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The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990–2016 and assesses how the burden of diarrhoea has changed in people of all ages. We modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types on the basis of vital registration and verbal autopsy data. We modelled diarrhoea incidence with a compartmental meta-regression tool that enforces an association between incidence and prevalence, and relies on scientific literature, population representative surveys, and health-care data. Diarrhoea deaths and episodes were attributed to 13 pathogens by use of a counterfactual population attributable fraction approach. Diarrhoea risk factors are also based on counterfactual estimates of risk exposure and the association between the risk and diarrhoea. Each modelled estimate accounted for uncertainty. In 2016, diarrhoea was the eighth leading cause of death among all ages (1 655 944 deaths, 95% uncertainty interval [UI] 1 244 073–2 366 552) and the fifth leading cause of death among children younger than 5 years (446 000 deaths, 390 894–504 613). Rotavirus was the leading aetiology for diarrhoea mortality among children younger than 5 years (128 515 deaths, 105 138–155 133) and among all ages (228 047 deaths, 183 526–292 737). Childhood wasting (low weight-for-height score), unsafe water, and unsafe sanitation were the leading risk factors for diarrhoea, responsible for 80·4% (95% UI 68·2–85·0), 72·1% (34·0–91·4), and 56·4% (49·3–62·7) of diarrhoea deaths in children younger than 5 years, respectively. Prevention of wasting in 1762 children (95% UI 1521–2170) could avert one death from diarrhoea. Substantial progress has been made globally in reducing the burden of diarrhoeal diseases, driven by decreases in several primary risk factors. However, this reduction has not been equal across locations, and burden among adults older than 70 years requires attention. Bill & Melinda Gates Foundation.

Objectives The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. Methods We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Results Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Conclusions Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.

Antimicrobials are among the most commonly misused medications, leading to antimicrobial resistance, and therefore demand more attention. There are limited studies documenting \"antimicrobial use-related problems\" in developing countries, especially in pediatric patients. This study aimed to evaluate the prevalence of antimicrobial use-related problems and risk factors among hospitalized pediatric patients. A hospital-based prospective observational study was conducted in Ayder comprehensive specialized hospital (ACSH) in the Tigray region, Ethiopia. The participants of the study were pediatric patients aged ≤15 years who were admitted with a diagnosis of infectious disease between September 2019 and November 2019. A total of 232 pediatric patients were included in the study. Of these, 59.5% of the patients were male and the mean age (SD) of the patients was 5.8 (5.2) years. Of the 232 patients surveyed, a total of 177 antimicrobial use-related problems were identified. One or more antimicrobial use-related problems have occurred in more than half of the patients (53.9%). The commonest antimicrobial use problems were unnecessary antimicrobial therapy (22.8%) followed by need additional antimicrobial therapy (16.4%). In a multivariate logistic regression model, patients with comorbidities (Adjusted odds ratio (AOR): 1.84, 95% confidence interval (CI): 1.04-3.27) and hospital stays exceeding one week (AOR=1.88, 95% CI: 1.08-3.26) were predictors of antimicrobial use-related problems. Antimicrobial use-related problems were found in a significant proportion of pediatric patients. Addressing these issues necessitates collaborative efforts, emphasizing targeted education, strengthened antimicrobial stewardship, ensuring responsible antimicrobial use and enhancing pediatric care.

The practice of self-medication during pregnancy is a global challenge that necessitates high attention as it poses a potential threat to the pregnant mother and fetus. However, little is known regarding self-medication practice and its contributors among pregnant women in our setting. The main aim of this study was to investigate the practice of self-medication and its contributing factors among pregnant women. A cross sectional study was conducted among pregnant women at antenatal care follow-up of Ayder comprehensive specialized hospital, Tigray, Ethiopia. Written informed consent was obtained from each participant before interview. Simple random sampling technique was employed to recruit participants in to the study. Data were collected by interviewing participants using the structured questionnaire. Binary logistic regressions analysis was performed to determine the contributing factors of self-medication practice during pregnancy. A p value of less than 0.05 was considered as significant. A total of 250 pregnant women were included in the study. Of the total, 40.8% practiced self-medication during the current pregnancy. Morning sickness (39.2%), headache (34.3%), and upper respiratory tract infections (29.4%) were the leading indications for self-medication. According to participant report, ease of access to medicines (25.5%), feelings that the disease is minor (21.6%) and timesaving (19.6%) were the most commonly reported reasons for self-medication practice. Absence of health insurance (AOR: 2.75, 95%CI: 1.29-5.89) and being on first trimester of pregnancy (AOR: 2.44, 95%CI: 1.02-5.86) were significant contributors of self-medication practice among pregnant women. In our study, high prevalence of self-medication was reported among pregnant women. Self-medication practice during pregnancy was higher among pregnant women on first trimester and those who were not having health insurance. Therefore, intervention programs should be designed to minimize the practice of self-medication during pregnancy.

Epilepsy is a major public health problem worldwide. Despite multiple drug therapies, people with epilepsy continue to have frequent seizures. There is a dearth of data on epilepsy treatment outcome and associated factors in our setting. Therefore, the aim of this was to assess treatment outcome and associated factors among epileptic patients on follow up at the neurologic clinic of Ayder comprehensive specialized hospital, Ethiopia. A cross-sectional study was conducted on randomly selected epileptic patients. Data were collected through patient interview and review of medical records. Epilepsy treatment outcome was evaluated in terms of seizure control status in the last one year follow up period. Binary logistic regression analysis was performed to identify predictors of treatment outcome. A total of 270 patients were included. Of whom, 46.6% had controlled seizures. Whereas, 38.5%, 8.8%, and 5.9% had experienced seizure attacks 1–5 times, 6–10 times, and greater than 10 times, respectively. Alcohol consumption [adjusted odds ratio [(AOR): 14.87, 95% confidence interval (CI): 3.25–68.11], negative medication belief [AOR: 3.0, 95%CI: 1.31–6.71], low medication adherence [AOR:11.52, 95%CI: 3.25–40.82], and presence of comorbidities [AOR: 10.35, 95%CI: 4.40–24.40] were predictors of uncontrolled seizure. Our finding revealed that more than half of the epileptic patients had uncontrolled seizure. Epileptic patients with a negative medication belief, comorbidities, low medication adherence, and those who consume alcohol were more likely to have uncontrolled seizure. Therefore, more emphasis should be given to these patients.

Background A vigilant prescription of drugs during pregnancy can potentially safeguard the growing fetus from the deleterious effect of the drug while attempting to manage the mother’s health problems. There is a paucity of information about the drug utilization pattern in the area of investigation. Hence, this study was implemented to investigate the pattern of drug utilization and its associated factors among pregnant women in Adigrat general hospital, Northern Ethiopia. Methods An institution-based cross-sectional study was conducted among randomly selected 314 pregnant women who attended obstetrics-gynecology and antenatal care units of the hospital. Relevant data were retrieved from the pregnant women’s medical records and registration logbook. The drugs prescribed were categorized based on the United States Food and Drug Administration (US-FDA) fetal harm classification system. Data analysis was done using SPSS version 20 statistical software. Multivariate logistic regression was employed to analyze the association of the explanatory variables with the medication use, and p  < 0.05 was declared statistically significant. Results The overall prescribed drug use in this study was found to be 87.7%. A considerable percentage of the study participants (41.4%) were prescribed with supplemental drugs (iron folate being the most prescribed drug) followed by antibiotics (23.4%) and analgesics (9.2%). According to the US-FDA drug’s risk classification, 42.5, 37, 13, and 7% of the drugs prescribed were from categories A, B, C, and D or X respectively. Prescribed drug use was more likely among pregnant women who completed primary [AOR = 5.34, 95% CI (1.53–18.6)] and secondary education [AOR = 4.1, 95% CI (1.16–14)], who had a history of chronic illness [AOR = 7.9, 95% CI (3.14–19.94)] and among multigravida women [AOR = 2.9, 95% CI (1.57 5.45)]. Conclusions The finding of this study revealed that a substantial proportion of pregnant women received drugs with potential harm to the mother and fetus. Reasonably, notifying health practitioners to rely on up-to-date treatment guidelines strictly is highly demanded. Moreover, counseling and educating pregnant women on the safe and appropriate use of medications during pregnancy are crucial to mitigate the burden that the mother and the growing fetus could face.

Optimizing exit-knowledge of ambulatory patients is a major professional responsibility of pharmacists to reassure safe and cost-effective medicines use. The study assessed the exit-knowledge of ambulatory patients on their dispensed medications and associated factors. Institutional-based cross-sectional study was conducted among ambulatory patients who visited the outpatient pharmacy of Ayder Comprehensive Specialized Hospital (ACSH) from December 2019 to February 2020. Data were entered, cleaned, and analyzed using SPSS version 20. Binary logistic regression was employed to determine factors associated with exit-knowledge on their dispensed medications. At a 95% confidence interval (CI), ≤0.05 was considered statistically significant. The study analyzed 400 patients; more than half of the participants were males (55.5%). The mean age of the participants was 41.3 years (mean ± standard deviation (SD), ±13). Less than half of the patients did not recall the name (44.5%) and major side effects (31.2%) of each medication. Furthermore, the overall sufficient knowledge was found to be 81%. Patients with single marital status were 4.454 times to have sufficient exit-knowledge of their dispensed medications than widowed ( =0.050) participants. Besides, patients who responded neutral clarity of pharmacist instruction had 4.745 times sufficient exit-knowledge than those who responded not clear ( =0.049). On the other hand, participants who got \"enough\" ( <0.0001) and \"not enough\" ( =0.006) information from the pharmacist were found to have a positive association with sufficient exit-knowledge than those who responded \"I do not know\". The majority of patients had sufficient exit-knowledge of their dispensed medications. Martially single, neutral clarity of pharmacist's instructions and adequacy of the information delivered by the pharmacist were positively associated with participants' exit-knowledge of their dispensed medications. Hence, conducting a multicenter study, we recommend pharmacists to counsel their patients to underpin patients' knowledge of their dispensed medications.

Ethiopia has one of the highest HIV burdens in sub-Saharan Africa. Despite the fact that second-line antiretroviral therapy (ART) has been available for more than ten years, studies on its effectiveness are scarce. To assess treatment outcomes and predictors of unfavorable outcomes in HIV patients receiving second-line ART at Ayder Comprehensive Specialized Hospital and Mekelle Hospital. An institution-based retrospective cohort study was conducted in two hospitals in Tigray Region, Ethiopia. We evaluated 192 patients aged ≥15 years who were switched to second-line from November 2009 to May 2020 after failure of first-line ART. The primary outcome was the time from the initiation of second-line ART to the occurrence of unfavorable treatment outcomes (treatment failure, death, and loss to follow-up). We performed Kaplan-Meier survival estimates to calculate the cumulative incidence rates of unfavorable outcomes. The mean age (SD) at the initiation of second-line ART was 39 (10.03) years, and the median CD4 cell count was 121 cells/microL. During a median follow-up of 4.6 years, 24 (12.5%) patients had died, 11 (5.7%) patients were lost to follow up, and 47 (24,4%) patients were experienced treatment failure. The incidence rates for unfavorable outcomes were 7.8 per 100 patients/years. Predictors for unfavorable outcomes were body mass index (BMI) <18.5 (adjusted hazard ratio [aHR] = 2.51, 95% confidence interval (CI): 1.27-4.95) and CD4 counts ≤100 cells/microL (aHR = 1.74, 95% CI: 1.09-2.79). Despite the failure of second-line ART, none of the patients received third-line ART. The incidence rate of unfavorable treatment outcomes for second-line ART was found to be high. A low BMI and a low baseline CD4 count were significant predictors of unfavourable outcomes and should be given special consideration in HIV care. A third-line ART regimen should also be considered for people who have failed second-line ART.

Intravenous medication administration errors (MAEs) may be accompanied by avoidable undesirable effects, which might result in clinical complications. The aim of the study was to determine the prevalence of MAEs and to identify the factors associated with such errors. A hospital-based cross-sectional study was conducted from March to April 2015. Data were collected by direct observation using a pretested data collection tool. Simple random sampling was used, and bivariate logistic regression model was used to identify the factors associated with MAEs. value <0.05 was considered statistically significant. A total of 134 patients were found to be eligible for the study. More than half of the study participants were males (76 [56.7%]). The rate of MAE was 46.1%, with the missed dose (n=162, 95.8%) being reported as the most common error. The age groups of 60-79 years (adjusted odds ratio = 2.166, confidence interval = 1.532-8.799) and 80-101 years (adjusted odds ratio = 1.52, confidence interval = 1.198-5.584) were the determinants of MAEs. A high prevalence of MAEs was found. Enhancing the knowledge and practical skills of clinical nurses might minimize such errors.