Introduction. Diabetes mellitus is a chronic debilitating condition characterized by an increased blood glucose level and is associated with significant morbidity, mortality, and increasing health care cost. Diabetic foot ulcers and lower extremity amputations are a common, complex, costly, and disabling complication of diabetes. An estimated 15% of patients with diabetes develop a lower extremity ulcer. Objective. The aim of this study was to assess knowledge, practice, and barriers of diabetic foot self-care among diabetic patients attending Felege Hiwot Referral Hospital. Method. Institution based descriptive cross-sectional study was conducted on 313 diabetic patients using convenient sampling technique. Furthermore, descriptive statistics and binary and multivariate logistic regression were employed to assess the predicators of knowledge and practice of diabetic foot care. Result. Majority of respondents were males (64.9%). The mean age was 39.1 ± 16. The mean knowledge score was 7.5 ± 2.02 of which 56.2% and 43.8% had good and poor knowledge of foot care, respectively. The mean practice score was 25.2 ± 6.466 of which 53.0% had good and the remaining 47.0% had poor foot care practice. Of 162 respondents having barriers, 56.8% reported "poor communication between patients and health care providers, " 50.6% cited "I did not know what to do, " and 44.4% responded "inconveniency for work" as barriers of foot care. Conclusion and Recommendation. Knowledge and practice of foot care of diabetic patients are still substandard. Poor communication between patients and nurses/physicians, lack of adequate knowledge, and inconveniency for work were commonly cited barriers of foot care. Policy makers should initiate interventional foot care education program throughout the regional state. The study hospital should consider establishing a specialized diabetic clinic in which foot care education can easily be integrated into follow-up care.
BackgroundThe prevalence of erectile dysfunction among diabetic men varies between 35–90%. Although erectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and demands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patient’s life including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the prevalence and determinants of erectile dysfunction among diabetic patients attending hospitals in the Central and Northwest zone of Tigray, Ethiopia.MethodsA hospital based cross-sectional study was conducted on 249 male diabetic patients attending five hospitals in the Central and Northwestern Zone of Tigray, Ethiopia using systematic random sampling. The data was collected from January 1 – February 30, 2016 and was entered and analyzed using SPSS version 20. Correlation and multivariate logistic regression was employed to test associations between independent and outcome variables.ResultsThe mean age of study participants was 43.39 years and the mean duration of diabetes diagnosis was 6.22 years. The overall prevalence of erectile dysfunction was 69.9%, with 32.9% suffering from mild, 31.7% moderate, and 5.2% severe erectile dysfunction. Multivariate logistic regression revealed that erective dysfunction was significantly predicted by old age (Adjusted Odds Ratio [AOR] =15.013, CI:3.212–70.166), longer duration of diabetes (AOR = 3.77, CI:1.291–11.051), and lower monthly income (AOR = 0.285, CI:0.132–0.615). No association was found with body mass index, co-morbidity, glycemic control, and alcohol consumption.ConclusionThe prevalence of erective dysfunction in this study population was very high. Age, income, and duration of diabetes were the independent predictors of erectile dysfunction. Nearly all of the patients in the sample (97%) had not been screened or treated for erectile dysfunction. Assessment and management of erectile dysfunction in the diabetic clinic should be part of routine medical care during follow-up visits with diabetic patients. Healthcare providers should put an emphasis on screening and treating older patients and those who had a diabetes diagnosis for a longer duration.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-017-0167-5) contains supplementary material, which is available to authorized users.
Background: Despite modern surgical techniques and the use of antibiotic prophylaxis, surgical site infection remains a burden for the patient and health system. It is a major cause of morbidity, prolonged hospital stay, and increased health costs. Thus, the main aim of this study was to determine the prevalence and root causes of surgical site infection among patients undergoing major surgery at an academic trauma and burn center in Ethiopia. Methods: A hospital based cross-sectional study was conducted on 249 patients during 6-months' time window. Data entered in SPSS and multivariate logistic regression was employed to determine the root causes and the outcome variable. Results: The prevalence of surgical site infection was found to be 24.6% of whom 10% develop deep site, 9.2% organ spaced and the remaining 5.2% develop superficial space surgical site infection. The prevalence was high in patients who had undergone orthopedics (54.3%) and abdominal (30%) surgeries. Educational status, pre-morbid illness, duration of pre-operative and post-operative hospital stay, ASA score, and type of the wound were significantly associated with SSI at p-value of ≤0.05. However, no association was found with BMI and location of the wound. Conclusions: The prevalence of surgical site infection in the study population is still high. Preoperative hospital stay, pre-morbid illness, pre-operative and post-operative hospital stay, ASA score, and type of the wound were the independent predictors of surgical site infection. The duration of pre and post-operative periods should be kept to a minimum as much as possible. Patients with pre-morbid history of chronic diseases and contaminated wound require special attention to decrease the rate of occurrence of infections. In addition, longitudinal studies should be carried out to identify more risk factors.
Background Undernutrition (Body Mass Index < 18.5 kg/m2) is a common problem and a major cause of hospital admission for patients living with HIV. Though sub-Saharan Africa is the most commonly affected region with HIV and malnutrition, a meta-analysis study that estimates the prevalence and correlates of undernutrition among adults living with HIV has not yet been conducted. The objective of this study was to determine the pooled prevalence of undernutrition and associated factors among adults living with HIV/AIDS in sub-Saharan Africa. Methods Studies published in English were searched systematically from databases such as PubMed, Google Scholar, and gray literature, as well as manually from references in published articles. Observational studies published from 2009 to November 2021 were included. The data extraction checklist was prepared using Microsoft Excel and includes author names, study area, publication year, sample size, prevalence/odds ratio, and confidence intervals. The results were presented and summarized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standard. Heterogeneity was investigated using the Q test, I2, τ2, τ and predictive interval. STATA version 17 was used to analyze the data. A meta-analysis using a random-effects model was used to determine the overall prevalence and adjusted odds ratio. The study has been registered in PROSPERO with a protocol number of CRD42021268603. Results In this study, a total of 44 studies and 22,316 participants were included. The pooled prevalence of undernutrition among adult people living with HIV (PLWHIV) was 23.72% (95% CI: 20.69–26.85). The factors associated with undernutrition were participants’ age (AOR = 0.5, 95% CI: 0.29–0.88), gender (AOR = 2.08, 95% CI: 0.22–20.00), World Health Organization (WHO) clinical stage (AOR = 3.25, 95% CI: 2.57–3.93), Cluster of Differentiation 4 (CD4 count) (AOR = 1.94, 95% CI: 1.53–2.28), and duration of ART (AOR = 2.32, 95% CI: 1.6–3.02). Conclusion The pooled prevalence of undernutrition among adult PLWHIV in sub-Saharan Africa remained high. WHO clinical stage, CD4 count, duration of ART treatment, age, and sex were found to be the factors associated with undernutrition. Reinforcing nutrition counseling, care, and support for adults living with HIV is recommended. Priority nutritional screening and interventions should be provided for patients with advanced WHO clinical stages, low CD4 counts, the male gender, younger age groups, and ART beginners.
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