Browsing by Author "Tesfaye, Fikru (PhD)"

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    Assessment of Hypertension Treatment Pattern At Selected Health Facilities in Addis Ababa and Consumption of Antihypertensive Drugs
    (Addis Ababa University, 2009-10) Teshale, Mewael; Gedif, Teferi (PhD); Tesfaye, Fikru (PhD)
    Background : Hypertens ion a long with other chronic diseases is on the rise in I~ thi opia. In fac t, the threats of non communicable diseases are not emerging rather they are well advanced and causing do uble burden to the society along with in fectious diseases. Unhealthy life sty le is the dcterminant for this dilemma. Needless to say, it needs time ly in tervention to tack le the problem. Despite or this fac t, studies on hypertension arc very few. This study assesses the treatment pattern to hypertension and consumption of antihypertensi ve drugs. Objective: To assess hypertension treatment pattern and consumption of anti hypertensive drugs. Methodology: An institution based cross sectional study involving retrospective data collection techniques (record review for the last five years and exit interview) was conducted between September and October 2008 . Results: The most commonl y prescribed drugs either alone or in combination were methyldopa, nifed ipine. hydrochlorothiazide. enalapril and atenolol. Treatment sh ift occurs freque ntly from thera peutic class to another on the basis of in effecti veness of the drug to adeq uate ly control blood pressu re, reason not known and side effect. Monoth erapy is favo red regard less of scx. Furosemide is the most consumed antihypertensive drug and nifedipine ranks the first with regards to cost of sales of antihypertensive drugs. Conclusion and recommendations: Methyldopa, ni fed ipine, hydrochlorothiazide, enalapri l and atenolol are widely used drugs for the treatment of hypertens ion whi ch is in accord with standa rd treatment guideli ne of the country. Future longitudinal research should be done to describc consumption trend of antihypertensive drugs.
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    Assessment of Intention and Practice of VCT And Infant Feeding In the Context of HIV/AIDs Among Lactating Mothers in Harar Town
    (Addis Abeba university, 2006-03) Assegid, Meselech; Tesfaye, Fikru (PhD)
    Introduction: - Mother-to-child transmission of HIV is the most significant route of HIV infection in children and by far the largest source of HIV infection in children below the age of 15 years Objectives: - the aim of this study was to assess current practices and future intention of lactating mothers on VCT and infant feeding in relation to prevention of MTCT of HIV in Harar town. Methods: - A community based cross sectional quantitative survey supplemented with a qualitative method was conducted from January to February 2006 using standardized questionnaire, among lactating mothers in Harar town selected using probability proportional to size. Results: - Lactating mothers had good knowledge of HIV/AIDS but fair knowledge on MTCT and PMTCT of HIV. Intention to undergo VCT had significant association with knowledge about PMTCT. Practices of VCT had significant association with age of mothers, parity, frequency of ANC check-up, HIV knowledge, PMTCT knowledge and attitude towards PLWHA. Conclusion: - There is a high intention to undergo VCT whereas only few mothers have undergone the test, indicating a wide gap between intention and practice. The mothers’ breast feeding practice in the context of HIV and nutrition is risky as suboptimal breast feeding practices are widespread. Recommendation: - Increasing utilization of MTCT, PMTCT, and VCT including optimal infant feeding requires IEC and BCC. Information, Education Communication (IEC) and Behavioural Change Communication (BCC) on VCT, MTCT, PMTCT and infant feeding shall be strengthened. Establish communication/ referral network between health facilities and organizations working on HIV/AIDS, vi i working towards alleviating the problem that social stigma poses on mothers’ adoption of safer infant feeding options to prevent MTCT of HIV and full day VCT services shall be made available for mothers seeking delivery services in hospitals to minimize missed opportunities.
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    Assessment of Nutritional Status of People with Major Mental Disorders and their Controls, in Meskan and Marako District (Butajira), Ethiopia
    (Addis Abeba Universty, 2002-03) Lijalem, Misganaw; Tesfaye, Fikru (PhD)
    Nested case-control study was carried out to assess nutritional status and identify other risk factors among people with major mental disorders (schizophrenia and bipolar), in Meskan and Marako district from Dec. 2001 to Feb. 2002. Data were collected on sociodemographic factors, lifestyle, and nutritional, reproductive health and dietary patterns. Complete data obtained from 434 cases and equal numbers of controls matched by sex, age in five years range and residence, on one to one ratio. The cohort list of Mental Health Research Project (MHRP) was used to identify all cases, and controls were selected from the nearest neighbors by frequency matching. Cases and controls were compared by socio-economic, nutritional, reproductive, and dietary characteristic. Major mental disorders were positively significantly associated with unmarried (OR=1.88 with 95%CI 1.33, 2.66), illiterates (OR=1.91 with 95%CI 1.04,2.29), Muslims (OR=1.50 with 95%CI 1.27,2.88), not having cattle (OR= 2.59 with 95%CI 1.47, 4.55) while owning a radio (OR= 0.66 with 95%CI 0.41,0.88), and spending less time on job (OR= 0.29(0.22, 0.40) were negatively significantly associated. 'Khat' chewing and cigarette smoking were also positively significantly associated (OR=2.68 with 95%CI 1.53,4.69 and OR=2.32 with 95%CI 1.37,3.90) respectively with major mental disorders. Adult malnutrition was positively significantly (OR=4.08 with 95%CI 1.42,11.74) and weight (OR=1.55 with 95%CI 1.08,2.24) associated with major mental disorders. Cases and controls were not different on micronutrient deficiencies, reproductive and dietary characteristics. The results of this study help the project managers and others in designing effective intervention strategies to improve the health of the community in general and those with mental health problems in particular. vii
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    Assessment of Risk Factors for Selected Chronic Diseases among Higher Education Students in Addis Ababa
    (Addis Abeba Universty, 2007-07) Lemma, Seblewengel; Tesfaye, Fikru (PhD)
    Background: The health system in developing countries, such as Ethiopia, is overwhelmed by infectious diseases and malnutrition. However, the growing burden of diet and lifestyle related chronic diseases have recently been recognized with its contribution to the double burden on diseases in these countries. Objective: The study was designed to assess the prevalence of common risk factors for chronic diseases among regular higher education students in Addis Ababa in 2007. Methods: This study is an institution-based cross sectional survey that employed cluster sampling method. The WHO STEPS questionnaire was administered to collect data on sociodemographic characteristics, behavioral risk factors, and selected physical measurements, such as blood pressure, weight, height, waist and hip circumference. Results: Prevalence of current cigarettes smoking was 9.5% in male and 3.4% in females. About 44% of participants reported alcohol consumption in 12 months prior to the survey, while 6.8% reported binge type of alcohol drinking. The prevalence of current khat chewing was 13.8% and 13.3% were daily khat users. Almost 99% of participants reported inadequate fruit and vegetable consumption, and 21% of participants added salt on their plate while they are eating their meal. About 31.6% of males and 47.8% of females were physically inactive or reported inadequate level of physical activity related to work, transport or leisure time. The overall prevalence of overweight or obesity was 5.5%, with 4.2% in males and 7.6% in females. Hypertension was detected in 10.4% of males and 6.7% of females. Adjusting to other variables, age, friend's history of smoking, current khat chewing and binge drinking were positively associated with current cigarette smoking status. Male sex, urban residence, friends' and father's khat consumption history were positively associated with current khat consumption. Sex, years of stay in college, living arrangement, and BMI were predictors of both systolic and diastolic blood pressure of the participants. Conclusion and recommendations: Inadequate consumption of fruits and vegetables, along with physical inactivity, are widely prevalent risk factors of chronic diseases among college vi students in Addis Ababa. Moreover, khat chewing, cigarette smoking, and alcohol consumption are common practice among the study population. The college, as a continuation of the high school, is a favorable (breading) environment for adoption and proliferation of substance use behavior. At the same time, it offers an opportunity for promotion of healthy life style and prevention of the risky behavior. The school administrative and members of the academic community should be aware of the prevailing situation and its potential consequences in order to curb the problem
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    Assessment of socio-cultural risks in relation to HIV transmission in pastoralist community of Surma woreda, SNNPR, Ethiopia
    (Addis Abeba Universty, 2006-04) Degu, Mesfin; Tesfaye, Fikru (PhD)
    Background: The magnitude and depth of HIV/AIDS impacts in sub-Saharan Africa are staggering. Over 36 million individuals are currently living with HIV/AIDS, 95% of whom are from developing countries. In the past, rates of HIV/AIDS in urban populations were greater than in rural areas; more recently, improved and expanded surveillance has shown that HIV prevalence in rural areas is lower than anticipated. Nevertheless, the differences in infection levels between rural and urban areas will be narrowed over time. The absolute number of HIV-infected persons in rural areas may equal or surpass the number in urban areas. In Ethiopia most of the studies on HIV/AIDS focused on urban centers; however, on the other hand, evidence has shown that the prevalence of HIV infection is increasing rapidly in rural areas. Pastoralists are among the marginalized people with diverse cultures, and these cultural practices have been cited to be fueling HIV transmission in pastoralist areas. Surma is pastoralist woreda found in Bench Maji zone (SNNPR), 750km from Addis Ababa. Different socio-cultural practices are predominantly performed in the community which may facilitate HIV in the community. Objective: This study aimed to identify socio-cultural risk factors for the transmission of HIV infection in pastoral communities of Surma woreda, SNNPR. Methods: A cross-sectional study was conducted using quantitative method involving 447 study participants in the age range of 15-49 who are residing 18 kebeles in Surma woreda. A qualitative method was also applied involving elders, influential peoples, traditional healers and community leaders. The study was conducted from Dec 2005 to Feb 2006, in surma woreda, Bench Maji zone, SNNPR. vi Results: The result of the study was based on 416 respondents who adequately responded to the questionnaire interview. Findings revealed over 88.2% of the study population were illiterate and 41.9% of married males involved causal sex during the post natal period of their wives. Over fifty two percent of respondents never heard about HIV\AIDS. 90.4% and 90.1 % of the respondents had been pierced skin and body tattooing respectively. According to the graded risk practices score, 70.4% of participants were among the high risk while 29.6% were at low risk category. Their awareness and knowledge about HIV\AIDS was less. In addition, the identified socio-cultural practices (skin piercing, body tattooing, tooth extraction, hair shaving, traditional surgery and cultural rituals) were found to fuel the transmission among the study population .Their sexual behavior also had a grave consequence for the wide spread of HIV\AIDS. The awareness towards VCT and willingness to undergo VCT was also low. Conclusions: The nearly created linkage, which is starting sex some of the surma people with nonendogenous people, will make the identified socio-cultural practices to play a considerable role in the transmission of HIV spread. In addition lower status of awareness and knowledge about HIV\AIDS, as well as dreadfully high illiteracy level made the study population at critical level for HIV spread. The liberal sexual practices with the recently amplifying level of alcoholism made horrible the probability of HIV spread in the community. Recommendation: Multidisciplinary survey teams urgently need to raise local awareness and knowledge of HIV\AIDS using culturally appropriate methods, and reduce high-risk behaviors to prevent the spread of HIV.
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    Assessment of the Effect of Nutritional Status' and Intestinal Parasitic Infection on Academic Performance of Elementary School Children in Teda Town, Gonder, Ethiopia.
    (Addis Ababa University, 2000-12) Abebe, Belete; Tesfaye, Fikru (PhD)
    A cross sect ional st udy was conducted invo lving 641 students of the two primary schoo ls of Teda town, North Gonder. The purpose of the study was to determine the nutritional and intesti nal parasitic infect ion (lP I) status of the chil dren, the effect of IPI and nutritional status on the chi Idren's academic performance, and the effect of IPI on nutrition. Data were collected us ing questionnaire and anthropometric measurements. Physical and stool examinations were also carried out. School average scores were obtained from school records. The data were entered, processed and ana lysed using EPI Info vers ion 6, computer software (and its subprogram EPINUT). Underweight and stun ting were found to be 59.S% and 41.7% respectively, whereas the overal l IPI rate was 77.7%. The commonest infection was Ascaris IUl11bricoides with prevalence or 66. 7%, followed by Entameba hi stolytica with prevalence of 14.S%. Low than high pupil s' school average score was signi ficantly associated with underweight, X' = 39.45, (p value < 0.0001), and with stunting, 'X = 19.79, (p < 0.001). Intestinal parasitic infection did not show any associat ion with the nutritional status and school perfo rmance orthe child ren. A higher proportion of the younger than the older age group was underweight, OR = I.S6 (95% CI = 1.32, 2.64). Also higher proportion of the urban students than that of the rural ones were unde rweight, OR = 2.25 (95% CI = 1.59, 3 . IS), and a significantly higher proport ion of the urban than the rural students were stunted. The town and the rural studen ts were not diffe rent regarding to II'I. Th is survey should sensitize concerned bod ies for improving primary school chi ldren's health and nutri tion. Recommendations are made to take actions to alleviate the lPI and nutri tional probl ems of the school children .
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    Assessment of the Prevalence of Intestinal Parasitic Infections among School Children and their Knowledge and Practice of Hygiene and Sanitation in Primary Second Cycle Schools, Debirebrhan Town
    (Addis Abeba Universty, 2010-06) Habteleul, Sisay; Tesfaye, Fikru (PhD)
    Background: Poor sanitation in schools can cause parasitic infection among school children that can result in impaired children’s growth and development. It also increases student’s absenteeism from school and affects student’s academic performance. Due to poor sanitation, about 40% of the world’s 400 million school age children are infected with intestinal worms. Objectives: To assess the prevalence of intestinal parasitic infection among school children and their knowledge and practice on hygiene and sanitation in Debrebrihan town second cycle schools. Methods: A cross-sectional study on prevalence of intestinal parasite infection and their knowledge and practice among school children were conducted in March 9 to April 5, 2010. A stool sample was taken from school children and examined using formol-ether concentration technique for parasite. The data on socio-demography and hygiene sanitation knowledge and practice variables, and sanitary survey of schools were collected using structured questionnaire and observational check-list respectively. The data were entered and cleaned using Epi-info window version 3.5 and analyzed by SPSS version 11. To assure the data quality, training for data collectors and supervisors was given and supervisors were checking the data consistency and completeness. Result: Of the total 721 study participants, 308 were males and 413 females. According to the findings of this study, 405 of the study participants were knowledgeable on hygiene and sanitation. More than half (56.4%) of the participants had a better hygiene and sanitation practice. The overall prevalence of at least one intestinal parasitic infection was 41.3%. Six species of intestinal parasites were identified. The predominant parasite was A.lubricoides with a prevalence of 12.3% followed by E.histolytica/dispar) and G.lambia. .Double intestinal parasitic infection rate was found to be 1.2 %( only 2 out of 165 Children). vii All the three schools do not meet the minimum required standard to the amount of water supply and latrine seats to students’ ratio. Conclusions and Recommendations: According to the findings, nearly more than half of the study participants had knowledge and practice on hygiene and sanitation. Relatively high prevalence of intestinal parasitic infection was seen among school children & schools lack basic sanitary facilities. Therefore, schools should improve basic sanitary facilities, knowledge and practice of students.
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    Impact of Food and Nutrition Security on Adherence to Anti-Retroviral Therapy (ART) and Treatment Outcomes among Adult PLWHA in Dire Dawa Provisional Administration
    (Addis Abeba University, 2007-06) Seifu, Abiy; Tesfaye, Fikru (PhD)
    Background: Adherence to Anti-Retroviral Therapy (ART) is critical for optimal virologic suppression and improved CD4+ cell count that in turn determines the survival of People Living with HIV/AIDS (PLWHA) on ART. So far a range of predictors of adherence to ART in many different social and cultural settings have been identified. However, household food and nutrition security as predictor of adherence to ART is less understood. Objective: The main objective of this research project is to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Method: A cross-sectional study was conducted to assess the effect of household food and nutrition security on adherence to ART and treatment outcomes. Both quantitative and qualitative research methods were applied to triangulate the findings of one with another. Adult PLWHA on ART for at least 3 months were the study participants. Availability of enough food/money to buy one, behavioral and subjective questions, meal frequency, dietary diversity, food aid and BMI were used as indicators to measure the household food and nutrition security situation of PLWHA and self-reported adherence as an indicator to measure adherence to ART. Change in CD4+ cell count, body weight, functional status and frequency of opportunistic infections were used to measure treatment outcomes. Result: Based on food security assessment core module close to 90% of PLWHA on ART in Dire Dawa were food insecure and 30.1% had at least mild malnutrition. On patient self report of adherence 96.6% of them were adherent to 95% of the ART drugs prescribed. The median change in CD4 count after 6 months and the median change in weight after 3 months of ART were 116 (IQR 82-182) and 3kg (IQR 1-6kg) respectively. Reported diarrhea and lung disease among the study participants were 17.9% and 54.1% respectively. Food and nutrition security indicators were associated with treatment Impact of food and nutrition security on adherence to ART and treatment outcomes AAU, FM, DCH, RH specialty track IX outcomes. Food aid contributed to functional improvement (OR 1.89, 95% CI 1.20-2.97). Dietary diversity and meal frequency were significantly positively correlated with change in weight and change in CD4 count respectively (p<0.05). Pre-ART nutritional status was significantly negatively correlated with change in weight after 3 months of ART (p<0.001). Discussion: Food and nutrition insecurity is a serious problem of PLWHA on ART. Overcoming all the odds to adhere to the treatment PLWHA in the present study were adherent to ART more than any documented adherence findings. But food and nutrition insecurity was silent factor that impede treatment outcomes. Food aid, dietary diversity and meal frequency were positively associated with functional improvement, weight gain and CD4 increase. Pre-ART nutritional status was negatively correlated with weight gain indicating better improvement among severely malnourished. Current malnutrition was significantly associated with reported opportunistic infections. Conclusion and recommendations: The mere success in achieving high level of adherence among PLWHA taking ART should not undermine the impact of food and nutrition security on the treatment outcomes which is the ultimate goal of the program. Lack of food to take with medication is the main reason for those few non-adherents and food ration improved functional status of PLWHA on ART. Food aid as relief together with a sustainable income generating activities need to be included in ART program.
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    Measuring Levels of Physical Activity Among Adults in Miskan and Mareko District: A Validation Study
    (Addis Abeba university, 2004-04) Tadesse, Zerihun; Tesfaye, Fikru (PhD)
    According to a substantial body of evidence, regular physical activity can bring significant health benefits to people of all ages and abilities. Scientific evidence increasingly indicates that physical activity can extend years of active independent living, reduce disability and improve the quality of life of young and older adults. Despite these evidences, little is known about physical activity or its measurement on a population basis. A cross-sectional community based study was conducted to assess reliability and validity of instruments for measuring levels of physical activity. The instrument with better reliability and validity was used to measure levels and assess determinants of physical activity. Simple random sampling was carried out to recruit a total of 940 subjects. Global Physical Activity Questionnaire (GPAQ) and International Physical Activity Questionnaire (IPAQ) were administered to all participants during the first contact. The questionnaires were administered again after 4 days to a randomly selected sub-sample of 151 participants in order to assess reliability. Validity of the questionnaires was assessed on another randomly selected group of 186 study participants who wore motion monitor for seven consecutive days. A set of reliability tests indicated that GPAQ and IPAQ had good repeatability; balance in favor of the former. Validity of the questionnaires was assessed by a number of methods. Unlike reliability, validity was modest: percent correctly classified by concurrent validity of GPAQ against IPAQ for various domains of activity was between 35.9 and 42.5; gross vii misclassification was in the range 17.7-26.3%. In criterion validity test of the questionnaires against motion monitor, percent correctly classified was between 21.0 and 35.5 for GPAQ and between 25.3 and 38.2 for IPAQ; gross misclassification was in the range of 21.1-40.3% for GPAQ and 18.3-41.9 for IPAQ. The prevalence of physical activity measured by GPAQ was found to be 77%(724/940). Cumulative assessment of reliability and validity of questionnaires used in this study indicated that GPAQ and IPAQ were appropriate for use in our setting. However, conducting similar reliability and validity studies across different seasons and regions is strongly recommended before applying them on large-scale studies.