Dietary Adherence and Associated Factors among Hypertensive Patients in Bahir Dar City Administration, Ethiopia, 2020

Introduction: Hypertension is considered one of the most challenging public health problems worldwide. Adherence to the recommended diet has a key role to reduce uncontrolled hypertension and hypertension-related complications. A study on dietary adherence among hypertensive patients and associated factors are limited in Ethiopia. So,this study aimed to assess dietary adherence and associated factors among hypertensive patients in Bahir Dar city governmental hospitals, Bahir Dar, Ethiopia. Method: A cross-sectional study was conducted at Bahir Dar city governmental hospitals from February- March 2020. Proportional allocation and systematic random sampling techniques were used to select 386 individuals with hypertension. The logistic regression model was used to assess the association between predictors and dietary adherence. The association was interpreted using the odds ratio and 95% confidence interval. Result: In this the proportion of dietary adherence was 32.8% (CI: 28.0, 37.6). Educational level college and above (AOR=3.0, CI=1.26, 7.08), received nutritional education (AOR=1.9, CI=1.05, 3.62), knowledgeable about hypertension (AOR=2.5, CI=1.36, 4.58), who had no co-morbidities (AOR=2.8, CI=1.49, 5.20), who lived two to four years with hypertension (AOR=2.4, CI=1.17, 5.07), and who had strong social support (AOR=7.1, CI=2.85, 17.46) had significantly association with dietary adherence. Conclusion and recommendations: This study demonstrated that low proportion of hypertensive individuals were adhered to recommended diet. Therefore, availed a social network of family and friends; providing dietary education to address the participants’ knowledge of hypertension, promote survival skill to new diagnosed and considered co-morbidities are an integral part of overall health in people with hypertension.

Risk Factors of White Blood Cell Progression Among Patients With Chronic Lymphocytic Leukemia at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

Background: Leukemia is a type of cancers that start in the bone marrow and produce a serious number of abnormal white blood cells. Bleeding and bruising problems, fatigue, fever, and an increased risk of infection are among symptoms of the disease. The main objective of this study is to identify the determinant of the progression rate of white blood cells among patients with chronic lymphocytic leukemia at Felege Hiwot Referral Hospital (FHRH), Bahir Dar, Ethiopia. Methods: A retrospective study design was conducted on 312 patients with chronic lymphocytic leukemia at FHRH, Bahir Dar, Ethiopia under treatment from 1 January 2017 to 31 December 2019. A linear mixed-effects model was considered for the progression of the white blood cell data. Results: The estimated coefficient of the fixed effect intercept was 84.68, indicating that the average white blood cell (WBC) count of the patients was 84.68 at baseline time by excluding all covariates in the model ( P-value <.001). Male sex ( β = 2.92, 95% confidence interval [CI] 0.58, 0.5.25), age ( β = .17, 95% CI 0.08, 0.28), widowed/divorced marital status ( β = 3.30, 95% CI 0.03, 6.57), medium chronic lymphocytic leukemia (CLL) stage ( β = −4.34, 95% CI −6.57, −2.68), high CLL stage ( β = −2.76, 95% CI −4.86, −0.67), hemoglobin ( β = .15, 95% CI 0.07, 0.22), platelet ( β = .09, 95% CI 0.02, 0.17), lymphocytes ( β = .16, 95% CI 0.03, 0.29), red blood cell (RBC) ( β = .17, 95% CI 0.09, 0.25), and follow-up time ( β = .27, 95% CI 0.19, 0.36) were significantly associated with the average WBC count of chronic lymphocytic leukemia patients. Conclusions: The finding showed that age, sex, lymphocytic, stage of chronic lymphocytic leukemia, marital status, platelet, hemoglobin, RBC, and follow-up time were significantly associated with the average WBC count of chronic lymphocytic leukemia patients. Therefore, health care providers should give due attention and prioritize those identified factors and give frequent counseling about improving the health of chronic lymphocytic leukemia patients.

PROMOTING SLOW TOURISM TO WRESTLE THE CHALLENGES OF SHORTER LENGTH OF TOURIST STAY: IMPLICATIONS FOR SUSTAINABLE TOURISM

Slow tourism is an eminent concept that aims to embolden extended tourist stay within a destination. The current study adopts qualitative research approach and extracts data from purposefully selected tourism professionals. The researcher employed both interview and focus group discussion to collect data required for this study. Findings of the current study unfold that slow tourism as a unique approach augments the overall tourism activities, mainly within emerging destinations. Even though slow tourism has received limited attention in Bahir Dar and its surroundings, it is quite substantive to discourage the negative economic, sociocultural and environmental impacts of tourism. However, absence of developed tourism infrastructures and limited understanding of stakeholders restrain the practice and development of slow tourism in the study area. In terms of policy references, the present study suggests that there is a need to develop a practical guideline to inculcate the fundamental concepts related to the practical applications of slow tourism in emerging destinations.

Sleep Quality and Associated Factors Among Type 2 Dm Patients and Non-Dm Individuals in Bahir Dar Governmental Hospitals: Comparative Cross-Sectional Study

Background: Multiple factors may contribute to sleep disruption in type 2 diabetic individuals. Sleep disruption in type 2 diabetic individuals is frequently associated with long-term damage, dysfunction, and failure of different organs. Nevertheless, literature in this regard is scanty in Ethiopia. Therefore, this study aimed to assess and compare the prevalence of poor sleep quality and associated factors among type 2 diabetic and non-diabetic individuals in Bahir Dar governmental hospitals.Methods: Comparative cross-sectional study was employed among 292 individuals with type 2 diabetes and 291 non-diabetic individuals in Bahir Dar governmental hospitals from March 01- to April-01. A two-stage cluster sampling method was employed to select participants. Pittsburgh sleep quality index was used for assessing sleep quality. For analysis, descriptive and summary statistics were used to determine the prevalence and percentage of variables. Chi-square test was also used for comparison. Binary logistic regression analysis was employed to determine the associated factors of poor sleep quality. Result: The prevalence of poor sleep was 50.7% (95% CI; 44.9-56.2) and 31.8% (95% CI 26.5-37.5) among individuals with type 2 diabetes and non-diabetic individuals respectively. Among the overall participants being type 2 diabetic patient was also found significantly associated with poor sleep quality as compared to non-diabetic individuals (AOR=1.89; 95% CI; 1.19-2.87). Comorbidity, duration of DM >10 years, Poor glycaemic control, having depression, low physical activity, and poor social support were factors significantly associated with poor sleep quality among individuals with type 2 diabetes. Among non-diabetic individual’s low physical activity, poor social support, having depression, and age group (>50 years) were factors significantly associated with poor sleep quality. Conclusion: In this study, the prevalence of poor sleep among individuals with type 2 diabetes was higher than non-diabetes individuals.

High prevalence of Antibiotic Resistance Bacteria isolated from Municipal Solid Waste Dumpsite, Bahir Dar, Ethiopia

Background The emergence of antibiotic resistance (ABR) among environmental microbes has been challenging global health. ABR can be transferred to human-associated bacteria aggravating the spread of antimicrobial resistance. Due to poor solid waste disposal practices, municipal solid waste dumpsite (MSWDS) can be a reservoir for antimicrobial resistant microorganisms, such as bacteria. This study aimed to assess the prevalence of antibiotic resistance (ABR) bacteria at Bahir Dar city MSWDS. Methods Soil samples were collected from three randomly selected sites within the dumpsite from November 2020 to May 2021. Bacteria were isolated, identified and tested for ABR using standard procedures. Results In this study, 71 distinct colonies were isolated and identified to ten bacterial genera based on cultural characteristics and biochemical tests. The pooled antibiotic résistance rate was 85.9%. Resistance to the tested antibiotics ranged between 0% for erythromycin and 100% for amoxicillin among the bacterial isolates. High proportions of the isolates were found to be resistant to amoxicillin (100%), vancomycin (87%) and nalidixic acid (73.3%). Substantial proportions of the isolates were also resistant to Streptomycin (54.5%), sulfonamide (50%) and tetracycline (48.5%). On the other hand, high sensitivity rates to erythromycin (90.91%), ciprofloxacin (83.10%), chloramphenicol (77.46%) and gentamicin (63.49%) were recorded. All isolates related to Staphylococcus spp., and most isolates related to Pseudomonas, Escherichia, Klebsiella, Salmonella, Enterococcus, Citrobacter, Shigella and Proteus species were resistant at least to one antibiotic drug. The overall multidrug resistance (MDR) rate was 49.3%, and a high rate of MDR was demonstrated among isolates related to Escherichia spp. (75%), Staphylococcus spp. (68.8%), Pseudomonas spp. (62.5%) and Klebsiella spp. (60%), where each isolate resisted at least 5 antibiotic drugs. Conclusion From the present study, it can be concluded that a high incidence of ABR exists in Bahir Dar city MSWDS. The occurrence of the high level of ABR to commonly used antibiotics in this study demands a proper waste management system, as well as surveillance programs to monitor for antimicrobial resistance determinants in municipal solid wastes. Moreover, detailed studies on the isolates and ABR genes will give a better insight into the prevalence of ABR in the waste dumpsite.

Investigation of Potential Environmental Impacts and Sustainable Management of Municipal Solid Waste using the Driving force-Pressure-State-Impact-Response-Outcome (DPSIRO) framework: Case of Bahir Dar, Ethiopia

The generation of MSW in urban areas in Ethiopia and elsewhere continues to increase and poses a challenge to city governments and citizens if the wastes are not properly managed. Applying an integrated system for managing MSW and recovering the material for use in new products can reduce the negative impacts on the environment. The purpose of this study is to apply the DPSIRO framework to develop a system that reduces the negative impacts of MSW in Bahir Dar city in a sustainable way. The research started by identifying the main driving forces that lead to the generation of MSW. Then, states because of pressures and the consequent impacts were investigated. Finally, the appropriate responses and outcomes obtained from the responses were dealt with. Methods used to quantify GHG emissions, leachate, and eutrophication potential were applied. According to the findings, the waste disposal site emits an estimated 46Gg of greenhouse gases per year in 2020.The eutrophication capacity of organic waste generated in the city was 0.0594 Kg N-equivalent or 59.4g N-equivalent. The waste also contains an average of 1,112mm of leachate per day on an annual basis. The state of the environment has an impact on human health and the ecosystem. Applying the circular economic system, knowledge transfer, and waste management fees are the main responses suggested to decision and policy makers. The responses correspond with balanced economic, social and environmental situations. Outcomes were quantified in terms of organic fertilizer, income and renewable energy (briquette) when the actions were taken.