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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    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.