Yeweyenhareg Feleke

Prevalence of oral and perioral manifestations in HIV positive adults at Tikur Anbessa Teaching Hospital Addis Ababa Ethiopia.

OBJECTIVE To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy. METHODS We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy. RESULTS The mean age of participants was 24.7 years. Three-fourths had household incomes under

A mixed-methods study on perceptions towards use of Rapid Ethical Assessment to improve informed consent processes for health research in a low-income setting

25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline. CONCLUSION Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.

Metabolic Syndrome Biomarkers in Type II Diabetic Ethiopian Patients

BackgroundRapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia.MethodsMixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health researchers and regulators including ethics committee members in Ethiopian health research institutions and universities.ResultsIn their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity (48.1%), inadequate information (34%), language barriers (28.2%), cultural differences (27.4%), undue expectations (26.6%) and power imbalances (20.7%). About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test (pilot) phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed.ConclusionThe study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended.

Prevalence of highly active antiretroviral therapy associated metabolic abnormalities and lipodystrophy in HIV infected patients.

Background: Insulin resistance, which precedes by many years the onset of and accompanies type II diabetes (T2D), is strongly associated with a clustering of cardiovascular risk factors, termed metabolic syndrome (MetS). Objectives: The aim of this study was to investigate the extent of MetS risk in T2D Ethiopian patients. Methods: A total of 72 T2D patients and 20 normal healthy controls without MetS were studied. Based on the world health organization criteria, 59.72% (43/72) of the patients had MetS. Results: Type 2 diabetic patients with MetS (0.953 ± 0.007) were significantly (P<0.01) obese than those without (0.913 ± 0.012). Plasma total triglyceride (TG) (206.9 ± 16.91) and blood pressure (138.8 ± 3.247) were strongly significantly high (P<0.001) in patients with MetS as compared to those without MetS (104.4 ± 6.766 and 122.8 ± 2.725, respectively). On the other hand, plasma high density lipoprotein-cholesterol (40.91 ± 3.070) and total peroxide (0.055 ± 0.001) were found at a significantly (P<0.05) lower amounts in patients with MetS as compared to those without (50.90 ± 2.601 and 0.052 ± 0.001, respectively). In patients with MetS, the IR index showed a significant association (P<0.05) with the dyslipidemia markers: TG (r=0.254), low density lipoprotein-cholesterol (r=0.262), and total cholesterol (r=0.320). Waist-hip circumference ratio showed a positive significant correlation with blood pressure (r=0.330, P<0.05) and C-reactive protein was strongly associated with serum insulin concentration (r=0.382, P<0.01). Conclusion: Ethiopian T2D patients with MetS are at a greater risk of hypertensive, dyslipidemia and oxidative stress states, and developing cardiovascular disorders. Interventions should be planned to help those patients avoid/delay onset of cardiovascular complications anticipated upon the accumulation of predisposing factors that are components of MetS.