Assessment of community pharmacy professionals’ knowledge and counseling skills achievement towards headache management : a cross-sectional and simulated-client based mixed study

We would like to thank the study participants for their valuable information and time.Peer reviewe

A cross sectional study on beliefs and roles of community pharmacy professionals in preventing and managing metabolic syndrome in an Ethiopian setting.

IntroductionMetabolic syndrome (MetS) is a group of cardiovascular risk factors, and its prevalence is becoming alarmingly high in Ethiopia. Studies uncovered as community pharmacy professionals (CPPs) have not yet well integrated into public health programs and priorities. In low income setting like Ethiopia, evidence regarding the roles CPPs in preventing and management of MetS is dearth.ObjectiveThe study was aimed to assess community pharmacy professionals'(CPPs) opinions about metabolic syndrome, describe their perception level towards the effectiveness of the main interventions and explore their extent of involvement in counseling patients with the metabolic syndrome in Gondar town, Northwestern Ethiopia.MethodA descriptive, cross-sectional study was conducted among pharmacists and druggists working in community medication retail outlets (CMROs) in Gondar town, northwestern Ethiopia from April 1 to May 31, 2019. Data were collected using a self-administered pre-tested questionnaire. Descriptive statistics was used to summarize different variables, and presented in tables and figure. An independent t-test and one way ANOVA (Analysis of Variance) were used to compare mean scores. A 5% level of significance was used.ResultOut of the 75 CPPs approached, 65(40 pharmacists and 25 druggists) completed the survey giving a response rate of 86.7%. Smoking cessation practice was identified to be low. There were a statistically significant difference (t = 2.144, P = 0.036) in the involvement towards counseling patients between CPPs who claimed to work in pharmacy (mean = 3.96 out of 5 points Likert scale) and drug stores (mean = 3.80 out of 5 points Likert scale).ConclusionThe study concluded that the overall involvement of professionals in counseling patients, opinion about metabolic syndrome, and perception towards the effectiveness of the intervention was found to be more or less positive. However, the provision of services, such as monitoring therapy, selling equipment for home blood pressure and glucose monitoring and documenting patient care services needs to be encouraged. Given proper education and training, the current study hope that community pharmacists could be an important front-line contributors to contain this emerging epidemic in Gondar town as well as in the entire nation

Pesticide Residue Analysis of Khat Leaves and Health Risks among Khat Chewers in the Amhara Region, Northwestern Ethiopia

Introduction. Farmers use a large number of pesticides to increase the productivity of Khat cultivation. Since Khat is consumed by many Ethiopians as a habit, there may be a significant concentration of pesticide residues in Khat leaves which result in adverse effects among the exposed population. Excess use of pesticides in Khat causes cancer, genotoxicity, and endocrine disturbances. The current study aimed to determine the concentration of selected pesticide residues on Khat leaves samples and to estimate the possible health risk on consumers. Methods. Thirty Khat samples were collected from Khat cultivators in the Amhara region, Ethiopia. Pesticide residue extraction and cleanup of Khat samples were performed using the QuEChERS method. Data were also collected about personal variables and Khat consumption habits. The pesticide concentrations were determined and the health risks were estimated. Results. Profenofos, dimethoate, and chlorpyrifos were detected in 6 (20%), 24 (80%), and 28 (93.3%) Khat samples, respectively. However, diazinon was detected in two samples and endosulfan I was not detected. The average concentration of chlorpyrifos, dimethoate, profenofos, and diazinon in Khat samples was 75.39 ± 20.26, 130 ± 48.94, 242.45 ± 119.79, and 81.5 ± 21.0 μg/kg, respectively. The HQ for diazinon was greater than 1 which shows the chronic health risks associated with intake of diazinon among Khat chewers. The acute health risks associated with intake of profenofos and diazinon were minimal. Discussion. Pesticide residue exposure is a risk factor for cardiac complications, reduction in antioxidant defense system, and developing neurological symptoms. All the pesticides were higher than the European Union Maximum Residue Levels (EU-MRL). Diazinon has the potential to cause higher chronic health risks. Chronic Khat chewers in the region may face potential health risks from pesticide residues. Awareness creation among people in the study area is necessary to avoid the adverse health effects of pesticide residues

Depression, Anxiety, Stress, and Associated Factors among Khat Chewers in Amhara Region, Northwest Ethiopia

Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem

Perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, Northwest Ethiopia

Introduction: The cause of schizophrenia could be a genetic predisposition, environment, viral infections, exposure to poison substances, living in a highly-populated area, and prenatal exposure to hunger mainly in the first three months. Evidence showed that the perceived cause of schizophrenia is supernatural, biological, spiritual, and social causes. Studies in Ethiopia showed that most of the general population perceived the causes of schizophrenia as traditional and the help they seek ranges to medical, religious, and social. Objective: This study aimed to assess perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, 2020 Methods: A community-based cross-sectional study was conducted from December 3 to 25, 2020. A simple random sampling technique was employed to select 435 study participants. Data were collected through a face-to-face interview, entered into EPI DATA version 3, and analyzed using SPSS version 21. Bivariable and multivariable binary logistic regression analyses were employed to identify factors significantly associated with help-seeking behavior for schizophrenia. Statistical significance was declared at p-value < 0.05 with 95% confidence interval. Results: Nearly two-thirds (63.8%), the majority (90.8%), and more than half (52.5%) of the participants seek medical, religious, and social help for schizophrenia respectively. Being student (AOR = 3.43; 95% CI: 1.44, 8.15), unemployed (AOR = 4.87; 95% CI: 1.4, 16.40), perceived biological cause (AOR = 1.7; 95% CI: 1.01, 2.89), perceived religious cause (AOR = 0.48; 95% CI: 0.29, 0.80), and perceived social cause (AOR = 2.05; 95% CI: 1.29, 3.25) were significantly associated with medical help seeking. Attending primary school (AOR = 0.17; 95% CI: 0.04, 0.76), employed (AOR = 0.12; 95% CI: 0.02, 0.64), perceived religious cause (AOR = 2.34; 95% CI: 1.06, 5.11) were significantly associated with religious help. Being in the age group of 18–24 years (AOR = 3.5; 95% CI: 1.33, 9.18) and 25–44 years (AOR = 1.94; 95% CI: 1.03, 3.68) were significantly associated with social intervention. Conclusion: Nearly two-thirds, the majority, and more than half of the respondents seek medical, religious, and social help for schizophrenia respectively. Being student, unemployed, perceived biological case, and perceived social cause increases the odds of seeking medical help while perceived religious cause decreases it. Being unemployed, attending primary school decreases the odds of seeking religious help whereas perceived religious cause increases it. Young adults have higher odds of social help-seeking behavior. It is better to create awareness for the community and consider integrating religious and social interventions into medical interventions

Assessment of community pharmacy professionals’ knowledge and counseling skills achievement towards headache management: a cross-sectional and simulated-client based mixed study

Background Headache is one of the most common disabling medical condition affecting over 40% of adults globally. Many patients with headache prefer to alleviate their symptom with a range of over-the-counter analgesics that are available in community medicine retail outlets (CMROs). However, data regarding how community pharmacists respond to headache presentation and their analgesic dispensing behaviors in Ethiopia is scarce. The present study aimed to assess the self-reported and actual practice of community pharmacists toward management of a headache in Gondar town, Ethiopia. Methods A dual-phase mixed-methods research design, including pseudo-client visits (between April 1 and 30, 2018) followed by a questionnaire-based cross-sectional study (between May 1 and 20, 2018) was conducted among CMROs in Gondar town, Ethiopia. Results Among the 60 pseudo-client visits, 95% of them dispensed medications. The overall counseling approach was found to be 42.6% which improved to 58.3% when the pseudo-clients demanded it. Duration (73.3%) and signs/symptoms (45%) of headache were asked before dispensing the medications. Dosing frequency (86.7%), indication (60%) and dosage form (35%) were the most discussed items. Ibuprofen (45%) and diclofenac (41.5%) were primarily added to paracetamol for better headache treatment. Effectiveness (61.7%) and cost (21.7%) were the main criteria to choose drugs. In the cross-sectional survey, 60 participants were requested and 51 of them agreed to participate (response rate of 85%). Of these participants, 64.7% agreed that managing headache symptomatically is challenging. Patient lack of confidence in dispensers (41.2%) and lack of updated medical information (31.4%) were reported as the primary barriers to counsel clients. Conclusion This study demonstrated the practical gaps in counseling practices and poor headache management of community pharmacies in Gondar city. National stakeholders in collaboration with academic organizations should be involved in continuous clinical training and education regarding proper counseling practices