Oumer Sada Muhammed

Objective: This study aimed to assess health-related quality of life (HRQoL) and identify associated factors among patients with chronic obstructive pulmonary disease (COPD) attending selected hospitals in Addis Ababa, Ethiopia. Design and setting: A hospital-based multicentre cross-sectional study was conducted among 205 patients with COPD attending the chest clinics of selected hospitals in Addis Ababa, Ethiopia, from June 2023 to December 2023. Participants: A total of 205 patients with COPD who had follow-up at outpatient departments of the chest clinic of the selected hospitals were included in the study. Main outcome measures: The main outcome of this study was HRQoL, which was assessed using the validated COPD Assessment Test-Amharic version (CAT-Am). Data analysis was performed using Stata version.17, and multivariable linear regression was employed to examine the relationship between HRQoL and independent variables. Variables with p-values <0.05 at a 95% CI were considered statistically significant. Results: The mean score of the overall CAT-Am was 20.24±8.13. Older age (β=0.11, 95% CI: 0.04 to 0.17), poor social support (β=2.49, 95% CI: 0.74 to 4.24), biomass fuel exposure (β=4.57, 95% CI:3.17 to 5.97), Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 2, 3 and 4 (β=2.12, 95% CI: 0.23 to 4.01; β=3.38, 95% CI: 1.11 to 5.66; β=5.20, 95% CI: 2.37 to 8.05, respectively), presence of comorbidity (β=4.03, 95% CI: 2.48 to 5.59), increased number of hospitalisations in the past year (β=2.78, 95% CI: 1.68 to 3.88), increased number of prescribed medications (β=0.40, 95% CI: 0.10 to 0.70), low medication adherence (β=2.79, 95% CI: 1.13 to 4.46), and moderate medication adherence (β=3.38, 95% CI: 1.65 to 5.11) were negatively associated with HRQoL. Conclusion and recommendations: In this study, patients with COPD had poor HRQoL, which indicates that patients need multidisciplinary interventions. Older age, poor social support, an increased number of prescribed medications, an increased number of hospitalisations in the past year, biomass fuel exposure, low and moderate medication adherence, GOLD severity stages 2, 3 and 4, and the presence of comorbidities require close follow-up to improve HRQoL. Further research should evaluate targeted strategies to address these determinants.

Background: Antimicrobial resistance (AMR) is a critical global health threat, particularly in low- and middle-income countries (LMICs). In Ethiopia, high infectious disease burdens, unregulated antimicrobial access, and low awareness exacerbate inappropriate use, accelerating AMR. While microbiological aspects of AMR are studied, behavioral and sociocultural factors influencing antimicrobial use remain underexplored. This study investigates these factors in Addis Ababa to inform strategies for mitigating AMR and improving public health outcomes. Methods: This qualitative study, conducted from April to May 2025 in Addis Ababa, Ethiopia, involved 25 in-depth interviews with patients and the general public across five public health facilities and three community pharmacies. Participants were selected using purposive and convenience sampling techniques. Semi-structured interviews, explored behavioral and sociocultural determinants of antimicrobial use. A codebook was refined iteratively by two coders to ensure consistency. Data were audio-recorded, transcribed, and analyzed using Dedoose software through thematic analysis. Ethical approval was obtained, and confidentiality was maintained throughout. The identified themes were linked with Theoretical domains framework domains to enhance the depth of understanding. Results: Five key themes emerged: limited knowledge and misconceptions about antimicrobials, with many viewing them as universal cures; prevalent self-medication and non-prescription use, driven by accessibility and trust in pharmacists; varied healthcare-seeking behaviors, influenced by trust and logistical barriers; sociocultural influences, including peer advice and traditional beliefs combining antibiotics with remedies; and structural and economic barriers, such as limited healthcare access and high costs, promoting misuse. These factors, rooted in knowledge gaps, cultural norms, and systemic weaknesses, contribute significantly to inappropriate antimicrobial use and AMR. Conclusion: The study highlights how misconceptions, self-medication, sociocultural norms, and structural barriers drive inappropriate antimicrobial use in Addis Ababa, exacerbating AMR. Multifaceted interventions are needed, including community education to address knowledge gaps, stricter prescription regulations, improved healthcare access through expanded insurance and clinics, and engagement with cultural leaders to align practices with evidence-based use. These strategies can mitigate AMR while ensuring equitable access to effective treatments, addressing both behavioral and systemic challenges.

Antimicrobial resistance (AMR) is a critical global health threat, exacerbated by inappropriate dispensing practices. Despite efforts to improve antimicrobial stewardship, behavioral determinants influencing antimicrobial dispensing remain understudied, particularly in low-resource settings like Ethiopia. This study was aimed to explore the behavioral drivers of antimicrobial dispensing among pharmacy professionals working at community drug retail outlets of Addis Ababa. This convergent, parallel mixed-methods study was conducted in three randomly selected sub-cities of Addis Ababa from March to May 2025. The quantitative component addressed the prevalence and predictors of dispensing behavior, surveying 240 pharmacy professionals selected via multi-stage sampling from 120 drug retail outlets. Data were collected using digital (Google Forms) and paper-based questionnaires, measuring TDF-based behavioral determinants and dispensing behavior. Participants were pharmacists and druggists with at least three months of dispensing experience, selected from private pharmacies and drug stores. Hierarchical multiple regression and confirmatory factor analysis were performed using SPSS and AMOS. The qualitative component explored contextual nuances through in-depth interviews with 16 professionals until thematic saturation, analyzed using Dedoose software with a thematic approach, without a predefined framework to allow free expression of feelings. Data quality was ensured through pre-testing, digital validation, and transcription cross-checking. Quantitative findings revealed inappropriate dispensing in 53.75% of cases (129/240). One-sample t-tests showed significant positive deviations for most TDF domains (p < .001), except environmental context (p = .642). Hierarchical regression indicated demographic and behavioral factors explained 62% of dispensing behavior variance, with age (β = 0.630, p < .001), female gender (β = 0.343, p < .001), and behavioral factors; (Professional Role and Self-Regulation: β = 0.456, p < .001; Emotional and Social Dynamics: (β = 0.359, p < .001)) as positive predictors, while Skills and Belief Systems (β=-0.431, p < .001) and experience (≥ 5 years) negatively predicted appropriate dispensing (β=-0.304, p < .001). Qualitative insights highlighted systemic barriers, including patient pressure, profit motives, and weak regulatory enforcement, which often overrode professional knowledge. Triangulation revealed that while pharmacists understood guidelines, workplace pressures and financial incentives drove non-compliance. Inappropriate antimicrobial dispensing was prevalent and significantly influenced by key determinants: longer experience negatively predicted appropriate dispensing, while female gender positively predicted it. Behavioral factors, particularly social and commercial pressures like patient demand and competition, were stronger drivers than knowledge alone.

Achieving optimal glycemic control is vital for managing diabetes mellitus and preventing its complications, yet it is particularly challenging for individuals with diabetes and concurrent chronic kidney disease. Chronic kidney disease disrupts glucose metabolism and excretion, leading to pronounced and variable blood glucose fluctuations, thereby complicating diabetes management. So far, the intricate impact of chronic kidney disease on the glycemic control status of diabetic patients remains obscure, especially in Sub-Saharan Africa where both diseases pose an escalating burden. This study aimed to assess prescription patterns, glycemic control status, and the contributing factors to poor glycemic control among diabetic patients with comorbid chronic kidney disease at Tikur Anbessa Specialized Hospital, Ethiopia. A facility-based cross-sectional study was conducted from March 15 to May 15, 2024, from the electronic medical records of diabetic patients with comorbid chronic kidney disease who had received regular treatment and follow-up at the adult diabetes mellitus clinic of Tikur Anbessa Specialized Hospital. The sample size was calculated by using a single population proportion formula and accordingly, a total of 384 patients were recruited randomly and enrolled in this study. Descriptive statistics was employed for analyzing quantitative variables. Logistic regression analysis was performed to identify predictors of poor glycemic control status. Statistical significance was established at p-value < 0.05. This study found that 98.2% of patients had type 2 diabetes, with a mean diabetes duration of 16.36 years. Only 4.4% achieved good glycemic control (glycated hemoglobin [HbA1c] < 7%), while 95.6% had poor glycemic control (HbA1c ≥ 7%). Insulin, metformin, and sodium glucose cotransporter-2 (SGLT-2) inhibitors were the most frequently prescribed anti-diabetic drug classes which accounted for 80.2%, 59.1%, and 41.4%, respectively. Presence of hypertension (AOR: 3.70, 95% CI: 1.08–12.71, P = 0.038) and regimen change in the past 01year (AOR: 0.34, 95% CI: 0.11–1.01, P = 0.050) were predictors of poor glycemic control status. This study reveals significant challenges in glycemic control among diabetic patients with comorbid chronic kidney disease (CKD). With only 4.4% of participants achieving optimal HbA1c levels, the findings underscore a critical public health concern regarding the management of diabetes in this vulnerable population. Not applicable.

Background: Available studies showed that antidepressants (ATDs) and antipsychotics are most frequently associated with adverse effects (AEs), which account for ~90% of all AEs in the psychiatry department. These AEs can range from mild to serious or potentially lethal events and pose a significant threat to the physical and mental well-being of patients leading to decreased quality of life, reduced drug adherence, and increased healthcare costs. Objective: This study aimed to assess the prevalence of self-reported ATD-related AEs among patients attending the psychiatric outpatient department (OPD) at Tikur Anbessa Specialized Hospital (TASH), Ethiopia, and examine current monitoring practices and corrective measures undertaken. Method: A hospital-based cross-sectional study was conducted in the psychiatric OPD of TASH from 1 April 2023 to 30 May 2023. Descriptive analysis was done to summarize the quantitative data. Logistic regression analysis was performed to identify predictors of occurrence of ATD-related AEs. Results: The overall prevalence of self-reported ATD-related AEs was 51.3%. The two most reported classes of ATDs were selective serotonin reuptake inhibitors (52.8%) and tricyclic ATDs (47.2%). Across all the utilized ATDs, sedation (46.2%), dry mouth (31.4%), constipation (21.8%), and sexual dysfunction (18.6%) were the most frequently exhibited AEs. Alas, roughly 60.3% of patients have never been asked by healthcare providers about their AEs. When AEs occurred, only 21.2% of patients consulted healthcare professionals for genuine guidance and support. Old age (odds ratio (OR) = 2.84, 95% confidence interval (CI) 1.09–7.40), duration of treatment of >1 year (OR = 2.17, 95% CI 1.07–4.43), daily ingestion of more than five pills (OR = 3.82, 95% CI 0.99–14.76), presence of asthma (OR = 3.45, 95% CI 1.02–11.68), and taking other psychotropic agents (OR = 2.92, 95% CI 1.40–6.07) were significantly associated with the occurrence of ATD-related AEs. Conclusion: This study unveiled a high prevalence of AEs among patients taking ATDs. Advanced age, long treatment duration, daily ingestion of more than five pills, presence of asthma, and taking other psychotropic medications were predictors of ATD-related AE occurrence.

Lupus nephritis (LN) is kidney involvement of systematic lupus erythematous that ranges from mild to severe and occurs in 60% of adult patients. Despite advances in therapy, LN morbidity and mortality remains high. There is a paucity of data regarding adult LN patient's treatment outcome, survival status, and associated factors in developing countries, particularly in Ethiopia. This study aimed to assess the treatment outcome, survival status, and associated factors of adult patients treated for LN in two selected tertiary hospitals [Tikur Anbessa Specialized Hospital (TASH) and St. Paul’s Hospital Millennium Medical College (SPHMMC)] of Addis Ababa, Ethiopia. A hospital-based retrospective cross-sectional multicenter study was conducted from January 1, 2016 to January 1, 2021. Socio-demographic, clinical, and treatment-related data were collected from patient’s medical records by using a structured abstraction checklist. Descriptive statistics were used to summarize the quantitative data as appropriate. The modified Aspreva Lupus Management Study (mALMS) criteria was applied to categorize LN treatment outcomes into complete, partial, and non-response. Multinomial logistic regression analysis was performed to identify predictors of LN treatment outcome. Patients’ survival was estimated by using Kaplan–Meier and Cox proportion regression analysis. P value < 0.05 was considered to declare statistical significance. A total of 200 LN patients were included in the final analysis. Amongst these, the majority of them (91.5%) were females. The median age of the patients was 28 (15–60) years. The mean duration of treatment follow-up was 28 months. The commonly prescribed immunosuppressive drugs during both the induction (49.5%) and maintenance (60%) phases were a combination of mycophenolate mofetil with prednisolone. Complete, partial, and non-responses at the last follow-up visit accounted for 66.5%, 18.0%, and 15.5%, respectively. Patient survival at the last follow-up visit was more than 90% for patients with complete response to the induction therapy. Non-response at the last follow-up visit was significantly associated with severe disease activity index (adjusted odds ratio [AOR] = 6.25, 95% confidence interval [CI] 1.49–26.10), presence of comorbidity (AOR = 0.21, 95% CI 0.05–0.92), baseline leucopenia (AOR = 14.2, 95% CI 1.04–201.3), partial response at the end of induction therapy (AOR = 32.63, 95% CI 1.4–736.0), and duration of induction therapy of greater than 6 months (AOR = 19.47, 95% CI 1.5–258.8). This study unveiled that lower numbers of LN patients were presented with non-response at the last follow-up visit and non-response to induction therapy was associated with lower patients’ survival rates compared with complete or partial response.

Nascent studies showed that patients with chronic medical illnesses such as diabetes mellitus (DM) and HIV/AIDS are highly vulnerable to face both treatment burden and regimen fatigue. However, an attempt made so far in this sphere in sub-Saharan African health care context is dearth. Thus, this study aimed to determine the level of treatment burden and regimen fatigue of diabetic and HIV patients attending adult diabetic and ART clinics of TASH and explore patients’ and health care workers’ propositions to reduce treatment burden and regimen fatigue. An explanatory sequential mixed methods study was conducted at the adult HIV and DM clinics of TASH, Addis Ababa, Ethiopia from February 01-March 30, 2022. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic and linear regression analyses were performed to identify predictors of treatment burden and regimen fatigue, respectively. P value < 0.05 was considered statistically significant. Qualitative data was analyzed by using a thematic analysis. A total of 300 patients (200 diabetes and 100 HIV) were included in the quantitative study. For the qualitative study, 14 patients and 10 health care workers (six nurses and four medical doctors) were included. Participants' mean global Treatment Burden Questionnaire (TBQ) and Treatment Regimen Fatigue Scale (TRFS) score were 28.86 ± 22.13 and − 42.82 ± 17.45, respectively. Roughly, 12% of patients experienced a high treatment burden. The presence of two or more comorbidities (adjusted odds ratio [AOR] = 7.95, 95% confidence interval [CI] 1.59–39.08), daily ingestion of more than five types of prescribed medications (AOR = 6.81, 95%CI 1.59–29.14), and good knowledge about DM and/or HIV (AOR = 0.33, 95%CI 0.12–0.92) were predictors of treatment burden. Poor availability of medications (β = 0.951, p < 0.001) was the only predictor of regimen fatigue. Patients and health care workers primarily proposed to foster self-care efficacy, advance administrative services of the clinic and hospital, and improve healthcare system provision. The findings of this study unveiled that a considerable proportion of patients experienced low levels of treatment burden and regimen fatigue. This study showed that boosting the patients’ self-care efficacy, upgrading administrative services of the clinic and hospital, and promoting the healthcare system provision had enormous significance in reducing treatment burden and regimen fatigue. Therefore, when designing patient-specific healthcare interventions for both HIV and diabetic patients’ various factors affecting both treatment burden and regimen fatigue should be considered to achieve the desired goals of therapy.

Nascent studies showed that patients with chronic medical illnesses such as diabetes mellitus (DM) and HIV/AIDS are highly vulnerable to face both treatment burden and regimen fatigue. However, attempt made so far on this sphere in sub-Saharan African health care context is dearth. Thus, this study aimed to assess patients’ and health care workers’ propositions on how to decrease treatment burden and regimen fatigue among HIV and diabetes patients attending the ART and DM clinics of Tikur Anbessa Specialized Hospital (TASH). An explanatory sequential mixed methods study was conducted at the adult HIV and DM clinics of TASH, Addis Ababa, Ethiopia from February 01-March 30, 2022. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic and linear regression analyses were performed to identify predictors of treatment burden and regimen fatigue, respectively. P value < 0.05 was considered statistically significant. Qualitative data was analyzed by using a thematic analysis. A total of 300 patients (200 diabetes and 100 HIV) were included in the quantitative study. For the qualitative study, 14 patients and 10 health care workers (six nurses and four medical doctors) were included. Participants mean global Treatment Burden Questionnaire (TBQ) and Treatment Regimen Fatigue Scale (TRFS) score were 28.86 ± 22.13 and − 42.82 ± 17.45, respectively. Roughly, 12% patients experienced high treatment burden. The presence of two or more comorbidities (adjusted odds ratio [AOR] = 7.95, 95% confidence interval [CI]: 1.59–39.08), daily ingestion of more than five prescribed medications (AOR = 6.81, 95%CI: 1.59–29.14), and good knowledge about DM and/or HIV (AOR = 0.33, 95%CI: 0.12–0.92) were predictors of treatment burden. Poor availability of medications (β = 0.951, p < 0.001) was the only predictor of regimen fatigue. Patients and health care workers primarily proposed to foster self-care efficacy, advance administrative services of the clinic and hospital, and improve healthcare system provision. The findings of this study unveiled that considerable proportion of patients experienced low levels of treatment burden and regimen fatigue. This study showed that boosting the patients’ self-care efficacy, upgrading administrative services of the clinic and hospital, and promoting the healthcare system provision had enormous significance to reduce treatment burden and regimen fatigue. Therefore, when designing patient specific healthcare interventions for both HIV and diabetic patients’ various factors affecting both treatment burden and regimen fatigue should be taken into account.

Emerging evidences hypothesized that patients with heart failure are susceptible to experience treatment burden. Despite this fact, no attempt was made so far to address this neoteric construct in the sub-Saharan African health care context. Hence, this study aimed to assess patients’ and health care providers’ perspectives on how to decrease treatment burden among patients with heart failure attending the adult cardiac clinic of Tikur Anbessa Specialized Hospital (TASH). An explanatory sequential mixed methods study was conducted at the adult cardiac clinic of TASH, Addis Ababa, Ethiopia from August 01 to September 30, 2021. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic regression analysis was performed to identify predictors of treatment burden. P value < 0.05 was considered to declare statistical significance. Qualitative data were analyzed by using thematic analysis. A total of 325 patients were enrolled in the quantitative study. For the qualitative study, 14 patients and 11 health care providers (five nurses and six medical doctors) were included. Participants mean global Treatment Burden Questionnaire (TBQ-15) score was 27.22 ± 19.35. Approximately 12% (n = 38) patients indicated high treatment burden (TBQ-15 global score ≥ 59) with a median global score of 63(60–69). Higher education level (adjusted odds ratio [AOR] = 6.66, 95% confidence interval [CI]: 1.16–38.43), presence of two and more comorbidities (AOR = 2.74, 95%CI: 1.02–7.39), daily intake of more than five pills (AOR = 7.38, 95%CI: 2.23–24.41), poor medication availability (AOR = 3.33, 95%CI: 1.33–8.36), presence of medication adverse effects (AOR = 4.04, 95%CI: 1.63–10.03), and higher monthly cost of medication (AOR = 5.29, 95%CI: 1.46–19.18) were predictors of treatment burden. Patients and healthcare providers' propositions were primarily focused on improving self-care management, structural organization of the clinic and hospital, and healthcare system provision. Our findings demonstrated that a substantial proportion of patients faced low levels of treatment burden. This study unveiled that improving self-care management, structural organization of the clinic, and healthcare system provision had paramount importance to reducing treatment burden. Hence, factors affecting treatment burden should be considered when designing tailored healthcare interventions for patients with heart failure.