AAU Institutional Repository (AAU-ETD)
Addis Ababa University Institutional repository is an open access repository that collects,preserves, and disseminates scholarly outputs of the university. AAU-ETD archives' collection of master's theses, doctoral dissertations and preprints showcase the wide range of academic research undertaken by AAU students over the course of the University's long history.
How to Submit Your Work
The repository contains scholarly work, both unpublished and published, by current or former AAU faculty, staff, and students, including Works by AAU students as part of their masters, doctoral, or post-doctoral research
- All AAU faculty, staff, and students are invited to submit their work to the repository. Please contact the library at your college.
You may contact digirep@aau.edu.et.with any questions about the repository
Colleges,Institutes in AAU-ETD
Select a college,institute to browse its collections.
Recent Submissions
Assessment of Chronic Respiratory Symptoms, Reduced Lung Function and Associated Factors Among Traffic Police Personnel of Addis Ababa, Ethiopia
(Addis Ababa University, 2025-06) Tesfaye,Eyerusalem; Belachew,Ayele(MD, MPH); Taye,Girma(PhD); Tamire,Mulugeta(PhD); Kumie,Abera(PhD)
Background: Chronic respiratory disease is a global public health challenge, specifically among occupational groups exposed to environmental pollution. Traffic police, who are frequently exposed to high levels of ambient air pollution, face the risk of developing chronic respiratory diseases. Understanding the prevalence of respiratory symptoms, assessing the lung function of traffic police, and identifying predictor factors for respiratory symptoms among traffic police personnel is crucial for developing effective public health interventions.
Objective: To assess the prevalence of chronic respiratory symptoms, lung function, and predictor factors among field and in-office traffic police personnel in Addis Ababa, Ethiopia.
Methods: A comparative cross-sectional study has been employed. Targeting field and in-office traffic police personnel respectively, as exposed to Vehicular related air pollution and control group. A simple random sampling procedure was applied to enroll 374 traffic police personnel. Data were collected using the ATS/ERS questionnaire and spirometry following the American Thoracic Society guidelines to assess respiratory symptoms and lung function parameters, respectively. Chi-square test, ANOVA, Multivariable logistic, and linear regression were applied to compare prevalence, mean, and measure association.
Result: A total of 374 traffic police personnel; 249 field traffic police and 125 in-office traffic police personnel were involved in the study. Respectively, field traffic police personnel were found to have a significantly higher prevalence of chronic respiratory symptoms than in-office traffic police personnel with 32.93% (27.36 - 39.03) and 18.4% (12.53 - 26.2) (p<0.003). Sex, work experience, and job status were significantly associated with developing chronic respiratory symptoms. While sex, age, being a field traffic police, years of employment, and previous occupational exposure to air pollutants demonstrate a negative relationship with lung function parameters (FEV1 and FVC) occupational safety and training on health topics showed a positive association with lung function parameters.
Conclusion: field traffic police personnel have higher odds of developing chronic respiratory symptoms, with lower lung function compared to in-office traffic police personnel. Stricter air quality regulation, Occupational Safety, and Health-focused modifications in the traffic police work environment are recommended. Longitudinal studies should be conducted to investigate further the impact of air pollution on respiratory health among traffic police personnel.
Fathers' Involvement in Child Feeding Practice and Its Associated Factors Among Fathers Having Children Aged 6-24 Months in Morabe Town Administration Silent Zone, 2025
(2025-06-10) Kedir Hussen; Abdissa Boka; Wudma Alemu
Background: Optimal child feeding is crucial for the health and development of infants and young children, significantly impacting growth and survival rates. However, there is a notable gap in understanding the responsibility of fathers in child feeding practices. Addressing this gap is essential for creating effective interventions that encourage paternal engagement, ultimately enhancing child well-being.
Objective: The objective of this study was to assess fathers' involvement in child feeding practices and to identify contributing factors among fathers of children in Worabe Town administration who are between the ages of 6 and 24 months.
Methods: community-based cross-sectional study, supplemented by qualitative methods, was conducted in Worabe Town Administration from February 20 to march 20, 2025.Participants in the study were chosen using a systematic random selection technique, and data was gathered through in-depth interviews until the information was saturated for the qualitative component and in-person interviews using a standardized questionnaire for the quantitative component After its completeness is checked. Data were entered into Epi Data version 4.6 and exported to SPSS version 27 then descriptive s were calculated. Bi variate and multivariate logistic regression analysis was employed to identify factors associated with fathers' involvement in child feeding. In bivariate analysis variables with a p value of ≤ 0.25 were included in the multivariate logistic regression analysis at a 95% confidence range. A significant association was declared when the p-value was less than 0.05. Qualitative data was manually analyzed by summarizing key themes and ideas expressed by participants.
Results: The study revealed that 42.1% of the respondents were involved in child feeding. Factors significantly associated were urban residence(AOR = 2.0; 95% CI: 1.88–3.57), secondary or higher education levels among fathers (5.2;95% CI: 2.59-10.46) and (5.4; 95% CI: 2.40,12.14), higher women’s education(AOR = 2.94; 95% CI: 1.24–6.98), having a male child (AOR = 1.8; 95% CI: 1.18– 2.69), daily laborer occupation(AOR=0.3; 95% CI: 0.13–0.64), good fathers knowledge (AOR = 1.73; 95% CI: 1.18–2.52) and positive attitude (AOR = 2.1;95% CI:1.4–3.1),supportive community encouragement (AOR=1.7;95%CI;1.16-2.44).
Conclusion: According the findings of this study, it showed that that the level of fathers’ involvement in child feeding remains low. Highlighting these findings, it is important to implement targeted interventions that promote awareness and education among male partners.
Prevalence of Undernutrition and its Association with Maternal Depression among Economically Disadvantaged Women with Children Aged 12-36 Months in Selected Urban Areas of Ethiopia
(Addis Ababa University, 2025-06) G/melak,Sitota; Darge,Tefera(PhD); Egata,Gudina(PhD)
Background: Undernutrition remains a global pressing public health issue, but few studies in Ethiopia have examined how maternal depression related to child undernutrition. We estimated the prevalence of child undernutrition and examined how undernutrition was associated with maternal depression in urban Ethiopia.
Objective: To assess the prevalence of undernutrition and its association with maternal depression among economically disadvantaged children aged 12-36 months in selected urban areas of Ethiopia.
Method: This study used extracted data from the baseline household survey conducted from June to September 2022 as part of the Growth and Economic Opportunities for Women (GrOW) Africa project. A cross-sectional design was computed among 627 mother-child pairs. Child undernutrition was assessed using anthropometric measures and maternal depression was assessed using the Patient Health Questionnaire-9(PHQ-9). The anthropometric indices were derived from WHO 2006 Child Growth Standard. The association between child undernutrition (stunting and underweight) and maternal depression was analyzed separately using binary logistic regression. However, regression analysis was not conducted for wasting due to its low prevalence, which could lead to unreliable results. Adjusted odds ratios (AORs) along with 95% confidence intervals (CIs) were estimated to measure the strength of the association.
Result: The prevalence of stunting, underweight, and wasting was 52.7% (95% CI: 48.7–56.5), 14.0% (95% CI: 11.3–16.7), and 3.6% (95% CI: 2.1–5.0), respectively. Maternal depression affected one in every six mothers (16.0%) (95% CI: 13.1–18.9). Maternal depression was significantly associated with stunting [AOR = 2.21; 95% CI: 1.11–2.15] but not with underweight, after controlling for possible confounding variables.
Conclusion: Undernutrition, mainly stunting and underweight are still alarming public problem in this study area. Maternal depression has significant association with stunting. Hence, integrating maternal mental health into child health program could enhance effort to combat child undernutrition.
Diabetes Mellitus:Trend,Risk Factors and Hyperglycemic crisis among adults in Selected Public Hospitals in Tigrai Region:a Multi - Facility Study
(Addis Ababa University, 2024-09) Tedla,Getachew Gebremedhin; Deyessa,Negussie(MD, Ph.D.)
Background: Diabetes mellitus is a pressing global health crisis, profoundly impacting mortality rates, morbidity, and economic stability. Type 1 and Type 2 diabetes are particularly severe public health challenges in low- and middle-income countries like Ethiopia, where urban diabetes incidence is alarmingly on the rise. The disease triggers serious acute and chronic complications, diminishing quality of life and inflating healthcare costs. Hyperglycemic crises, rampant in low-income settings such as Ethiopia, further exacerbate the burden, leading to disability, reduced life expectancy, and escalated healthcare expenses. Despite being a leading cause of hospital admissions and deaths, comprehensive data on diabetes trends, Type 2 diabetes risk factors among middle-aged adults, and treatment outcomes for hyperglycemic crises remain scarce in Ethiopia and other sub-Saharan African nations.
Objective: This study aimed to assess time trends in proportions of people with type 1 and type 2 diabetes and risk factors for type 2 diabetes among people attending adult medical outpatient departments, and treatment outcomes of patients with hyperglycemic crises admitted in adult medical wards in selected public hospitals in Tigrai Region.
Methods: A comprehensive study conducted across seven public hospitals in the Tigrai Region aimed to investigate time trends in the proportion of type 1 and type 2 diabetes cases alongside hyperglycemic crises. This retrospective cross-sectional hospital-based research spanned from September 2018 to June 2019. It involved the extensive review of 299,806 adult patient records from registry logbooks, 3056 medical charts focusing on diabetes trends, and 589 cases of hyperglycemic crises using a data abstraction checklist. Additionally, a matched case-control study at Ayder Comprehensive Specialized Hospital explored factors associated with type 2 diabetes among middle-aged adults. The study employed rigorous methods, including lottery-based sampling, to select 120 confirmed type 2 diabetes patients and 240 non-diabetic controls aged 45 to 64 years consecutively. Data collection utilized the WHO STEPS protocol customized for the local context to comprehensively assess the case-control study's socio-demographic, lifestyle, physical, and biomarker measurements. For the trend analysis of type 1 and type 2 diabetes, an Extended Mantel-Haenszel chi-square test of the linear trend was used. Associations between exposure and outcome variables in the case-control study were determined using bivariate and multivariable conditional logistic regression. The study employed descriptive statistics and a logistic regression model to determine the relationship between exposure and outcome variables for hyperglycemic crises related to in-hospital mortality using SPSS version 25. The significance level was set at p < 0.05 (two-tailed) for all statistical tests. The overall findings were presented using figures, tables, and text. Ethical approval and permissions were secured, ensuring compliance with ethical standards and participant confidentiality throughout the study.
Results: From September 1, 2013, to August 31, 2018, among 299,806 adult patients receiving care at outpatient departments, the proportion of people with confirmed diabetes was 10.2 per 1000 adult patients (95% CI: 9.8-10.6). The proportion of people with diabetes significantly rose from 6.8 to 14.3 per 1000 adult patients during this period. Specifically, the proportion of type 1 diabetes increased from 1.0 to 2.2 per 1000 adult urban residents (Ptrend=0.002) and from 1.2 to 2.6 per 1000 adult rural residents (Ptrend=0.001). Similarly, the proportion of type 2 diabetes increased from 6.9 to 14.0 per 1000 adult urban residents (P trend=0.001) and from 4.0 to 9.5 per 1000 adult rural residents (Ptrend=0.001). Notably, this increase was more pronounced among women for both type 1 and type 2 diabetes.
The mean ages of cases and controls were similar at 55.9±5.0 years and 55.7±4.8 years, respectively. The odds of Type 2 diabetes were significantly higher among urban residents (AOR=5.1, 95% CI [2.0, 13.2]), widowhood individuals (AOR=3.3, 95% CI [1.3, 8.6]), divorced individuals (AOR=2.8, 95% CI[1.1,7.3]), a positive family history of diabetes (AOR=5.4, 95% CI [2.4, 12.5]), daily alcohol consumption (AOR=3.5, 95% CI [1.2, 10.2]), consumption of white rice as a favorite food (AOR=3.8, 95%CI [1.2,11.6]), elevated waist circumference (AOR=2.4, 95% CI [1.1,5.0]), and elevated waist-to-height ratio (AOR=4.4, 95% CI [1.7, 11.2]), hypertension (AOR=3.0, 95% CI [1.7,5.5]), dyslipidemia (AOR=2.8, 95% CI [1.5, 5.4]), Conversely, engaging in moderate to vigorous intensity leisure physical activity was associated with lower odds of Type 2 diabetes (AOR=0.27, 95% CI [0.1, 0.72]).
The mean age of patients with diabetic ketoacidosis and hyperosmolar hyperglycemic state was 42.9(±13.6) and 59.3(±11.2) years, respectively. About 24.2% of diabetic ketoacidosis and 42% of hyperosmolar hyperglycemic state patients were precipitated by infection, and also 163(37.6%) diabetes ketoacidosis and 33(21.2%) hyperosmolar hyperglycemic state were newly diagnosed diabetes patients. The in-hospital mortality was 78(13.2%), of which 43(7.3%) deaths were in patients with hyperosmolar hyperglycemic states. Rural residents had a higher proportion of in-hospital mortality (17.9%) compared to urban residents (10.4%). Patients without a history of diabetes were younger (mean age 43.9±12.6 vs. 48.4±14.9), more likely to reside in rural areas (53.1% vs. 30.3%), and had a lower proportion of Type 2 diabetes (38.3% vs. 53.7%), hyperosmolar hyperglycemic state (15.8% vs. 31.8%), and lower proportion of in-hospital mortality (8.7% vs. 15.5%) compared to those with known diabetes. Rural residence (AOR 3.1, 95% CI 1.8-5.4), history of stroke (AOR 2.7, 95% CI 1.3-5.6), Type 2 diabetes (AOR 2.3, 95% CI 1.1-4.7), hyperosmolar hyperglycemic state (AOR 2.4, 95% CI 1.1-5.4), and prior diabetes history (AOR 2.0, 95% CI 1.04-3.8) were significantly associated with increased mortality risk. Conversely, presentation with excessive thirst was associated with lower in-hospital mortality risk (AOR 0.47, 95% CI 0.27-0.81).
Conclusions: The proportion of people with type 1 and type 2 diabetes has increased among urban and rural residents over time during the study period. Factors such as urban residency, widowhood/divorce, family history of diabetes, daily alcohol consumption, white rice, elevated waist circumference, hypertension, and dyslipidemia were associated with a higher risk of type 2 diabetes. In contrast, engagement in moderate to vigorous physical activity was protective. Rural residents and patients with hyperosmolar hyperglycemic states had higher in-mortality, with a history of stroke, type 2 diabetes, hyperosmolar hyperglycemic state, and history of diabetes being significant predictors, while polydipsia was protective. Health education is crucial for raising awareness about substance misuse, physical activity, and healthy eating habits at workplaces, schools, and community and family levels. Targeted screening programs for patients with existing diabetes may reduce morbidity and mortality if cost-effective interventions (for example education on healthy eating, regular physical activity, medication, and self-monitoring of blood glucose) are available. A feasible option might be to implement diabetes screening for patients aged 45 and above and those with known diabetes risk factors attending hospital adult medical outpatient departments for co-existing illnesses(patients with malaria, tuberculosis, hypertension, and so on). Furthermore, decentralizing diabetes care services to lower-level health facilities, enhancing the efficiency of bidirectional referral systems and ensuring the quality, availability, and affordability of insulin and other diabetes commodities are imperative to improve outcomes for people with diabetes in Ethiopia and similar settings.
In-Hospital Mortality and Its Predictors Among ST-Segment Elevation Myocardial Infarction Patients at Gesund Cardiac and Medical Center
(Addis Ababa Ethiopia, 2025-05-08) Petros Melese; Achamyelesh Tadele; Lemlem Beza; Bekele Alemayehu
Background: ST-segment elevation myocardial infarction (STEMI), which is a severe form of myocardial infarction (MI), results from complete coronary artery occlusion and is characterized by high morbidity and mortality. Although STEMI accounts for increased mortality, little evidence that points to in-hospital mortality and predictors in Ethiopia exists. This study tries to address this gap.
Objective: To assess in-hospital mortality and its predictors among ST-segment elevation myocardial infarction patients at Gensund Cardiac and Medical Center, Addis Ababa, Ethiopia 2025.
Methods: Retrospective cross-sectional study was conducted from February 2024 to January 2025. And sample size was determined using a single population proportion formula to obtain a total of 229 STEMI patients. Data were collected from patients' Medical records with a structured checklist. Binary Logistic regression was used in order to identify predictors of STEMI in-hospital mortality, with statistical significance set at p < 0.05 and 95% confidence
level.
Results: Of 229 STEMI patients, the majority were men (86.5%), with a mean age of 59.27 ± 8.93 years. Surprisingly, (13.1%) thirty were Killip class III&IV and (7.9%) eighteen had ejection fraction (LVEF) of <30% In-hospital mortality was (7.4%, n=17). Killip class III & IV (COR = 6.8; [95% CI: 3.2–14.5; P < 0.001], AOR = 6.2; [95% CI: 2.9–13.1; P = 0.001]) and LVEF <30% (COR = 4.7; [95% CI: 2.0–10.8; P = 0.002], AOR = 4.1; [95% CI: 1.8–9.2; P =
0.004]) were independent predictors of in-hospital mortality among STEMI patients.
Conclusion: Taken together, the in-hospital mortality rate among STEMI patients in this study was relatively low; however, advanced Killip class and markedly reduced left ventricular ejection fraction emerged as independent predictors of adverse outcomes. Tackling these critical predictors through early risk identification and implementation of effective preventive measures remains essential to minimizing this burden.