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This study aimed to investigate the current knowledge and experiences of consumers in Australia on adverse drug reaction (ADR) reporting and their reasons for reporting or not reporting ADRs, with a focus on the use of digital tools for ADR reporting. METHODS: A cross-sectional online survey was conducted among adults who had taken medicine in Australia. A structured questionnaire with multiple choice or Likert scale responses with an option for participants to provide free-text responses and pretested for face validity was used. Consumer characteristics, knowledge, and ADR reporting practices were analyzed using descriptive statistics and the chi-square test or Fisher's exact test. RESULTS: A total of 544 survey responses were included in the analysis. The majority of respondents were women (68%), and 22% were aged between 65 and 74 years. Fifty-eight percent (n = 317) of respondents knew that they could report ADRs to either the Therapeutic Goods Administration (TGA), state or territory government health department, or healthcare professionals. Three-quarters (n = 405) of respondents stated that they had experienced an ADR; of these, 36% reported an ADR to either the TGA, state or territory government health department, or healthcare professionals. Among those who reported ADRs, 58% were unaware that they could use digital tools to report ADRs. The main reason for not reporting was that they did not think the ADR was serious enough to report (39%). CONCLUSION: Over half of consumers knew that they could report ADR; however, improved consumer awareness about using digital tools for ADR reporting and increased ADR reporting is needed.

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BACKGROUND: Hypertension is a prevalent comorbid condition in diabetes, affecting ∼20-60% of patients with diabetes, depending on obesity, ethnicity, and age. Adults with diabetes historically have two or three times higher rate of cardiovascular disease (CVD) than adults without diabetes. OBJECTIVE: The aim of this study was to assess blood pressure (BP) control and its predictors among hypertensive diabetic patients on follow-up at the chronic clinic of Nekemte Referral Hospital (NRH) in West Ethiopia. METHODS: A cross-sectional study was conducted among hypertensive adult patients comorbid with diabetes taking antihypertensive drugs for at least one year in NRH. Both bivariable and multivariable analyses were done. The odds ratio, along with 95% confidence level, was estimated to identify factors associated with uncontrolled BP by using multivariable logistic regression analysis. The level of statistical significance was declared at p value <0.05 levels. The patient's written informed consent was obtained after explaining the purpose and procedures of the study. RESULTS: A total of 186 study participants were included in this study. The mean age of the participants was 51.2 ± 12.2 years. Blood pressure and blood glucose were controlled in 104 (55.9%) and 106 (57.0%) study participants, respectively. In the multivariable analysis, age ≥60 years (AOR = 4.537, 95% CI = 1.142-18.024, p=0.032), duration with hypertension ≥5 years (AOR = 3.534, 95% CI = 1.062-11.760, p=0.040), cigarette smoking (AOR = 7.697, 95% CI = 2.356-25.146, p=0.001), nonadherence (AOR = 6.584, 95% CI = 2.337-18.553, p < 0.001), and uncontrolled glycaemia (AOR = 21.630, 95% CI = 8.057-58.070, p < 0.001) were independent predictors of uncontrolled blood pressure. CONCLUSION: Compared to the previous studies, BP was better controlled among hypertensive diabetic patients in the present study. Older age, longer duration with hypertension, cigarette smoking, nonadherence, and uncontrolled glycaemia were predictors of uncontrolled BP. Thus, interventions on modifiable factors should be done to improve BP control of patients' comorbid with diabetes.

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BACKGROUND: Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. This study aims to assess the level of glycemic control and factors contributing to uncontrolled glycemia among diabetic patients at the Nekemte Referral Hospital, West Ethiopia. METHODS: A cross sectional study was conducted on diabetic patients attending the diabetes clinic of Nekemte Referral Hospital. A total of 252 study participants were included in the study. Data were collected by interviewing patients during hospital visits and reviewing respective databases. The association between dependent and independent variables was assessed using bivariable and stepwise multivariable logistic regression. A variable with a p-value < 0.05 was considered as an independent predictor. A patient's written informed consent was obtained after explaining the purpose and procedures of the study. RESULTS: Mean age of the participants was 41.7 ± 17.6 years. The majority of the participants (67.1%) had poor knowledge about diabetes. The glycemic rate control was 40.5%; while more than half of the participants (59.5%) had poor glycemic control. On multivariable logistic analysis poor glycemic control was more likely to occur among unemployed (p < 0.001), patients with no family/social support (p = 0.024), duration of diabetes >10 years (p = 0.005), poor knowledge about diabetes (p = 0.012), taking insulin (p = 0.004) and taking metformin plus glibenclamide (p < 0.001). CONCLUSION: A finding of this study revealed that a glycemic control of study participants was poor. Thus greater effort is needed to improve glycemic control. Health care professionals should work on improving the adherence to anti-diabetic medications of diabetic patients and knowledge of diabetic patients on diabetes by providing education to the patients during follow up to improve glycemic control.

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OBJECTIVE: To assess the self-care practices and associated factors among diabetic patients in West Ethiopia. RESULTS: A total of 252 study participants were included in the study, of this 54.8% were male. Of the participants more than half 150 (59.5%) had poor glycemic control and 153 (60.7%) of the participants had good self-care. Majority of the study participants 209 (82.9%) had adequate foot care and more than half 175 (69.4%) and 160 (63.5%) had adequate dietary plan and exercise management respectively. However of the total diabetic patients only 38 (15.1%) had adequate blood glucose testing practices. On multivariable logistic analysis poor self-care practices were more likely to occur among male patients (AOR = 5.551, 95% CI = 2.055-14.997, p = 0.001), patients living in rural area (AOR = 5.517, 95% CI = 2.184-13.938, p < 0.001), patients with duration of diabetes < 6 years (AOR = 41.023, 95% CI = 7.373-228.257, p < 0.001), patients with no access for self-monitoring blood glucose (AOR = 9.448, 95% CI = 2.198-40.617, p = 0.003), patients with poor knowledge about diabetes (AOR = 67.917, 95% CI = 8.212-561.686, p < 0.001) and patients with comorbidities (AOR = 18.621, 95% CI = 4.415-78.540, p < 0.001).

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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).

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BACKGROUND: Malnutrition is a silent killer that is underreported, underaddressed, and as a result underprioritized. It is reported that severe acute malnutrition is the commonest reason for pediatrics hospital admission in many poor countries; 25 to 30% of children with severe malnutrition die during hospital admissions. OBJECTIVE: To determine treatment outcome of severe acute malnutrition and identify its determinants among pediatric patients in pediatrics ward of Nekemte Referral Hospital. METHODS: A retrospective hospital-based cross-sectional study was done from November 2015 to April 2017. Data had been collected by using checklist for recording information from patient card and register book. Association between independent variables and depend variable was assessed using bivariate and stepwise multivariable logistic regression, respectively. Level of statistical significance was declared at p value < 0.05. RESULTS: Out of 205 admitted children with severe acute malnutrition, 137 (66.8%) cases were cured from SAM, 9 (4.4%) cases were died because of SAM, and (16.6%) cases were defaulter from SAM management, and 25 (12.2%) cases were transferred out. Multivariable logistic regression showed that children admitted with both edema and wasting AOR = 8.30, 95% CI (1.72, 40.09) P=0.008, children without hypothermia AOR = 2.91, 95%CI (1.10, 7.69) P=0.031, children who stay 8-14 days AOR = 3.86, 95%CI (1.01, 14.75) P=0.048, children without pneumonia AOR = 7.82, 95%CI (2.74, 222.29) P=0.001, children without anemia AOR = 3.22, 95%CI (1.04, 9.97) P=0.042, and children without HIV AOR = 9.21, 95% CI (2.20, 38.54) P=0.002 were more likely to be cured from severe acute malnutrition. CONCLUSION: Treatment outcome of severe acute malnutrition in this study is good. It shows that around three-fourths of the children were cured. Factors such as admission criteria, hypothermia, length of stay, pneumonia, anemia, and presence of HIV were associated with treatment response.

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BACKGROUND: Tuberculosis (TB) now ranks alongside HIV (Human Immunodeficiency Virus) as a leading cause of death worldwide. Globally, 9.6 million people were estimated to have fallen ill with TB in 2014. The aim of this study is to assess the knowledge and healthcare seeking behaviour of tuberculosis patents in Gimbi General Hospital, West Ethiopia. METHODS: A cross sectional study was conducted among tuberculosis patients from March 8 to April 30, 2015. The data collection method was face-to-face interview through structured standard questionnaire. To identify the factors associated with knowledge about TB and healthcare seeking behavior, backward logistic regression analysis was used. RESULTS: Of the 138 TB patients, 85(61.6%) had good knowledge about TB while 53(38.4%) had poor knowledge about TB. On multivariable logistic analysis, poor knowledge about TB was more likely to occur among TB patients in intensive treatment phase (Adjusted odds ratio (AOR)=4.1, 95% CI= 1.7-9.6, p=0.001). CONCLUSION: TB patients had good knowledge on signs and symptoms of TB, transmission of TB and healthcare seeking behaviour of TB, but their knowledge on the cause of TB, treatment of TB and prevention of TB were not adequate. This study also revealed that the health careseeking behaviour of TB patients were good.

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BACKGROUND: Medication errors cause a large number of adverse drug events with negative patient health outcomes and are a major public-health burden contributing to 18.7-56 % of all adverse drug events among hospitalized patients. The aim of this study was to assess the incidence and determinants of medication errors and adverse drug events among hospitalized children. METHODS: A prospective observational study was conducted among hospitalized children in the pediatrics ward of Nekemte Referral Hospital from February 24 to March 28, 2014. Data were collected by using checklist guided observation and review of medication order sheets, medication administration records, and other medical charts of the patients. To identify the independent predictors of medication errors and adverse drug events, backward logistic regression analysis was used. Statistical significance was considered at p-value <0.05. RESULTS: Out of 233 patients who were included in the study, 175 (75.1 %) of patients were exposed to medication errors. From the 1,115 medication orders reviewed, 513 (46.0 %) medication errors, 75 (6.7 %) potential adverse drug events and 17 (1.5 %) actual adverse drug events were identified. Of the 17 adverse drug events, eight (47.0 %) were preventable while nine (53.0 %) were not. Most medication errors were dosing errors (118; 23.0 %), followed by wrong drug (109; 21.2 %) and wrong time of administration (79; 15.4 %). On multivariable logistic regression analysis, length of hospital stay of ≥ 5 days (AOR = 4.2, 95 % CI = 1.7-10.4, p = 0.002), and number of medication of 4-6 (AOR = 4.9, 95 % CI = 2.3-10.3, p < 0.001) and number of medication of ≥7 (AOR = 10.4, 95 % CI = 3.0-35.9, p < 0.001) were independent predictors of medication errors; and length of hospital stay of ≥ 5 days (AOR = 3.5, 95 % CI = 1.2-10.1, p = 0.023) and number of disease conditions =2 (AOR = 4.6, 95 % CI = 1.4-15.1, p = 0.014) were independent predictors of adverse drug events. CONCLUSION: Medication errors and adverse drug events are common on the pediatrics ward of Nekemte Referral Hospital. In particular, children with multiple medications and longer hospital stays, and those with co-morbidities and longer hospital stays, were at greater risk for medication errors and adverse drug events, respectively.

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Background. Adverse drug reactions are global problems of major concern. Adverse drug reaction reporting helps the drug monitoring system to detect the unwanted effects of those drugs which are already in the market. Aims. To assess the knowledge, attitude, and practice of health care professionals working in Nekemte town towards adverse drug reaction reporting. Methods and Materials. A cross-sectional study design was conducted on a total of 133 health care professionals by interview to assess their knowledge, attitude, and practice using structured questionnaire. Results. Of the total respondents, only 64 (48.2%), 56 (42.1%), and 13 (9.8%) health care professionals have correctly answered the knowledge, attitude, and practice assessment questions, respectively. Lack of awareness and knowledge on what, when, and to whom to report adverse drug reactions and lack of commitments of health care professionals were identified as the major discouraging factors against adverse drug reaction reporting. Conclusion. This study has revealed that the knowledge, attitude, and practice of the health care professionals working in Nekemte town towards spontaneous adverse drug reaction reporting were low that we would like to recommend the concerned bodies to strive on the improvement of the knowledge, attitude, and practice status of health care professionals.

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