Internal Medicine

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    A Prospective Cross Sectional Study to Evaluate the Incidence of Acute Transfusion Reaction and its Associated Risk Factors in Ateritiary Care Center in Ethiopia.
    (Addis Ababa University, 2023-02) Assefa Temesgen; Tadesse Fissehatsion
    Background: Transfusion reactions are adverse events associated with the transfusion of whole blood or one of its components. There is no institutional or national data in Ethiopia regarding the incidence of ATR & their risk factors. The aim of this study is to measure the incidence of ATRs, frequency& time of occurrence of each ATR & evaluate their association with risk factors there by contributing to the institutional & national hem vigilance system. Objective: The main objective of the study is to measure the incidence of ATR & determine their association with different clinical variables. Methods: Prospective cross sectional study design is used to study in patient & outpatient adult transfusion recipients at the department of internal medicine, data was collected with a structured check list, analyzed with IBM SPSS version 24 software. Result: A total of 210 study participants with the age of 13 & above were included in the study from September 1, 2022 – November 30 2022. 50.5 % of study participants are male & 49.5% are females ,the most common age group are between the age of 18 -40,the commonest blood group was O positive. Acute myelogenous leukemia is the commonest underlying diagnosis of the study participants; PRBC is transfused for the majority of patients given for 74.8% of cases. ATR incidence is found to be 10%,ATR was reported in 19.6%of platelet transfused patients as compared to 7% of PRBC, and none of FFP transfused patients develop ATR. FNHTR & urticaria are the commonest ATR observed. Significant association is seen between ATR & female gender, autoimmune disease & ABO incompatible platelet transfusion. Conclusion: The incidence of ATR is higher than reported from previous studies indicating the need to improve institutional transfusion services particularly in high risk patients.
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    A Research Thesis on Assessment of Knowledge, Attitude and Practice on Radiation Safety among nuclear medicine staff members in Service de medicine nuclear-CHU de Bab El Oued, Algiers, Algeria
    (Addis Ababa University, 2025-04-14) Gizachew Hiruy; Yohannes Jorge; Desalegn Abeje; Bouyoucef Salaheddine
    Background: Nuclear medicine staff members who involved in this study typically include a variety of professionals who work together to perform diagnostic imaging and therapeutic procedures using radiopharmaceuticals. Radiation safety is a critical aspect of the nuclear medicine practice. It encompasses practices and protocols designed to protect patients, healthcare workers, and the general public from the harmful effects of radiation exposure. Objective: To Assess Knowledge, Attitude and Practice on radiation safety among nuclear medicine staff members in Service de medicine nuclear-CHU de Bab El Oued Algiers, Algeria,2024. Methods and Materials: The survey was conducted as institution based cross sectional study, using a structured questionnaire on nuclear medicine staff members in Service de medicine nuclear-CHU de-Bab El Oued Algiers, Algeria. The study was conducted from August 2024 – February 2025. Result: In this study, a total of 48 participants were included in the analysis, resulting in a response rate of 96%. While staff members generally possess a solid understanding and knowledge of fundamental radiation safety principles but certain concerning findings emerged regarding their attitudes and practices. Specifically, it was found that staff members with less than one year of experience demonstrated a lower attitude score towards radiation safety with the level of significance 0.010 (p<0.05). Additionally, study participants holding doctorate degrees shows admirable knowledge levels and a positive attitude towards radiation safety; but, their practical application was inadequate p-value of 0.016 (p<0.05). Recommendations and Conclusion: This study discloses certain concerning trends regarding their attitudes and practices. To address these, it’s recommended that nuclear medicine centers implement ongoing professional training programs, particularly targeting newer staff members. These short-term training sessions should deliver basic knowledges with emphasize on building good attitude and believes on the importance of radiation safety. Interventions are also needed to bridge the gap between theoretical understanding and practical implementation.
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    A Retrospective Analysis of Newly Diagnosed ITP Patients to Analyze Response to First and Further Line Treatments.
    (Addis Ababa University, 2023-03) Maasho Biniam; Gebrmedhin Amha
    Background:Primary immune thrombocytopenia (ITP) is a relativelyuncommon hematologic disorder with an estimatedincidence of 3 to 6 patients /100,000 per year in the West. Initial response rates to corticosteroids average at 70%.In our country data on patient characteristics and outcome of therapy are scarce. ObjectiveThe primary objective of this study is to determine the rate of initial response to corticosteroids in newlydiagnosed IT patients.Secondary objectives include duration ofresponse ,association between independent/patient variables and response, duration of PDN therapy and outcomes with further line treatments. Method: This is a retrospective, single-center study conducted at Tikur Anbessa Specialized Hospital, a tertiary care hospitallocated in Addis Ababa.All newly diagnosed ITP patients for whom adequate information regarding their outcome after 1st line therapy was availablewere included in this study. Data obtained thru a standardized questioner was analyzed by IBM-IPSS version 20 statisticalsoftware. Result: A total of 48 study participants with the age of 18 & above were included in the study. Females constitute 85% of theparticipants. 63% of the patients are less than 35 years old. The mean and range of age are 34 Yrs and 17 Yrs – 52 Yrs.62 % had an initial response to steroids (52% complete response). The rate of SR at 6 months was 68%, a statisticallysignificant difference from previous reports (P-value < 0.0001< , with a 95% C.I. = 0.4544 - 0.7856).Rituximab and prednisolone were the most frequently used 2nd line drugs. 6 patients were splenectomized. Patients with aresponse to 1st line prednisolone had a marginally significant better outcome with 2nd /3rd line rituximab Conclusion: Initial response rate to steroids was in line with previous studies done elsewhere. The SR rate was 68% that issignificantly more than that reported in previous studies of 1st line prednisolone therapy in newly diagnosed ITP patients.
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    A Survey on the Indications, Diagnostic Efficacy and Safety of Fiberoptic Bronchoscopy in Tikur Anbessa Specialized Hospital: Retrospective study from Dec, 2021 to Nov, 2023
    (Addis Ababa University, 2024-03) Ahmed Seid; Yusuf Hanan; Kebede Dawit ; Worku Aschalew
    Background:In the field of respiratory medicine, Fiberoptic bronchoscopy (FOB) is a crucial diagnostic tool for both infectious respiratory diseases including Tuberculosis and non-infectious conditions, including lung cancer since it allows for direct visualization and sampling of the airways. Given the fact that both are one of the leading causes of morbidity and mortality in Ethiopia and worldwide, a comprehensive retrospective analysis of its usage, safety and diagnostic yield is beneficial to optimize its integration into the hospital's diagnostic protocols. Objective:This study aims to assess the indications, diagnostic efficacy and safety of FOB in the context of Tikur Anbessa Specialized Hospital (TASH) over a two-year period from December 2021 to November 2023. Methods:This study systematically analyses electronic medical records, bronchoscopy procedural reports and pathology and microbiology reports from TASH over a two-year period spanning from December 2021 to November 2023. Data extraction focuses on patient demographics,smoking history, platelet count and coagulation profile, indications for the procedure,bronchoscopic procedures and finally the safety and diagnostic outcomes of all patients whoundergo bronchoscopy over the specified period of time. A waiver was taken from the IRB forthe Ethical aspect of the study and patients’ information is anonymised. Collected data isevaluated for consistency and completeness by the investigator. Following collection, data iscleaned, coded, and analysed by SPSS version 26 software. Results:From a total of 227 bronchoscopies, records were available for 205 procedures, with a meanpatient age of 43.63 years. The majority were male (52.2%), and 83.9% fell within the agerange of 18-65 years. From the cases with HIV testing result, 11/108 (10.2%) were positive.Common indications for bronchoscopy include suspected mass or malignancy (45.85%),tuberculosis (28.29%), and airway inspection (13.66%). Comorbiditiessuch ashypertension(14.15%) and bronchiectasis (11.71%) were identified. Samples collected during bronchoscopyinclude bronchoalveolar lavage (78.54%), transbronchial biopsy (25.85%), and endobronchialbiopsy (10.24%). The overall diagnostic yield for FOB was 75.6%, with specific diagnosticyields for TB, sarcoidosis, and lung cancer at 41.38%, 45.45%, and 51.06%, respectively. Lungcancer was diagnosed in 23.41% of all cases, with adenocarcinoma (43.3%) being the mostprevalent subtype. Tuberculosis and sarcoidosis were diagnosed in 14.63% and 5.36% of cases,respectively. Most cases (93.17%) were complication-free, with minor bleeding, hypertension,hypoxemia, and pneumothorax (on 2 patients) observed in a small percentage. Conclusion:Our study shows that the commonest indication for FOB is workup of suspected mass. FOB inTASH has a better yield compared to most other reports from Africa. The highest yield asexpected was when there was a visible mass and coupled with endobronchial sampling.Cytology from fluid analysis has the lowest yield for malignancy. The practice of FOB inTASH is a safe procedure and even though rare, blind transbronchial biopsy has a risk ofpneumothorax. The commonest histologic type of lung cancer identified is Adenocarcinomabut it was squamous cell carcinoma among smokers.
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    Accuracy of Revised Ibd-Refer Criteria for Evaluation of Patients with Suspected Inflammatory Bowel Disease in Low Resource Setting: A Diagnostic Prospective Cohort Study
    (Addis Ababa University, 2024-05) Rodas Temesgen; Yohannes Berhanu
    Background: Diagnosis of inflammatory bowel disease (IBD) often faces significant delays. Early recognition tools offer the best chance for timely treatment and positive outcomes. Objective: To prospectively validate the original IBD REFER criteria and Assess the diagnostic accuracy of revised IBD-REFER criteria for clinical use in screening at-risk patients and determine the diagnostic delay in three Ethiopian gastroenterology centers in 2024. Method: A multi-center prospective diagnostic cohort study of 272 undiagnosed GI clinic patients was employed. A modified Delphi method with three steps was used to establish consensus among 10 expert gastroenterologists. Both revised and original IBD-REFER criteria were scored for each patient. Data was presented as means [± standard deviation], or medians (interquartile range [IQR]). A point estimate (e.g., odds ratio, sensitivity, specificity) was accompanied by 95% confidence intervals [CI]. All comparisons were made with two-sided significance levels of p < 0.05 and analyzed with SPSS V20.0. Result: This study involved 272 participants from three medical centers in Addis Ababa, Ethiopia. Gastrointestinal symptoms were prevalent, with 23.6% experiencing watery diarrhea for at least one month and 11.8% having recurrent diarrhea for at least two weeks. Elevated ESR or CRP was noted in 34.7% of participants, and 28.0% experienced involuntary weight loss. The original IBD REFER criteria showed a sensitivity of 97.8% and specificity of 58.4%, while the revised criteria had the same sensitivity but a slightly lower specificity of 52.7%. The positive predictive value (PPV) and negative predictive value (NPV) for the original IBD REFER criteria were 31.9% and 99.2%, respectively, while the revised criteria had a PPV of 29.1% and an NPV of 99.2%. The area under the ROC curve (AUC) for the original IBD REFER criteria was 0.65, compared to 0.64 for the revised criteria. Multivariable logistic regression identified watery diarrhea lasting for at least one month (AOR: 14.8 (95%CI: 4.1, 54.3)), recurrent bloody diarrhea for at least two weeks (AOR: 88.6 (95% CI: 15.7, 499.9)) Eelevated ESR or CRP, weight loss, and a history of unexplained bowel obstruction to be associated with IBD diagnosis. The mean time to diagnosis for IBD was 26.6 months, with a range of 2 to 186 months, longer for Crohn’s disease (27.2 months) compared to ulcerative colitis (25.6 months). Conclusion: The study highlights the significant challenges in diagnosing IBD in low-resource settings like Ethiopia, emphasizing the need for improved diagnostic pathways and early referral systems. Future research should focus on refining diagnostic criteria to enhance specificity and exploring the integration of advanced diagnostic tools. Addressing these challenges can lead to earlier diagnosis, better patient outcomes, and reduced disease-related complications in resourceV limited settings. Keywords-Inflammatory bowel disease, IBD REFER Criteria, diagnostic delay, screening criteria, Ethiopia
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    Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study
    (Addis Abeba University, 2021-05) Alemayehu Mulualem; Abebe Sintayehu; Yadeta Dejuma; Alemayehu Bekele
    Background: Hypertension is the most common cardiovascular problem globally with a particularly increasing burden in developing countries like Ethiopia. Ambulatory blood pressure (ABPM) is superior to office blood pressure (OBP) measurement for diagnosing, prognosticating and following treatment efficacy for hypertension. There is no available data on ABPM control pattern in Ethiopians. This study will determine the ABPM control patterns in Ethiopian hypertensive patients on treatment. Material and Methods: This was a cross sectional study in hypertensive patients at Tikur Anbessa Specialized Hospitals outpatient departments carried out during January to May 2021. ABPM values of 244 consecutively sampled patients were analyzed. All patients had their BP monitored over 24 h with a Tonoport V (GE CS V6 71), and the data was interpreted using GE CardiosoftTM ABPM software in accordance with European Society of hypertension guidelines. Ethical clearance was given by Addis Ababa University Institutional Review Board and the study was conducted in compliance to standard ethical guidelines. Results: The study involved 244 adult hypertensive patients; mean age of the patients was 59.4years and, 54% were females. 58.6% of patients had controlled OBP, while only 45.1% had controlled ABPM. The mean OBP was 137 (19)/81 (10) mmHg and mean 24-hr ABP was 137 (16)/81 (10) mmHg; mean daytime BP was 136/79 ± 17/11 mmHg; mean night-time BP, 138/84 ± 16/11 mmHg. Mean ABPM values were not significantly different between men and women. Comparison of ABPM values with OBP revealed high prevalence of the white coat effect (32%) and masked uncontrolled hypertension (46%). Presence of comorbidities particularly diabetes predicted poor ABPM control. Conclusion: More than half of patients had uncontrolled BP as per ABPM criteria and significant discrepancy exists between ABPM and OBP in assessing adequacy of BP control. Guiding management decisions using ABPM can improve BP control rates.
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    Assessing Palliative Care Needs and Associated Factors among Females with Gynecologic Malignancies Visiting TASH: Facility Based Prospective Study, 2023-2024
    (Addis Ababa University, 2024-10-19) Rediet Mekuria; Sisay Teklu
    Palliative care offers comprehensive support to patients and their families coping with life-limiting illnesses, addressing physical, psychosocial, and spiritual dimensions of suffering. In Ethiopia, palliative care is a relatively new concept and faces numerous challenges, including underutilization and an increasing burden due to a growing population affected by chronic and life-limiting illnesses such as cancer, HIV/AIDS, and cardiovascular diseases. Despite the high need, access to palliative care services remains limited due to insufficient healthcare infrastructure, a lack of trained professionals, and cultural barriers related to EOL care. Additionally, public awareness of palliative care is low, leading to a gap between need and utilization. These factors contribute to a heavy burden on families and the healthcare system, making it a critical area for improvement in public Health Care system of Ethiopia
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    Assessing the Risk Factors, Clinical and Coronary Angiographic Profile, and Hospital Mortality of Acute Coronary Syndrome in Young People : 5-Year Retrospective Cross-Sectional Study
    (Addis Ababa University, 2024-04) Zelalem Belay; Bekele Alemayehu
    The incidence of coronary disease is positively associated with age. However, in recent years there has been an increased incidence of Acute Coronary Syndromes (ACS) in young adults. The cardiovascular risk profile of these patients appears to be different
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    Assessment of Adherence to Iron – Folic Acid Supplementation Amongpregnant Women Atselected Health Centers of Gandhi Memorial Hospitalcatchments, Addis Ababa Ethiopia; Cross Sectional Study 2023/24
    (Addis Ababa University, 2024-10-11) Bethelhem Taddesse; Ahmed Abdu
    Assessment of Adherence to Iron – Folic Acid Supplementation Amongpregnant Women Atselected Health Centers of Gandhi Memorial Hospitalcatchments, Addis Ababa Ethiopia; Cross Sectional Study
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    Assessment of Bone Scintigraphy Results and Its Clinical Indications and Determinants in Prostate Cancer Patients at CHU Bab El Oued, Algiers, Algeria
    (Addis Ababa University, 2025-03-01) Faiz Kubes; Bethelhem Worku; Aschalew Alemu; Salah Bouyoucef
    Background Prostate cancer is a leading malignancy among men worldwide, with bone metastases being a critical factor in disease progression and patient prognosis. Bone scintigraphy is a widely used imaging technique for detecting bone metastases, but its clinical utility varies based on patient characteristics. This study evaluates the clinical indicators influencing bone scintigraphy outcomes in prostate cancer patients at CHU Bab El Oued, Algiers, Algeria. Objective To investigate the clinical indications and determinants influencing the use of bone scintigraphy in prostate cancer patients at CHU Bab El Oued. Methods A retrospective observational study was conducted on 354 prostate cancer patients who underwent bone scintigraphy at CHU Bab El Oued. Descriptive statistics, Chi-Square tests, logistic regression, and ROC curve analysis were used to examine associations between PSA levels, Gleason scores, age, and bone scintigraphy results. Results Of the 354 patients studied, 32.2% of patients had positive bone scintigraphy results, indicating metastasis. Higher PSA levels (>20 ng/mL) and Gleason scores (≥8) were significantly associated with positive bone scans (p < 0.001). Age was not a significant predictor of metastasis (p = 0.691). Logistic regression analysis confirmed PSA and Gleason scores as key predictors of metastasis, with higher Gleason scores increasing the risk by 2.26 times (OR = 2.266, p < 0.001). The ROC curve showed strong predictive ability (AUC = 0.89), suggesting high accuracy in predicting bone metastases. Conclusion Bone scintigraphy is indicated for prostate cancer patients with specific high-risk features to detect bone metastases effectively. Specifically, PSA levels and Gleason scores are strong predictors of bone metastases, with higher values (PSA >20 ng/mL and Gleason score ≥8) significantly increasing the likelihood of positive findings, while age alone does not play a significant role. The predictive model demonstrated high accuracy, reinforcing the need for targeted use of bone scintigraphy in high-risk patients to optimize clinical decision-making.
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    Assessment of Clinical Practice of Secondary Prophylaxis for Varceal Bleeding and Prevalence of Recurrence, among Adult Patients in TikurAnbesa Specialized Hospital, in Addis Ababa, Ethiopia, 2020.
    (Addis Abeba University, 2020-12) Jemal Kamil; Mersdessa Guda
    Background; in this era of COVID-19 epidemic health care workers are at increased risk of contracting the disease. The WHO estimates that around 20% of HCW have already acquired the infection in the world worst affected areas. It is a paramount important to prevent spread of infection among the HCWs as they can be a source of community transmission. There are some evidences showing there is a gap in knowledge, attitude and practice of personal protective equipment use among the health care workers. Objective: To assess knowledge, attitude and practice of PPE among HCWs that are currently working in Tikur Anbessa Specialized hospital and Eka Kotebe general hospital, Addis Ababa, Ethiopia. Methodology: This cross-sectional, descriptive study was conducted on HCWs of TASH and EKGH in the month of October 2020. Participants were selected using convenient sampling method and 45 itemed, web-based, self-administered questionnaires were used for data collection via internet access. Data analysis was done using SPSS version 26. Socio-demographic and important information assessing KAP were collected. Result: A total of 277 HCWs responded to the questionnaire from both centers. The mean age was 30.77±5.78 years. Among them majority was male (n=158, 57%) and majority were from TASH 261 (94.2%). Medical doctors constituted 73.2% (n=203) followed by nurses (n=70, 25.3%). On average, 38.6% had 8hours of work per day. Among the responders, 18.8% (n=51) uses informal ways to gather information and 19.1% (n=53) of HCWs tested positive for COVID-19. Knowledge, attitude and practices regarding PPE use among these HCWs were 73.9%, 40.3% and 57.7% respectively. Conclusion and Recommendation: This survey shows that there is poor attitude and practice of PPE especially N95 use among HCWs. Institution based training and inclusive updates needs to be implemented. patients who were on follow up 11.5% had experienced recurrence of variceal bleeding. xi Conclusion and recommendation:-There was a significant gap in clinical practice of guideline recommended secondary prophylaxis for the prevention of variceal rebleeding in patients on follow up in TASH during the study period. There was lack of continuous supply of EVL bands in the country and appropriate escalation of the dose of propranolol was not implemented as per guideline recommendations in significant proportion of patient. Physicians should follow the appropriate evidence based guidelines in the management of variceal bleeding and prevention of rebleeding. Furthermore the hospital should avail necessary supplies like EVL which are vital for endoscopic intervention to control acute bleeding and for prevention of rebleedin
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    Assessment of Complete response rate of Post-Thyroidectomy Radioactive Iodine Therapy for Differentiated Thyroid Cancer at Nuclear Medicine center of CHU de Bab El Oued, Algiers, Algeria
    (Addis Ababa University, 2025-04-11) Mariya Jemal; Beyene Assefa; Hagos Tesfay; Bouyoucef salah-eddine; Lydia Cherhome
    Background: -. Thyroid cancer is the most common endocrine cancer globally, with a rapidly increasing incidence rate. Since the most common subtype of thyroid cancer is DTC, which includes papillary and follicular ca, it has a good prognosis with more than 90% survival rate. RAI treatment of thyroid cancer is a well-evaluated therapeutic model and is given in combination with surgery for the purpose of thyroid tissue ablation, adjuvant therapy, and distance metastatic treatment. Even though the complete response rate of RAI is high, it is affected by different factors, including histology type, age, lymph node involvement, and so on. Also, the dose and outcome depend on these factors. Patient can have low risk, intermediate risk, or high risk thyroid cancer disease category. Objective: To assess the complete response rate of post thyroidectomy RAI therapy for differentiated thyroid cancer patients treated in 2021GC (and follow up from January 2021 to november2024) by using a retrospective study at the Service de Medicine Nucleaire-CHU de Bab El Oued, Algeria Methods: Retrospective study in 164 different thyroid cancer patients who underwent thyroidectomy and took treatment of radioactive iodine in Service de Medicine Nucleaire-CHU de Bab El Oued, Algeria from January 1/2021 to december31/2021 and follow up from January 2021 to november2024.Chi- square (χ2) test was used for comparisons categorical variables. To identify significant predictor univariate logistic regression was conducted at a 25% significance level. Subsequently, multivariate regression analysis was performed on these variables, with a 5% significance level. Result :-A total of 159 patient were included in the study, out of these 144(90.6%) were female and 15(9.%)Were male .Majority of patient were in the age range of 30 to 45 years old (45.9).Complete response rate of patients was 88%, by which majority of patient reach to this state with in the 1st 2 years of follow up (82%).lymph node involvement, high base line Tg level, sex, RAI dose was found to have significant association with complete response outcome but the only independent predictor factor was found to be having higher baseline Thyroglobulin level. vii Conclusion and recommendation: in this study it is found that patients who have low and intermediate risk characteristics have good complete response rate, and since there was incomplete data for some patient who have high risk disease characteristics, it is difficult to conclude about the complete response rate of high risk patients. The only associated factor which is found to have independent predictive factor to have low complete response rate is having high baseline thyroglobulin level. Based on this assessment, since patient with high baseline Tg level has lower response rate, we recommend giving emphasis to these patients, which might bring better complete response rate.
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    Assessment of Dyslipidemia and its Associated Risk Factors among Adult Type-2 Diabetic Patients on Follow up at Tikur Anbessa Specialized Hospital: A Hospital Based Cross Sectional Study
    (Addis Abeba University, 2021-12) Addis Wondwosen; Aberra Theodros
    Background: Dyslipidemia is one of the major modifiable risk factors for cardiovascular diseases (CVD)in a type-2 diabetic (T2DM) patient. Dyslipidemia in T2DM patients is attributed to increased free fatty acid flux secondary to insulin resistance. Globally burden of dyslipidemia in diabetic patients is continuously increasing. Intensive management of dyslipidemia and its associated factors is required to prevent cardiovascular disease. Objective: The study was designed to assess the prevalence and associated factors of dyslipidemia among adult patients with type 2 diabetes at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Method: An institution-based- cross-sectional study was conducted from July 10 toNovember 10, 2021.A convenience sampling technique was used to recruit 208 T2DM patients. Data on socio-demographic characteristics, behavioral, and clinical factors were collected using a structured questionnaire through face to face interview. Anthropometry and blood pressure were measured. Laboratory data were retrieved from patients chart. Data was entered and analyzed using SPSS version 25. To identify determinant factors of dyslipidemia, bivariate and multivariate binary logistic regression analyses were done.Statistical significance was considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimatesofthestrengthofthe association. Results: The overall prevalence of dyslipidemia among study participants was78.4%.Hypertriglyceridemia was found in 42.8%, hypercholesterolemia in 25.1%, high low-density lipoprotein in30.3%, and low high-densitylipoprotein in 36.5% study participants. Longer duration of diabetes&physical inactivity were significantly associated with dyslipidemia. Patients who have more than 10years duration of diabetes had five times (95% CI, 1.24-20.149) more risk of dyslipidemia as comparedwith less than 5 years duration. Type2 DM patients who don’t perform moderate physical activity hadnearly three times (95% CI, 1.077-7.767) increased risk of dyslipidemia as compared with those whoperform 5-7 days moderate physical activity in a week. Conclusion: A high prevalence of dyslipidemia was found among T2DM patients in the study area. Physical inactivity and longer duration of diabetes were significantly associated with dyslipidemia among T2DM patients. Clinicians need to screen, treat, and educate diabetic patients about dyslipidemia and its associated risk factors.
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    Assessment of Health-Related Quality of Life in Patients with Inflammatory Bowel Disease at Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Ababa University, 2024-02) Berihun Asrat; Mohammed Duelsome
    Introduction: Inflammatory bowel diseases are chronic progressive/relapsing conditions that affect the younger population and have been associated with reduced health-related quality of life.HRQOL is an important outcome measure in IBD and helps to understand impact of the disease on the patient and the effect of treatment on the disease.Aim: To assess health-related quality of life in IBD patients and associated socio-demographic and clinical factors. Methods: A hospital-based cross-sectional study using theShortInflammatory Bowel Disease Questionnaire" (SIBDQ) was conducted in Tikur Anbessa Special Hospital from September 1,2023 to December 30, 2023. Data were entered and analyzed using SPSS version 27. Descriptive statistics were used to show frequencies and percentages. A binary logistic regression model was used to assess predictors of impaired HRQOL in patients with IBD. Strength of association is measured by AOR and 95% CI. Variables with a P-value < 0.05 have a statistically significant association. Results: Thirty-one percent of IBD patients in our study had impaired HRQOL (SIBDQ<50) with no statistically significant difference between IBD types, gender, marital status, residence, surgical treatment and duration of IBD. Unemployment (AOR= 4.36; CI 95%:1.34-14.18; p=0.014), notbeing in remission (AOR= 14.62; CI 95%: 2.31-92.53; p= 0.004), comorbidity (AOR= 9.18 ;CI95%: 2.24-37.69, p=0.002), admission (AOR= 5.08; CI 95%: 1.45-17.76, p=0.011) and symptom duration > 6 months before diagnosis (AOR= 4.679; CI 95%: 1.31-16.74; P=0.018) were significantly associated with impaired HRQOL. Conclusion: In our study, about one in three of IBD patients had impaired HRQOL. HRQOL was better with controlled disease activityno hospitalization, no EIMs, and nocomorbidity;earlydiagnosis,employment,andhighereducational level.
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    Assessment of Indications and Clinical Significance of Bone Scintigraphy among Patients Referred to Nuclear Medicine Unit, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2023-02) Yemaneberha Solome; Worku Bethelehem; Abeje Desalegn
    Background: Bone scintigraphy is a very sensitive diagnostic nuclear medicine imaging technique that uses a radiotracer to assess the distribution of active bonegrowth in the skeleton in relation to malignant and benign disease as well as aphysiologic process. The general indications for bone scintigraphy are to investigatefor particular bone disease, unexplained symptoms and prior to therapy for metabolicevaluation. There is no baseline study to assess the indications and clinicalsignificance in TASH. Objective: The aim of this study was to evaluate the clinical indication and significance of bone scintigraphy in patients who were referred to Tikur Anbessa Specialized Hospital. Methods: A hospital-based retrospective cross-sectional study was conducted using secondary data from a record of a bone scintigraphy from 2007 to 2012 at the Nuclear Medicine Unit at Tikur Anbessa Hospital. SPSS version 22 was used to examine and analyze the gathered data using descriptive and inferential statistics. Result: In this investigation, 110 Planar and SPECT scan record of patients was used.Out of which 76 (69.1%) were female and 34 (30.9%) were male. The most common indications was the evaluation of metastatic breast cancer at 59 (53.6%), followed by prostatic cancer 22 (20%), Using a binary logistic regression analysis there was a significant correlation between female patients and positive outcome of scans p=0.06 and OR=4. Those aged between 40-49 years had a significant correlation with outcome of the scan compared to their oldest counterpart ( >70yr) p=0.03, OR=11. Conclusion: In this study, 94.5% of indications were for oncologic work up. Breast cancer metastatic workup is the most common indication. Positive results were four times more likely to be seen in female patients than males. People between the ages of 40 and 49 had an eleven fold higher likelihood of obtaining positive scans than theoldest age group (>70 years).
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    Assessment of Knowledge and Attitude Towards The Management of Differentiated Thyroid Cancer and The Utilization of Radioactive Iodine Among Physicians in Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-03-22) Bekalu Awoke; Bethelhem Worku; Masresha Ahmed
    Background: The most common type of thyroid cancer is differentiated thyroid carcinoma (DTC), which has a generally excellent prognosis when properly managed. The usual treatment method involves thyroidectomy followed by radioactive iodine (RAI). Among other factors, physician attitude and knowledge affect the outcomes of these treatments. Objective: To assess physicians’ knowledge and attitude regarding the management of differentiated thyroid cancer (DTC) and the utilization of radioactive iodine (RAI) at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Method: A hospital-based cross-sectional study was conducted among physicians in the department of General Surgery, Oncology, Nuclear Medicine, and Endocrinology at Tikur Anbessa Specialized Hospital. Data was gathered using semi-structured questionnaires. SPSS version 27 was used to enter and analyze the data. Binary logistic regressions were used for both bivariate and multivariate analysis. Results: One hundred and thirty-seven questionnaires were collected and assessed. The age range of participants was 26-45. The mean age was 31.26 (±3.51). Among respondents 72, (52.6%) were females. Among participants, 104 (75.9%) had training on DTC management and utilization of radioactive iodine. The majority of respondents, 113 (82.5%) were from the General Surgery department. 66 (48.2%) of respondents have sufficient knowledge towards the management of differentiated thyroid cancer, radioactive iodine utilization. whereas, 75 (54.7%) of them has a positive attitude towards the management of differentiated thyroid cancer, and utilization of radioactive iodine. Significant associations between knowledge and age, work experience, training, surgery, and oncology departments were observed. Attitude level is also affected by the experience and knowledge of respondents. viii Conclusion and recommendations: Despite a good attitude, this study showed poor knowledge in participants towards the management of differentiated thyroid cancer and utilization of radioactive iodine. Therefore, this study recommends awareness creation and health professionals training through seminars, and lectures to raise their knowledge towards the management of differentiated thyroid cancer and utilization of radioactive iodine.
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    Assessment of Knowledge and Practice of ICU Care Bundles in Infection Control among Physicians and Nurses Working in Three Governmental Hospitals (Tikur Anbesa Specialized Hospital (TASH),Yekatit 12 and st. Peter Specialized Hospital) Adult ICU,Ethiopia, 2021
    (Addis Abeba University, 2021-12) Teshome Mulugeta; Haile Tewodros
    Background: Intensive care is a continuum of care from various source of admissions where patients‘ requiring a frequent evaluation and support to assure safe and effective outcomes. Mortality in intensive care unit (ICU) is a global burden which results in a huge loss of productivity and financial costs. In Africa, the ICU mortality rate is high compared to developed continents. ‗‗Evidence-Based Bundle‘‘ of care which involves 3–5 structured interventions help to reduce and prevent hospital acquired infections (HAI‘s). OBJECTIVE: To assess the knowledge and practice of ICU care bundles among physicians and nurses working in three government hospitals Adult ICU, Addis Ababa, Ethiopia 2021. METHODS: A cross-sectional descriptive study was conducted using a structured questionnaire and observational check list. Proportional sampling technique was used. Collected data was cleaned, coded and entered in to excel and SPSS version 26was used for analysis and descriptive methods such as frequencies, or proportions. A score of ≥ 60% is considered as knowledgeable or good practice. X2 tests were used to look for association with P <0.05. RESULT: A total of 101 health professionals participated with the response rate of 96.2%. Of this 53 (52.5%) were nursesand48(47.3%)were physicians, majority 55 (54.5%) were fromTASH, 64.4% of them were males and the mean age of respondents was 29.4 (SD ± 3.32) years.Regarding knowledge of ICU care bundles, 53 (52.5%), 69 (68.3%) and 79 (78.2%) were knowledgeable regarding VAP, sepsis and urinary catheter care bundle respectively. But 50(49.5%), 64 (63.4%) and 68 (67.3%) were observed to have good practice of elements of VAP,sepsis and urinary catheter care bundles in their daily activity respectively. This study also showed that there is significant association between knowledge and practices (p < 0.001). DISCUSSION AND CONCLUSION: Even through nurses' and physicians‘ overall knowledge regarding ICU care bundles was good, the practice was inadequate and the health care workers do not implement the latest evidenced based bundle practices. So the overall knowledge and practice of ICU care bundles used for prevention of ICU infection was suboptimal
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    Assessment of Knowledge and Practice towards Household Transmission Prevention among People with Chronic Hepatitis B Attending Liver Clinic at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia.
    (Addis Abeba University, 2021-12) Liban Dida; Belachew Hiwot
    Background: Hepatitis B infection is a major global public health problem. Better disease related knowledge among Hepatitis B patients is important for prevention of transmission an facilitate screening of their sexual partners and household contacts. Objective: To assess the level of knowledge and practice of household transmission prevention among people with chronic hepatitis B attending liver clinic at Tikur Anbessa Specialized Hospital, Ethiopia. Methods: A cross-sectional study among 229 hepatitis B patients visiting liver clinic for follow-up service was undertaken in 2021. Data were collected using a structured interviewer guided questionnaires and analyzed using descriptive and inferential statistical methods in SPSS 26. Results: Mean age of respondents was 40 years, 68% were male, Mean total knowledge score was 11.1(79 out of 100) with 65% of respondents scoring ≥75 (defined as a high knowledge). In adjusted linear regression, age <40 years, presence of additional infected household members and disease duration >3 years were associated with higher knowledge score (R2= 0.106,F=8.936, P<0.001).Mean total practice score was 4.7 with only 38.6% of participants scoring ≥6(defined as good prevention practice). In Adjusted logistic regression, factors associated with poor practice were; low level of education (OR: 5.218; 95%CI: 1.34-20.23; p=0.017), being onanti HBV treatment (OR: 3.582; 95%CI: 1.04-12.33; p=0.043) and duration of follow up at TASH <2 years (OR: 2.93; 95%CI: 1.14-7.55; p=0.025). Conclusion: Poor implementation of recommended prevention practices and misunderstandings about transmission were identified among chronic hepatitis B patients
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    Assessment of Knowledge on Hepatitis B infection, Hepatitis B Vaccine and Vaccination Status among Health Care Workers in TASH from March 10-Sept 10 ,2020 G.C
    (Addis Abeba University, 2020-12) Girum Alebachew; Birhanu Yohannes
    Background: Hepatitis B infection is usually higher among health workers than the general population, particularly in the sub-Saharan region. WHO recommends vaccination for all health care workers (HCWs) against the highly infectious, blood borne virus: HBV. However, previous studies reported that knowledge of HCWs toward the hepatitis B infection, Hepatitis B vaccine and their vaccination coverage was low and vary among HCWs in different settings. Objective: This study was aimed to assess knowledge about HBV infection, HBV vaccine and status of HBV vaccination among healthcare workers in TASH, Addis Ababa, Ethiopia from March 10 to September 10, 2020. Methods and materials: Hospital based cross-sectional study was conducted on 358 HCWs who were selected randomly. Stratified random sampling method was used to collect the data using self-administered questionnaire. Then, the data was entered into Epi-data 4.2 version and was exported to Statistical Package for Social Science (SPSS) version 26 for analysis. All covariates that showed p value < 0.25 in binary logistic analysis were further analyzed by multiple logistic regressions to detect true predictors. Result: Among the health care workers, who participated in this study, 180 (51.4%) of them had adequate knowledge on the HBV infection. Medical doctors were the most knowledgeable among the HCWs, with interns [AOR=11.3(95% CI=4.5-28.6)], consultant physicians [AOR=7(95% CI=3.1-15.9)] & resident physicians [AOR=3.5(95% CI=1.9-6.9)] being significant predictors of good knowledge. Vaccination coverage was 60% which was predicted by a shorter work experience [AOR=4.7(95%=1.4-5.8)]. Conclusion: This study reveals that general knowledge level of HCWs about HBV is inadequate and vaccine coverage is suboptimal. Thus, concerned stakeholders should devote more efforts to improve the HCWs awareness about the virus and role of its vaccine and also more work to avail vaccine. Keywords: Health care workers, knowledge level, vaccination status
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    Assessment of Knowledge, Attitude and Practice of Diabetic Foot Care among Diabetic Patients in Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Abeba University, 2021-12) Fekadu Elfign; Reja Ahmed
    Background- The prevalence of diabetes continues to be a growing problem throughout the world and contributes significantly to the health care burden. One of the major complications that diabetes carries is foot ulcer. Diabetic foot ulcer (DFU) is one of the most feared complications and a common reason for the hospitalization of diabetic patients. The ultimate endpoint of diabetic foot disease could be amputation, which is associated with significant morbidity and mortality. It also has significant social, psychological, and financial consequences. Objective- This study is designed to address the status of knowledge, attitude and practice of diabetic foot care and barriers to foot care practice among diabetic patients on follow up at Endocrine clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methodology- This is a descriptive cross-sectional study which was done on diabetic patients on follow up at Endocrine clinic in Tikur Anbessa specialized hospital. The study included 378 diabetic patients using a convenient sampling technique. All patients whose records met the inclusion criteria were reviewed. SPSS version 25 was used for data analyses.Knowledgeattitude, and practice of foot care were assessed using descriptive statistics and bivariable and multivariable logistic regression. Results- A total of 378 study diabetic patients were included in this study where the mean age of the participants was 54 years. There was comparable sex distribution. The mean knowledge score using questionnaires adapted from recommendations by American College of Foot and Ankle surgeons was 12.1 1.94 of which 47.6% and 52.4% had good and poor knowledge of diabetes foot care respectively. The mean attitude score using questionnaires adapted from a previous Saudi study was 3.85 0.90 of which 73.5% had good attitude and the remaining 26.5% had poor attitude towards foot care. The practice score using questionnaires that were adapted from the Nottingham Assessment of Functional Foot Care (NAFFC) was considered good if the participants scored above mean. Based on that, 54.5% of the participants had good practice while45.5% of the participants were considered to have poor practice. With regards to barriers of foot care nearly one third didn’t know what to do, 27.5% didn’t think it was important, and 6.9% of the participants mentioned poor communication between patients and HCP. Conclusion and recommendation- Knowledge and practice of foot care among diabetes patients in our study participants weren’t satisfactory. The result of this study displays the gaps in their knowledge and practice and puts an emphasis on the need for patient education. Most patients are reported to have good attitude which can signify that patients are willing to learn and practice if they get access to proper diabetes education. In conclusion, it is important to focus on the role of health education to minimize diabetic foot complications.