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.

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The repository contains scholarly work, both unpublished and published, by current or former AAU faculty, staff, and students, including Works by AAU students as part of their masters, doctoral, or post-doctoral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.

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Recent Submissions

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The Magnitude of Antihypertensive Medications Adherence, Blood Pressure Control and Associated Factor Among Hypertensive Patients at Selected Health Center ,A.A, Ethiopia.
(Addis Ababa University, 2024-02-08) ErmiyasKuma; AbenetTafesse; YaredZenebe; SebelewengelAsmare
Background: Hypertension is a major risk factor for stroke, contributing to high mortality and morbidity, particularly in low-income countries like Ethiopia. Studies indicate a rising incidence of stroke in developing nations, with intracerebral hemorrhage disproportionately affecting low-income populations. Assessing blood pressure control, medication adherence, and associated factors is essential for identifying key contributors to the increasing stroke burden and guiding targeted interventions. While most existing data come from hospital-based studies, this research focuses on primary healthcare facilities, where a significant proportion of hypertensive patients receive follow-up care. Future studies can explore additional contributing factors to the growing burden of stroke in developing countries. Methods: Across-sectional study was conducted using multi-stage sampling at selected health centers from October to December 2024. Data were collected via structured questionnaires and analyzed using SPSS version 25. Multiple logistic regression model wasemployedtodetermine factors associated with BP control and medication adherence. Results: Of 348 patients, only 27.3% achieving the target Blood pressure of <130/80 mmHg,while 35.1% fellinto the category of 130/80-139/89 mmHgand 35.9% hadhigh BP(>139/89 mmHg),indicating poor control. High medication adherence was observed in 43.1%ofparticipants, 32.2% moderate adherence, but 24.7% had low adherence. Factors significantly associated with BP control included adherence levels, frequency of BPmonitoring, appointment frequency, education, income, and age. Medication adherence wasinfluenced by income, appointment frequency, blood pressure monitoring frequency, fruit consumption, and salt intake. Lifestyle modifications such as exercise and dietary habits showed concerning trends but were not significant predictors in the regression model. Significant proportion of the patients are on monotherapy. Conclusion: Poor blood pressure control and suboptimal medication adherence underscore the urgent need for targeted interventions to reduce the burden of stroke and other hypertension-related complications in Ethiopia. Key strategies include enhancing patient education, improving access to healthcare and strengthening healthcare systems through regular follow-up appointments and promoting home blood pressure monitoring. Additionally, promoting healthy lifestyle choices, addressing financial barriers, and optimization in treatment regimens to prevent therapeutic inertia are essential to improving hypertension management. These efforts can help mitigate the burden ofstroke and other cardiovascular diseases. Further research, including longitudinal and qualitative studies, is recommended to explore underlying barriers, identify effective intervention strategies, and investigate other contributing factors beyond hypertension-related issues.
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Assessment of cognitive function and associated factors among Parkinson’s disease patients and control group using IDEA cognitive screen, TASH, A.A, Ethiopia.
(Addis Ababa University, 2024-02-14) Hanna Kiflu; Seid Ali; Getahun Mengistu
Background: The global prevalence of Parkinson’s disease (PD) is on the rise and is expected to reach nearly 9 million cases by 2030. Cognitive impairment (CI), which encompasses both dementia and cognitive impairment without dementia (CIND), represents a common complications of PD that carry significant clinical consequences. About 40% of individuals with PD develop dementia—this rate is six times greater than that of age-matched healthy peers. The Identification of Dementia in Elderly Africans (IDEA) cognitive screen is a concise, multi dimensional assessment tool created to tackle the educational bias seen in other cognitive screening instruments used in sub-Saharan Africa. This research evaluates cognitive ability in PD patients utilizing the validated IDEA cognitive screen. In our clinical environment, there is a need for routine cognitive impairment screening among PD patients. This need arises from the lengthy and education-biased nature of currently available validated cognitive assessment tools. Conversely, the IDEA screen is a brief cognitive assessment that is practical for implementation in busy tertiary hospitals such as TASH. Objective: To assess cognitive function and associated factors among Parkinson’s disease patients and baseline characteristics matched control group using IDEA cognitive screen, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia Methods: A comparative cross-sectional study was conducted using systematic random sampling on 150 PD patients and on 150 baseline-matched control group; age, sex, educational level & comorbidity at TASH from September to December 2024. Data were collected using pretested questionnaires and the IDEA cognitive tool by trained neurology residents & general practitioners. The data was cleaned, edited, entered, and analyzed using SPSS version 30. A non parametric regression model was employed to determine factors associated with cognitive function impairment. Results: Among 150 PD patients, 3.3% met the criteria for probable dementia and 9.3% for possible dementia based on IDEA screening. The prevalence of cognitive impairment in the PD group was 9.9% higher than in the matched control group. The median IDEA score was significantly lower in PD patients (12.4 ± 2.25) compared to controls (13.31 ± 1.53). Among PD patients, median IDEA scores declined progressively with older age and lower educational attainment. Illiteracy emerged as the sole significant predictor of cognitive impairment in multivariate analysis. Conclusion: In this study, IDEA revealed probable or possible dementia in 12.6% of PD patients versus 2.7% of controls, reflecting a fourfold higher prevalence of cognitive impairment in PD. Illiteracy was the sole significant predictor of dementia in PD patients, highlighting residual educational bias despite IDEA’s design for low-literacy settings. Key suggestions from the study iv include developing education-stratified IDEA cutoffs for urban LMIC populations, validating IDEA against PD-specific diagnostic tools, improving healthcare-seeking behavior among PD patients, and supplementing IDEA with PD-focused cognitive screens to better capture PD associated mild cognitive impairment. Further research, such as multicenter stu
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Magnitude of Hyponatremia and its Associated Factors Among Acute Stroke Patients Admitted in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2025-02-11) Wubsew Shimelis; . Amanuel Amare; Fikru Tsehayneh; Selam Kifelew
BACKGROUND: Stroke is a serious life-threatening medical condition which is responsible for more than six million deaths annually. It has become the second-leading cause of death and the third-leading cause of combined death and disability worldwide. In Ethiopia as well it is now regarded as a public health threat & remains an important cause of temporary & permanent disability. Significant determinants of poor outcome and mortality in stroke patients is related to both medical and neurological complications. Hyponatremia in stroke is frequently faced electrolyte disturbance. It is observed either on admission or during their hospitalization and associated with increased morbidity and mortality. OBJECTIVE: The end goal of this study is to measure magnitude of hyponatremia and its factors associated with it in acute stroke patients admitted in TASH. It also address associated conditions as contributory of hyponatremia. Magnitude of hypokalemia will be studied along with it as it is measure simultaneously in our laboratories. METHODOLOGY: A prospective observational cross-sectional study design was employed. Eligible men & women age 13 years and above who are willing and able to hand informed consent was participate in this study. Patients with transient ischemic attack (TIA), NIHSS < 5 were excluded from the study. Validated tools like NIHSS, GCS, ICH score and mRS were used to measure the predictor variables. SPSS statistical software has been used to analyze collected data. Binary logistic regression analysis was computed and variables with p-value < 0.25 were considered candidates for multivariable logistic regression. Adjusted Odds Ratios (AOR) with 95% confidence interval was estimated to identify the association. The statistical value was declared as a value of P < 0.05. Result: A sum of 88 stroke patients were engaged in the study with a response rate of 93.6%. The study found that, 39 (44.3%) patients had documented hyponatremia (either within 24hrs of admission, 24hrs to 14 days of admissions or both). The study revealed that patients who were given mannitol infusion treatment (AOR = 4.24, 95% CI: 1.08 16.6) and a proton pump inhibitor (AOR = 4.84, 95% CI: 1.33–17.5) were factors associated with hyponatremia. Conclusion: Hyponatremia is prevalent in acute stroke patients. Receiving mannitol infusion and proton pump inhibitors treatment were identified to be critically associated with hyponatremia among acute stroke patients. Therefore, the review implies a robust emphasis is needed to monitoring and therapeutically managing sodium levels among acute stroke patients.
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Perception and Beliefs of Clergy Regarding on Epilepsy Addis Ababa, Ethiopia
(Addis Ababa University, 2025-02-12) Mesfin Behailu; Abenet Tafesse; Yared Zenebe; Seblewongel Anbessie; Mulugeta Tamirie
Epilepsy is old disease of brain and accompanying with misconception. the first choice of place in the pathway in the treatment of epilepsy patients in Ethiopia is holy water due to religion beliefs. As a result, modern treatments are not the main treatment of choice for the majority of Ethiopian’s epileptic patients. Priests, Imam and or traditional healers are front liner care provider. The target population of this study was the clergy serving in the Churches and Mosques in Addis Ababa. To achieve the general objectives, a qualitative research method was used to explore the beliefs and perception of clergy regarding on epilepsy. Non probability purposive sampling technique was used to meet the inclusion criteria and therefore semi-structured focused group discussion and key informant were used as a method of data collection tools. The finding showed that study participants expressed perceptions and thoughts towards epilepsy disease including about its cause, stigma and misconception, role of clergy in supporting individual with epilepsy. All of the clergies accepted the dual cause concepts of epilepsy .According to them, both spiritual and medical reason attributed for epilepsy. They mentioned their challenges where some individuals feign epilepsy to commit theft, creating fear and mistrust among clergy members. There is a growing recognition of the need to integrate spiritual and medical treatment for epilepsy. Clergy members emphasized that medications are not a sin and should not be seen as contradictory to faith, and they encouraged the use of both spiritual and medical approaches. Providing structured training for clergy on epilepsy and its treatment as well as Fostering collaboration between religious institutions and healthcare providers are recommended. Objectives: To explore the perceptions and beliefs of clergy working at churches and mosques found in the capital city of Ethiopia. Methods: Adescriptive phenomenology qualitative thematic analysis study was conducted with interviews using a semi-structured type of guided interview. The study used a non-probability purposive sampling method
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Chronic Pain and Its Impact on Health-Related Quality of Life among Stroke Survivors in TASH
(Addis Ababa University, 2025-02-19) Abdunasir Siraj; Guta Zeneba; Dereje Melka; Biniyam A. Ayele; Yared Mamushet
Background: Globally, more than 100 million individuals have survived a stroke, making it one of the leading causes of disabilities. The survivors may face various post-stroke sequelae such as depression, language abnormalities, and debilitating chronic pain. Some previous studies conducted else including Ethiopia, have shown that post-stroke survivors have a lower quality of life compared to the general population. Although little information is available in this regard, its contributory impact on HRQoL is unknown and therefore we examined the impact of chronic pain on health-related quality of life among stroke survivors for some improved programmatic initiatives contextually. Objective: This study aimed to determine the magnitude of chronic pain in stroke survivor patients and its impact on their health-related quality of life among patients attending the Stroke clinic, at Tikur Anbessa Specialized Hospital (TASH) Methodology: An institution-based cross-sectional study was used to assess post-stroke patients who visited TASH from September 20 to December 20, 2024. All eligible patients aged above 18 years, able to communicate, and at least three months post-stroke were included. A validated tool; the Brief Pain Inventory (BPI) screening tool and the short version of the Stroke Specific Quality of Life Scale (SS-QoL), were administered through face-to-face structured interviews. Both descriptive and inferential statistics were used and p-value <0.05 was considered significant. Result: A total of 132 stroke survivors were involved. The mean age of the respondents was 56.93 years, ranging from 18 to 87 years. Males account higher proportion 57.6% (76). Ischemic stroke is the most common type of stroke account 69.7% (92). Pain was reported by 22.7% (30) of the patients (95% CI: 15.9%-30.8%), with Central Post-Stroke Pain (CPSP) being the most common type. The pain was significantly associated with a decrease in HRQoL, affecting both physical domain (p < 0.00) and psychosocial domain (P < 0.001). Other factors negatively affecting physical domain are such as occupation (unemployed (p=0.023), retired (p=<0.001) Housewife/housekeeping (p=0.006) and education (illiterate (p= 0.026)). Psychosocial domain is negatively affected by occupation (unemployed (p=0.017). Conclusion: Chronic pain is a prevalent and debilitating complication among stroke survivors, significantly reducing HRQoL. Effective pain management strategies are essential to improve the quality of life in this population.