Indoor air bacterial load and antibiotic susceptibility pattern of isolates in operating rooms and surgical wards at jimma university specialized hospital, southwest ethiopia

Background

Surgical site infection is the second most common health care associated infection. One of the risk factors for such infection is bacterial contamination of operating rooms'' and surgical wards'' indoor air. In view of that, the microbiological quality of air can be considered as a mirror of the hygienic condition of these rooms. Thus, the objective of this study was to determine the bacterial load and antibiotic susceptibility pattern of isolates in operating rooms'' and surgical wards'' indoor air of Jimma University Specialized Hospital.

Methods

A cross sectional study was conducted to measure indoor air microbial quality of operating rooms and surgical wards from October to January 2009/2010 on 108 indoor air samples collected in twelve rounds using purposive sampling technique by Settle Plate Method (Passive Air Sampling following 1/1/1 Schedule). Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 16 and interpreted according to scientifically determined baseline values initially suggested by Fisher.

Results

The mean aerobic colony counts obtained in OR-1(46cfu/hr) and OR-2(28cfu/hr) was far beyond the set 5–8cfu/hr acceptable standards for passive room. Similarly the highest mean aerobic colony counts of 465cfu/hr and 461cfu/hr were observed in Female room-1 and room-2 respectively when compared to the acceptable range of 250–450cfu/hr. In this study only 3 isolates of S. pyogenes and 48 isolates of S. aureus were identified. Over 66% of S. aureus was identified in Critical Zone of Operating rooms. All isolates of S. aureus showed 100% and 82.8% resistance to methicillin and ampicillin respectively.

Conclusion

Higher degree of aerobic bacterial load was measured from operating rooms'' and surgical wards'' indoor air. Reducing foot trafficking, improving the ventilation system and routine cleaning has to be made to maintain the aerobic bacteria load with in optimal level.     

Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia

Background

Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to choose the correct empirical treatment. Therefore, the aim of this study was to determine the type and antibiotic resistance pattern of the urinary pathogens isolated from patients attending Jimma University Specialized Hospital from April to June 2010.

Methods

A hospital based cross sectional stud was conducted and urine samples were collected using the mid-stream “clean catch” method from 228 clinically-suspected cases of urinary tract infections and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for the isolated pathogens using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.

Results

Significant bacteria were detected from 9.2% of the total patients. The most common pathogens isolated were Escherichia coli (33.3%), Klebsiella pneumoniae (19%) and S. saprophyticus (14.3%). E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin and amoxacillin (100%) however, all isolates of E. coli and K. pneumoniae were susceptible to ciprofloxacin. S. saprophyticus and S. aureus were resistant to ampicillin (100%) and amoxicillin (66.7%). For all UTI isolates, least resistance was observed against drugs such as ceftriaxone, gentamycin and chloramphenicol.

Conclusion

This study finding showed that E. coli isolates were the predominant pathogens and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs.     

Reasons and outcomes of admissions to the medical wards of jimma university specialized hospital, southwest ethiopia

Background

Non-communicable diseases are the main reasons for admission to the medical wards in high-income countries. While in low and middle income countries communicable diseases are the main reasons for admission to the medical wards. However, in some low and middle income countries the reasons for admission are changing from communicable diseases to non-communicable diseases. But, data on reasons for admission to the medical wards of low income countries is scarce. Therefore, this study takes one year data from a low income country referral hospital aiming at describing the recent reasons and outcomes of medical admissions to see whether there is a change in reasons for admission and the outcome.

Methods

A retrospective study examined patient case notes and ward registration books of medical admissions at Jimma University Specialized Hospital from January 1, 2008 to December 31, 2008. Socio-demographic variables, reasons and outcomes of admission were some of the variables recorded during the data collection. The International Statistical Classification of Disease was used for sorting and categorizing the diagnosis. The data was then analyzed using SPSS windows version 13.0.

Result

A total of 610 patient case notes were reviewed. The mean age of the patients was 36 years (SD ± 15.75). The highest number of admissions 218 (35.7%) was among the age groups 21 to 30 years. Communicable diseases; namely severe community acquired pneumonia 139(22.8%), all infectious and parasitic diseases category 100 (16.4%), and pyogenic as well as chronic meningitis 80(13.1%) were the most common reasons for admission. The death rate among patients admitted to the medical wards was 12.6%.

Conclusions

Communicable diseases were still the common reasons for medical admissions at Jimma University Specialized Hospital. The outcome of medical admissions has not changed over sixteen years.     

Magnitude and pattern of injury in jimma university specialized hospital, South west ethiopia

Background

Injury statistics in Ethiopia provides little knowledge about its magnitude and related information needed for prevention. This study, therefore, aims to determine the magnitude and pattern of injury in Jimma University Specialized Hospital (JUSH).

Methods

A retrospective review of records of all injured patients seen at surgical outpatient department from April 09, 2010 to January 07, 2011; was conducted in January 2011. Data were collected using a structured checklist that was developed by adapting the World Health Organization instrument. Five degree holder nurses collected the data while investigators closely supervised. Socio demographic characteristics of the patients and injury related information were collected. Data were analyzed using SPSS for windows version 16.0.

Results

Of 13500 patients who visited surgical outpatient department of JUSH during the study period, 1102(8.2%) were injury cases. The commonest mechanism of injury was blunt assault, 341(30.9%), followed by road traffic accident, 334(30.3). Fracture was the leading outcome of injury, 454(41.2%), followed by bruise or skin laceration, 404(36.7%). Significantly more males had cut, (AOR=2.0; 95% CI=1.2, 3.3) and stab, (AOR=3.0; 95% CI=1.6, 5.7), injuries compared to females. Conversely, significantly fewer males had burn, (AOR=0.4, 95% CI=0.2, 0.8) and road traffic accident, (AOR=0.7, 95% CI=0.5, 0.9), than females. Most, 715(95.8%), patients were presented to the hospital within one week. The commonest functional limitations were; difficulty to use hands, 312(28.3%) and difficulty to use legs, 217(19.7%). Eighty three, (7.5%) of the patients died and road traffic accident alone accounted for almost half, 179 (49.7%), of the severe injuries.

Conclusion

The magnitude of injury in the hospital was considerably high. Age and sex were predictors of injury. Appropriate prevention strategies should be designed and implemented against assault, road traffic accident and cut by sharp tool.     

Bacteraemia among severely malnourished children in jimma university hospital, ethiopia

Background

Sever acute malnutrition severely suppresses every component of the immune system leading to increased susceptibility and severity to infection. However, symptoms and signs of infections are often unapparent making prompt clinical diagnosis and early treatment very difficult. The aim of the study was to determine the magnitude of bacteraemia and antimicrobial sensitivity among severely malnourished children.

Methods

Severely malnourished children admitted in Jimma University Specialized Hospital were enrolled between October, 2009 to May, 2010. Blood samples were collected, processed and bacterial isolates were identified using standard bacteriological procedures. Then, antibiotic susceptibility pattern of the isolates was determined by using Kirby-Bauer technique.

Results

Bacteraemia was seen in 35 (20.6%) of the 170 study subjects. There were a total of 35 bacterial isolates, Gram positive bacteria constitute 24(68.6%) of the isolates, where Staphylococcus aureus was the leading Gram positive isolate while Klebsiella species were the dominant Gram negative isolates. Twelve (7.1%) children died and 4 (33.3%) of them had bacteraemia. While susceptibility was more than 80% to Gentamicin, Ciprofloxacin and Ceftriaxone, increased level of resistance was documented to commonly used antibiotics, such as Amoxycillin, Co-trimoxazole and Chloramphenicol.

Conclusion

High prevalence of bacteraemia with predominating Gram positive isolates and increased level of resistance to commonly used antibiotics was shown among severely malnourished children in Jimma. Further studies are required to revise the current guideline for antibiotic choice.     

Patients' preoperative expectation and outcome of cataract surgery at jimma university specialized hospital -department of ophthalmology

Background

Patient''s satisfaction for a given treatment is an important clinical outcome because a satisfied patient is more likely to comply with treatments, attend follow-ups and advocate the service to others. Therefore, knowing patients'' expectations before a planned procedure or treatment and the actual level of satisfaction and fulfillment of their initial expectations thereafter is much helpful. As far as the knowledge and experience of the researchers is concerned, there has not been any study conducted in Ethiopia to find out about patients'' preoperative expectations and postoperative level of satisfaction for actual outcomes. This study was therefore, conducted to describe and find out the relationship between preoperative expectations of cataract patients and the actual postoperative experience and their satisfaction level following the surgery at ophthalmology department in Jimma University Specialized Hospital.

Methods

A prospective cohort study of patients undergoing first eye cataract surgery was conducted from July 10 to Oct., 10, 2007 in the Ophthalmology department of Jimma University Specialized Hospital. Detailed interviews that included general and vision specific health status measures and patients'' preoperative expectations for cataract surgery outcomes were performed followed by visual acuity testing. Postoperatively, visual acuity testing was taken again and patients'' level of satisfaction with attained postoperative vision was assessed. Data were collected and filled in a separate questionnaire form for each patient, and entered into a computer and analyzed using SPSS for Windows version 12.0.

Results

Of the 200 patients operated for cataract, 179 (89.5%) were followed for the whole five weeks. The average expected preoperative Visual Function-15 score was 96.3, compared to an achieved (postoperative) Visual Function-15 score of just 96.2. However, the most unrealistic expectations observed were reading small prints and doing fine handiwork. The final pinhole visual acuity postoperatively was ≤ 6/18 in 126 (70.4%) patients. Of the 78 (39%) patients who were bilaterally blind preoperatively, 5 (2.5%) patients remained blind postoperatively.

Conclusions

Significant improvements were obtained in clinical, functional, and perceived vision by cataract surgery involving extracapsular cataract extraction with posterior chamber intraocular lens implantations. Expectations regarding visual functioning after cataract surgery were very high, and in most cases and in most cases they were fulfilled.     

Hypertensive disorders of pregnancy in jimma university specialized hospital

Background

Hypertensive disorders represent the most common medical complications of pregnancy with a reported incidence between 5 and 10%. The disorders are major causes of maternal and perinatal morbidities and mortalities. This study was conducted to determine the pattern and outcomes of pregnancies complicated by hypertensive disorders.

Methods

Hospital based cross-sectional study was conducted on all mothers who gave birth in the labor ward of Jimma University Specialized Hospital from April 1, 2009 to March 31, 2010. Data was collected by interviewing the mothers and review of their medical records using structured questionnaire and checklist, respectively. Data analysis was performed using SPSS for windows version 16.0.

Result

Majority (52.5%) of the mothers were in the age group of 25 - 34 years. The overall prevalence of hypertensive disorders of pregnancy was 8.5%. Severe preeclampsia accounted for 51.9% of the cases followed by eclampsia (23.4%). Residential area of the mothers (urban/rural) was found to have statistically significant association with severity of the disorder. Most (66.5% and 74.7%) of the mothers were nulliparous and had antenatal care follow-up during the index pregnancy, respectively. Antenatal care follow-up and parity had no statistically significant association with severity of the disease. The case fatality rate of hypertensive disorders of pregnancy was 1.3% with perinatal mortality of 317.1/1000 births.

Conclusion

Pregnancies complicated by hypertensive disorders have poor maternal and perinatal outcomes and rural women were more affected. Quality antenatal care services with good obstetric and neonatal care at delivery are essential for early recognition and management of hypertensive disorders of pregnancy.     

Impact assessment of gilgel gibe hydroelectric dam on schitosomiasis: a cross sectional study in southwest ethiopia

Background

Intestinal schistosomiasis is prevalent in East Africa including Ethiopia. Constructed five years back, Gilgel Gibe dam is suspected to harbor the intermediate host for transmission of schistosomiasis. The objective of this study was to determine the prevalence of intestinal schistosomiasis and risk factors among school children.

Methods

A comparative cross-sectional study was carried out in October 2008 in four Woredas bordering Gilgel Gibe dam, within 10 kilometers, and Bulbul, which is 30 Kms away from the dam. Children attending grades 1–8 in the schools located adjacent to the dam constituted the cases and those living in Bulbul constitute the controls. Using Epinfo version 6.0 for cross-sectional study, a sample size of 937 was determined. Sample size allocation was done 2:1 for cases and control. After interview, stool sample was collected and analyzed. Screening for the presence of intermediate host and physiochemical analyses of selected water bodies along the major water contact sites of the reservoir was also done Data were entered into computer and analyzed using SPSS for windows version 13.0.1.

Results

Out of 624 sampled cases and 312 controls, 585 and 270 participated in the study giving a response rate of 93.8% and 86.5%, respectively. Four hundred seventy four (81.0% of the cases and 203 (75.2%) controls use latrine regularly. On stool examination, 406 (47.5%) children, 295 (50.4%) cases and 111 (41.1%) controls) were positive to intestinal parasites but only two children, both from the control groups, were positive for Schistosoma mansoni. The three river water samples on which malacological survey was done had similar physicochemical characteristics in many ways except high conductivity, pH and percent of dissolved oxygen concentration (milligram per liter) at one site where uninfected Biomphilaria Pfeifferi was found

Conclusion

The study revealed that schistosomiasis is not yet a problem at Gilgel-Gibe dam. But, continuous surveying is required as the intermediate host is prevalent, the water bodies are suitable for the intermediate host and cases of schistosomiasis are identified 30 kms away the dam, in control area.     

Knowledge, attitude and practice of emergency contraception among graduating female students of jimma university, southwest ethiopia

Background

Emergency contraception refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods including emergency contraceptives. The objective of this study was to assess the knowledge, attitude and practice of emergency contraception among graduating female students of Jimma University main campus.

Methods

A cross-sectional study was conducted in Jimma University main campus in 2009. The calculated sample size was allocated to each faculty proportions to size of female students. Then within the faculty the sample unit was selected by using simple random sampling technique. Data was collected using self administered questionnaire and analyzed using SPSS for widow version 16.0.

Results

A total of 389 (96.5%) volunteered graduating female students participated in the study. One hundred sixty three (41.9%) were ever heard of Emergency Contraceptive, only 11(6.8%) used the method. The common sources of information were friends 60 (36.5%), radio 37 (22.8%) and television 20 (12.3%). One hundred sixteen (71.2%) agreed to use Emergency Contraceptive when they practice unintended sexual intercourse.

Conclusion

Awareness and use of emergency contraception among graduating female students of Jimma University was low. There is a need to educate adolescents about emergency contraceptives, with emphasis on available methods and correct timing of use.     

The pattern of cardiac diseases at the cardiac clinic of jimma university specialised hospital, South west ethiopia

Background

Rheumatic heart disease is the commonest cardiac disease in most sub-Saharan African countries, followed by hypertensive heart disease which is rising along with the other non-communicable diseases. However the pattern in our setting is not known. This study aimed to determine the pattern of cardiac diseases among adult patients on follow-up at the cardiac follow-up clinic of Jimma University Specialized Hospital.

Methods

A cross-sectional study was conducted on cardiac patients who are newly enrolled to the cardiac follow up clinic of Jimma university specialized hospital during a five year period from 2003 to 2008. Out of the total 837 cases that were newly enrolled to the clinic in the five year period, 781 patients who had complete record about etiologic diagnosis were included in the study. The data were collected using structured record review checklist. The collected data were then analyzed using SPSS for windows version 12.0.

Results

Rheumatic heart disease was the diagnosis in 256 (32.8%) of the cardiac cases on follow-up followed by hypertensive heart disease and cardiomyopathy accounting for 189 (24.2%) and 158 (20.2%) of cases, respectively. Among Rheumatic heart disease patients; male to female ratio was 0.86:1 and the mean age was 31.4 years. One hundred ninety three (75.4%) of the cases with rheumatic heart disease had echocardiographic report that showed valve(s) involvements of pure MS in 99 (51.3%) and combined MS, MR in 49 (25.4%). Overall, hypertension contributed for a total of 241 (30.9%) of cardiac patients that included 189 (24.2%) hypertensive heart disease and 52 (6.7%) as one major risk factor for ischemic heart disease.

Conclusion

Rheumatic, hypertensive and cardiomyopathic heart diseases accounted for more than three-quarters of cardiac diseases in the study population. This study highlighted the need for further study to determine the burden at community setting.     

规范化教育对糖尿病并发症的治疗效果研究

目的研究长期规范化教育对糖尿病并发症的治疗效果。方法研究对象来自南充市中心医院的2型糖尿病患者,使用随机数字法将研究对象分为治疗组104例,对照组102例。治疗组采用普通内科治疗联合长期规范化化教育,而对照组仅使用普通内科治疗。治疗前和治疗后2年收集相关资料,评价代谢变化及各种并发症的发生情况。结果糖尿病教育治疗2年后,治疗组代谢指标控制情况均好于对照组。治疗组的体重指数（BMI）、空腹血糖（FBG）、餐后2 h血糖（2h PBG）、糖化血红蛋白（Hb A1c）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL-C）均低于对照组,高密度脂蛋白-胆固醇（HDL-C）高于对照组（P〈0.05）;治疗组糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、糖尿病性脑梗死、糖尿病性心脏病、糖尿病足病的发生率分别为3.8%,8.7%,8.7%,1.9%,1.9%,1.0%;对照组的发生率分别为14.7%,22.5%,28.4%,8.8%,8.8%,8.8%;治疗组的各种并发症发生率均低于对照组,差异有统计学意义（P〈0.05）。结论长期规范化化全方位教育能全面持久的改善糖尿病患者糖、脂代谢,减少或延缓各种并发症的发生和发展。     

Incidence, causes and outcome of obstructed labor in jimma university specialized hospital

Background

Obstructed labor is one of the common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Africa has the highest maternal mortality in the world, estimated at an average of about 1,000 deaths per 100,000 live births. This study was conducted to assess the incidence, causes and outcome of obstructed labor in Jimma University Specialized Hospital.

Methods

Hospital-based, cross-sectional study was conducted on all mothers who were admitted and delivered in the labor ward of Jimma University Specialized Hospital from November 1, 2008 to April 30, 2009. Data was collected using structured questionnaire and checklist, and then analyzed using SPSS for windows version 16.0.

Results

The incidence of obstructed labor was 12.2%. Out of these 61.5% did not have antenatal care follow-up. Most of the cases, accounting for 145(81.0%), 160 (89.4%) and 170 (93.9%) were referred from health centers, visited the hospital after at least 12 hours of labor and came from a distance of more than 10 kilometers, respectively. The causes of obstructed labor were cephalo-pelvic disproportion in 121(67.6%) and malpresentation in 50 (27.9%) of the cases. The commonest maternal complications observed were uterine rupture in 55 (45.1%) and sepsis in 48 (39.3%) of the cases with complications. Forty-five point eight percent of fetuses were born alive and all had low first minute APGAR score.

Conclusion

The incidence of obstructed labor was high with high rate of complications. The antenatal care follow-up practice was also found to be low. Improved antenatal care coverage, good referral system, and availing comprehensive obstetric care in nearby health institution are recommended to prevent obstructed labor and its complications.     

糖尿病患者慢性并发症及其影响因素研究

目的:调查与分析糖尿病患者中并发症情况及其影响因素,为预防和控制并发症提供依据。方法:选取在门诊连续治疗3个月以上糖尿病患者,通过门诊访谈、病历调查,收集患者的人口学资料、心血管危险因素、疾病控制情况及慢性并发症发生情况。结果:经调查289名患者,并发症排前三位的为白内障、神经病变和微量白蛋白尿。相关因素分析显示与病程、年龄、饮酒、血压、血脂有关。结论:积极控制血糖、血压、血脂、适量饮酒以及对年龄大、病程长者加强随访能延缓并发症的发生。     

The quality of care provided to patients with chronic non-communicable diseases: a retrospective multi-setup study in jimma zone, southwest ethiopia

Background

Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However, access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in Ethiopia. In this study we assessed the quality of care patients with Chronic Non-Communicable Diseases received in hospital and health center setups.

Methods

A retrospective multi-setup study was conducted in Jimma University Specialized Hospital and four Health Centers in Jimma Zone from February to March 2010. A total of 52 process indicators of quality covering three disease conditions: Diabetes, Hypertension and Epilepsy were measured by reviewing randomly selected medical records. Quality of care was measured as a proportion of recommended components of care actually provided to patients. And also outcome and structural measures were assessed to supplement process measures of quality.

Results

Six hundred seventy four medical records were reviewed. Recommended care components were actually provided to patients in 35.1% (95% CI:34.1%, 36.0%), 38.5% (95% CI:37.5%, 39.5%) and 60.1% (95% CI:59.3%, 61.0%) of times on which patients were eligible, among patients with Diabetes, Hypertension and Epilepsy, respectively. After case mix adjustment, it was found that 45.9% (95% CI:45.4%, 46.5%) of recommended components of care was actually provided to patients. This was 45.1% (95% CI:44.4%, 45.8%) in the hospital and 30.5% (95% CI:29.7%, 31.3%) in the health centers. Among patients for whom outcome data was available, optimal level of disease control was achieved only for 47 (30.5%), 40 (38.5%) and 193 (52.9%) of patients with Diabetes, Hypertension and Epilepsy, respectively.

Conclusion

The quality of care provided to patients with Chronic Non-Communicable Diseases is very low in both settings though it is relatively better in Jimma University Specialized Hospital. Therefore, a continuous process of quality improvement is recommended in both settings.     

Prevalence and predictors of intestinal helminthiasis among school children in jimma zone; a cross-sectional study

Background

Globally, millions of people suffer from intestinal parasitic infections. These infections are among the most common resulting in considerable morbidity and mortality. In Ethiopia and particularly in Jimma and its surroundings intestinal parasitic infections are highly prevalent because of low living standards and poor environmental sanitation. The objective of the survey was to determine the prevalence and predictors of intestinal parasitosis among school children in four woredas of Jimma zone surrounding Gilgel gibe hydraulic dam and serve as a base line data to help evaluate health promoting activities for the future and monitor those already delivered to the community.

Methods

A cross-sectional study was carried out in October, 2008 in four Woredas of Jimma zone bordering Gilgel Gibe Dam. Children attending grades 1–8 in the schools located within 10 Kms ofthe Dam in the four bordering woredas and those living 30 Kms away from the shore line were the study subjects. Six hundred twenty four and 321 children were selected from the schools around Gilgel Gibe dam and from the schools in Bulbul, respectively. Data on background of participant was collected and stool specimen collected and processed. Data were filtered and entered into computer then analyzed using SPSS for windows version 13.0.1.

Results

Of the 937 selected individuals, 855 participated in the study giving a response rate of 91.2%. The prevalence of intestinal parasitosis was 47.1% where 174 (20%) had Ascaris lumbricoides monoinfection; 4.3% had dual infection involving Ascaris lumbricoides and hookworm and 0.2% had triple infection but all the infections were of light intensity. In addition, there was no association between prevalence of intestinal parasitosis with availability or regular use of latrine and clinical symptoms.

Conclusion

The prevalence and intensity of intestinal parasites in the study area is lower than national, urban and rural setting of Jimma zone. These might be due to a better awareness of the study community on prevention of intestinal parasitosis following increased health promoting activities in the area, delivered through various activities of Jimma Public health training program.     

中国 6 省糖尿病患者糖尿病慢性并发症自报率及影响因素研究

目的了解糖尿病患者糖尿病并发症认知情况及其影响因素。方法按照经济水平和地域划分,在我国东、中、西部地区随机抽取6省作为调查省份,采用方便抽样方法,于2013年3_5月对6省三甲医院就诊的糖尿病患者进行问卷调查。结果共调查糖尿病患者639人,男性329人（51.5％）,女性310人（48.5％）。被确诊患糖尿病时的年龄最小为4岁,最大82岁,平均（51.1±11.4）岁,中位数51.0岁。被确诊时间距调查时间最短为3个月,最长为53年,平均（8.2±7.0）年,中位数7.0年。糖尿病慢性并发症自报率为36.8％,自报并发症发生率由高到低依次为视网膜病变（24.7％）、神经病变（13.0％）、糖尿病足（9.7％）和糖尿病肾病（9.4％）。年龄（以45岁以下组为对照,46～60岁组OR：1.150,95％CI：0.574～2.302）,61岁以上组OR=1.848,95％CI：0.924～3.695）、患病年限（以≤5年组为对照,患病6～10年组OR=1.856,95％CI：1.215～2.835;患病11年及以上组OR=3.075,95％CI：2.018～4.687）、糖尿病知识得分（以低分组为对照,中分组OR=1.166,95％CI：0.788～1.724;高分组OR=1.897,95％CI：1.140～3.159）是糖尿病慢性并发症自报率的影响因素（P〈0.05）。结论糖尿病患者慢性并发症自报率低,应加强糖尿病患者健康教育,提高糖尿病患者的疾病认知和疾病自我管理能力,降低糖尿病急慢性并发症的发生。     

480例2型糖尿病慢性并发症的调查分析

目的：了解2型糖尿病患者慢性并发症与年龄、病程、血糖的关系。方法：对患者按不同的年龄、病程、血糖分为3组分别进行统计分析。结果：2型糖尿病慢性并发症随者病程延长、年龄增长及血糖升高而呈上升趋势,此趋势在年龄40岁,病程5～10年,血糖≥10 mmol/L以上尤为明显。以高血压（HT）、糖尿病肾病（DN）、糖尿病视网膜病变（DR）发病率最高,分别为40.6%、30.83%、31.04%。在不同年龄组以高血压发病最早,≤30岁组为25%,冠心病（CHD）和脑血管病（CVD）上升速度最快,≥60岁组比≤39岁组分别增长5.5倍和4.5倍。在不同的病程组仍是高血压发病最高,≤5年时高达29%,以DN和下肢血管病变（PVD）上升最快,≥10年组比≤5年组增长分别为3.29倍和3.75倍。在不同的血糖组仍然是高血压发病率最高,≤10 mmol/L组已达到24%,以DN、DR上升最快,≥15.1 mmol/L比≤10 mmol/L组增长分别为3.13倍、3.5倍。结论：随着年龄的增加、病程增长、血糖的升高糖尿病慢性并发症的发生率也随之增长。     

幽门螺杆菌感染与2型糖尿病并发症关系的临床研究

目的 探讨幽门螺杆菌(Hp)感染与2型糖尿病并发症的相关性.方法 85例2型糖尿病患者经检测后分为Hp阴性组(42例)和Hp阳性组(43例),观察比较两组三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、肿瘤坏死因子-α (TNF-α)水平和并发症发生情况.结果 Hp阳性组TG、LDL-C、FPG、HbA1c、TNF-α明显高于Hp阴性组[(4.83±0.95) mmol/L比(3.03±0.75) mmol/L、(4.99±0.96) mmol/L比(3.91±0.87) mmol/L、(10.85±2.97) mmol/L比(8.11±2.69) mmol/L、(9.35±1.96)％比(7.08±1.53)％、(7.33 ±-0.78) ng/L比(3.65±0.98) ng/L],两组比较差异有统计学意义(P＜ 0.01); Hp阳性组心血管病、脑血管病、糖尿病肾病、糖尿病眼底改变、糖尿病足发生率分别为51.16％(22/43)、37.21％(16/43)、27.91％ (12/43)、34.88％(15/43)、23.26％(10/43),明显高于Hp阴性组的28.57％(12/42)、16.67％ (7/42)、9.52％ (4/42)、14.29％(6/42)、7.14％(3/42),两组比较差异有统计学意义(P＜0.05).结论 2型糖尿病Hp感染可使TG、LDL-C、FPG、HbA1c、TNF-α升高,并能增加糖尿病并发症发生率.