Browsing by Author "Betre, Mulugeta(PhD)"

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    Assessement of Parental Influence on Pediatrics Highly Active Antiretroviral Therapy (HAART) Adherence in Addis Ababa, Ethiopia, May 2010
    (Addis Abeba Universty, 2010-05) Betre, Mulugeta(PhD)
    Back ground: Ensuring good adherence is critical to the success of highly active anti-retroviral therapy (HAART). Failure to adhere very closely to the regimens results in continued viral replication, treatment failure and the emergence of drug resistant strains of human immune deficiency virus (HIV). Although parents and caregivers may have primary responsibility for their children's medication-taking, there is no single study that examined parents influence on pediatrics highly active anti-retroviral therapy (HAART) adherence in our set up. The result of the study is expected to help device intervention strategies to improving children’s adherence on highly active anti-retroviral therapy (HAART). Objectives: To assess the status, determinants of adherence and identify parental factors influencing pediatrics highly active anti retroviral therapy (HAART) adherence in Addis Ababa. Methods: An observational: descriptive, cross sectional study was conducted in 9 Health institutions: public, private and Non Governmental Organizations (NGOs) in Addis Ababa. Multi-stage sampling procedure was used to select a total of 586 children: age 0 - 14 years, Human Immune Deficiency Virus (HIV) infected and started anti-retroviral therapy (ART) 12 weeks ago. Primary care givers of the children were enrolled after the nature of the study was explained that allowed informed decision to be made and written consent obtained. Data was collected from February 8- May 10, 2010 on socio demographic, parent factors, clinical markers, care givers to provider relationship and regimen variables. Structured questionnaire and focus group discussion were used. Univariate, bivariate and multivariate analysis was carried out. Result: The parental factors were strongly associated with non adherence; children who had non biological parents [OR=9.805(95%CI= 2.198, 43.736)], parents who didn’t communicate about HIV and ART adherence to their children [OR=3.915 (95%CI= 1.273, 12.036)], and parents who hadn’t good relationship with health care providers [OR=29.592(95%CI= 1.326, 660.333)] were more likely non adherent. Children who had more than four siblings [OR= 5.676 (95% CI=2.100, 15.339)] were also significantly associated with non adherence Conclusion: The parental factors were strongly associated with non adherence. The need for providers to have smooth relation ship with the care givers of the HIV infected children on antiretroviral therapy, support caregivers to communicate with their children about the disease and antiretroviral therapy adherence is critical. Further research is recommended to explore the validation of self report adherence using longitudinal study designs.
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    Assessment of Knowledge, Attitude and Utilization of Emergency Contraception among Unmarried Women of Reproductive age in Adama, Ethiopia
    (Addis Abeba Universty, 2012-05) Jima, Aman; Betre, Mulugeta(PhD)
    Background: Unwanted pregnancy and unsafe abortion could be avoided by using contraceptives, including emergency contraceptive even after unprotected sexual intercourse. Many unmarried women are at high risk of unintended pregnancy; they have limited knowledge of contraception and generally lack access to services or do not feel comfortable using these services. Emergency contraception adds important option for helping sexually active unmarried women to avoid unintended pregnancy. Knowledge, attitude and utilization of emergency contraceptives among unmarried women are of paramount importance because of high rates of unwanted pregnancies as well as unsafe abortion. Objectives: To assess knowledge, attitude and utilization of emergency contraception among unmarried women of reproductive age. Methods: A cross-sectional community based survey was conducted among 491 unmarried women of reproductive age at Adama Town. Among 14 urban kebeles, one kebele were selected using simple random sampling method. Systematic sampling technique was used to identify the respondents at an interval of every ninth household after the first respondent was identified by simple random sampling method from the first nine households. A pre-tested structured questionnaire was used to collect data. Data analysis was done using chi-square test and binary logistic regression to measure the association between dependent and independent variables. Result: About 38.7 % of the total unmarried women participated in the study had knowledge of emergency contraception. Of those ever heard of EC 95% mentioned oral pills only and the reminder (5%) mentioned oral pill and intra uterine device. About 61.3% of those ever heard of emergency contraception had positive attitude towards making EC available to all women who need it but only 4.2% respondents reported that they had used emergency contraception previously. Age, educational status, occupation, knowledge of time in menstrual cycle when pregnancy is more likely to occur, experience of sexual intercourse and having discussion on reproductive health are significantly associated with awareness of EC (p < 0.001). Conclusion & recommendations: The study has shown that there is low level of knowledge and practice of emergency contraceptives among urban unmarried women. Therefore, there is a need to emphasize on increasing awareness and accessibility of emergency contraception to all.
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    Assessment of Sexual Risk Perception and the Determinants of Protective Behavior of Stis/Hiv/Aids among Female College Students, in Debere-Markos Town, Amhara Regional State, Ethiopia
    (Addis Abeba Universty, 2010-06) Alemu, Daniel; Betre, Mulugeta(PhD)
    Background: Young people between the ages of 15 and 24 years are both the most threatened globally, accounting for half of all new cases and the greatest hope for curving the epidemic of HIV/AIDS. Young populations, especially never-married sexually active females have the greatest risk of HIV infection. They may not be aware of their vulnerability to it or of how best to prevent it. There is a great gap between knowledge and practice which needs detailed research that address determinants. Objective: To assess female college student’s knowledge, sexual behavior, risk perception and determinants of protective behavior of STIs/HIV/AIDS in Debre Markos town. Methods: A descriptive cross-sectional institution based survey was conducted from February to April, 2010 and was complimented by qualitative study. Result: 340 students interviewed and four focus group discussions were conducted. Students’ comprehensive knowledge was (15.5%). Only 7.4% perceived risky sexual behavior that can exposed them for HIV. Among the study subjects 25% were sexually active. Sixty percent of the respondents had used condoms consistently during their last sexual exercise. Ten percent of never married respondents had experienced sexual intercourse. 75.4% did not used condoms during their last sexual contact. Of all participants 61% of the study group had ever tested for HIV in the last 12-months. Among those respondents who had sexual intercourse in the last one year 6.8% had symptom of STI as foul smelling genital discharge and/or genital ulcer. Thirteen percent of respondents had ever forced by their sexual partners and 5% of sexually active students had more than one sexual partner. Conclusion: Though awareness of HIV/AIDS/STIs among female college students was relatively high, they had low comprehensive knowledge that capable of them to prevent infections of STIs and HIV. Regarding risky sexual behavior and self risk perception, most of the study subjects had involved in risky sexual behaviors but the great majority of them considered themselves having low or no risk for HIV infection. Protective behavior such as utilization of condom use was found to be inadequate but self recognition of HIV status in the last 12 months was relatively higher. Recommendation: Continuous IEC/BCC intervention programs paying attention on the misconceptions and protective behaviors against HIV/STIs; creating a positive youth friendly environment to address sensitive gender-related issues and access protective means like condom provision within the institution and the community; Emphasis should be given to ensure access VIII for young people to sex education, HIV/STIs, including information about contraceptives. Students have to be further promoted to HIV counseling and testing services. Key words: Sexual behavior; Risk perceptions; protective behavior; HIV, AIDS and STIs.
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    Assessment of the Knowledge, Attitude and Practice of Health Care Workers on Universal Precaution in North Wollo Zone, Amhara Region, North Eastern Ethiopia, 2006
    (Addis Abeba university, 2007-04) Damte, Mesele; Betre, Mulugeta(PhD)
    Background Employing universal precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Objectives: The main objective of the study was to assess the knowledge, attitude and practices of health care workers on universal precautions and factors in health institutes. Methods: This cross sectional health institution based survey was conducted in North Wollo Zone from January through September 2006. The study has used quantitative and qualitative methods. Statistical significance was determined by computing mean variations using T test and one-way ANOVA methods. Results: - The response rate for quantitative method was 93.4%. The mean knowledge score of health care workers was 2.53 ± (SD 1.17) and 156 (44.4%) of the respondents had greater or equal to the mean score. Seventy-nine (87.8%) of the observed injection practices was found to be unsafe to the health care workers and clients or community. The overall hand hygiene adherence rate was 28.34% ± (SD 27.58%). Correct hand hygiene practice has statistically significant association with availability of water, alcohol, and participating on UP trainings (OR (95% CI) = 6.89(2.66, 17.87), (OR (95% CI) = 3.95(1.46, 10.68), and (OR (95% CI) = 5.84(2.32, 14.72). Also female health care workers better adhere to hand hygiene than male (OR (95% CI) = 0.15(0.06, 0.38). According to the FGD’s result luck of supplies and facilities were the main factors for unsafe practices in health institutes. Conclusion: Considerable proportion of health care workers in North Wollo had lacked proper knowledge, attitude and practice towards universal precautions. Equally health care facilities in North Wollo were not adequately prepared in supplying essential materials to safe practices. Providing training on universal precaution to all health care staff and enhancing sustainable supplies systems are recommended. Key words: universal precaution, health care workers, universal precaution related practice and hand hygiene.
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    Primary HIV Infection in Patients Presenting with Conventional Sexually Transmitted Infections (STIs) in Ethiopia: Magnitude and Risk Factors
    (Addis Abeba Universty, 2006-07) Girma, Asaminew; Betre, Mulugeta(PhD)
    Inclusion of incidence data in the surveillance system of HIV is important in order to generate accurate data for effective prevention and control of the pandemic. Retrospective cross-sectional HIV seroprevalence and seroincidence survey was conducted to determine the magnitude of Primary HIV Infection (PHI) and, to identify and describe factors associated with it on stored sera of 455 STIs cases that had been collected and stored during the validation study of syndromic case management algorithms for STIs in Ethiopia, between January - May 2003. Standard HIV-antibody tests were done on all sera and IgG-capture BED-EIA on positive samples for detecting recent infections. Negative Serum samples for HIV antibodies were screened by nucleic acid amplification (HIV RNA PCR) for viral RNA. Incidence was calculated using the consensus formula. OR with 95% CI was used to measure the degree of association between associated factors and PHI and, logistic regression analysis was done to identify predictors of PHI. The overall HIV1/2 seropositivity was found to be 33% and the rate varies among the major STI syndromes, namely, VDS(35%), UDS(20.2%) and GUS(60.5%). Out of the 150 HIV antibody positive cases 15 (prevalence, 3.3%) were recently infected and, annual HIV incidence was estimated to be 11.8% (95% CI, 6.02, 17.58). Acute HIV infection was detected in 7 cases (prevalence, 1.5%) out of 305 HIV antibody negative sera indicating that standard HIV-antibody tests detected only 95.5% of the total HIV infections. The over all prevalence of PHI was 4.8%. Considering both recent and acute infections annual HIV incidence was estimated to be10.1% (95% CI, 5.13 - 14.97). Diagnosis of syphilis was found to be an independent risk factor for PHI for both sexes. Age group 35 – 39 years in males was found to be significantly associated with PHI. The estimated high incidence (10.1%) of HIV-1 infection in this study population indicated that HIV infection is still spreading and targeted intervention is highly recommended. Strong and sustained Provider Initiated HIV Counseling and Testing (PIHCT) with subsequent follow up is recommended for STI patients, particularly those with GUS, during their first appearance at health institutions.