Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population

Medicinal plant knowledge of the Bench ethnic group of Ethiopia: an ethnobotanical investigation

<p>Abstract</p> <p>Background</p> <p>Plants have traditionally been used as a source of medicine in Ethiopia since early times for the control of various ailments afflicting humans and their domestic animals. However, little work has been made in the past to properly document and promote the knowledge. Today medicinal plants and the associated knowledge in the country are threatened due to deforestation, environmental degradation and acculturation. Urgent ethnobotanical studies and subsequent conservation measures are, therefore, required to salvage these resources from further loss. The purpose of the present study was to record and analyse traditional medicinal plant knowledge of the Bench ethnic group in Southwest Ethiopia.</p> <p>Methods</p> <p>Semi-structured interviews were conducted with Bench informants selected during transect walks made to houses as well as those identified as knowledgeable by local administrators and elders to gather data regarding local names of medicinal plants used, parts harvested, ailments treated, remedy preparation methods, administration routes, dosage and side effects. The same method was also employed to gather information on marketability, habitat and abundance of the reported medicinal plants. Purposive sampling method was used in the selection of study sites within the study district. Fidelity Level (FL) value was calculated for each claimed medicinal plant to estimate its healing potential.</p> <p>Results</p> <p>The study revealed 35 Bench medicinal plants: 32 used against human ailments and three to treat both human and livestock ailments. The majority of Bench medicinal plants were herbs and leaf was the most frequently used part in the preparation of remedies. Significantly higher average number of medicinal plants was claimed by men, older people and illiterate ones as compared to women, younger people and literate ones, respectively. The majority of the medicinal plants used in the study area were uncultivated ones.</p> <p>Conclusion</p> <p>The study revealed acculturation as the major threat to the continuation of the traditional medical practice in the study area. Awareness should, therefore, be created among the Bench community, especially the young ones, by concerned organizations and individuals regarding the usefulness of the practice.</p

Traditional medicinal plant knowledge and use by local healers in Sekoru District, Jimma Zone, Southwestern Ethiopia

The knowledge and use of medicinal plant species by traditional healers was investigated in Sekoru District, Jimma Zone, Southwestern Ethiopia from December 2005 to November 2006. Traditional healers of the study area were selected randomly and interviewed with the help of translators to gather information on the knowledge and use of medicinal plants used as a remedy for human ailments in the study area. In the current study, it was reported that 27 plant species belonging to 27 genera and 18 families were commonly used to treat various human ailments. Most of these species (85.71%) were wild and harvested mainly for their leaves (64.52%). The most cited ethnomedicinal plant species was Alysicarpus quartinianus A. Rich., whose roots and leaves were reported by traditional healers to be crushed in fresh and applied as a lotion on the lesions of patients of Abiato (Shererit). No significant correlation was observed between the age of traditional healers and the number of species reported and the indigenous knowledge transfer was found to be similar. More than one medicinal plant species were used more frequently than the use of a single species for remedy preparations. Plant parts used for remedy preparations showed significant difference with medicinal plant species abundance in the study area

Do ethnobotanical and laboratory data predict clinical safety and efficacy of anti-malarial plants?

<p>Abstract</p> <p>Background</p> <p>Over 1200 plant species are reported in ethnobotanical studies for the treatment of malaria and fevers, so it is important to prioritize plants for further development of anti-malarials.</p> <p>Methods</p> <p>The “RITAM score” was designed to combine information from systematic literature searches of published ethnobotanical studies and laboratory pharmacological studies of efficacy and safety, in order to prioritize plants for further research. It was evaluated by correlating it with the results of clinical trials.</p> <p>Results and discussion</p> <p>The laboratory efficacy score correlated with clinical parasite clearance (r_s=0.7). The ethnobotanical component correlated weakly with clinical symptom clearance but not with parasite clearance. The safety component was difficult to validate as all plants entering clinical trials were generally considered safe, so there was no clinical data on toxic plants.</p> <p>Conclusion</p> <p>The RITAM score (especially the efficacy and safety components) can be used as part of the selection process for prioritising plants for further research as anti-malarial drug candidates. The validation in this study was limited by the very small number of available clinical studies, and the heterogeneity of patients included.</p

Prevalence and Predictors of Inappropriate Medications Prescribing Among Elderly Outpatients at a University Hospital in Northwestern Ethiopia: A Retrospective Cross-Sectional Study

A cross-sectional study was conducted at Gondar university referral hospital from 10th of February to 5th of March 2012 using retrospective data on the diseases and medications from medical records of 392 elderly outpatients aged 60 years or older. Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer’s criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, respectively. Statistical analyses done included binary logistic regression using SPSS version 16. The results indicated that anti-infectives were the most commonly prescribed medications. Average number of medications per patient was 1.63 and antibiotics were prescribed during 35.5% of patient encounters. Among the 255 patients aged 65 years or older, 25 (9.8%) were prescribed potentially inappropriate medications based on 2002 Beers criteria. Among the 189 patients prescribed with two or more medications, 47 (24.9%) encountered at least one potential drug-drug interaction. Number of medications and diagnosis with hypertension were significant predictors of potentially inappropriate medication and presence of drug interactions. Based on WHO's prescribing indicators, the pattern of prescribing was generally acceptable except for high prescription of antibiotics. However, considerable proportion of cases of prescribing of potentially inappropriate medications and those with potential drug-drug interactions were documented in this study.Keywords: Beers list/criteria, drug-drug interaction, elderly, prescribing pattern, Ethiopi

Epidemiology of antibacterial drug resistance in northern Ethiopia

Antibacterial drug resistance is a worldwide problem. The situation in developing countries like Ethiopia is particularly serious. Since the presence of drug resistant bacteria in the environment is a threat to public health, updated information on local bacterial isolates and drug sensitivity patterns is very crucial for evidence based treatment decisions. This cross-sectional retrospective survey on antibacterial drug resistance was, therefore, conducted to determine the extent of antibacterial drugs resistance in northern Ethiopia. The results of specimens collected and tested in Mekelle Regional Microbiological Laboratory from 2001 to 2005 were analyzed. The most commonly isolated Gram-negative bacteria were Escherichia coli 580 (52.7%) followed by Pseudomonas aeruginosa 139 (12.6%) and Pseudomonas mirabilis 77 (7.0%); while from Gram-positive bacteria, Staphylococcus saprophyticus 643 (63.8%) and Staphylococcus aureus 249 (24.9%) were predominant. The resistance rate of E. coli, S. aureus and S. saprophyticus to ampicillin were 89.0%, 89.0% and 92.3%, respectively. The same group of bacterial isolates showed resistance to cotrimoxazole at the rate of 76.0%, 82.3% and 89.0%, while for tetracycline it was 87.0%, 85.9% and 92.7%, respectively. This study indicated an alarmingly high rate of resistance among bacterial isolates to commonly used antibacterial drugs in the Region. Thus rational use of drugs should be practiced and modifications of empirical therapy should be done through periodic monitoring of the resistance profiles of bacterial isolates to antibacterial drugs.Keywords: epidemiology, antibacterial, resistance, Tigray, Northern Ethiopi

Quality of Pharmacy Services in Government Hospitals in Addis Ababa, Ethiopia

Quality of pharmaceutical services can be measured at the levels of the structure, process and outcome. Although quality assessments of pharmaceutical services are common in many parts of the world, there is limited information on the quality of hospital pharmacy services in Ethiopia. This study attempted to assess the structural and process aspects of pharmaceutical services in hospitals in Addis Ababa. A  descriptive cross sectional survey of the pharmacy units of selected hospitals in Addis Ababa was conducted between August and December, 2009 using mixed method (qualitative and quantitative). A total of nineteen pharmacy units in the six hospitals were studied for structural quality. Deficiencies were observed with most of the structural aspects. Simple dispensing aids like tablet counting tray were absent in 8 (42.1%) of the pharmacy units and all had inadequate space for different purposes especially for storage of pharmaceuticals. The documentation and implementation of therapeutic objectives and monitoring plan aspects of pharmaceutical care were the most underperformed domains by the pharmacy professionals. The majority of pharmacy professionals (68.6%) never participated in ward rounds and the major reason for this was reported to be absence of in-built system in the hospital for the involvement of pharmacists in ward rounds. This study generally showed that there is a low level of quality of pharmacy services in the studied hospitals with respect to the availability of important materials, space and the involvement of pharmacy professionals in pharmaceutical care.Keywords: quality, pharmaceutical care, government hospitals, Addis Ababa, Ethiopi

Knowledge About Malaria, and Coverage and Utilization Pattern of Mosquito Nets in Pawe Woreda, Northwest Ethiopia: A Community Based Survey

Malaria is a major public health problem and the leading communicable disease in Ethiopia. Interruption of contact between humans and mosquitoes through the use of insecticide-treated mosquito nets (ITNs) is an encouraging approach to protect people from malaria infection. This paper reflects on how people in an area of seasonal malaria, perceive the cause and transmission of the disease, and also assesses the coverage and utilization pattern of long-lasting insecticidal mosquito nets (LLINs) in Pawe special District, Beneshangul-Gumuz National Regional State, Northwest Ethiopia. Both a cross-sectional household survey using a pre-tested interviewer administered semi-structured questionnaire and qualitative methods, including focus group discussions (FGDs) and key-informant interviews were employed in the data collection. Data were collected primarily from mothers. Although the study revealed that the Pawe community largely believes malaria to be preventable, the majority of the respondents could not correctly answer the cause, transmission and diagnosis methods of malaria. The survey also showed that 427 (98.8%) respondents reported to own at least one mosquito net. In conclusion, it is recommended that efforts on the prevention and control of malaria should be enhanced by increasing awareness of the community about the correct cause; transmission and diagnosis methods; appropriate utilization of mosquito nets, and on the nature of LLINs.Keywords: malaria, insecticide-treated mosquito nets, utilization pattern, Beneshangul-Gumuz, Northwest Ethiopi

Assessment of Knowledge, Attitude and Practice about Tuberculosis and its Treatment Among Patients and Community in East Shoa Zone, Oromyia Regional State, Ethiopia

Good public understanding of tuberculosis (TB), its cause, signs and symptoms, mode of transmissions and treatment is considered to be important for prompt health care seeking, adherence to treatment and reduction of stigma associated with the disease. The present study was conducted to assess the knowledge, attitude and practices (KAP) of household heads and TB patients about TB and its treatment. A crosssectional survey where the KAP of the community and TB patients was carried out using an interviewer administered questionnaire and exit interview, respectively. Six rural and one urban Kebeles from Lume Woreda, and two hospitals and four health centres in East Showa Zone, Oromia Regional State, Ethiopia were included in the study. Among 614 household heads interviewed, 31.0% knew that TB is caused by germs; 14.7% mentioned that ventilating the living room as a means to prevent TB; 33.0% believed that TB patients must always be admitted for treatment and 39.9% knew that Anti-TB drugs are freely dispensed. Traditional medicine and use of holy water were mentioned by 20.8% and 22.6% of the respondents respectively, as a cure for TB. Of 170 TB patients interviewed, 30.6% reported to have first visited private health institutions before they resorted to government health facilities; only 18.5% were under direct observation of health providers while swallowing anti-TB medicaments during the first two months of treatment. Around 53% of the patients reported that they were given adequate information about side effects of anti-TB drugs. The study revealed the need for basic health education especially in rural Ethiopia. Erroneous beliefs about traditional medicine and holy water should be changed through appropriate health education. Regular supportive supervision and on-the-job training programmes are required to improve patient support by the health workers in the studied areas.Key words: knowledge, attitude, practice, tuberculosis, East Sho

Ethnopharmaceutical Study of Medicinal Plants of Metekel Zone, Benishangul-Gumuz Regional State, Mid-West Ethiopia

Traditional medicine (TM) has been an important source of healthcare in Ethiopia, as in most developing countries around the world, and the TM practice is mainly based on medicinal plants. This cross-sectional, community-based survey was aimed at documenting the knowledge associated with the use of medicinal plants in the Benishangul-Gumuz Region. Six hundred households (HHs) were interviewed using semistructured questionnaires and six focused group discussions (FGDs) were conducted. Prevalence of illness episodes was 5.2%, in two weeks recall period and the overall action taken for the perceived illness was 95.7%; out of which 41.6% used TM. TM was a more frequent choice of care for females than males and for the Gumuz people than the other ethnic groups. Low cost, efficacy and geographical accessibility were the reasons for choosing TM. Fifty-one plant species belonging to 29 families were reported, each with local and scientific names, parts used, and methods of preparation and administration. Malaria and headache, and respiratory complaints have the highest informant consensus factor (ICF) values. The major proportion of plants was collected from wild sources and leaf and root parts were commonly used. The formulations were made in the form of liquids, raw herbs and pastes in order of frequency. The dominant route of administration was oral, followed by topical application. This study demonstrated that TM is still an important component of the public healthcare in the study community.Keywords: ethnopharmacy, medicinal plants, traditional medicine, house-hold, focus group discussio