scholarly journals Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ameha Zeleke Zewudie ◽  
Tolcha Regasa ◽  
Solomon Hambisa ◽  
Dejen Nureye ◽  
Yitagesu Mamo ◽  
...  

Background. Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Methods. A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. Results. Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65   adjusted   odd   ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001 ), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001 ), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001 ), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03 ) were independent predictors of poor treatment outcomes. Conclusion. Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).

2019 ◽  
Author(s):  
Le Hong Van ◽  
Phan Trieu Phu ◽  
Dao Nguyen Vinh ◽  
Vo Thanh Son ◽  
Nguyen Thi Hanh ◽  
...  

Abstract Background: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcome. Predictors of poor outcomes vary in different regions. Vietnam is among the 30 countries with high burden of MDR-TB. We aim to describe demographic characteristics and identify risk factors for poor outcome of MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods: This retrospective study included 2,266 patients who initiated MDR-TB treatment from 2011 to 2015 in HCMC. Treatment outcomes were available in 2,240 patients. Data was collected from standardized paper-based treatment cards and electronic records. Kruskal Wallis test was used to diagnose the change of median of age and body mass index (BMI) over 5 years, and Wilcoxon test to compare median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression on multiple imputation was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results: Among 2,266 eligible cases, 60.2% were failure of category I or II regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. Notification rate increased 24.7% from 2011 to 2015.Treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty and 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1kg/m2 of BMI for patients with BMI<21). Conclusion: Our study describes the increasing cases of MDR-TB in HCMC during 2011 to 2015. Patients with HIV, high smear grade, malnutrition and history of previous MDR-TB treatment should receive additional care. Keywords: multidrug resistant tuberculosis; retrospective; treatment outcome; risk factors; Vietnam


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hilina Tsegaw ◽  
Mohammed Yimam ◽  
Dejen Nureye ◽  
Workineh Woldeselassie ◽  
Solomon Hambisa

Background. Pneumonia remains the leading cause of hospitalization and mortality in young children in low- and middle-income countries. This study is aimed to assess predictors of treatment outcomes among pediatric patients hospitalized with pneumonia in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A facility-based retrospective cross-sectional study was conducted among pediatric patients admitted with pneumonia, considering patient medical charts recorded for a 1-year period from February 2017 to February 2018. The sample size was computed based on a single population proportion formula and giving a total sample size of 207. The systematic random sampling method was employed to select patient cards from the sampling frame. The data extraction format was used to extract any relevant information from patient chart. The processed data were analyzed by using Statistical Package for Social Sciences (SPSS, version 21). Descriptive statistics were used to summarize the patients’ baseline characteristics and related information. The logistic regression model was fitted to determine factors associated with treatment outcomes. To identify predictors of poor treatment outcome, the level of significance was set at P < 0.05 . Results. From a total of 207 patient charts reviewed, more than half (55.6%) of the study participants were males. Majority of patients, 130 (62.8%), were in the age range of 1 month–11 months. Furthermore, 191 (92.3%) patients had good treatment outcome. Patients who treated with ceftriaxone + azithromycin were less likely to have poor treatment outcome compared with patients who were placed on crystalline penicillin (AOR = 0.86, 95% CI 0.01–0.83). On the contrary, patients who stayed ≥ 8 days were about 14.3 times more likely to have poor treatment outcome compared with patients who stayed ≤ 3 days (AOR = 14.3, 95% CI 1.35–151.1). Conclusion. Even though the study revealed good treatment outcome among the pediatric patients, particular consideration should be given to children in need of other interventions.


2020 ◽  
Author(s):  
Le Hong Van ◽  
Phan Trieu Phu ◽  
Dao Nguyen Vinh ◽  
Vo Thanh Son ◽  
Nguyen Thi Hanh ◽  
...  

Abstract Background: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam.Methods: This retrospective study included 2,266 patients who initiated MDR-TB treatment between 2011-2015 in HCMC. Treatment outcomes were available for 2,240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program.Results: Among 2,266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011-2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1kg/m2 of BMI for patients with BMI<21).Conclusion: The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011-2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.


2019 ◽  
Author(s):  
Belayneh Kefale ◽  
Guye Betero ◽  
Gobezie Temesgen ◽  
Amsalu Degu

Abstract Background: Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past few years in Ethiopia, there is a paucity of data regarding to stroke treatment outcomes and associated factors. Hence, this study was aimed to assess management practice, and treatment outcome and its associated factors among hospitalized stroke patients.Method an institutional based cross sectional study was conducted among 111 hospitalized stroke patients in the medical ward of Ambo University Referral Hospital(AURH), who had been hospitalized for the last three years (March 30/2016- May30/2019). All patients diagnosed with stroke and hospitalized in the medical ward of AURH were included in the study. Data were analyzed with SPSS version 25.0 statistical software. Bivariate and multivariate binary logistic regression analysis was conducted to identify the predictors of poor treatment outcome.Result The present study showed that ischemic stroke was the most prevalent (80.1%) form of stroke diagnosed in the study setting. Nonetheless, 18.2% of patients were diagnosed with hemorrhagic stroke. Among 111 study participants, 69 (62.2%) patients had good treatment outcome. From 42(37.8%) study participants with poor treatment outcome, 18(42.8%) were dead and 12 (28.6%) were with disability and left against medical advice on self and family request while the remaining 12 (28.6%) were referred to other higher health facility. Social history (substance abuse P=00.046, AOR=2.684, 95%CI 1.091-6.604), age (P=0.026, AOR= 3.256, 95%CI = 1.145-9.260) and chief compliant (P=0.009, AOR=0.254, 95%CI=0.091-0.708) were the predictors of treatment outcome among hospitalized stroke patients. Other variables like types of stroke, co-morbidity, and others did not show significant association with treatment outcome.Conclusion The present study showed that ischemic stroke was the most predominantly diagnosed type of stroke in our setting. Acetyl salicylic acid and ACE inhibitor based regimens were frequently used in the management of stroke and hypertension, respectively. Nearly one third of the study participants had good treatment outcome. Nonetheless, death was reported in 16.2% of hospitalized stroke patients in the study setting. Being older and substance abusers, and the presence of hemiparesis during the initial hospital admission were significant predictors of poor treatment outcome.


2019 ◽  
Vol 13 (1) ◽  
pp. 58-64
Author(s):  
Mohammed Gebre Dedefo ◽  
Meti Teressa Sirata ◽  
Balisa Mosisa Ejeta ◽  
Getu Bayisa Wakjira ◽  
Ginenus Fekadu ◽  
...  

Background: Tuberculosis (TB) is a major public health concern in the developing world. World Health Organization’s (WHO’s) list of 30 high TB burden countries accounted for 87% of the world’s cases. The annual infection rate in developing countries reached 2% or more; where as in developed countries this figure is 0.5%. Objective: The objective of this study is to assess treatment outcomes of tuberculosis retreatment case and its determinants at Nekemte Referral Hospital (NRH), West Ethiopia. Methods: A retrospective cross-sectional study was conducted. All registered adult TB patients under retreatment regimen who were treated at NRH TB clinics from January 2014 to December 2017 were included in this study. A multiple logistic regression was used to assess the significance and strength of association. A P-value <0.05 was used as statistically significant. Results: The prevalence of retreatment case was 12.12%. Of 219 study participants 159(72.6%) were patients with relapse, 43(19.6%) were with retreatment after failure and 17(7.8%) were patients who return after loss to follow-up. On multivariable logistic analysis poor treatment outcome was more likely to occur among patients with positive Acid Fast Bacilli (AFB) result at 5th month (Adjusted odds ratio (AOR =4.3, 95%, (1.8-10.0) p=0.001) and patients taking category 1 (2ERHZ/4RH) drugs (AOR=2.1, 95% CI= (1.1-4.5) p=0.048). Conclusion: This study showed that treatment outcomes of TB retreatment case were below standard set by the WHO. Factors that were significantly associated with poor treatment outcome were positive AFB resulting at 5th month and patients on category 1(2ERHZ/4RH).


BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ginenus Fekadu ◽  
Legese Chelkeba ◽  
Ayantu Kebede

The Editor and Publisher have retracted this article [1]. This article was published as the result of a technical error which resulted in two versions [1, 2] of the same article being published. [2] is the final version of the article. Springer Nature apologises to the authors and to readers for the inconvenience caused. All authors agree with this retraction.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Kidu Gidey ◽  
Desalegn Belay ◽  
Berhane Yohannes Hailu ◽  
Tesfaye Dessale Kassa ◽  
Yirga Legesse Niriayo

Background. Visceral leishmaniasis (VL), one of the most neglected tropical diseases, is placing a huge burden on Ethiopia. Despite the introduction of antileishmanial drugs, treatment outcomes across regions are variable due to drug resistance and other factors. Thus, understanding of VL treatment outcomes and its contributing factors helps decisions on treatment. However, the magnitude and the risk factors of poor treatment outcome are not well studied in our setting. Therefore, our study was designed to assess treatment outcomes and associated factors in patients with VL. Materials and Methods. A cross-sectional study was conducted in VL patients admitted between June 2016 and April 2018 to Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia. Data was collected through chart review of patient records. Logistic regression analysis was used to identify factors associated with poor treatment outcome. Results. A total of 148 VL patients were included in the study. The mean age (SD) of the patients was 32.86 (11.9) years; most of them (94.6%) were male patients. The proportion of poor treatment outcome was 12.1%. Multivariable logistic regression analysis showed that long duration of illness (> four weeks) (adjusted odds ratio (AOR): 6.1 [95% confidence interval (CI); 1.3-28.6], p=0.02) and concomitant tuberculosis (TB) infection (AOR 4.6 [95% CI; 1.1-19.1], p=0.04) were the independent predictors of poor treatment outcome. Conclusions. Poor treatment outcome was observed in a considerable proportion of VL patients. Long duration of illness and coinfection with TB were associated with poor VL treatment outcome. Hence, early diagnosis and effective prompt treatment are important to improve treatment outcomes among VL patients. Special attention should also be given in the treatment of VL/TB coinfected patients in our setting.


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