Assessment of the extent and monetary loss in the selected public hospitals in Jimma Zone, Ethiopia: expired medicine perspectives

IntroductionMedicine plays a crucial role in the field of healthcare as a therapeutically significant pharmaceutical product. By effectively preventing diseases, medicine has the power to save countless lives and improve the quality of life for people worldwide. However, despite hospitals' efforts to provide medical care to patients, a significant issue arises from the substantial amount of drugs that go unused due to expiration dates. This problem is particularly prevalent in resource-limited countries like Ethiopia, where the pharmaceutical supply system fails to adequately address the issue of expired drugs in public hospitals, leading to an unsatisfactory situation. Hence, the objective of this study was to assess the economic impact and volume of expired medicines in the selected public hospitals in Jimma Zone, Southwestern Ethiopia.MethodsA hospital-based cross-sectional study design was conducted to assess the economic impact and volume of expired medicines available in the public hospitals in Jimma Zone. All available hospitals that fulfilled the EFDA guidelines were included. The medication expiration rate was calculated by dividing the total monetary value of expired medicines in a year by the total value of medicines received in the same year multiplied by 100. Then, the collected data was cleared, filtered, coded, and quantitatively analyzed using the Microsoft Excel 2010 version.ResultsThe average medicine waste rate was 4.87% in the fiscal year of 2019/2020 and 2020/2021 in Jimma Zone public hospitals worth 32,453.3 US$. Additionally, the facility wasted an estimated of 2711.44 US$ on the disposal of expired medicines. The expiration of medicines has been linked to several issues, including near-expiry, irrational prescribing practices, and weak participation of clinicians in medicine selection and quantification of the facility. Additionally, only two hospitals had relatively good storage and handling practices.ConclusionOverall, the expiration rate of medicines in the public hospitals in Jimma Zone was greater than the allowed level of 2%. In order to optimize the allocation of healthcare funds and ensure the appropriate use of pharmacologically significant medications it is vital to conduct a comprehensive examination at the national level within a regional hospitals

Bibliography of the Literatures on Tuberculosis, TB/HIV and MDRTB in Ethiopia from 2001 – 2017

Ethiopia is among the thirty-high tuberculosis (TB) burden countries with multidrug resistant tuberculosis (MDR-TB) and Tuberculosis/Human Immunodeficiency Virus (TB/HIV). Given the public health importance of the problem, it is apparent that probing the work done in this regard is essential to mitigate the problem and thus we reviewed research repositories and compile directories of researches in Ethiopia from Jan 1, 2001 to Dec 30, 2017 in order to avail evidence-based information to stakeholders and beneficiaries intervening the problem in the country. The evidences generated in this bibliography are through different databases and websites using key terms. A range of different published and unpublished literatures (journal articles, conference presentations, reports/manual/book, and graduate theses or dissertations) on TB, MDR-TB, extensively drug resistant TB (XDR-TB), or TB/HIV are presented. We presented literatures by four themes (Biomedical and clinical researches, epidemiological researches, operational or implementation researches, and health systems researches). A total of 1571 researches and reports were accessed through the above search engines and revealed 635 epidemiological researches followed by 538 clinical or biomedical researches, 257 operational or implementation research, and 141 health systems research. Interestingly, up to 2008 clinical or biomedical researchers were the leading researches and from 2009 onwards, epidemiological researches held the largest constituency. In conclusion, TB or TB/HIV and MDR-TB literatures in Ethiopia have substantially increased over years. Referred journal publications took theleading source and epidemiologic studies were the commonest one. We suggest the need to focus on operational or implementation and health system researches to plummet the disease spreading, drug resistance and impact. We also recommend a regular update of the bibliography every 3 to 4 years with annotations

A Facility-Based Study of the Impact of COVID-19 on Supply Chain Performance of HIV/AIDS Commodities in Anambra State, Nigeria

The COVID-19 pandemic and its induced lockdown resulted in huge disruptions that affected access to and availability of healthcare commodities at different levels of the supply chain system. An understanding of the pandemic impact in different areas will help in designing strategies to mitigate future disruptions. This study was designed to evaluate the supply chain performance of HIV/AIDS commodities through the review of key performance indicators in health facilities in Anambra State, Nigeria, during the COVID-19 pandemic lockdown. A facility-based cross- sectional study was conducted across 27 selected health facilities in the state. Facilities were selected using a stratified random sampling technique. Data was collected using a combination of a semi-structured questionnaire and observational checklists adapted from a previous study and the Logistics Indicators Assessment Tool (LIAT). Data obtained were analyzed using SPSS software (version 23). A total number of 44 focal personnel managing the HIV/AIDS supply chain in 17 secondary health centres (SHCs) and 10 primary health centres (PHCs) participated in the study. Tenofovir/Lamivudine/Dolutegravir (300/300/50mg) and Nevirapine 10mg/ml oral suspension were the two most available drugs at 85.19% and 78% respectively whereas Determine and Uni-Gold were the most available non- drug commodities at 92.59%, and 81.48% respectively during the lockdown period. The Stat-Pak test kit was stocked out in 30% of the facilities during the lockdown with emergency orders of at least one HIV commodity recorded in 37% of the facilities during this period. Expired products were recorded in 48% of the health facilities and this amounted to a loss of USD 4,027.25. The COVID-19 crisis exposed vulnerabilities in Anambra State's HIV/AIDS commodity supply chain. Instances of emergency orders, stock-outs, and wastage highlight the need for a more resilient system. Investing in an agile supply chain is crucial for ensuring uninterrupted access to essential healthcare commodities during disruptions

Bibliography on HIV/AIDS in Ethiopia and Ethiopians in the Diaspora: The 2013 Update

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Análisis sobre la baja de productos farmacéuticos, dispositivos médicos y sanitarios del CENARES – MINSA, 2021

El presente estudio titulado Análisis sobre la baja de productos farmacéuticos, dispositivos médicos y sanitarios del CENARES – MINSA, 2021, tiene como objetivo: Determinar los factores que influyen en la baja de los productos farmacéuticos, dispositivos médicos y sanitarios del CENARES-MINSA, 2021. Estudio de tipo básico, diseño no experimental, de corte transversal, de nivel descriptivo, correlacional y enfoque cuantitativo. Con una muestra de 75 colaborares (personal profesional y técnico). Para la recolección de información se utilizó como instrumento al cuestionario, conformado por 41 ítems y validados por 3 expertos, quienes estuvieron de acuerdo de que el instrumento es factible y aplicable. Se utilizó el indicador estadístico Alfa de Cronbach; siendo el valor mínimo aceptable para el coeficiente alfa de Cronbach el 0.70, por lo que, al tener un estadístico de 0.971, se considera una fiabilidad excelente del instrumento. Como resultado se aprecia que el nivel de significancia (0.000) es menor a 0.05, afirmando que existe asociación entre las variables “Baja” y “Productos farmacéuticos, dispositivos médicos y sanitarios”. Según el coeficiente de correlación, con un valor cercano a 1 (0.687), el grado de relación es media alta y positiva

The major Ethiopian milksheds : an assessment of development potential

The development potential of 8 milksheds in Ethiopia was assessed and ranked for potential for value chain development, as part of the MIDD project. Major criteria for ranking were market potential, production potential, presence of services, and commercialization level of the value chain. Highest ranking milk sheds were Addis Abeba, Adama-Asella, and Bahir Dar–Gondar milksheds

Brucellosis in Ethiopia: epidemiology and public health significance.

ABSTRACT Brucellosis is a common bacterial zoonotic disease that has important veterinary and public health concerns and economic impact in Sub-Saharan Africa including Ethiopia. A cross-sectional study was conducted in Addis Ababa Dairy farms and four selected districts of Borena Pastoral setting in Southern Ethiopia from November 2016 to February 2018 to estimate the prevalence of brucellosis and associated risk factors in cattle, sheep and goats and occupationally associated humans. A total of 2300 cattle, 882 small ruminants and 341 humans were serum sampled and serially tested for antibody against Brucella infection using Rose Bengal Test for screening and further confirmed by Competitive-Enzyme Linked Immunosorbent Assay. The overall individual animal level seroprevalence was 0.06 % (95% CI: 0.002 -0.4) in commercial dairy cattle in Addis Ababa, 2.4 % (CI: 1.4-3.7) in cattle, and 3.2 % (CI: 2.1-4.6) in small ruminants; both in Borena pastoral region, Southern Ethiopia. The seroprevalence recorded in humans occupationally linked to livestock production systems in Borena was 2.6 % (CI: 1.2-5). Herd size, parity, and history of abortion were risk factors associated with Brucella seropositivity (p<0.05) in cattle whereas in small ruminants the results show that district, age group, flock size, and history of abortion were found to be significantly associated risk factors with Brucella infection (P<0.05). The risk factors for Brucella infection in humans were assisting in calving and presence of seropositive animals at household (p<0.05). Existence of more than one seroreactor animal species in some villages in Borena indicates more credence to the possibility of cross-species transmission of Brucella infections. Human seropositivity in the households with seropositive animals provides evidence of a public health hazard. In addition, an outbreak investigation of abortion at Adami Tullu Agricultural Research centre, central Ethiopia, was made to isolate and characterise the causative agents using cultural and molecular tools. Fifteen Brucella abortus were isolated from various tissue samples and vaginal swabs collected during postmortem examination of seropositive animals in the centre. The B. abortus isolates and two B. melitensis previously isolated from vaginal swab of goats with history of abortion were whole genome sequenced (WGS). Subsequent phylogenetic analysis involved whole genome SNPs,core-genome SNPs, and in silico analysis of Multilocus Sequence Typing and Multiple Loci Variable Number of Tandem Repeats to characterise and determine global clustering of Ethiopian isolates. The result indicated that the B. abortus isolates from the outbreak were distinct and there were eight genotypes comprising single, double and triple locus variants circulating in the centre. Panel 1 and Panel 2A markers in MLVA-16 typing displayed no diversity among the neotypes suggesting that these are an early branching genotypes of the same strain. The core-genome phylogeny revealed that Ethiopian B. abortus form a distinct African clade branching basally with isolates previously described from Mozambique and Kenya. This clade was previously represented by only a small number of isolates, and thus the placement of Ethiopian B. abortus from the current study within this group substantially increases the representation of these basal B. abortus strains in genomic databases. On the other hand, B. melitensis isolates fall into a distinct African cluster with most isolates from Eastern African countries such as Somalia, Kenya, Eritrea, and Tanzania. The first isolation and molecular characterisation of circulating Brucella species in Ethiopia is a crucial step in planning and designing intervention strategies in the country. A coordinated One Health approach involving active involvement of human and animal health efforts to enhance public health and improve livestock productivity is recommended