Internal Medicine

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    Prevalence of Pulmonary Hypertension and its Associated Factors among Chronic Kidney Disease Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-04-05) Yemisrach Begasha; Hanan Yusuf
    Background: Pulmonary Hypertension (PH) is associated with high morbidity and mortality in chronic kidney disease (CKD) including patients on dialysis, but its magnitude remains unknown in Ethiopia. Objective: To determine the prevalence of PH and its associated factors among CKD patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A four-year retrospective study was conducted among patients with CKD who have follow-ups from (sept.2020 to sept.2024) at renal and diabetic clinics in Tikur Anbessa Specialized Hospital, Ethiopia. The data was extracted using the Kobo collected from the patient's medical record chart and the electronic medical records software. We used SPSS version 27.1 for data cleaning and analysis. A logistic regression analysis was used to identify the variables associated with the pulmonary hypertension risk. All variables with a p-value. Results: A total of 243 chronic kidney disease patients were included, with a mean age of 60.95 ± 12.53 years, and 61.7% were male. The prevalence of pulmonary hypertension (PH) was 16.04% (95% CI: 11.8–21.7%), with 6.2% classified as severe. Advanced CKD (stages 3–5) (AOR: 3.32, 95% CI: 1.95–11.58, p=0.048), type 2 diabetes mellitus (AOR: 3.18, 95% CI: 1.28 7.89, p=0.01), and hypertension (AOR: 3.11, 95% CI: 1.35–7.19, p=0.008) were identified as independent risk factors for PH. Conclusion and recommendations: Pulmonary hypertension (PH) is a significant comorbidity among Ethiopian CKD patients, with modifiable risk factors contributing to its development. These findings highlight the need for routine PH screening in high-risk CKD populations and context-specific management strategies in resource-limited setups. Keywords: Pulmonary hypertension, Chronic kidney disease, Prevalence, Risk factors, Ethiopia.
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    Procedural Success Rate and its Associated Factors of Transcatheter Atrial Septal Defect Device Closure among Adolescent and Adult Patients In Ethiopia, 2024
    (Addis Ababa University, 2025-04-05) Derebe Assefa; Desalew Mekonnen
    Background – Atrial septal defect (ASD) is the leading congenital heart disease(CHD) in adults and its prevalence is increasing. Secundum ASD is the most common type of ASD, and it results in different complications if left untreated. Surgery has been the only option to close ASD for several decades. Transcatheter ASD device closure has revolutionized and replaced surgery due to its lower complication rate, avoidance of cardiopulmonary bypass, lower comorbidity, lower cost, avoidance of sternotomy scar and shorter hospital stay. But the efficacy and safety of this noninvasive procedure is not well known in East Africa, including Ethiopia. Therefore, the aim of the study is to assess the success rate and its predictors of transcatheter ASD device closure in Ethiopia. Method – Institution-based retrospective study was conducted at Cardiac Center Ethiopia(CCE) from May 2024 to December 2024. Consecutive adolescent and adult patients who underwent transcatheter ASD device closure from September 2009 to August 2024 were included. The data on sociodemographic characteristics, clinical factors, comorbidities and procedural variables were collected from patient medical records using a structured data abstraction checklist. The data was analyzed with SPSS version 26. Result – A total of 71 patients were included in the study. About 80% of the patients were adults whereas the remaining 20% were adolescents and females accounted for 63.4% of the patients. Transcatheter device closure of ASD was successful in 66 of 71 patients (93%). Absence of a prominent eustachian valve was significantly associated with success rate of transcatheter ASD device closure. Device embolization was the most common complication. Conclusion – Success rate of transcatheter ASD device closure among adolescent and adult patients is effective and safe in Ethiopia. Procedural complications are rare and device embolization is the most common complication. Prominent eustachian valve is an independent predictor of procedural success rate of transcatheter ASD device closure. Keywords: Atrial septal defect, transcatheter device closure, success rate, Ethiopia
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    Inpatient Prevalence of Symptomatic Venous Thromboembolism and Associated Factors in Tuberculosis Patients, in two Major Referral Hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-06-05) Assefa Dessalegn; Hanan Yusuf
    Introduction: Background: Tuberculosis (TB) is a significant risk factor for venous thromboembolism (VTE), yet data on VTE prevalence and predictors in TB-endemic, resource limited settings including in Ethiopia remain scarce. Objective: To assess the inpatient prevalence of VTE and associated factors in TB patients in Tikur Anbesa Specialized Hospital(TASH) and St. Peter Hospital, in Addis Ababa, Ethiopia from January to December 2024. Methods: A hospital-based study was conducted among selected referral hospitals, enrolling 122 TB patients. Data on socio-demographics, clinical profiles, radiological findings, and VTE diagnosis were collected. Multivariable logistic regression identified predictors of VTE. Results: A total of 122 (93 from St. Petros Hospital and 29 from TAS) patients were hospitalized with a diagnosis of TB during the study period. They were predominantly male (60.7%) and aged 18–39 years (56.6%). The prevalence of VTE was (15/122) 12.3% (95%CI, 7.0-19.5%), with 93.3% of cases diagnosed after anti-TB treatment initiation and 50.0% (7/14) of the cases occurring after 4 weeks of anti-TB treatment. Only 41% of patients received VTE prophylaxis Anemia (64.6%females,78.4%males)andthrombocytopenia(34.4%)werecommonhematologic abnormalities. HIV is the most prevalent (23.0%) among comorbidities. Extrapulmonary TB was independently associated with VTE (adjusted odds ratio [AOR] = 5.35, 95% CI: 1.04–27.41, p = 0.04). Cavitary pulmonary TB (AOR = 6.65, p = 0.08) and female sex (AOR = 5.29, p = 0.09) showed elevated but non-significant odds. Conclusion: VTE is prevalent among hospitalized TB patients in Ethiopia, particularly those with extrapulmonary involvement. Routine screening, targeted thromboprophylaxis for high-risk subgroups (e.g., EPTB), and standardized protocols are urgently needed to mitigate morbidity in TB-endemic regions. XI Keywords: Tuberculosis, VTE, PE, DVT, Ethiopia
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    Prevalence of Osteoporosis in Rheumatoid Arthritis Patients and Associated Risk Factors at Tikur Anbassa Specialized Hospital Lancet Specialized Hospital and Rheum Rheumatology and Internal Medicine Specialized Centre, Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-04) Asres Mahder ; Abdissa Becky; Demelash Birhanu
    Background: One of the most well known extra articular consequences of RA is osteoporosis (OP), which affects nearly twice as many RA patients as the general population. Approximately 30% of RA patients had osteoporosis, compared to 17% of age and sex matched controls who had the condition. Complex processes, including the generation of inflammatory cytokines, the activation of osteoclasts, and the use of glucocorticoids to treat RA, lead to bone fragility in the disease. Objective: Assessment of the prevalence and associated risk factors of osteoporosis in rheumatoid arthritis patients at Tikur Anbessa Specialized Hospital, Lancet Specialized Hospital and Rheum Rheumatology and Internal Medicine Specialized Centre. Methods: A hospital based cross sectional study was conducted at Tikur Anbessa specialized Hospital, Lancet Specialized Hospital and Rheum Rheumatology and Internal Medicine Specialized Centre, from October 1 to November 30. Data were collected using a structured chart review administered questionnaire and data extraction form. Data were analyzed using SPSS V25. To identify associated risk factors in osteoporosis of patients with rheumatoid arthritis, bivariable and multivariable analysis were done. In our study, multivariable analysis was used, a P value of less than 0.05 was considered statistically significant. Text, tables, and graphs were used to convey the results, which were then evaluated to provide useful information. Results: The prevalence of osteoporosis was 58% among RA patients. The determinant factors of osteoporosis were age >60 compared to age 40 60 years (AOR=10.3), duration of RA >15 years compared to those with duration of RA <15 years (AOR=7.3), use of prednisolone medication (AOR=7.5), and HDL ≤40 mg (AOR=6.1). The continuous variables of age, duration of RA, serum creatinine mg/dl, and diastolic and systolic blood pressure showed a positive significant relationship with BMD. Conclusion: In this study, the prevalence of osteoporosis was 58% among RA patients. Age, duration of RA, Serum creatinine, and diastolic and systolic blood pressures were significantly associated with increased risk of osteoporosis.
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    Cytological Patterns of Patients Presenting with Lymphadenopathy in Tikur Anbessa Specialized Hospital Retrospective Cross-Sectional Study
    (Addis Ababa University, 2025-01-19) Abdurrhman Kedir; Yonas Girma
    Background: - From benign infections to rare malignancies, lymph node enlargement, or lymphadenopathy, presents a diagnostic challenge. Children often experience harmless or infectious causes, while adults face a spectrum from benign to cancerous origins. Acute or chronic, unexplained cases emerge in 0.6% of the population yearly. Though only 1.1% link to cancer, this risk increases with age. Understanding these patterns aids in the proper evaluation and management of lymphadenopathy across different patient groups. Objective – This study was intended to examine the clinicopathological characteristics and Cytological patterns in patients presenting with lymphadenopathy in Tikur Anbesa Specialized Hospital (TASH), from 2019-2023. Methods: A hospital-based retrospective cross-sectional analysis of all the cases of lymphadenopathy from January 2019 to December 2023 was conducted at the (TASH) department of pathology. The study population was all patients who had lymph node aspiration done in the pathology department at TASH during the study period. Data was collected from the registries and digital sources, imported into a computer, and analyzed using SPSS version 27. Ethical clearance was obtained from the Department Research and Publication Committee (DRPC) of pathology. Continuous data was summarized and described as a function of their statistical distribution, using means or medians, standard deviation and interquartile range. Categorical data was summarized as frequencies and proportions. Data was presented and visualized using tables and graphical charts. Result: A total of 840 cases were evaluated out of which, 508 (60.5%) were females and 332 (39.5%) were males making the F: M ratio of 1.53:1. The patients were between the ages of 6 months and 85 years with a mean of 35.7 years. The majority of lymphadenopathies were localized (91%) and involved the cervical lymph nodes (51.4%). Significant portion of the patients presented with metastatic lesions (46.19%) followed by reactive lymphadenopathy (21%), lymphoma (17%) and tuberculous lymphadenitis (10.4%). Metastatic lesions were most frequently encountered in female patients between the ages of 31 50 years and commonly involved the axillary lymph nodes. Carcinomas comprise the majority of 6 metastatic lesions (93.04%). Reactive lymphadenitis was most commonly seen under the age of 10 years and involved the cervical lymph nodes. Non-Hodgkin lymphoma made up 79% of lymphoma cases and had the highest number of cases with generalized lymphadenopathy. Conclusion: Fine needle aspiration cytology (FNAC) is a simple, safe and rapid diagnostic tool in the assessment of patients with enlarged lymph nodes. It is important to know the patterns of diagnosis in a particular geographic area for accurate patient assessment. In our current study, metastatic lesions are the most common causes of lymph node enlargement in TASH. Keywords: Cytological pattern, Clinicopathological Characteristics, lymphadenopathy, pathology.
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    Histopathologic Patterns of Thyroid Cancer from September 2019 up Toaugust 2024 in Tikur-Anbessa Specialized Hospital
    (Addis Ababa University, 2025-06-15) Alemwork Amare; Wondwossen Ergete
    Background: Thyroid cancer (TC) is the most common endocrine cancer globally, representing 1.5% of all cancers. The prevalence of thyroid cancer varies across different geographic areas. In Ethiopia, there are some studies and data on the prevalence of thyroid cancer and indicate that the prevalence of thyroid cancer is increasing, with papillary thyroid cancer being the predominant type, accounting for approximately 22% of all endocrine cancers and 85% of thyroid cancers. There are also regional variations in the distribution of different histologic subtypes. Understanding the histopathologic patterns of thyroid carcinoma is vital for accurate diagnosis, prognosis prediction, and the delivery of appropriate treatment options. Objective: To describe the five-year histopathological patterns of thyroid cancer at Tikur Anbessa Specialized Hospital (TASH) over a period from September 2019 up to August 2024. Method: Institution based retrospective quantitative descriptive statistical study done at the Department of Pathology at Tikur Anbessa Specialized Hospital between September 2019 and August 2024. Data was collected from all hard copies of thyroid cancer histopathology reports during this period. The data was cleaned and exported to SPSS version 26 for analysis. Result: a total of 211 cases were analyzed and majority were females (74.8%) compared with males (25.2%) having F:M of 3:1. The mean age was 39.39 (SD=15.55). The commonest histopathologic pattern was PTC 142(67.3%) cases with mean age of 36.22 (SD=15.04) followed by FTC 21(10%) cases with mean age of 43.86 (SD=13.65). Only one case of DHGTC documented and was the least common histopathologic pattern (0.5%). ATC 4(1.9%) was the second least common, with mean age of 63(SD=8.9). From 205 of staged TC, majority of patients had pathologic Stage PT3 (42.6 %) cancer. About 44 cases had LN metastasis and majority of LN metastasis seen in PTC (37/44). Conclusion: PTC is the most common histopathologic pattern of TC followed by FTC. DHGTC is the least common TC. Females affected more commonly than males. This result is in line with majority of local and international studies. Keywords: Thyroid cancer, Histopathologic pattern, Pathology, Tikur Anbessa Specialized Hospital, Ethiopia.
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    Assessment of the Quality of Outpatient Endoscopic Procedures by Using A Patient Satisfaction Questionnaire at Tikur Anbessa Specialized Hospital Addis Abeba Ethiopia, 2024
    (Addis Ababa University, 2024-04) Amanuel Alemayehu; Yohannes Birhanu
    Background Outpatient endoscopic procedures, such as gastroscopy and colonoscopy, are essential diagnostic and therapeutic tools in gastroenterology. As healthcare systems increasingly focus on quality improvement and patient-centered care, patient satisfaction has emerged as a critical indicator of the overall quality of healthcare services. The Global Endoscopy Satisfaction Questionnaire (GESQ) is a validated tool measuring patient satisfaction in endoscopic settings Objective To assess the quality of outpatient endoscopic procedures at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, by evaluating patient satisfaction using the Global Endoscopy Satisfaction Questionnaire (GESQ) Method Singe center institution-based cross-sectional prospective study conducted From January 1 2024 to March 30, 2024 at Tikur Anbessa specialized hospital was included in the study. Collected data from the patient was entered and analyzed with SPSS version 26, and chi-square test was used to assess the association of independent variables with the dependent variable. Result – Total of 200 patient who were eligible was included for final analysis. Majority of the study participants were in the age group of 18-30 years with mean and SD of 40.81±16.99 respectively and male accounts 51% .Seventy-five percent of the patient had community health insurance and 38% of the participants were waited for endoscopic procedure for more than 4weeks. 75% of the patient had community health insurance Concerning to the information before endoscopy, the overall mean score is 74% and regarding the hospital and the skill of provider, the mean score of satisfaction was 87%, rate of communication skills of the person who performed the endoscopy 92%. Regarding to pain and discomfort, the mean score is 61.5% and 76.2% of the participants were satisfied on information after endoscopy. The current study found that the overall mean satisfaction score on quality of endoscopy procedure using GESQ was 75%. Having community health insurance (p=0.041) and increasing duration of waiting for endoscopic procedure (p=0.019) were significantly associated with lesser satisfaction. Those who were Informed about potential complication of the procedure (p=0.004) and were told what to do after procedure (p=0.000) had significantly higher satisfaction 10 Conclusion - The current study found that the overall mean satisfaction score on quality of endoscopy procedure using GESQ was 75%. Statistical significance on satisfaction of quality of procedure seen on community health insurance, duration of waiting for endoscopic procedure, information about potential complication of the procedure and informed what to do after the procedure. Key words- Patient Satisfaction Questionnaire, Outpatient Endoscopy, Patient Satisfaction Questionnaire, GESQ (Global Endoscopy Satisfaction Questionnaire), Quality Improvement in Endoscopy Tikur Anbessa Specialized Hospital
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    Trends of Optimal Anti-Coagulation For Patients with Atrial fibrillation at Tikur Anbesa Specialized Hospital, Cardiology Unit
    (Addis Ababa University, 2025-04-15) Dawit Bineyam; Dejuma Yadeta
    Background:Atrial fibrillation (AF) is a major risk factor for stroke, and proper anticoagulation management is one of the main pillars of treatment of atrial fibrillation to prevent cardioembolic complications.However, data on anticoagulation practices and quality are limited in Ethiopia. Identifying gaps in anticoagulation management is critical for improving patient outcomes and reducing stroke-related morbidity in low-resource settings. Objective: to determine the status of anticoagulation therapy in high risk atrial fibrillation patients and identify predictors of suboptimal anticoagulation in high-risk AF patients who had follow up at TikurAnbessa specialized hospital (TASH), Ethiopia. Methods: A retrospective cohort study was conducted at TASH from March to September 2024. Data were extracted from electronic and paper records, including demographics, commodities, anticoagulant type, and INR values. For those taking warfarin, anti-coagulation quality was assessed using Time in Therapeutic Range (TTR) with a target TTR of ≥65%. Data analysis was performed using SPSS version. Multivariable logistic regression was applied to identify predictors of suboptimal anticoagulation, with statistical significance set. Results: A total of 173 adults with high risk AF (mean age 64.7 ± 13.2 years; 64.7% female) were included. Of these, 90.2% were anticoagulated, while 9.8% were untreated despite being at high stroke risk. Among the 108 warfarin users, 76.9% had suboptimal International Normalized Ratio (INR) control (TTR ≤65%). Direct oral anticoagulants (DOACs) were prescribed to 30.7% (48/156) of anticoagulated patients, with 20.8% (10/48) exhibiting suboptimal anticoagulation. Overall, 59.6% (93/156) of anticoagulated patients had suboptimal anticoagulation. Logistic regression identified increasing age (AOR = 1.05, 95% CI: 1.02–1.09, p = 0.001) and community-based health insurance (CBHI) enrollment (AOR = 2.24, 95% CI: 1.08–4.67, p = 0.03) as significant predictors of suboptimal anticoagulation. Conclusion: Suboptimal anticoagulation remains a significant challenge in Ethiopia, driven by factors such as age and CBHI. Addressing these issues through expanded insurance coverage, point-of-care INR testing, and targeted provider education is essential to improving outcomes for AFpatients. Keywords: AF, anticoagulation, warfarin, DOACs, Ethiopia, low-resource settings.
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    Health-Related Quality of Life among Patients of Systemic Lupus Erythematosus and Risk Factors for Poor Hrqol at Health Facilities in Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-04-10) Biruk Sisay; Becky Abdissa
    Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that significantly affects the health-related quality of life (HRQoL) of patients. Understanding the factors influencing HRQoL in SLE patients is crucial for improving patient care and outcomes. Objective: To assess HRQoL and identify the factors associated with HRQoL in patients with SLE attending selected rheumatology clinics in Addis Ababa. Methods: A multicenter, cross-sectional study was conducted in three rheumatology clinics in Addis Ababa, Ethiopia, from January 2024 to January 2025. The estimated sample size was 141. HRQoL was assessed using the SF-36 tool, and the overall HRQoL score, the Physical Component Summary (PCS), and the Mental Component Summary (MCS) scores were determined. Data were collected through chart reviews, electronic medical records, and phone interviews with patients. Data entry and analysis were performed using SPSS version 27.1. Multivariable linear regression was used to identify factors significantly associated with HRQoL, allowing for the evaluation of demographic, clinical, and socio-occupational influences on HRQoL among patients with SLE. Results: The study included 121 SLE patients with a mean age of 35.4 ± 12.3 years, of whom 99.2% were female. The overall mean HRQoL score was 48.41 ± 5.7, with the mean scores for the Physical Component Summary and Mental Component Summary being 46.28 ± 8.4 and 50.54 ± 8.03, respectively. In multivariable linear regression analysis, age (B = -0.144, 95% CI: 0.277 to -0.010, P = 0.035), disease duration (B = -1.215, 95% CI: -2.161 to -0.268, P = 0.02), disease activity (B = -5.41, 95% CI: -9.578 to -1.287, P = 0.01), and occupation (housewives: B = -3.057, 95% CI: -5.670 to -0.444, P = 0.022) were significantly associated with poor HRQoL. Conclusion and Recommendations: The HRQoL among SLE patients was found to be low. Disease activity and sociodemographic factors significantly influenced HRQoL. The findings underscore the importance of regularly monitoring disease activity and HRQoL, and suggest that interventions targeted at high-risk groups could improve the quality of life for these patients. Keywords: Systemic Lupus Erythematosus, Health-Related Quality of Life, Disease Activity.
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    Clinical Risk Assessment of Osteoporosis in Patients with Overt Hyperthyroidism in Tikur Anbessa Specialized Hospital, Endocrinology Unit, April 2025
    (Addis Ababa University, 2025-04-19) Zerubabel Getahun; Paulos Efrem
    Osteoporosis is a significant public health concern characterized by low bone mineral density and an increased fracture risk, particularly in patients with overt hyperthyroidism. However, data on the magnitude of osteoporosis risk in this population, particularly in Ethiopia, remain limited. Objective To assess the 10-year osteoporotic fracture risk and its determinants among patients with overt hyperthyroidism at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. Methods An institution-based prospective cross-sectional study was conducted among adult patients diagnosed with hyperthyroidism receiving follow-up care at the Endocrine Clinic of Tikur Anbessa Specialized Hospital. The FRAX score was used to assess the 10-year osteoporotic fracture risk. Data were collected using a standardized, pre-tested questionnaire. Statistical analysis was performed using SPSS, with descriptive statistics used to summarize patient characteristics. Logistic regression analysis was planned to identify factors associated with intermediate to high osteoporotic fracture risk, with a significance level of 95%. However, regression analysis could not be conducted due to the small number of patients in these categories. Results Overall, a total of 134 patients with hyperthyroidism were included in this study, with a mean age of 56.3 ± 10.9 years; the majority (88.1%) was female. The most common cause of hyperthyroidism was toxic multinodular goiter (49.3%), followed by Graves' disease (15.7%). All patients except four were taking antithyroid medication at the time of testing, and over half of the patients had normal or elevated TSH levels. The 10-year fracture risk calculated using the FRAX tool showed a low mean risk for major osteoporotic fractures (2.72%) and hip fractures (0.71%). Only 3.7% (5/134) of patients were classified as being at high risk for hip fractures (≥3%). The risk factors for intermediate to high osteoporotic fracture risk could not be determined because there were not enough patients in these categories to conduct regression analysis. Conclusion and Recommendations The results provide evidence of low 10-year osteoporotic fracture risk for patients with hyperthyroidism, with only a small percentage of patients at high risk for hip fractures. Future studies would benefit from larger sample sizes and longer follow-up periods to better establish this information, particularly in limited-resource environments, as fracture risk may be unrecognized, particularly due to limitations in diagnostics. Keywords: Osteoporosis, Hyperthyroidism, FRAX, Bone Mineral Density
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    Bacteriological Quality, Antimicrobial Resistance Profile of Escherichia Coli and Associated Factors of Tap Water at Gulelle and Yeka Sub-Cities of Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-05) Fente,Desalegn; Hailu Melese ; Abera Dessie
    Background: Providing safe water, sanitation, and hygiene (WASH) services is a challenge in low-income countries. Objective: This study aimed to assess the bacteriological quality of tap water, antimicrobial resistance profile of Escherichia coli and associated factors of tap water in Gulelle and Yeka sub-cities of Addis Ababa, Ethiopia. Methods: A community-based cross-sectional study was conducted on 341 tap water samples collected from May 13 to July 26 2024. Sample culturing for the isolation of coliforms was carried out through the application of membrane filtration technique and aerobic plate count (APC) carried out by the pouring plate method. The coliforms were enumerated and presented in CFU/100 ml of the water sample and APC presented in CFU/ 100ml. The antimicrobial susceptibility testing was done using the Kirby–Bauer method on Mueller–Hinton Agar. The data were entered and analyzed using SPSS version 27, both bi-variable and multivariable logistic regression analyses were employed. A p-value of less than 0.05 was considered statistically significant. Results: From a total 341 of tap water samples, 64 (18.8%), 50 (14.7%), 30 (8.8%), and 278 (81.5%) of them contaminated with total coliforms, thermotolerant, E. coli, and APC, respectively was indicate a contamination level. The isolated E. coli exhibited a significant level of antimicrobial resistance, with complete resistance observed to amoxicillin (100%), ampicillin (80%), and nitrofurantoin (70%). In contrast, all 30 E. coli were (100%) susceptible to ciprofloxacin and gentamicin, while 25 isolates (83.3%) demonstrated susceptibility to Tazobactam and chloramphenicol. Multi drug-resistances, amoxicillin (100%), ampicillin (80%), and nitrofurantoin (70%), were observed in Escherichia coli. The contamination of tap water with E. coli was significantly linked to some factors, including the existence of damaged or leaking pipes (AOR: 9.9, 95% CI: 4.09-24.15), the close proximity of latrines to water sources (AOR: 7.19, 95% CI: 2.93-17.64), and inadequate waste management practices (AOR: 2.5, 95% CI: 1.02-6.3). Conclusion and recommendation: In this research, the analysis of tap water samples revealed a significant level of contamination, indicating that the tap water was polluted at a rate of 64.7 CFU per 100 milliliters. This situation necessitates the implementation of water quality and antimicrobial resistance surveillance and monitoring.
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    Trends of Optimal Anti-Coagulation For Patients with Atrialfibrillation at Tikur Anbesa Specialized Hospital, Cardiology Unit
    (Addis Ababa University, 2025-06-15) Dawit Bineyam; Dejuma Yadeta
    Atrial fibrillation (AF) is a major risk factor for stroke, and proper anticoagulation management is one of the main pillars of treatment of atrial fibrillation to prevent cardioembolic complications.However, data on anticoagulation practices and quality are limited in Ethiopia. Identifying gaps in anticoagulation management is critical for improving patient outcomes and reducing stroke-related morbidity in low-resource settings
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    Assessment of the Patient Reported Health Related Quality of Life and its Associated Factors Among Patients with ESKD Undergoing Hemodialysis in Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-04) Eleni Amissew; Yewondwossen Tadesse
    Background: ESKD and hemodialysis impose a significant burden on HRQOL, particularly in low-resource settings. Understanding the patient-reported outcomes health related quality of care among ESKD patients on hemodialysis is crucial for improving patient-centered care.
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    Microbiological Profile and Resistance Patterns in Adult Medical ICU Patients: A Multicenter Study in Addis Ababa
    (Addis Ababa University, 2025-06-15) Elias Tekleselassie; Wondossen Amogne
    Background Antimicrobial resistance (AMR) is one of the most significant threats to humanity, with its impact being highest in low and middle-income countries (LMICs). Although intensive care units (ICUs) house a small proportion of hospital patients, they account for a significant share of multidrug-resistant (MDR) organisms, leading to increased morbidity and mortality. Objectives To assess microbiologic profile and resistance patterns among adult medical ICU patients Methods A multicenter retrospective cross-sectional study was conducted in 5 government owned hospital medical ICUs (TASH, St. Paul, Zewditu, Yekatit and ALERT), data was collected via online questionnaire from microbiology logs and patient charts of those with positive cultures excluding contaminant growth from March 2023 up to March 2025. Collected data was analyzed via SPSS version 30 and association with dependent and independent variables was assessed via Chi-square tests, bivariate analysis and logistic regression. Results A total of 281 cultures analyzed, gram-negatives accounted for 87.9% led by Acinetobacter at 27.4% followed by K.pneumoniae at 23.3% accounting nearly 1/2. Other gram negatives included Pseudomonas 13.5%, E.coli 8.5%, other Klebsiella spp 5.6%, small percentages of Enterobacter, Proteus and Citrobacter. Gram-positives accounted for 8.9% with S.aureus (5.0%) and Enterococcus spp (3.9%) and fungal isolates in 2.1%. CRAB was identified in 20.6%, CRE 21.7%, ESBL 11%, MDR Pseudomonas 7.1%, MRSA 2.8% and VRE 2.1%. Factors associated with AMR included increased total hospital stay prior to cultures and prior use of Meropenem. Overall mortality was 42.7% with half occurring in the first 8 days and strongest predictors being shock, increasing age, longer ICU stay prior to cultures and bloodstream infection. Conclusion AMR is a significant problem in ICUs in Addis Ababa with very high prevalence of gram negatives exhibiting resistance to most antibiotics including Carbapenems limiting available options amplifying the need for effective antibiotic stewardship and IPC programs. The strongest predictors of mortality included presence of shock and source of infection (bloodstream, CNS) urging early critical care interventions and improved resource allocation to reduce mortality. Keywords: AMR, ICU, microbiologic profile, bacterial resistance, mortality
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    Effect of Christian Orthodox Fasting on Glycemic and Blood Pressure Control among type 2 Diabetic Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024
    (Addis Ababa University, 2024-10-13) Fasika Gintamo; Sisay Teklu
    Introduction:Type 2 diabetes mellitus (T2DM), frequently complicated by hypertension, poses significant challenges in low-resource settings. Structured fasting, a religious relevant practice in regions like Ethiopia, remains understudied for its metabolic benefits and risks. Objective: To assess the effect of Christian orthodox fasting on glycemic and blood pressure control among type 2 diabetic patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024. Methods: institutional based : observational longitudinal study was conducted from August 7 to August 22, 2024, at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. Seventy patients who had been fasting during the Assumption fast and attended the outpatient clinic were selected using convenience sampling. Data were entered into SPSS version 26 for cleaning and analysis. A paired t-test assessed the significance of differences between the means of two sets of data. Result: This study was conducted on 68 patients with type 2 diabetes, with a mean age of 56.5 years and 52.9% of participants being male. The study demonstrated that mean fasting significantly reduced fasting blood glucose by 19.56 mg/dL (p=0.001). Glycemic control within the target range of 80–130 mg/dL improved from 67.6% to 91.2% after fasting. Mean blood pressure also improved, with systolic blood pressure decreasing by 9.19 mmHg and diastolic blood pressure by 9.44 mmHg (p=0.001). Additionally, the proportion of patients exceeding hypertensive thresholds (SBP >130 mmHg, DBP >80 mmHg) declined by 19.2% and 38.3%, respectively, after fasting. Conclusion and recommendation: Fasting significantly improved glycemic control and blood pressure management. It should be incorporated into diabetes management with personalized protocols and monitoring. Multicenter trials with diverse cohorts and long-term follow-up are needed to validate sustainability and refine protocols. Keywords: Type 2 diabetes, fasting, glycemic control, blood pressure, Ethiopia
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    Assessment of Magnitude and Determinants of Variceal Bleeding among Cirrhotic Patients at Tikur Anbessa Specialized Hospital:A Retrospective Follow up Study
    (Addis Ababa University, 2025-04-23) Getachew Kassaw; Rezene Berhe
    Gastroesophageal varices (GEVs) rupture and bleeding are severe complications of chronic liver disease (CLD), often leading to high mortality. Identifying determinant factors associated with gastroesophageal variceal hemorrhage (GEVH) is crucial for the effective management and prevention of these life threatening complications.
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    The Rate and Predictors of Progression among Chronic Kidney Disease Patients on Follow-Up, Addis Ababa, Ethiopia, 2020 – 2024
    (Addis Ababa University, 2025-01-05) Getasew Kassaw; Addisu Melkie
    Chronic kidney disease (CKD) is a progressive condition and a major global health issue that affects over 8 million people worldwide. However, information on the rate and predictors of CKD progression is limited. Therefore, this study aimed to assess the rate and predictors of CKD progression in chronic kidney disease patients who underwent follow-up in Addis Ababa, Ethiopia, from 2020 to 2024.
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    The Rate and Predictors of Progression among Chronic Kidney Disease Patients on Follow-Up, Addis Ababa, Ethiopia, 2020 – 2024
    (Addis Ababa University, 2025-01-23) Getasew Kassaw; Addisu Melkie
    Background: Chronic kidney disease (CKD) is a progressive condition and a major global health issue that affects over 8 million people worldwide. However, information on the rate and predictors of CKD progression is limited. Therefore, this study aimed to assess the rate and predictors of CKD progression in chronic kidney disease patients who underwent follow-up in Addis Ababa, Ethiopia, from 2020 to 2024. Methods: A retrospective cohort study was conducted among patients with chronic kidney disease in Tikur Anbesa Specialized Hospital and Saint Paul Millennium Medical College from June 1, 2020, to August 31, 2024. A systematic random sampling technique was used to collect 402 study participants using Kobo toolbox software. The data was exported to STATA version 17 for analysis. A linear mixed-effects model of statistical analysis was used considering the random and fixed effects of the longitudinal data, and the mean estimated glomerular filtration rate and overall mean difference were adjusted using Bonferroni corrections. Multivariable linear mixed effects regression was performed for variables with a p-value of < 0.20 on the bivariate analysis to identify independent predictors of chronic kidney disease and variables with a p-value less than 0.05 in the multivariable analysis were considered to have statistical significance. Results: Among the 402 patients, 64.93% were males. The mean age of the participants was 55.9 + 15.2 years, and 300 (74.63%) were in the age group of 40–74 years. The mean eGFR improved linearly by 2.7, 5.3, 7.63 and 6.44 from the baseline eGFR on years 1, 2, 3 and 4 respectively. The total chronic kidney disease events were 21.83% rapid progression with a total mean eGFR decline of -13.20 (SD = 8.97), 34.73% regression with mean eGFR 13.48 (SD = 7.65), 43.44% had a stable course with mean eGFR of 0.29 (SD =2.64) and 42.03% had achieved remission. Females, patients using ACEI or ARB, and metformin were predictors of a higher estimated glomerular filtration rate by 4.75 (CI: 1.43, 8.08), 5.17 (CI: 2.44, 7.89) and 4.58 (CI: 0.09, 9.07), respectively, compared to their counterparts. Baseline hemoglobin < 10.5g/dl, having diabetes mellitus, baseline proteinuria > +1 and primary education were predictors of declining estimated GFR by -11.02 (CI; -14.59, -7.45), -3.05 (CI; -5.75, -0.35), 3.47 (CI; -6.85, -0.09) and -5.28 (CI; -9.99, -0.57) respectively. Conclusions: Treatment or management strategies seem to be effective, leading to a notable improvement in kidney function over time in this patient cohort in this setting. This suggests that patients are moving toward recovery or at least significant stabilization of their condition. Close monitoring and addressing of these predictors, improvement of data registration systems by hospitals, and further research on the topic incorporating hospitals with no nephrologist care is recommended. Keywords: chronic kidney disease, estimated GFR, Progression, Predictors, linear mixed effect model, Ethiopia
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    Clinical and Functional Assessment of Copd Patientsand Correlation of their 6mwt with Spirometry Andhrql Measures. A Cross Sectional Study in the Largestchest Referral Clinic In Tash, Addis Ababa Ethiopia,2025
    (Addis Ababa University, 2025-03-10) Haymanot Abebe; Hanan Yusuf
    Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by airflow limitation and reduced exercise capacity, often assessed using the Six-Minute Walk Test (6MWT) and spirometric indices. The 6-minute walk test (6MWT) is easy to perform, well-tolerated, and more reflective of activities of daily living. Spirometry is unavailable in many areas of Ethiopia, where 6MWT can be done easily. The purpose of this study is to assess the relationship between Distance covered by 6MWT and other physiologic parameters of COPD with Spirometry result. Objectives: To assess 6MWT and its correlation with spirometry variable as a predictor of COPD severity and to assess the health-related quality of life (HRQL) with various COPD related variables of COPD patients visiting TASH-chest follow-up clinic in Addis Ababa Ethiopia, a cross-sectional Analytical study from July to December 2024. Methods: COPD patients diagnosed using spirometry and Chest CT imaging. Participants were selected from consecutive patients with confirmed chronic COPD. The 6MWT and Spirometry test conducted as per American Thoracic Society (ATS) guidelines, and percent predicted 6MWD was calculated. Quality of life assessed by health-related quality of life (HRQoL) questionnaires, including modified Medical Research Council dyspnea scale (mMRC) and COPD Assessment Test (CAT). Distance in meters and Exercise induced desaturation measured following 6-minute walk test (6MWT). Data were collected, checked, and analyzed using SPSS V26. Chi-square and t-tests assessed associations, with significance set at P < 0.05. Results: Nighty Five COPD patients were included, almost half (48.4%) were classified as GOLD 2, with 37.9% were GOLD ABE Group B, and 75.8% had poor functional status. The mean 6MWD was 364.46 meters (SD = 112.78). older age, worse HRQoL, higher (mMRC) and greater CAT were significantly associated with reduced walking capacity. Significant predictor of unmet 6MWD were having age 56-75 years (64.9%), being overweight/ obesity, biomass smoke exposure, active smoking, and poor treatment adherence. Regarding HRQoL, worse dyspnea, higher CAT scores, and lower lung function (FEV₁%) correlated with greater impairment, while better 6MWD (r =-0.366, P < 0.001) was correlated with improved HRQoL. From spirometric parameters FEV₁% predicted (mean = 54.74, SD = 19.05; r = 0.221, P = 0.032), strongly correlated with 6MWD. While FVC% predicted (mean = 68.56, SD = 21.09; r = 0.194, P = 0.059) slightly failed to reach significance. The ratio FEV₁/FVC (mean = 62.97, SD=13.42; r = 0.023, P = 0.821) had no significant correlation with 6MWD. Astrong positive correlation between pre- and post-walk heart rate (r = 0.817, p < 0.001) and pre- and post-walk SpO₂% (r = 0.773, p < 0.001) Conclusions: this study shows in COPD, 6MWD significantly correlated with the spirometry parameters (FEV1). COPD patients with greater symptom burden, worse lung function, and unhealthy lifestyle factors have reduced exercise capacity and poorer quality of life. Unmet six-minute walk distance was more common in those with obesity, biomass smoke exposure, smoking, and poor treatment adherence. 6MWD correlate with decline in the pulmonary function, it can potentially be used to follow patients where spirometry is not feasible to perform. Keywords: COPD patients, 6MWT distances, Spirometry, TASH, Addis Ababa, Ethiopia
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    Prevalence of Dialysis Catheter-Related Complication and Associated Risk Factors in Patients on Chronic Hemodialysis in Eight Dialysis Centers in Addis Ababa 2023-2024
    (Addis Ababa University, 2025-02-13) Helen G/Medhin; Getahun Tarekegn
    Background Central venous catheters are widely used to initiate hemodialysis despite recommendations for arteriovenous access use from the Dialysis Outcomes. Catheter-related complications are notable in patients on chronic hemodialysis. However, data on the prevalence is lacking. This study determined the prevalence and risk factors associated with catheter-related complications among patients receiving chronic hemodialysis in eight hemodialysis centers in Addis Ababa. Objective Assessed the prevalence of dialysis catheter-related complications among patients on chronic hemodialysis and the associated risk factors in patients on chronic dialysis in dialysis centers in Addis Ababa. Methodology A multi-center cross-sectional study involving 239 chronic hemodialysis patients using dialysis catheters for access was conducted at eight dialysis centers in Addis Ababa. Result In the study, it was found that complications related to catheters occurred in 48.1% of all patients. The proportion of patients who experienced catheter-related infections was 45.2%. The overall incidence of catheter infections was 11.07 per 1,000 catheter days. Notably, catheter-related bloodstream infections accounted for 86.1% of all catheter-related infections. Additionally, factors such as catheter reinsertion, the presence of underlying diabetes, and the duration of the catheter on day 30 were associated with an increased risk of infection. Conclusion This study found a high rate of dialysis catheter-related complications. Measures to minimize catheter-related complications should be implemented. Key words Central venous catheter, chronic hemodialysis, arteriovenous access complications among patients receiving chronic hemodialysis in eight hemodialysis centers in Addis Ababa