Browsing by Author "Ali, Ahmed(PhD)"

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    Assessment of Factors Associated With Unintended Pregnancy among Pregnant Women in Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-07) Kassie, Tadele; Ali, Ahmed(PhD); Tefera, Worku
    Background: Unintended pregnancy is an important public health issue in both developing and developed countries because of its serious consequences for women and their families, which include the possibility of unsafe abortion, delayed prenatal care, poor maternal mental health and poor child health outcomes. Objective: The major objective of this study was to identify the magnitude and factors associated with unintended pregnancy among pregnant women attending antenatal care in Addis Ababa. Methods: A facility based cross-sectional study was conducted on 393 women attending antenatal care clinic at Addis Ababa in ten public health centers from February to May 2015. Simple random sampling technique was used to select health centers. Data were collected by trained data collectors using Pre-tested structured questionnaires. Data were checked for completeness, consistency, coded and entered in to SPSS version 20 software and analyzed. The association between variables were analyzed using bivariate analysis, multiple logistic regression models and the level of significance of association were determined at P- value <0.05. Results: The magnitude of unintended pregnancy was 36.4 95% CI;( 31%.8, 41.7%). The odds of unintended pregnancy among no Spousal communication were 4 times more likely than Spousal communication, Odds of unintended pregnancy among own business maker were 4 times more likely than unintended pregnancy compared to house wives. The odds of unintended pregnancy among inadequate awareness on Intra Uterine Device were 4 times more likely to be experience to unintended pregnancy than from those who have adequate awareness on Intra Uterine Device Conclusion: According to this study, women education, occupation, spousal communication and awareness of long term family planning were significantly associated with unintended pregnancy. Recommendation: There is an apparent need to design strategies of communication within couples on fertility and contraceptive issues through peer education and promote long term modern family planning methods
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    Assessment of HIV Risk Perception and Condom Use among Youth in Debre Birhan District, Central Ethiopia
    (Addis Ababa University, 2005-04) Zewdie, Zebideru; Ali, Ahmed(PhD)
    Young people between the ages of 15 and 24 years are both the most threatened globally, accounting for half of all new cases of HIV and the greatest hope for turning the tide against AIDS. Significant proportion of the population particularly the youth are at high risk of HIV infection despite high level of knowledge about HIV/AIDS. Although various surveys have been made to study the sexual behavior of youth in Ethiopia, few studies assess youth risk perception to HIV/AIDS. This cross-sectional survey was conducted from December 2004 to January 2005 to assess HIV risk perception and condom use among youth in Debre Birhan Town of Amhara Region. A total of 663 youths were interviewed and four focus group discussions were conducted. In this study 32.7% of the respondents were sexually active. The mean age at first sexual intercourse was 18.1+ sd 2.1 years. Sixty-two (28.6%) of the sexually active respondents reported that they have more than one sexual partner. Among the sexually active respondents 38.7% had ever used condom and only 44.9% use condom consistently. Condom use was associated with marital status (AOR=0.08, 95% CI=0.01, 0.36), education (AOR=6.92, 95% CI=1.49, 32.00) and reported number of sexual partners (AOR=4.16, 95% CI=1.34, 12.87). With the above risk sexual behavior, participants’ attitude towards perceiving themselves at risk of HIV infection was only 4.5%. Knowledge of HIV transmission, (AOR =3.25, 95% CI=1.61, 6.55), number of reported sexual partners, (AOR=2.09, 95% CI=1.01, 4.33), condom use (AOR=0.30, 95% CI=0.14, 0.67), and khat (AOR=2.73, 95% CI=1.03, 7.22) were significantly associated with self-risk perception to HIV. From this study, it was concluded that despite the high knowledge the youths have on HIV/AIDS, they still engage in high- risk sexual behavior and perception of risk acquisition is very low. Thus, peer-based interventions to delay sex and negotiate condom use, youthfriendly sexual and reproductive health services including VCT and developing life skills to enable a change of attitude of the youth to avoid HIV/AIDS are recommended. Key words: Youth, Risk perception, Condom use, Debre Birhan District
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    Assessment of Quality of Postabortion Care in Government Hospitals in Addis Ababa
    (Addis Ababa University, 2002-04) Melkamu, Yilma; Enqusilassie, Fikre; Ali, Ahmed(PhD)
    Abortion related complications are major causes of maternal morbidity, mortality and disability in developing countries including Ethiopia. Countries have been trying to improve postabortion care (PAC) services in the last decade. A cross sectional descriptive study was conducted on quality of PAC in government hospitals in Addis Ababa, Ethiopia, from November 2001- February 2002. Assessments conducted involved interactions between providers and patients, information provision, postabortion FP counseling and method provision, provider’s technical competence and equipment and supplies of the hospitals. Patient interview, direct observation, provider interview and inventory of equipment and supplies were used for the assessment. Interaction between providers and patients was found to be satisfactory whereas information provisions on important aspects of care such as danger signs and follow-up needs were very limited. Postabortion FP counseling and method provision were also found to be very low. About 20% and only 3% received FP counseling and contraceptives respectively. Other reproductive health related issues such as STDs and HIV/AIDS are rarely raised by the providers during managing patients. Overall, 92.3% of the patients responded that they were satisfied with the services. Those who responded that waiting time was too long, who had difficulty in locating or getting services and those who responded that the general information provision was inadequate appeared to be less satisfied. Those with spontaneous abortion of current pregnancy were also less satisfied 9 with the services they received. Significant proportions of the providers were trained on PAC and related issues. Implications of the findings were discussed and recommendations were made
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    Assessment of the Role of Currently Married Men Age 20-64 Years in Contraceptive Use and Fertility Preference, In Hossana, SNNPRG-Ethiopia
    (Addis Ababa University, 2004-04) Tuloro, Tsedeke; Ali, Ahmed(PhD); Davy, Gail(PhD)
    This is a community based cross-sectional study conducted in Hossana Town southern Ethiopia n from December to January 2004; to assess the role of currently married men age 20-64 years in contraceptive use and fertility presences. A multistage sampling procedure was carried out to interview 776 men in study area. A pre-tested structured questionnaire complemented with focus group discussion was the main instrument used for data collection. The study revealed that median age at marriage was found to be 25.9 years in the Study are. Average number of living children in the study area was found to be 3.84, while ideal number of children desired was 5.2 children per men. Ninety one point five percent of the study population has heard of contraception and 79.4% of the study population knew at least one method of contraception. The contraceptive prevalence in Hossana Town was 47.6%. Among the non-users of family planning 13% of respondents mentioned desired to have more children, 8.4% mentioned that respondent opposed, followed by fear of side effects (5.4%), religious prohibition (4.5%) and known no methods was (2.7%). Fourteen point six percent of men in the study area was discontinued using family planning due to desire to have more children. The most commonly mentioned reason for using contraception among current users was childspacing by 30.7% and the second most commonly mentioned reason was child limiting by 17.5%. Thirty –seven point eight percent of men in the study area have never used family planning methods. Fifty-nine point four percent of men in the study area have mentioned intention to use family planning in the near future. Knowledge about contraception, family size, discussion with wives about family planning and fertility in the family, attitudes of respondents and their partners were found to be determinates for contraception. Participating of men in family planning service delivery system, maximizing access to good quality services, improving the quality of family planning services, and making contraceptive method mix easier to obtain and use will help to meet need of many men
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    Assessment of “Trends in HIV Test and Sero Prevalence” Among Randomly Selected Antenatal Care Attendees in Government Health Centers in Addis Ababa
    (Addis Ababa University, 2007) Zegeye, Tiruneh; Ali, Ahmed(PhD)
    Despite increasing availability of PMTCT of HIV services, improved awareness of women about MTCT of HIV and grave psychological, social and economic consequences that MTCT of HIV poses at all socio-economic levels, information based on serial data from PMTCT program are limited at global, regional and national levels to asses and track trends in service utilization and HIV sero prevalence among pregnant mothers. Therefore, to asses trends, in HIV test and sero prevalence among ANC attendees in government owned health centers in Addis Ababa since 2002, a retrospective record review was conducted in Addis Ababa in April 2007. A total of 2402 randomly selected individual PMTCT counseled client’s records from 2002- 2006 were reviewed retrospectively. All required data related to client’s HIV test and relevant socio demographic factors were gathered. Data entry, cleaning and analysis were subsequently conducted using Epi-Info software program. Analysis was done mainly focusing on changes in HIV tests and sero prevalence from one year to another during the study period (2002-2006) and comparing each year’s prevalence with the one in 2002. For the years 2002-2006, the overall prevalence of HIV test among PMTCT counseled ANC attendees and sero-prevalence among voluntarily tested ANC attendees were, 93% ( range, 88.3% - 96%) and 9.5% (range, 6% - 13.2%) respectively. Prevalence of HIV testing acceptance among counseled ANC attendees has significantly increased (p-value < 0.05, 2 for trend=4.490) from 90% in 2002 to 96% in 2006. Taking the 2002 HIV sero prevalence rate of 11.7% in this study as baseline prevalence, no statistically significant decline ( 2 for trend =1.391, p value > 0.1), in HIV sero prevalence was observed since 2002. Moreover, only 39% of pregnant mothers in Addis Ababa utilized PMTCT services. Trends in HIV testes among PMTCT counseled ANC attendees in Addis Ababa are increasing mainly because of an opt-out strategy. HIV sero prevalence among ANC attendees in Addis Ababa has not shown any significant decline since 2002, though figures show mixed pattern of increase and decline among this group of mothers. PMTCT services utilization rate is generally low among pregnant mothers in Addis Ababa
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    Developing a Scale for Measuring Perceived Barriers to Behavioral Change Towards HIV/AIDS Preventiion
    (Addis Ababa University, 2006-06) Negatu, Tilahun; Ali, Ahmed(PhD)
    Despite the extensive interventions, there hasn’t been a corresponding decline in the rate of Sero-prevalence of HIV/AIDS. Why could this be the case? In contrary to the increased knowledge, there appears to be little change in behavior. What is then the challenge in connecting knowledge to actual behavior change? These challenges haven’t been identified and measured in local contexts. The objective of this study was to develop a scale for measuring perceived barriers to behavioral change towards HIV/AIDS prevention. More specifically, to identify & describe perceived barriers to behavioral change; to construct a scale for measuring perceived barriers to behavioral change; to evaluate the reliability and validity of the scale, and to determine the relative importance of the barriers. A cross-sectional study with qualitative & quantitative phases was conducted at Debub University on regular students. The qualitative part, comprising of in-depth interview and free listing, is designed to identify the major perceived barriers to behavioral change. A preliminary likert-type scale of items, after pilot test and expert review, was administered to 480 students, selected using stratified random sampling technique, for rating. Item analysis criteria selected 28 of the 55 items for factor analysis. Principal component analysis yielded 5 components explaining 63% of the variance after deletion of two other items. The total scale has 0.845 reliability and 0.642 validity. The components were found to measure a single construct. This resulted in a 26-item PBBC instrument. The enjoyment component was found to have higher weight in regression and the risk components have higher relative importance in summated scores. vii In conclusion, the instrument developed has acceptable reliability and validity. Further refining, revising and optimizing of the instrument were recommended
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    Effects of HIV/AIDS and Interventions to Mitigate the Epidemic at Public Primary and Secondary Schools in Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-08) Menna, Takele; Ali, Ahmed(PhD); Worku, Alemayehu(Professor)
    Background Globally, HIV/AIDS is one of the most profound developmental challenges faced in the human history. Despite the fact that the epidemic is affecting almost all development sectors, it is widely asserted that the education sector has been profoundly affected. The effects of the epidemic on the education sector are complex. In its current disposition, education remains the most human intensive public sector in Ethiopia. Cumulatively, the sector has a total of 17,413,176 students, 314,524 teachers and more than 80,000 non-teaching staff (constituting a total of more than 24% of the country’s population). Mitigating the effects of HIV/AIDS on the education sector is especially important, since this sector trains all public servants. Moreover, it is crucial to provide all concerned at different levels with some research based and up-dated data on the effects of HIV/AIDS on the education sector and interventions to mitigate the epidemic for evidence based prevention, control, and care and support programs. Objective of the study: To assess the effects of HIV/AIDS and interventions against the epidemic with particular emphasis on the public primary and secondary schools in Addis Ababa, Ethiopia Methodology: This study consisted of community and school based longitudinal, cross-sectional and quasi experimental study designs which were conducted among teachers and students at public primary and secondary schools in Addis Ababa in the year 2012/13. The selection of schools was conducted in three phases: 103 primary and secondary schools in phase I, 30 secondary schools in phase II and 4 secondary schools in phase III. The selections were done randomly in Phase I and II and purposively in Phase III. Furthermore, triangulations of various methods of data collection were used to increase the validity of the study. For the specific objective I or assessing the trend of mortality among teachers in the era of HIV /AIDS a longitudinal study with a verbal autopsy approach was used. But for the specific objectives II, III and IV or examining the proportion of students who lost one or both parents due to HIV/AIDS related causes, investigating factors associated with HIV Counselling and Testing /HCT/ among xiii secondary school students, and assessing factors associated with HCT up-take and its correlations with risky sexual practices among primary and secondary school teachers in Addis Ababa a cross- sectional study design was used. In addition, for the specific objective V or examining the effects of school- based HIV prevention interventions on sexual behaviours of students at secondary schools a quasi-experimental study design was used. Sampling techniques and sample sizes varied as per the five different, but practically interrelated specific objectives in order to address each of them effectively and adequately. Data collections were conducted by 12 diploma graduate nurses under the supervision of 2 senior health professionals and the principal investigator. Data were entered first into Epi-Info software, version 3.5.4 for cleaning and were transported to SPSS software version 20.0 for analysis. Various statistical methods, including descriptive statistics, Chi squared test and multiple logistic regressions were used to show the magnitudes of the problems and the relation-ships of different factors with the effects of HIV /AIDS and the interventions to mitigate the epidemic by controlling various confounders at the same time. Results As the verbal autopsy data of deceased teachers demonstrated the proportionate mortality ratio between the total and HIV/AIDS related mortality declined from 0.33 to 0.18 during the first two years (Nov.2005-Oct.2007) and the last two years (Nov.2012-Oct.2013) of the study period, respectively. The decline in the HIV/AIDS related mortality was statistically significant with Mantel Haenszel Chi-square=7.04(P<0.01) (Paper I). The overall prevalence of parental death among secondary school students was 347(17.8 %) 95% CI (16.2%, 19.6%) and the HIV/AIDS proportionate mortality ratio was 28% (97/347) A multivariable binary logistic regression analysis demonstrated that high HIV/AIDS related knowledge (AOR= 0.39 ; 95% CI, 0.18-0.84), positive attitude towards HIV prevention methods (AOR=0.48 ; 95% CI, 0.23-0.97) , being tested for HIV (AOR= 0.52 ; 95% CI, 0.31-0.87) and chewing Khat (AOR= 2.59 ; 95% CI,1.28-5.26)] were significantly associated with having xiv multiple sexual partners among both orphaned and non-orphaned secondary school youths (Paper II) . In addition, the proportion of secondary school students who were never tested for HIV was 761/1948 (39.1%), with 95% CI (36.3 -41.8 %). Of those who were never tested, 820 (69.4%) with 95%CI, (66.3%- 72.5%) reported their willingness to go for HCT within two months after the survey (Paper III). A multivariable binary logistic regression analysis showed that age being >18 (AOR= 2.64 ; 95% CI, 1.46-4.77) and having multiple sexual partners in the previous year (AOR= 2.08 ; 95% CI, 1.21-3.57 were positively associated with being ever tested for HIV (paper III). As the comparative cross sectional study /Paper IV/ indicated, the proportion of teachers who had ever been tested for HIV was 739/1034 (71.5%) with 95% CI (69.1% -74.2 %). Multivariable binary logistic regression analyses showed that male teachers (AOR=0.63 ; 95% CI, 0.44-0.90) had lower chance of being ever tested for HIV compared with female teachers. Married teachers (AOR=0.30;95% CI,0.19-0.47) also had lower chance of being ever tested for HIV compared with unmarried teachers. Age being >45 (AOR= 4.05 ; 95% CI, 1.82-9.03) , high HCT related knowledge (AOR=3.56;95% CI,1.73-7.32) and perceived risk of HIV AOR=1.43; 95% CI,1.04-1.96) were positively associated with determinants of HCT. Regarding factors associated with HIV Counseling and Testing, teachers who never had HCT were more likely to have multiple sexual partners than their counterparts (AOR=1.85; 95% CI, 1.08-3.15). In contrast, those teachers ever tested for HIV were less likely to use condoms consistently compared to those who were never tested (AOR=0.55; 95% CI, 0.32-0.96 (Paper IV). The quasi-experimental study (Paper V) showed that students in the peer education intervention group were more empowered compared to the control group. Comprehensive knowledge of HIV xv (P-Values =0.004) and willingness to go for HIV counseling and testing (P-value= 0.01) demonstrated significant differences among intervention group during post intervention period. Students in the intervention group were more likely to use condoms during post intervention period compared to students in the control group [AOR=4.73 (95% CI (1.40-16.0)] (Paper V) Conclusions  The findings of this study have demonstrated a statistically significant decline in the total and HIV/AIDS related mortality between November 2005 and October 2013 among teachers at public primary and secondary schools in Addis Ababa.  Significant proportion of secondary school youths lost at least one parent due to various causes including HIV/AIDS. High knowledge of HIV/AIDS, positive attitude towards ‘ABC’ rules for HIV prevention, being tested for HIV and chewing khat were more likely to be factors associated with multiple sexual partnership among secondary school students in Addis Ababa.  The observed proportion of HCT among secondary school students was low. Of the selected predictors, age, grade level, having sexual intercourse and practicing sex with multiple sexual partners in previous year were associated with ever having HCT as well as showing willingness to go for it in the near future.  Gender, age, marital status, knowledge of HCT, and perceived risk were found to be factors associated with HCT uptake among primary and secondary school teachers. Being faithful to a partner and inconsistent use of condom were observed correlates of HCT among teachers.  Despite the short follow up period, students in the peer education intervention group demonstrated positive changes in HIV related comprehensive knowledge and showed xvi better interest to go for HIV testing in the near future. In addition, positive changes on risky sexual behaviors were reported from the intervention group. Recommendations:  The Ministry of Education and its collaborators should inject more resources to improve the quality of teaching and learning of HIV / AIDS Program for the School Community  HIV/AIDS related interventions in the education sector should also be strengthened with practical strategies of controlling health risk habits such as chewing Khat and drinking alcohol, besides sexual risky behaviors.  Since the present study has focused on schools in Addis Ababa only, there is a need for large scale or nationwide studies with more representative sample size to consolidate much needed empirical evidence on HIV/AIDS effects among the school community. Keywords: Education Sector, Primary and Secondary schools, Teachers, Students, HIV/AIDS , Risky Sexual Behavior, Orphans, Mortality, Peer Education, Factors associated, and HIV Counseling and Testing
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    Retrospective Record Assessment of Visceral Leishmaniasis (VL) Patients in Kahsaye-Abera Hospital and Knowledge, Attitude and Practice Pertaining to Visceral Leishmaniasis Among the Indigenous People and Migrant Workers in Kafta- Humera District
    (Addis Ababa University, 2005-04) Fesseha, Tadesse; Hailemariam, Damen(PhD); Ali, Ahmed(PhD)
    According to a substantial body of evidence, leishmaniasis is posing burden on people of all ages living in different parts of the world at varying degrees of morbidity and mortality. Visceral leishmaniasis (VL) is endemic in the south, southwest, north, North West and north east peripheral low lands of Ethiopia. K/Humera, in Tigray Region is VL endemic. Its proximity to the Sudan, economic attraction and a venue for several migrant workers further complicates the problem. With the objective of describing the magnitude of visceral leishmaniasis at Kahsaye-Abera Hospital, a study was conducted using a pre-tested questionnaire and a retrospective clinical records review. The knowledge and practice of both migrant workers and indigenous people was found to be 56.1%, 77.2% and 6.9%, 68% respectively. Out of the 931 migrant workers, 69% were familiar with the work kala azar compared to 85.8% of the indigenous population. A bit higher than 40% of both cohorts accessed the information from health facilities with only 4% of the labor migrant force and 14.7% of the local inhabitants from the media. A wide gap of behavioral practice was evidenced between the labor migrants and local residents, where 93.1% migrant workers and 29% indigenous people exhibited poor practice towards visceral leishmaniasis. Of the 882 retrospectively reviewed patients’ records, only 174 (19.7%) had no any inter-current infections whereas majority of the group 80.2% had atleast one concurrent infection with the highest rate of respiratory infections, 48.4% and the HIV/leishmania co-infection was as high as 25%. HIV co-infected VL cases were seven times more likely to relapse compared to HIV negative VL cases. Respondents were less familiar with the sandflies as the major players in the transmission of VL (kala azar) and had unsatisfactory perception and poor practice towards kala azar. Moreover, mortality and HIV/VL co-infection rate was among the highest. Health workers and other stake holders should join hands to adequately disseminate information to the community to actively participate in the sphere of prevention