Browsing by Author "Naod Firdu"

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    Adherence to Highly Active Antiretroviral Therapy and its Associated factors among HIV Infected Adolescents in Addis Ababa, Ethiopia
    (Addis Abeba University, 2014-06) Naod Firdu; Fikre Enquoselassie; Degu Jerene
    Background: For antiretroviral therapy (ART)to work effectively, adherence is very crucial.However, most of the studies done on ART adherence are either on children or on adults. There is limited information on the level of adherence among adolescents. Since the physical,biological and behavioral changes which occur during adolescence could affect ART adherence, we endeavored to assess the level of adherence among adolescents treated at three hospitals in Addis Ababa, Ethiopia. Study Objective: This study was carried out to assess the magnitude of ART adherence among HIV infected adolescents in Addis Ababa, Ethiopia. It also looked into the various sociodemographic, behavioral and clinical factors associated with ART adherence among adolescents. Study Methods: Using a cross-sectional study design, 273 HIV infected adolescents receiving ART were interviewed from three hospitals in Addis Ababa. We used a structured questionnaire to measure adherence levels using patient self-reports among randomly selected adolescents aged 13-19 years. Data was entered using Epi Info version 3.5.4 and exported to SPSS version 21 for analysis. Bivariate and multivariate methods were used for analysis. Results: We interviewed 273 adolescents aged 13 to 19 years, and 144 (52.7%)of the participants were female. Their mean age was 15.42 years (SD± 1.75). The self-reported adherence rate of the respondents was 79.1% (216/273). Most (96%)were on first line antiretroviral drugs. The median duration on ART was 7 years (IQR, 3). On Bivariate analysis; WHO stage, being on Cotrimoxazole Prophylactic Therapy (CPT), marital and living status of the parent, whether parent was on ART and having special instructions for ART medications were associated with optimum adherence. However only WHO stage IV (adjusted OR, 12.874 95% CI, 2.079-79.706), being on CPT (adjusted OR, 0.339 CI, 0.124-0.97)and adolescents with widowed parent (Adjusted OR, 0.087 with CI, 0.021-0.359) were significantly associated with optimum adolescent ART adherence. Conclusions: The level of self-reported ART adherence among HIV infected adolescents at the three hospitals was below the recommended threshold. Being in advanced WHO clinical stage was associated with better adherence levels, but history of taking CPT was associated with poorer adherence. Earlier presentation of adolescents to care should be encouraged, but more targeted adherence support should be planned for those who present at early stage of their illness.
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    Compiled Body of Works in Field Epidemiology
    (Addis Abeba University, 2019-06) Habtamu Tilahun; Girma Taye; Naod Firdu
    This document contains a two years Field Epidemiology Training Program outputs which is equivalent with thesis to be submitted to graduate School of Public Health for fulfillment of masters degree in Field Epidemiology. It includes reports of diseases outbreak investigations,public health surveillance data analysis, surveillance system evaluation, narrative summary of disaster situation report, manuscript, abstracts, and training reports. Chapter One: Contains disease outbreak investigations. I have conducted two outbreak investigations. The first outbreak investigation was conducted using unmatched case control study design. The investigation report contains abstract, introduction, methods, discussions,conclusion, recommendations and references separately. The second outbreak investigation was conducted on suspected Chicken pox outbreak in Yirga chefe town. It is descriptive outbreak investigation and response among two internally displaced population sites. It conatains introduction, objective, methods, results, discussion, conclusion, recommendations and references separately. Chapter Two: contains report of surveillance data analysis which was conducted on Analysis of Influenza of five years. Five years data (2013 to 2017) was used in the analysis. The objective of this study was to describe Influenza like illness cases distribution by person, place, and time to recommend possible solutions based on the findings. Chapter Three: Addresses Malaria surveillance system evaluation in Bahir dar zuria district of Amhara regional state. This chapter clearly presents the purpose and objectives of the malaria surveillance and its progress towards achieving its objectives. The surveillance system attributes: simplicity, flexibility, stability, acceptability, representativeness, timeliness, data quality, and sensitivity were also assessed in this chapter. Chapter Four: Contains report of assessment of Health Profile data description of Burie zuria district in West Gojjam zone of Amhara regional state. In this chapter health and health related data of the woreda were evidently presented which is indicative for prioritizing public health problems in the woreda. Chapter Five: Contains Scientific Manuscript for Peer reviewed Journals. It’s on five years surveillance data of Infeluenza in shiro meda health center sentinel site. Chapter Six: Contains the abstract on Influenza surveillance data in Shiro meda health center sentinel site from year 2013 to 2017, abstract on outbreak investigation of Measles in Dgehabour city of Somali region in March 2019 and outbreak investigation of suspected chicken pox in Yirga chefe town in August 2018. Chapter Seven: Contains the disaster situation report of Gedeo zone in SNNP region. It describes the disaster situation of internally displaced Population from East and West Guji zones of Oromia regional state. It has its own introduction, objective, method, result, discussion and recommendations separately. Chapter Eight: Contains the project proposal to conduct an assessment on Knowledge, Attitude and practice towards use of Insecticide treated bednets in Burie zuria district of west gojjam zone of Amhara regional stae. It has separate introduction, objectives, and methods. Chapter Nine: Contains the training report of Rapid response team (RRT) in four woredas of Gedeo zone of SNNP region in August 2018.
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    Compiled Body of Works in Field Epidemiology
    (Addis Ababa University, 2019-05) Tadesse G/Mariam; Alemayehu Worku; Naod Firdu
    The Ethiopian Field Epidemiology Training Program is a two year post graduate training program. The training is provided in collaboration with Addis Ababa University, School of Public Health, Ministry of Health and Ethiopian Public Health Association. The program designed to work 75% of the time in service and 25% theory, it is learning by doing. For the partial fulfillment of master‘s in public health in field epidemiology, this summary compiled two year residency outputs; surveillance data analysis, surveillance system evaluation, health profile, outbreak investigation, manuscript and disaster report. The document is organized in eight chapters; chapter one deals about outbreak investigation. During the residency period it has been conducted two outbreak investigation; one was measles outbreak investigation which was conducted in South Sudan refugee camp in Gambella region. On this investigation we conducted a case control study. The second outbreak investigation was a case study on food poison conducted in Kubri Kebele Lare woreda Gambella region. Chapter two explains about manuscript on measles outbreak investigation. Chapter three explains about surveillance data analysis which was conducted Gambella region on Malaria disease. The analysis was made from the year 2015-2017 and it address the burden of rubella disease in the country by place, person and time. Similarly chapter four is about malaria surveillance system evaluation conducted in Gog wereda Gambella region. In this chapter purpose and objective of surveillance system, progress towards the objective and also attributes of the surveillance system was discussed. Chapter five is about health profile of Itang special wereda Gambella region. In this chapter health and health related data of the woreda presented. Chapter six presents narrative summary of disaster situation which was conducted in Nuer Zone Gambella region; as part of early warning and vulnerability assessment. It was done together with partners working on health and nutrition. The assessment was conducted to identify potential problems which need humanitarian assistance in the Maher season. Chapter seven presents Project proposal on knowledge, attitude and practice of notifiable disease surveillance and reporting. The proposal intended to do descriptive cross-sectional study in Nuer Zone Gambella regional state. Finally, chapter eight presents Public Health Emergency Lare woreda yearly bulletin prepared.
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    Effect of Maternal Waiting Home Utilization on Maternal and Perinatal Health Outcomes, in Selekleka Primary Hospital, Northern Ethiopia: Retrospective Cohort Study.
    (Addis Ababa Universty, 2018-06) Tekia Zafu; Naod Firdu
    Background: Maternal waiting home is a facility within easy reach of a hospital or health center which provides emergency obstetric and newborn care (EmONC) to accommodate women in their final weeks of pregnancy. World health organization has been introducing maternal waiting home services in order to increases maternal health utilization to improve maternal and newborn health outcomes. However, according to previous studies, its effect on maternal and perinatal health outcomes is controversial. Objective: This study was aimed to assess the effect of maternal waiting home utilization on maternal and perinatal health outcomes. Methods: Retrospective cohort study was conducted from 01/01/2018 to 30/01/2018 and compared maternal waiting home user (330) and non-user (343) mothers who were admitted for delivery between 01/01/2015 and 31/12/2017 in Selekleka primary hospital, Tigray, Ethiopia. They were selected using simple random sampling method. The survival time of the mothers and their newborns were evaluated using life table and Kaplan Meier survival function. Cox proportional hazard regression model was used to determine the hazard ratio of maternal and perinatal death and complications for each predictor. Result: The incidence rates of maternal complications and perinatal death and complications were significantly lower among the maternal waiting home users than non-users. Maternal waiting home user mothers [AHR: 0.11 95% CI: 0.07 - 0.19] and mothers who gave birth twin [AHR: 3.4, 95% CI: 1.5 - 7.4] were the independent predictors of the maternal complication. Similarly newborn born from maternal waiting home user mothers [AHR: 0.16, 95%CI: 0.08- 0.31], born from complicated mothers [AHR=2.91, 95% CI: 1.68 - 5.05], newborn lives in rural area [AHR=0.49, 95% CI: 0.25 - 0.96] and newborn weighted <2500 gm [AHR: 2.26, 95% CI: 1.1, 4.64] were the independent predictors of the perinatal death and complications. Conclusion and Recommendations: The incidence rate of maternal and perinatal death and complications were significantly lower among the maternal waiting home users’ group, and the government should have to encourage and support to the mothers to use maternal waiting home services.
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    Practice of Ergonomic Principles to Prevent Work-Related Musculoskeletal Disorder and Associated Factors among Health Care Workers in Public Hospitals of Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-07) Yohannes Kenne; Naod Firdu; Wondimu Ayele
    Background: -Healthcare providers are at risk of Work-related musculoskeletal disorders including low back pain, neck pain, shoulder pain and results in discomfort, inability to perform tasks properly, and affects the quality of life and reduces productivity. Practice of ergonomics principle to prevent work-related musculoskeletal disorder among healthcare providers is not well studied in Ethiopia. Objective:-This study aimed to assess the Practice of ergonomics principle to prevent work-related musculoskeletal disorder among healthcare providers in public hospitals. Methods:-Institutional-based Cross-sectional study design was conduct among 422 selected health workers from February- April/2020 in three selected public hospitals found in AA City Administration. Participants were selected by using systematic random sampling techniques. A semi-structured self-administered questionnaire was used to collect data. Data were entered to EPIdata 3.1 and exported to SPSS 20 for further analysis. Descriptive statistic was used to summarize knowledge, attitude and practice and also ordinal logistic regression was applied to test significant association. Result: -A response rate of this study was 94%. 239 (60.2%) of the respondents were female and 224(56.4%) of them were single in marital status. 262(66%) of study respondents had a fair knowledge level regarding WRMSDs preventions and occurrence. And again 254(64%) of the respondents had a poor attitude toward WRMSDs. Only 9(2.3%) of the respondents were practicing of ergonomic principles while at work. The level of knowledge was significantly associated with practices of ergonomics principles. Practices of ergonomics principles was significantly associated with sex of respondents, number of working days per week, number of working hours per day were significantly associated with level of practice at p-value <0.05. Conclusion and Recommendation: - the proportion of health workers knowledge, found to be unsatisfactory in the prevention and occurrence of WRMSDs and poor attitude and practices of ergonomic principles might result in a high prevalence of WRMSDs and also there are associated factors with practice level. So it is recommended that healthcare providers should focus on preventive strategies and health facilities and government should give attention on preventive strategies and developing guidelines
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    Survival of Stroke Patients According to Hypertension Status in Northern Ethiopia
    (Addis Ababa University, 2019) Zenawi Hagos; Naod Firdu ; Wondimu Ayele; Yared Mamushet
    Background: Globally, stroke appears as a major cause of preventable death and disability. In Ethiopia, the intra-hospital mortality of stroke is significant and there is scarcity of epidemiologic data whether there is a difference in the overall survival time between hypertensive and non-hypertensive adult stroke patients admitted in specialized hospitals. Objectives: To determine the survival of stroke patients according to their hypertension status admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia from March 1, 2012 to February 28, 2019. Methods: A facility-based retrospective cohort study conducted among all cohorts of confirmed first-ever stroke patients admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Kaplan-Meier survival analysis applied to estimate the survival probability of hypertensive and non-hypertensive first ever stroke patients. Cox proportional hazards regression model used to determine the adjusted hazard ratio of death for each main baseline predictor variable, with 95% CI and P-value <0.05 was used to declare statistical significance. The assumptions of Cox proportional hazards regression model assessed by the global test, Schoenfeld residuals. Results: There were 503 (323 were hypertensive, 180 Non-hypertensive) confirmed first, ever stroke patients, the overall median age of the patients was 65 years, IQR (53-75) years. Seventy-five (14.91%) of them were dead, with median survival time of 48 days and 428 (85.09%) of them were censored. At any particular point in time the hazard of death among hypertensive patients was two times higher than non-hypertensive patients but this was not found to be a statistically significant (adjusted HR=2.13: 95% CI 0.66-6.81). Glasgow coma scale 3-8 at admission (adjusted HR=10.12; 95% CI 2.58-40.68), presence of stroke complications (adjusted HR=7.23; 95% CI 1.86-28.26) and borderline high total cholesterol level (adjusted HR=3.57; 95% CI 1.15-11.1),were the only independent predictors of intrahospital patient mortality. Conclusion and recommendations: There was a non-significant difference in the overall survival time between hypertensive and non-hypertensive first-ever stroke patients. Early identification and treatment of stroke complications, co-morbidities along with strict follow up of comatose patients may improve intra hospital survival of stroke patients and we recommend community based studies using large sample size.