Browsing by Author "Hussen Mekonnen"

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    Effect of Antiretroviral Therapy(ART) on Fertility Intentions and Contraceptive Preference of HIV Positive Women in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2015-05) Hussen Mekonnen; Fikre Enquselassie
    Background: The advent of antiretroviral therapy (ART) has improved quality of life and survival for people living with HIV (PLWH) and now days HIV infection can be seen as a chronic manageable disease, as a result many will contemplate child bearing. Although, ART has influence in improving quality of life and reduce mother to child transmission of HIV virus(MTCT) in developed countries, vertical transmission accounts for more than 90% of pediatric AIDS in prevalent areas, as a result, reproductive assistance to HIV positive women is important to have informed decision making about child bearing and child rearing. In Ethiopia, while anti-retroviral therapy (ART) services are increasingly available, information about fertility intentions, contraceptive use and method preference among women living with HIV in relation to ART use is scarce. Moreover, change in fertility intentions 12 months after ART initiation and reasons in selection of those options are lacking. Those factors raise concern on possible exposure of many HIV positive women to the potential risk of unintended pregnancy and hinder them from seeking options. Objectives: the purpose of the study was to assess effect of ART on the fertility intentions and contraceptive use and method preference of HIV positive women in Addis Ababa, Ethiopia. Methodology: Health facility based cross sectional quantitative and qualitative studies including follow up studies were conducted. For the quantitative part, a total of 1855 HIV positive women aged 15-49 years for cross sectional survey and 360 HIV positive women participated for the follow up study. Focus group discussion, in depth interviews and key informant interviews were done for the qualitative part. Data were collected from June 2012 to December 2013 using validated structured questionnaires for quantitative and semi structured questionnaires for qualitative part. Data were double entered in to epidemiological software (Epi Info version3.5.1). Descriptive statistics, bivareate and multivariate statistical analysis were done using SPSS version 20 software. Results: Overall, 44% of women reported childbearing intention and 71% women reported using contraception 75% (n=579) ART users and 65% (n=422) ART naïve women. Male condom and injectable were the most preferred contraceptive methods among both groups. The proportion of fertility intention 12 months after antiretroviral therapy (ART) initiation was higher among ART initiated 55.5% (n=106) than ART naïve 40% (n=68) women. The presence of ART, improvement of health condition and the influence of husband, family, community and associated stigma were the main reasons for childbearing intentions of women in the study area. In adjusted logistic regression analysis, ART users had higher fertility intention (AOR; 1.26,95%CI; 1.01 to 1.60) than ART naïve. Furthermore, being in a sexual relationship, young age, being single and having fewer or no children were found to be predictors of fertility intentions. Women receiving ART reported more use of contraceptives (AOR 1.60, 95% CI, 1.30- 2.12)than ART naïve women. In addition to this, presence of partner (AOR 2.32, 95% CI, 1.60-3.40),disclosure of HIV status to husband (AOR 2.23, 95 % CI, 1.21-4.12), presence of living children: one (AOR 1.7, 95% C I, 1.03-2.40), two (AOR 2.6, 95% CI, 1.7-4.02) and three (AOR3.3, 95% CI, 1.90-5.60) respectively were found to be predictors of contraceptive use among HIV positive women. Overall, 41.0 % (147/360) of the women reported fertility intentions at the baseline, while 48.3%( 174/360) reported fertility intentions 12 months after follow up. The proportion of fertility intention 12 months after antiretroviral therapy (ART) initiation was higher among ART initiated55.8% (106/190) than HAART naïve 40% (68/170) women. Furthermore, the need for more children 12 months after ART initiation was significantly associated with woman’s ART use(AOR, 2.46, 95%CI, 1.20-5.20). Single and married women (AOR, 5.32, 95%CI, 1.10-25.92)(AOR: 6.34, 95%CI, 1.43-27.99) respectively, were more likely to report fertility intention than divorced/ widowed women. Women who had at least one child (AOR, 0.32, 95% CI, 0.13-0.85) were less likely to change fertility intentions compared to women with no children. Conclusions: Fertility intentions are common among HIV positive women and change in intention for a child starts soon after initiation of ART. About three in four HIV positive women use contraceptive methods mainly condoms. Dual contraceptive method use was negligible among the study subjects.Fertility and contraceptive decisions of women are influenced by presence of ART, partnerdesire, family and community perception and associated stigma. Many participants indicated that health service providers are supportive in offering information more on preventive methods rather than discussing fertility and contraceptive options. Recommendations: It is necessary to strengthen an integrated sexual and reproductive health (SRH) service and HIV prevention, ART services to address the diverse SRH needs of HIV positive women in the study area. Furthermore, updating health care providers with fertility and contraceptive knowledge is valuable to enhance family planning and preventive practice of women.
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    Infection Prevention Compliance and Associated Factors Among Nurses Working at Dialysis Units for Chronic Kidney Disease Patients in Addis Ababa
    (Addis Ababa University, 2024-06) Tigle Nadew ; Hussen Mekonnen ; Abigiya Wondimagegnehu
    Background: Chronic kidney disease patients on hemodialysis have an increased risk of infection due to the nature of the disease and the type of treatment they receive. In many developing countries including Ethiopia, there is low level of compliance of infection prevention practice between medical professionals, despite the rise of highly contagious illnesses. Effective interventions can be developed by critically assessing the elements that contribute to this problem. Objective: To assess infection prevention compliance and associated factors among nurses working at dialysis units for chronic kidney disease patients in Addis Ababa. Methods: A facility-based cross-sectional study was carried out among nurses working at dialysis units for chronic kidney disease patients in Addis Ababa from Jan-March 2024. A total of 251 nurses were included. A structured self-administered questionnaire which has eight components and a checklist were used for data collection. Descriptive statistics and correlation estimates were used. For regression analysis, the study applies Principal Component Analysis to generate an index. Finally, logistic regression was done and adjusted odds ratio (AOR) with a 95% confidence interval was estimated in the final model. P-values of below 0.05 were regarded as significantly associated variables. Results: The result showed that 105 nurses 45.66% were non compliant to infection prevention and control practices. The multivariable logistic regression result indicates, monthly salary10,000.00-20,000.00) [(AOR:3.23 ,95%CI (1.20-8.70)], nurses who had duty [(AOR: 0.48 ,95%CI (0.25-0.93)], and work environment factor [(AOR: 6.57 ,95%CI (3.38-12.78)] were predictors of infection prevention compliance. Conclusion and recommendation: Infection prevention compliance was not sufficiently practiced among dialysis unit nurses. Monthly salary, frequency of duty and work environment factors were factors associated with infection prevention compliance. Thus, intervention should focus on encouraging nurses by giving competitive benefit through salary increment, decreasing workload and creating good work environmental factors by ensuring sufficient and sustainable resources.
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    Stigma Towards Tuberculosis Patients in Shasemene Town.
    (Addis Ababa University, 2004-03) Hussen Mekonnen; Mesfine Addisse
    A community based cross sectional survey was conducted from November 2003 to March 2004 to assess the magnitude of stigma towards tuberculosis patients among the residents of Shashemene town, age 18 years and above. A multistage sampling procedure was used to select 845 study subjects. Both quantitative and qualitative data collection methods were utilized. The study shows that there was a misconception about cause of tuberculosis and its transmission in which majority 90.2% of the respondents reported cold as the major cause of tuberculosis, and 397(48.6%) of the respondents reported that all TB patients are infected with HIV/AIDS. Four hundred ninety one (60.1%) and 400(49%) of respondents reported that eating together and shearing toilet with TB patients, respectively, could transmit TB. Most of the respondents reported the presence of stigma towards tuberculosis patients, in which , 612(74.9%) of the respondents were not willing to disclose their disease status and 364(44.6%) of the respondents also were not willing to allow their child to learn in the same School where a child who have tuberculosis is learning. Five hundred and three (61.6%) of the respondents were not willing a teacher who has got tuberculosis to teach in the school weather he/she has started the treatment. Further more, 391(47.9%) of the respondents were not willing to allow a marriage between their daughter/son with a person who has been cured from tuberculosis. Most participants of the Focus Group Discussion (FGD) sessions reported that all tuberculosis patients were considered to have HIV/AIDS. Thus, careful design and implementation of health education and incorporation of the issues of tuberculosis related stigma along with other programs of TB and HIV/AIDS and further studies to enrich the knowledge about stigma surrounding TB and TB patients are recommended.