School of Nursing and Midwifery

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    Acceptance Rate and Associated Factors of Immediate Postpartum Intrauterine Contraceptive Device among Women who Delivered Selected Public Hospitals of Addis Ababa, Ethiopia, 2021
    (Addis Ababa University, 2021-05) T/silassie Wondossen; Mekonen Hussen( Prof); Mekonen Baize (Msc)
    Background: Despite of highly effective, inexpensive, non-hormonal and immediately reversible. The acceptance rate of postpartum intrauterine contraceptive device was very low in developing countries including Ethiopia. Therefore, the goal of the study to determined acceptance rate with its associated factors among women who delivered in selected public hospitals of Addis Ababa. Objective Acceptance rate and associated factors of immediate postpartum intrauterine contraceptive device among women who delivered in selected public hospitals of Addis Ababa, Ethiopia. Method: - A cross-sectional study design based on an institution was used on 336 participants. Data collectors used a pre-tested and organized questionnaire to collect information. The data was entered into EpiData 4. 6 statistical packages and then exported to SPSS version 25 for further analysis. To assess the relationship between each independent variable and the dependent variable, bivariate and multivariate logistic regression analyses were utilized. Result: -The acceptance rate was founded to be a total of 336 participants responded (98.5 %). Immediately delivered women's educational status (AOR =0.160, 95 % CI: (0.040-0.649) Private employers, daily laborer, and student were significantly linked(AOR=4.269, 95 % CI: (1.280-14.234) (AOR=7.373, 95 % CI: (1.534-35.433)(P<0.013), and (AOR=11.004, 95 % CI: (1.602-75.572) respectively. Monthly income of 3201-5250, 5251-7900, and maternal monthly income greater than 7901 (AOR =4.731,95 % CI: (1.497-14.949) (AOR =5.712, 95 % CI: (1.489-21.910) and (AOR =6.589, 95 %CI: (1.736-25.009) were all significantly related. Favorable attitude (AOR = 14.457,95 % CI: (4.999-41.806). This was found to be significantly linked to the acceptance rate of immediate postpartum intrauterine contraceptive device. Conclusion and recommendations: The rate of immediate postpartum intrauterine contraceptive device uptake was low. Maternal education, occupation, monthly income,and attitude are all linked to acceptance rates. Health-care education, a change in women's attitudes, and frequent training for healthcare workers are all important.
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    Adherence to Adjuvant Hormonal Therapy and Associated Actors Among Women with Breast Cancer Attending at Tikur Anbessa specialized hospital, Addis Abeba, Ethiopia, 2019.
    (Addis Ababa University, 2019-06) Wako Zerko; Mengistu Daniel (prof); Getahun Negalign(BSc)
    Background: Breast cancer is one of leading cause of morbidity and mortality in Ethiopia.Adjuvant hormonal therapy (AHT) is one of the treatment modality given for a patient withbreast cancer with estrogen receptor positive after primary treatment for 5-10 years. Nonadherence to adjuvant hormone therapy inbreast cancer survivors is commonand associated with increased risk of recurrence of cancer,invade the other breast,and consequently increase morbidity and mortality. Objective:Toassess level of adherence to adjuvant hormonal therapy and associated factors amongwomen with breast cancer who attends oncology outpatient at Tikur AnbessaSpecialized Hospital. Method: Institutional based cross-sectional study was conducted. Convenience sampling technique was used to select 216 participants. A semi-structured questionnaire was used after some modifications and Morisky Medication Adherence Scale (MMAS-8). Data were enteredin EpiData version 4.4.2.1 and exported to SPSS version 24, and analyzed using ordinal logistic regression with OR and 95%CI. Result: Out of 216, 209 women with breast cancer participated in the study with response rate of 97%. The level of adherence was 41%, 33%, and 26% for low, medium and high adherence respectively. Age group <45 is likely to be high adherence compared to >65 with (OR= 2.6,CI (3.8-7.6) p-value 0.001); being from urban (OR= 1.5, CI (1.1-2.8, p-value 0.001); being on tamoxifen (OR= 1.6, CI (0.4-2.2), p-value 0.005); having side effect (OR= 1.5, CI (0.4-1.9), pvalue 0.004); comorbidity (OR= 1.6, CI (1.5-3.4, p-value 0.001) and Getting a thorough therapeutic communication (OR= 1.7, CI (1.2-3.2), p-value 0.001) were found to be significantly associated with adherence to AHT. Conclusions and recommendations: In summary, the high adherence level to AHT among women with breast cancer was 26% in Tikur Anbessa Specialized Hospital. Age, place of residence, types of AHT, side effect, comorbidity, therapeutic communication from health care providers were significantly associated with adherence. Healthcare provider should give health education concerning medication usage, management of side effects and should also give due attention to rural patient.
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    Adherence to diabetes self –management and associated factors among adolescents with Type 1 diabetes in public hospitals of Addis Ababa, Ethiopia, 2021.
    (Addis Abeba University, 2021-06) Muse, Yomilan Geneti; Sr. Wondwossen, Kalkidan(Assistant Professor); Adimasu, Mekonen(BSC, MSC)
    Background: Type 1 diabetes is one of the quickly growing problems in Ethiopia. Adherence to diabetes self-management of adolescents with type 1 diabetes is crucial for the control of type 1 diabetes to diminish mortality and morbidity. Prove of level of adherence to diabetes selfmanagement and associated factors in adolescents with type 1 diabetes in Ethiopia is unknown. Objectives: To determine adherence to diabetes self-management and associated factors among adolescents with type 1 diabetes in public hospitals of Addis Ababa, Ethiopia, from March 10 to April 25, 2021. Method: Institutional based cross-sectional study was done in four arbitrary chosen public hospitals of Addis Ababa. Systematic random sampling technique was used to select a total of 422 participants. A structured and pretested questionnaire was prepared and interview technique was used for data collection. The data was collected by utilizing Kobo collect version 1.30.1 and exported to excel for checking and cleaning. Later the data was exported to SPSS version 25 for analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis was performed. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05. Results: With 98.1% response rate, a total of 414 diabetic adolescents were interviewed. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. The prevalence of poor adherence to insulin administration, dietary management, management of hypoglycemia, blood glucose testing, and regulation of exercise were 56.8%, 68.4%, 42%, 54.8% and 50.5% respectively. Self-efficacy (AOR=8.7, 95% CI: (1.9, 14.1) and P=0.005), social support (AOR=4.6, 95%CI: (1.5,13.5) and P=0.006), age (AOR=0.2, 95%CI: (0.1,0.4) and P=0.001), good knowledge of the disease (AOR=9.046, 95%CI: (3.83,13.5) and P=0.000), moderate knowledge (AOR=6.763, 95%CI: (2.18,12.921) and P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95%CI:(0.02-0.2) and P=0.005) were significantly associated with adherence to diabetes self-management. Conclusions and Recommendations: More than half of the participants had poor adherence. Planning a comprehensive rule of adherence and expanding the recurrence of follow-up visits in diabetic clinics were profoundly suggested.
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    Adherence to Self Management and Associated Factors Among Hypertensive Patients Attending Chronic Follow Up Units of Public Health Hospitals in Addis Ababa, Ethiopia, 2016
    (Addis Ababa University, 2016-06) Tibebu, Abel; Mengistu, Daniel (Assistant Professor)
    Background - One of the most prevalent non communicable diseases is hypertension. The availability of effective antihypertensive medications didn‟t bring the expected outcomes in terms of controlling blood pressure. The rationale for these and other findings of uncontrolled hypertension direct towards poor adherence. The most neglected causes of uncontrolled hypertension are unhealthy lifestyles. Few studies are conducted to show the gap and magnitude of self-management adherence. Objectives – This study tried to assess the self-management adherence of hypertensive patients attending follow up at chronic follow up units of public health hospitals in Addis Ababa, Ethiopia,2016. Method – Institutional based cross sectional study was conducted in four public health hospitals which were selected by lottery method. The final calculated sample size was 416 which were proportionally allocated to each of the institutions and systematic random sampling was used. Data was checked, cleaned and entered in to Epidata software version 3.1, and was imported to SPSS version 21 software for analysis. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between independent variables and dependent variables were analyzed using bivariate and multivariate analysis. The study was conducted from February 15 – April 15, 2016. Results – The study included 404 respondents with 97% response rate. 210(52%) were male and mean age was 54±10.77 years. The respondents‟ adherence to lifestyle modifications and anti- hypertensive medications were 23% and 66.8% respectively. The lifestyle and medication related adherences were found to be better in females, patients who had comorbidities and have been knowledgeable about the disease and was poor among young adult respondents. Conclusion and Recommendations – The rates of adherence to medication and life-style changes were generally found to be low. Educational sessions that especially focus on lifestyle modifications and ongoing support for patients should be designed and studies which assess all the components of self-management should be conducted for comparison among different subgroups. Keywords – Self management, Adherence, Hypertension, Lifestyle modifications, Anti- hypertensive medications
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    Adolescent Communication to their Parents on Sexual and Reproductive issues and Associated Factors Among Secondary School Students in Meki Town, East Shoa, Oromia, Ethiopia: Mixed Method Study 2023
    (Addis Ababa Unaiversity, 2023) Furo Barke; Berhe Semarya; Genzeb Siraye
    BACKGROUND: Adolescents are more vulnerable than any other age group to a range of sexual and reproductive health problems. Adolescents are exposed to various sexual and reproductive risks due to lack of communication with their parents, such as early-unprotected sex, early pregnancy, school dropout, sexually transmitted Infections (STIs) and human immune virus (HIV). OBJECTIVES: To assess adolescent parent sexual and reproductive health communication and associated factors among secondary school students in Meki town, East Shoa, Oromia, Ethiopia 2023. METHODS: Institution based convergent mixed method was applied. The study was conducted from February 20- March 20/2023 among 392 students at Meki town. The quantitative data was collected using pretested structured self-administered questionnaire by systematic sampling technique. Data was entered using EPI data version 4.6.0.6 and then transport to SPSS window version 25 for statistical analysis. The association was determined using 95% CI and p value (<0.05) for multivariable logistic regression. The qualitative data was collected using interview guides(open-ended). The response was tape-recorded. In-depth interview was conducted among purposively selected parents. Thematic analysis was used using Atlas ti 9 software. Result: The proportion of respondents who had communicated with their parents regarding SRH issues on at least two components was 156 (39.8%). Being grade 10 student (AOR = 0.44: 95% CI; 0.225-0.862), merchant mothers (AOR =2.76: 95% CI; 1.36-5.62), attitude toward SRH (AOR= 0.182 95% CI, 0.1-0.333), adolescent had SRH information (AOR=3.28; 95% CI 1.3- 8.23) and knowledge of SRH issues (AOR=1.75: 95% CI: 1.03-2.98) were significantly associated. Five themes were discussing about SRH components, Source of SRH information,approach to Improve SRH discussion, SRH reason and challenges for not discussing and SRH discussion age and satisfaction. Conclusion and Recommendation: There was insufficient adolescent-parent communication regarding SRH components. The main reason from both quantitative and qualitative study was cultural barriers, fear of parent response, lack of trust in adolescent, morally unacceptable and shame to talk. The Ministry of Health has to give focus and facilitate health care professional, different government sector, and nongovernmental organization to work on it.
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    Agreement Between Enzyme Linked Immunosorbent Assay with Rapid Plasma Reagin and Treponemapallidumhaem Agglutination Assay for Screening and diagnosis of syphilis at National Blood Bank Service in Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-08) Afework, Ejigayehu; Hussein, Mintewab (PhD)
    Background: Serological diagnosis of syphilis is based on demonstration of specific treponemal antibody and non treponemal antibodies (reagin) in body fluids. Accurate and reliable testing is a critical step in ensuring the diagnosis of syphilis and the safety of blood transfusion service. Performance agreement between syphilis tests is not documented well in Ethiopia. Objectives: To determine agreement between Enzyme Linked Immunosorbent Assay with Rapid Plasma Reagin and TreponemapallidumHaemagglutination Assay for screening and diagnosis of syphilis. .Methods:Laboratory based Cross sectional study was carried out from January 2016 to June 2016 at National Blood Bank Service Addis Ababa, Ethiopia. All positive (One hundred and ninety) and 190 negative samples were used which stored in NBBS (National Blood Bank Service) laboratory from July 2015 to Dec 2015 (total 380 samples). Systematic random sampling method was used to select negative samples .The data was analyzed by SPSS version 20 software. The percentage agreement and κ value were compared; the sensitivity, specificity, positive predictive value and negative predictive value of the ELISA and RPR were calculated. P value less than 0.05 were taken as statistical significant. Results:From 190 ELISA positive sera, 151 (80%) were confirmed as positive by TPHA, 39 (20 %) were found to be false positive. 59 (39%) of samples were positive and 92 (61%) were false negative by RPR. From 190 ELISA negative sera all were negative by RPR and TPHA. The sensitivity, specificity, PPV and NPV of ELISA was 99.9%, 85%, 79 % and 100% respectively. While RPR was 62%, 99 %, 100% and 63 % respectively. Percent agreement of ELISA with TPHA was 90% and corresponding kappa value was substantial 0.795. Percent agreement for RPR was 66 % with kappa value of 0.375 which was a fair agreement.Chi-square result with p value 0.000 which is statistical significant indicate the association between categorical variables. Conclusion The study demonstrated that ELISA was very sensitive. There was good agreement between ELISA and TPHA. RPR was with high specific and weak sensitive results. There was poor agreement between RPR and TPHA
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    Antenatal Care and Health Facility Delivery Practice Among Mothers in Konso Woreda, Southern Ethiopia
    (Addis Ababa University, 2016-05) Urmale, Kusse; Yisma, Engida (PhD)
    Background: Worldwide, developing countries accounted for the majority of maternal deaths. Even though antenatal care and institutional delivery were mentioned among the interventions directed toward improving maternal health, their utilization is unsatisfactory in most resource-poor settimgs. Objectice: The main objective of this study was to assess antenatal care and health facility delivery practice among mothers in Konso Woreda, Southern Ethiopia from March 21 to April 16, 2016 Methods: A community based cross-sectional study was done from March 21, 2016 to April 16, 2016 on sample of 865 mothers who gave birth in the last one year prior to the study in Konso Woreda by employing multi-stage stratified cluster sampling technique. The data were collectied using a pre-tested interviewer administered questionnaire. We analysed the data to identify the factors associataed with antenatal care and health facility delivery practice using logistic regression analysis. Results: The proportion of mothers who made at least one antenatal care visit for their most recent birth was 82.0% however, only 54% of them had received the recommended four or more visits. Although the proportion of at least one antenatal care visits was high, only 60% of the mothers gave birth at health institutions. After controlling for residence, husband education and household wealth quintile in the adjusted logistic regression model, maternal age, possession of communication Medias and walking distance (in hours) to the nearest health were found significantly associated with antenatal care practice. Similarly after controlling for residence and pregnancy intention, provision of delivery care by the nearest health facility and proximity of the health facility to the residence were found to significantly affect institutional delivery. Conclusions and recommendations: Despite high attendance of at least one antenatal care visit, low utilization of the recommended antenatal care visits and institutional delivery was observed. Socio-demographic, obstetric and health facility factors were associated with both antenatal care and health facility delivery practice. More effort should be taken to equip health facilities with the capacity to provide maternal health care services, delivery care in particular. Keywords: Antenatal care practice, Health facility delivery practice, Konso Woreda.
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    Anti- Retoviral Therapy Adherence Among Hiv-Infected Children Aged 2-14 Years in Tikur Anbessa Sepcialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-06) Diriba, Ketema; Mengistu, Zuriyash (PhD)
    Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. The fact that a nearly perfect adherence is required in ART has remained a major challenge to people infected with HIV. Consequently, non-adherence to the proposed antiretroviral regimen is considered to be one of the greatest dangers to the response to treatment on an individual level and the dissemination of resistant viruses on the community level. Objectives: - The aim of the study was to identify the adherence level and associated factors with adherence to ART among HIV infected children aged 2- 14 years in Black Lion Specialized Hospital ART clinic, Addis Ababa, Ethiopia. Method: - A cross-sectional study was conducted between April and May, 2015 in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 190 children aged 2-14 years on first line ARV regimen for at least six month were included in the study. The registered list of the children on ART by unique ART registration number was used as sampling frame. Data was collected by using interview with structured questionnaire. Ethical clearance was secured from Addis Ababa University College of health sciences institutional ethical review board. The collected data was cleaned, checked for quality, coded and analyzed by using manual and statistical methods, logistic regressions were computed. Odds ratios were computed to determine the level of significance. Result: A total of 190 children were included in this study, and 89.8% of the participants had taken their prescribed ARV drugs fully for the past 7 days. Considering individuals who had ever missed their dose regardless of time reference, overall adherence rate 87.75% was obtained. Although most frequently mentioned reason of missing their dose in the last one week was forgetting (48.1%), ADRs, Quarrel among family are also found to be barriers to adherence. After controlling the effects of other variables, two variables namely income and occupation were found to be significantly associated with adherence to ART in children. Conclusion: Adherence rate obtained in this study is lower than what is required. Forgetfulness, ADRs, and quarrel among family were most frequently mentioned barriers of adherence. Income and occupation are factors found to be significantly associated with adherence to ART in children
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    Antibiotic Resistance Patterns of Gram Negative Fermentative and non Bacilli isolated from patients Referred to Arsho Advanced Medical Laboratory Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Tsige, Estifanos; Bitew, Adane (Associate Professor)
    Background: Gram negative bacilli are the most frequently isolated bacteria which recovered from various clinical samples. Conventionally, these microorganisms subdivided into two major groups’ fermentative and non-fermentative gram-negative bacteria. The aim of this study is to determine antibiotic resistance patterns of fermentative and non-fermentative gram negative bacilli from various clinical samples in study area. Method: A laboratory based cross-sectional study conducted at Arsho Advanced Medical laboratory, Addis Ababa, Ethiopia from January to April 2017; Study participants were required Urine , CSF, wound, Nasal fluid ,Ear ,Blood, Body fluid, Semen were collected and cultured on Blood agar, MacConkey agar and chocolate agar and incubated according to standard conditions. Then Species identification and antimicrobial susceptibility testing of gram negative bacteria were determined by automated Vitek 2 compact system using GN and AST GN72 card. Result: From the total of 824 various specimens, 284(34.5%) were culture positive , of which (90.8%, 258/284) of the isolates were fermentative and (9.2%), 26/284) were non fermentative Gram- negative bacteria from wide range of clinical specimens such as in urine 197(69.4%), in wound and abscess 34(11.9%), in Ear 20(7.0%), in CSF 11(3.87%), in Nasal 11(3.9%), in Blood 4 (1.4%), in Bodyfluid4 (1.4%) and in semen 3(1.1%) .The most common Gram- negative bacterial isolates being Escherichia coli 152(53.5%), followed by Klebsiella pneumonia 40(14.1%), Pseudomonas aeruginosa 13(4.6%), Proteus mirabilis 13(4.6%), Acinetobacter baumannii 8(2.8%) were the most dominant isolate respectively. Among gram negative bacteria, K.pneumoniae (82.5%), E.coli (82.9%), P.aeruginosa (100%), and A. baumanii (100%) were multi drug resistance. Concussion: High antimicrobial resistance and multi drug resistance was demonstrated over the study period, which may be due to associated with the improper antibiotic consumption or lack of a proper guideline for empirical therapy. Keywords: Antibiogram, Enterobacteriaceae, fermentative and non-fermenting gram-negative bacilli, antimicrobial susceptibility test and antimicrobial resistant
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    Antibiotic Susceptibility Pattern of Neisseria Meningitides Isolates From Asymptomatic Carriers in Gurage Zone, Southern Ethiopia
    (Addis Abeba university, 2017-06) Mulatu, Fikerte; Desta, Kassu(PhD)
    Background: Neisseria meningitides represents a pathogen of great public health importance in both developed and developing countries. Resistance to some antimicrobial agents used either for therapy of invasive infections or for prophylaxis of case contacts has long been recognized. However, there is a limited data in relation with the antimicrobial resistance pattern of Neisseria meningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibility pattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups at Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtained from MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia were screened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) was done on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used for treatment and prophylaxis of meningococcal disease was investigated. The AST was performed for Neisseria meningitides isolates according to the criteria of the CLSI guide line by disk diffusion method. Data was analysed by using SPSS version 20.0 software. Results: From 187 Neisseria meningitides isolates 8(4.28%) were serogroup X, 24(12.83%) were serogroup Y, 1(0.53%) was serogroup W135 and 154(82.35%) were non determinant (ND). Resistance for Cotrimoxazol was high accounting 116(62%) followed by Ciprofloxacine 112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem 21(11%) , Minocycline 15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin 6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomatic carriers for the present study is high. Continued surveillance of meningococci for antimicrobial resistance is necessary to monitor early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis and treatment. Key words: Neisseria meningitides, serogroups, sensitivity pattern, drug resistance
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    Antibiotic Susceptibility Pattern of Neisseria meningitides Isolates from Asymptomatic Carriers in Gurage zone, Southern Ethiopia
    (Addis Ababa University, 2017-06) Mulatu, Fikerte; Desta, Kassu (Assistant Professor)
    Background: Neisseria meningitides represents a pathogen of great public health importance in both developed and developing countries. Resistance to some antimicrobial agents used either for therapy of invasive infections or for prophylaxis of case contacts has long been recognized. However, there is a limited data in relation with the antimicrobial resistance pattern of Neisseria meningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibility pattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups at Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtained from MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia were screened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) was done on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used for treatment and prophylaxis of meningococcal disease was investigated. The AST was performed for Neisseria meningitides isolates according to the criteria of the CLSI guide line by disk diffusion method. Data was analysed by using SPSS version 20.0 software. Results: From 187 Neisseria meningitides isolates 8(4.28%) were serogroup X, 24(12.83%) were serogroup Y, 1(0.53%) was serogroup W135 and 154(82.35%) were non determinant (ND). Resistance for Cotrimoxazol was high accounting 116(62%) followed by Ciprofloxacine 112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem 21(11%) , Minocycline 15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin 6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomatic carriers for the present study is high. Continued surveillance of meningococci for antimicrobial resistance is necessary to monitor early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis and treatment. Key words: Neisseria meningitides, serogroups, sensitivity pattern, drug resistance
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    Antihypertensive Medication Adherence and its Associated Factors Among Hypertensive Patients in North Showa Zone Public Hospitals, Ethiopia 2021
    (Addis Ababa University, 2021-06) Getaye Asfaw; Mengistu Zuriash( PHD); Alemu Tsion(MSc)
    Adherence to antihypertensive medication plays a tremendous role in controlling BP,however poor adherence to antihypertensive medication leads to complications of HTN,wastage of health care resources, and workload on health care providers which results inpoor clinical outcome. This study aimed to assess antihypertensive medication adherenceand its associated factors among hypertensive patients’ in North Showa Zone public hospitals’, Oromia regional state, North Ethiopia. 2021. An institutional-based crosssectional stud was conducted fromFebruary 8 toMarch8/2021in three public hospitals o f North ShowaZone.Out of four public hospitals,three hospitalswereselected throug hsimplerandomsamplingtechniques andthefinalsamplesize348was selected systematic random sampling.Datawere checked,cleaned andentered itEpidatasoftware version3.1,and imported to SPSS version 23 software for analysis.Descriptive analysis was done and presented in frequencies and percentages. The association between independent and dependent variables was analyzed using bivariate and multivariate analysis, and variablesthat show P-values of < 0.05 with 95% CI will be considered statistically significant. This study includes 348 participants with a 97.4% response rate. Of the respondents, 56.9%adhere to their medication. Marital status (AOR=3.24,95%CI=1.12-9.60), residence (AOR=2.59,95%CI=1.42-4.75), Controlled BP (AOR=4.26, 95%CI=2.37-7.67), number of medication (AOR= 2.59,95%CI=1.35-4.97), comorbidity (AOR=2.24, 95%CI=1.334.67),knowledge (AOR=5.01,95%CI=2.69-9.35), insurance coverage user(AOR=2.20,95%CI=1.23-3.95) and forgetfulness were found statistically significant. The adherence status of this study was sub-optimal and the knowledge status of patients about HTN and their treatments was the most associated factor. Give health education for patients about HTN and its treatments, early diagnosis, and management of comorbidity, and adherence counseling are important for improving the adherence status of clients.
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    Antimicrobial Susceptibility Pattern of Bacterial Isolates From Wound Infections at all Africa Leprosy, Tuberculosis and Rehabilitation Training Center, Addis Ababa Ethiopia
    (Addis Ababa University, 2017-06) Tessema, Asdesach; Bitew, Adane (Associate Professor)
    Background: Wound develops into an infected state when the balance between microorganism and the host shifts in favour of the micro-organism. Antimicrobial resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs. Objective: The main objective of this study was to isolate etiology of wound infections and determine their antimicrobial susceptibility pattern. Methods: A cross-sectional study was conducted at ALERT Center from February to May 2017. Swabs from different types of wounds was taken and processed to isolate etiologic agents by using standard microbiological techniques. Antimicrobial susceptibility tests were performed by disc diffusion technique as per the standard modified Kirby-Bauer method. Results: In this study 171 bacterial isolates were recovered from 188 specimens showing an isolation rate of 86.2%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 96 (51.1%) followed by Klebsiella pneumoniae 26 (15.2%), Escherichia coli 23(13.4%). Out of 162 positive samples 9(5.5%) were mixed infections. Staphylococcus aureus exhibited highest sensitivity against Clindamycin (95.8%), Gentamycin (94.8%), Chloramphenicol (92.7%), Ciprofloxacillin (89.6%) and Cotrimoxazole (84%). Gram negative isolates, E.coli, P.vulgaris, P.mirabilis, P.aeroginosa and Citrobacter showed the highest sensitivity against Amikacin (100 %). E.coli showed high resistance for Ampicilin (95.7%) and Augumentin (91.3%) where as P.vulgaris showed 100% resistance for Ampicilin and 90.9 % for Tetracycline. Conclusion: There was high prevalence of bacterial isolates in this study. S. aureus was the predominant isolate 96 (56.1%). Most of the isolates showed high resistance to commonly used antimicrobials. The antimicrobial profile of drugs demonstrated that the commonly prescribed drugs against Gram positive bacteria (Penicillin, Tetracycline) and Gram-negative bacteria (Ampicillin and Tetracycline) as a single agent for empirical treatment of wound infections would not cover the majority of wounds infections. Antimicrobial treatment should be based on the result of culture and sensitivity. Keyword: wound infection, bacterial isolates, drug resistance pattern.
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    Antimicrobial Susceptibility Pattern of Common Bacteria Isolateted from Wound Infection In Paediatric Surgical Patients at Yekatit 12 Hospitals, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2017-06) Mahmud, Tofik; Desta, Kassu (Assistant Professor)
    Background: Wound infections contribute significantly to morbidity and mortality in surgical patients. Factors that increase the risk of wound infection include patient conditions such as; age, obesity, malnutrition, smoking, and the state of the wound which includes nonviable tissue in the wound, foreign bodies, long surgical procedures, and others. However microorganisms are the major causes with bacteria being the most prevalent. Severe and poorly managed infections can lead to gas gangrene and tetanus which may cause long-term disabilities. Bacterial wound infections are a common finding in open injuries.. Objective: The study aimed to identify bacteria that cause wound infections and to determine their antimicrobial patterns in the pediatric surgical wards at Yekatit 12 Hospital, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from December 2016 to April. A total 150 clinical specimens were collected from study participant. All wound samples were cultured on Blood agar and MacConkey agar. All culture positive samples were characterized by gram stain and biochemical tests using the standard procedure. Antimicrobial susceptibility test was performed using Kirby-Bauer method. All demographic, laboratory and risk factors data obtained were entered and analyzed using SPSS version 20. Result: The burden of wound infection among pediatric patients was 123 (82%). Of which 90 [65.7%] were gram positive and 47 [34.3%] were gram negative bacteria. Staphylococcus aureus 79[52.7%] was the most prevalent followed by Pseudomonas aeruginosa 26 [17.3%] and Proteus spp 14 [9.3%].Patients who had mixed infections were 8.67% of the total participants. Staphylococcus aureus was highly sensitive to ceftriaxone but resistant to ceftazidime [91.1%]. Methicillin Resistant Staphylococcus aureus formed 50.6% of the Staphylococcus aureus isolates. Beta hemolytic Streptococcus was highly sensitive to amoxicillin clavulanate and resistant to cefuroxime. Escherichia coli was sensitive to ciprofloxacin but resistant to amoxicillin clavulanate, cefuroxime, ceftriaxone, imipenem and ceftazidime. Klebsiellaspp was sensitive to all the antibiotics that were tested. Proteus mirabilis was sensitive to all the antibiotics except ceftazidime. The Non lactose fermenters were only sensitive to imipenem, ciprofloxacin and cefoxitim. Pseudomonas aeruginosa was highly sensitive to ciprofloxacin and imipenem but less sensitive to ceftazidime and resistant to ceftriaxone.Ceftriaxone, cefuroxime, flucloxacillin and amoxicillin clavulanate were widely used beside other antibiotics for either prophylaxis or treatment of the wound infections. Conclusion: The prevalence of wound infection remains high despite wide use of antibiotics in the paediatric surgical wards. Resistance to new antibiotics like imipenem was observed. Key terms: Bacterial isolates, antimicrobial susceptibility pattern, surgical site infection
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    Antimicrobial Susceptibility Pattern of Gram Negative Bacterial Isolates From Sewages Polluted Urban Rivers, Addis Ababa, Ethiopia, 2017
    (Addis Ababa University, 2017-06) Belachew, Teshome; Desta, Kassu (Assistant Professor)
    Background: rivers are an important source for drinking, irrigation, recreation and other domestic purposes. However, if it is polluted, it can act as the storehouse of harmful infectious agents that possess multiple drug resistant genes, which is a growing public health concern. Objective: To determine gram negative bacterial profile and antimicrobial susceptibility pattern from selected sewage polluted urban rivers of Addis Ababa. Methods: A cross sectional prospective study was conducted from February – April 2017. Water samples were collected from the rivers that pass through ten sub cities of Addis Ababa. Turbid samples were tenfold diluted (1:10) with sterile physiological saline. Samples were inoculated on blood and MacConkey agar. Presumptively isolated organisms were identified by BioMerieux VITEK 2 COMPACT machine. Antimicrobialsusceptibility patternwas alsoperformedfor 19 antibiotics by the machine with minimum inhibitory concentration technique. Epidata 3.1 was used as data entry and SPSS 20 was used for data analysis. Results:From a total of 94 river water samples, 150 gram negative bacterial isolates were recovered to the species level and 30 isolates were not identified by the machine. The isolation rate was 98% (92 samples were positive for one or more than one bacterial isolates). The predominant species were A. hydrophylia/cavae 26 (17%) followed by E.coli 23(15%), K.pneumonia 18(12%), Rautella species 18(12%), K. oxytoca 17 (11%).The least identified species was E.gergovia and C.braki1(1%). A. Hydrophila/Cavae showed high level of resistance to cefazolin 10 (38%), cefoxitin 9 (35%) and trimethoprim sulphomethoxazole 10 (38%). E.coli. showed also high level of resistance to many of tested antibiotics like ampicillin 21 (91.3%), and 16(70%) resistance to Cefalotin, Cefuroxime, Ceftriaxone and Cefepime. Both K.Pneumoniae and K.oxytoca showed high resistance to ampicillin 16(94%) and 17(95%) respectively. Among identified bacterial species, most of them showed multidrug resistant pattern. Providential retigerri showed 100% MDR Followed by P.Alkalificiens (90%), E.coli (78%), Morganella species (75%), and C.frundi (60%). Conclusion and Recommendation: A.hydrophila/cavae and E.Coliwere the most predominant bacterial isolates. Most of identified bacterial species were highly resistant to ampicillin and amoxicillin/clavulnic acid. Drug resistance and MDR were very high in this study. Key words: Gram negative bacteria, Multidrug Resistance, Antimicrobial susceptibility pattern, River, Addis Ababa
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    Antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College
    (Addis Ababa University, 2014-05) Merga, Yamirot; Bitew, Adane (Associate Professor)
    Background: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Objective: This study was carried out in order to determine the antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12 Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained from patients in sterile universal bottles. Urine collected from each patient was inoculated onto CLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml, Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically. Bacterial isolates were characterized/ indented by gram stain and by using an array of standard routine biochemical test. Antimicrobial susceptibility test was carried out by using the Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics was computed for most of the study variables and Frequency distribution tables were used to describe the findings. In this study a total of 384 pediatric patients (199 males and 185 females) aged between 0 years to 15 years from whom urine sample were collected were enrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36 (19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuria and the largest number of study subjects were below age 3 years and the largest positive culture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacter and Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsilla spp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus in one and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%), Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of bacterial isolates E. coli was found out to be the most common pathogen followed by Klebsiella spp.. Furthermore E. coli and klebsiella spp. were the most common pathogen in female patients accounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was much higher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant to cefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was 100% resistances to gentamicin, trimetroprimsulfamethoxazole , agumentin, and nalidixic acid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine, cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100% sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4% to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and Erythromycin. S. aurues was 100% susceptible to ciprofloxacin, cefuroxime, gentamicin, trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while coagulase negative staphylococci were resistance to all of the above drugs except Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in 73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of Bacterial Uropathogen Isolates from Pediatric Patients and highlighted the major bacterial uro- pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore, species bacterial pathogens and their frequency was consistent with the usually reported pattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp. In this study Majority of gram negative species were susceptible to ciprofloxacin, norfloxacine and nitrofurantion (except proteus spp) and gram positive species were susceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treat UTI in children however Most of bacterial isolates were multidrug resistant and it is therefore suggested that appropriate antimicrobials should be administered to reduce the risk of multi drug resistant organisms developing and avert ineffectiveness of antibiotics
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    Antiretroviral Treatment Associated Hyperglycemia and Dyslipidemia among HIV Infected Patients at Burayu Health Center, Addis Ababa, Ethiopia, 2012
    (Addis Abeba University, 2012-06) Abebe, Molla; Kinde, Samuel; Dr.Tegbaru, Belete
    Introduction: Development of HAART has brought significant suppression of viral replication, decreasing morbidity and mortality and dramatically transforming HIV into chronic disease. Unfortunately, the prospect of maintaining patients on HAART for long term may be restricted by a heterogeneous collection of unexpected metabolic abnormalities, including dysregulation of glucose metabolism, dyslipidemia and lipodystrophy. Objective: To assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on adult HIV infected individuals at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naïve and HAART initiated patients (n=126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. TC, TG, HDL-C, LDL-C and glucose were determined using COBAS INTERGA 400 chemistry analyzer. The data were analyzed using SPSS version 19 software. Chi-square, student-t-test and logistic regression were used to assess association between variables. P value < 0.05 was considered as statistically significant. Result: Of 252 study participants, 72.2% were females, mean age was 35.3 years; mean BMI was 21.4; mean time with the virus was 20.6 months; 62.7% were married; 48.4% were at primary educational level; 52.4% were house wives; 15.5% were TB-HIV co-infected and 43.7% were categorized as WHO stage one. The prevalence of hyperglycemia, hypertriglyceridemia, hypercholesterolemia, decreased HDL-C and increased LDL-C was 7.9%, 22.8%, 42.1%, 50.8% and 23% in HAART initiated and 5.6%, 10.3%, 11.1%, 73% and 7.1% in non-HAART groups, respectively. ART regimens observed as a first line were only containing 2 nucleoside backbones (from AZT/D4T/3TC/TDF) with either NVP or EFV. Serum TG level ≥200 mg/dl was more common among patients who received D4T based than those with AZT based antiretrovirals (34% versus 16.4%, P = 0.029). Conclusion: First-line HAART is associated with potentially atherogenic lipid profile levels in patients with HIV infection compared to untreated patients in our setting. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.
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    Application of Data Mining Technology in Predicting The Seropre valence of Hbv, Hcv,Hiv; The Case of The National Blood Bank of Addis Ababa, Ethiopia
    (Addis Ababa University, 2011-07) Gebregziabher, Haftom; Meshesha, Million(PhD)
    Recent advancements in communication technologies, on the one hand, and computer hardware and database technologies, on the other hand, have made it easy for organizations to collect, store and manipulate massive amounts of data. As stated by Deogan, these large databases contain potential gold mine of valuable information, but it is beyond human ability to analyze substantial amounts of data and extract meaningful patterns. As the volume of data increases, the proportion of information in which people could understand decreases substantially. The applications of learning algorithms in knowledge discovery are promising and they are relevant area of research offering new possibilities and benefits in real-world applications such as blood bank data warehouse. The availability of optimal blood in blood banks is a critical and important aspect in a Blood transfusion service. Blood banks are typically based on a healthy person voluntarily donating blood used for transfusions. The ability to identify regular blood donors enables blood bank and voluntary organizations to plan systematically for organizing blood donation camps in an efficient manner. The objective of this study is to explore the immense applicability of data mining technology in the Ethiopian National Blood Bank Service by developing a predictive model that could help in the donor recruitment strategies by identifying donors that are at risk of TTI’s which can help in the collection of safe blood group which in turn assists in maintaining optimal blood. The analysis has been carried out on 14575 blood donor’s dataset that has at least one pathogen using the J48 decision tree and Naïve Bayes algorithm implemented in Weka. J48 decision tree algorithm with the overall model accuracy of 89 % has offered interesting rules
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    Application of Home Validated Panel Dna Materials for Proficiency Testing of Who Endorsed Molecular Assays: Mtbdrplus and Xpert Mtb/Rif Assay
    (Addis Ababa University, 2016-06) Dagne, Zekarias; Desta, Kassu (Assistant Professor)
    Background: Tuberculosis (TB) is a major public health problem in Ethiopia. Laboratory plays an important role in the diagnosis of TB and its treatment monitoring. Quality assured molecular drug susceptibility assay is an essential for rapid detection of MDR-TB cases and early treatment initiation Proficiency testing is one of the EQA methods in evaluating the quality service delivery however, it was not widely applied for molecular assays in Ethiopia mainly due to the inadequate capacity of preparing PT DNA panels’ in-country. Objective: The aim of this study was to assess Application of Homemade and validated panel DNA Materials for Proficiency Testing of the WHO endorsed Molecular Assays (GenoType® MTBDRplus and Xpert MTB/RIF assays) in TB Culture and DST laboratories, and in selected GeneXpert sites of Ethiopia. Methods: A cross sectional study was conducted in five regional reference laboratories and two specialized hospital TB culture and DST laboratories which have molecular GenoType® MTBDRplus assay of Ethiopia, and in eight selected health facilities with Xpert MTB/RIF testing sites in Addis Ababa during the period between July 2015 and January 2016. PT DNA materials were validated at EPHI, NTRL and distributed to MTBDRplus and Xpert MTB/RIF testing facilities. All data from participating laboratories were captured and analyzed using SPSS version 20. A total of 194 (130 for MTBDRplus and 64 Xpert MTB/RIF) DNA panels were distributed to regional reference and hospital TB laboratories. Test results agreement between the participant laboratories and reference were estimated using Kappa statistics. The sensitivity, specificity, predictive value susceptible, predictive value resistance, accuracy and reproducibility of participant laboratories were calculated against the reference lab. Results: 130 panel samples with a combination of 65 (50%) spiked sputum and 65 (50%) extracted DNA were tested in seven Regional Reference Laboratories which have MTBDRplus assay. Almost all, 129 (99.2 %) were correctly reported to the Isoniazid and Rifampicin susceptibility. Sixty nine (53.1%) reported isolates were resistance to both INH and RIF (MDR), 41 (31.5%) susceptible to both INH and RIF, and 19 (14.6%) INH susceptible but RIF resistance strains correctly reported with respect to the reference result. There was 100% agreement in detecting MDR and resistance to any of the two drugs (INH and RIF) (kappa = 1) but the agreement was 97.8% for the detection of susceptible strains (Kappa = 0.9). Among 64 spiked sputum strains (32 M. tuberculosis DNA with no RIF resistance and 32 M. tuberculosis DNA with RIF resistance (probe E Mutant detected ) distributed to GeneXpert sites, all of them were correctly reported. Overall agreement on detection of M. tuberculosis and RIF susceptibility was 100 % (Kappa =1.0). Conclusion: There was an excellent agreement between the participant laboratories and the reference laboratory for the detection M. tuberculosis and drug susceptibility using MTBDRplus and Xpert MTB/RIF assays. Therefore, we can apply home validated PT DNA panels as one of the EQA methods for WHO endorsed molecular assays MTBDRplus, whereas in the Xpert MTB/RIF assay a large scale validation is important to use as Panel test since, the sites we used for this study in Addis Ababa, are small compared to the general population in Ethiopian context.
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    Assesement of Fathers Attitude Towards Breast Feeding and Associated Factors Among Fathers who Acompaing Their Partner for Delivery in Selected Govemental Hospitals Ofaddis Abeba, Ethopia, 2017
    (Addis Ababa University, 2017-06) Birhanu, Elasbet; Fantahun, Addishiwot (PhD)
    Background Breast feeding is unambiguously important for child growth and development. World health organization and united nation children’s emergency international fund recommended that children get breast milk exclusively for 6 months and extends to 24 months with other additional feedings. However, these days there are many problems are seen in relation to initiation and continuation of breast feeding practice. Out of those problems, fathers support and father’s attitude towards breast feeding is directly or indirectly affects initiation and continuation rate of breast feeding. Objective The aim of this study will be to investigate father’s attitude towards breast feeding and its associated factors in selected governmental hospitals from April 17 to May 17, 2017 in Addis Ababa Ethiopia. Methods The study was used institutional based cross-sectional quantitative method with structured interview as a data collection tool. In order to select sampling units from the given 8 hospitals, lottery method was used and 4 hospitals were selected. A total of 422 fathers participated in this study and allocate to each selected hospitals proportion to size. To select study participant’s convenience sampling was used. All interview questions analyzed by using SPSS version 20 for data entry and analysis. Results A total of 243(52%) of participants had negative attitude towards breast feeding poor breast feeding knowledge (35%), fathers not support in house hold chores(46.2%) and cultural role(56.9%) had association with negative attitude. Conclusion and recommendation 52% of the participants had negative attitude towards breast feeding. Good breast feeding knowledge, fathers support in house hold chores and cultural role were found to be associated with attitude about breast feeding in this study. Guide lines should be developed and implemented related to breast feeding attitude of fathers. Key words: breast feeding, fathers, attitude.