BackgroundInappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration.MethodsA comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics.ResultsInappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals.ConclusionsInappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.

The objectives of the this study were to assess the influence of CYP3A5 genotype and sex on the variability in total CYP3A activity and to compare 4b-hydroxycholesterol and omeprazole sulfoxidation as phenotypic markers for CYP3A activity in Ethiopians. Healthy subjects (n ¼ 150) were genotyped for CYP3A5*3, *6 and *7 using allele-specific PCR and Taqman genotyping assays. Plasma levels of 4b-hydroxycholesterol, 3 h post-dose omeprazole and omeprazole sulfone, were determined by gas chromatography-mass spectrometry and high performance liquid chromatography, respectively. The frequency of CYP3A5*1, *3, *6 and *7 was 20.5, 67.3, 12.2 and 0%, respectively. The mean plasma 4b-hydroxycholesterol level was 35.4 ng ml À1. The mean 4b-hydroxycholesterol level (P ¼ 0.0001) and the 4b-hydroxycholesterol/cholesterol ratio (P ¼ 0.004) were higher in women than in men. CYP3A5 genotype significantly correlated with the plasma 4b-hydroxycholesterol concentration (P ¼ 0.003) and 4b-hydroxycholesterol/ cholesterol ratio (P ¼ 0.0002). The omeprazole/omeprazole sulfone ratio was significantly correlated with 4b-hydroxycholesterol and 4b-hydroxycholesterol/cholesterol ratio in CYP3A5*0/*0 genotypes but not in individuals carrying the CYP3A5*1 allele. No correlation of omeprazole/omeprazole sulfone ratio with sex or CYP3A5 genotype was observed. A clear gene-dose effect implies plasma 4b-hydroxycholesterol level as a useful endogenous biomarker for total CYP3A activity (CYP3A5 plus CYP3A4) whereas the omeprazole/omeprazole sulfone ratio reflects mainly CYP3A4 activity. Sex and CYP3A5 genotype influence total CYP3A activity. Ethiopians display high total CYP3A activity and a unique distribution of CYP3A5 variant alleles not described hitherto.

Introduction: Khat chewing is believed to be rapidly increasing worldwide. Worldwide, it is estimated that 10 million people consume khat daily. Khat chewing practice renders certain influence on physical and psychological well being of the community and it can cause more serious adverse psychiatric, cardiovascular, dental and gastrointestinal effects. The recent sharp increase in khat consumption may not only affect the health of individuals but could also have serious socioeconomic consequences. This study was conducted to assess prevalence of khat chewing practice, its associated factors and perceived health effects among communities in Dera woreda, Amhara region, Ethiopia 2013. Methods: Community-based cross-sectional study was conducted by using both quantitative and qualitative method of data. The sample size for quantitative was determined by using single population proportion formula and the households were selected by systematic sampling method and in the selected household, one respondent was selected by lottery among members of household aged 15 years and above. Data were collected by means of a pretested questionnaire; analysis was carried out using SPSS version 16. For the qualitative part ten in-depth interviews were conducted on purposely selected individuals and sample size for this method was determined through continuing to interview participants until no new information was obtained. Results: The response rate was 98.3%. Current prevalence of khat chewing practice was 17%. Males were more likely to chew khat (AOR, 18.53; 95%CI, 7.20-47.66) compared to females. Muslims were more likely to chew khat (AOR, 4.34; 95%CI, 2.07-9.11) compared to Orthodox Christians. Respondents who had family member chewing khat were more likely to chew khat (AOR, 2.67; 95%CI, 1.15-6.21) compared to family member without a chewer. Among all the respondents, 92.8% perceived the health effects of khat chewing practice. Respondents who did not perceive health effect of khat were 5 times more likely to chew khat (AOR = 5.10, 95%CI; 1.64-15.5) compared to those who perceived health effect of khat. Conclusions: The prevalence of khat chewing practice was 17% with high proportion of the khat chewers found in the urban setting. Sex, religion, residence, family chewing habit and perceived health effect were significantly associated factors with khat chewing practice. In this study 92.8% of the respondents perceived that khat chewing practice had harmful effects on health and the perceived health effects reported were sleeping disorder, hallucination, tooth staining, anxiety, and loss of appetite, depression, constipation, gastritis, hypertension and psychosis.

Background. Unknown proportions of tuberculosis cases remain undiagnosed and untreated as result of several factors which further increases the number of tuberculosis cases per index case. Objective. To identify factors associated with patient's delay in initiating treatment of tuberculosis. Methods. Cross-sectional study was employed from January to April, 2013, in Bahir Dar Ethiopia. A total of 360 patients were included. Data were collected from tuberculosis patients using a semistructured questionnaire. Data were entered and analyzed using SPSS version 16 windows. Multivariate logistic regression analysis was used to identify factors associated with patient delay. Results. Of all patients, 211 (62%) sought medical care after the WHO recommended period (21 days). The median patient delays of smear positive, smear negative, and extrapulmonary patients were 27 (IQR: 10–59), 30 (IQR: 9–65), and 31 (IQR: 10–150) days, respectively, with statistically significant variations among them (ANOVA: F = 5.96; P < 0.003). Place of residence and educational status were the predictors of patient delay. Conclusion. Around two-thirds of all patients and more than half of smear positive tuberculosis patients were delayed in seeking medical care within the recommended period. Provision of DOTS service in the vicinity and health education on TB may reduce patient delay and its consequences.

Background Eradication of Helicobacter pylori infection with standard triple therapy has been accepted to curb associated risks of chronic gastritis andpeptic ulcer disease. Objective To assess H . pylori eradication rate of standard triple therapy and patient related factors affecting eradication rate. Methods A facility based prospective follow up study was conducted in Bahir Dar City Administration, Ethiopia, on consented outpatients presented with gastritis and peptic ulcer disease and positive for H . pylori stool antigen test from May 2016 to April 2018. Eradication was confirmed with stool antigen test made after 4–6 weeks of standard triple therapy, comprising of proton pump inhibitor, clarithromycin and amoxicillin. Pre-developed questionnaire and data collection formats were used to collect variables before and after therapy. Bivariate and backward stepwise multivariate logistic regression was used to analyze data. P-value < 0.05 at 95%CI was considered as significant. Results The overall H . pylori eradication rate was 90.3% (379/421). Almost 80% of the patients were urban residents. Mean (±SD) age and body weight of patients were 30.63 (± 10.74) years and 56.79 (± 10.17) kg, respectively. Self-reported adverse drug effects and area of residence of patients were factors affecting eradication rate significantly. Patients with no self-reported adverse drug effect were 3.85 (AOR: 3.85; 95%CI (1.41–5.26)) times more likely to eradicate H . pylori infection compared to those reported adverse effects. Patients living in rural area were 2.7 (AOR: 2.7; 95%CI (1.19–20.0)) times more likely to achieve eradication compared to urban residents. Conclusion H . pylori eradication rate is within the recommended level for clinical practice, indicating that modifications of the standard triple therapy observed in the different healthcare institutions are not evidence-based. Emphasis should be given to adverse drug effects of medications and tailored counseling based on area of residence could have a contribution in improving eradication rate.