Browsing by Author "Mekuria, Banchirega"

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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 Laboratory Commodities Supply Chain Performance in Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Mekuria, Banchirega; Jebena, Tariku (PhD)
    Supply chain operation reference is a model that provides “a unique framework that links business process, metrics, best practices and technology into a unified structure to support communication among supply chain partners and to improve the effectiveness of supply chain management and related supply chain improvement activities. The aim of this study is to assess the performance of laboratory commodities supply chain of Amanuel Mental Specialized Hospital. The study focused on five supply chain performance attributes which are supply chain reliability, supply chain responsiveness, supply chain agility, supply chain operational cost and inventory management Practice. A case study design using SCOR model was used to conduct the study on laboratory supply chain performance in Amanuel Specialized mental hospital. The research used both qualitative and quantitative approach. The quantitative data was analyzed using excel for descriptive statistics and the qualitative data was used to further explain the findings of the quantitative data. All one year data of report and request form, intra facility report and request form model, model 19 and 22, inventory reports, stock out report form, bin cards and stock cards were used. Census is sample selection technique to study the quantitative variable. Data for each metrics were obtained from the process components that are used to drive the calculation according to the SCOR guide. Structured data collection format and interview guide were used to collect data. Decomposition analysis method was used to measure the performance gap and identify root cause. The study found out that perfect order fulfillment of laboratory commodities were 25%. The order fulfillment cycle time was 54.45. The asset turnover rate was 0.72. Some of the root causes mainly contributed for low performance was unavailability laboratory commodities with required kind and quantity at distributers and delay to authorize payment. Therefore strengthening collaborative planning, forecasting and replenishment between the hospital and suppliers, establishing long term supplier agreement between the private suppliers and Improving the authorization of payment timely are some of the recommended practices. Key word: Laboratory commodities, supply chain performance supply chain operation reference