Background: Tuberculosis remains the major public health problem besides tremendous efforts to combat it. Most tuberculosis patients are treated with a standard dose of first-line anti-TB drugs. The cure rate, however, varies from patient to patient. Various factors have been related to anti-TB treatment failure. In recent years, studies associating lower plasma concentrations of anti-TB drugs with poor treatment outcomes are emerging although the results are inconclusive. Objective: Investigate the impact of first-line anti-tubercular drugs pharmacokinetics on treatment outcome. Methods: A systematic search of Pubmed, EMBASE, Web of Science, and the Cochrane Library for articles published in the English language between January 2010 to June 2020 was conducted to identify eligible studies describing associations of first-line anti-tubercular drug pharmacokinetics with treatment outcomes. The primary outcomes considered were pharmacokinetics parameter results and its association with treatment outcome. Results: The search identified 1754 articles of which twelve articles; ten prospective observational studies and two controlled clinical trials fulfilled the eligibility criteria. The majority of the studies showed target concentrations for the first-line anti-tubercular drugs below the current standard range. Among the twelve studies, eleven studies assessed rifampicin pharmacokinetics of which eight reported association of drug concentration and treatment outcomes. Similarly, four out of eight and three out of seven reported drug concentration and treatment outcome association for isoniazid and pyrazinamide, respectively. Despite the low plasma concentration, a favorable treatment outcome was achieved for the bulk of the patients. Irrespective of the inconsistency, an increase in exposure to rifampicin improved the outcome, and lower rifampicin, isoniazid, and pyrazinamide concentration are associated with poor outcome. No data are available for ethambutol associating its pharmacokinetics with treatment outcomes. Conclusion: The pharmacokinetics of first-line antitubercular drugs can influence treatment outcomes. Further controlled clinical studies are, however, required to establish these relationships.

Background Rifamycins are a novel class of antibiotics clinically approved for tuberculosis chemotherapy. They are characterized by high inter-individual variation in pharmacokinetics. This systematic review aims to present the contribution of genetic variations in drug-metabolizing enzymes and transporter proteins to the inter-individual variation of rifamycin pharmacokinetics. Method We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. The search for relevant studies was done through PubMed, Embase, Web of Science, and Scopus databases. Studies reporting single nucleotide polymorphism in drug transporters and metabolizing enzymes’ influence on rifamycin pharmacokinetics were solely included. Two reviewers independently performed data extraction. Results The search identified 117 articles of which 15 fulfilled the eligibility criteria and were included in the final data synthesis. The single nucleotides polymorphism in the drug transporters SLCO1B1 rs4149032, rs2306283, rs11045819, and ABCB1 rs1045642 for rifampicin, drug metabolizing enzyme AADAC rs1803155 for rifapentine and CES2 c.-22263A>G (g.738A>G) for rifampicin partly contributes to the variability of pharmacokinetic parameters in tuberculosis patients. Conclusion The pharmacokinetics of rifamycins is influenced by genetic variation of drug-metabolizing enzymes and transporters. Controlled clinical studies are, however, required to establish these relationships.

Background: Job satisfaction is an important determinant of workers' motivation, retention, and performance. Each individual working in different segments of the health sector has an impact on the quality and accessibility of the services the health care system provides to the community. Many studies assessed health care workers' job satisfaction. However, the majority of previous studies focused on specific health professionals and facilities. The present study assessed job satisfaction and its associated factors among governmental health workers in West Shoa Zone, Oromia, EthiopiaMethods: An institutional-based cross-sectional study was conducted in West Shoa, Oromia Regional State, Ethiopia, from March 23/2020 to April 15/2020. A total of 429 health workers were identified from type A, B, and C districts. Participants were proportionally allocated for each district and the individual participant was selected using simple random sampling methods. Data was collected using a self-administered structured questionnaire and entered into EpiInfo 7. Data analysis was done using SPSS version 22 software. Mean and/or median were used for continuous variables, whereas; the percentage was used for categorical variables. Bivariate logistic regression analysis was done to assess the association between each independent variable and outcome variable. Multivariate binary logistic regression using adjusted odds ratios and 95% confidence intervals were estimated to assess the strength of association. Results: From the total of 429 study participants, 422 of them were fully responded to the survey with a response rate of 98.3%. The overall level of job satisfaction was 46%. Management. The policy of the worker organization [AOR 0.07, 95% CI: 0.03-.21)], the relationship among the workers [AOR 0.08(95% CI .03-.23], presence of benefit package [AOR 0.07, (95% CI .02-.22], work environment [AOR 0.11, (95% CI: 0. 04-.31], personal growth and development [AOR 0.11 (95% CI: 0.04-.33], supportive supervision from immediate supervisor [AOR 0.04 (95% CI: 0.014-.14] and the nature of work category [AOR 0.03 (95% CI: 0.01-.1] were independently associated with job satisfaction. Conclusions: The overall job satisfaction of health workers in the study area was low. Management and policy of the worker organization, the relationship among the workers, presence of benefit package, work conditioning, personal growth, and development, supportive supervision from immediate supervisor and the nature of work category were among the predictor of job satisfaction.

Purpose To assess the non-prescription use of antibiotics and associated factors in Ambo Town, West Shoa, Oromia, Ethiopia. Methods An institutional-based cross-sectional study design supported with the qualitative study was conducted in Ambo Town from February 1 to March 1, 2020. Data were collected using a pretested semi-structured questionnaire and in-depth interview guide questions. Simple random sampling was used to select retail outlets and systematic random sampling to select study participants. The data analysis was done using SPSS and univariate and multivariate binary logistic regression analysis was performed to identify factors associated with non-prescription use of antibiotics. Thematic framework analysis was applied for the qualitative data. Results From the 421 study sample, a total of 399 participants were interviewed with a 94.8% response rate. Among the study participants, 214 (53.6) were males, 228 (57.1%) were married, 191 (47.9%) were orthodox by religion, and 343 (86%) were Oromo by ethnicity. One hundred seventy-two (43.1%; 95% CI: 38.6, 48.1) of the participants had used non-prescribed antibiotics. Being male [AOR=2.21 95% CI: 1.276, 3.835], residing in rural area [AOR=3.659, 95% CI: 1.479, 9.054], holding diploma [AOR=0.120, 95% CI: 0.025, 0.591], and hold BSC degree [AOR=0.050, 95% CI: 0.007, 0.378], and being farmer [AOR=0.034, 95% CI: 0.004, 0.285] showed significant association with the non-prescription use of antibiotics. Conclusion This study concluded that the non-prescription use of antibiotics 172 (43.1%) was relatively high. Being male, residing in a rural area, holding a diploma, BSc degree, and being a farmer were significantly associated with non-prescription use of antibiotics. So, West Shoa Zone regulatory body should actively focus on the prevention of non-prescription use of antibiotics through health communication and public awareness on the demerits of non-prescription use of antibiotics.

Background The non-prescription use of antibiotics is a major challenge faced by all nations. The practice is pronounced in developing and low-income countries where legislation and regulations are weak. The present study assessed the non-prescription use of antibiotics and associated factors in Ambo town, West Shoa, Oromiya, Ethiopia. Methods Institutional based cross-sectional study design supported with the qualitative study was conducted in Ambo town from February 1to March 1, 2020. Data were collected using a pre-tested semi-structured questionnaire and in-depth interview guide questions. Simple random sampling was used to select retail outlets and systematic random sampling to select study participants. The data analysis was done using SPSS and univariate and multivariate binary logistic regression analysis were performed to identify factors associated with non-prescription use of antibiotics. Thematic framework analysis was applied for the qualitative data. Results From a 421 study sample, a total of 399 participants were interviewed with a 94.8% response rate. Among the study participants 214 (53.6) were males, 228 (57.1%) were married, 191(47.9%) were orthodox by religion and, 343(86%) were Oromo by ethnicity. One hundred seventy two (43.1%) 95% CI= (38.6, 48.1) of the participants had used non prescribed Antibiotics. Being male [AOR = 2.21 95%CI 1.276,3.835], residing in rural area [AOR = 3.659, 95%CI 1.479, 9.054], holding Diploma[AOR = 0.120, 95% CI 0.025, 0.591], and hold BSC Degree [AOR = 0.050, 95% CI 0.007, 0.378], and being farmer [AOR = 0.034, 95% CI 0.004, 0.285] showed significant association with the non prescription use of Antibiotics. Conclusion This study concluded that the non-prescription use of antibiotics 172 (43.1%) was relatively high. Being male, residing in a rural area, holding a diploma, BSc Degree, and being a farmer were significantly associated with non-prescription use of antibiotics. So West Shoa Zone regulatory body should actively focus on the prevention of non-prescription use of Antibiotics through health communication and public awareness on the demerits of non-prescription use of Antibiotics