Browsing by Author "Taye Melaku"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Clinical Outcomes of Diabetic Foot Ulcer: A 5-Year Retrospective Analysis at a Tertiary Referral Hospital in Ethiopia.
    (Addis Ababa University, 2023-12) Taye Melaku; Reja Ahmed
    Background:Diabetic foot ulcer is a common, serious, and costly complication of diabetes. It is the leading cause of non-traumatic lower extremity amputation carrying a high risk of morbidity and mortality.The clinical outcomes of diabetic foot ulcer in Ethiopia are not well studied. This study aimed to assess the outcomes of diabetic foot ulcer at tertiary care setting in Ethiopia. Methods:A retrospective study conducted including all consecutive patients with diabetic foot ulcer admitted to a 642-bed tertiary hospital in Ethiopia from January 2018 to October 2022. Data were collected using a pretested, structured questionnaire. Then, the open data kit (ODK) completedform was exported and analyzed using SPSS version 25. Descriptive statistics were used to describe participants’ characteristics. To identify determinants of lower extremity amputation,bivariable and multivariable binary logistic regression analyses were done. Statistical significance was considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. Results:A total of 146 participants were included (79.5% were males, mean (±SD) age was 59.4 (±11.7)years). Glycemic goal achieved in 12.3% of patients while only 4.8% met their triple targets ofblood glucose, blood pressure and lipids. Lower extremity amputation was performed in 53.4% of the patients with major amputation done for the overwhelming majority. In-patient mortality was 8.2%. Independent predictors of amputation were: long standing diabetes (duration ≥10 years:Adjusted Odds Ratio: 2.42; [95% Confidence Interval: 1.01-5.80]), longer ulcer duration beforepresentation (every week of delayed presentation: 1.14 [1.01-1.03]), history of previous foot ulcer(4.34 [1.55-12.13]), advanced ulcer stages with University of Texas stage C or D (2.86 [1.19-6.90]). There was statistically non-significant trend of increased risk of amputation with advancing age and insulin treatment. Conclusion: the rate of lower extremity amputation in diabetic foot ulcer was excessively high.Long standing diabetes, ulcer duration, history of previous foot ulcer, and advanced ulcer severity were significantly associated with amputation. Prompt attention to these risk factors may reduce amputation rate among these patients. The high LEA rate in a low-income country indicates the mega-disparity in preventive and limb saving interventions reflecting the global health inequity that needs addressing.
  • No Thumbnail Available
    Item
    Knowledge of the Therapeutic Goals of Diabetes Care among Patients with Type 2 Diabetes at Tikur Anbessa Specialized Hospital: A Hospital-Based Cross-Sectional Study, 2020.
    (Addis Abeba University, 2020-12) Taye Melaku; Tarekegn Getahun
    Background :Diabetes is a growing public health challenge worldwide, including Ethiopia. Comprehensive multifactorial cardiovascular risk reduction is recommended to reduce diabetes-associated morbidity and mortality but achieving the triplet goals (optimization of blood glucose, blood pressure and low density lipoprotein levels) remained a global clinical challenge. Patients’ knowledge of these therapeutic goals of diabetes care contributes to improved self-care and glycemic control. However, the patients’ knowledge of the therapeutic goals in diabetes and its determinants have not been studied comprehensively in Ethiopia. Objective :This study was conducted to assess patients’ knowledge of the therapeutic goals of diabetes management and the factors associated with the knowledge score. Methods A cross-sectional survey was conducted from March 3 to June 10, 2020, at the diabetes clinic in Tikur Anbessa Specialized Hospital. Data were collected using a pretested, structured, intervieweradministered questionnaire. Then, the open data kit (ODK) completed form was exported and analyzed using SPSS version 25. To identify determinants of knowledge, bivariable and multivariable binary logistic regression analyses were done. Statistical significance was considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association Results A total of 419 participants were included. The mean knowledge score was 4.7 ±2.2 points (out of 10). Overall, the percentage of patients with a good understanding of the therapeutic goals of diabetes management was 59.5%. The percentages of patients who reported knowing their target goals for blood pressure, fasting blood sugar, hemoglobin A1C, and low-density lipoprotein were 79.5, 77.3, 11.7, and 7.2% respectively. Correct target goals for BP, FBS, A1c, and LDL-C were reported by 75.7, 73.0, 4.1, and 1.0% respectively. The percentages of patients who reported knowing their recent levels for BP, FBS, A1C, and LDL-C were 72.3, 80.2, 16.7, and 8.1% respectively. The multivariable binary regression analysis demonstrated that patients with longer diabetes duration (AOR = 1.04, 95% CI: 1.01-1.07) and an increased household income by 1000 Ethiopian birr (AOR = 1.12, 95% CI: 1.02-1.23) were associated with the odds of having good knowledge of the therapeutic goals. For each one year increase in the age of participants, the odds of having good knowledge of diabetes therapeutic goals decreases by 3% [AOR = 0.97; 95% CI: 0.95-0.99]. However, compared to higher education level, having no formal education or primary education was significantly associated with poor knowledge (AOR = 0.03; 95% CI: 0.006-0.13 and AOR = 0.27; 95% CI: 0.15-0.49, respectively). Besides, the odds of having good knowledge of the therapeutic goals for divorced patients with diabetes decreases by 63% as compared to married participants [AOR = 0.37%; 95% CI: 0.18-0.76]. Conclusion: This study demonstrated that the majority of participants knew their BP and FBS targets and own recent levels while only a minority of patients understood their A1c and LDL-C targets and recent values. It highlighted the need for the provision of patient-centered diabetic education and sharing responsibility for patients achieving diabetes treatment goals. Keywords: diabetes mellitus, knowledge of therapeutic goals, Tikur Anbessa Specialized Hospital, cross-sectional study