Browsing by Author "Firdu, Naod"

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    Adherence to Highly Active Antiretroviral Therapy and its Associated factors among HIV Infected Adolescents in Addis Ababa, Ethiopia
    (Addis Abeba University, 2014-06) Firdu, Naod; Dr. Enquoselassie, Fikre(PhD); Dr. Jerene, Degu(MD, PhD)
    Background: For antiretroviral therapy (ART)to work effectively, adherence is very crucial. However, most of the studies done on ART adherence are either on children or on adults. There is limited information on the level of adherence among adolescents. Since the physical, biological and behavioral changes which occur during adolescence could affect ART adherence, we endeavored to assess the level of adherence among adolescents treated at three hospitals in Addis Ababa, Ethiopia. Study Objective: This study was carried out to assess the magnitude of ART adherence among HIV infected adolescents in Addis Ababa, Ethiopia. It also looked into the various sociodemographic, behavioral and clinical factors associated with ART adherence among adolescents. Study Methods: Using a cross-sectional study design, 273 HIV infected adolescents receiving ART were interviewed from three hospitals in Addis Ababa. We used a structured questionnaire to measure adherence levels using patient self-reports among randomly selected adolescents aged 13-19 years. Data was entered using Epi Info version 3.5.4 and exported to SPSS version 21 for analysis. Bivariate and multivariate methods were used for analysis. Results: We interviewed 273 adolescents aged 13 to 19 years, and 144 (52.7%)of the participants were female. Their mean age was 15.42 years (SD± 1.75). The self-reported adherence rate of the respondents was 79.1% (216/273). Most (96%)were on first line antiretroviral drugs. The median duration on ART was 7 years (IQR, 3). On Bivariate analysis; WHO stage, being on Cotrimoxazole Prophylactic Therapy (CPT), marital and living status of the parent, whether parent was on ART and having special instructions for ART medications were associated with optimum adherence. However only WHO stage IV (adjusted OR, 12.874 95% CI, 2.079-79.706), being on CPT (adjusted OR, 0.339 CI, 0.124-0.97)and adolescents with widowed parent (Adjusted OR, 0.087 with CI, 0.021-0.359) were significantly associated with optimum adolescent ART adherence. Conclusions: The level of self-reported ART adherence among HIV infected adolescents at the three hospitals was below the recommended threshold. Being in advanced WHO clinical stage was associated with better adherence levels, but history of taking CPT was associated with poorer adherence. Earlier presentation of adolescents to care should be encouraged, but more targeted adherence support should be planned for those who present at early stage of their illness.
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    Assessing the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose Level and Their Risk Factors among Federal Police Members at Federal Police Commission Residing In Addis Ababa, Ethiopia between April and May 2015
    (Addis Ababa University, 2015-05) Tesfaye, Tariku; Firdu, Naod
    Background Globally, the prevalence of diabetes mellitus across various occupational groups and its relationship with an occupational factor is a topic of recent interest. Police officers as an occupational group are exposed to unhealthy life style, excessive alcohol consumption and smoking which intern leads to diabetes mellitus and other cardiovascular diseases than the general population. Due to this reason the present study were conducted among federal police officers in Addis Ababa. Objectives: The objective of this study was to assess the prevalence of diabetes mellitus and impaired fasting glucose level and identify their risk factors among federal police members at Federal Police Commission residing in Addis Ababa, Ethiopia between April and May 2015 Methodology: A cross-sectional study was employed using multi-stage sampling technique. The study populations were all federal police members living in Addis Ababa and served the police commission for at least a year. The total sample size for the study was 1003. The data were collected using structured questionnaire, physical examinations and blood samples, by using the WHO stepwise approach. Data were entered into SPSS version 20.0. The entered data were cleaned and analyzed Frequency distributions, percentage, tables and charts were used to show result of univariate analysis. Cross tabulation, chi-square tests, and 95% confidence interval used to present results of bivariate analysis. Multivariate logistic regression analyses were done to control potential confounding variables. xi Result: Out of 1003 eligible subjects 936 (93.3) police officer were participated in this study. Of the total subjects tested for blood glucose level the prevalence of impaired glucose homeostasis (IGH) were 13%, out of which 47 (5.0 %) were diabetes and 73 (8.0%) impaired fasting glucose. Age ≥45 years (p=0.044, AOR= 4.9 (1.04, 23.1)), having history of first degree relative who suffered from diabetes (P=0.008, AOR= 3.2 (1.4, 7.5)), and Hypertension (P=0.000, AOR= 4.5 (2.6, 7.8)), Body Mass Index (P=0.000, AOR= 6.0 (1.2, 30.2)) were found to have stastical significance with the prevalence of Impaired Glucose Homeostasis among the study participants. Conclusion: The study identified a high prevalence of diabetes mellitus and impaired fasting glucose level among police officers. Finally, the study recommend awareness and prevention of diabetes mellitus program should be given priority as that of communicable diseases by federal police health service directorate, Federal Minster Health and Non Governmental Organizations who works in collaboration with Federal Police Commissions
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    Survival and Its Determinant of Multidrug-Resistant Tuberculosis Patients with (HIV) Co-Infection: St. Peter Tuberculosis Specialized Hospital Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-12) Abebe, Yemarwuha; Ayele, Wondimu; Firdu, Naod
    Back ground According to World Health Organization (WHO) 2015 report globally 480 000 new cases and 190,000 estimated deaths occurred in 2014 due to MDR TB. Ethiopia ranked 7th from top 22 highest TB-burden and 15th from 27 highest MDR-TB burden countries; and one of high HIV/AIDS prevalent in Sub-Sahara African countries. Nevertheless, a little known about Survival of Multidrug-resistant Tuberculosis patients with HIV/AIDS co-infection in Ethiopia. Hence, this study is to determine the Survival and their determinants in MDR TB patients co-infected with HIV/AIDS Addis Ababa, Ethiopia Method A retrospective cohort study design was conduct at St. Peter TB specialized hospital Addis Ababa, Ethiopia; from February to March 2016. Survival of exposed and non-exposed groups was compared by Kaplan-Meier survival functions by using log-rank test. Factors that associated with outcome variables at 20 % (p<0.2) significant level in the bivariate analysis was included in the final Multivariable analysis. Cox proportional hazards regression model was used to determine factors associated with risk of death by controlling confounding and effect modifier. Result Out of 93 expose groups 48 (51.61%) were female and the rest 45 (48.39%) were male. Ninety three exposed study subjects were survive for a total of 26,581 person per 10000 days, and 213 non-exposed study subjects were survive for a total of 63,782 person per 10000 days. Median survival time of exposed study subjects was 269 person days and for non-exposed study subjects had 254 person days median survival time. Kaplan Meier survival curve shows lower survival (long-rank test, P<0.010) was seen in exposed groups compared to non-exposed group throughout the follow up time with parallel survival estimate curve. Independently associated factors for increasing risk of death was hospitalization at the time of treatment initiation (HR: 8.64; [1.11 - 67.00]), presence of HIV co-infection (HR: 2.15; [1.04 - 4.46] and age greater than or equal to 65 (HR: 10.07; [1.80 - 56.29]. Conclusion This study find out MDR TB patients without HIV had better survival than those MDR TB patients with HIV co-infection. Hospitalization at the time of treatment initiation, presence of HIV co-infection and age greater than or equal to 65 years of age increase the risk of death. Recommendations Early detection (diagnosis) and treatment for MDR TB for HIV positive patients; regular medical check-up for MDR TB to aged people; decrease hospitalization by early diagnosis and treatment and further studies on MDR TB and survival of older population