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Mental health impact of the COVID-19 pandemic on frontline healthcare workers in Ethiopia: a scoping review of associated mental health risk and protective factors

Por: Draebel · T. A. · Birhanu · Z. · Lien · L. · Soerensen · J. B. · Andersen · L. S. · Terefe Tucho · G. · Mekonnen · H.
Objectives

The mental health impacts of COVID-19 on frontline healthcare workers have been reported globally; however, there is limited evidence from low-income countries such as Ethiopia. We reviewed the literature to understand how COVID-19 impacted the mental health of frontline healthcare workers, including the associated risk and protective factors.

Design

A scoping review of peer-reviewed research was conducted between 2020–2025 to explore the mental health and well-being of frontline healthcare workers in Ethiopia during COVID-19. The process adhered to the guidelines for data extraction outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Our search identified 35 studies, of which 29 studies were included in the final synthesis.

Data sources

Three online databases, PubMed, Web of Science and PsycInfo, were systematically searched for data.

Eligibility criteria

Studies were considered for inclusion in the review if they focused on mental health conditions and psychosocial well-being among healthcare workers during COVID-19 in Ethiopia. Studies were only included if published in English and excluded if they were conference abstracts, case studies, reviews, commentaries, contained incomplete data or lacked variables of interest.

Data extraction and synthesis

Data extraction was conducted manually by two reviewers by using a data extraction sheet created in Excel.

Results

Most frontline healthcare workers experienced symptoms of insomnia, psychological distress, stress, anxiety, post-traumatic stress disorder and depression during COVID-19. Female frontline healthcare workers, nurses, midwives and laboratory technicians reported higher rates of adverse mental health outcomes. Our results found that being married, living together with a spouse and having a high educational level were risk factors for adverse mental health outcomes.

Conclusion

The mental health and well-being of frontline healthcare workers is at risk during a global health crisis; however, there is a limited understanding of how to protect the mental health of frontline healthcare workers in low-income countries, such as Ethiopia, at such a critical time. Additional research is needed to better inform mental health preparedness interventions for frontline healthcare workers in these contexts, particularly given predictions of another pandemic occurring within the next decade.

Detecting undiagnosed hypertension using repeated blood pressure measurements: a cross-sectional study in rural Sidama Region, Ethiopia

Por: Birhanu · B. E. · Likka · M. H. · Areru · H. A. · Hibstu · D. T. · Lindtjorn · B.
Objective

To determine the prevalence of undiagnosed hypertension and its risk factors among adults in rural Sidama Region, Ethiopia, using a two-step diagnostic method.

Design

A community-based cross-sectional study was conducted from 1 April to 31 July 2024. Data were collected among adults aged 45 years and above using the World Health Organization STEPwise Approach to Surveillance questionnaire. The Demographic and Health Survey questionnaire was also used to collect data on household characteristics.

Setting

Selected rural kebeles of Shebedino district, Sidama, Ethiopia.

Participants

2875 adults aged ≥45 years identified via census.

Outcome measures

Undiagnosed hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, in individuals with no history of the condition.

Results

The prevalence of undiagnosed hypertension ranged from 7.7% (95% CI: 6.7% to 8.7%) to 14.3% (95% CI: 13.0% to 15.6%). The previously diagnosed hypertensive cases were found in 3.3% (95% CI: 2.7% to 4.1%). Female sex (AOR 2.02; 95% CI: 1.44 to 2.82), age ≥ 65 years (AOR 1.48; 95%CI: 1.01 to 2.15), and history of alcohol drinking and khat chewing (AOR 2.94; 95%CI: 1.52 to 5.66) were significantly associated with undiagnosed hypertension. Lack of awareness of salt-related health risks (AOR 3.14; 95% CI: 2.30 to 4.30) and no prior blood pressure measurement (AOR 5.60; 95% CI: 1.73 to 18.07) were also associated with undiagnosed hypertension.

Conclusions

Undiagnosed hypertension is common among adults aged ≥45 years in the rural Sidama Region. Female sex, older age, substance use, limited awareness of salt-related health risks, and lack of prior blood pressure measurement were the identified risk factors. Regular screening should be implemented to detect cases at an early stage.

Evaluation of <i>Pseudomonas fluorescens</i> for biocontrol of early blight (<i>Alternaria solani</i>) in tomato in North Wollo, Ethiopia

by Birhan Berihun Abebe, Abebe Girma Demissie, Habtie Bassie Felatie, Aderajew Adgo Tesema, Baye Wodajo, Wondye Ayaliew Shiferaw, Sualih Gobeze Hailu

Tomato (Solanum lycopersicum) is a widely used vegetable in Ethiopia, but its production is severely affected by late blight, early blight and bacterial wilt. This study aims to isolate Pseudomonas fluorescens as a bio-control agent against Alternaria solani. Biological control using Pseudomonas fluorescens offers a potential alternative to chemical fungicides. Rhizosphere soil and healthy tomato roots were sampled from three Kebeles in North Wollo, Ethiopia. P. fluorescens was isolated on Pseudomonas Isolation Agar, while A. solani isolated from infected leaves on Potato Dextrose Agar and confirmed pathogenic on tomato seedlings. Three isolates of P. fluorescens (Pfs12, Pfk13, Pfsa31) were screened in vitro using the dual culture method, and their efficacy was further tested in vivo under greenhouse conditions. Isolates Pfs12 and Pfk13 showed moderate effectiveness against the radial growth of A. solani, achieving percent growth inhibitions of 56.04% and 55.04%, respectively. The standard chemical treatment (mancozeb) resulted in a 54.84% growth inhibition. The control group (Pseudomonas fluorescens) also demonstrated a moderate growth inhibition of 57.65% against A. solani. Data were gathered regarding disease parameters. The day after transplanting, the percent disease index was significantly lower in all treated groups compared to the control (water). The isolate Pfsa31 achieved the lowest disease index of 24.733%, which was comparable to the standard chemical treatment at 28.467%. Both treatments were significantly different from the control (water) at 60.333%. The findings showed the bio-control potential of selected P. fluorescens isolates as effective and environmentally sustainable alternatives to synthetic fungicides for the management of early blight disease in tomato cultivation, emphasizing the importance of utilizing indigenous strains for optimal performance.

Prevalence of diabetes mellitus among adults aged 45 years and above in rural Sidama, Ethiopia: a two-step community-based cross-sectional study

Por: Hibstu · D. T. · Likka · M. H. · Areru · H. A. · Birhanu · B. E. · Lindtjorn · B.
Objective

To determine the prevalence of undiagnosed diabetes and identify associated factors using a two-step diagnostic method combining fasting blood sugar with confirmatory glycated haemoglobin A1c (HbA1c) testing among adults 45 years and above in rural Sidama, Ethiopia.

Design

A community-based cross-sectional design was conducted from 1 April to 31 July 2024. Data were collected through a census of adults aged 45 years and above using a pretested WHO-STEPwise questionnaire. Physical and biochemical tests were performed following standard protocols. Data were analysed using Stata V.17.

Setting

Selected rural kebeles of Shebedino district, Sidama, Ethiopia.

Participants

2875 adults aged 45 years and above.

Primary outcome measures

Undiagnosed diabetes confirmed by HbA1c levels (≥48 mmol/mol or ≥6.5%).

Results

The prevalence of undiagnosed diabetes confirmed by HbA1c was 1.2% (35 of 2871; 95% CI: 0.9% to 1.7%). Previously diagnosed diabetes was found in 0.5% (14 of 2875; 95% CI: 0.3% to 0.8%). The total diabetes prevalence, confirmed by HbA1c or prior diagnosis, was 1.7% (49 of 2871; 95% CI: 1.3% to 2.3%). A total of 1327 out of 2875 (46%) participants were undernourished. Advanced age (β=0.21; 95% CI: 0.08 to 0.32, p=0.001), and estimated annual income (β=0.15; 95% CI: 0.02 to 0.28; p=0.029) were significantly associated with elevated fasting blood sugar levels.

Conclusion

The prevalence of undiagnosed diabetes among rural adult population was low. Older age and higher income were significantly associated with elevated fasting blood sugar. Routine community-based diabetes screening among older population, health education and nutrition-focused interventions are recommended to sustain the low burden and address undernutrition.

Burden and predictors of age-related macular degeneration among old age patients with diabetes attending comprehensive specialised hospitals in Northwest Ethiopia: a multicentre cross-sectional prospective study

Por: Shumye · A. F. · Desalegn · G. K. · Tegegn · M. T. · Worku · E. M. · Lorato · M. M. · Bogale · Z. M. · Tegegne · M. M. · Alimaw · Y. A. · Mengistu · H. G. · Bekele · M. M. · Bayabil · A. Z. · Birhan · G. S. · Eticha · B. L.
Objective

This study aims to assess the burden and predictors of age-related macular degeneration (AMD) among older age patients with diabetes attending comprehensive specialised hospitals in Northwest Ethiopia.

Design

A multicentre cross-sectional study was conducted among older patients with diabetes using a systematic random sampling technique.

Setting

The study was conducted at five comprehensive specialised hospitals in Northwest Ethiopia from 8 May to 8 June 2023.

Participants

The study included 832 diabetic individuals aged 40 years and above.

Main outcome measures

Data were collected using a pretested structured questionnaire and physical examinations.

Result

In this study, a total of 832 participants were involved, with a response rate of 96.85%. The burden of AMD was 15.4% (95% CI 13.0% to 18.0%). Male sex (adjusted OR (AOR) 2.04, 95% CI 1.17 to 3.56), older age (AOR 6.91, 95% CI 3.17 to 15.08), diabetes duration of 10 and more years (AOR 3.00, 95% CI 1.91 to 4.69), higher body mass index (AOR 2.56, 95% CI 1.15 to 5.71), presence of hypertension (AOR 2.45, 95% CI 1.56 to 3.85) and family history of diabetes mellitus (DM) (AOR 2.29, 95% CI 1.40 to 3.76) were positively associated with AMD.

Conclusions

This study found that the prevalence of AMD among patients with diabetes was 15.4%. Older age, male sex, longer DM duration, higher body mass index, presence of hypertension and family history of DM were significantly associated with AMD. Targeted screening of at-risk individuals for AMD, public health awareness campaigns focusing on these factors and further research to understand the burden and underlying mechanisms of these associations with AMD are recommended.

Eye check-up practice and its associated factors among adult diabetic patients attending primary hospitals of Central Gondar Zone, Northwest Ethiopia, 2024: a cross-sectional multicentre study

Por: Desalegn · G. K. · Birhan · G. S. · Bogale · Z. M. · Assefa · A. L.
Objectives

This study aimed to assess eye check-up practice and associated factors among patients with diabetes attending primary hospitals in the Central Gondar Zone, Northwest Ethiopia.

Design

A multicentre hospital-based cross-sectional study.

Setting

This study was conducted at primary hospitals in Central Gondar Zone, Northwest Ethiopia, from 10 June 2024 to 10 July 2024.

Participants

The study included 689 consecutive adult patients with diabetes who met the inclusion criteria.

Primary and secondary outcome measures

Participants were diagnosed with diabetes mellitus by a general practitioner. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire. Binary logistic regression was performed to identify associated factors, with significance considered at a p

Results

A total of 689 participants were involved in this study, with a response rate of 98.4%. The proportion of good eye check-up practice was 20.6% (95% CI: 17.6% to 23.8%). Factors associated with good eye check-up practice included urban residence (adjusted OR, AOR=4.10, 95% CI: 1.72 to 9.82), diabetes duration of 12+ years (AOR=4.98, 95% CI: 1.43 to 17.38), previous eye disease (AOR=3.78, 95% CI: 1.79 to 7.95), good knowledge of diabetic retinopathy (AOR=3.22, 95% CI: 1.42 to 7.29), higher family income (AOR=3.80, 95% CI: 1.27 to 11.36), referral from a diabetic clinic (AOR=3.48, 95% CI: 1.58 to 7.67) and a favourable attitude (AOR=3.75, 95% CI: 1.46 to 9.65).

Conclusions

This study revealed a low proportion of good eye check-up practices among patients with diabetes. Urban residency, longer duration of diabetes, higher income, clinic referrals, history of eye disease, knowledge of diabetic retinopathy and a favourable attitude were significantly associated with good eye check-up practices. Therefore, targeted health education and strengthened referral systems are recommended to improve regular eye check-up practices among individuals with diabetes.

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