Browsing by Author "Getachew, Sefonias"

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    Determinants of Multi Drug Resistant Tuberculosis (MDR-TB) among Tuberculosis Patients in Addis Ababa, Ethiopia: Case Control Study
    (Addis Abeba Universty, 2012-04) Getachew, Sefonias; Enquselassie, Fikre (PhD)
    Background: Tuberculosis (TB) is a major cause of death in developing countries; it comprises of 25% of avoidable adult deaths. Even though the global burden and incidence rates of TB have been declining since 2004, drug-resistant tuberculosis remains a growing threat to public health despite advances made in treatment and diagnosis over the past decade. Multidrug-resistant tuberculosis (MDR-TB) which is resistant to at least two drugs of the most powerful first-line treatment, rifampicin (RIF) and isoniazid (INH) is one of the challenging problem worldwide. Ethiopia ranks 15th among 27 high burden MDR-TB countries in the world with an estimated 5200 new cases of MDR-TB each year. Objective: of the study was to assess the potential determinants of MDR-TB among tuberculosis patients in Addis Ababa. Method: A facility based unmatched case control study design was conducted from December 21, 2011 to January 30, 2012. Cases were tuberculosis patients with culture-proved mycobacterium tuberculosis resistant to at least both to isoniazid (INH) and rifampicin (RIF) and controls were Tuberculosis patients with smear positive mycobacterium tuberculosis who turned negative for the recent test after 2nd, 5th or 6th months of treatment course. The case to control ratio was 1 : 2. Cases were selected from two hospitals which give MDR-TB treatment namely St. Peter and Defence Teaching and Referral hospitals. Controls were selected from two hospitals (Federal police and Defence Teaching and Referral hospitals) and seven health centres. Simple random sampling was used to select patients from the register of each hospital and health centres involved. To identify the determinants a multi variate logistic regression was done. Results: A total of 75 cases and 148 controls were interviewed. Among the respondents 41(54.7%) of cases and 84(56.8%) of controls were males. The mean (standard deviation) age among cases and controls were 30.6(10.4) and 28.6(9.9) respectively. The likelihood of MDR-TB were higher among those who reside out of Addis Ababa ( AOR=18.85 (2.21, 161.10), HIV infected (AOR=9.10( 1.48, 54.37) and on previous treatment of TB ( AOR=65.57(14.21, 302.64) and proved to be statistically significant. Conclusion: Previous treatment of TB, HIV infection and residence out of Addis Ababa were the independent predictors of MDR-TB and thus needs a better attention of the national TB prevention and control activities according to the contextual situations so that to avert the rising problem from the country and furthermore, to keep the health of the community.
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    Health Related Quality of Life and Its Associate Factors among Breast Cancer Survivors at Tikur Anbessa Specialized Referral Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-06) Yilma, Tewodros; Deyessa, Negussie(PhD); Getachew, Sefonias
    Background: Breast cancer is certainly the commonest forms of cancers among women in Ethiopia. For a long time the focus has been on clinical management of cancers but now Health Related Quality of Life (HRQOL) is emerging as an important health outcome which requires to be incorporated in the holistic management of patients. Evaluating the HRQOL, is used to identify cancer patients in need of clinical attention and to evaluate interventions for cancer patients and lead to better outcome. There were no studies conducted in Ethiopia that have investigated HRQOL issues among breast cancer survivors. Objective: To assess the level of health related quality of life and to identify associate factors among women breast cancer survivors at Tikur Anbessa Specialized Refereal Hospital, Addis Ababa. Methods: The study was hospital based cross-sectional research involving 360 breast cancer survivors from March 20 to June 30, 2015. The translated to Amharic version of European organization for research and treatment of cancer quality of life questionnaire QLQ-C30 (Quality of Life Questionnaire-Cancer 30) and QLQ-BR23 (Quality of Life Questionnaire- Breast Cancer 23) were used to measure the health related quality of life. The data entered, cleaned and analyzed by using SPSS 20 version software. Multiple binary logistic analysis was performed to examine the effect of independent variables on HRQOL further more analysis of variance (ANOVAs) and t-test was performed to examine the relationship between independent variables and functional and symptom scales. Results: Overall, 360 respondents participated in this study making the response rate at 94.48% percent. The mean score for HRQOL was 60.53. For bivariate analysis age, marital status, educational status, average monthly income, medical services status, types of anti cancer treatment, co-morbidity and cancer stage were associated with HRQOL. Whereas age, lower average monthly income (≤ 600 ETB), time since diagnosis, co-morbidity and current cancer stage remained significant in multivariate analysis. In all functional and symptom scales of the QLQ C30 and QLQ 30 except sexual functioning, sexual enjoyment and upset by hair loss were significantly associated with HRQOL. Conclusion: The study revealed that the mean health related quality of life among breast cancer patients were 60.5 and was comparable with the international findings. Significant determinant of health related quality of life include; age, low monthly income, high year of diagnosis, co-morbidity and being stage four and all functional and symptom scale variables except sexual functioning, sexual enjoyment and upset by hair loss. Based on the findings of the study it is important to prioritize such groups of breast cancer survivors for targeted programs to improve the health related quality of life and contribute for better out come
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    Utilization of Long Acting and Permanent Family Planning Methods Among Women of Reproductive Age Group in Debre Birhan Town, North Shewa Ethiopia
    (Addis Ababa University, 2014-06) Asegidew, Wondwosen; Kaba, Mirgissa(PhD); Getachew, Sefonias
    Back ground: Contraceptive use including short and long acting and permanent methods are recorded to help families to space and limit their size to their economic capacity. Wider access and use of long-acting and permanent methods of contraception are the most effective contraceptives available to contribute to reduction of high levels of population growth and maternal mortality and morbidity. Yet, utilization of LAPMs in Ethiopian is recorded to be low. Objective: The purpose of this study is to describe utilization of long acting and permanent family planning methods and identify associated factors among women of 18-49 years age group in Debre Birhan Town, North Shewa Zone, Amhara Region. Methods: A community based cross sectional study supported with qualitative method was conducted in four selected Kebeles of Debre Birhan town. Systematic random sampling method was used to select study subjects for the survey while purposive sampling was used to select study subjects for qualitative study. A pre-tested structured questionnaire was used to collect quantitative data and interviewer topic guide was used for qualitative. The survey data was entered in to Epi, Info version 3.5.4 and exported, cleaned and analyzed using SPSS version 21. Open code version 3.6.2 was used to categorize and code qualitative data. Factors associated with utilization of LAPMs were identified using logistic regression model and content analysis of qualitative data. Results: Current utilization of LAPMs among women of reproductive age was found to be 27.3%. Those women, who are aware of LAPMs, have positive attitude about LAPMs and those who were satisfied with the service were found to be used LAPMs AOR=4.21, 95%CI 1.53-11.55, AOR=1.81, 95%CI 1.12-2.94 and AOR=1.86, 95%CI: 1.14-3.04 respectively. Myths and misconceptions about utilization of IUCD and implants were major barriers to the use of LAPMs. Conclusion: Awareness, positive attitude and satisfaction with LAPMs were factors promoting use of LAPMs, whereas myth and misconception in the community hinders the utilization of LAPMs. Therefore; sustained and appropriate information on LAPMs should be provided to raise awareness of women and the community. The Town health office should design educational programs that promote and reduce barriers to LAPMs at community level in the Town