Browsing by Author "Sefonias Getachew"

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    Alcohol Use and Associated Factors During Pregnancy at Kolfe Keraniyo Sub City in Addis Ababa, Ethiopia, 2017
    (Addis Ababa Universty, 2018-01) Maereg Fekade; Sefonias Getachew
    Background: The use of alcohol is increasing from time to time in all segments of demographics and has become one of the rising major public health and socioeconomic problems worldwide. Alcohol use during pregnancy is associated with significant risks to the unborn child and can contribute to prenatal complications. In Ethiopia, there is expansion of alcohol use and have reached to women in their fertile age that include pregnant woman. Objectives: The main objective of this study was to assess the magnitude and associated factors of alcohol use during pregnancy in Kolfe sub city. Methods: Institutional based cross sectional study was conducted from April to June, 2017 in Addis Ababa, Ethiopia. A total of 380 pregnant women were selected by using systematic random sampling and included in the study. Data was collected using questionnaire. The collected data was coded and entered in the computer using Epi Data version 3.1 and the data was analyzed using SPSS for window version 20. Descriptive statistics such as frequency, proportions, means, medians and standard deviations were calculated. A binary logistic regression model was used to identify associated factors for alcohol use among pregnant women. The results were described using adjusted odds ratio with 95% confidence interval and statistical significant was considered at p value < 0.05. Results: This study revealed that the overall prevalence of alcohol use among pregnant women was found to be 39.8%. The factors like not having formal education[AOR 95% CI=8.47(2.42, 29.62), having primary education [AOR 95% CI= 4.26(1.23, 14.74), being housewife[AOR 95% CI= 4.18(2.13,8.22), unplanned pregnancy [AOR 95% CI=2.47(1.33, 4.60), having history of abortion[AOR 95% CI=3.33(1.33, 6.05)], not having awareness on the effect of alcohol on the fetus[AOR 95% CI=4.66(2.53,8.61)], and not having family social support [AOR 95% CI= 2(1.14,3.53) were found to be significantly associated with alcohol use among pregnant women. Conclusions and Recommendations: the study found high level of alcohol use by pregnant women at Kolfe sub city. Not having education, having primary education, being housewife, unplanned pregnancy, having history of abortion, not having awareness on the effect of alcohol on the fetus, and not having family social support are found to be predictors of alcohol use. Factors associated with alcohol use during pregnancy are essential to reduce alcohol use and its health effect.
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    Association of Pre-Hospital Care and Injury Severity among Road Traffic Injured Patients Admitted in Addis Ababa Public Hospitals Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-10) Bethelhem Fekadu; Sefonias Getachew
    Background: Globally, about 1.25 million people die every year due to road traffic related cases and as many as 50 million more are injured and it is a number one cause for the death among those aged 15-29 years. Ethiopia is one of the countries with the highest number of road traffic injuries in the world. Pre-hospital care play an important role in life support services. The present study was carried out to assess the association of pre-hospital care and injury severity for road traffic accident victims in Addis Ababa public hospitals, Addis Ababa, Ethiopia. Methods: A facility based cross sectional study design was used. Systematic random sampling was used to reach 391 road traffic injured patients from public hospitals. Both patient medical report and a structured questionnaire which is adopted from standardized tool from WHO was used. Kampala Trauma Score II (KTS II) was calculated for the outcome variable injury severity and was ranked as severe injury and non-severe injury. Data was entered to Epidata 4.2 and exported and analyzed through Statistical Package for the Social Sciences (SPSS) version 20.Descriptive analysis was conducted to determine with frequency, proportions and summary measure. Bivariate and multivariable logistic regression was used to identify the relation of independent predictors with the injury severity. The p value less than 0.05 was considered for statistical significance. Results: A total of 385 road traffic injured victims were included. Participants who scored severe injury were 22.9%. The male to female ratio was 2:1. The patient’s ages range from 15- 80, with a mean of 32 and standard deviation of ± 12 years. Pedestrians (48.6%) who were travelling were the majority of road traffic crash victims. More than half of the patients did not get any kind of pre-hospital care before reaching to health facility. Frequently raised reasons for this were lack of equipment (50.6%) and poor knowledge (36.8%). People who had pre-hospital care were less likely to develop severe injury (AOR 0.4595% CI (0.24,0.842)). Additionally, age of the patient and being a driver significantly influenced injury severity score. Conclusion: Road traffic accident constitute major public health problem causing a burden in the health care system. Integrating pre-hospital care in the health care system also plays a major role in minimizing further damage caused by RTA.
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    Compiled Body of Work in Field Epidemiology
    (Addis Ababa University, 2024-09) Faris Sulyman; Ahmed Ali ; Sefonias Getachew
    Introduction: Cholera is a diarrheal illness caused by the gram-negative bacterium Vibrio cholera. It is marked by severe watery diarrhea, which can rapidly result in dehydration and death if left untreated. In June 2023, an unusual increase in cases of watery diarrhea was reported in Soro Woreda, Hadiya Zone. Methods: Between September 1 and October 30, 2023, a descriptive analysis was conducted on the line list of 101 cholera patients. We defined cases, selected study participants, and performed descriptive analysis. We analyzed data in Microsoft Excel 2010, calculating and describing frequency, percentage, mean and median; attack rate (AR), and case fatality rate. Results: The line list showed 101 cases and three deaths, with a CFR of 2.9%. Of the cases, 44(43.5%) were male, while 57 (56.4%) were female. The age-specific case fatality rate was highest among those aged 15 to 44 which was 43 (43.6). The kebele with the most reported cases was Oda 46 (45.5%). The outbreak began on July 7th and continued until December 30th, 2023. Of the overall cases, 66 (66.3%) were seriously dehydrated. Conclusion: Cholera epidemic with a higher overall attack and case fatality rate was confirmed. Females were more affected than males, and the majority of those affected were above the age of fifteen. We advocate preventing future outbreaks, implementing response measures to reduce morbidity and mortality, and developing future cholera prevention policies for the Zone.
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    Compiled Body of Works in Field Epidemiology
    (Addis Abeba University, 2021-03) Ababu Fayisa; Ahmed Ali; Sefonias Getachew
    This document constitutes two years Field Epidemiology Training Program outputs, submitted to graduate school of public health for partial fulfillment of master degree in Field Epidemiology. Compiled Body of work comprises outputs like; case outbreak investigations, public health surveillance data analysis, surveillance system evaluation, health profile description, narrative summary of disaster situation report, scientific manuscript, abstracts, protocol/proposal for epidemiologic research project and others like Public Health Emergency Management (PHEM) weekly bulletin and Supportive supervision report. The document is organized in nine chapters as below:- Chapter one: outbreak investigations on Scabies and Measles in Kenna District of Konso Zone and Mareko District of Gurage Zone in Southern Nations, Nationalities and Peoples Regional state Ethiopia respectively. Both investigations were conducted using a case control study design. Each outbreak investigation reports contain abstracts, introduction, methods and materials, results, discussions, conclusion and recommendations. Chapter two: surveillance data analysis for the last consecutive five years (2014 to 2018) on Dysentery surveillance data in Southern Nations, Nationalities and Peoples Regional Health Bureau. Dysentery case in this Region was continuously reported and followed using weekly trends. Chapter three: surveillance system evaluation on Neonatal Tetanus (NNT) in Hawassa City Administration in the preceding two EFY (2010 &2011). This evaluation was conducted as per the national protocol for NNT surveillance system evaluation. It addressed PHEM surveillance system attributes like simplicity, flexibility, stability, acceptability, representativeness, sensitivity and positive predictive value, timeliness and data quality. Chapter four: Health Profile assessment/description in Gorche District of Sidama Zone, SNNPR Ethiopia. In this chapter, health and health related data of the District were presented which is very imperative for prioritizing high priority problems based on the data of 2017/2018. Chapter five: This chapter comprises of scientific manuscripts for peer reviewed journals on measles outbreak investigation in Mareko District Chapter Six: This chapter includes abstracts of dysentery surveillance data analysis in SNNPR, outbreak investigations of scabies in Kenna District in Konso Zone and narrative summary of disaster situation following flooding and land slid in Konta special district were presented. Chapter Seven:Is on narrative summary of disaster situation visited following flooding and landslide in Konta special district of SNNPR. In this situation, there were loss in human life and resources. Chapter Eight: A research protocol/proposal was developed for the study of the magnitude of hypertension and its associated factors among adults in Burayu Town of Finfine special zone, Oromia Regional State, Ethiopia. Chapter nine: In this chapter other outputs were presented. Those included PHEM weekly bulletin prepared during residency and Supportive supervision done on Malaria epidemic situation response in Wolayita and Hadiya Zones of SNNP Regional State. Also, there is COVID-19 pandemic response activity report that was done in Kirkos Sub-city of Addis Ababa City Administration.
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    Compiled Body of Works in Field Epidemiology
    (Addis Abeba Universty, 2017-06) Sisay Awoke; Sefonias Getachew
    Introduction: Measles is an acute, highly contagious viral disease caused by measles virus and transmitted primarily by respiratory droplets or airborne spray to mucous membranes in the upper respiratory tract or the conjunctiva. Globally during 2002–2009, 180,284 suspected measles cases were reported, of these, 97,204 (54%) were discarded because of a negative or indeterminate measles specific IgM test result; 10,071 (14%) had unknown classification; and 73,009 (41%) were confirmed as measles. Among 2,190 suspected measles cases reported in 61 separate outbreaks in Ethiopia (2015), of which 929 cases were confirmed positive. The aim of this study was to investigate the outbreak and identify associated factors for measles outbreak and to take possible intervention measures in Basso Liben district. Methods and materials: We conducted 1: 2 unmatched case control studies. Face to face interview was conducted to gathered information from cases and controls by using structured questionnaire. Sample size was calculated using Stat calc function of Epi-info version 7 with confidence level of 95%, power of 80%, and assuming percent of controls exposed 18% and percent of cases with exposure 52% for un-vaccination. Total sample size included in the study was 30 cases and 60 controls. Before conducting interview informed verbal consent was obtained from all study participants to meet ethical standards. We entered data to Epi info version 7 and analyzed it by using SPSSversion20 software; finally the model was fitted by using multivariate logistic regression with 95% confidence level and p-value <0.05. Results :In Basso Liben district the total attack rate of measles was 1.24 per 1000 population. The highest age specific attack rate was in under- one age groups (4.76 per 1000 children), and the next was in age groups 1-4 years old which was 3.28 per 1000 population. In multivariate logistic regression contact history with measles case AOR=8.132 (95% CI 2.047, 32.297) and presence of measles case in the neighbor AOR= 6.928 (95% CI 1.37, 29.12) were risk factors for contracting measles. Sisay Awoke, sisaya16@gmail.com,Ethiopian Field Epidemiology Training Program Sisay Awoke, sisaya16@gmail.com, Ethiopian Field Epidemiology Training Program Page 14 But previous history of measles case AOR= 0.10 (95% CI 0.02, 0.56) and vaccinated with measles vaccine AOR=0.11(95%CI 0.021, 0.573) were protective associated factors for measles. Conclusion :In multivariate logistic analysis presences of measles case in the neighbor and contact with measles case were significant associated factors for contracting measles, but previous history of being measles case and vaccination were protective factors for measles. Basso Liben district health office and health centers should improve and strength routine measles vaccine immunization coverage and also under- 30 years age groups should be targeted for supplementary immunization programme for measles.
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    Determinants of Multi Drug Resistant Tuberculosis (MDR-TB) among Tuberculosis Patients in Addis Ababa, Ethiopia: Case Control Study
    (Addis Abeba Universty, 2012-04) Sefonias Getachew; Fikre Enquselassie
    Background: Tuberculosis (TB) is a major cause of death in developing countries; it comprises of 25% of avoidable adult deaths. Even though the global burden and incidence rates of TB have been declining since 2004, drug-resistant tuberculosis remains a growing threat to public health despite advances made in treatment and diagnosis over the past decade. Multidrug-resistant tuberculosis (MDR-TB) which is resistant to at least two drugs of the most powerful first-line treatment, rifampicin (RIF) and isoniazid (INH) is one of the challenging problem worldwide. Ethiopia ranks 15th among 27 high burden MDR-TB countries in the world with an estimated 5200 new cases of MDR-TB each year. Objective: of the study was to assess the potential determinants of MDR-TB among tuberculosis patients in Addis Ababa. Method: A facility based unmatched case control study design was conducted from December 21, 2011 to January 30, 2012. Cases were tuberculosis patients with culture-proved mycobacterium tuberculosis resistant to at least both to isoniazid (INH) and rifampicin (RIF) and controls were Tuberculosis patients with smear positive mycobacterium tuberculosis who turned negative for the recent test after 2nd, 5th or 6th months of treatment course. The case to control ratio was 1 : 2. Cases were selected from two hospitals which give MDR-TB treatment namely St. Peter and Defence Teaching and Referral hospitals. Controls were selected from two hospitals (Federal police and Defence Teaching and Referral hospitals) and seven health centres. Simple random sampling was used to select patients from the register of each hospital and health centres involved. To identify the determinants a multi variate logistic regression was done. Results: A total of 75 cases and 148 controls were interviewed. Among the respondents 41(54.7%) of cases and 84(56.8%) of controls were males. The mean (standard deviation) age among cases and controls were 30.6(10.4) and 28.6(9.9) respectively. The likelihood of MDR-TB were higher among those who reside out of Addis Ababa ( AOR=18.85 (2.21, 161.10), HIV infected (AOR=9.10( 1.48, 54.37) and on previous treatment of TB (AOR=65.57 (14.21, 302.64) and proved to be statistically significant. Conclusion: Previous treatment of TB, HIV infection and residence out of Addis Ababa were the independent predictors of MDR-TB and thus needs a better attention of the national TB prevention and control activities according to the contextual situations so that to avert the rising problem from the country and furthermore, to keep the health of the community.
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    Determinants of Survival among Breast Cancer Patients in Hawassa,Southern Ethiopia: a Retrospective study,2019.
    (Addis Abeba University, 2019-09) Abel Shita; Alemayehu Worku; Sefonias Getachew
    Background: Breast cancer (BC) is the second most common of all cancers and the commonest in women contributing 12% of all new cancer cases and 25% of all cancers in women. It is the most prevalent cancer in Ethiopia. Even if the estimation of BC survival is beneficial to improve the current breast cancer care & treatment, studies are lacking in Ethiopia. Objectives: To identify determinants of survival and to estimate cumulative survival probabilities of patient’s with BC that are diagnosed from 2013-2018 in Hawassa University Comprehensive Specialized Hospital and Yanet Hospital. Methods: A health facility-based retrospective study of 302 patients was conducted. The median survival was estimated by Kaplan- Meier. Log Rank test was used to compare survival among groups. Cox proportional hazards model was used to identify determinants. Results were repaired as hazard ratio (HR) along with the corresponding 95% CI. Sensitivity analysis was done with the assumption of lost to follow-ups (LTF) might die 3 months after last hospital visit. Results: Majorities (83.4%) were presented at an advanced stage. The study participants had followed for a total of 4685.62 person-months. Their median survival is 50.61 months (IQR=18.38-50.80) declined to 30.57 months in worst case analysis (WCA), the outcome of 57 patients were unknown (majorities, 96% being advanced stage) and 67 patients were died. The overall survival (OS) of patients at two years is 69.3% (61.30, 76.03) and it declines to 51.3 % in WCA. Rural residence (AHR=2.71, 95% CI: 1.44, 5.09), travel time > 7 hours(AHR=3.42, 95% CI: 1.05, 11.10), duration of symptom 7-23 months (AHR=2.63, 95% CI:1.22, 5.64), > 23 months (AHR=2.37, 95% CI: 1.00, 5.59), advanced stage (AHR=3.01, 95% CI: 1.05, 8.59) and not taking chemotherapy (AHR=6.69, 95% CI: 2.20, 20.30) were independent predictors of death. Through WCA, rural residence, advanced stage of BC, not having breast surgery, poor adherence to chemotherapy were independent predictors of death. Conclusion: The 2 years OS is low in Hawassa (69.3% and declines to 51.3% in WCA). Rural residence, advanced stage and poor adherence to chemotherapy were independent determinants of death. Increasing early diagnosis of BC and access to cancer treatment is mandatory.
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    Determinants of Survival, Survival time and Recurrence After Surgery among Colon Cancer Patients at Tikur Anbessa Hospital, Addis Ababa , Ethiopia , Retrospective Cohort Study
    (Addis Ababa university, 2023-10-23) Sara Teklewold ; Sefonias Getachew
    Colon cancer is cancer of the large intestine that originates from the colonic epithelial cells that line the lumen of the intestine. It is the fourth most common and fatal cancer worldwide. Globally there were nearly 1.2 million incident cases and over half a million deaths from colon cancer in 2020. In Ethiopia colon cancer is the 5th leading cause of death. Lack of timely seeking of medical help and organized screening practice for early identification of diseases combined with lack of access to curative and palliative care has become reasons for the high burden of premature death in the country. Understanding the survival time and determinants of survival is crucial in developing effective strategies to improve patient outcomes and reduce mortality rates in this setting
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    Early Detection, Referral and Outcome of Breast Abnormalities at Selected Primary Health Care Facilities in Addis Ababa: A Multi-Center Mixed Method Study.
    (Addis Ababa University, 2024-06) Bethlehem Fiseha ; Sefonias Getachew; Lidya Genene
    Background; There are more than 2.3 million cases of breast cancer each year, making it the most common form of cancer. Benign breast conditions, which are not studied well in Ethiopia, together with misdiagnosis and the knowledge gap among health professionals, make the burden even worse. Therefore, this study is crucial in bridging the knowledge gap with this regard. Objective; The aim of this study was to assess the magnitude of patients with breast abnormalities; referral; and professionals’ knowledge about breast cancer early detection work at selected primary health care facilities in Addis Ababa in 2024. Methods; A multi-center, mixed-method study using a multi-stage sampling method was conducted at primary healthcare facilities. The quantitative study, which was a retrospective cross sectional study, was conducted on all case note audits of patients for year 2023 to assess magnitude and patient outcomes. The other quantitative study had a cross-sectional design and a self-administered questionnaire was provided to health care professionals to assess their knowledge about breast cancer early detection work. The data was collected using Open Data Kit. The qualitative study was conducted with phenomenological study approach. The quantitative data was analyzed using STATA version 14 software. Descriptive statistics was done using frequency and percentages. Categorical data analysis and binary logistic regression were also done. Odds Ratio with its 95% Confidence Interval was used as a measure of association. Variables having a p value less than 0.05 in the multivariable model were considered as having significant association with the dependent variable. Results; The prevalence of breast abnormalities at the selected health facilities was 170.31 per 100,000 population among adult population and 109.14 per 100,000 female populations among women 30 and older. Patient delay was more than 30 days in 23.5% (85) of the cases. Only 14.9% (54 of the patients were referred to the next health facilities and physical examination was done only for 20.4% (74) of them. Of the health professionals, 27.6% (137) were knowledgeable (95%CI (0.24, 0.32)). Among trained health professionals, 72.7% (32) had poor knowledge. Work experience (AOR=5.61, 95% CI, (1.32, 23.9)); and risk factor identification (AOR=3.53, 95% CI, (1.66, 7.50)) were factors affecting knowledge of health professionals about breast cancer early detection work. The qualitative findings confirmed and explained the quantitative study findings such as absence of referral feedback, screening services and diagnostic investigations; poor knowledge of health professionals; and patient and healthcare related delays. Conclusions; There is higher prevalence of breast abnormalities among age 30 and above. Only 14.9% (54) of the patients were referred to the next health facility. Absence of diagnostic investigations and referrals with incomplete information together with absence of referral feedbacks deterred the referral experience. Majority of primary healthcare professionals have poor knowledge of breast cancer early detection work resulting in misdiagnosis and negligence. Trainings were given for very few of the health professionals and it was not effective that majority of the trained ones were not knowledgeable.