Browsing by Author "Gedif, Teferi (PhD)"

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    Anti-Malarial Drug and Mosquito Net Use Pattern in Pawe Special Woreda: A Community Based Survey
    (Addis Ababa University, 2009-06) Mussa, Seid; Gedif, Teferi (PhD)
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    Anti-Malarial Drug and Mosquito Net Use Pattern in Pawe Special Woreda: A Community Based Survey
    (Addis Ababa University, 2009-07) Mussa, Seid; Gedif, Teferi (PhD)
    Background: Malaria is a major public health problem and the leading communicable disease in Ethiopia. Interruption of contact between humans and mosquitoes through the use of insecticidetreated bed nets (ITNs) is a promising approach to protect people from malaria infection. Treatment failures and mortality due to malaria has risen in recent years, probably due to increasing resistance to anti-malarial medicines. Improper drug storage and rampant selfmedication are some of the factors that may contribute to an increase in the development of drug resistance by malaria parasites towards anti-malarials. Study objective: To assess the utilization pattern of anti-malarial drugs, and mosquito net coverage in Pawe special Woreda, Beneshangul-Gumuz National Regional State. Methodology: The study was conducted in Pawe Special Woreda, Beneshangul-Gumuz Regional State between August and September 2008. Both quantitative and qualitative methods were employed in the data collection. Qualitative methods employed include focus group discussions and key-informant interviews. The quantitative method used is a community based cross-sectional household survey. The study utilized a trained interviewer administered questionnaire for data collection. Data was collected primarily from mothers. Quantitative data was entered using EPI-Info software Version 6.04 and analyzed by SPSS version 11 statistical packages. Qualitative data were analysed through thematic content analysis in an attempt to answer key questions of the study. Results: Perceived malaria prevalence was found to be 6.1 %. Sixty nine, (38.8%) of those with reported malaria/symptom complexes in the last two weeks preceding the interview date se lfmedicated themselves with anti-malarials. Households with a family size of less than or equal to 5 persons (OR=0.47, CI=0.25, 0.90, P=0.02) were less likely to self-care with anti-malarials than those with a family size of more than 5 persons.
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    Assessment of Bacterial Resistance Trend and Contributing Factors to Fluoroquinolone among Patients’ Specimens Analyzed At International Clinical Laboratories in Addis Ababa
    (Addis Ababa University, 2017-06) Mekuria, Banchirega; Gedif, Teferi (PhD)
    Introduction: Fluoroquinolones are a group of antimicrobials which are widely used globally and thus microorganisms becoming resistant to them. As there is limited current data on specific microorganisms’ resistance to fluoroquinolones in Ethiopia; this study aimed to generate information on the bacterial resistance against fluoroquinolones. Objective: To assess the bacterial resistance trend to fluoroquinolone among patients’ specimens analyzed at International Clinical Laboratories and contributing factors in Addis Ababa, Ethiopia Method: A retrospective, cross-sectional study design was employed using records from microbiology laboratory registers of International Clinical Laboratories documented from January 2013 to December 2016. Descriptive analysis and inferential statistics were computed. In addition, qualitative study using phenomenological method was conducted in health facilities of Addis Ababa to explore the contributing factors for resistance from prescribers’ and dispensers’ perspective. A thematic analysis was used to analyze the qualitative data. Result: The overall bacterial resistance to fluoroquinolones was 42.5%. The resistance was high against nalidixic acid (63.3%) followed by norfloxacin (44.4%). Enterococci and E.coli isolates were developing high level of resistance to ciprofloxacin and norfloxacin while enterococci was highly resistant to nalidixic acid (77.8%) followed by Pseudomonas (75.0%) isolates. In general, resistance to fluoroquinolone increases as patients’ age increases. Resistance against fluoroquinolones in patients of age 60 and above years were more than 5 times AOR= 5.63 (4.71, 6.73) that of the resistance in patient’s age less than 15 years. The resistance to fluoroquinolones increased from 40.4% in 2013 to 45.1% in 2014 and reached to the 49.0% in year 2015 and then declined to 46.3% in 2016(P <0.05). Key informants revealed that inappropriate practices of physicians, pharmacists and patients and incomplete diagnostic services contributed to fluoroquinolone resistances. Strengthen the regulation regarding over the counter sell of antibiotics, educating the public to improve awareness, promoting ethical practice would also help rationalizing the prescribing and dispensing practices, and instituting evidence based use of antibiotics are recommended as a solution. Conclusion: The retrospective study showed high bacterial resistance to fluoroquinolones. There was an increasing trend of bacterial resistance with time. Key informants stated that inappropriate prescribing and over the counter sell of antibiotics as well as irrational use by patients contributed to bacterial resistance to fluoroquinolones. Recommendation: The study suggests updating of health professionals on susceptibility pattern of bacteria and rational prescription to improve use of fluoroquinolones, Promoting ethical practice, improving the regulation and supervision on over the counter sell of antibiotics at private medicine retail outlet and continuous awareness raising and behavioral change communication has to be devised towards rational use to the community were some of the proposed containment mechanism for bacterial resistance to fluoroquinolones. Key word: Fluoroquinolone, resistance, bacterial isolates, resistance trends
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    Assessment of Dot Implementation in Tigray, Northern Ethiopia
    (Addis Ababa University, 2009-07) Alisani, Seid; Gedif, Teferi (PhD); Tadesse, Zerihun (PhD)
    Mycobacterium tuberculosis infects one third of the world's population. Ethiopia ranks seventh in the world & third in Africa with TB prevalence. TB is the leading cause of morbidity, the third cause of hospital admission and the second cause of hospital death in Ethiopia. TB patients take drugs for very long period of time. Hence, adherence is a major problem. To resolve this issue, the World Health Organization recommends the strategy of Directly Observed Therapy-Short Course (DOTS) which includes Directly Observed Treatment (DOT) to ensure a better patient adherence. The observer may be a health worker or a trained and supervised community member. Studies elsewhere show varying results on the effectiveness of Community Based DOT (CBDOT) compared to Health Facility Based DOT (HBDOT) option. In Ethiopia, although attempts have been made to assess quality of DOT implementation, comparative effectiveness of CBDOT versus HBDOT programs has not yet been assessed. This study was conducted to assess effectiveness of DOT implementation in CBDOT and HBDOT program areas in Tigray region. The study also aimed to compare implementation practice between the two DOT options and identify the factors affecting DOT implementation. The study was a comparative cross sectional study conducted between October and December, 2008. Both quantitative and qualitative methods were used for data collection. The quantitative methods used were retrospective review of Unit TB Registers avai lable in the health faci lities, prospective observation of DOT observers' practice, exit interview of TB patients and selfadministered questionnaire for health profess ionals. The qualitative method used was Focus Group Discussions (FGD) for both groups. A total of 378 patients, 118 from Hintalo Wajirat (CBDOT) and 266 from Enderta (HBDOT) Woredas, registered from September 2005 to February 2008 treatment outcomes were reviewed retrospectively from Unit TB Registers. Effectiveness was measured by success rate. Treatment was successful for 101 (88.6%) and 181 (87.4%) new TB patients in CBDOT and HBDOT program areas, respectively. For new sputum smear positive pulmonary TB cases treatment was successful for 19 (90.5%) patients in CBDOT and 28 (84.8%) patients in HBDOT options. CBDOT option was as effective as HBDOT in treating TB patients and can achieve good treatment outcomes. CBDOT option also reduced transfer out of TB patients.This study found out that DOT implementation as indicated by observation of DOT provider practice was comparable for CBDOT and HBDOT program areas. This indicated that CBDOT observers can practice DOT like HBDOT providers. Hence, CBDOT can complement HBDOT and could be a viable alternative in areas where people live faraway from health facilities. The study also identified access, acceptability of DOT option and DOT providers, awareness of patients and providers, support to the patient, incentive to CBDOT providers, health improvement, documentation and supervision as factors that could affect DOT implementation. Voluntary Community Health Workers are available in each and every village and are willing to render service to their villagers. National/regional policy should be adopted to equip them with proper training and provide supportive supervision so that they tremendously increase both access and quality of DOT. Mechanisms should be devised to ensure that health workers develop supportive attitude and facilitate wide scale deployment of voluntary Community Health Workers. Key words: TB, DOT, CBDOT, HBDOT, Effectiveness, Treatment success and Tigray
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    Assessment of HIV treatment outcome among mentally disordered patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-12) Ibrahim, Nebila; Gedif, Teferi (PhD); Alem, Atalay(Professor)
    Assessment of HIV treatment outcome among mentally disordered patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Nebila Ibrahim Addis Ababa University, 2015 Human immunodeficiency virus infection usually leads to clinical diseases that affect almost every organ system and present with a wide range of symptoms and syndromes. Accurate assessment and diagnosis of systemic as well as central nervous system impairment requires close medical and psychiatric management. Therefore, psychiatric disorders associated with HIV/AIDS should be accurately identified and treated as its impact on health is substantial. The aim of this study was to assess the HIV treatment outcome among mentally disoredred patients following their treatment at Amanuel Mental Specialized Hospital. A retrospective study was conducted from September 2010 to August 2013 among HIV positive patients (N=337). Data on socio-demographic characteristic of patients, HIV stage based on WHO classification, the type of psychiatric disorder, medication, treatment outcome, and CD4 count were collected from patients’ chart. Among the 337 study participants, 138 (40.9%) were diagnosed to have a psychiatric condition. Out of these patients, more than 70% and 90%, respectively, showed an improvement in their CD4 count and WHO class over the three years period. The adherence among the HIV infected mentally ill patients was rated to be good in 39%, fair in 47%, and poor in 67% of the patients. Compared to psychiatric patients, the adherence of non-psychiatric HIV patients to their ART medication was significantly higher (OR = 3.06; P=0.046). Forty one percent of the study participants had opportunistic infection; of these 73.2 % were psychiatric patients. Overall, the co-occurrence of HIV and Psychiatric illness did not influence the treatment outcome. However, this does not completely exclude the attention needed to be given to these patients regarding adequate ART treatment. Therefore, further studies should be done to come up with optimum management of HIV positive patients with mental illness. Key words: Mental illness, HIV in Ethiopia, treatment outcome and Amanuel Mental Specialized Hospital
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    Assessment of Hypertension Treatment Pattern At Selected Health Facilities in Addis Ababa and Consumption of Antihypertensive Drugs
    (Addis Ababa University, 2009-10) Teshale, Mewael; Gedif, Teferi (PhD); Tesfaye, Fikru (PhD)
    Background : Hypertens ion a long with other chronic diseases is on the rise in I~ thi opia. In fac t, the threats of non communicable diseases are not emerging rather they are well advanced and causing do uble burden to the society along with in fectious diseases. Unhealthy life sty le is the dcterminant for this dilemma. Needless to say, it needs time ly in tervention to tack le the problem. Despite or this fac t, studies on hypertension arc very few. This study assesses the treatment pattern to hypertension and consumption of antihypertensi ve drugs. Objective: To assess hypertension treatment pattern and consumption of anti hypertensive drugs. Methodology: An institution based cross sectional study involving retrospective data collection techniques (record review for the last five years and exit interview) was conducted between September and October 2008 . Results: The most commonl y prescribed drugs either alone or in combination were methyldopa, nifed ipine. hydrochlorothiazide. enalapril and atenolol. Treatment sh ift occurs freque ntly from thera peutic class to another on the basis of in effecti veness of the drug to adeq uate ly control blood pressu re, reason not known and side effect. Monoth erapy is favo red regard less of scx. Furosemide is the most consumed antihypertensive drug and nifedipine ranks the first with regards to cost of sales of antihypertensive drugs. Conclusion and recommendations: Methyldopa, ni fed ipine, hydrochlorothiazide, enalapri l and atenolol are widely used drugs for the treatment of hypertens ion whi ch is in accord with standa rd treatment guideli ne of the country. Future longitudinal research should be done to describc consumption trend of antihypertensive drugs.
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    Assessment of Knowledge, Attitude and Practices on Adverse Drug Reaction Reporting among Pharmacy Personnel Working at Community Pharmacy, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-05) Goshime, Alaynesh; Gedif, Teferi (PhD)
    Assessment of Knowledge, Attitude and Practice on Adverse Drug Reaction Reporting among Pharmacy Personnel Working at Community Pharmacy, Addis Ababa, Ethiopia Alaynesh Goshime Addis Ababa University, 2015 Modern medicines have changed the way in which diseases are managed and controlled. However, despite all their benefits, evidence continues to mount that adverse drug reactions (ADRs) are common cause of illness, disability and even death. Knowledge, attitude and practices of health professionals towards ADR reporting are known to have crucial contribution in the detection and reporting of the reactions. A cross sectional study was conducted on a sample of 379 pharmacy personnel working at randomly selected community pharmacies of Addis Ababa to assess their knowledge, attitude and practice towards ADR reporting. Data was collected using self administered questionnaire. Majority of the respondents were male (57.5%) and in the age group 26-30 (55.1%). Over half (70.7%) of the respondents had poor knowledge. One hundred seventy three (45.6%) participants encountered ADRs in the past 12 months but none of them reported to the relevant authority. The majority of respondents (82.8%) had a positive attitude towards ADRs reporting. The study revealed that majority of pharmacy personnel at community pharmacy in Addis Ababa had poor knowledge, positive attitudes and very limited practices towards ADR reporting. The Ethiopian Food, Medicine and Health Care Administration and Control Authority should create awareness iv on the existence of ADR monitoring system and the purpose and importance of ADR reporting and should also conduct continuous trainings and seminars about ADR reporting with community pharmacies dispensers and finally ADR reporting forms should be made available at community pharmacies. Keywords: Pharmacovigilance , ADR reporting, Community Pharmacy Personnel, Knowledge, Attitude, Practice
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    Assessment of medicines wastage and its contributing factors in selected public health facilities in South West Shoa Zone, Oromia Regional State, Ethiopia
    (Addis Ababa University, 2017-06) Tadesse, Esayas; Gedif, Teferi (PhD)
    Medicines wastage occurs when medicines are damaged, obsoleted or expired and become unsafe for use. It is a burden to many health facilities and increases cost to the health care system. In Ethiopia, although there are reports that reveal the presence of wasted medicines in the country, there is limited objective evidence on the type and extent of medicines wastage as well as its contributing factors. Therefore, the objective of this study was to determine medicines wastage rate and to identify its contributing factors in the sampled public health facilities of South West Shoa Zone, Oromia Regional State, Ethiopia. The study employed a facility based cross-sectional survey and qualitative study in one hospital and nine health centers from May 2- 27, 2016. Both quantitative and qualitative data collection methods were used in the study. The quantitative data was collected by data abstraction formats and self-administered questionnaires and analyzed using SPSS version 21.0. The analysis was performed in aggregate and included descriptive statistics. And the qualitative data was collected through in-depth interview with the heads of the health facility and pharmacy case team leaders and analyzed using thematic analysis. The total monetary value of wasted medicines in the surveyed health facilities in EFY 2005-2007 was 500,522.09 Ethiopian Birr, while in the same period all surveyed health facilities received medicines worth of 6,635,910.97 Ethiopian Birr, resulting wastage rate of 7.5%. Of the total value of wasted medicines, anti-infectives (39.1%), medicines used for correcting water, electrolyte and acid-base balance (12.9%) and GIT medicines (10.6%) were the top three therapeutic classes. Oral rehydration salt 245osml/l powder (6.3%), metronidazole 250mg capsule (4.1%), and tetracycline 250mg capsules (3.2%) were also the most commonly wasted medicines. More than half of the wasted medicines were in solid dosage forms (54.3%), followed by liquid dosage forms (40.8%) and nearly 96% of the source for wastage was expiry of medicines. IX In both quantitative and qualitative study, delivery of near expiry date medicines by suppliers, lack of system to move nearly expired medicines from one facility to another, presence of over stocked medicines due to improper forecasting of need in the facilities, lack of electronic stock management tools and shortage of pharmacy professionals in the health facilities were identified as contributing factors for medicines wastage. In conclusion, the extent of medicines wastage in public health facilities of South West Shoa Zone was estimated to be 7.5%. It is recommended that the health facilities should document and maintain a written record of all medicines wastage. A mechanism of exchanging medicines from overstock to under stock areas should be created, and a strong partnership or a common plat forum should be established among key stake holders to have regular discussion on preventive strategies. Key words: Medicines wastage, wastage rate, expired medicines, public health facility, Ethiopia
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    Assessment of multi drug resistant tuberculosis rate and associated factors in public health facilities of Dessie City Administration, North East Amhara, Ethiopia.
    (Addis Ababa University, 2015-12) Shegaw, Gashaw; Gedif, Teferi (PhD)
    Assessment of multi drug resistant tuberculosis rate and associated factors in public health facilities of Dessie City Administration, North East Amhara, Ethiopia. Gashaw Shegaw Addis Ababa University, 2015 The history of TB treatment has observed sequential development of resistance to anti-TB drugs. MDR-TB is defined as an MDR-TB suspect who is sputum culture positive and whose TB is due to Mycobacterium TB that are resistant in-vitro to at least INH and RMP. The emergence of MDR-TB is a threat for the populations of resource limited countries. In Ethiopia MDR-TB is becoming a challenge, because of poor adherence to treatment, TB/HIV co-infection, a few diagnostic and treatment facilities and inadequate trained health professionals. Dessie is densely populated town with high flow of people within the region as well as from neighborhood regions. It is also vulnerable for counterfeit anti-TB drugs through contraband. The aim of this study is to determine rate of MDR-TB and to identify associated factors in Dessie City Administration, North East Amhara, Ethiopia. A facility based retrospective cross sectional study design employing medical records review of TB registration books supplemented by key informants’ interviews which cover retrospective review period of July 1, 2012 to June 30, 2014. Prevalence rate of MDR-TB for combined, new and retreated TB cases of all form from public health facilities, were found to be 2.1/100, 0.3/100 and 21.6/100 respectively. Adherence of TB patients to TB treatment (COR=9.0, 95% CI [1.03-78.57]) and previous history of TB treatment (AOR=66.87, 95% CI [6.94-644.10]) were found to be a risk factors for MDR-TB. And related to TB type all MDR-TB cases were dominantly pulmonary TB. Key words: Tuberculosis, Multi drug resistance, Rate, Associated factors, anti TB drugs.
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    Assessment of Pharmacy Workforce in Ethiopia
    (Addis Ababa University, 2011-03) Beedemariam, Gebremedhin; Gedif, Teferi (PhD)
    Background: Human resources for health have long been recognized as the cornerstone for the success of the health sector programs. In this regard, proper planning of the development of human capital based on evidence related to the number of working force available, factors that contribute to the attrition of the available health professionals and international standards, is crucial. Although most developed countries have a well documented data of health workers in general and pharmacy workforce in particular, the developing world like Ethiopia are severely lagging in developing an evidence related to its education and work-force development. The country lacks an adequate national pharmacy workforce data. As a result, fundamental questions regarding the status of the pharmacy workforce, its level of performance and the problems they face remain largely unanswered. So, the results of this unique national survey allow critical evaluation of the national pharmacy workforce which should be considered in the national health care policies and workforce planning that impact the health, labor and education policies. Objective: To assess pharmacy work force in Ethiopia. Methodology: A national census and descriptive cross-sectional survey of the pharmacy workforce in Ethiopia was conducted between June and September, 2010. A complete enumeration of pharmacists was conducted in all pharmaceutical sectors across the country. On the other hand, other variables related to pharmacists‘ job satisfaction and work-life change were assessed taking cross-section of the pharmacists by applying stratified sampling method. Six regions/city administration (Afar and Benshangul Gumuz from the historically disadvantaged regions and Addis Ababa, Amhara, Oromia, and Tigray from the other regions/city administration) were involved in the study. Both qualitative and quantitative methods were employed in data collection. The quantitative data was collected by self administered questionnaire, census form and structured data abstraction format. The qualitative data was collected by in-depth interview with key informants from the Regional Health Bureaus, Federal Ministry of Health and pharmacists from different batches. Results: The total number of pharmacists in the country was 1898 (2.38 pharmacists per 100,000 population). Pharmacists were found unevenly distributed between regions, private and public sectors. The maldistribution of pharmacists was evident that pharmacists‘ density per 100,000 IX population ranges from 0.66 in Afar to 29.88 in Addis Ababa. To attain WHO recommended ratio and African countries average pharmacists density, currently Ethiopia needs to have a total of 39,918 and 6,387 pharmacists, respectively. The forecasted demand of pharmacists for 2024/25 fiscal year based on both the lower and middle income countries scenario, and the lower, middle and higher income countries scenario is estimated to be within the range of 28,278 to 30,003 pharmacists. The fourteen years (1993-2006) annual average Pharmacists‘ loss rate was found to be 6.5%. Pharmacists appeared to be less satisfied with their work, with overall mean job satisfaction score of 3.0 (SD = 1.11) in a scale of 1-5. Relation with colleague and fellow professionals was an item with the highest mean job satisfaction score (3.74 ± 1.06), while remuneration (with mean score of 2.55, SD = 1.22) ranked least by pharmacists. Pharmacists working in hospital pharmacy, level IV cities/towns, and younger pharmacists were significantly less satisfied than pharmacists on the other category. Out of 393 pharmacists interviewed, 37.7%, 11.2% and 12.1% of them reported that they were highly likely to leave their current area of practice, reduce hours of work, and leave the profession within the next two years, respectively. Conclusion and Recommendation: This study has shown that the country suffers from shortage of pharmacists, particularly the emerging regions. The double digit economic development of the country contributes to increase the demand for pharmacists and the forecasted need for 2024/25 fiscal year is about 28,278 to 30,003 pharmacists. The introduction of new curriculum is also expected to boost the country‘s demand for more number of pharmacists. This shortage of pharmacists could undermine equitable access and availability of medicines to the communities in the country and therefore deter the reduction of morbidity and mortality. Hence, the government should give due attention to maximize patients‘ benefit from the underutilized pharmacy profession. Key words: Pharmacy, Ethiopia, Pharmacist density, Job satisfaction, Plan to change work-life
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    Assessment of the knowledge and practice of Health Extension Workers regarding the medicine they handle, in selected districts of Sidama Zone, Southern Ethiopia
    (Addis Ababa University, 2014-04) Shuke, Ayalnesh; Gedif, Teferi (PhD); Dejene, Michael
    The involvement of the CHW (community health workers) in drug provision has increased the availability of essential drugs lowest feasible cost to the population at the peripheral level. Some experts remain cautious about this approach, because of concerns that allowing CHWs to distribute anti-infective will increase the inappropriate use of drugs and accelerate the development of drug resistance. So this thesis assessed the knowledge and practice of HEWs regarding the medicines they handle in Sidama Zone. A cross-sectional study was conducted from December 2011 to January 2012. A structured questionnaire was used to collect data from a total of 55 HEWs available in the health posts (HP).Thirty HPs were selected from 3 districts. Medical record review was also made. Results showed that only 36.4% respondents were aware of the correct adult doses of Chloroquine and 29% and 40% of the respondents could not tell the dose of Coartem® and Chloroquine without referring to the treatment guideline, respectively. Fifty-two(94.5%) of the respondents did not knew the drug interaction between Coartem® and oral contraceptives and only 12.5% of the respondents were aware of food requirement while taking Coartem®. Only 3.6% and 29(52.7%) of HEWs reported correct doses of Amoxicillin and Cotrimoxazole, respectively. Of a total of 356 prescriptions, 50(14%) were not consistent with recommended guidelines. Therefore, the Zonal health department/ Woreda Health Office should organize refresher trainings for the HEWs to improve their knowledge about doses, drug interactions and contraindications of antimalarial drugs and antibiotics. And they should also encourage the consistency of the HEWs practice to the recommended guidelines regarding appropriate treatment choices.
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    Assessment of Utilization Pattern of Topical Steroids in Alert Hospital
    (Addis Ababa University, 2014-04) Negussie, Hanna; Gedif, Teferi (PhD)
    Topical steroids comprise the mainstay treatment of skin diseases. However, irrational prescription of topical steroids is a common occurrence in clinical practice and they are being abused by health professionals and patients alike. This study was performed to assess the utilization pattern of topical steroids in ALERT Hospital, Addis Ababa. The study employed a descriptive, cross sectional study design, using both quantitative and qualitative methods between August and November, 2013. Data abstraction format was used to collect the data from a total of 660 patient records and an interview guide was employed to collect data qualitatively. The quantitative data was analyzed using SPSS version 16 and the qualitative data was analyzed thematically. The majority of patients were females 380(60.9%) and their mean age was 24.2 years. Eczematous dermatitis 211(30.0%) was the single most common skin diseases observed. However, infectious skin diseases were the most common skin dermatoses 230(33.8%) when combined. The most commonly prescribed classes of drugs were topical steroids and its combination 315(28.4%) followed by anti-fungal drugs 245(22.1%). There were a total of 1108 drugs prescribed, with an average of 1.77 drugs per prescription. Topical steroids and its combination were found to be the most commonly prescribed drugs. A total of 315 topical steroids were prescribed and brand name was used in 307(97.5%) of them. The most commonly prescribed topical corticosteroids were betamethasone dipropionate 77(24.4%) and clobetasol propionate 73(23.2%), which are potent and very potent topical corticosteroids, respectively. Out of all the topical corticosteroids prescribed, the majority were potent 174(55.2%) and very potent 73(23.2%). Prescribers‘ adherence is to the ALERT Medicines Formulary and National Standard Treatment Guideline was found to be 100% and 58.1%, respectively. In most prescriptions, site of application, duration of treatment and quantity to be dispensed was inadequate; a practice that should be improved. Key words: Prescription pattern, Topical steroids/corticosteroids, Skin diseases
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    Awareness and Utilization of Emergency Contraceptive among Second Cycle Primary Female Evening Students in Hawassa
    (Addis Ababa University, 2013-05) Adinew, Alemayehu; Gedif, Teferi (PhD)
    An unintended pregnancy is mistimed or unwanted one. It is a public health problem which affects maternal and child health. Unintended pregnancies are also significant among adolescents. Unintended pregnancy is a big problem in Ethiopia particularly among these age groups. Sexual violence is another major health problem because of consequences such as unwanted pregnancy abortion and sexually transmitted diseases and physical and mental trauma all of which could contribute to the high rate of female drop out from schools. Emergency contraception utilization can potentially reduce unintended pregnancies resulted from unprotected sexual intercourse or sexual violence and thus the risks related to it. Disparities in knowledge, access and use of family planning methods have also been observed in the country. This study assessed awareness and utilization of emergency contraceptive among second cycle primary school female evening students. A cross sectional study design was used. A total of 628 self administered questionnaire were distributed in class rooms for second cycle primary school (Grade 5-8) female evening students in Hawassa whose age was ≥ 15 years to assess their awareness, attitude and practice of emergency contraceptive and to identify their determinants which will be helpful in designing strategies to address reproductive health needs. The response rate was 463 (73.73%). To complement the quantitative data, key informant interview was also held with Family Guidance Association Ethiopia; Hawassa Branch, school directors, community pharmacy professional and DKT Ethiopia Hawassa branch manager. To determine the association between dependent and independent variables, multivariate logistic regression model at 95% confidence interval was used. Thematic analysis was used for qualitative data. Among 463 students surveyed, 120 (25.9%) of them ever had sexual intercourse the mean age at first sexual intercourse was 15.5 (SD+ 2.17); (10-20 years) and 74 (16%) had ever used contraceptives. Of those who had ever heard about emergency contraception (EC), 120 (55.8%) knew at least one correct method of EC. Only 34 (28.3%) of respondents who have ever heard about EC, had good knowledge of EC. 73 (60.8%) of the respondents had favorable attitude towards EC. However, only 27 (5.8%) study participants had ever used EC. In spite of this, of those who had ever used Emergency Contraceptive Pills (ECPs), 6 (42.9%) of respondents used it more than one time with mean frequency of 4.00 (SD±3.00). xii In the adjusted logistic regression model, ever heard of Family Planning (FP) and grade level were identified to be positively associated [(AOR= 1.885; CI (1.032-3.443), (AOR=2.119; CI (1.083-4.147) for grade seven and AOR=2.068; CI (1.126-3.797) for grade eight respectively] with awareness about EC. Marital status, contraceptives use experience, fair and good knowledge of EC were identified as [(AOR=0.060; CI (0.005-0.771) for widowed, AOR=0.100; CI (0.22-0.446) for divorced, AOR=0.007; CI (0.002-0.022) and AOR=0.006; CI (0.002-0.023) respectively] negatively associated with attitude. Sexual intercourse experience, fair and good knowledge of EC had positive association [AOR=67.578; CI (6.382-715.533), AOR=15.565; CI (2.316-104.623) and AOR=89.324; CI (10.821-737.313) respectively] with utilization of EC. Awareness and utilization of EC among primary second cycle female evening students were found to be low. In addition, ever heard about FP, grade level, marital status, contraceptives use experience, fair, good knowledge of EC, sexual intercourse experience were identified to be determinants of awareness and utilization of EC. Due to this fact, stakeholders should collaborate and come up with ways by which awareness could be improved.
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    Cost as a Barrier to Access: Availability, Affordability and Identifying Component Cost of Essential Medicines
    (Addis Ababa University, 2009-06) Nuru, Mohammedsied; Gedif, Teferi (PhD)
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    Determinants of Highly Active Antiretroviral Therapy (HAART) Adherence and Improved Quality of Life for People Living with Hiv/Aids (PLWHA) in Afar Region, Ethiopia
    (Addis Ababa University, 2009-10) Yimer, Zinet; Gedif, Teferi (PhD)
    Background: Highly Active Antiretroviral Therapy (HAART) regimens greatly reduce the morbidity and mortality associated with HIV infection, high adherence for an optimal response to HAART is requirement. Unfortunately, adherence to HAART is difficult and poor adherence is common. Low adherence and the closely related phenomenon of drug resistance are thought to be the most important reasons for failed ARVs treatment. Better QOL score may relate with better adherence to HAART regimens, better PHS and MHS score. Objective: To determine the cutTent adherence rate and its determinants as well as to assess quality of life of patients among PLWHA currently on HAART in Afar Region, Ethiopia. Method: A cross-sectional Survey on assessment of factors affecting adherence to HAART was conducted between August 2007 and October 2007 in selected health institution of Afar Region, and both qualitative and quantitative data collection methods were employed in the stud y. Results: A total of 422 PLWHA and currently on HAART were participated in the study. Study participants were 222(52.6%) females and 200(47.4%) males, most of participants were in the age group of 25-44. According to 15-days recall self-report, 402(95.3%) of participants were adherent to doses of HAART. Adherence rate obtained from unannounced pill-count was also 53%. Traveling so could not keep the routine, too busy, lack of food and difficult to take many pills were the most common reasons reported for missed doses. In multiple logistic regress ion among the socio-demographic variables, employment was associated with better adherence score (OR, .001; CI, .001-.344, P=.026). Pill burden (OR= .001, CI .001-.089, P=O.OOI) and long time with virus (OR=.044, CI, .003-.714), P=0.028) were associated with better self-reported adherence. Age (OR= 1l.822, CI 1.274-109.65, P=0.030), gender (OR= 16.19, CI 1.111 - 232. 18, P=.046), level of education (OR= 12.899, CI l.007-165.242, P=0.049) also long time with HAART (OR= 33.391, CI, l.066-1046.279, P=0.046) among factors weakly associates with adherence. Shortage of medicines for OIs, quality of care, lack of income, and lack of food were reported among the factors more affect adherence among most of FGDs participants. Stigma, regimen factors like pill burden, side effect and structural issues were reported as factors less affects adherence to HAART. Adherence was assoc iated with better PHS and M HS sco re, which is to mean better QOL. Conclnsion: self report HAART adherence rate in th is population is better than studies in hi gh income countr ies as well as in Africa and in other Regions of Ethiopia, in spite of the fact th at patients in Ethiopia face a large number of economical problems. However, non-adherence remains an unsettling barrier for treatment success and is ever-present among patients receiving ARYs therapy. To improve adherence establishing reliable drug supply, training of ex tra number of staffs, simplifying dosage regimens and confidentiality should be mai ntained. Also study with intervention with some adherence support program may help to address factors on non ad herence. Key words: Highly Active Antiretroviral Therapy (HAART), Adherence, HIY/AlDS, Quality or Life (QOL), SF-36, Afar Region, Ethiopia.
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    Ethno medcinal Study of Plants In Jigjiga Woreda, Eastern Ethiopia
    (Addis Ababa University, 2015-03) Issa, Arebu; Gedif, Teferi (PhD); Asres, Kaleab (PhD); Gebre-Mariam, Tsige (Professor)
    Traditional medicine (TM) is the ancient and culture bound medical practice which existed in human societies before the application of modern science to health. The practice of TM varies widely, in keeping with the societal and cultural heritage of different countries. The heritage has not been well documented in the developing countries including Ethiopia and this is even more so in the emerging regions of the country. The objective of this study was to determine the prevalence and identify factors determining the use of TM and record medicinal plants used by Somali ethnic group in Ethiopia. A community based cross-sectional study in which ethno medicinal information was collected from the community by using semi-structured questionnaires, supplemented by an in-depth interview with the healers, field observations, and market survey was conducted. The questionnaire was administered to 800 heads of households, 9 healers and 2 markets & 3 herbal drug shops. The study documented an overall prevalence rate of 40% in the use of herbal medicine in one month recall period. A total of 107 plant species were reported, among these plant species, 34 were fully identified by their scientific names. The reasons for preferring for herbal drugs were lower price, efficacy and geographic inaccessibility of modern medicine. The study found that leaves are the most frequently utilized plant part (30.5%), followed by roots (23%). Religion is the main source of knowledge for the healers. Age, gender, educational status and occupation are important factors that determine the use of TM. This comprehensive ethno- medicinal study showed that the community in Jigjiga Woreda II relies on considerable number of traditional medicinal plant species to treat wide spectrum of human ailments. Key words: Ethnomedcine, Herbal medicine, In-depth interview, Market survey, Medcinal plants, Prevalence, Traditional medicine
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    Ethnopharmacological Survey of Medicinal Plants among the Hamer Ethnic Group, Hamer Woreda, South Omo Zone, SNNPR, Ethiopia and Evaluation of a Selected Plant for its Antimalarial Activity
    (Addis Ababa University, 2012-07) Paulos, Biniam; Asres, Kaleab (PhD); Gedif, Teferi (PhD)
    Health seeking behaviour of people around the globe will be affected by different socio-cultural and economical factors. People in Ethiopia, particularly tribal people have long history of using medicinal plants as a major component of their traditional medical practices over many centuries to satisfy their health care needs. The transfer of this sort of knowledge from generation to generation is mainly effected by words of mouth. Cross-sectional survey was conducted to document ethnopharmacological information of the Hamer semi pastoralists by using semi structured questionnaires administered to eight traditional healers/key informants and one thousand six hundred household (HH) respondents supplemented by eight focus group discussions (FGDs). The majority (84%) of HH respondents were males, 94.4% of whom suffered illnesses in the last two weeks recall period and had taken action. The prevalence of the use of traditional medicine among the Hamer community was found to be very common as indicated by FGD participants, key informants and HH respondents. HH respondents reported that traditional medical practices are their first choice when family members get sick. Females’ preference of traditional medical practices was higher than males. The main reasons for the preference of the community members to traditional medical practices include its effectiveness, low cost and ease of availability. A total of sixty medicinal plants were reported and collected along with their local names, indication(s), parts used and method of preparations. The health seeking behavior of the Hamer ethnic group is affected by different socioeconomic and cultural factors. There is also a strong indication for traditional medical practices and use of plant materials to treat various ailments and health problems among the study population. Therefore, due attention should be given to these traditional medical practices. The ethnopharmacological survey part of this study revealed that Aloe otallensis Baker., an indigenous Ethiopian plant, was among the most widely used medicinal plants by the members of the Hamer Ethnic Group. The plant is used for the treatment of malaria and wound healing. Malaria, a diseases caused by protozoan parasites is a major obstacle to the socioeconomic xii development of several developing countries including Ethiopia. The phytoconstituents of A. otallensis studied by thin layer chromatography (TLC) and its antimalarial and antioxidant activities were assessed by in vivo four day Plasmodium berghei suppressive test and 1,1- diphenyl-2-picrylhydrazyl (DPPH) assay, respectively. The study revealed the presence of picataloside (2,8-O,O-di (β-D-glucopyranosyl)-1,2,8-trihydroxy-3-methylnaphtalene) in the exudate of A. otallensis, which was isolated from the plant for the first time. The study further showed that the leaf exudate of the plant possesses maximum antimalarial activity (60.7% suppression) at a dose of 300 mg/kg. Similarly, at a dose of 100 mg/kg the isolated compound suppressed P. berghei parasites by 47.9%. Both the exudate and the isolated compound displayed comparable radical scavenging activity possessing IC50 value of 26.9 and 26.2 μg/ml, respectively in DPPH assay. The results of the present study do seem to justify the traditional use of A. ottalensis for the treatment of malaria.