Browsing by Author "Worku, Alemayehu (PhD)"

Now showing 1 - 8 of 8
  • No Thumbnail Available
    Item
    Assesment of the Magnitude of Valid dose of Child Vaccination & its Associated factors among Children aged 12 – 23 months in Duguna Fango Woreda, Wolayta Zone, Southern Nation & Nationality People Region, February 10 – 29, 2016
    (Addis Abeba University, 2016-10) Feseha, Haimanot; Worku, Alemayehu (PhD)
    Background: Studies have demonstrated that high vaccination coverage rates do not necessarily imply valid dose vaccinations. The timely start of vaccination is important in light of the rapid waning of trans-placental immunity in the first year of life against vaccine-preventable diseases. Delayed doses in turn put individuals at risk of disease due to waning immunity over time and put the whole community at risk of epidemic. The valid dose of vaccination for children is important to build baby's immunity at an early age in order to reduce his/her risk of serious disease or death. Thus, it is important to take the valid dose of vaccination into account. Objective: Assessment of the magnitude of valid dose of child vaccination & its associated factor among children aged 12 – 23 months in Duguna Fango woreda, wolayta zone, Southern nation & nationality people region, Ethiopia, February 10 – 29, 2016. Methodology: Community based cross sectional study was conducted in Duguna fango woreda, Wolaita zone from February 10 - 29, 2016 G.C. A total of 491 children of aged between 12-23 months with vaccination card & registered in health faccility vaccination registration book is included in this study. World health organization cluster sampling techniques was used to identify study units. Data were obtain from vaccination cards & registration book from vaccinated health facility. Information on maternal socio-demographic characteristics and household variables were collected using an interviewer-administered structured questionnaire. Data were entered and analyzed using SPSS version 20. Bivariate analysis was done to test the association between independent and dependent variables. Variables with P<0.2 in the bivariate analysis were included in multivariate logistic regression to determine the valid dose of childhood vaccination. Result: From total of 491 children included in the study only 32.2% (95%CI: 28.1, 36.0) are found to have valid dose vaccination. Mother’s educational status with AOR of 1.86 (0.86, 4.0), Income 3.62 (0.98, 3.39), caregiver’s age 3.22 (0.17, 60.2), knowledge on session’s time specifically on the second session time AOR=5.2 (95% CI: 1.26, 29.4), quality and accessibility to health facility 15.12 (1.54, 148.05) & Proper appointment given with AOR of 41.63 (4.45, 388.73) were the main factors associated with having a valid dose vaccination of children aged b/n 12 – 23 month. Conclusion: There is low magnitude of valid dose vaccination among children aged 12-23 months in Duguna Fango woreda. Hence Wolaita zone health department, Duguna fango woreda health office & the health facilities under these woreda should work strong and intensive awareness creation activities on these mentioned contributing major factors above to improve a valid dose vaccination of children in their area and acquire quality vaccination service to the community
  • No Thumbnail Available
    Item
    Determinant Factors for the Occurrence of Tuberculosis among People Living With HIV After Art Initiation in Addis Ababa, Ethiopia: a Case Control Study
    (Addis Abeba, 2012-06) Tilahun, Kelemu; Worku, Alemayehu (PhD)
    Introduction: Tuberculosis is the leading killer of people with HIV/AIDS and the first presenting sign in the majority of AIDS patients. The risk of developing tuberculosis is estimated to be between 20- 37 times greater in people living with HIV than among those without HIV infection in their life time. In the developing world, many patients either have a history of tuberculosis when they initiate antiretroviral therapy, or they develop TB while receiving ART. ART diminishes the risk for TB as the CD4 count rises, yet the excess risk for TB is never eliminated even if CD4 levels return to normal levels. Objective: To assess determinant factors for the occurrence of TB among PLWHIV after ART initiation in public hospitals and health centers in Addis Ababa. Methodology: A case control study was conducted from December 2011 to February 2012 in selected 2 public hospitals and 13 health centers in Addis Ababa. The sample size of the study was 613 (204 cases and 409 controls). Cases were adult people living with HIV who developed TB after ART initiation and on anti TB treatment in the last 6 months prior to data collection and Controls were adult people living with HIV who did not develop TB after ART initiation. An interviewer administered structured questionnaire was used to collect information. Bivariate and multivariate analysis was performed by using logistic regression to determine independent factors of TB among PLWHIV after ART initiation. Result: After adjustment for potential confounders, having separate kitchen (AOR=0.50; 95% CI: 0.26, 0.96), the presence of INH prophylaxis (AOR=0.35; 95% CI: 0.125, 0.69) and cotrimoxazole prophylaxis (AOR=0.19; 95%CI: 0.06, 0.62) had an independent protective benefit against risk of tuberculosis. In contrary being bedridden (AOR= 9.36; 95%CI: 3.39, 25.85), having WHO clinical stage III or IV (AOR= 3.40; 95% CI: 1.69, 6.87), having opportunistic infection at ART initiation (AOR=5.22; 95%CI: 2.67, 10.27), the ART regimen initiated at base line and hemoglobin level less than 10mg/dl (AOR=0.35 ;95% CI: 0.125, 0.69) were an independent predictors for increased risk of tuberculosis in people living with HIV after ART initiation. Conclusion: Increasing coverage of INH preventive therapy and cotrimoxazole preventive therapy reduced the overall risk of TB among HIV patients who initatiated treatment. Targeting special attention is need to be provided for patients who have advanced condition(WHO clinical stage III or IV disease, being bedridden and having hemoglobin level less than 10mg/dl) would also reduce the risk of development of new TB infection. Improving housing condition and living standard is also recommended.
  • No Thumbnail Available
    Item
    Ethiopian Field Epidemiology Training Program (EFELTP) Compiled Body of Works in Field Epidemiology
    (Addis Abeba Universty, 2016-05) Mekonnen, Meklit; Worku, Alemayehu (PhD)
    Background: Shigellosis is the most common cause of outbreak of bloody diarrhea worldwide with secondary infection rates as high as 40% in the household and case fatality rate of 15-20%. Method: Unmatched 1:2 case-control study was conducted from July 2- 10, 2015. Data were collected using Semi- structured questionnaire. Stool and drinking water sample were also collected, transported and examined as per standard Microbiologic procedures. Data were entered and analyzed in Epiinfo 7 and SPSS, ARC GIS. To measure the significance of association we constructed odds ratio, 95% CI. Results: A total of 86 dysentery cases with no death were identified. The median age of case and control were 25 (Range, 2- 62 years). The overall attack rate (AR) was 2.3 per 1000 (86) population. Highest attack rate was observed among 15- 44 years (2.6 per 1000), highest cases were registered from Arib Gebeya Kebele 4.4 per 1000 population .In multivariate analysis the statically significant variables are no access to latrine AOR=7.2 (95% CI: 1.8 – 29.4), washing hands without soap AOR 5.1=(95%CI: 2.4 -11.1),not washing of hands after using toilet AOR=5.6 (95%CI: 2.5– 12.1), open filled dispose of household garbage AOR 9.2=(95%CI: 3.7 – 22), were risk factors for dysentery diseases but treating water with chemical /boil AOR=0.16 (95%CI :0.06 – 0.39) were protective factors.50%.Stool samples collected for microbiological culture were positives for shigella dysentery and water specimens collected from spring and pipeline was positive for coliform count at 370c/48 hrs /100ml was >180,Eshenerichia Coil Type 1 present and commented as Bacteriologically the water is not potable and chlorination necessary. Conclusion: There was an outbreak of dysentery in Dera woreda due to shigella dysentery, the most likely common source of the epidemic was contamination of water. Therefore, provision of safe drinking water supply and raising community awareness about hygienic practices to control diarrheal disease is necessary. Key words: Dysentery, Shigellosis, Dera, Ethiopia
  • No Thumbnail Available
    Item
    First line Antiretroviral Treatment Failure and Factors Associated with it in Addis Ababa, 2009
    (Addis Abeba Universty, 2009-06) Ejigu, Selamawit; Worku, Alemayehu (PhD)
    Background Monitoring patient response with viral load, which is the gold standard, is not feasible in resource limited settings. Therefore it’s essential to look for factors that can be used to identify those patients at higher risk of treatment failure in these settings. Objective To explore factors that can be used to identify those at a higher risk of treatment failure. Method A Nested case-control study from a cohort of HIV patients on ART at government hospitals in Addis Ababa was conducted through review of medical records. A total sample size of 423 with 141 patients with failure of their first line regimen (cases) and 282 patients without failure (controls) is used. Base line socio-demographic and clinical information were collected. Comparison of survival times were made through Kaplan Meier and Log-rank tests. Independent predictors of treatment failure were identifies using multivariate COX regression analysis. Results The mean survival time (without treatment failure) was 53 months (95% CI, 50 – 57). Females were found to have a higher survival time of 57months (95%CI, 52-62, P= 0.01) and males have a significantly higher risk of developing treatment failure with an adjusted HR of 1.518 (95%CI, 1.084-2.125, P=0.01). Those with two or more episodes of poor adherence during their follow-up have a significantly higher adjusted hazard ratio of 4.02 (95% CI, 2.71, 5.96, P=<0.001) compared to those with no episode of poor adherence. Missed appointment is another independent predictor of treatment failure with adjusted HR of 1.77 (1.11, 2.96, P= 0.03). Conclusion This study has shown that non- adherence to medication and clinic visits are independently associated with treatment failure. Following patients closely for their level of adherence and their trend of missing clinic visits can be used to help identify those at higher risk of treatment failure. Providing intense adherence counseling for these patients may prevent occurrence of failure.
  • No Thumbnail Available
    Item
    Gender Based Violence and Risk of HIV Infection among Women Attending VCT Services in Addis Ababa City
    (Addis Abeba University, 2005-05) Amdie, Gulelat; Worku, Alemayehu (PhD)
    Background: HIV/AIDS and violence are among the major health problems affecting the lives of millions of women, worldwide. As women get increasingly infected by HIV/AIDS, violence and fear of violence are emerging as important risk factors contributing to their vulnerability to HIV infection, directly through forced sex and indirectly by constraining women’s ability to negotiate safe sexual behavior. Few studies linked men’s use of violence to their own high risk sexual behavior, hence, their own as well as their partner’s risk of HIV infection. Despite the recognition of both problems of violence and HIV in Ethiopia, no study yet assessed gender based violence as a risk factor for women’s HIV infection. Objectives: This study was conducted: to measure the prevalence of various forms of gender based violence, including intimate partner physical and sexual violence and to assess associations between gender-based violence, HIV risk behaviors and HIV infection among women attending voluntary counseling and testing service in Addis Ababa City. Methods: We did a cross sectional study among 743 women attending VCT service at six health institutions in Addis Ababa City. Women who ever engaged in steady heterosexual relationship interviewed and socio-demographic characteristics, risk behavior including multiple male partners, casual partners, transactional sex, condom use and alcohol/Khat use and experience of psychological, physical and sexual violence from intimate partner, childhood sexual assault, forced first intercourse and sexual assault by non partners were assessed using structured questionnaire and linked with women serostatus data. ix RESULT: The prevalence of lifetime intimate partner physical and sexual violence was 54.6% and 41% respectively and 21.8% of women reported experiencing forced sex or rape at their first sex. At the date of interview 35.4% of women tested HIV positive. After adjustment for socio-demographic characteristics and women risk behavior, intimate partner violence was associated with HIV seropositivity. Childhood sexual assault, forced first intercourse and adult sexual assault by non partner were not associated with HIV serostatus. In our study participants, condom use, refusal of sex and demand for monogamous relationship was affected by intimate partner violence. CONCLUSION: in our study participants, women partnered with violent men are at increased risk of HIV infection. Our data support the hypotheses that abusive partners are more likely to have HIV and place their female partners at high risk of HIV. HIV/AIDS intervention need to target male sexual risk taking and need to work at broader and societal level to challenge cultures of violence and male dominant norms of power relations.
  • No Thumbnail Available
    Item
    Impacts of HIV/Aids on the Public Sector Health Care Services in Dire Dawa Administrative Council, Eastern Ethiopia
    (Addis Abeba Universty, 2004-07) Oljira, Lemessa; Worku, Alemayehu (PhD)
    A retrospective review of financial documents, cards and/or registration books of HIV/AIDS clients/patients served/treated in Dil chora Hospital for one year and health workers death information in the last ten years was conducted to assess the impacts of HIV/AIDS on the public sector health care services in Dire Dawa Administrative Council. There were a total of 809 HIV/AIDS service users at Dil chora Hospital from July 2002 to June 2003 out of which 206(25.5%) were HIV test positive. Majority of the HIV test positives and patients treated for opportunistic infections were between the age group of 15 to 50 years. The jobless, illiterate, widowed and divorced were more likely to test positive. The health care system subsidized greater proportion of HIV/AIDS services: only 3.6% and 7.9% of expenditure on VCT and treatment of opportunistic infections were recovered from user fees respectively. Admission of one patient with AIDS case barred on average admissions of two patients with other causes. The record of 16 health care worker’s died of any cause has been found in the last ten years: 75% of them were males, the mean age at death was 31.18 years and 81.25% were health assistants. This study indicated that HIV/AIDS is: directing health care resources to prime age adults (15 to 50 years of age), blocking other patients from in-patient health care. And health care workers are dying prematurely from any cause. Lastly, ascertaining that all segments of the population are reached by IEC, properly targeting subsidy and looking for other possible ways of caring for AIDS cases, and ensuring health care workers safety at work are worth recommending. Key words: HIV/AIDS, cost, impact, public sector, health care.
  • No Thumbnail Available
    Item
    Prevalence and Incidence Of HIV-1 Infection, Knowledge And Willingness to Participate in HIV Vaccine Trial among Residents of Wonji Shoa Sugar Estate
    (Addis Abeba Universty, 2003-07) Gessesse, Neway; Worku, Alemayehu (PhD)
    Ethiopia is one of the countries most seriously affected by HIV/AIDS in the world. With 2.2 million individuals living with the virus the 2001 estimate of HIV prevalence is 6.6% ranging from 3.7% in the rural to 13.7% in the urban centers. This cross sectional study is aimed at investigation of the prevalence and incidence of HIV- 1 infection and to assess knowledge and willingness to participate in HIV vaccine trial among residents of Wonji Shoa Sugar Estate. It was conducted in Wonji Shoa Sugar Estate between December 2002 and February 2003. A total of 1998 and 371 randomly selected individuals aged 18-29 participated in the serosurvey and behavioral survey respectively. Information regarding sociodemographic characteristics, sexual behavior and knowledge on HIV and vaccines was collected using a structured questionnaire. ELISA test was used to determine the prevalence of HIV-1 infection and the BED IgG capture assay was applied to identify recent infections. The prevalence and incidence of HIV-1 infection was found to be 2.46% and 0.4 per 100 persons respectively. Prevalence of HIV-1 infection was significantly higher among females 3.49% (P<0.05) in the age groups 20-24 and 25-29 years (3.57% and 4.83%, p<0.05, respectively) among the residents of the two factory villages Wonji (3.58%) and Shoa (3.34%) and among day laborers (3.73%) all with p<0.05. There was high knowledge of HIV prevention and low level of misconceptions regarding transmission viii but low condom use among those involved in risky sexual behaviors. The majority were also assuming themselves as not being high risk for HIV while they were involved in risky sexual behavior. Despite misconceptions on the uses of vaccines, the majority of the respondents were willing to participate in HIV vaccine trial. From this study it was concluded that Wonji Shoa Sugar Estate is a low HIV prevalence site with the incidence of HIV infection a bit higher than the existing cohort with adequate knowledge of HIV and few misconceptions regarding transmission of HIV, use of vaccines and remarkable majority willing to participate in HIV vaccine trial. To maintain the prevalence and incidence of HIV-1 infections at a further lower level and conduct HIV vaccine trial a more focused educational intervention is required for the general community with special emphasis on females and the residents of the two factory villages is recommended. The low incidence of HIV-1 infection and the high willingness of participants to enroll in a HIV vaccine trial make Wonji a potential site for Phase I/II vaccine trial.
  • No Thumbnail Available
    Item
    Survival and morbidity of breastfeeding versus formula feeding infants and young children of HIV-infected women who are on PMTCT follow up on selected hospitals in Addis Ababa, Ethiopia, 2013: a retrospective cohort study.
    (Addis Abeba University, 2013-08) Assefa, Mekonnen; Worku, Alemayehu (PhD)
    BACKGROUND: Nearly 90% of the almost half a million children who yearly become infected with HIV through their mothers live in sub-Saharan Africa. Infant feeding in the context of HIV is complex because of the major influence that feeding practices and nutrition have on child survival. HIV-infected mothers face a dilemma regarding how to feed their newborn infants due to the competing risk of HIV transmission associated with breast-feeding and the risk of increased morbidity and mortality associated with formula feeding. OBJECTIVE: To compare the survival and health benefits of breast feeding and formula feeding infants and young children of HIV infected women followed the PMTCT programs. Method: A retrospective cohort study design was employed to compare the HIV free survival of exposed infants and young children who were on breast fed and formula fed. Data was extracted from PMTCT registration book and exposed infants follow up card. Data were entered in Epi info (version 3.5.3 software) and exported into SPSS version 16 and STATA version11 statistical software for analysis. Infants and young children morbidity and HIV infection (i.e., the complement of HIV-free survival) were compared by using Kaplan- Meier time-to-event method and long rank test was used to compare HIV free survival between the two groups. Cox regression analysis was used to assess the determinant factors. RESULTS: Overall probability of HIV free survival in formula fed infants and young children was significantly higher than breast fed infants and young children (log rank test statistics =6.13, df=1, p=0.013). Breast fed infants and young children had four (adjusted HR =3.8, 95%CI 1.311.1) times higher risks to acquire HIV infection as compared to formula fed infants and young children. Mothers who didn’t use any PMTCT intervention had five fold risk to transmit HIV infection to their infants (Adjusted HR=4.8, 95%CI; 1.1-22.5). There was no statistical significant different risk of developing any types of morbidity between the two groups (log rank statistics =0.92, df=1, p=0.34). There were totally seven deaths of infants in both cohorts. Conclusion and recommendations: the 18 month cumulative probability of HIV free survival was significantly lower in the breast feeding infants and young children as compared to formula fed infants and young children. Using formula feeding or Breastfeeding and receiving ARVs prophylaxis should be the one that will most likely give infants the greatest chance of HIV-free survival.