13 (1.51, 11.3)] were identified as determinant factors for intention to leave.ConclusionThe overall intention to leave their current job among nurses working in selected federal hospitals in Ethiopia was high. The government of Ethiopia should balance the salary of nurses with the current market level. Hospital leaders should plan the way nurses develop their educational and job carrier levels.
Project description:BackgroundBecause maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.MethodsA facility-based cross-sectional study was conducted in five selected public hospitals of Addis Ababa, Ethiopia from May 1, 2015 to April 30, 2016. All maternal near-miss cases admitted to the selected hospitals during the study period were prospectively recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant's record.ResultsDuring the one-year period, there were a total of 238 maternal near-miss cases and 29,697 live births in all participating hospitals, which provides a maternal near-miss incidence ratio of 8.01 per 1000 live births. The underlying causes of the majority of maternal near-miss cases were hypertensive disorders and obstetric hemorrhage. Anemia was the major contributing cause reported for maternal near-miss. Most of the maternal near-miss cases occurred before the women's arrival at the participating hospitals.ConclusionThe study demonstrated a lower maternal near-miss incidence ratio compared to previous country-level studies. The majority of the near-miss cases occurred before the women's arrival at the participating hospitals, which underscores the importance of improving pre-hospital barriers. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.
Project description:IntroductionAutism is a neurodevelopmental disorder that occurs in the early childhood period and is characterized by altered social interaction, communication problems, repetitive, and stereotyped behavior. Genetic, environmental, or physical risk factors are associated with prenatal, natal, or postnatal complications, leading to the development of autism spectrum disorders. Prompt diagnosis and management should be an integral component of the care provision in countries like Ethiopia.ObjectiveThis study aimed to assess knowledge of childhood autism among nurses working in governmental hospitals in Addis Ababa, Ethiopia.MethodsInstitutional based cross-sectional study design was used. The sample size was calculated using the single population proportion formula, and the final sample size was 360. Final study subjects were selected by using the simple random sampling method. Data were collected using structured self-administered questionnaires and were then coded and entered into Epi-data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were utilized to show frequencies and percentages, and analysis of variance was carried out to compute the association between the dependent and independent variables. Independent t-test was also done to see the association between dependent variables and independent variables with two means. A p-value of less than 0.05 was considered statistically significant.ResultsThe mean score for knowledge-related items was 8.79 ± 0.4. In this study, out of 331 nurses, 180 (54.35%) had good knowledge. Significant mean score difference was observed among age distribution (F-Ratio = 2.8, p-value = 0.04), level of education (F-ratio = 13.97, p < 0.001) and work experience (F-Ratio = 3.07 p-value = 0.017).ConclusionA significant gap was observed in the overall knowledge of childhood autism among nurses employed in the governmental hospitals of Addis Ababa. The respondents' knowledge level was significantly different among age group distributions, education levels, and work experience.
Project description:The COVID-19 pandemic continues to grow around the world and has caused enormous mortality and morbidity. The severity and mortality of coronavirus disease are associated with various comorbidities. The infection fatality rate was reported to be inconsistent with different studies. Therefore, the aim of this study was to assess the magnitude and factors associated with mortality among patients admitted to Eka Kotebe General Hospital, Addis Ababa, Ethiopia. An institutional-based cross-sectional study was conducted at Eka Kotebe General Hospital among patients who were admitted for COVID-19 from January 15, 2021, to June 30, 2021. A total of 393 records of patients were selected by simple random sampling. Data was extracted from compiled data forms where available information was already tabulated. Data was entered and analyzed using SPSS version 25. The determinant factors associated with mortality among COVID-19 patients were identified using bivariate and multivariable logistic regression analysis. A statistical association was declared with multivariable logistic regression using a 95% confidence interval and a P-value of less than 0.05. The proportion of COVID-19 mortality among patients admitted to Eka Kotebe General Hospital was 8.1% (95% CI (5.4-10.8%)). Age >50 years [AOR = 7.91; 95% CI (2.34-25.70)], being male [AOR = 2.09; 95% CI (1.20-3.65)], having diabetes mellitus [AOR = 2.64; 95% CI (1.30-5.35)], having hypertension [AOR = 2.67; 95% CI (1.22-5.88)] and having chronic kidney disease [AOR = 12.04; 95% CI (4.03-14.22)] were determinant factors of COVID-19 mortality. The current study findings revealed that COVID-19 mortality was high among hospitalized COVID-19 patients. Furthermore, age, gender, diabetes mellitus, hypertension, and chronic kidney disease were discovered to be independent predictors of COVID-19 mortality. Therefore, older COVID-19 patients and those with established comorbidities such as hypertension, diabetes, and end-stage renal disease should receive comprehensive preventative efforts, including vaccination.
Project description:IntroductionPostpartum hemorrhage (PPH) is responsible for half of all maternal deaths during childbirth. Despite being preventable and curable, PPH remains the leading cause of maternal death in Ethiopia. Therefore, the aim of this study was to identify the determinants of PPH among women delivered at public hospitals in Addis Ababa, Ethiopia, in 2022.MethodsA facility-based, unmatched case control study with 378 study participants was carried out in selected public hospitals in Addis Ababa, Ethiopia. Women who gave birth and developed PPH were considered cases, while women who gave birth in public hospitals in Addis Ababa and did not develop PPH were controls. Binary and multivariable logistic regression analyses were used to identify independent predictors of PPH. Variables was considered statistically significant in the final model if their p-value was less than 0.05.ResultsThe result of this study identified that antenatal care follow-up (AOR: 2.58; 95% CI: 1.12, 5.96), history of cesarean delivery (AOR: 3.47; 95% CI: 1.40, 8.58), prolonged labor (AOR: 5.14; CI: 2.07, 12.75), and genital trauma apart from episiotomy (AOR: 4.39; CI: 1.51, 12.81) were determinants of PPH.ConclusionAccording to the finding of this study duration of labor, history of cesarean section, antenatal care follow-up, and genital trauma other than episiotomy were independent determinants of PPH. Therefore, it is crucial to screen and closely monitor high-risk mothers during antepartum care visit, including those who have a history of cesarean delivery.
Project description:BackgroundTurnover intention is a probability of an employee to leave the current institution within a certain period due to various factors. It is the strongest predictor of actual turnover expected to increase as the intention increases. Emergency Department (ED) nurses are especially vulnerable to high turnover because of their increased risk of developing burnout and compassion fatigue associated with the work environment. This study is aimed to assess nurses' intention to leave emergency departments and associated factors at selected governmental hospitals in Addis Ababa, Ethiopia.MethodsInstitutional based cross-sectional study was conducted on 102 nurses in three selected governmental hospitals, Addis Ababa from February 19 to March 31, 2018, using a structured pre-tested self-administered questionnaire. The logistic regression model was used and an adjusted odds ratio with a 95% confidence interval was calculated to identify associated factors.ResultA total of 102 respondents were involved with a response rate of 91.1%. Among them, 79 (77.5%) respondents had the intention to leave the current working unit of the emergency department or hospital. Significant predictive factors of nurses' intention to leave their institutions are educational status (adjusted odds ratio (OR) =4.700, 95% confidence interval (CI) = 1.033-50.772; p < 0.048), monthly income of less than 3145 Birr (adjusted OR = 6.05, 95% CI = 1.056-34.641; p < 0.043) and professional autonomy (adjusted OR = 0.191, 95% CI = 0.040-0.908; p < 0.037).ConclusionMore than 77% of the respondents have the intention to leave their current working place of the emergency unit. Educational status, monthly income, and autonomy were significantly associated with emergency nurses' turnover intention in three governmental hospitals. Emergency leaders and hospital managers should have made efforts to enhance nurses' decision making for patient care activities and shared decision overwork or unit related activities.
Project description:BackgroundChild mortality remains a global public health problem, particularly in Sub-Saharan Africa. After initiating ART, the mortality rate among HIV-infected children in Ethiopia was 12-17 deaths per 1000 child-year.ObjectiveTo determine the time to death and its predictors among under-five children on antiretroviral treatment in public hospitals of Addis Ababa, Ethiopia, from April 12, 2017, to May 12, 2022.MethodAn institution-based retrospective follow-up study was conducted among 415 HIV-infected children at selected public hospitals of the Addis Ababa town administration. Computer generated simple random sampling technique was used to select each sampling unit. Data was extracted using a structured data extraction checklist. Data were entered into EPI data 4.2 and analyzed using STATA 14. The child mortality rate was calculated. The Cox proportional hazards regression model was fitted to identify predictor factors. The result of the study was presented using text, tables, graphs, and charts. An adjusted hazard ratio with a 95% confidence interval and a p-value less than 0.05 was used to declare the level of significance.ResultA total of 415 (97.42%) of the 426 children on ART were included for analysis. Of these, 41(9.88%) children were died during the following period. The study participants were followed for a total of 8237 person- months of risk time. The overall mortality rate was 4.98 (95% CI: 3.67-6.77) per 1000 child-months. The estimated survival after starting ART was 61.42% at 56 months of follow-up. Severe underweight (AHR = 3.19; 95% CI: 1.32-7.71), tuberculosis (AHR = 3.86; CI: 1.76-8.47), low hemoglobin level (AHR = 2.51; CI: 1.02-6.20), and advanced WHO clinical stages at enrolment (AHR = 3.38; CI: 1.08-10.58) were predictors of death among HIV-infected under-five children on ART.ConclusionThe incidence of mortality was 4.98 per 1000 child-months. Severe underweight, tuberculosis infection, low hemoglobin level, and advanced WHO clinical stages at enrolment were predictors of death among under-five children on ART.
Project description:BackgroundContinuing professional development has been mandatory for healthcare professionals to renew their licenses. However, there is a shortage of information regarding physicians' perceptions of continuing professional development. Therefore, it is timely to assess the perception of physicians and barriers toward continuing professional development.MethodsAn institution-based quantitative design triangulated with a qualitative research design was conducted. A total of 367 and 6 study participants were included in the quantitative and qualitative study, respectively. Simple random and purposive sampling strategies were employed to select participants for the quantitative and qualitative parts. Quantitative Data was inserted in EPI-INFO version 7 and cleaned and analyzed using the Statistical Package for the Social Sciences,version 25 statistical program. Binary-dependent categorical variables were analyzed using binary logistic regression. Multiple logistic regression analysis was assessed to observe the association between perception and various explanatory variables. Thematic content analysis was conducted to develop items from transcribed qualitative information.ResultThis study involved 367 participants from three government teaching hospitals in Addis Ababa, Ethiopia. Being younger (20-30) had significantly higher odds of positively perceiving continuing professional development. It also showed that the department of healthcare Professionals had a statistically significant association with the perception of continuing professional development. Those working in Internal Medicine and Obstetrics and Gynecology departments and healthcare professionals had significantly higher odds of perceiving continuing professional development as good. The interviews revealed that the barriers to continuing professional development are divided into Individual and health system barriers. The Individual barriers include awareness gap, Motivation Issues and Family size, whereas the health system-related barriers include recognition, infrastructure, time, place, and accessibility. CONCLUSION AND RECOMMENDATION: The study identified the department of the healthcare professional as significantly associated with perception of continuing professional development. Improving patient care collaboration and career progression influenced physicians' perception of continuing professional development. The study findings suggest the need for effective strategies to enhance physicians' engagement in continuing professional development and improve the quality of healthcare services in Ethiopia.