Suchergebnisse

Objectives: To assess the extent and nature of drug utilization among pregnant women attending antenatal care in hospitals of Mekelle, Tigray, Ethiopia. Methods: Institution-based cross sectional study was conducted by reviewing the antenatal care follow up cards and interviewing pregnant women using semi-structured questionnaire by nurses working in the four hospitals. Details of drugs self utilized and prescribed during the current pregnancy were investigated and categorized according to the United States Food and Drug Administration fetal risk classification. Data was analyzed using SPSS version 20.0. Result: Of the 400 participants, majority 199 (49.8%) were in age group of 26-36years. 38 (9.5%) and 8 (2%) have self utilized modern and herbal drugs, respectively. Majority 26 (59.1%) were analgesics. Most 32 (84.2%) of the self medicated modern drugs were from category C, followed by category B. Illiterates and secondary school complete participants have practiced self medication 3.7 times (AOR 3.65 (1.31, 10.20), p=0.014) and 4.03 times (AOR 4.03 (1.09, 14.96), p=0.038) more than the tertiary complete participants, respectively. Self medication use was 3.7 times more among non government employees than governmental employees (AOR 3.68 (1.11, 12.17), p=0.033). Forty one (10.2%) of the participants had chronic diseases where most 26 (39.4%) were from category C, followed by category D 17 (25.8%). Of all the participants, 249 (62.2%) consumed one or more prescription drugs, with 1.86±0.94 average number of drugs prescribed per pregnant women. Majority 190 (76.3%) were from category B, followed by category C 94 (37.8%), category A 53 (21.3%), category C/D 23 (9.2%), category D 22 (8.8%), category B/C 7 (2.8%), category A/C 3 (1.2%) and category X 1 (0.4%). One hundred one (40.6%) of the drugs were prescribed in Ayder referral hospital, followed by Mekelle 93 (37.3%), kalkidan 31 (12.4%) and Meskerem 24 (9.6%) hospitals. Majority of the drugs prescribed in each hospital were from category B (80 (32.1%), 71 (28.5%), 21 (8.4%) and 18 (7.2%), respectively. Antibacterial drugs were the most commonly prescribed 146 (38.7%). Conclusion: Majority consumed one or more prescription drugs. Most of them were from category B. Keywords: pregnancy, self medications, prescription drugs, US FDA fetal risk classification, Hospitals of Mekelle.

Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

OBJECTIVE: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. DESIGN: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. DATA SOURCES: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. ELIGIBILITY CRITERIA: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. DATA EXTRACTION AND SYNTHESIS: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. RESULTS: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. CONCLUSIONS: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

© BMJ Publishing Group Limited 2020. Objective The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.