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Development and validation of a risk prediction model for chronic kidney disease among adult hypertensive patients having follow-up at University of Gondar Comprehensive Specialised Hospital, Ethiopia: a retrospective cohort study

Por: Tilahun · A. D. · Limenih · M. A. · Muluneh · A. G. · Hailu · W. · Anlay · D. Z. · Liyew · B. · Muche · A. A.
Objective

Chronic kidney disease (CKD) arises due to uncontrolled hypertension (HTN). HTN significantly increases the risk of complications in vital organs, mainly the kidneys. If hypertensive individuals receive early intervention, the majority of these complications and deaths from CKD can be avoided. Having a clinically applicable tool to predict the future risk of those complications can prevent early disability and premature mortality. However, to this day, there is a lack of a validated risk prediction model specifically designed for CKD of hypertensive patients in Ethiopia. We aimed to develop a risk prediction model for CKD among hypertensive patients at the University of Gondar Comprehensive Specialised Hospital (UoGCSH), Ethiopia.

Study design

A retrospective follow-up study was conducted from 1 January 2012 to 30 December 2021. The Least Absolute Shrinkage and Selection Operator regression methods were used to select predictors. The performance of the models was assessed using the Area Under the Curve and calibration plots. The internal validity of the model was evaluated using bootstrapping methods, and the model was presented as a nomogram. Decision curve analysis was conducted to assess the net benefit of the prediction model in clinical and public health contexts.

Setting

Data from patients’ medical records were collected via the Kobo Toolbox in the UoGCSH.

Participant

We followed a total of 1120 Patients diagnosed with HTN.

Results

The incidence of CKD among adult hypertensive patients was 19.82% (95% CI 17.59% to 22.26%). In the multivariable logistic regression analysis, age, residency, baseline blood pressure status, type of HTN, family history of HTN, baseline serum creatinine levels, proteinuria at baseline and dyslipidaemia were identified as statistically significant predictors of CKD. The nomogram demonstrated a discriminatory power of 91.98% (95% CI 90.09% to 93.88%) and a calibration p value of 0.327. The sensitivity and specificity of the prediction model were 80.63% (95% CI 74.81% to 85.61%) and 87.97% (95% CI 85.66% to 90.03%), respectively. The developed nomogram has a greater net benefit than using the treat-all or treat-none strategies when the threshold probability of the patient is increased.

Conclusion

The nomogram demonstrated excellent discrimination and calibration in identifying hypertensive patients at high risk of CKD. This predictive model offers clinicians a valuable tool for early identification of high-risk individuals, enabling timely interventions, personalised counselling and optimised management through close monitoring to prevent disease progression.

Prevalence of primary teeth extraction and associated factors among under five children in Adea Berga Woreda, West Shewa, Oromia, Ethiopia, 2024: a community-based cross-sectional study

Por: Atomsa · L. · Bekele · K. · Tilahun · A. · Shigign · E. · Dinsa · F. · Tesema · T. M. · Mogasa · T.
Objective

To assess the prevalence of primary teeth extraction and associated factors among children under 5 years old living in Adea Berga Woreda, West Shewa, Oromia, Ethiopia.

Design

A community-based cross-sectional study using interviewer-administered questionnaire.

Participants/setting

A total of 542 caregivers of under-five children participated in the study, which was conducted in Adea Berga Woreda, West Shewa, Oromia, Ethiopia, from 1 to 30 July 2024.

Main outcome

Prevalence of primary teeth extraction among under-five children.

Results

Of the 550 study participants, 542 responded, yielding a response rate of 98.5%. The prevalence of primary teeth extraction was 14.02%. Factors significantly associated with primary tooth extraction included residence (adjusted OR (AOR) 2.33; 95% CI 1.27 to 4.28), having information about scientific solutions for teething symptoms (AOR 2.10; 95% CI 1.16 to 3.79), a history of traditional medicine use (AOR 5.68; 95% CI 3.06 to 10.55), and the primary teeth extraction is traditional practice in the community (AOR 3.79; 95% CI 2.06 to 6.97).

Conclusions

Primary teeth extraction is a significant public health issue in the study area. Living in rural areas, lacking information about scientific treatments for teething symptoms, the traditional practice of primary teeth extraction and a history of using traditional medicines were identified as predictors of primary tooth extraction.

Opportunities, challenges and perceived strategies for the uptake of the OraQuick HIV self-test among female sex workers in Ethiopia: a qualitative study

Por: Ayele · M. · Alamrew · A. · Lake · E. S. · Yilak · G. · Tilahun · B. D. · Tenaw · L. A. · Tunta · A. · Erega · B. B. · Gashaw · A. · Kumie · G.
Objective

To explore the opportunities, challenges and perceived strategies for the uptake of OraQuick HIV self-testing (HIVST) among female sex workers in Ethiopia.

Design

A phenomenological study design, with the Integrated Behavioural Model used as a framework for analysis and interpretation.

Setting

Woldia, North Wollo, Ethiopia, 13–30 February 2024.

Participants

Twenty female sex workers and 18 key informants in Woldia participated in in-depth interviews, key informant interviews and focus group discussions.

Results

The advantages related to OraQuick HIVST include its privacy, ease of use, reduced waiting time, lowered transportation costs, usability for immobile individuals, application in screening for index case testing programmes, providing confidence and reliability and the elimination of the need for healthcare providers during testing. Perceived possible challenges for the uptake of OraQuick HIVST included kit shortage, absence of policies or guidelines for HIVST, lack of post-test counselling and immediate treatment for positive individuals, potential psychological trauma such as suicidal ideation or attempts, lack of linkage to care for those with reactive results, inaccurate reporting of positive results or result concealment and doubts about reliability before education. Strategies perceived for enhancing the uptake of OraQuick HIVST included making the HIVST kit accessible to higher education communities, addressing HIVST-related doubts by including phone or email contact information, advocating and creating awareness about OraQuick HIVST and ensuring the availability of kits in easily accessible locations.

Conclusion

The study findings highlight many positive opportunities related to the uptake of OraQuick HIVST. Policymakers should prioritise addressing the challenges identified and implementing the proposed strategies to enhance the uptake of OraQuick HIVST, potentially leading to improved HIV testing rates and outcomes.

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