Browsing by Author "Addissie, Adamu (PhD)"
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Item Assesment of Knowledge about Cervical Cancer and Barriers towards Cervical Cancer Screening among HIV Positive Women, in Health Centers of Addis Ababa, Ethiopia(Addis Abeba Universty, 2016) Shiferaw, Saba; Addissie, Adamu (PhD)Background: Cervical cancer is the second most common women cancer with 528,000 new cases each year worldwide. Current estimates indicate that every year 7095 women are diagnosed with cervical cancer and 4732 die from the disease in Ethiopia. The magnitude of precancerous cervical cancer lesions as well as invasive cervical cancer is higher in HIV-infected women than others. Participation in screening for cervical cancer is poor among Ethiopian HIV patients. The awareness women have about the disease can play a vital role in the prevention, early diagnosis and treatment of cervical cancer. Information regarding this area is very scares in HIV patient of Ethiopia, so this study aims to assess women’s knowledge about cervical cancer and barriers to cervical cancer screening among women living with HIV in health centers of Addis Ababa city. Methodology: A facility based cross sectional study design using both quantitative and qualitative method was conducted among 594 HIV positive women with age between 21and 65 years. Univariate and binary logistic regression analysis were performed. Chi square test was used and p-value < 0.05 was considered for multiple regressions. Open code analysis was used to code and categorize qualitative data, and then thematic analysis was employed. Result: Out of 581 women enrolled with mean age 34.9±7.7 years, 41.1% were married, 34.1% had primary school while 57.8% of participants have heard about cervical cancer. Only 21.3% were knowledgeable about cervical cancer and cervical cancer screening, 86.2% were willing to be screened and 10.8%% were already screened for cervical cancer. In multivariate analysis educational status and knowing someone with cervical cancer were associated with knowledge score with p < 0.05. Conclusion and recommendation: Knowledge regarding cervical cancer is poor among HIV positive women and screening rate was low. The most commonly identified barrier was lack of awareness, so it is needed to scale up health education regarding cervical cancer and screening methods for HIV positive women in Addis Ababa.Item Assessment of Knowledge and Attitude of Cervical Cancer and Screening among Primary Health Care Workers of West Wollega Zone, Ethiopia,2016.(Addis Abeba Universty, 2016-05) Bekela, Eba; Addissie, Adamu (PhD)Back ground: Cancer of the uterine cervix is the most common cancers among women worldwide. The global burden of cervical cancer is disproportionately high among the developing countries. Sub-Sahara Africa is the region with the highest incidence of cervical cancer. In Ethiopia many women seek treatment only at a very late stage when their cancer has significantly advanced and facing a higher probability of mortality, though it is a preventable and curable disease if identified at an early stage. Knowledge of cervical cancer helps to have a clear understanding of the need for early detection. Objectives:The aim of this study is to assess knowledge and attitude of cervical cancer and screening among primary health care workers of west Wollega, Ethiopia, 2016. Methods: An institutional based cross-sectional study was conducted from February -June 2016 among 417 west wollega primary health service providers. Stratified sampling technique was utilized to stratify study source into Hospitals and health center. Bivaraite and multivariate analysis were used. Results: Over all knowledge of cervical cancer was 36% and knowledge of cervical cancer screening were 15% and 44.6%of participants had positive attitude towards cervical cancer. Profession of the respondents was found to be statistically significant towards knowledge of cervical cancer. Majority of the respondent were not heard about cervical cancer screening. Level of knowledge of cervical carcinoma was associated with attitude on screening, those with good knowledge were more positive Conclusion and recommendation: The study revealed that low level of knowledge on cervical cancer and screening. And also participants had negative attitude. There is aneed to design and implement awareness creation program on cervical cancer and screeningItem Assessment of Magnitude, Barriers and outcomes Related with HIV Serostatus Disclosure among art users, in Addis Ababa art providing Health Facilities(Addis Abeba Universty, 2009-06) Koyira, Aklilu; Addissie, Adamu (PhD)Background:- Disclosure of HIV Serostatus to sexual partner and other individuals is important in prevention of new HIV infection transmission especially in developing countries and helps to initiate early treatment and in order to obtain appropriate support from sexual partners, family members and the whole community at large. Objective:- The aim of the study was to identify the magnitude, barriers and outcomes associated with HIV serostatus disclosure among ART users in Addis Ababa ART providing health facilities to their sexual partners and to significant others. Study Design:- Facility based quantitative cross-sectional study was conducted from April-2009 to May- 2009 in Addis Ababa ART providing health facilities using structured questionnaires among ART receiving clients who were married or who were in cohabiting sexual relation with their sexual partners and living together at the time of their initial VCT. Quantitative study was supplemented by qualitative study among ART receiving clients who were involved in PLWHA organizations. Result:- In the study 341 study participants who were married in legal way and who were not married in legal way (cohabiting) at the time of their initial VCT were involved in the study. Among them 157(46%) were male study participants and 184(54%) of them were female study participants. Total disclosure rate was 88.3 (89% for males and 87.5% for females). Bivariate and multivariate analysis identified factors associated with disclosure of HIV serostatus to sexual partners includes: Living with sexual partners in legal marital relationship, living with sexual partners within the same household, smooth marital relationship with sexual partner, having sexual partner whose HIV serostatus was positive and discussing with sexual partner about HIV and VCT before HIV diagnosis were identified factors for disclosing HIV serostatus to sexual partners COR 2.737(1.360, 5.430) and AOR 3.572(1.399, 9.122), COR 2.745 (1.336, 5.64), COR 4.608(2.311,9.191) and AOR 5.263(2.360, 11.740) , COR 4.991(2.002, 12.440) and AOR 8.024(2.807, 22.935), COR 5.341(1.820,15.672), COR 6.604(2.224, 19.607) at the 95% CI respectively). Barriers and dalliance for disclosure of HIV serostatus identified were: fear of loss of support from sexual partners (9.4%), not having enough time to discuss with their sexual partner about their HIV serostatus (7.9%) and sexual partner may get anger (6.2%) were some of identified reasons among other identified reasons. Reassurance by disclosed individuals, obtaining support from people, being annoyed by disclosed people; being threatened and beaten by their sexual partners were some of the outcomes associated with disclosing HIV serostatus. Conclusion:- Even if the disclosure rate of the study is encourage as it is compared with developing countries still significantly proportion of peoples did not disclose their HIV serostatus immediately and not disclose until know and were found engaged in unprotected sexual activity which could hamper strong effort made to prevent new HIV transmission to sexual partners.Item Assessment of Noise induced hearing loss and Associated Factors among Workers in Akaki basic Metal Industry, Addis Ababa, Ethiopia(Addis Abeba Universty, 2015-06) Hailu, Ashenafi; Addissie, Adamu (PhD)Background: - Excessive occupational exposure to noise results in a well-recognized occupational hearing loss and now is taken as a global problem. Worldwide, approximately 600 million workers are exposed and 16% of disabling hearing loss in adults is attributed to occupational noise. However, in developing countries including Ethiopia there is no systematized recording and reporting of noise induced health problems. Objectives: - To assess the magnitude and associated factors of noise induced hearing loss among Akaki basic metal Industry workers, between March and April, 2015. Methodology: - Institutional based cross-sectional study was conducted in Akaki Basic metal Industry. A total of 244 eligible workers were included in study by using simple random sampling from workers` attendance sheet of respective sections. A pre-tested interviewing questionnaire, Environment noise survey, audiometric test were conducted. Epi-Info version 7 software was used for data entry and cleaning and then data exported to SPSS version 21 software for further analysis. Logistic regression model was used to identify factors associated with outcome variable. Results:- Audiometric measurement revealed that the prevalence of noise induced hearing loss in Akaki Basic Metal Industry was 22% (95% CI 17- 27). Previous exposure of noise (AOR = 2.8, 95% CI: 1.032-7.923), service year 11-20 years (AOR = 2.3, 95% CI: 1.078- 6.262) and service years 21-30 years (AOR = 5.2, 95% CI: 2.317- 11.507) when compared with 1-10 years’ service respectively were significantly associated with noise induced hearing loss. But, drinking alcohol (AOR= 1.6, 0.740-3.236) and being hypertensive (AOR = 1.7, CI: 0.800 – 3.776) respectively were not significantly associated with NIHL. The environmental noise level measurement was Mean (SD) of 89 + 13.65 dB A. Conclusion: - The prevalence of hearing loss in Akaki basic metal industry shows significant number with association of level of exposure, previously exposure to noise and duration of exposure. This shows as great effort is needed from administrative of the industry to provide appropriate hearing protective devices based on noise level of sections and change the behavior of workers towards using it, monitor noise level according to the country`s standard and installation of acoustics materials with in the industry to protect the health of workers from noise hazard.Item Assessment of sexual behaviors and factors influencing risk perception on HIV/AIDS among preparatory students in Adama town, East Shoa zone, Oromia region, Ethiopia(Addis Abeba Universty, 2011-05) Gashaw, Ketema; Addissie, Adamu (PhD)Background: Globally an estimated 11.8 million young people aged 15 to 24 are living with HIV/AIDS. Each day, nearly 6,000 young people between the ages of 15 and 24 become infected with HIV. In Ethiopia there are currently 1.2 million PLHIV, with an adult HIV prevalence of 2.4%. Study show that as high as 48.2% of in school youth who were engaged in risky sexual behaviors considered themselves to be at no or low risk of HIV infection. Objective: To assess sexual behaviors and identify factors influencing risk perception towards HIV/AIDS among preparatory students in Adama town. Methods: This cross-sectional survey was conducted from December 27, 2010 to January 12, 2011. Quantitative study was conducted based on self administered questionnaire among 737 in school youths with 97.23% response rate. To support quantitative findings, a qualitative study also was conducted using four focus group discussions. Quantitative data was analyzed using SPSS16 version and qualitative data by thematic analysis. Results: Out of the total respondents 47.1% were males and 52% were grade 11th. About 19.7% of the respondents were sexually experienced. Thirty Six (24.8%) of the sexually experienced respondents reported that they have more than one sexual partners and 7(4.8%) have had sex with commercial sex workers. Among the sexually active respondents 21(22.1%) had never used condom and only 37 (38.9%) use condom consistently. Only 16(2.2%) of Participants perceive they are at risk of HIV infection. In multivariate analysis, being a female by sex (AOR= 0.61(0.39, 0.94), Older youth (20-24) years AOR=3.69(2.09, 6.54), and Khat chewing AOR=3.96(2.34, 6.69) with 95% CI have shown significant association with sexual experience. Conclusions and Recommendation: School youths were beginning sexual intercourse earlier, practicing sex with multiple partners, and with commercial sex workers, and low rate of condom use during their sexual encounter. They have very low personal risk perception towards HIV infection. Therefore programs targeted towards youths should be promoted youths participation and give emphasis on developing their life skills to put knowledge in to practice.Item Compiled Body of Works in Field Epidemiology(Addis Abeba Universty, 2016-05) Mekonnen, Mikiyas; Addissie, Adamu (PhD)This document contains two years Field Epidemiology Training Program outputs, to be submitted to school of public health for fulfillment of Masters Degree in Field Epidemiology. This Compiled Body of Work has eight chapters and eight annexes. Reports of diseases outbreak investigations, public health surveillance data analysis, surveillance system evaluation, narrative summary of disaster situation report, manuscript and abstracts presented in eight chapters. Chapter One: This chapter contains findings of two outbreak investigations. The first outbreak investigation was conducted on an outbreak of psychogenic disorder in primary school of Sululta district, Oromia Regional State. The objective of the investigation was to verify the outbreak and asses the distribution and risk factors of the outbreak to implement control measures. We used a descriptive analysis of the line list followed by a sex matched case-control study; we identified 183 case of psychogenic disorder (conversion disorder) with female dominance (62%). The outbreak was controlled mainly by giving health education to students, teachers and families of cases. We recommend provision of health education to community of the locality on psychogenic disorders. On a bigger scale, we recommend primary schools in the country to have a school Psychologist to help on overall psychological problems of students including in a possible incidences of mass psychogenic disorders. The second outbreak investigation was on Measles outbreak in Telalake district of Afar. We used a descriptive analysis of the line list followed by a sex matched case-control study; we identified 21 cases of Measles (the first five cases were lab confirmed). Eighty-one percent of the cases were not vaccinated for measles. The outbreak was controlled by providing mass vaccination and health education activities. We recommend strengthening health education and routine and catch up immunization programs activities by the district health office to prevent similar outbreaks. Chapter Two: Presents report of surveillance data analysis conducted on maternal death. We retrospectively analyzed national surveillance report collected from October 2013 to September 2015 to describe the distribution and determinate of maternal death in Ethiopia. The summary of the findings has shown that the overall maternal mortality ratio is 28.9 per 100,000 live birth with big disparity among regions the maximum being at Dire Dawa 94 deaths per 100,00 live Page xvi birth and the minimum being at addis Ababa 2.7 deaths per 100,000 live births. The top three causes of maternal deaths found to be hemorrhage followed by sepsis and hypertensive disease of pregnancy. We recommend much focus should be given to the top three common causes of maternal deaths (hemorrhage, sepsis and hypertensive disease of pregnancy) to reduce and improve maternal outcomes. The number of reported maternal mortality is far below the local and international estimates, which needs an evaluation of the overall maternal mortality surveillance system (based on this result, we conducted evaluation of MDSR system in Tigray region which presented in the next chapter).Item Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) Compiled Body of Works in Field Epidemiology(Addis Abeba Universty, 2015-05) Mamo, Dereje; Addissie, Adamu (PhD)Background: In Southern Nation Nationalities and Peoples' Region outbreaks of measles occur every year. On December 23/2013 the regional PHEM received a report of suspected outbreak of measles from Gedeb woreda and we conducted to verify the outbreak, identify risk factors and implement control measures to contain the outbreak. Methods: Unmatched cases-control study was conducted enrolling 41 cases and 82 controls (1:2 ratios).The study was conducted in Gedeb Woreda, Gedeo Zone, SNNPR from December 13/2013 to January 15/2014. Data was collected using structured questionnaire and analyzed using EpiInfo 7.1.4.0 and MS Excel 2013. Result: We identified a total of 108 cases of measles (5 laboratory confirmed and 48 epi-linked) with median age of 7years, ranging from 6 months to 16 years. The most affected age group was under five years of age (47.2%) followed by 5-9 years of age group (36.1%).The age specific attack rate was also highest in age group of under five year (185/100,000) followed by those 5-9 years of age group (132/100,000) with case fatality of 0% for all. From all measles patients 95 (88%) have no history of vaccination and only the rest 13 (12%) of the cases have history of at least one dose of measles vaccine exposure. The proportion of male 63(58%) was higher than female cases of measles [1:1.4]. Conclusion: The incidence rate of measles in Gedeb woreda was highest among children under 5 years of age (185/100,000) and it is essentially less than measles incidences recorded in different regions of the country. Sub optimal measles vaccination coverage for consecutive years resulted in increased number of susceptible population and triggered the outbreak finally. Key words: Outbreak investigation, Measles, SNNPRItem Ethiopian Field Epidemiology and Laboratory Training Program (EFETP) Compiled Body of Works in Field Epidemiology(Addis Abeba Universty, 2015-05) Hailu, Engdayehu; Addissie, Adamu (PhD)Abstract Introduction: Measles is an acute, highly contagious viral disease caused by measles virus. Measles is the fifth killer disease among <5 Yrs of age worldwide. Measles case account for 4% of childhood mortality in Ethiopia. Suspected outbreak of measles was investigated to determine risk factors associated with and to take preventive and control measures based on the findings. Methods: We conducted a descriptive study followed by 1:1 unmatched case control study. EpiInfo7 were used for data processing and analysis. Result: A total of 67 measles cases (5 IgM positive) with median age of 4 year (Q1=0.2; Q3=10) and no deaths reported. The overall attack rate in Kebele was 113 cases with <1, 1-4 and 10-14 year children recorded the highest attack rate of 343, 392 and 244 cases per 10,000 population respectively. The odds of illness in those vaccinated were 0.16 times less than those who were not vaccinated [95%CI (0.07-0.34)]. Contact with the case [95%CI (1.95-8.35)] and <5 year malnutrition [95%CI (1.47-7.82) were significantly associated with the disease. Cases from households of family size >7 persons and illiterate parents were 3.02 times [95%CI (1.49-6.10)] and 4 times [95%CI (1.93-8.21)] more likely to develop measles respectively. Conclusion: An outbreak of measles occurred in Melgano Doya Kebele of Bona Zuria Woreda. Unvaccination, having contact with case, living in crowded room, <5 children malnutrition and illiteracy of parents were associated with contracting measles. <5 years children vaccination, case management, health education and active case search undertaken as prevention and control measure. Keywords: Measles outbreak, Melgano Doya, Bona Zuria, EthiopiaItem Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology(Addis Abeba Universty, 2014-06) Gurmamo, Markos; Addissie, Adamu (PhD)Back Ground: Malaria is Mosquito vector borne blood parasitic Disease and One of the major Health problems of humankind. Even though intensive control measure like vector control, environmental management through community participation, malaria disease remained public Health concern of our country. Unusual Malaria cases increment was reported from Le-Zembara kebele, Tembaro district, Kembata Tembaro Zone, SNNPR, Ethiopia, in January 2016. We investigated the outbreak to describe the Magnitude of the disease and identify the risk factors associated with the outbreak. Method: Microscopic and RDT laboratory investigation conducted to confirm the disease. Person, place and time describe the disease magnitude. The threshold of the malaria disease in this kebele is compared by using the previous same season case data. We conducted the case control study with randomly selected 44 cases and 88 unmatched community controls. Epi Info 7.1.4 and Microsoft Excel were used to perform data entry and analysis. We also assessed environmental risk factors for the outbreak. Previous years’ malaria data was received to establish threshold level and understand trends of the disease. We conducted case control study randomly selected 44 cases unmatched 88 community controls from the community. Result: - A total of 659 confirmed malaria cases (Attack Rate: 106 per 1000) and zero death were reported from January to February 2016 with the peak in February. Slide positivity rate was 77.8 %. Above 4 years age group were more affected by malaria (Age specific attack rate of per population was 121). Using bed net every night was preventive effect for the disease (Odds Ratio: 0.6, 95%CI, and 0.7-1.4). Presence of stagnant water (Odds Ratio: 6.2, 95%CI 1.5-24.8), presence of intermittent rivers in the area is (Odds of 1.6, 95%, 0.7-3.3 were associated with the disease occurrence. Conclusion and Recommendation:- Presence of stagnant water bodies near living area , Low utilization of Insecticide treated bed nets in the households and staying more time outside during night time are most associated factors for this malaria disease outbreak .Kebele was not 2 | P a g e ( B O W , M a r k o s G u r m a m o K a l o r e ) J u n e , 2 0 1 7 . sprayed with IRS (Propecxure chemical) since 12 months. We recommend the draining of stagnant water bodies, Proper Utilization of ITNs, and spray of IRS FOR households. Key Words: Malaria, Outbreak, Case-Control, Le-Zembara, Ethiopia.Item Factors Associated With Cervical Precancerous Lesion among Women Screened for Cervical Cancer in Addis Ababa, Ethiopia 2016(Addis Ababa University, 2016-06) Teame, Hirut; Addissie, Adamu (PhD)Background: Cervical cancer is the second most prevalent cancer among women in the developing countries including Ethiopia. Identifying the factors associated with cervical precancerous lesion may help us to address the cervical cancer related problem. Studies on the issues of factors associated with cervical precancerous lesion in women are limited in Ethiopia. Objective: To determine factors associated with cervical precancerous lesion among women screened for cervical cancer in Addis Ababa. Methods: Hospital based unmatched case control study was conducted in selected health facilities of Addis Ababa city from March to April 2016. Data was collected from 114 cases and 229 controls using interviewer administered questionnaire and entered to Epi Info version 7 and exported to SPSS version 20 for analysis. The odds ratio with their 95% confidence interval and two-tailed P value were calculated. Variables with P value ≤ 0.2 in the bivariate analysis were included in the multivariate logistic regression. Statistical significance was declared if P value < 0.05. Result: The magnitude of cervical precancerous lesion was 12.8%. Being in the age group of 40-49 years (44.9%) were significantly associated with cervical precancerous lesion than being in age group of 30-39 years (39.07%) (AOR=2.40, 95%CI (1.27-4.54)). Women having history of sexually transmitted infections (18.08%) were significantly associated with cervical precancerous lesion than those who did not have history of sexual transmitted infection (81.92%) (AOR=3.20, 95%CI (1.26-8.10)). Women who had two or more lifetime sexual partners (AOR= 2.17 95%CI (1.01-4.67)) and those whose husband had two or more other lifetime sexual partners (AOR=3.03, 95%CI (1.25, 7.33) were significantly associated with cervical precancerous lesion. Conclusions: Age group of 40-49 years, lifetime history of sexual transmitted infections, two or more life time sexual partners of the women and two or more other lifetime sexual partners of the husband were increasing risk of cervical precancerous lesion. Women above the age of 40 years, with history of sexually transmitted infections and history of multiple sexual partners should be encourage to be screened for cervical cancer. Key Words: cervical cancer, cervical precancerous lesion, Addis Ababa and Ethiopia.Item Fertility Desire and Contraceptive Utilization among People Living with HIV/AIDS in follow up care in Hosanna ART Units(Addis Abeba Universty, 2010-07) Abebe, Mitsiwat; Addissie, Adamu (PhD)ackground: HIV positive individuals may or may not have intention to have children. They could also have different degrees of utilization and demand for family planning. The extent of the intention and how it varies by individual, social, health and demographic characteristics is not well understood. The desire of HIV infected persons to have children in the future has significant implication for the transmission of HIV to sexual partners or newborns. So this study contributes a lot for program planners. Objective of the study: to determine the fertility desire and contraceptive utilization among PLWHAs in ART follow up care in Hossana hospital and health center. Methodology: A cross sectional institution based study design supplemented by qualitative indepth interview was done between December to May 2010 The study was conducted in Hosanna Town (Hospital and health center), Hadiya zone, Southern Ethiopia. The study population were all PLWHA who had at least one visit to the selected ARV treatment units and age group 18- 49 for women and 18-59 for men and the sample size taken were 321 and selected using quota sampling technique. Pre-tested questionnaire was used to collect the data which was entered using EPI info window 2000 and analyzed by SPSS 11.0 statistical packages. The qualitative study sample depended on the level of saturation of information and interview includes respondents, health care provider working in PMTCT, VCT, ART and FP department. Purposive sampling was applied to select study subjects from each institution. Tape record is used then transcribed to meaningful phrases, data were grouped in to thematic area and words of the respondents were quoted accordingly. Result: Thirty-six (37.9%) male and eighty one (35.8%) female respondents expressed the desire for children, giving a total of 117 (36.45%) of all respondents. In general PLWHAs who intended to have children were those PLWHAs having no children (Adjusted OR 60.89, 95% CI 8.02, 462.05). Those who intended to use family planning in the future were more likely to desire children (Adjusted OR 4.35, 95% CI 1.61, 11.73) than their counter parts. But if partner decide not to have children they were less likely to desire (lower desire) for children (Adjusted OR 0.02, 95%CI 0.001, 0.41). Thirty-six (37.9%)men and 66(29.2%) women, overall 102(31.8%) were using family planning during the study period. Factors associated with family planning use were being married (Adjusted OR 7.83, 95%CI 1.08, 56.79), having three or more children (Adjusted OR 4.54, 95%CI 1.12, 18.48), and having knowledge on mother to child transmission (Adjusted OR 4.29, 95%CI 1.98, 9.26) and plan to have children in the future (Adjusted OR 0.29, 95%CI 0.1, 0.82) were less likely to use family planning than their counter parts. Conclusion and Recommendation A high proportion of HIV positive individuals who received medical care expressed a desire for children. The extent of fertility intention and family planning needs of these people has implication for vertical, heterosexual transmission and need consideration. A better and evidence based understanding of fertility intentions and demand for contraception is needed to promote and protect the rights of women and men living with HIV/AIDs to make informed decisions about reproduction and to have access to appropriate sexual reproductive health services.Item Information needs of breast cancer patients attending care at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, 2017(Addis Abeba Universty, 2017-06) Legese, Birhan; Addissie, Adamu (PhD)Background: Breast cancer is the leading cancer among women in Ethiopia worldwide. Cancer patients are always eager to have information about every topic related to their illness and having the information is helpful for them to cope and for a better quality of life. But little is known about the information needs of breast cancer patients. So this study will address that gap. Objective: Assessing the information needs of breast cancer patients attending care at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, 2017 Methods: Hospital based cross sectional study and qualitative methods was used. Toronto informational needs questionnaire was used to address the information needs and data on sociodemographic factors was assessed using structured questionnaire from literatures. Semi-structured interviews were conducted with patients and their care givers to support the quantitative part. Likert scales to determine whether patients need to know more about 52 items of information categorized under five domains namely treatment, disease, and investigative tests, physical and psychosocial was used. High mean score show higher information needs. One way ANOVA and regression was done to see association of sociodemographic and clinical variables with information needs. All statistical analysis was performed using STATA (Version 14), and statistical significance was set at P < 0.05. Result: The total mean score for overall information need among breast cancer patients is 238.7(22.5) which means 4.59 with a range scale of 156-260. Among the five subscales information on disease and information on treatment were the most highly needed areas with mean percentage of 94.8 and 93.7 respectively and 254(67%) of them preferred the information to come from health professionals. Diagnosing as stage IV (p=0.02) &Urban residence is associated with less and high information needs respectively when compared to other categories. Conclusion and recommendation: The information needs of breast cancer patients were high. Determining what the patient’s needs is an important aspect of providing health care especially in cancer care. The health care system should include a way of information provision for breast cancer patients based on their needs.Item Intention to use long acting and Permanent Contraceptive Methods and factors affecting it among Married Women in Adigrat Town, Tigray, Ethiopia, January 2012(Addis Abeba Universty, 2012-06) Gebremariam, Alem; Addissie, Adamu (PhD)Introduction: Despite the increase in contraceptive use worldwide over the last decade, there is still discrepancy in the need to limit birth and utilization of modern contraceptives specifically long acting and permanent contraception methods in sub-Saharan Africa including Ethiopia. Intention to use long acting and permanent methods of contraception is an important indicator of the potential demand for family planning services. Objective: To assess intention to use long acting and permanent contraceptive methods and factors affecting it among married women in the reproductive age group in Adigrat town Method: A quantitative cross sectional study design complemented by qualitative method was conducted. The total 594 sample size was proportionally allocated to each of the three selected kebeles. Systematic random sampling was used to reach at the study subjects. Structured questionnaire and guides were used for the quantitative and qualitative method respectively. Data was entered in to Epi Info version 3.5.1 and analyzed using Statistical Package for Social Sciences version 16. Multivariate logistic regression was done to control effect of confounders. Open code software was used to carry out content analysis of the qualitative data. Result: Intention to use LAPMs was 48.4%. The main reasons for not intending to use were fear of side effect and infertility after use. Participants perception on husbands support for LAPMs use (AOR=0.2, 95% CI=0.09, 0.45) and LAPMs can harm the womb (AOR=0.24, 95% CI=0.14, 0.41), knowledge of LAPMs (AOR=4.7, 95% CI=1.58, 14.01) were significantly associated with intention to use LAPMs. Desire to have birth within the next 2 years (AOR=1.9, 95% CI=1.22, 3.13), ideal desired number of children (AOR=0.7, 95% CI=0.62, 0.88), partner’s education and participants occupation status were also significantly associated with intention. Conclusion: The magnitude of intention to use LAPMs in the study area was low. The main limiting factors were fear of side effect and infertility after LAPMs use, knowledge on LAPMs and perception on partner’s support. This needs more effort from the family planning providers and program facilitators to address misconceptions that exist about LAPMs and highlight the benefits of LAPMs and not only women but also their spouses should be included in family planning programs.Item Interventional study on the effect of rapid ethical assessment on informed consent comprehension and quality of informed consent process, and associated factors in biomedical research in Wukiro kilte-awulaelo and Hintalo-wajirat districts, Tigray, Ethiopia(Addis Abeba Universty, 2014-04) Abay, Serebe; Addissie, Adamu (PhD)Back ground: Informed consent is a corner stone in researches involving human participants. The process of obtaining informed consent is a challenge for low-literacy and resource-limited settings. Potential research participant should be assisted with interventions to improve their comprehension. Rapid Ethical Assessment (REA) is an intervention developed to contextualize consent processes in low-income setting. An interventional study was done to evaluate the effects REA on recruitment rate, compliance rate, comprehension level and quality of the informed consent process among participants of biomedical research. Methods: A community based qualitative study followed by institutional based interventional study was employed among pregnant women of age 18-45 years in Wukiro kilte-awulaelo and Hintalo-wajirat districts, Tigray regional state, Ethiopia from July 8 to August 20, 2013. The intervention was modifications in the informed consent content and process based on community based qualitative REA findings. This qualitative REA study was done among key informants in the intervention site concerning biomedical research, cancer in general and cervical cancer particularly, communication channel, socio-cultural dynamics, sample collection and how to find informed volunteer participants with fully understanding for the parent study. We did a total of 11 formal recorded In-depth Interviews (IDIs), and 5 Focused Group Discussions (FGDs) with key informants. A total of 300 healthy pregnant women who were eligible for the Parent Study were included in this study. One hundred fifty were allocated in to intervention group with modified and 150 in to control group with the standard informed consent forms and procedures. In both group comprehension levels and quality of consent process were measured using Modular Informed Consent Comprehension Assessment (MICCA) and Quality of Informed Consent (QuIC) process assessment tools, respectively. Result: The initial recruitment rate to participate in the parent study for the intervention and control groups were 88.7% and 80.7%, respectively. The compliance rate to show follow-up 12 days after initial consent were 85.7% for the intervention group and 70.3% for control group. Overall mean score of informed consent comprehension for the intervention and control groups were 73.1% and 45.2%, respectively. Mean difference in comprehension score was 27.9% (P<0.000, 95% CI= 24.0%-33.4%). Educational level of secondary and above (AOR= 6.68, 95% CI=1.01- 44.03), Previous participation in any biomedical research (AOR=2.77, 95% CI=1.01-7.58), being Merchants by occupation (AOR=5.43, 95% CI=1.78-16.60) and having monthly income less than 1000.00 Ethiopian birr (AOR= 0.38, 95% IX CI=0.15-0.96) were found significantly associated with comprehension score status. Concerning the quality of informed consent process the mean scores for the intervention group was 89.1% and for control group was 78.5%. The mean difference in quality of informed consent process was 10.5% (P<0.000, 95% CI =6.8-14.2). No significant association was found between socio-demographic variables and quality of informed consent process taking a mean score of 75% as a cut point. Conclusion and recommendation: The level informed consent comprehension, recruitment rate, compliance rate and quality of consent process among the control group were low as compared to the intervention group. These were improved through modifying the consent form and information sheet locally and contextually tailored to the study area based on REA findings. This implies that potential study participant in a research can be assisted to comprehend consent components, and subsequently comply with further tasks to be performed. Therefore, it is recommended that REA to be further used to address gaps on comprehension and quality of informed consent process. Key words: modified and standard consent forms, recruitment rate, compliance rate, Informed consent comprehension level, Quality of informed consent process, Rapid Ethical Assessment (REA), EthiopiaItem The Magnitude and Associated Factors of Repeat induced Abortion among Women of Reproductive Age Group Who Seeks Abortion Care Services at Marie Stopes International Ethiopia Clinics In Addis Ababa, Ethiopia.(Addis Abeba Universty, 2015-12) Alemayehu, Bethelihem; Addissie, Adamu (PhD)Background: Repeated induced abortion is important public health concern both in the developing and developed world that increases maternal morbidity and mortality. There is a no of research towards the magnitude and associated factors of repeat induced abortion in developing countries particularly in Addis Ababa, Ethiopia. Objectives: The objectives of this study was to determine the magnitude and associated factors of repeated induced abortion among abortion care service seekers at Mare Stopes International Ethiopia (MSIE) clinics in Addis Ababa, Ethiopia. Methods: A cross sectional study was conducted on 429 women seeking abortion care at Marie stopes international Ethiopia clinics. Simple random sampling technique was used to selectstudy participants. Data were collected by trained data collectors at one of Marie stopes international clinics by 22 mothers using structured questionnaires after that done the necessary correction. Data were checked for completeness, consistency, coded and entered and analyzed through SPSS version 20.Bivariate and multivariate logistic regression analysis was computed to test the strength of association and the p-value <0.05 was considered as statistical significant. Result:The magnitude of repeat induced abortion is 33.6 %. Based on this study educational status of college diploma and above (AOR=9.2, 95%CI; 2.3-35.3), monthly income of ETB 1001-2000(AOR=3.7; CI: 1.7-7.8), and years in marriage of 2-5 years (AOR=3.3; 95%CI: 1.6- 6.7) and of 5-10 years (AOR=2.6; 95% CI: 1.3-4.9)last abortion time of 1-2years (AOR=0.4;95%CI:0.2-97) and above three years last time abortion (AOR=0.35; 95%CI:0.13- 0.9) significantly associated with the repeat induced abortion among reproductive age group of women at Maries topes international Ethiopia clinics in Addis Ababa, Ethiopia. Conclusion and recommendation: The finding of this study showed that the magnitude of repeat induced abortion is similar with the reports from developing countries but it was lower than that of developed countries. Higher educationallevels, monthly income, years in marriage and time of last abortion were the associated factors for repeat induced abortion. Health promotion messages are needed to focus to improve the knowledge of women about contraceptives as a primary prevention of repeated induced abortion.