Jimma University Medical Center Research Articles

Predictors of Induction of Labor and Success Rate Among Mothers Giving Birth at Jimma University Medical Centre South West Ethiopia: Unmatched Case Control Study

BACKGROUNDInduction of labor is defined as the process of artificially stimulating the uterus to start labor. Despite the unquestionable reputation of labor induction for ending pregnancies, there is a risk to the mother and/or the fetus. Studies from developed and developing countries report increased labor induction rates with additional cases of cesarean section (CS) and fetal distress.OBJECTIVEThe main aim of this study is to assess predictors of induction of labor and the success rate among mothers giving birth at Jimma University Medical Centre Southwest Ethiopia.METHODSA facility based unmatched case control quantitative study design was done among 694 (cases = 347 plus controls is 347) mothers. A systematic random sampling technique was used to select both cases and controls from the registration delivery log book. A standard document review checklist was used to collect data. Multivariate binary logistic regression analysis was done to identify predictors of the outcome of the variable.RESULTSThe study findings revealed that the success rate of induction of labor in this study was 73.8%. Mothers with stillbirth history were three times more likely to be induced compared with mothers without stillbirth history. Mothers with abortion history were seven times more likely to be induced than mothers without an abortion history. Mothers with a gestational age of ≥42 weeks were 17 times more likely to be induced than mothers with a gestational age of 38–41 weeks. Mothers who had no antenatal care follow-up were seven times more likely to be induced than mothers who had antenatal care follow-up.CONCLUSIONMaternal age, gestational age, history of abortion, and history of stillbirth were significant predictors of induction of labor which was claimed to increase the rate of uterine rupture, CS and admission to a neonatal intensive care unit (NICU).

Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia

BackgroundPelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018.MethodA Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient’s chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups.ResultsAmong 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse.Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively.Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury.ConclusionThe prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.

Utilization and Completeness of Surgical Safety Checklist with Associated Factors in Surgical Units of Jimma University Medical Center, Ethiopia.

IntroductionSurgical safety checklist is used for every patient undergoing a surgical procedure and is now employed by a majority of surgical providers around the world, but the utilization and completion of surgical safety checklists were low in lower- and middle-income countries.ObjectiveThe objective of this study was to evaluate the utilization and completeness of the surgical safety checklist in surgical units of Jimma University Medical Center, Ethiopia.MethodsHospital-based prospective cross-sectional study was conducted from October 1 to 30, 2020. A total of 384 surgical cases were included in the study. Checklists were kept as part of each patient’s medical record, and consecutive post-operative patient charts were included in the study. The data were collected using the modified version of the WHO checklist constituted of 27 items. The collected data were cleaned, coded, and entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. Binary and multiple logistic regression analyses were computed, and the level of statistical significance was determined at p < 0.05.ResultsThe use of a surgical safety checklist was 93.5%. The checklist was completed 17.3% of the time, with sign-in, time-out, and sign-out being completed 83%, 25%, and 35% of the time, respectively. Utilization of the surgical safety checklist was 87.4%, which is lower in elective surgeries (AOR = 0.126 95% CI (0.039–0.414)) compared with the emergency procedure. Once more, the completeness of the safety checklist was 63.3%, which is lower in elective surgery (AOR = 0.367 95% CI (0.208–0.65)) than in emergency procedures.ConclusionThe use of a surgical safety checklist was promising, while the completeness of the checklist was poor that demands further improvement. Time-out was the least completed section of the checklist. Completion of the checklist was high in the first case on the positions of the theatre list.

Reasons for Emergency Department Visit, Outcomes, and Associated Factors of Oncologic Patients at Emergency Department of Jimma University Medical Centre.

The number of oncologic patients visiting the emergency department (ED) is increasing and represent a challenge for the emergency team owing to they might have acute sign and symptoms of a still undiagnosed malignancy, management of treatment-related side effects, co-morbidities, and palliative care. Thus, this study was aimed to identify reasons for ED visits, management outcomes, and associated factors of oncologic patients. A prospective cross-sectional study was conducted from March 11, 2021 to August 25, 2021 at the ED of Jimma University Medical Center on a total of 338 oncologic patients. Data were collected from the patient and the patient's medical record using a questionnaire developed from up-to-date similar literatures. The questionnaire was started filled out upon diagnosis of cancer and completed during discharge from the ED. The outcomes of the patients were dichotomized into died and survived then, it was analyzed using frequency and bivariate logistic regression. The most common reasons for oncologic patients ED visit were neutropenic fever 79 (23.4%) followed by vomiting 38 (11.2%) and electrolyte abnormality 37 (10.9%) respectively. Among oncologic patients visited ED, 137 (40.5%) of them were admitted to ward and 126 (37.3%) of them were discharged with improvement while 64 (18.9%) of them were died. Based on multivariate logistic regression, those patients who had distant metastasis cancer (AOR 1.85; 95% CI 1.03-7.21), comorbidity (AOR 2.56; 95% CI 1.20, 6.96), and ECOG >3 (AOR 2.40; 95% CI 1.25,13.43) were more likely to die than their counterparts. Most of the oncologic patients visited ED due to neutropenic fever, nausea and or vomiting, and electrolyte disorder. Amongst oncologic patients who were visited ED, most of them were admitted to ward while around one-fifth of them were died. Having distant metastasis cancer, comorbidity and ECOG >3 were independent predictors of an oncologic patient's outcome at the ED.

Prevalence of long-acting reversible contraceptive methods utilization and associated factors among counseled mothers in immediate postpartum period at Jimma University medical center, Ethiopia

BackgroundPostpartum family planning is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first twelve months following childbirth. The immediate postpartum period is particularly favorable time to provide long-acting reversible contraception methods; and postpartum provision is safe and effective. Despite the advantages of long acting reversible contraception methods, they may be infrequently used in Ethiopia.ObjectiveThis study assessed the prevalence and associated factors of long-acting reversible contraceptive methods utilization among counseled mothers in immediate postpartum period.MethodsA cross-sectional study was conducted on 393 women who gave birth at Jimma University Medical Centre from 12 November 2016 to 21 January 2017, Ethiopia. Data were collected by face-to-face interview using pre-tested structured questionnaire and by record reviewing using data compiling form; and analyzed using SPSS version 20. Logistic regression was used to identify associated factors for long acting contraceptive methods use. P-value less than 0.05 at 95% confidence level was taken as significance level.ResultsPrevalence of reversible long acting contraceptive methods utilization among immediate postpartum mothers was 53.2% (209/393) and more than three-fourths (78.0%) of participants used implanon. The most common reported reason for not using reversible long acting contraceptive methods was preference of other contraceptive methods like short acting contraceptives (25.5%). Having more than four alive kids (AOR 2.6, 95% CI: 1.15,5.95), high monthly income (≥1000 ETB) (AOR 2.4, 95% CI: 1.08,7.20), planning to delay next pregnancy by more than 2 years (AOR 4.0, 95% CI: 1.60,9.28), mothers with no fertility desire (AOR 2.0, 95% CI: 1.12,3.15), prior use of reversible long acting contraceptive methods (AOR 3.0, 95% CI: 1.30,7.20) and receiving counseling during antenatal care follow-up and before delivery (AOR 2.0, 95% CI: 1.01, 4.73) were associated with immediate postpartum reversible long acting contraceptive methods use.Conclusion and recommendationsAlthough the prevalence of reversible long acting contraceptive methods utilization in immediate postpartum was high, counseling mothers during ANC follow-up and before delivery can further increase its utilization. Therefore, the need for providing counseling during ANC follow up and before delivery to increase utilization of immediate postpartum reversible long acting contraceptive methods use is emphasized.

Time to Diabetic Retinopathy and Its Risk Factors among Diabetes Mellitus Patients in Jimma University Medical Center, Jimma, Southwest Ethiopia.

Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the eye. Globally, diabetic retinopathy affects more than 103.12 million people. Diabetic retinopathy is among the leading causes of vision loss at the global level, including in Ethiopia. Therefore, the study aimed to assess the time to develop diabetic retinopathy and identify factors associated with diabetic retinopathy among diabetes patients. A retrospective study was conducted from September 1, 2021 to January 30, 2022. Data was collected using semistructured questionnaire. The Cox proportional hazard model were used to determine the median time to develop diabetic retinopathy and identify predictors of diabetic retinopathy. Data was analyzed using R software. A total of 373 diabetes patients were included in this study. The prevalence of diabetic retinopathy was 41.3%. The median time was 41 months, ranging from 39 to 73 months. Elder age (HR=3.17, 95%CI: 1.53, 6.58), being male (HR=2.34, 95%CI: 1.35, 6.15), previous family history of diabetes (HR=4.16, 95%CI: 2.19, 8.37), longer duration of diabetes (HR=2.86, 95%CI: 1.41, 5.31) received only insulin therapy (HR=3.91, 95%CI: 1.36, 7.94), and high systolic blood pressure(HR=2.32; 95%CI: 1.12, 4.39) were statistically significant factors related to development of diabetes retinopathy. More than half of diabetic patinets in this study were developed retinopathy diabetes within a few months of being diagnosed. As a result, we advocate that the best way to preserve our vision from diabetic retinopathy is to maintain our diabetes under control, and the high-risk population receive early screening for diabetes.

Assessment of Risk Factors for Advanced Open Angle Glaucoma Presentation among Patients Visiting Jimma University Medical Center, Jimma, Ethiopia.

Glaucoma is the predominant cause of irreversible blindness, particularly the late presentation. The purpose of this study is to identify the risk factors associated with late presentation in Jimma University Medical Center. A case-control study was done among patients newly diagnosed to have open angle glaucoma (of any type) at Jimma University Medical Center from July 2014 - January 2019. Cases were patients/eyes diagnosed to have any type of open angle glaucoma with advanced glaucomatous disc features, whereas controls were patients diagnosed with early and moderate stages of glaucoma. There were 205 (116 cases and 89 controls) participants. The mean age of the participants at the time of diagnosis was 58.3±13.4yrs. Family history of blindness, presenting IOP, type of glaucoma and age were independently associated with late presentation. Patients with family history of blindness had late advanced glaucoma five times higher than those with no family history of blindness. The presence of late glaucoma among patients with presenting intra ocular pressure < 30mmHg is lower than those having ≥30mmHg (Adjusted Odds Ratio= 0.136). Primary open-angle glaucoma patients were less likely to present with advanced glaucoma than pseudoexfoliative glaucoma patients (Adjusted Odds Ratio=0.39). The chance of presenting with late glaucoma was increased by 3.4% for every one year increment of age. Presence of family history of blindness, high presenting intraocular pressure, pseudoexfoliative glaucoma and old age are risk factors for late presentation of glaucoma.

Adverse Perinatal and Maternal Outcomes and Associated Factors among Women with Antepartum Hemorrhage in Jimma University Medical Center, Southwest Ethiopia, 2020.

Globally, antepartum hemorrhage is the main cause of perinatal and maternal morbidity and mortality during pregnancy and childbearing. To assess adverse perinatal and maternal outcomes and associated factors among women with antepartum hemorrhage in Jimma University Medical Center, Southwest Ethiopia, 2020. Prospective cross-section study was conducted, and data were collected through face to face interview among pregnant women admitted with antepartum hemorrhage. Patient condition was observed and followed up, and patient card was reviewed. Data were coded, checked, entered into EPI version 4.6, and exported to SPSS version 26.0 for analysis. Multivariate logistic regression analysis was made to determine independent factors associated with adverse outcomes. A total of 377 pregnant women were included, and nearly half (192 (50.9%)) of women experienced adverse maternal outcome and 113 (30%) women experienced adverse perinatal outcome. The status of vital sign, address, parity, antenatal care, duration of bleeding before arrival, gestational age, prematurity, and amount of vaginal bleeding were factors significantly associated with adverse maternal and perinatal outcome at p value <0.05. Vital sign derangement, vaginal bleeding for ≥12 hrs, gestation age before 37 weeks, rural address, prim parity, amount of vaginal bleeding, and prematurity baby has predicted high rate of adverse perinatal and maternal outcomes. Recommendation. Jimma Hospital should give patient-centered service and strengthen counseling on danger sign of pregnancy to alert women early health care seeking and immediate resuscitation, and appropriate management should be given for women admitted with APH to minimize of adverse perinatal and maternal outcomes.

Dietary self-care and associated factors among diabetic patients in Jimma University Medical Centre, South West Ethiopia; A path analysis.

BackgroundDiabetes Mellitus (DM), a chronic metabolic disorder that caused about 4.2 million deaths and at least 760 billion dollars’ expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths, due to DM reached 34,262 in 2013. Studies show effective lifestyle interventions; particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs.ObjectiveTo assess diabetic self-care, dietary practice and associated factors among diabetes patients.MethodInstitution-basedbased cross-sectional study design was employed from february15-May15, 2020 in Jimma university medical Centre (JUMC). Systematic sampling of every other patient (K = 2.7) was employed to interview 371 participants. A previously validated tool was used to collect data through a face-to-face interview. A path analysis was used to fit the structural model and tests the hypothesized Health Belief Model (HBM) relationships.ResultResponse rate was 95.4% (354). Around 52% of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practices respectively. With unstandardized coefficient (standard error) self-efficacy0.10 (0.01) being the strongest cues to action0.10 (0.02), perceived threat0.02 (0.01), and perceived barrier-0.08(0.01) constructs of HBM have a significant effect on dietary practice. Knowledge, social support and diabetes distress exert a significant indirect effect on dietary practice through health belief constructs with unstandardized path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively.ConclusionIn this study, the proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice; therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.

Caregiver satisfaction and its associated factors in pediatric wards of Jimma University Medical Center, Southwest Ethiopia

BackgroundMeasuring the caregivers' satisfaction is vital for the effectiveness of childcare. Children admitted to pediatric wards require special hospital situations, a bespoke approach from the medical team, and the participation of caregivers. It is important to give attention to the caregivers while planning for child services. The purpose of this study was to assess the caregiver’s satisfaction with the services provided in pediatric wards of Jimma University Medical Center and identify its associated factors.MethodsFacility-based cross-sectional study design was done at Jimma University Medical Center. Participants in the study were primary caregivers who spent two or more days in the pediatric ward with their admitted children. Data were collected from 400 selected caregivers. A consecutive sampling method was employed. Principal component analysis was done for all Likert scale instruments to extract factor (s) representing each of the scales and to have factor scores. Variables with the Likert scale were treated as continuous after principal component analysis was employed. Using these factor scores, a multiple linear regression analysis was carried out to identify factors associated with caregivers' satisfaction with service in pediatric wards. A significance level of less than 0.05 was used in the final model to determine statistical significance.ResultThis study showed that caregivers' satisfaction with the services in the pediatric ward was 68%. Level of education (β = -0.24, (95% CI; -.411, -.070)), availability of basic facilities (β = 0.163, (95% CI; .063, .263)), patience to listen to patients' problem (β = 0.431, (95% CI; .324, .537, staff communication with client (β = 0.163, (95% CI; -4.839, -1.610)), availability of laboratory tests and its service (β = -0.964, (95% CI; -1.435, -.493)), availability of drug, imaging and service at radiology (β = 2.907, (95% CI; 1.470, 4.344)) and availability of pathology and its service (β = 1.869, (95% CI; .993, 2.746)) were significant factors associated with caregivers satisfaction with health service in pediatrics ward.ConclusionCaregivers were moderately satisfied. Education level, availability of basic facilities communication with client, and the availability of laboratory tests and drugs were factors that significantly associated with caregiver satisfaction. Hospital should avail laboratory tests and drugs in order to maintain high levels of caregiver satisfaction.

Adherence to Self-Care Behaviors and Associated Factors among Adult Heart Failure Patients Attending Chronic Follow-Up Care at Jimma University Medical Center, Southwest Ethiopia

Background: Optimal outcomes and quality of life in patients with heart failure (HF) depend on effective self-care activities. However, patients may experience difficulties, and their performance may be inconsistent. Aim: To determine the level of adherence to self-care behaviors and associated factors among adult HF patients attending chronic follow-up care at Jimma University Medical Center (JUMC). Methods: A cross-sectional study was conducted between August and September 2021. Data were collected through face-to-face interviews and by reviewing patients’ medical records. The collected data were analyzed using SPSS version 25 and the findings were presented in frequency, percentage, mean (SD), and median (IQR). Multivariate logistic regression was performed to determine factors associated with adherence to self-care behaviors. Odds ratios with 95% confidence intervals and p-values were used to report the findings. Results: Out of 266 HF patients, 50.0% had good adherence towards self-care behavior recommendations. The highest following recommendation was taking medication as prescribed (75.5%), followed by a dietary recommendation of a low-salt diet (45.2%). Participants who could not read and write (adjusted odds ratio (AOR) = 0.30 (95% confidence interval (CI) 0.13, 0.71), P = 0.006), had an illness duration greater than or equal to ten years (AOR = 0.31 (95% CI 0.12, 0.82), P = 0.02), in the NYHA class II HF (AOR = 0.33 (95% CI 0.15, 0.73), P = 0.007) were negatively associated with good adherence to self-care behavior recommendations. Conclusion: In this study, only half of the respondents had good adherence to self-care behaviors. Lower educational level, longer illness duration, and NYHA class II HF were predictors of poor adherence to self-care. Therefore, nurses should devise strategies to counsel or educate the HF patients on self-care practice recommendations, particularly patients with a lower education level and who lived longer with HF.

Expressed emotion of caregivers among schizophrenic patients visiting Jimma University Medical Center Psychiatry Outpatient Unit, Southwest Ethiopia

BackgroundExpressed emotion (EE) measures the emotion among caregivers of schizophrenic patients and is predictive of symptom levels in a range of medical and psychiatric conditions. It is worth assessing expressed emotion and associated factors among caregivers of patients with schizophrenia in Ethiopia since there is limited data on this issue in this part of the world.ObjectiveTo assess the status of expressed emotions and selected patients’ clinical factors among caregivers of patients with schizophrenia attending Psychiatry Outpatient Unit of Jimma University Medical Center, Southwest Ethiopia, 2019.MethodA cross-sectional study was conducted on 422 caregivers of schizophrenic patients using a consecutive sampling technique. Data were collected using a structured interviewer administrated questionnaires (Family Questionnairre) which assessed the level of expressed emotion. Data were entered into Epidata 4.4 and analyzed by Statistical package for social science (SPSS) version 25. Descriptive statistics was which used to summarize data, bivariate logistic regression was done to identify candidate variables for multivariable logistic regressions and the association between expressed emotion and predictor variables was identified by using multiple logistic regression models.ResultsHigh expressed emotion was observed in 43.6% of respondents while caring for schizophrenic patients for about 6–8 years, having 3–4 episodes of the illness which was significantly associated with high expressed emotion.ConclusionsThis study revealed that there is a high level of expressed emotion among caregivers. It also showed that increment in the episode of the illnesses had a significant association with high caregivers’ expressed emotion. Hence, health care systems which provide interventions for patients with schizophrenia need to design proper strategies to address caregivers’ needs as well.

Knowledge of modifiable cardiovascular diseases risk factors and its primary prevention practices among diabetic patients at Jimma University Medical Centre: A cross-sectional study.

Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity globally. This is due to the increasing prevalence of modifiable CVDs risk factors. Hence, the study was aimed to identify knowledge and unhealthy behaviors that contribute to CVD among diabetes mellitus patients. An institutional-based cross-sectional study design was employed among diabetes mellitus patients. A close-ended questionnaire developed from up-to-date similar literature was pretested and face-to-face interview techniques were used to collect data. Checked data were entered into the Epidata 4.1 versions. Then, descriptive and bivariate logistic regression was done using SPSS 25 versions. Of the study participants included in the study, 318, more than half of them, 167(52.5%), were aged ≥45 years and 187(58.8%) of them were females. Among the study participants, more than half, 198(62.3%), had good Knowledge of modifiable CVDs risk factors. Most of the study participants identified consuming foods rich in fats instead of vegetables and fruits 198(62.3%), followed by physical inactivity 196(61.6%) as a risk factor for CVD. Regarding CVDs prevention practice, 175(55.0%) of the patients had a good practice. More than three-fourths, 267(84.0%), practice avoiding foods rich in fats and, sugar, and cigarette smoking 250(78.6%). Predictors like educational status, college and above (AOR 2.68; 95% CI 1.14-6.27), and urban residence area (AOR 1.94; 95% CI 1.09-3.15) were associated with knowledge of CVDs risk factors. While sex, marital status monthly income, and age of the participants had no association with knowledge and prevention practice of modifiable CVDs risk factors. The study participants' knowledge and prevention practice of modifiable cardiovascular disease risk factors was satisfactory, even though continuous awareness creation is required to lower CVD mortality and morbidity burdens. Educational status and residence are of the study participants affect the knowledge and prevention practice modifiable of cardiovascular disease risk factors.

The cost of suspected and confirmed bacterial meningitis cases treated at Jimma University Medical Center, Ethiopia

Infections of the central nervous system (CNS) such as meningitis or encephalitis can be caused by myriad of microorganisms and may be life-threatening. In Ethiopia, it is an important cause of premature death and disability, being the 9th most common cause of years of life lost and loss of disability-adjusted life years.The objective of this study was to estimate the cost of suspected and confirmed bacterial meningitis among inpatient managed patients at JUMC. A facility-based cross-sectional study was conducted from July 28 to September 12, 2018. A semi-structured questionnaire was used in this study. Checklists were used to collect the types of laboratory tests performed and prescribed medications. This cost of illness study was conducted from the patient perspectives. We employed a micro-costing bottom-up approach to estimate the direct cost of meningitis. The human capital approach was used for estimating wages lost. Among total patients admitted and treated in JUMC, higher proportions (69.8%) were suspected bacterial meningitis but have been treated as confirmed cases. Total median costs for both suspected and confirmed bacterial meningitis patients were estimated to be ETB 98,812.32 (US $ 3,593.2; IQR 1,303.0 to 5,734.0). Total median direct cost was ETB 79,248.02 (US $ 2,881.75; IQR 890.7 to 3,576.7). Moreover, 45.3% of the patients reported that they were either admitted or given medication at JUMC or nearby health facility before their current admissions. These findings indicate that most cases of bacterial meningitis were treated only empirically, and the cost of the treatment was high, especially for resource-limited countries like Ethiopia. To minimize the burden of meningitis and avoid unnecessary hospitalizations, the availability of diagnostic techniques is vitally important.

Modeling Time to Blindness of Glaucoma Patients: A Case Study at Jimma University Medical Center.

Glaucoma is a significant public health problem due to its substantial increase in the projected number of glaucoma cases. In Ethiopia, glaucoma accounts for 5.2% of irreversible blindness and is the fifth main cause of blindness. The main objective of this study was to modeling time to blindness of left and right eyes of glaucoma patients. An institution-based retrospective cohort study. This study was conducted among 315 glaucoma patients admitted to the Ophthalmology Department of Jimma University Medical Center (JUMC), Southwest Ethiopia, from January 1, 2016, to August 30, 2020. Kaplan-Meier survival analysis and semiparametric and parametric copula models were applied to identify factors that affect time to the blindness in glaucoma patients and the dependence between time to the blindness of the left and right eyes, respectively. An Akaike information criterion (AIC) was used to select the best non-nested model. In total, 211 (66.9%) out of 315 glaucoma patients were blind, whereas 104 (33.1%) patients were censored. The median time to the blindness of the left and right eyes was determined to be 12 months. The result suggested that the risk of the blindness in male patients was 1.005 (P = 0.01) times higher than that in female patients, and the risk of the blindness in patients who had early, moderate, and advanced glaucoma was estimated to be 0.582 (P = 0.002), 0.485 (P = 0.001) and 0.887 (P = 0.003) times less than that in the patients with absolute glaucoma, respectively. Age, place of residence, gender, type of medication, diabetes disease, stage of glaucoma, duration of treatment, intraocular pressure (IOP), and cup-disk ratio were significantly associated with and affected by the time to the blindness of left and right eyes in glaucoma patients. Awareness should be given to the community to reduce the burden of glaucoma.

Drug therapy problems and predicting factors among ambulatory epileptic patients in Jimma Medical Center, Southwest Ethiopia.

BackgroundThe care of epileptic patients is complicated by the cognitive adverse effect of the drug, disease, pharmacokinetics, and pharmacodynamics properties of antiepileptic drugs which in turn intensify the risk of drug therapy problems among epileptic patients.ObjectiveTo assess drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center, Southwest Ethiopia, from September 2020 to May 2021.MethodologyA hospital-based prospective observational study was conducted. A semi-structured questionnaire was used to collect data from patients as well as from charts. Drug therapy problems were identified using Cipolle’s, Morley, and Strand drug therapy problem identification and classification method. Data were entered into Epi data manager version 4.6 and exported to statistical software package for social science version 23.0 for analysis. Multiplestepwise backward logistic regression analysis was carried out to identify predictors of drug therapy problems. The 95% CI was used to show an association between the dependent and independent variables. P-value < 0.05 was considered as statistically significant.ResultsOf the total 320 epileptic patients 224(70.0%) patients had at least one drug therapy problem. A total of 395 drug therapy problems were identified among two hundred twenty-four patients with an average of 1.2 drug therapy problems per patient. The frequently identified drug therapy problems were non-compliance 115(29.11), adverse drug reaction 110(27.84%), and dose too low 103(26%). Getting of a drug by purchasing [AOR = 4.6,95%CI:(2.05–10.7)], poorly involvement of the patients in therapeutic decision making [AOR = 3.02,95%CI:(1.5–6.06)], the number of medications ≥ two [AOR = 5.3,95%CI:(1.2–22.9)] and having had uncontrolled seizure [AOR = 10.9,95%CI:(4.9–24.2)] were independent predictors of drug therapy problems.ConclusionsDrug therapy problems were common among epileptic patients in the study area. Patients who were getting their drugs by purchasing, poorly involved in therapeutic decision making, having had an uncontrolled seizure, and taking two and above drugs were more likely to experience drug therapy problems. Therefore, due attention should be given to patients with the aforementioned problems to decrease the occurrence of drug therapy problems and improve overall outcomes among epileptic patients.

Knowledge and practices of hand hygiene among the health care providers of Jimma University Medical Center Jimma Oromia Ethiopia

Knowledge and practices of hand hygiene among the health care providers of Jimma University Medical Center Jimma Oromia Ethiopia

Parental Satisfaction with Neonatal Intensive Care Unit Services and Associated Factors in Jimma University Medical Center, Ethiopia

Parental Satisfaction with Neonatal Intensive Care Unit Services and Associated Factors in Jimma University Medical Center, Ethiopia

IDF21-0068 Joint modeling of incident CKD and its association with fasting blood sugar change among diabetic patients

Background: CKD is one of most common microvascular complication of DM and become a major health burden worldwide. Despite the effect of fasting blood sugar on the rate of prevent diabetic kidney disease has a pivotal role on the prevention of the diseases, their association is not well investigated. Therefore, the aim of this study was to assess Incidence and predictors of chronic kidney disease and its association with longitudinal fasting blood sugar change among diabetic patients in Southwest Ethiopia. Aim: To determine incidence and predictors of CKD and modeling its association with FBG change among DM patients in Jimma University medical center, Southwest Ethiopia from 2012 to 2020. Method: A retrospective follow-up study was conducted among type 1 and type 2 DM, Southwest Ethiopia. A total of 437 diabetes patients who newly enrolled in the DM chronic care from 2012 to 2015 were selected using the simple random sampling technique. Selected patients with complete information were followed until February 2020. Data was extracted from patients’ medical records. Cox proportional hazard with linear mixed effect model was jointly modeled using Bayesian approach, and 95% credible interval was used to select significant variables. Model adequacy was checked by residuals plot. Results: A total of 437 DM patients with complete information were followed for 27494.44 PM observation. Overall, 63 patients developed CKD with an incidence rate of 2.29 per1000 PM observation (95% CI: [1.79, 2.93]. FBG was significantly associated with risk of CKD (AHR=4.23, 95% CrI [2.53, 8.23]). Female sex (AHR= 0.51, 95%CrI: [0.27, 0.94]), positive proteinuria (AHR= 2.85, 95%CrI: [1.48, 5.55]), having hypertension (AHR= 2.31, 95%CrI: [1.03, 5.56]) and HDL <40 mg/dl (AHR=3.19, 95% CrI [1.73, 5.98]) were significant predictors of CKD. Discussion: CKD among DM patients continue to be a significant public health problem in Ethiopia. Longitudinal FBG change had significant associations with risk of CKD and high FBS can be used as a signal to screen DM patients for CKD. Female sex, positive proteinuria, hypertension and HDL-C <40mg/dl were significant predictors of chronic kidney disease.

Classification of Parkinson’s Disease Using EMG Signals from Different Upper Limb Movements Based on Multiclass Support Vector Machine

Parkinson’s disease (PD) is the second most common neurodegenerative disease that affects a wide range of productive individuals worldwide. The common approach to diagnose PD is through clinical assessment of the patient, which is highly subjective and time consuming. Electromyography (EMG) can be taken as a cheap way of PD diagnosis. However, highly experienced experts are required to interpret the signals. The manual procedures are complex, time-consuming, and prone to error resulting in misdiagnosis. In this research, an automatic system for detection and classification of PD stages using EMG signals acquired from different upper limb movements is proposed. In addition, effective upper limb movement for the identification of PD has been investigated. The data required for training and testing the system was collected from flexor carpi radialis and biceps brachii muscles of 15 PD patients and 10 healthy control subjects at Jimma University Medical Center. The raw EMG signal was preprocessed and frequency and time-domain features were extracted. A multiclass support vector machine model was then trained for four-class classification (normal, early, moderate, and advanced PD levels). The performance of the system was evaluated using different performance evaluators and a promising result has been obtained. 90%, 91.7%, 95%, and 96.6% overall classification accuracies were obtained for elbow flexion by 90-degrees without load, elbow flexion by 90-degrees with load, touching the shoulder, and wrist pronation, respectively. A user-friendly interface has been also developed for ease of use of the automatic PD classification system.