Browsing by Author "Gebremichael, Bereket (BSc, MSc)"

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    Incidence and predictors of lost to follow up among children on antiretiroviral therapy at east and west Gojjam zone referral hospitals, amhara regional state, 2018: a retrospective cohort study
    (Addis Ababa University, 2018-06) Fetene, Tamene; Gebremichael, Bereket (BSc, MSc)
    Background: Globally, 36.7 million people were living with HIV up to midd-2017 of which 2.1 million were children less than 15 years. Antiretroviral therapy is introduced to maintain maximal suppression of viral replication, to restore immune function, to reduce HIV-related morbidity and mortality and to prolong survival. However, effectiveness of highly active ART could vary from region to region because of the difference in the retention of patients on antiretroviral therapy. Objectives: The main aim of the study is to asses incidence and predictors of lost to follow up among children on antiretroviral therapy at East and West Gojjam Zone referral hospitals, 2018. Methods: Six years of retrospective follow up study was conducted among 561 children aged less than or equal to 14 years who were newly enrolled in HIV care clinic from 1st of January 2012 to December 31, 2017 after gating ethical clearance from institutional review board of Addis Ababa University. Data was entered into and cleared using Epi-Data version 3.1 and then was exported to STATA version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the cumulative survival time and Log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of lost to follow up (LTFU). Results: Out of the 561 charts reviewed, 533 children records were included in the final analysis. A total of 46 new LTFU cases were observed during the 15288 Person months follow up period. Hence, the overall incidence rate of LTFU was 3.6 per 100 person years. Baseline age <1 year (AHR; 3.7, 95% CI: 1.08, 12.68), and 1-5 years (AHR:3.86, 95% CI:1.73,8.61),OIs at baseline (AHR:2.26,95%CI:(1.08,4.71),hemoglobin level<10gm/dl(AHR:3.57,95% CI:1.54,8.24),baseline malnutrition in the form of underweight(weight for age Z score (WAZ)<-2)(AHR:5.67,95%CI :2.11,15.21)were independent predictors of LTFU occurrence. Conclusion and Recommendation: The first 18th months of ART initiation is the time of high LTFU .Baseline age <1 year and 1-5 years, WAZ<-2, OIs at baseline, not taking cotrimoxazole preventive therapy and Hgb <10gm/dl were an independent predictor of LTFU. Hence, Special emphasis and close follow up should be given to patients in the first 18th months of ART initiation and to those children having the above predictors.
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    knowledge, attitude and practice on key essential nutrition action messages and associated factors among mothers of children birth-24 month in Wereilu wereda, South Wollo Zone, Amhara, Northeast Ethiopia, 2018
    (Addis Ababa University, 2018-06) Beletew, Biruk; Gebremichael, Bereket (BSc, MSc)
    Background-The first 1000 days: the period from the start of a mother‟s pregnancy through her child‟s second birthday, is a critical window period. It is a time that the child‟s brain and body - develops rapidly. If children do not get the right nutrients during this period, the damage is often irreversible. An essential nutrition action is one of the most effective preventive actions for reducing nutrition related morbidity and mortality among young children. Nonetheless there is limited evidence regarding it. Objective-The main aim of this study was to assess knowledge, attitude and practice of key essential nutrition action messages and associated factors among mothers of children birth – 24 month in Wereilu Wereda, South Wollo Zone, Northeast Ethiopia. Methods - A community based cross-sectional study design was conducted on 563 mothers of children from birth up to 24 month in Wereilu Wereda from April 1–15, 2018. Multi stage sampling technique was employed. Structured, adapted and pre-tested questionnaire was used to collect the data through interviewing technique. The data was entered by using EPI-data Version 4.2 and exported to SPSS version 24.0 for analysis. Bivariate and multivariable logistic regression was carried out to asses‟ assosation between outcome and predictor variables. Result: The prevalence of good knowledge, attitude and practice were 365(66.4%), 379(68.9%) and 256(46.5%) respectively. Independent predictors of good practice were: educational status of the mother and the father, monthly income, parity, place of birth, PNC follw-up, level of knowledge and level of attitude. Attitude were significantly affected by sex of the child, place of birth, ANC follow-up, PNC and level of knowledge.Knowledge were significantly associated with educational status of the mother, residence, ANC, PNC and nutrition information. Conclusion and Recommendations: The practices of key ENA messages in the study area were found to be low; the knowledge and attitude were relatively higher than their practice. So it is better to improve access to information to the community on key ENA messages through trained health workers coupled with Medias.
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    Predictors of neonatal sepsis in public referral hospitals of east and west Gojjam zones of Amhara regional state, north west Ethiopia: a case control study
    (Addis Ababa University, 2018-06) Yirga, Tadesse; Gebremichael, Bereket (BSc, MSc)
    Introduction: Globally, neonatal sepsis is one of the most leading reasons for inflated death and illness of neonates. It is also one of the most common causes of neonatal death in Ethiopia. Identification of the determinants for neonatal sepsis and treatment of newborns with sepsis, is not adequate in low income countries. Despite few studies related to neonatal sepsis there are inconsistencies among findings. Identification of risk factors and early initiation of therapy can significantly reduce the burden of neonatal death and illness. Objective: The main aim of this study was to assess predictors of neonatal sepsis in public referral hospitals of East and West Gojjam Zones in Amhara Region, North Ethiopia from March-April 2018. Methods: Institutional based unmatched case-control study was conducted among a total sample size of 231 (77 cases and 154 controls) in Debre Markos referral hospital and Felege Hiwot referral hospital from March 2018- April 2018. Neonates diagnosed as sepsis were considered as cases and neonates diagnosed with other problem except sepsis were controls. Study participants were selected from NICUs in the two referral hospitals. For each case two consecutive controls were selected by lottery method. Data was collected using structured pretested questionnaire through face to face interview with index mothers and by neonatal record review using checklists. It was entered into Epi data version 3.1 and exported to STATA/ SE software version 14. Finally, it was analyzed by logistic regression model. Variables with (p< 0.25) in bivariate analysis, were entered to multivariable logistic regression. Statistical significance was declared at P<0.05. Result: In this study, 77 cases and 154 controls with their mothers were included with the overall response rate of 100%. After multivariable logistic regression analysis, significantly associated variables with sepsis were; Number of maternal ANC service <3 (AOR=4.35, 95%CI=1.66-11.45), Duration of rupture of membrane > 18hours (AOR=10.37, 95%CI= 2.31-46.52), meconium stained amniotic fluid ( AOR =3.87, 95%CI=1.53-9.77), urinary tract infection during pregnancy (AOR=10.8, 95% CI=3.44-33.97), intranatal fever (AOR=3.19, 95% CI=1.07-9.47), first minute APGAR score <7 (AOR=3.17, 95% CI=1.30-7.71), resuscitation at birth (AOR= 5.35, 95% CI= 1.86-15.45), nasogastric tube (NGT) insertion (AOR=3.73, 95% CI=1.37-10.16). Conclusion: In this study, neonatal invasive procedures, neonatal and maternal variables were found to be significantly associated with the risk of neonatal sepsis. Therefore, Professionals should adapt risk based early recognition systems and implement standardized emergency treatments. Potential researchers on sepsis should include neonates in the community which may increase external a validity of the study.