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Time to first optimal glycaemic control and associated factors among adult patients with diabetes at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia: a retrospective cohort study

Por: Getahun · A. D. · Ayele · E. M. · Tsega · T. D. · Anberbr · S. S. · Geremew · G. W. · Biyazin · A. A. · Taye · B. M. · Mekonnen · G. A.
Objective

To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.

Design

A retrospective cohort study.

Setting

University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.

Participants

We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.

Outcome measures

The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.

Results

Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.

Conclusion

The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.

Syndemics of depression, sick role and activation status among newly diagnosed adults with diabetes mellitus in Bahir Dar, Ethiopia: a 6-month follow-up study protocol

Por: Awoke · W. · Alene · G. D. · Admasie · A. · Getahun · F. A.
Introduction

Diabetes mellitus (DM) and depression commonly coexist. Each condition increases the risk of developing the other and adversely affects treatment outcomes. Such complex interactions of diseases, referred to as syndemics, have not been well studied. This study aims to assess the syndemics of depression, sick role and activation status among newly diagnosed adults living with DM.

Methods and analysis

A prospective 6-month follow-up study will be conducted with 485 participants. Depression will be assessed with the 9-item Patient Health Questionnaire, applying a cut-off score of 10. The primary outcome will be glycaemic control, and the secondary outcomes will be health-related quality of life (HRQoL) and functional disability status. Depression, the primary outcome and the secondary outcomes, will be measured at baseline, 3 months and 6 months. The sick role, activation status and health system perspectives will be explored using qualitative methods following the second measurement. Data will be collected from adults living with DM, healthcare providers and healthcare managers. Qualitative sampling will continue until data saturation is reached.

Quantitative analysis will be done using STATA V.17. The prevalence of depression will be determined at baseline. Associated factors will be analysed using Poisson regression with a robust variance estimator. Incidence rate of depression, glycaemic control, HRQoL and disability status will be measured at 3 and 6 months. A multilevel mixed-effects generalised linear model will be fitted, with the three measurement time points nested within individuals, and individuals nested within health institutions. Qualitative data will be analysed thematically using NVivo V.12 software.

Ethics and dissemination

Ethics approval has been granted by the institutional review board of Bahir Dar University (protocol number 3098/25). Findings will be disseminated through peer-reviewed publications, conference presentations and local channels for community audiences.

Trial registration number

Protocol number 3098/25.

Acute gastroenteritis and associated factors among under-five children visiting public hospitals in Jigjiga City, Somali Region, Ethiopia: a hospital-based cross-sectional study

Por: Getahun · M. A. · Ayehubizu · L. M. · Ahmed · A. M. · Ali · S. Y. · Abdilahi · A. M. · Shegere · M. M.
Objective

The study aims to assess the magnitude of acute gastroenteritis and associated factors among under-five children visiting public hospitals in Jigjiga City, Somali Region, Ethiopia.

Design

A hospital-based cross-sectional study design was used to carry out the study. We then employed a systematic random sampling technique through face-to-face interviews to gather the data. A structured questionnaire consisting of socio-demographic, behavioural, environmental and clinical factors was developed after reviewing relevant literature.

Setting

The study was conducted in public hospitals located in Jigjiga City, Somali Region, Ethiopia.

Participants

A total of 353 under-five children visiting public hospitals were involved in the study.

Outcome measures

The primary outcome of the study was the prevalence of acute gastroenteritis.

Result

The 2-week prevalence of acute gastroenteritis among under-five children was 24.6% (95% CI 23.4% to 25.9%). The study found strong links between acute gastroenteritis and having a household greater than five (adjusted OR (AOR)=2.94, 95% CI 1.55 to 5.60), an unprotected source of drinking water (AOR=2.74, 95% CI 1.29 to 5.82), unimproved latrine facilities (AOR=3.15, 95% CI 1.26 to 7.78), the presence of faeces around the latrine (AOR=3.53, 95% CI 1.77 to 7.03) and mothers or caregivers’ history of diarrhoea over the past 2 weeks (AOR=6.23, 95% CI 3.22 to 12.06).

Conclusion

The overall prevalence of acute gastroenteritis in Jigjiga City was relatively high in the 2-week period. Having a household greater than five, an unprotected source of drinking water and unimproved latrine facilities was a significant predictor of acute gastroenteritis. Additionally, the presence of faeces around the latrines and the history of diarrhoea in mothers or caregivers over the past 2 weeks were strongly linked to acute gastroenteritis.

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