Browsing by Author "Mitike, Getnet (PhD)"

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    Acceptance of Index Case HIV Testing and Counseling among HIV Patients under Ossa Care and Support Outlets and Zewditu Memorial Hospital, Addis Ababa
    (Addis Abeba University, 2013-09) Abraham, Haileyesus; Mitike, Getnet (PhD)
    Background: HIV Counseling and Testing is one of the effective means for prevention of the spread of HIV infection. Partners and family members of PLHIVs are at higher risk for HIV infection. Thus, studying the acceptance of index case HTC and disclosure is important to improve the service. Objectives: This study aims to identify barriers to disclose HIV status by index clients and factors predict the acceptance of ICHTC. Methods: A cross-sectional study was conducted in Zewditu Memorial hospital and OSSA care and support outlet. A facility based systematic random sampling was followed to select 452 HIV positive individuals. Descriptive and inferential stastics wre usedto assess factors associated with acceptance of index case HTC and disclosure of HIV sero status. Result፡ The level of disclosure to main sexual partner was 56%. PLHIVs who had no sexual partner than spouse [OR: 8.15; 95% CI, 2.06-32.19] and had positive attitude to index case HTC [OR: 2.55; 95% CI, 1.63-4.0] were more likely to disclose their status. Index clients whose family and partner accepted HTC were 64% and 73%, respectively. Disclosure of status to family [OR: 2.40; 95% CI, 1.54-3.74] and friends [OR: 2.06; 95% CI, 1.19-3.57], being knowledgable [OR: 2.19; 95% CI, 1.39-3.44] and non-regular partnership [OR: 3.86; 95% CI, 1.68-8.83] were positively associated with acceptance of ICHTC. Nondisclosure to main sexual partner was protective to acceptance HTC. Conclusion and recommendation: Disclosure of self status, positive attitude to HTC, initiation for testng and being knowledgeable were factors influenced acceptance of HTC. Poor knowledge on HIV and risk assessment and negative attitude to ICHTC were barriers to disclosure. Intervention should prioritize mutual disclosure of HIV status, make clear understanding on HIV and its risks, benefits of ICHTC and develop positive attitude to ICHTC.
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    Assessment of time to recurrence of opportunistic infections in people living with HIV/AIDS, in Debre Markos town, East Gojam zone, North West Ethiopia, in 2013. (Retrospective Cohort study)
    (Addis Abeba University, 2013-05) Mellie, Habtamu; Mitike, Getnet (PhD)
    According to 2011 Ethiopian demographic health survey the national adult HIV prevalence is 1.5 %. In the same survey, HIV prevalence was 2.2% in the Amhara Region. In the region of North West Ethiopia, 88.9% of pre-ART PLWHA has any type of OI at initiation of ART. Different studies showed the effect of ART improves time to death of PLWHA however, little is known about its effect on improving time of recurrence of OI and factors associated with it and magnitude of the recurrence. Hence this study will be used to plan resources needed for chronic HIV/AIDS care and to identify factors affecting patients’ survival. Objective: To assess time to recurrence of OIs and factors associated with it and to determine magnitude of recurrence in PLWHA in Debre Markos town in 2013. Method: Institution based comparative retrospective cohort study were used and the required sample size was 536. All 18 years old and above PLWHA who were on chronic HIV care in Debre Makkos town health institutions was the source population for the study. Study participants were selected from the list of PLWHA attending the public health facilities using simple random sampling procedure by data collectors who are working in ART clinic. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Actuarial life table and Kaplan-meier survival was used to estimate survival and log rank test was used to compare survival curves. Cox proportional-hazard regression model was used to calculate the uni-variate and adjusted hazard rate and to determine independent predictors of time to recurrence of OI. Result: Among study participates 66% were females and the median age was 32 years. Most of them were urban 70.1%, orthodox 92.4%, not educated 44%, married 43.3% and employed 20%. During a median of 43 person weeks follow up OIs recurred in three quarter (75.7%) study participants. The Incidence rate of OI recurrence was 13.1(95 CI: 11.9-14.5) per 1000 person weeks. Using the Kaplan-meier survival estimation the median time of survival was 57 weeks. After adjusted for covariates the significant predictors for survival were marital status, occupational status, follow up CD4 count, base line Hgb value, ART exposure status, base line ART adherence status, base line and follow up prophylaxis exposure status and follow up prophylaxis adherence status, Conclusion and recommendation: Governmental and non-governmental organizations working on HIV/AIDS should give especial attention for risk groups like widowed, not taking treatment/ adhere ART or prophylaxis while continuing HIV care for all PLWHA.
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    Assessment of voluntary HIV counselling and testing (VCT) service Utilization among married couples in Gondar City, North West Ethiopia
    (Addis Abeba Universty, 2010-06) Abera, Ketema; Mitike, Getnet (PhD)
    Background: voluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Ethiopia. However, the utilization of VCT service particularly among married couples is very low in Gondar city. We therefore conducted this study to determine the prevalence, willingness and factors associated with VCT service utilization among married couples in Gondar city. Methods: a population based cross sectional study employing both quantitative and qualitative research method was conducted between February and March 2010. A total of 846 married couples aged 18 years and above were sampled from 3 randomly selected kebeles. Data was collected on VCT service utilization and independent variables. Binary logistic regression (bivariate and multivariate analysis) was performed to determine the predictors of VCT service utilization among married couples. Results: 838 married couples (1676 individuals) participated in the study with a response rate of 99.05 %. VCT use was higher among married women in the age group of 18-30 years and 31-40 years than married men. The major barriers to VCT service utilization among married couples were stigma, discrimination, fear of test results, partner rejection, and fear of marital breakage. However, 76.1% of married couples reported that they had willingness to use VCT. Conclusion: the VCT service utilization among married couples in Gondar city was very low. In order to increase VCT service utilization, there should be particular attention on health education, home based VCT programs, pertinent media programs and community mobilization
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    Assessmentt off Clliientts Sattiisffacttiion wiitth Outtpattiientt Serrviices iin Tiigrray Zonall Hospiittalls
    (Addis Abeba University, 2006-07) Adane, Girmay; Mitike, Getnet (PhD)
    Most zonal hospitals in Tigray are among the oldest hospitals in the region, now serving for the huge population of the region that were originally established about 40 or more years ago for a much lesser population. Through time the significant increase in population growth has resulted in an extremely increased demand for health services, while the hospital capacity and facilities are not correspondingly changing. Different efforts are on process to fulfill the hospitals with the right manpower, medical equipment and other facilities to meet the needs of the clients. However the level of clients satisfaction is not known since no systematic study was carried out to assess the condition. A cross sectional study was conducted from November to April 2006. A combination of methods was used in collecting data for this study. These were both the quantitative and qualitative techniques. Three zonal hospitals were included in the study by simple random sampling technique. A total of 422 respondents were recruited for the study selected by systematic random sampling technique in the zonal hospitals. Structured questionnaire was used to collect the data in the zonal hospitals. In addition, FGDs with the clients and In depth interviews with the key personnel of the selected hospitals were also conducted to gather information. Epi6 and SPSS 10.0 statistical packages were used for data management. Among the clients, 52.6 % are male, 40.5% of the total clients are illiterates, 45.3% are from the rural areas and 33.6 % are non paying. The findings of the study showed that the client satisfaction level with the outpatient departments in the zonal hospitals was 43.6 %. Satisfaction was rated highest with courtesy and respect by the health workers with 93.8 % satisfaction rate. Dissatisfaction was rated highest by respondents with the lack of drugs and supplies in the hospitals pharmacies with 64.9% reporting dissatisfaction. Nearly half of the respondents (46.7 %) responded they were not satisfied with the information provision by the health workers about the services and their health problems. 96 % of the clients got a prescription for drugs and supplies. Of those with the prescription paper, only one third (32 %) got all the prescribed drugs and supplies. 44.2 % of the respondents were dissatisfied with the overall waiting time to get the hospital services. In conclusion, many clients were found to be dissatisfied with the services of the outpatient departments of the zonal hospitals. In addition the FGDs and In depth interviews showed that clients dissatisfaction was associated with the lack of drugs and supplies, long waiting time and inadequate information provision like that of the factors identified during the exit interview. Thus, the level of clients’ vi dissatisfaction is high. Therefore revising the allocation of budget for the hospitals to enable them keep the basic drugs and supplies and reassessment of the functions of the special pharmacies in the hospitals, Improving and strengthening the existing information provision to clients and developing a new hospital structure is recommended. Key words: - Hospital, Out patient department, satisfaction
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    Privacy and Confidentiality Issues of AnEmr Application: Health Professionals, Health Managers and Patients’ Perception in Zewditu and Ras Desta Damtew Hospitals
    (Addis Ababa University, 2013-06) Tadesse, Mamush; Mitike, Getnet (PhD); Abebe, Ermias (PhD)
    Introduction Establishing a nationwide Electronic Health Record system has become a primary objective for many countries around the world in order to improve the quality of healthcare while at the same time decreasing its cost. However, implementation of EHR systems is being hindered by several obstacles, among which are concerns about data privacy and trustworthiness. With the introduction of e-health, concerns of right to data privacy became a primary concern for the patients and health professionals. Objective The objective of this study is to explore the perception of health professionals, managers and patients’ towards privacy and confidentiality issues of Electronic Medical Records in Zewditu and Ras Desta Damtew memorial hospitals. Method A hospital based cross-sectional, quantitative study was conducted among 420 health professionals and patients to assess health care professionals, health managers and patients attitude towards privacy issues of EMR. The sample size was calculated using single population proportion formula. The data was collected through standardized questionnaire. Respondents were assessed by socio-demographic, knowledge, attitude and practice variables. Result Among users of EMR, 229 (79.8 %) are trained to use the software by NGO, Government, and by themselves or self trained. About 66 (28.8%) replied the training prepared them fully to keep patient privacy, 120 (52.2%) mostly prepared, 41(17.9%) somewhat prepared and the rest 2 (0.7%) said not at all. Forty eight (21%) of the respondents have no individual Log in Id and passwords. They have no other option to enter their patients data other than sharing others passwords. Nineteen (16.5%) of patients even don’t know that their health data will go into computerized method. In this study, patients who are relatively literate (assessed by their educational status) showed concerns of privacy issues but illiterate patients didn’t know risks and benefits of computerized medical record. Almost all patients want to be asked before their health data is taken for research or other purpose. Overall managers, health professionals and patients are comfortable by the existing system except privacy concerns.Conclusion and Recommendation In this study, all respondents believe that EMR system is likely to increase the quality of care. At the same time, respondents have significant concerns about the privacy of their medical records. There is no means to control (audit trial) over who can access patient data among employees. Most respondents are obliged to share passwords because they have no individual Log in Id and passwords. This shows the presence of some gaps not to ensure privacy of patient information. Even though respondents are comfortable by the EMR system, privacy concerns are still there. Therefore, government and other responsible bodies should implement and enforce strategies to strengthen privacy. Health care providers should inform to their patients how their health data is being stored in order to increase their awareness, avoid confusion and build public trust