1,720,974 research outputs found
Comparative Impact of Integrated Palliative Care vs. Standard Care on the Quality of Life in Cancer Patients: A Global Systematic Review and Meta-Analysis of Randomized Controlled Trials.
No full textIntroductionCancer is a leading cause of global morbidity and mortality, significantly impairing patients' quality of life (QoL). Integrated Palliative Care (IPC) has been proposed as a holistic approach to enhance quality of life by addressing patients' physical, emotional, and psychosocial needs. While some studies suggest Integrated Palliative Care improves quality of life more than standard care, the evidence remains inconclusive. This systematic review and meta-analysis aim to evaluate the comparative impact of Integrated Palliative Care versus standard care on the quality of life in cancer patients. MethodsA comprehensive search of databases including PubMed, Cochrane Library, and Embase was conducted. We selected randomized controlled trials (RCTs) comparing Integrated Palliative Care and standard care for cancer patients, focusing on the quality of life as measured by validated tools such as the EORTC QLQ-C30 and FACT-G. Data were pooled using a random-effects model to account for study heterogeneity. Subgroup and sensitivity analyses were also performed. ResultsNine randomized controlled trials involving 1,794 patients met the inclusion criteria. Meta-analysis showed that Integrated Palliative Care significantly improved quality of life compared to standard care (SMD = 3.25; 95% CI: 1.20-5.30; p < 0.001). Studies conducted in Asia showed the highest standardized mean difference (SMD = 6.15; 95% CI: 3.07-9.23; p < 0.001), followed closely by studies from Africa (SMD = 6.0; 95% CI: 5.13-6.87; p < 0.001), compared to those from other regions. Similarly, research focusing on lung cancer patients showed the greatest standardized mean difference of (SMD = 6.15; 95% CI: 3.07-9.23; p < 0.001) relative to other cancer types. Furthermore, studies involving newly diagnosed cancer patients recorded the highest standardized mean difference of (SMD = 5.69; 95% CI: 4.57-6.80; p < 0.001). ConclusionIntegrated Palliative Care significantly enhances the quality of life in cancer patients compared to standard care. These findings support integrating Integrated Palliative Care into oncology practices to provide comprehensive, patient-centered care that addresses both physical and emotional needs. Further research should explore long-term benefits across diverse populations
Prevalence of polypharmacy among older adults in Ethiopia: a systematic review and meta-analysis
No full textAbstract Polypharmacy is a significant concern for older adults. Taking multiple medicines to prevent and treat comorbidities is very common in older adults, potentially leading to polypharmacy. Polypharmacy is associated with the development of geriatric syndromes, including cognitive impairment, delirium, falls, frailty, urinary incontinence, and weight loss. The prevalence of polypharmacy varies according to the literature. There is a paucity of data regarding the prevalence of polypharmacy among older adults. Therefore, this study aimed to estimate the pooled prevalence of polypharmacy among older adults in Ethiopia. A comprehensive search of databases, including PubMed, MEDLINE, EMBASE, Hinari, Cumulative Index to Nursing and Allied Health Literature, International Scientific Indexing, Cochrane library and Web of Science, and Google Scholar, was conducted. STATA statistical software (version 17) was used to analyze the data. Forest plot and I2 heterogeneity test were computed to examine the existence of heterogeneity. Subgroup analysis and sensitivity analysis were done to explore the source of heterogeneity. Publication bias was evaluated by using funnel plots and Egger’s test. A random effect model was used to determine the pooled prevalence of polypharmacy. After reviewing 123 studies, 13 studies with a total of 3547 older adults fulfilled the inclusion criteria and were included in this meta-analysis. The result from 13 studies revealed that the pooled prevalence of polypharmacy among older adults in Ethiopia was 37.10% (95CI: 28.28–45.91). A Subgroup Meta-analysis showed that the heterogeneity level was slightly lower among studies done in Oromia region (I2 = 46.62, P-value = 0.154). Higher pooled polypharmacy prevalence was found among older adults with cardiovascular disorders (42.7%) and admitted patients (51.4%). In general, it was found that the pooled prevalence of polypharmacy among older adults in Ethiopia was high. More than one in three older adults take five or more medications at a time. Thus, intervention focusing on rational geriatric pharmacotherapy is significant to prevent unnecessary pill burden, adverse drug events, medical costs, geriatric morbidity, and mortality. Furthermore, enhancing pharmacist roles towards medication therapy management and safety monitoring in older adults is also indicated
Time to first childbirth and its predictors among reproductive-age women in Ethiopia: survival analysis of recent evidence from the EDHS 2019
Get PDFBackgroundBeing a mother for the first time is the most significant event in a woman's life. “Age at first birth” refers to a mother's age in years when she gives birth to her first child. The age of first childbirth has physical, economic, and social implications. However, little is known about this issue in Ethiopia. Thus, this study sought to determine the time to first childbirth and its predictors at a national level.MethodsData were extracted from the 2019 Ethiopia Demographic and Health Survey using STATA version 17 software. A total of 8,885 weighted reproductive-age women (15–49 years) were included in this study. A Kaplan–Meier survivor curve was generated to estimate the time of first childbirth. A log-rank test was used to compare the difference in survival curves. Akaike information criteria and Bayesian information criteria were calculated to select the appropriate survival model for the data. The Weibull accelerated failure time model with no frailty distribution was used to identify significant predictors.ResultsThe overall median survival time to first childbirth was 18 years. The significant predictors of time to first childbirth were the educational level of the mother [primary education (ϕ = 1.036, 95% CI: 1.011, 1.063), secondary and above education (ϕ = 1.154, 95% CI: 1.118, 1.191)], knowledge of any contraceptive method [know at least one (ϕ = 1.051, 95% CI: 1.006, 1.101)], and media exposure (ϕ = 1.048, 95% CI: 1.011, 1.086).ConclusionThe median survival time to first childbirth was 18 years, which is lower than the optimal age for first childbirth (late 20 s and early 30 s). The timing of first childbirth in Ethiopia is mainly influenced by the educational level of women, knowledge of contraceptive methods, and exposure to media. Thus, exposing women to educational materials and other awareness-creation campaigns regarding the consequences of early first childbirth and strategies to improve women's knowledge of contraceptive methods is highly recommended
Virological outcomes of antiretroviral therapy and its determinants among HIV patients in Ethiopia: Implications for achieving the 95-95-95 target.
No full textBackgroundDespite significant advancements in HIV treatment, virological outcomes remain a critical issue. Ethiopia did not meet the 90:90:90 targets set for 2020, which aimed for 90% of people on antiretroviral therapy to achieve viral suppression. As the country shifts its focus toward the 95:95:95 targets for 2030-seeking to achieve 95% viral suppression among those on ART-it is crucial to deepen our understanding of viral suppression and the factors that influence it.MethodsVirological suppression was examined among 410 HIV-positive individuals on ART using the EPHIA survey. The survey employed a two-stage, stratified sampling design across urban areas in nine regions and two city administrations. Data analysis was conducted with STATA version 18, and multicollinearity was assessed using variance inflation factors. A logistic regression model identified significant determinants of viral suppression, with variables having a p-value of ≤0.05 considered statistically significant in the multivariable analysis.ResultsThe findings revealed that 364 participants (88.78%) achieved viral suppression. Key determinants of virological outcomes included a higher wealth level (AOR = 2.67, 95% CI: 1.15-6.22), the presence of active TB (AOR = 0.27, 95% CI: 0.14-0.57), hepatitis B virus (AOR = 0.20, 95% CI: 0.10-0.31), and the utilization of HIV support group care (AOR = 3.14, 95% CI: 1.35-6.30).ConclusionViral suppression among HIV patients is 88.78%, which even falls short of the WHO's 90% target for 2020, indicating the substantial work required to achieve 95% by 2030. To improve virological outcomes, it is crucial to increase support for low-income patients, enhance management of co-infections like TB and hepatitis B, and expand access to HIV support groups for better adherence and care
Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019
No full textObjectives To identify the predictors of late initiation of breastfeeding practice in Ethiopia.Design Cross-sectional study design.Setting Ethiopia.Participants A total of 1982 weighted samples of mothers with children aged under 24 months were included.Outcome measure Late initiation of breastfeeding practice.Results The prevalence of late breastfeeding initiation practice is 26.4% (95 CI 24.4 to 28.3). Being a young mother (15–24 years) (adjusted odds ratio (AOR) =1.66; 95 CI 1.06 to 2.62), no antenatal care (ANC) visit (AOR=1.45; 95 CI 1.04 to 2.02), caesarean section (AOR=4.79; 95 CI 3.19 to 7.21) and home delivery (AOR=1.53; 95 CI 1.14 to 2.06) were found to be the determinants of late initiation of breast feeding.Conclusion More than one-fourth of newborn children do not start breast feeding within the WHO-recommended time (first hour). Programmes should focus on promoting the health facility birth and increasing the ANC visits. Further emphasis should be placed on young mothers and those who deliver via caesarean section to improve the timely initiation of breast feeding
Spatial variation and determinants of delayed breastfeeding initiation in Ethiopia: spatial and multilevel analysis of recent evidence from EDHS 2019
No full textAbstract Background Despite the World Health Organization’s firm recommendation to start breastfeeding during the first hour after delivery, nearly 54% of children in low- and middle-income countries are unable to initiate breastfeeding within the recommended time frame. Understanding the initiation of breastfeeding is essential for optimal child health and maternal well-being. Methods This study was conducted using the recent Ethiopian Demographic and Health Survey (EDHS) data (2019) on a weighted sample of 1982 Ethiopian mothers of children aged under 24 months. The data extraction was conducted between August 1 and 30, 2023. Delayed’ initiation of breastfeeding is defined as failure to initiate breastfeeding within one hour after birth. STATA version 17 was used for non-spatial analysis. ArcGIS Pro and Sat Scan version 9.6 were used to map the visual presentation of delayed breastfeeding initiation. Global Moran’s I was computed to determine whether delayed breastfeeding initiation is randomly distributed, clustered, or dispersed. Getis-Ord Gi* Spatial Statistics was done to identify significant spatial clusters of cold and hot spot areas. Multilevel mixed-effect logistic regression analysis was computed to identify determinants of delayed breastfeeding initiation. Results The prevalence of delayed breastfeeding initiation is 26.4% (95% CI 24.4, 28.3). Significant clustering of delayed initiation of breastfeeding practice was found in the Somali region. Less clustering was identified in Northern Amhara, Addis Ababa and Dire Dawa. Being a young mother (15–24 years) (AOR 1.66; 95% CI 1.06, 2.62), no antenatal care (AOR 1.45; 95% CI 1.04, 2.02), cesarean section (AOR 4.79; 95% CI 3.19, 7.21) and home birth (AOR 1.53; 95% CI 1.14, 2.06) were found to be determinants of delayed initiation of breastfeeding. Conclusions In Ethiopia, delayed breastfeeding initiation is distributed non-randomly. Significant hotspot areas were identified in the eastern part of Ethiopia. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on promoting health facility birth and increasing antenatal care visits. Further emphasis should be considered on supporting young mothers and those giving birth via cesarean section to improve timely breastfeeding initiation
Trends, prevalence, and determinants of unfavorable tuberculosis treatment outcomes among adult patients in Northeast Ethiopia: The race to achieve a 90 % treatment success rate by 2025
No full textBackground: Tuberculosis (TB) continues to be a significant public health issue, especially in developing nations like Ethiopia. The country aims to reach a 90 % treatment success rate for TB by 2025. However, there is a considerable lack of recent data on treatment outcomes in the region. Current data on treatment outcomes and their determinants are crucial for guiding early interventions and aligning efforts with national goals and the End TB Strategy. Understanding the current state of TB treatment outcomes and influencing factors is vital for implementing effective interventions and measuring progress toward the target. Methods: A four-year retrospective study (2019–2022) was conducted. From 323 patient files, 312 were eligible to be included in the final analysis, resulting in a response rate of 96.6 %. Data collection utilized a structured checklist, and analysis was performed with STATA version 18. The Mann-Kendall trend test was used to detect trends in TB incidence. Multicollinearity was checked using variance inflation factors (VIFs). A logistic regression model identified determinants of treatment outcomes. Results: The study revealed that 84.94 % of participants achieved favorable treatment outcomes, while 15.06 % had unfavorable outcomes. A decreasing trend in unfavorable outcomes was noted, from 18.84 % in 2019 to 10.71 % in 2022 (Kendall's tau (τ) = −0.0686). Determinants of unfavorable outcomes included older age (AOR: 3.59, 95 % CI: 1.23–10.56), HIV positivity (AOR: 5.43, 95 % CI: 1.65–10.83), and smear-negative pulmonary TB (AOR: 3.82, 95 % CI: 1.39–10.45). Conclusion: The overall treatment success rate of 84.94 % is below the global target of >90 % for 2025. Tailored treatment strategies for older patients and those co-infected with HIV are recommended. Additionally, improving TB diagnostic capabilities is essential for early intervention and achieving better outcomes
Incidence and determinants of mortality among patients with colorectal cancer in oncology centers of Amhara region, Ethiopia, 2024: multicenter retrospective follow up study
No full textAbstract Introduction Colorectal cancer is a significant cause of mortality globally, with several factors impacting patient outcomes, including access to healthcare, early detection, and treatment. Despite this, the specific factors affecting incidence of death among colorectal cancer patients in the Amhara region have not been thoroughly investigated. Thus, this study seeks to assess incidence and determinants of mortality among colorectal cancer patients in Amhara Region oncology centers. Results The mean age of the participants was 48.6 years (SD ± 15). Median survival time was 23.8 months. The overall incidence rate or incidence density of a colorectal cancer mortality rate was 2.9 per 100 person-months (95% CI: 2.5–3.4). Survival rates of colorectal cancer patients 1and 5 year was 69.78% and 16.1%, respectively. The result of the multivariable analysis showed that colorectal cancer patients who had presenting symptoms [AHR = 2.67 (95% CI: 1.95, 3.67)], Base line HGB level < 12.5 mg/dl [AHR = 1.63 (95% CI: 1.12, 2.37)], WHO or ECOG poor performance status [AHR = 2.99 (95% CI: 2.17, 4.12), late stage of cancer [AHR = 2.32 (95% CI: 1.42, 3.79)] and location of tumor on colorectal [AHR = 1.76 (95% CI: 1.20, 2.55)] were significantly associated with mortality of colorectal cancer. Conclusion and recommendation The study highlights significant findings on the survival and mortality of colorectal cancer patients. The overall mortality rate was 2.9 per 100 person-months. Multivariable analysis identified presenting symptoms, low baseline hemoglobin levels, poor performance status, late-stage cancer, and tumor location as significant predictors of mortality. Highlighting the need for early detection and targeted care strategies
Uptake of the Second Dose of the Measles Vaccine and Its Determinants Among Children Aged Less Than 5 Years: Systematic Review and Meta-Analysis
No full textBackgroundEthiopia is faced with poor measles-containing vaccine second dose (MCV2) coverage, leading to recurrent outbreaks.
ObjectiveThis meta-analysis and systematic review aimed at combining evidence of MCV2 uptake in Ethiopia and its determinants to inform interventions for increased vaccination uptake and control of public health challenges.
MethodsThis review examined observational quantitative research on measles second dose vaccination among children in Ethiopia using databases such as PubMed Central, Cochrane Library, Web of Science, Scopus, MEDLINE, and Embase. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Heterogeneity was evaluated using I2 statistics and the Cochran Q test, and the analysis used a random-effects model. Publication bias was assessed through funnel plots, the Egger test, and nonparametric trim-and-fill tests.
ResultsThe overall MCV2 uptake among children aged <5 years in Ethiopia was only 34.4% (95% CI 18.8%-49.9%). Significant determinants of MCV2 uptake included high level of maternal education (adjusted odds ratio [AOR] 3.31, 95% CI 1.32-5.30), attendance to antenatal care follow-ups (AOR 2.02, 95% CI 1.12-2.92), use of postnatal care services (AOR 3.03, 95% CI 1.77-4.28), reduced waiting times at vaccination sites (AOR 2.56, 95% CI 1.98-3.13), good awareness of measles vaccination (AOR 2.17, 95% CI 1.59-2.74), and positive perceptions of the vaccine (AOR 3.58, 95% CI 1.97-6.30).
ConclusionsThis study found that the uptake of MCV2 among children aged <5 years in Ethiopia was 34%, which is far below the global and national goal of 95%. Key factors contributing to low coverage include mothers’ educational levels, use of antenatal and postnatal care services, waiting times at vaccination sites, and mothers’ awareness of the measles vaccine. Improving community-based education programs, increasing access to antenatal and postnatal care services, reducing waiting times, and raising awareness about immunization all contribute to increasing vaccine uptake.
Trial RegistrationPROSPERO CRD42024619031; https://www.crd.york.ac.uk/PROSPERO/view/CRD4202461903
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