Epidemiology
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Item Time to Initiation of Adjuvant Chemotherapy and its Predictors among Adult Colorectal Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia; a Retrospective Cohort Study 2013-2018.(Addis Ababa university, 2023-10-10) Lopiso Sisay; Taye GirmaColorectal cancer (CRC) is world’s third most commonly diagnosed cancer type and the second most fatal cancer globally accounting for 10% and 9.4% respectively in 2020. Objectives: to assess the time to initiation of Adjuvant Chemotherapy (ACT) and its predictors among adults with CRC at Tikur Anbesa Specialized Hospital (TASH), Ethiopia, 2013 -2018Item Compiled Body of Works in Field Epidemiology(Addis Ababa university, 2023-06-22) Abebe Alemayehu; Ali AhmedThe Ethiopia Field Epidemiology Training Program (EFETP) is a two year an in-service training program in field epidemiology adapted from the United States Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS) program. The program is designed to assist the Ministry of Health in building or strengthening health systems by recruiting promising health workers and building their competencies through on-the-job mentorship and training. The EFETP program has two main components, each of which contributes to the award of the Master‗s degree (MPH) in Field Epidemiology. A classroom-teaching component (25%) and practical attachment or field placement component (75%) consisting of disease investigations, surveillance evaluations, surveys, and applied research on national health problemsItem Compiled Body of works in Field Epidemiology(Addis Ababa University, 2023-05) File,Ebsa; Deyasa,Negussie(Prof.); Ayele,Wondimu(Dr.)The Ethiopia Field Epidemiology and Training Programme (EFETP), which was inspired by the Centers for Disease Control and Prevention (CDC) in the United States, is a two-year in- service training program in field epidemiology. The program's goal is to recruit promising healthcare professionals and develop their competencies through on-the-job mentoring and training in order to help the Ministry of Health establish or strengthen health systems. The program is divided into two primary parts: classroom instruction (25%) and practical application or field placement (75%). The residency culminates in a final output of works that is equivalent to a thesis for the graduate school of public health in order to meet a portion of the requirements for a master's degree in field epidemiology. Eight chapters make up these outputs of work, which include a report on outbreak investigations, an analysis of surveillance data, an assessment of a surveillance system, a description of a health profile, scientific manuscripts for peer-reviewed journals, abstracts for scientific presentations, a proposal for an epidemiological research project, and yet another output report. Different approaches were used to complete these work products. In chapter one, two outbreaks were looked into: a malaria outbreak in the Loma district of the Dawro zone, in the SWEP region of Ethiopia, in June 2022; and a measles outbreak in the Raso district of the Afder zone, in the Somali region of Ethiopia, in May 2022. Chapters 2, 3, and 4 contain: Surveillance Data Analysis: National Malaria Surveillance Data Analysis, Ethiopia, 2016-2020 GC, Evaluation of the Malaria Surveillance System in Gambella Region, Gambella Zuria Woreda, Western Ethiopia and Health Profile Description of Bosat district, Oromia Regional State, Ethiopia 2021 included respectively. Chapters seven and eight of the document, Summary of Disaster Situation on Health and Nutrition Emergency Needs Assessment Report for the South West Ethiopia Region, Dawro Zone, June 2022, and Protocol/Proposal for Epidemiologic Research Project, which titled “Distribution of Malaria and Mosquito Species along Pagag Point of Entry in Lare Woreda, Gambella, Ethiopia: Cross Sectional Study. Finally, chapter nine includes one additional output of National Weekly epidemiological bulletin of Week 16: April 18 – April 24, 2022.Item Addis Ababa University, College of Health Science, School of public Health, Department of Preventive Medicine, Field epidemiology and Laboratory Training Program ( EFELTP)(Addis Ababa University, 2023-09) Tessema,Emiru; Worku,Alemayehu(Prof.); Abagaro,Abdulnasir (MPH, PhD Candidate)Background: Ninety-Four per cent (94%) of malaria morbidity and mortality cases are attributed to the African region. Ethiopia is among ten African countries contributing to these cases. 60% of the Ethiopian population lives in malaria-risk areas with different levels of malaria risk. Although the country has made significant progress towards malaria elimination, seasonal outbreaks persistently resurface, including in previously non-malarious areas where people had low immunity. Abobo woreda is an epidemic-prone high- transmission area with stable transmission. However, the district experienced a malaria outbreak starting in the 21st Epi week of 2022, which prompted the investigation. Methods-We did a descriptive study, followed by two case-control studies with randomly chosen cases (86) and community controls (172). The malaria cases were confirmed with RDT or microscopy, and the controls had no symptoms during the outbreak. We collected data through a questionnaire given by an interviewer, entered it into Epi-info version-7, and analyzed it with SPSS version 20. We did bivariate and multivariable logistic regression to find out what factors caused malaria. Result: Between the 21st and 36th Epi weeks of 2022, 198 cases of malaria were reported, with no deaths. With a mean age of 22 (12.31 SD) years, the overall attack rate was 20.2/1000. The two most common species were Plasmodium vivax (PF) 71 (8%) and Plasmodium falciparum (PF) 755. Breeding location close to the house (AOR = 4.28; 95% CI: 1.8–10.27), sleeping outside (AOR = 3.94; 95% CI: 2.18–7.37), and a residence with open eaves (AOR = 3.82; 95% CI: 1.97–7.93) were all independent risk variables. Regular use of ITNS (AOR=0.195; 95%CI: 0.068–0.56), IRS-sprayed homes (AOR=0.42; 95%CI: 0.22-0.80), awareness of malaria transmission (AOR=0.51; 95%CI: 0.28–0.93), and preventative and control measures (AOR=0.50; 95%CI: 0.27–0.93) were protective measures. Conclusion and recommendation: Risk factors included sleeping outside, being close to a breading site, and having an open ceiling. However, taking preventative steps like utilizing ITNS, having your house sprayed with IRS, and being knowledgeable about prevention and transmission were all necessary. Regular environmental monitoring, a strengthened surveillance system, communication about behavioral change, ensuring sustainable use of COMPILED BODY OF WORK IN FIELD EPIDEMIOLOGY BY EMIRU TESSEMA,2023 ITNS, and more research with an emphasis on entomology and climate variables were among our recommendations.Item Association between multimorbidity and blood glucose control among patients with type 2 diabetes mellitus at selected Health Centers, Addis Ababa, Ethiopia, 2024: Unmatched case-control study(Addis Ababa University, 2024-06) Tegen,Ephrata; Ali,Ahmed (PhD); Seid, Yimer(MPH, PhDc)Background- Uncontrolled blood glucose level is an important public health concern due to the development of diabetic-related complications and death. Multi-morbidity is considerably more common in type 2 diabetes patients, and it can have a substantial effect on blood glucose control. However, despite a high prevalence of multimorbidity reported in Addis Ababa, its association with blood glucose control was not well studied in this study area. Objective- To assess the association between multi-morbidity and blood glucose control among adult type 2 diabetes patients at selected health centers, Addis Ababa, Ethiopia, 2024. Methods- A facility-based unmatched case-control study was carried out from February 12 to March 31, 2024, using interviewer-administered structured questionnaires and medical records. A multi-stage sampling method was employed in the selection of study participants. Data were collected using KoboToolbox and exported to the Statistical Package for Social Science version 26.0 for analysis. Bivariable and Multi-variable logistic regressions were utilized to determine the association between multi-morbidity and blood glucose control and other determinant factors associated with uncontrolled blood glucose. Results- The response rate of the study participants was 98%. From the participants, 148(43.3%) had multi-morbidity, of which 92 (80.7%) had uncontrolled blood glucose control. The presence of multi-morbidity (AOR: 6.52, CI: 2.92-14.54) was significantly associated with uncontrolled blood glucose levels. Moreover, medication non-adherence (AOR: 2.42, CI: 1.03-5.71), using oral hypoglycemic agent alone (AOR: 0.11, CI: 0.01-0.82), having polypharmacy (AOR: 0.03, CI: 0.01-0.16), dietary non-compliance (AOR: 4.44, CI: 1.8-10.94) and alcohol consumption (AOR: 3.63, CI: 1.36-9.69) were determinants of uncontrolled blood glucose level. Conclusion: This study showed that significant number of patients with type 2 diabetes mellitus failed to control their blood glucose levels due to additional non-communicable chronic diseases they had. Therefore, need to consider comprehensive patient-centered approaches that take into account the complex care needs of those patients living with multi-morbidity.Item Economic Burden of Diabetesmellitus on Patients and Their Families Attending Hospitals in Addis Ababa, Ethiopia(Addis Ababa University, 2023-12-13) Kilil Kebron; Sale WorknehDiabetes is a chronic disease that imposes a substantial economic burden on countries, health systems, patients, and their families. The cost of treating and caring for diabetes puts a significant strain on household budgets exposing household for catastrophic expenditure.Item Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology(Addis Ababa University, 2024-10) G/Mariam,Ashenafi; Taye,Girma(BSc, MSc, PhD, Ass.Prof.); Adissie,Adamu(MD, PHD); Abagero,Abdulnasir(MPH, PhD candidate)Introduction: Any one of the four closely related viral serotypes can cause dengue. Mosquito species is a vector for dengue for human transmission. The disease is most common in tropical and subtropical areas, where year-round transmission is made possible by mosquito vectors sustained by favorable environmental circumstances. The first-ever DF outbreak in the Somali region occurred in Godey Town, Ethiopia in 2014; a comparable outbreak was documented in Dire Dawa, Ethiopia, in 2013. The purpose of this study is to look into the outbreak, identify the etiology, and identify risk factors related to it. Methods: A total of 117 individuals were carefully chosen to participate in a community-based case-control study, consisting of 39 cases and 78 controls in a 1:2 ratio. The distribution of the disease by person, place, and time was assessed through a descriptive study based on the total number of cases during the outbreak. Following this, an unmatched case-control investigation was conducted to confirm the outbreak and identify its risk factors. Data were collected using structured questionnaires. Using Epi Info, the data was entered, and SPSS version 26 was used for analysis. To determine the relationship between the independent variable and the outcome variable, binary and multivariable logistic regression models were used. A p-value of 0.05 or less indicated that a variable was significant. Results: A total of 105 cases were found, and their attack rate and case fatality rate were 1.64 per 1000 and 0, respectively. 52 (49.5%) of these were female and 53 (50.5%) were male. Of 15 kebeles 14 kebeles from Gode town own are affected. The age group of 21 to 30 years old had the greatest age-specific attack rate and 15 kebeles 02 had the highest attack rate of 20.51/1000 population. An unmatched case-control study was conducted with 39 cases and 78 controls. having LLINs (AOR 0.038, 95% CI 0.003-0.543) and applying mosquito repellent on the skin (AOR 0.092, 95% CI 0.023-0.372) were found to be protective factors. On the other hand, not using LLINs (AOR 13.208, 95% CI 2.898-60.207) and the presence of larvae in the household (AOR 5.723, 95% CI 1.592-20.573) were identified as significant risk factors associated with dengue fever. Conclusion: having latrines and the use of mosquito repellent on your skin have a proactive factor so it needs to be aware the community and mosquito repellent supply should be encouraged. No usage of LLINs and the presence of Larvae in the household have a significant association with the disease pattern of the area so needs to conduct vector control activities at the household level and enhance risk communication and community engagement activitiesItem Time to Recovery and Predictors among COVID-19 Patients Under Home-Based Isolation and Care Services in Addis Ababa,Ethiopia.(Addis Ababa University, 2024-06) Bizuneh,Ayele; Asfaw,Zeytu Gashaw(PhD); Wondimagegnehu,Abigiya(MPH, PhD Fellow)Background: The COVID-19 pandemic has significantly impacted health systems globally. Ethiopia has recorded over 7,574 COVID-19-related deaths and nearly 500,000 confirmed cases. While 81.3% of cases in Ethiopia have been handled via home-based isolation and Care (HBIC), there are still uncertainties about the health consequences for patients receiving this type of care. Objectives: The objective of this study was to investigate the recovery experience of COVID-19 patients under home-based isolation and care services in Addis Ababa between January 17, 2023 and June 23, 2023. This includes time to recovery, recovery incidence rates, and associated factors. Methods: This retrospective cohort study was conducted in Addis Ababa from January 20,2024 to June 23, 2024. The study population comprised 272 COVID-19 patients who received HBIC from January 17 to June 23, 2023. Secondary data from the Ethiopian Public Health Institute and Armauer Hansen Research Institute was analyzed using Kaplan-Meier survival estimates and Cox regression model. Results: The analysis revealed an overall median recovery time of 7 days among COVID-19 patients within the HBIC. Specifically, vaccinated individuals had median recovery time of 7 days, while unvaccinated individuals had median recovery time of 8 days. The findings also indicated incidence density rates of 11.64, 13.19, and 10.34 recoveries per 100 person-days for the overall, vaccinated patients, and unvaccinated patients, respectively. Factors associated with time to recovery among COVID-19 patients under HBIC were: being vaccinated (AHR: 1.62, 95% CI: 1.18-2.23), Aged 30-39 (AHR: 2.13, 95% CI: 1.27-3.58), Absence of comorbidities (AHR: 1.87, 95% CI: 1.16-3.01), Prior infection (AHR: 2.11, 95% CI: 1.37-3.22), using public transport (AHR: 0.45, 95% CI: 0.32-0.65), smoking history (AHR: 0.44, 95% CI: 0.22-0.86), absence of mask use (AHR: 0.39, 95% CI: 0.28-0.55), lack of hand hygiene practice (AHR: 0.72, 95% CI: 0.53-0.99), and BMI ≤18.5 Kg/M2 (AHR: 0.67, 95% CI: 0.48-0.95) or 25-29.9 Kg/M2 (AHR: 0.38, 95% CI: 0.15-0.96). Conclusion: This study revealed the median time, rate and associated factors under home based isolation and care service. The relatively shorter median time among vaccinated groups indicate the viability of vaccination in recovery trajectories. The varying recovery rate with the different covariates and significant association of those covariates with time to recovery indicates the need for considering tailored interventions in those patients.Item Compiled Body of Works in Field Epidemiology(Addis Ababa University, 2024-10) Zeben,Eshetu; Deyessa,Negussie((MD, PhD- ); Seid,Yimer(MPH, Ass.Prof.); Abebe, Yonas (BSc, MPH)Despite numerous interventions aimed at combating infectious diseases, they continue to pose a significant global health challenge. Prevention is a fundamental component of the Ethiopian government's policy agenda, which includes initiatives to bolster immune system strength. The Ethiopia Field Epidemiology Training Program, overseen by the U.S. Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service (EIS), endeavors to enhance the diagnostic and preventive capacities of public health professionals in relation to critical diseases. During my tenure at Addis Ababa University School of Public Health and the Oromia Regional Health Field Base (Bale Zone Health Office) from January 2023 to September 12, 2024, several notable activities were undertaken. These encompassed the analysis of severe acute malnutrition (SAM) survey data from January 3 to January 25, 2023, scrutiny of Woreda health profile data from February 13 to February 30, 2023, investigation of a cholera outbreak from January 19 to February 2023, monitoring of a measles outbreak from June 19 to September 17, 2023, and the production of a research paper on type 2 diabetes self-care practices and associated factors among patients attending public hospitals in the Bale Zone from February 5 to March 22, 2024. Additionally, we conducted various training sessions and composed essays and articles that were published in reputable journals. However, this document only includes detailed information from one weekly report, with access to others provided through hyperlinks. The measles investigation, conducted between June 27 and September 17, 2023, identified 48 cases and 2 deaths in Agarfa Woreda, Bale zone, Oromia Region. To address these issues, we suggest intensifying the utilization of the second measles vaccine and raising public awareness about its significance. Between January 2023 and February 2023, there were cholera outbreak 25 cases of Vibrio cholera, with no fatalities. The causes of cholera include security concerns, inadequate infrastructure, insufficient healthcare services, and lack of clean water. To combat this, we propose providing clean and adequate water, avoiding contact with infected individuals, actively identifying affected individuals, delivering emergency treatment, and developing cholera vaccines. Surveillance data analysis of severe acute malnutrition (SAM) in the Bale one health office demonstrated a gradual increase in cases over the years, particularly in 2020 G.C.; However, deaths resulting from SAM decreased during this period. The Serveillance Evaluation System on weekly disease and surveillance (WDSS) and Maternal and perinatal death (MPDSR) also assessed the comprehensiveness, reason-ability, flexibility, and effectiveness of the analysis and data management processes, although timeliness, consistency, and Representativeness were not always ensured. Maternal health services were generally commendable, but respiratory issues, diarrhea, and inadequate healthcare services were prevalent. XIV The findings of all these studies are incorporated in academic reports prepared for submission to peer-reviewed journals. A research discussion was also developed, focusing on malnutrition (SAM) data analysis in the Bale zone , Oromia Region. In July 2023, a disaster assessment was undertaken to address the cholera outbreak affecting five villages in the Bale Zone district's of Oromia Region, aiming to identify people's needs and implement public health measures. The primary health concerns identified were diarrhea, malaria, and other infectious diseases. Our research study concentrates on type 2 diabetic patients admitted to public hospitals in the Bale Districts, Oromia Region, and their personal experiences with diabetes. We conduct our final thesis research on self-care practices and associated factors among type 2 diabetes mellitus patients attending public hospitals in Bale zone, Oromia region, Ethiopia. We selected 411 patients for a cross-sectional study using systematic random sampling and collected information regarding social factors, medical records, diabetes self- management, medication adherence, and self-care via the KoBotool database. The findings indicated that 59.4% of Type 2 Diabetes Mellitus patients demonstrated good self-care level, while 40.6% exhibited poor self-care behavior. Enhanced self-care was positively associated with higher income, self-employment, diabetes education, membership in a diabetes organization, knowledge about care, positive self-esteem, and absence of diabetes complications. Furthermore, We present the weekly epidemiological bulletin from the Public health emergency management (PHEM) reports of the Bale zone health office and Oromia Regional Health Directorates for weeks 1-4, 28- 41, and 42-49 of 2023.Item Compiled Body of Work in Field Epidemiology(Addis Ababa University, 2024-09) Mohammed,Faris Sulyman; Ali,Ahmed(PHD, Professor); Getachew,Sefonias (PHD)Introduction: Cholera is a diarrheal illness caused by the gram-negative bacterium Vibrio cholera. It is marked by severe watery diarrhea, which can rapidly result in dehydration and death if left untreated. In June 2023, an unusual increase in cases of watery diarrhea was reported in Soro Woreda, Hadiya Zone. Methods: Between September 1 and October 30, 2023, a descriptive analysis was conducted on the line list of 101 cholera patients. We defined cases, selected study participants, and performed descriptive analysis. We analyzed data in Microsoft Excel 2010, calculating and describing frequency, percentage, mean and median; attack rate (AR), and case fatality rate. Results: The line list showed 101 cases and three deaths, with a CFR of 2.9%. Of the cases, 44 (43.5%) were male, while 57 (56.4%) were female. The age-specific case fatality rate was highest among those aged 15 to 44 which was 43 (43.6). The kebele with the most reported cases was Oda 46 (45.5%). The outbreak began on July 7th and continued until December 30th, 2023. Of the overall cases, 66 (66.3%) were seriously dehydrated. Conclusion: Cholera epidemic with a higher overall attack and case fatality rate was confirmed. Females were more affected than males, and the majority of those affected were above the age of fifteen. We advocate preventing future outbreaks, implementing response measures to reduce morbidity and mortality, and developing future cholera prevention policies for the Zone.Item Residential Disparities in Iron Utilization during Pregnancy in Ethiopia(Addis Ababa University, 2024-05) Tesfaye,Hanim; Deressa,Wakgari(Prof.); Kifle,Awgichew(Assis. Prof.)Background: Low levels of hemoglobin are the major cause of symptoms related to low circulation of oxygen throughout the body. Taking iron supplements during the time of pregnancy helps pregnant women accumulate the additional blood they need. In Ethiopia very few pregnant women take iron supplement for more than 90 days. Therefore, this research aims to identify factors that affect iron utilization during pregnancy and explains between rural-urban differences in Iron Utilization during pregnancy Method: The 2022 Ethiopian National Health Equity Survey (ENHES) dataset was used and secondary analysis was performed. A sample of 5,316 of mothers who gave birth five years prior to the study were those that were included in the analysis process. Multi-level logistic regression analysis was done by STATA version 16.0 and blinder Oaxaca decomposition were applied. Results: This study revealed that 37.2% of the women took IFA below the recommended period during pregnancy. Rural – urban differences in the utilization of IFAS women was showed as 9%. In addition, women in the Afar region had the lowest usage of iron. Married women [AOR = 1.40, 95% CI: (1.04, 1.88)], women with higher wealth status [AOR= 1.95, 95% CI:(1.45, 2.62)], women enrolled in community-based health insurance [AOR = 1.50, 95% CI:(1.30, 1.74)], and women who had more than four antenatal (ANC) visits [AOR = 1.62, 95% CI: (1.42, 1.83)] showed a higher odd to use iron supplementation. Conversely, women with larger family sizes (more than 6 members) [AOR = 0.65, 95% CI (0.54, 0.80)] and women who reside more than 5 kilometers away from a healthcare facility [AOR = 0.87, 95% CI:(0.05, 0.15)] were less inclined to take iron supplements during pregnancy. Conclusion: The findings show that some of the factors that increase iron utilization are high wealth, using community-based health insurance program, being married and attending antenatal care. On the other hand, mothers who have large family sizes and live more than 5km far from health centers are less probable to take iron supplements. Promoting women’s education and maternal health services like ANC visits and participating in community-based health insurance (CBHI); specifically in growing regions and rural parts.Item Assessment of the screening uptake and health facility related facilitators, and barriers for cervical cancer screening uptake at primary health care facilities in southeast Oromia, Ethiopia(Addis Ababa University, 2024-11) Amberbi, Melat; Gizaw,Muluken (PhD)Background: Cervical cancer is the second most common cancer-causing morbidity and mortality among women in Ethiopia, yet screening uptake is low despite recommended decentralized approaches and awareness initiatives. The opportunistic screening strategy faces significant health facility barriers, including access issues, financial constraints, and inadequate provider training. These obstacles impede women's participation in screening programs. Consequently, many miss opportunities for early detection and treatment, negatively impacting health outcomes. Therefore, to maximize the uptake and meet the purpose of efforts to enhance cervical cancer screening uptake, it is necessary to know more about health facility related barriers and facilitators for cervical cancer screening uptake. Objectives: To assess cervical cancer screening uptake and health facility related facilitators, and barriers for cervical cancer screening uptake at primary health care facilities in Ethiopia, 2024. Methods: An explanatory sequential mixed study approach of qualitative interviews (n=16) and cross sectional study among 629 women was conducted from January to September 2024 at six health care facilities in southeast Oromia. Systematic random sampling was employed to recruit survey participants from the selected health facilities while purposive sampling was used for key informant interviews. Descriptive statistics were used to summarize the quantitative data and multivariable logistic regression was employed to identified health facility related facilitators, and barriers for cervical cancer screening uptake. Qualitative data were analyzed using thematic analysis approach through preparing themes and subthemes to change raw data to categorized form. Results: Cervical cancer screening uptake among women in this study population was 15.6% (95% CI 12.9, 18.6). TV/Radio was the main source of information about cervical cancer and its screening. age group of 40-44 years (AOR= 3.34; 95% CI (1.27, 8.78)), completed college and above (AOR=4.14, 95% CI (1.1, 15.8)), income level of >7800 (AOR = 8.3; 95% CI (1.86, 35.54)), received CC counseling (AOR=6.52, 95% CI (3.1, 14.1)) and good knowledge (AOR = 6.53; 95% CI (3.2, 13.34)) were significantly associated with cervical cancer screening uptake. The qualitative findings identified feeling healthy, embarrassment, lack of recommendation by HCP, service interruption, availability of traditional treatment as barriers for cervical cancer screening uptake. Furthermore, availability of trained HCP, availability of equipment, and information dissemination through mass media, spousal support, and availability of female provider mentioned as facilitators for CC screening uptake. Conclusions and recommendation: Cervical cancer screening uptake among eligible women was significantly lower in the study area. Age group, women education level, knowledge of women, income level, and availability of CC counselling were factors associated with screening uptake. Furthermore lack of recommendation by HCP and lack of resources including screening room and number of provider were identified as health system related barriers. Therefore, it is necessary to execute planned health education and awareness development at health facilities, particularly in primary health care, in order to increase the adoption of cervical cancer screening services. Additionally, all women who attend the health center for any service should get counselling regarding the advantages of CC screeningItem Infection Prevention compliance and Associated Factors Among Nurses Working at Dialysis Units for Chronic Kidney Disease Patients in Addis Ababa(Addis Ababa University, 2024-06) Nadew,Tigle; Mekonnen,Hussen(PhD); Wondimagegnehu,Abigiya(PhD candidate)Background: Chronic kidney disease patients on hemodialysis have an increased risk of infection due to the nature of the disease and the type of treatment they receive. In many developing countries including Ethiopia, there is low level of compliance of infection prevention practice between medical professionals, despite the rise of highly contagious illnesses. Effective interventions can be developed by critically assessing the elements that contribute to this problem. Objective: To assess infection prevention compliance and associated factors among nurses working at dialysis units for chronic kidney disease patients in Addis Ababa. Methods: A facility-based cross-sectional study was carried out among nurses working at dialysis units for chronic kidney disease patients in Addis Ababa from Jan-March 2024. A total of 251 nurses were included. A structured self-administered questionnaire which has eight components and a checklist were used for data collection. Descriptive statistics and correlation estimates were used. For regression analysis, the study applies Principal Component Analysis to generate an index. Finally, logistic regression was done and adjusted odds ratio (AOR) with a 95% confidence interval was estimated in the final model. P-values of below 0.05 were regarded as significantly associated variables. Results: The result showed that 105 nurses 45.66% were non compliant to infection prevention and control practices. The multivariable logistic regression result indicates, monthly salary10,000.00-20,000.00) [(AOR:3.23 ,95%CI (1.20-8.70)], nurses who had duty [(AOR: 0.48 ,95%CI (0.25-0.93)], and work environment factor [(AOR: 6.57 ,95%CI (3.38-12.78)] were predictors of infection prevention compliance. Conclusion and recommendation: Infection prevention compliance was not sufficiently practiced among dialysis unit nurses. Monthly salary, frequency of duty and work environment factors were factors associated with infection prevention compliance. Thus, intervention should focus on encouraging nurses by giving competitive benefit through salary increment, decreasing workload and creating good work environmental factors by ensuring sufficient and sustainable resources.Item Assessment of Ethical Issues Among Women Attending Cervical Cancer Screening in Public Health Facilities, Addis Ababa, Ethiopia: A Cross- Sectional Study(Addis Ababa University, 2024-10) Solomon,Yeelshaday; Gizaw,Muluken (PhD); Merawi,Fasil(PhD)Background: Cervical cancer is the fourth leading cause of cancer deaths among women, resulting in 350,000 deaths worldwide in 2022. In Ethiopia, it is the second most common cancer, with 8,168 cases reported. Screenings like visual inspection with acetic acid (VIA) are essential for early detection, but challenges related to informed consent, privacy, and confidentiality persists. This study aims to assess key ethical issues in cervical cancer screening practices to enhance these programs. Objectives: To assess ethical issues among women attending cervical cancer screening in public health facilities in Addis Ababa. Method: A cross-sectional study was conducted at selected governmental health centers and referral hospitals, involving 422 women undergoing cervical cancer screening. Data analyzed using SPSS Statistics 27. Descriptive analyses assessed frequencies of privacy, confidentiality, and informed consent issues, while chi-square tests examined relationships among variables. Results: Participants reported high satisfaction, with 97.4% noting positive interactions with health workers and 98.6% receiving clear information. However, 5% experienced privacy concerns during examinations, and 3.3% reported unauthorized information disclosure. Significant associations were found: marital status influenced confidentiality assurance (p = .010), facility type affected confidentiality (p < .001), and both age (p = .005) and employment status (p = .022) impacted information clarity. Conclusion: High satisfaction with cervical cancer screening exists in Addis Ababa, but privacy and confidentiality concerns remain. Recommendation: Enhance ethical practices through improved privacy measures, provider training, and patient involvement; use qualitative research to assess impact.Item Compiled Body of Works in Field Epidemiology in Ethiopia(Addis Ababa University, 2011-02) Beyene,Zayeda; Luce,Richard( DVM, MPH); Addissie,Adamu (MD, MPH, MA)Background: Malaria is a major cause of mortality and morbidity in Ethiopia. The disease is distributed in most parts of the country including Tigray. In April 2009 surveillance information and notification to the Regional Health Bureau suggested an increase in the number of malaria cases in one district. An investigation was conducted to describe the epidemiology of the outbreak and develop recommendations and guidance to improve control efforts. Methods: Secondary data was collected from logbooks in the district health office and health centre, entered into an electronic database and analyzed was using Excel. Results: 1775 suspected malaria cases and 1 death were identified between April 22 and May 11. Cases were reported from 8 villages; 930 (52.3%) were male, 685 (39%) were between 15 and 44 years of age. Rapid diagnostic tests were performed on 854 blood samples; 543 (64%) were positive for Plasmodium falciparum. The highest attack rate (AR) occurred in the villages of Asteleke (AR 47.4%; 609/1285) and Tseberek (AR 33.6%; 390/1160). Mass febrile treatment with Co-Artem was undertaken in the district. Distribution of insecticide treated nets (ITNs) had last occurred in 2005. Conclusion: A large outbreak of Plasmodium falciparum was confirmed; however, there was an extended delay in response and investigation activities. ITNs were not in use and increased frequency of distribution is necessary. Notification procedures must be improved to decrease delays in notification and facilitate earlier response activities.Item Assessment of the Validity and Predictive Performance of Nutritional Risk Screening (NRS 2002) tool in Adult Patients Admitted to Intensive Care Units in Hospitals in Addis Ababa, Ethiopia, 2024 GC: A Facility-Based Prospective Cohort Study(Addis Ababa University, 2024-10-17) Sihawe Derese; Bilal ShikurMalnutrition is a major concern for patients admitted to Intensive Care Units both globally and in developing countries, and is associated with poor clinical outcomes such as prolonged length of hospital stay, increased mortality, and complications. Quick and simple nutrition screening methods can help to direct nutrition therapy in the intensive care unit. Ethiopia currently lacks validated tools for conducting nutritional screening among critically ill patients. The need for a validated tool to assess malnutrition risk, and the potential benefits it offers among critically ill patients in Ethiopia are the driving forces behind this studyItem Ethiopia Field Epidemiology and Laborarory Training Program (Efeltp)Compiled Body of Works in Field Epidemiology(Addis Ababa University, 2024-07-05) Yohanis Tesfaye; Abdulnasir AbegaroUncontrolled hypertension accounts for nearly 1 billion, accounts 66.8% in developed and 61.6% in developing countries, sub-Saharan Africa (SSA) is estimated 70% and Ethiopia ranges from 37-63%. Blood pressure control rates are critically low,with 30% of individuals achieving control at levels of 140/90mmHg.And the impact of social determinants on hypertension attributed mortality in the context of dveloping countries is not well understood, particularly in Ethiopia studies conducted on prevalence and determinants of uncontrolled HTN is limited and none research was conducted as Sheger city. Thus, the aim of the study was to determine the prevalence and determinants of uncontrolled hypertension at Sheger citItem Field Epidemiology Training Program (FETP) Compiled Body of Works in Field Epidemiology(Addis Ababa University, 2024-10-13) Gashaw Beyene; Alemayehu WorkuMalaria is a protozoal disease caused by Plasmodium. It is one of the public health threats of the world, mainly affecting sub-Saharan Africa. An outbreak of malaria was reported from Sofi district of Hareri region in June 2024 and we investigated the outbreak to identify the risk factors.Item Success Rate and Time-To-Live Birth of Fertility Treatments among Couples Attending Fertility Centers in Addis Ababa, Ethiopia.(Addis Ababa University, 2024-06) Kasahun,Saron; Asfaw,Zeytu Gashaw (PhD)Background: Despite impacting one in six individuals globally, infertility remains a neglected public health issue, particularly in low- and middle-income countries like Ethiopia. The emergence of local fertility centers offers promising alternatives to costly outgoing travel, crucial data on treatment success rates remains scarce. Objective: To assess the treatment success rate and time to live birth of infertility treatments among couples attending public and private fertility centers in Addis Ababa, Ethiopia. Methods: A cross-sectional study using data from patient chart was conducted among 411 couples from St. Paul’s Hospital Millennium Medical College and Ethio fertility and IVF center in Addis Ababa. A simple random sampling technique was used to select samples from participants who started fertility treatments from March 2021 to February 2023. Data was collected by three nurses who work at the facilities using the data abstraction format and questionnaire under close supervision. Descriptive statistics and binary logistic regression analysis were used to assess the success rates of treatments in terms of clinical pregnancy, and Kaplan-Meier, Life Table, log-rank test and Cox regression were used to analyze the data on the time-to-live birth. Results: Among the 411 couples who took fertility treatments, 47% and 33.1% were able to achieve clinical pregnancy and live birth, respectively. In-vitro fertilization has 39.3% success rate per cycle whereas, Intrauterine insemination registered 12% success per cycle. In terms of live birth, In-vitro fertilization procedure also achieved highest hazard of live birth compared to Intrauterine insemination. Woman’s age ≥35, increased duration of infertility, and the presence of Tubal factor infertility were negative predictors of clinical pregnancy rate while, Antral follicle count ≥5, increase in number of treatment cycles, increase in endometrial thickness and increase in number of frozen cycle of IVF/ICSI indicated a higher chance of treatment success. Age ≥35, longer duration of infertility, frozen cycle type, AFC <5 and fewer number of treatment cycles had negative influence on live birth compared to their counter others. Conclusion: Younger women and couples with repeated treatment cycles have better outcomes at clinical pregnancy and live birth. Assisted reproductive technology in Addis Ababa reach internationally comparable levels. Early intervention of infertility and repeated treatment cycles should be made available for all parts of Ethiopia and public awareness should be createdItem Examining the Association between diabetic health literacy and blood glucose control among Patients with Diabetes at Public Health Facilities in Bishoftu Town, Oromia, Ethiopia 2023/2024: Unmatched Case-Control Study.(Addis Ababa University, 2024-06) Asmelash,Lidya; Deyess,Negussie( (MD, PhD); Seid ,Yimer (BSc, MPH, PhD Candidate)Background: Uncontrolled blood glucose levels in most diabetes patients result from poor diabetes health literacy and are linked with significant mortality and morbidity. Diabetes patients with poor diabetic health literacy may have inadequate glycemic control likely to experience complications from the disease. However, insufficient studies support such a hypothesis in most low-income countries. Therefore, the main goal of this study is to investigate the link between diabetic health literacy and blood glucose levels in diabetic patients. Methods: A health facility-based case-control study was carried out in Bishoftu town, involving all individuals diagnosed with DM who began follow-up. Cases included diabetic patients with uncontrolled blood glucose, while controls consisted of diabetic patients with controlled blood glucose. The sample size was determined using Epi-Info, comprising 94 cases and 276 controls. A structured, interview-administered questionnaire was utilized to gather data. The data analysis was conducted using STATA version 17. Descriptive analysis was conducted using simple frequencies and cross-tabulations to examine sociodemographic characteristics and other independent variables. Bivariate data analysis checked the correlation between diabetic health literacy and other independent variables against blood glucose level. Moreover, a multivariable analysis using binary logistic regression was conducted to identify independent predictors of blood glucose levels. Results: In this study, average age (SD) to the cases and the controls were 48 (17.2) and 47 (17.3), respectively. Diabetic patients with uncontrolled blood glucose levels were 4.7 times more likely to have an impact on low health literacy than patients with controlled blood glucose levels (AOR = 4.7, 95%CI: 2.16, 10.24) and 2.9 times more likely to have an impact on moderate health literacy than patients with controlled blood glucose levels (AOR = 2.9, 95%CI: 1.37, 6.02), Patients who exercised physically (AOR= 0.41, 95%CI: 0.21, 0.78), good treatment adherence (AOR= 0.44, 95%CI: 0.22, 0.87) were statistically significant factor with uncontrolled blood glucose level. Conclusion: The study conducted on the link among health literacy of diabetes and blood glucose control levels among diabetic patients was identified several factors such as low and moderate diabetic health literacy older age, engagement in physical activities and good adherence to treatment were associated with achieving the target of blood glucose level control.