Master of Public Health

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MAGNITUDE OF HEALTH-RELATED QUALITY OF LIFE AND ASSOCIATED FACTORS AMONG ADULT DIABETES MELLITUS PATIENTS IN PUBLIC GENERAL HOSPITALS OF SIDAMA REGION, ETHIOPIA
(hawassa universty, 2023-11) AHMED BEDRU
Background: Diabetes mellitus is a chronic disease with considerable impact on health status and quality of life. Health-related quality of life (HRQOL) is a multifaceted concept that is strongly impacted by diabetes in developing countries. Objective: This study aimed to assess the magnitude of health-related quality of life and associated factors among adult diabetic patients attending public general hospitals in Sidama Region, Ethiopia, 2023. Methods: An institutional-based cross-sectional study design was applied on systematically selected 417 adult diabetic patients in public general hospitals in the Sidama region from June 16 to July 15, 2023. HRQOL was evaluated using the World Health Organization Quality of Life Brief Version questionnaire. Binary logistic regression analysis was used to see the association between dependent and independent variables. Candidates for multivariable analysis were variables with p < 0.25 in the bivariable analysis, and p < 0.05 with a 95% confidence interval was considered to declare a statistically significant association. Results: Of the 417 study participants, 48.4% had a good HRQOL. Factors significantly associated with good HRQOL were age between 29 and 39 years [AOR = 2.54 (95% CI, 1.24 5.20)], marital status being married [AOR = 5.2 (95% CI, 1.80-14.97)], college and above education [AOR = 5.48 (95% CI, 1.41-21.33)], occupation being student [AOR = 5.47 (95% CI, 1.19-25.19)], community based health insurance utilization [AOR = 3.18 (95% CI, 1.55-6.53)], doing physical exercise [AOR = 4.25 (95% CI, 2.37-7.61)], duration of illness more than 59 months [AOR = 6.79 (95% CI, 3.28-14.05)], insulin only treatment modality [AOR = 2.46 (95% CI, 1.01-6.04)], absence of DM-related complications [AOR = 3.52 (95% CI, 1.57-7.89)]. Conclusion: Nearly half of the study participants had a good health-related quality of life. Except age, all associated factors identified in this study are modifiable if appropriate measures or strategies are provided and implemented accordingly
Willingness to Renew Community Based Health Insurance Membership and Associated Factors in Maraka woreda, Dawuro zone, South-west Regional State, Ethiopia
(hawassa universty, 2023-11) Mikiyas Zelalem
Background: Although potential instrument to achieve Universal Health Coverage, Community Based Health Insurance schemes commonly suffer from low membership renewal, which threatens the schemes’ sustainability in many developing countries. Hence, this study investigated the willingness to renew Community Based Health Insurance membership and associated factors among enrolled households in Maraka woreda, Dawuro zone. Objective: To assess willingness to renew Community Based Health Insurance membership and associated factors in Maraka woreda, Dawuro zone. Methodology: Community based cross-sectional mixed methods design with sequential explanatory qualitative methods was employed. Using multi-stage random sampling, 5 kebeles were included in the study, from which 693 enrolled households were selected through systematic random sampling (k=5). Descriptive, bivariate, and multivariate logistic regression analyses of data was done using SPSS version 25 software, with statistical significance considered at P-value <0.05. Qualitative data were collected through focus group discussions and key informant interviews, with samples selected using maximum-variation methods. The obtained data were coded and thematically analyzed using ATLAS.ti 9 software. Results: Willingness to renew Community Based Health Insurance membership was shown to be 79.1%. Presence of chronic illness (AOR = 0.30; CI: 0.18-0.52), proportion of household members with poor self-rated health status (AOR = 2.01; CI: 1.04-3.72), recent hospitalization history (AOR = 0.2; CI: 0.11-0.35), perceived availability of medications (AOR = 2.52; CI: 1.48-4.29), premium affordability (AOR = 2.2, CI: 1.26-4.79), perceived benefit packages adequacy (AOR = 2.90; CI: 1.76-4.79), enrollment duration (AOR = 4.01; CI: 2.12-7.56), and participation in scheme related meetings (AOR = 2.40; CI: 1.27-4.58) were predictors shown to be significantly associated with members’ willingness to renew membership. Conclusion: Magnitude of willingness to renew Community Based Health Insurance membership in the woreda was shown to be relatively lower than the woreda’s renewal target for 2016 E.C. Therefore, increased scheme transparency and community engagement, along with policy interventions involving differential premium pricing based on ability to pay and upgrading of the current scheme design to a larger regional or federal pool are recommended to increase members’ desire to renew membership.
LEVEL OF PATIENT SATISFACTION AND ASSOCIATED FACTORS AMONG PRIVATE WING PATIENTS OF WOLAITA SODO UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, WOLAITA, ETHIOPIA: A HEALTH FACILITY-BASED CONVERGENT PARALLEL MIXED STUDY
(hawassa universty, 2023-11) BINYAM DANIEL
Background: To improve the quality of health care given in the private wing, the health care provider needs to know what factors influence patient satisfaction. Although few studies have been conducted on patient satisfaction in private-wing health services it was never been done in this study area. Objective: To assess the level of Patient Satisfaction and associated factors among Private wing patients of Wolaita Sodo University Comprehensive and Specialized Hospital, Wolaita, Ethiopia 2023 G.C Methods: A health facility-based convergent parallel mixed study was conducted. A Systematic random sampling technique was used to select 300 patients. Data was collected by the ODK collect app and was then imported to SPSS version 25 for analysis. The views of 7 qualitative participants selected conveniently until data saturation were explored using in-depth interview. Frequency distribution of variables was tabulated. Bivariate and multivariable logistic regressions were fitted to identify the factors that determine patient satisfaction. Qualitative data analysis used a thematic analysis technique which was supported by ATLAS.ti 7.5.16 data management software. Result: A total of 300 patients were included in the study and 260 (86.7%) (95% CI= 82.3-90.3) of the patients were satisfied with the service they had gotten. Age between 18-34 (AOR= 0.26, 95% CI= 0.17-0.36), doctors explain medical terms (AOR= 3.50, 95%CI= 1.21-10.07), pharmacist explains about the medication (AOR= 3.16, 95%CI= 1.06-9.41) were significantly associated with patient satisfaction. Similarly, the lack of drugs and supplies in the hospital pharmacies and laboratory, and the unavailability of private toilets and showers were also major problems that led to less satisfaction with the overall private wing services. Conclusion and recommendation: In conclusion, the net overall level of satisfaction was high. Regarding this study, significant predictors of patient satisfaction were age, doctors explain medical terms, and pharmacists explains about the medication. Making all the essential laboratory investigations, drugs, and standard medical equipment available in the hospital along with toilets and showers available in every private room is important to improve patient satisfaction in the private wing setting
VACCINE COLD CHAIN MANAGEMENT PRACTICE AND ITS ASSOCIATED FACTORS IN PUBLIC HEALTH INSTITUTIONS OF WEST ARSI ZONE, OROMIA, ETHIOPIA, 2023
(hawassa universty, 2023-11) ABDO HAJO JARSO
Background: In spite of high immunization coverage still there is high range of child mortality due to vaccine preventable diseases (VPDs).This problem is attributed to reduced vaccine potency resulted because of failure in cold chain management system which is less considered in developing countries including Ethiopia, particularly in this study area. Objective: The aim of this study was to assess vaccine cold chain management practice and its associated factors in public health institutions of west Arsi zone, Oromia, Ethiopia 2023. Methods: A facility-based cross-sectional study was conducted in all health institutions of randomly selected woredas in the west Arsi zone. A structured self-administered questionnaire and on-spot observation checklists were used to collect data from the healthcare facilities. Epi-data version 4.6.0.6 was used for data entry and Statistical Package for Social Sciences (SPSS) version 26 was used for analysis. The bivariate and multiple logistic regression analyses were conducted. Adjusted odd ratio (AOR) with a 95% confidence interval (CI) was used to determine the strength of association and the level of significance was set at P-value < 0.05. Result: In this study, more than half (54.1%) of the public health institutions had good vaccine cold chain management practices. Good knowledge of vaccine handlers Adjusted Odds Ratio( AOR) (95% Confidence Interval(CI) = 3.85(1.32-11.25), regular supportive supervision AOR (95% CI)= 4.81(1.60-14.4), availability of Expanded program of immunization (EPI) guideline in healthcare facilities AOR (95% CI)= 5.21(1.67-16.3), no workloads AOR (95% CI)= 3.20(1.06-9.71) and using of vaccine request format AOR (95% CI)= 3.67(1.21-11.10) were positively associated with good vaccine cold chain management practice. Conclusion: Vaccine handlers working in the study area of public health facilities had poor vaccine cold chain management practice. Enhancing the knowledge of vaccine handlers, providing guidelines, vaccine request forms, supportive supervision, and monitoring their practice toward cold chain management may help to improve practice towards vaccine cold chain management.
MAGNITUDE OF URBAN MALARIA AND ITS ASSOCIATED RISK FACTORS IN DAMBOYA TOWN, KEMBATA ZONE, CENTRAL ETHIOPIA
(hawassa universty, 2023-11) BIRUK MULACHEW GELESHO
Background: In Africa, urban malaria is emerging as a potential Health problem. Because of the rapidly growing number of towns in Ethiopia, there is a persistent need to improve the understanding of the epidemiology of urban malaria. Objective: This study aimed to determine the prevalence of urban malaria and its associated risk factors in Damboya town Kambata Zone, Central Ethiopia region. Methods: A Community-based cross-sectional study was carried out in Damboya town from March 7 to May 29, 2023. A total of 422 individuals were randomly selected and a structured questionnaire was employed to collect socio-demographic data and malaria-associated risk factors. Finger/ heel prick blood was used to detect malaria parasites by light microscopy and malaria rapid diagnostic test. Data were entered in Epi data 3.1 and analyzed in SPSS version 25 software. The association between dependent and independent variables was explored by using binary logistic regression analyses. An adjusted odds ratio with a 95% confidence interval was calculated and the association was declared at a P-value of <0.05. Result: The overall prevalence of malaria was 5% (95%CI:3.1-7.5) with the predominant P. vivax infections accounting for 61.9%. The presence of stagnant water (AOR=3.88, 95% CI: 1.14-13.22, P=0.030), unavailability of insecticide-treated bed net (AOR=3.24, 95% CI: 1.01 10.41, P=0.048), living in a house with eaves (AOR=4.22, 95%CI: 1.17-15.00, p=0.027), were more significantly associated with malaria prevalence. Conclusion: Malaria is still a public health problem in Damboya town. Thus, improved access to all malaria interventions is needed to interrupt the transmission in the community of this town.
QUALITY OF MEDICAL RECORDS IN PUBLIC HOSPITAL OF WOLAYTA ZONE, SOUTH ETHIOPIA: 2023 MIXED STUDY
(hawassa universty, 2023-11) MUHIDN JEMAL
Background – Medical record is a multifunctional document that is used to communicate and document critical information about patients’ medical care among health care professionals. Medical record completeness is a key performance indicator that is related with delivery of health care services in the hospital. Medical recording system has faced challenges related with resources and lack of infrastructure in worldwide trend. Studies have indicated that medical record systems are lacking medical record management quality in low income countries. Objective- To asses quality of medical records in public hospital of Wolaita zone, south Ethiopia, 2023 Methods- Institutional based cross-sectional study concurrently with qualitative study using stratified sampling method was conducted from March 1-15, 2023. A purposive criterion sampling method key interview method was used qualitative data. A total of 406 Medical records were reviewed at three public hospitals in Wolaiyta zone. Review of medical records was done using a checklist and key informant interviews of health professionals and medical record staff. The quantitative data were collected kobo toolkits and exported and analyzed by SPSS version 26.0.the qualitative data was collected analyzed manually by thematic analysis. Results. A total of 406 medical records were reviewed during data collection period of medical records of three public hospitals, with 100% retrieval rate. In the assessment of quality of medical record, clinical components were lowered (76%) compared to Administrative components (87%).Majority of the respondents said that|“… Since lack of regular monitoring and evaluation process, there was problem in quality of medical records in the hospital According to the expected national standard, the study also showed that average quality of medical records of the study area was 68%. Records tertiary hospitals were 44.5% less likely to be quality record as compared to records in primary hospitals Conclusion: The majority of medical records had poor completeness of administrative data, clinical, financial, and legal contents. The overall quality of medical records in Wolaita Zone was very low for components of the quality of medical records as per the standard of hospital requirements.
DETERMINANTS OF SEVERE ACUTE MALNUTRITION AMONG CHILDREN 6-23 MONTHS OF AGE IN DARA WOREDA PUBLIC HEALTH FACILITIES, SIDAMA REGION, ETHIOPIA: - A CASE CONTROL STUDY
(Hawassa University, 2024-04) MEKDES SEIFU
BACKGROUND Severe acute malnutrition remains a major killer of children under five years of age, especially in developing world, including Ethiopia. Identification of the determinants of severe acute malnutrition under the age of two years can significantly reduce the burden of child morbidity and mortality. OBJECTIVE: To assess determinants of severe acute malnutrition among 6-23-month children METHODS: A facility-based unmatched case-control study was conducted on children aged 6 23 months (213 cases and 213 controls) from four health centers in Dara woreda from February 1 to May 1, 2024. Children aged 6–23 months with severe acute malnutrition were cases and those visiting health centers outpatient service without diagnosis of severe acute malnutrition were controls. The study participants were selected using consecutive sampling technique. Data were collected by the Kobo toolbox and were exported to the Statistical Package for Social Sciences computer software program version 25 for analysis. Descriptive statistics and binary logistic regression were done and variables with p-value less than 0.25 were eligible for the final model. A multivariable logistic regression was also performed and statistically significant level was declared at a p-value < 0.05. The odds ratio at 95% CI was used to measure the strength of association between outcome and predictor variables. The result was presented with different texts, graphs, and tables. Result: - The factors associated with severe acute malnutrition were perceived birth weight [AOR= 0.09, 95% CI=0.03-0.29], getting nutritional information [AOR=17.12; 95% CI: 6.18 47.37], introduction of complementary feeding after six months [AOR= 0.40; 95% CI: 0.18 0.89] and dietary diversity score < 5 groups [AOR= 4.62; 95% CI= 2.30-9.47] were significant. Conclusion: In this study, perceived birth weight, nutritional information, initiation of complementary feeding and dietary diversity were significantly associated with severe acute malnutrition. Thus, emphasis should be given to improving infant and young child feeding practices, especially timely initiation of complementary feeding and dietary diversity.
INCIDENCE ANDPREDICTORSOFMORTALITYAMONGNEONATESWITH RESPIRATORYDISTRESSSYNDROMEADMITTEDTONEONATAL INTENSIVECAREUNITSOFPUBLICHOSPITALSINHAWASSA,ETHIOPIA.
(Hawassa University, 2024-04) BITSIT DEMEKE(BSc)
Background: Respiratory distress syndrome (RDS) is a major contributor to increased level of morbidity and mortality among neonates. It is one of the primary reasons for admission in to neonatal intensive care units. This syndrome is one of the main causes of respiratory failure, morbidity, and mortality in Ethiopia, which drives up the expense of neonatal treatment in the country. Ethiopia is one of the top five nations with the highest number of newborn mortalities with RDS being the significant factor. Objective: This study is aimed to determine the incidence and predictors of mortality among neonates with respiratory distress syndrome admitted to the neonatal intensive care units of public hospitals in Hawassa, Ethiopia, 2024. Method: A retrospective cohort study was conducted from April 1-30, 2024. A total of 858 neonates were sampled using simple random sampling. Data were collected from medical records by data extraction tool using KoBo toolbox and exported to STATA version 16 for analysis. Median time, Kaplan-Meier survival estimation curves, and log-rank tests were then computed. Bivariable and multivariable regression were fitted to identify the predictors of respiratory distress syndrome. Adjusted hazard ratio with a 95% confidence interval was subsequently calculated. Variables with reported p-values < 0.05 were considered statistically significant. Results: A 858 (93.4%) were included in the study. The incidence rate of RDS mortality was 39.475 per 1000 neonate-days (95% CI: 35.33- 43.62) with 8809 neonate-days of observation. Perinatal Asphyxia (AHR: 1.79; 95% CI: 1.37- 2.34), birth weight less than 2500 gram (AHR: 1.70 (95% CI: 1.10-2.64) and hypothermia (AHR: 1.66; 95% CI: 1.27-2.17) were statistically significant predictors of mortality of neonates with respiratory distress syndrome. Conclusion: The incidence rate of mortality among neonates with RDS was 39.475. Perinatal Asphyxia, hypothermia and birth weight less than 2500 gram were significant predictors of mortality of neonates with respiratory distress syndrome. Hence, attention should be given to the care of neonates. xi
INCIDENCE ANDPREDICTORSOFMORTALITYAMONGNEONATESWITH RESPIRATORYDISTRESSSYNDROMEADMITTEDTONEONATAL INTENSIVECAREUNITSOFPUBLICHOSPITALSINHAWASSA,ETHIOPIA
(Hawassa University, 2024-05) BITSIT DEMEKE
Background: Respiratory distress syndrome (RDS) is a major contributor to increased level of morbidity and mortality among neonates. It is one of the primary reasons for admission in to neonatal intensive care units. This syndrome is one of the main causes of respiratory failure, morbidity, and mortality in Ethiopia, which drives up the expense of neonatal treatment in the country. Ethiopia is one of the top five nations with the highest number of newborn mortalities with RDS being the significant factor. Objective: This study is aimed to determine the incidence and predictors of mortality among neonates with respiratory distress syndrome admitted to the neonatal intensive care units of public hospitals in Hawassa, Ethiopia, 2024. Method: A retrospective cohort study was conducted from April 1-30, 2024. A total of 858 neonates were sampled using simple random sampling. Data were collected from medical records by data extraction tool using KoBo toolbox and exported to STATA version 16 for analysis. Median time, Kaplan-Meier survival estimation curves, and log-rank tests were then computed. Bivariable and multivariable regression were fitted to identify the predictors of respiratory distress syndrome. Adjusted hazard ratio with a 95% confidence interval was subsequently calculated. Variables with reported p-values < 0.05 were considered statistically significant. Results: A 858 (93.4%) were included in the study. The incidence rate of RDS mortality was 39.475 per 1000 neonate-days (95% CI: 35.33- 43.62) with 8809 neonate-days of observation. Perinatal Asphyxia (AHR: 1.79; 95% CI: 1.37- 2.34), birth weight less than 2500 gram (AHR: 1.70 (95% CI: 1.10-2.64) and hypothermia (AHR: 1.66; 95% CI: 1.27-2.17) were statistically significant predictors of mortality of neonates with respiratory distress syndrome. Conclusion: The incidence rate of mortality among neonates with RDS was 39.475. Perinatal Asphyxia, hypothermia and birth weight less than 2500 gram were significant predictors of mortality of neonates with respiratory distress syndrome. Hence, attention should be given to the care of neonates
DETERMINANTS OF DELAY IN TREATMENT SEEKING FOR DIARRHEAL DISEASES AMONG MOTHERS WITH UNDER-FIVE CHILDREN IN PUBLIC HOSPITALS OF SIDAMA REGION ,SOUTHERN ETHIOPIA: UNMATCHED CASE CONTROL STUDY
(Hawassa University, 2024-05) MENELIK MATHEWOS
Background-.A significant majority of pediatric diarrheal deaths are caused by delays in receiving timely, appropriate care. Life-threatening consequences are decreased when under five children with diarrhea obtain medical attention promptly and appropriately. Therefore, this study looked into factors that contributed to mothers of children under five delaying of treatment for diarrheal illnesses. Objective – To assess determinant of delay in treatment seeking for diarrheal disease among mothers with under five children in public hospitals in Sidama region, southern, Ethiopia from April 1 to May 30,2024 Methods - A Facility-based unmatched case control study was conducted on 414(207 Cases and 207 Controls). Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired with their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Data were collected using KOBO collect with smart Phone and analyzed by using SPSS 26. Bivariate and multivariable logistic regressions were computed to identify independent determinants of delay in treatment seeking. Association was described using an adjusted odds ratio along with their 95% confidence interval. Significance was declared at p<0.05 in the multivariable logistic regression. Results- from 418 selected participants, 414 mothers (207 cases and 207 controls) were included. Being rural resident (AOR 3.40(95 % CI 2.03-5.72), Child age < 24 months (AOR 4.43(95 % CI=2.35-8.34), Mothers without formal education (AOR 11.679(95 % CI 3.705 36.81), difficult to pay cost of treatment (AOR 4.345(95 % CI 2.019-9.352), Absence of health insurance AOR 3.182(95 % CI 1.945-5.207), were significant determinants of delayed treatment seeking. Conclusion-Young age of child, rural residence, Educational level of mothers, difficulty to pay Cost of treatment and absence of health insurance were important determinants of delay in treatment seeking. Thus comprehensive strategies that might enhance health facility accessibility crucial to reduce diarrhea related complications
REPRODUCTIVE HEALTH SERVICE UTILIZATION AND BURDEN OF PROBLEMS AMONG WOMEN WITH DISABILITIES IN SIDAMA REGION, ETHIOPIA
(Hawassa University, 2024-05) ZELALEM TENAW BOGALE
Background: Women with disabilities are more likely to experience unintended pregnancy and sexual violence. However, there is no enough evidence about contraceptive utilization, unintended pregnancy, sexual violence and determinant factors among reproductive-age women with disabilities in Ethiopia. This knowledge gap is particularly pronounced in rural settings and among individuals with disabilities beyond the categories of the young, blind, and deaf. Additionally, the influence of contextual factors on these aspects remains inadequately explored. Therefore, this study aimed to assess reproductive health service utilization and burden of problems among women with disabilities in Central Sidama (Dale and Wonsho districts and Yirgalem city administration) Region, Ethiopia. Methods: A community-based disability-specific house-to-house census was conducted from May 1-30, 2022, to determine the reproductive-age of women with disabilities. After the census, a cross-sectional study design was used from June 20 to July 15, 2022, to investigate reproductive health service utilization and burden of problems, and their determinants (Objectives I, II, and III). The sample sizes were determined independently for each objective. Specifically, 620 reproductive-age females with disabilities participated in Objective I, 363 women with disabilities participated in Objective II, and 652 reproductive-age females with disabilities participated in Objective III. I allocated the sample size proportionally to the 30 randomly selected kebeles. A multi-stage stratified cluster sampling technique was used to select the study participants. Pretested structured and unstructured data collection tools were used, and face-to-face interview was conducted. The data was collected using the Kobo Collect application version 2021.3.4. After collection, the data were imported into Stata version 16 for analysis. A descriptive and multilevel binary logistic regression analysis model was applied. Then, bi-variable multilevel logistic regression was done to identify eligible variables (P-value<0.20) for multivariable multilevel logistic regression analysis. A P-value of <0.05 and a 95% confidence level were used to determine statistical significance. Results: Among reproductive-age females with disabilities, 27.3 % (95% CI: 23.8 %, 31.0 %) were current contraceptive users. Of the users, 82 (48.5%) used implants. The odds of contraceptive utilization is (AOR=9.03; 95% CI: 4.39, 18.6) times higher among reproductive age women who have good contraceptive knowledge compared to their counterparts. Reproductive -age women with disabilities who have transport accessibility to health facilities are (AOR=2.28; 95% CI: 1.32, 3.94) times more likely to use contraceptives compared to those who have no transport access to health facilities. Compared to young reproductive-age (15 to 24 years old) women with disabilities, those aged 25 to 34 years are (AOR=3.04; 95% CI: 1.53, 6.04) times higher odds of contraceptive utilization. Reproductive-age women with a hearing disability have (AOR = 0.38; 95% CI: 0.18, 0.79) lower chance of contraceptive utilization. Similarly, those with paralysis of the extremities (AOR = 0.06; 95% CI: 0.03, 0.12) demonstrate a lower chance of contraceptive utilization, while reproductive-age women using a wheelchair also showed (AOR = 0.10; 95% CI: 0.05, 0.22) lower chance of contraceptive utilization compared to reproductive-age women with vision disability (Objective I). The prevalence of current (most recent) unintended pregnancy among women with disabilities was 65.6% (95% CI: 60.4, 70.6). Compared with poor income tercile, women who have a middle-income tercile have (AOR = 2.07; 95% CI: 1.02, 4.20) times higher risk for unintended pregnancy. Women with disabilities who gave birth (AOR = 2.20; 95% CI: 1.21, 3.99) have a higher risk of unintended pregnancy compared to those who have not given birth. The risk of unintended pregnancy is (AOR = 0.26; 95% CI: 0.12, 0.57) lower among women with extremity paralysis compared with vision disability. Compared with rural resident women with urban residents have (AOR = 0.22; 95% CI: 0.12, 0.40) a lower risk of unintended pregnancy. Women with disabilities who drink alcohol have (AOR = 0.28; 95% CI: 0.11, 0.74) a lower risk of unintended pregnancy when compared with those who did not drink alcohol (Objective II). On the other hand, the prevalence of lifetime sexual violence among reproductive-age females with disabilities was 59.8% (95% CI: 56, 63.56). Reproductive-age women with disabilities who reside in urban settings have (AOR = 0.51; 95% CI: 0.29, 0.88) a lower risk of sexual violence compared to their counterparts in rural settings. Compared with young (15 to 24 years old) reproductive-age women with disabilities, those aged 25 to 34 years have (AOR = 5.9; CI: 3.01, 11.6) times higher risk of sexual violence. Similarly, reproductive-age women with disabilities aged 35 to 49 years have (AOR = 3.47; CI: 1.48, 8.14) times higher risk of sexual violence. Reproductive-age women with disabilities having no sexuality information have (AOR = 11.3; CI: 6.24, 20.5) times higher risk of sexual violence compared to their counterparts who have sexuality information. and having hearing disabilities (AOR = 3.19; CI: 1.49, 6.83) were factors associated with sexual violence (Objective III). Conclusion: This study revealed that the burden of unintended pregnancy and sexual violence among reproductive-age women with disabilities are high. Moreover, contraceptive utilization among reproductive-age females with disabilities is low. Contraceptive knowledge, age, transport accessibility, and types of disability determine contraceptive utilization. On the other hand, parity, residency, income, alcohol utilization, and types of disability were the determinant risk factors of unintended pregnancy. Also, age, residency, sexuality information, and types of disability were the determinant factors of sexual violence. Therefore, it is essential to design and implement strategies for raising contraceptive awareness and incorporating at-home contraceptive provision strategies into health extension programs to enhance contraceptive utilization. Furthermore, strengthening education and information dissemination about contraceptive utilization, reproductive health problems and its prevention strategies in rural settings are vital to mitigate unintended pregnancy and sexual violence.
FACTORS ASSOCIATED WITH DIETARY PRACTICE AND NUTRITIONAL STATUS AMONG PREGNANT WOMEN ATTENDING ANC AT MAALIE WOREDA, SOUTH OMO ZONE, ETHIOPIA: FACILITY BASED CROSS SECTIONAL STUDY.
(Hawassa University, 2024-05) WONDU BERRA
Background: Maternal dietary practices during pregnancy play an important role. Hence, this study was intended to assess factors associated with the dietary practice and nutritional status of pregnant women in Maalie Woreda, South Omo zone, Ethiopia. Methods: Facility based cross-sectional study design was conducted among 318 pregnant women had participated. Socio demographic and socio economic data were collected using a structured interviewer-administered questionnaire. The dietary practice was measured using 16 dietary practice questions. Dietary diversity was obtained by using a 24-hr dietary recall method and Nutritional status was assessed by using mid-upper arm circumference (MUAC) measurements. Binary and multiple logistic regression analysis were conducted. Variables with P ≤ 0.2 in bivariate analysis were entered for multiple logistic regressions. At a 95% confidence interval, variable with < 0.05 in multiple logistic regression analysis was considered statistically significantly associated with dietary practice and Nutritional status. Result: About 68.6% of the pregnant women had poor dietary practice and 34.3% were undernourished. Educational status (AOR=4.6; 95% CI: 1.50, 11.51), family income (AOR=2.61; 95% CI: 1.35, 6.43), family size (AOR=2.30; 95% CI: 1.10, 2.87), ANC visits (AOR=2.49, 95% CI: 1.09, 4.03), nutrition counseling (AOR=1.81; 95% CI: 1.12, 5.46) and Knowledge (AOR=1.28; 95% CI: 1.13, 4.19) were significantly associated with dietary practice. Husband occupation (AOR=3.29; 95% CI: 1.79, 71.2), cash decision maker (AOR=2.27; 95% CI: 1.14, 3.92), nutrition counseling (AOR=1.73; 95% CI: 1.42, 7.26), Source of nutrition information (AOR=1.51; 95% CI: 1.07 , 8.3), Dietary practice (AOR=1.87; 95% CI: 1.21, 3.51), and knowledge (AOR=1.92; 95% CI: 1.05, 3.06) were significantly associated with nutritional status. Conclusion: The prevalence of good dietary practice during pregnancy was 31.4% and 34.3% were undernourished. Educational status, family income, family size, number of pregnancy, ANC visits, nutrition counseling, Diversity of diet and Knowledge which were significantly associated with dietary practice. Government, health extension workers and responsible stakeholders should focus on pregnant women to have ANC follow-up.
ANTI-RETROVIRAL REGIMEN CHANGE AND ITS PREDICTORS AMONG PEOPLE LIVING WITH HIV AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, SOUTHERN ETHIOPIA
(Hawassa University, 2024-05) WONAGO PETROS
Background: Anti-retroviral regimen change is among the major challenges for the success of treatment among people living with human immunodeficiency virus (PLHIV), affecting its sustainability and outcome among ART patients. Yet, the evidence on the incidence and predictors of regimen change is unknown in this setting and the region. Objective: The aim of this study was to determine the incidence of antiretroviral regimen change and its predictors among PLHIV at Hawassa University Comprehensive Specialized Hospital in 2024 Methods: An institutional-based retrospective cohort study was conducted among PLHIV who started ART from January 1, 2006, to December 31, 2023. Regimen change was defined as changing the ART regimen due to adverse events. Records were reviewed and standard data extraction form was used to collect data on a kobo tool kit. A Kaplan-Meier plot with a log-rank test at p<0.05 was used to estimate the median follow-up time and compare survival between the covariates. Bi-variable cox-regression analysis was done and variables with p≤0.25 were entered into the multivariable cox-regression model. Predictors with p values<0.05 reported with their adjusted hazard ratios and the 95% confidence intervals. Results: A total of 3856 patients were followed for 39,350 person-years of observation with the median follow-up period of 11.2 years. The incidence rate of anti-retroviral regimen change was 12.1 (95% confidence interval (CI): 11.5–12.7) per 100 person-years. Female gender (Adjusted hazard ratio (AHR) = 2.9, 95%CI = 2.6–3.4), occurrence of TB (AHR = 4.6, 95%CI = 2.9–7.4), occurrence of side effects (AHR = 3.4, 95%CI = 2.9–3.8), baseline CD4 count below 100 cells/mm3 (AHR = 1.3, 95%CI = 1.1–1.6) and availability of social support (AHR = 0.47, 95%CI = 0.38–0.58) were the predictors of regimen change among PLHIV receiving anti-retroviral therapy. Conclusion and recommendation: The incidence of regimen change in this study was comparable to other findings. A number of variables predicted regimen change and female gender, occurrence of drug side effects, occurrence of TB, CD4 below 100cells/mm3 and availability of social support were predictors of incidence of regimen change. Clinicians are recommended to early assess the adverse effects, TB, immunologic failure and strengthen social support to reduce the risk of regimen change among PLIHV.
INCIDENCE AND PREDICTORS OF NON-COMMUNICABLE DISEASE AMONG ADULT HIV-POSITIVE PATIENTS AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL
(Hawassa University, 2024-05) TSION TESFAYE
Background: Due to the extended life expectancy of HIV/AIDS patients with the availability of antiretroviral therapy, concerns have risen regarding the co-occurrence of HIV and non communicable diseases (NCDs). Thus, this study aims to contribute to scientific knowledge on NCDs among people living with HIV (PLHIV) aged 18 and above at Hawassa Comprehensive and Specialized Hospital. Objective: To determine the incidence and predictors of non-communicable diseases among adult HIV-positive patients at Hawassa University Comprehensive Specialized Hospital 2024. Methods: A retrospective cohort study was conducted from April 1–30, 2024. All HIV-positive patients who fulfilled the eligible criteria and had been followed up at Hawassa University Comprehensive Specialized Hospital from 2003-2022 were considered the total sample size for this particular study. Data was collected from medical records using a standardized checklist using the Kobo toolbox. Statistical Package for Social Studies version 26.0 was used for data analysis. Kaplan-Meier survival function was used to estimate NCDs' free survival time and to compare NCDs' free survival time with a log-rank test. Both bi-variable and multivariable Cox proportional hazard models were fitted to identify the predictors of NCDs. Adjusted hazard ratio (AHR), P-value <0.05, and 95% confidence interval (CI) were used to report the result. Result: The incidence rate was 8.5 per 100 PYs. Those with a family size >=4 (AHR = 0.6, 95% CI0.4-0.9) Other occupational status (student, prisoner, commercial sex worker )(AHR = 0.4, 95% CI: (0.3-0.7), BMI >=25 (AHR = 2.2, CI: 1.3-3.7), and poor ART adherence (AHR = 3.3, CI: (2-5.5) were predictors for time to any one of the non-communicable disease development. Conclusion and Recommendation: Given the overall incidence of any one of the NCDs, was high, policymakers need to focus on screening and treatment strategies for PLHIV, while healthcare providers need to offer counseling on drug adherence, lifestyle, and diet.
DETERMINANTS OF DELAY IN TREATMENT SEEKING FOR DIARRHEAL DISEASES AMONG MOTHERS WITH UNDER-FIVE CHILDREN IN PUBLIC HOSPITALS OF SIDAMA REGION ,SOUTHERN ETHIOPIA: UNMATCHED CASE CONTROL STUDY
(Hawassa University, 2024-05) MENELIK MATHEWOS
Background-.A significant majority of pediatric diarrheal deaths are caused by delays in receiving timely, appropriate care. Life-threatening consequences are decreased when under five children with diarrhea obtain medical attention promptly and appropriately. Therefore, this study looked into factors that contributed to mothers of children under five delaying of treatment for diarrheal illnesses. Objective – To assess determinant of delay in treatment seeking for diarrheal disease among mothers with under five children in public hospitals in Sidama region, southern, Ethiopia from April 1 to May 30,2024 Methods - A Facility-based unmatched case control study was conducted on 414(207 Cases and 207 Controls). Cases were under-five children paired with their mothers/caregivers who sought treatment after 24 hours of the onset of signs and symptoms of diarrheal diseases, and controls were under-five children paired with their mothers/caregivers who sought treatment within 24 hours of the onset of signs and symptoms of diarrheal diseases. Data were collected using KOBO collect with smart Phone and analyzed by using SPSS 26. Bivariate and multivariable logistic regressions were computed to identify independent determinants of delay in treatment seeking. Association was described using an adjusted odds ratio along with their 95% confidence interval. Significance was declared at p<0.05 in the multivariable logistic regression. Results- from 418 selected participants, 414 mothers (207 cases and 207 controls) were included. Being rural resident (AOR 3.40(95 % CI 2.03-5.72), Child age < 24 months (AOR 4.43(95 % CI=2.35-8.34), Mothers without formal education (AOR 11.679(95 % CI 3.705 36.81), difficult to pay cost of treatment (AOR 4.345(95 % CI 2.019-9.352), Absence of health insurance AOR 3.182(95 % CI 1.945-5.207), were significant determinants of delayed treatment seeking. Conclusion-Young age of child, rural residence, Educational level of mothers, difficulty to pay Cost of treatment and absence of health insurance were important determinants of delay in treatment seeking. Thus comprehensive strategies that might enhance health facility accessibility crucial to reduce diarrhea related complications.
TIME TO VIRAL LOAD SUPPRESSION AND ITS PREDICTORS AMONG ADULT HIV PATIENTS WITH HIGH VIRAL LOAD ON ANTI RETROVIRAL TREATMENT IN SELECTED HOSPITALS OF SOUTHERN ETHIOPIA: A RETROSPECTIVE COHORT STUDY
(Hawassa University, 2024-06) ABDULKADIR HASEN
Background: More than 1000 copies of the HIV per milliliter is strongly associated with poorer survival of patients and increased new transmissions of virus. Determining time to viral load suppression and its predictor among HIV patient was crucial to evaluate the implementation of routine viral load monitoring, treatment response and progression toward national target. Objective: To determine time to viral load suppression and it’s predictors among adult HIV patients with high viral load on anti- retroviral treatment in selected hospitals of southern Ethiopia. Method: A retrospective cohort study was conducted among 344 adult HIV patients initiated to ART from January 01, 2016 to December 31, 2022 on first line treatment regimen. A simple random sampling technique was used to select study participant. Data were collected by Kobo Toolbox and extracted to SPSS for data analysis. Kaplan-Meier was used to estimate time to viral suppression. Cox-proportional hazard model was used to determine independent predictors of viral load suppression. Adjusted hazard rate with 95% CI reported and p-values <0.05 was used to declare statistical significance in multivariable analysis. Results: A total of 344 HIV patient records were reviewed. In this study the overall median time to viral suppression was 5 months. The incidence rate of viral load suppression was 15.3 per 100 person-months. The study found that factors such as no opportunistic infection (AHR: 1.44; 95% CI: 1.06, 1.96), no substance use (AHR: 1.54; 95% CI: 1.19, 1.99) and baseline CD4 cell counts 200-350cell/mm3 (AHR: 1.75; 95% CI: 1.24, 2.45), and >350cell/mm3 (AHR: 1.53; 95% CI: 1.02, 2.28) were associated with higher chance of viral load suppression. Being on ART drug regimen TDF+3TC+NVP (AHR: 0.21; 95% CI: 0.07, 0.68), and AZT-3TC-EFV(AHR: 0.50; 95% CI: 0.26, 0.96) and ART duration 13-24 months (AHR: 0.72; 95% CI: 0.53, 0.98), 25-59 months (AHR: 0.68; 95% CI: 0.50, 0.93) and above 60 months (AHR: 0.26; 95% CI: 0.12, 0.58), were associated with less chance of viral load suppression at multivariate analysis. Conclusion: The median time to viral suppression was 5 months. Opportunistic infection, baseline CD4 counts, ART dugs regimen, duration on ART and substance use were independent predictors of time to high viral load suppression after controlling for others factors. Prioritizing interventions targeting opportunistic infections and substance use cessation, initiate to DTG contain ART drug regimens could improve viral load suppression and patient outcomes.
DISRESPECTFUL AND ABUSIVE MATERNITY CARE DURING CHILDBIRTH AND ASSOCIATED FACTORS AT PUBLIC HEALTH FACILITIES IN SHASHEMENE TOWN, SOUTHERN ETHIOPIA
(Hawassa University, 2024-06) MITIKU DEJENU
Background: Disrespect and abuse during childbirth in healthcare facilities is a global public health issue that negatively impacts the utilization of skilled birth services. In Ethiopia, despite policies promoting equitable maternal care, there is a high prevalence of disrespect and abuse, which deters women from accessing healthcare facilities. There is a notable research gap, with limited mixed-method studies providing a comprehensive understanding of the issue. Objective: To assess the magnitude and associated factors of disrespectful and abusive maternity care during childbirth at public health facilities in Shashemene Town, Southern Ethiopia, 2024. Methods: A facility-based cross-sectional study using both quantitative and qualitative methods was conducted. The study included 383 mothers, selected through systematic sampling, who gave birth at selected public facilities. Quantitative data were collected using structured questionnaires administered via interviews, while qualitative data were gathered through in depth and key informant interviews with mothers and healthcare providers. Quantitative data were analyzed using SPSS, with descriptive statistics determining the extent of disrespect and abuse. Bivariable and multivariable logistic regression identified associated factors, with a p value less than 0.05 considered significant. Thematic analysis was used for qualitative data. Result: The study found that 68.1% of mothers experienced disrespectful and abusive maternity care. Common forms included non-consented care (68.1%), non-dignified care (63.2%), non confidential care (55.9%), and physical abuse (32.6%). Factors significantly associated with increased odds of experiencing disrespect and abuse included having no formal education [AOR=3.73, 95% CI: 1.93-12.79], primary education [AOR=2.28, 95% CI: 1.08-4.81], residing in rural areas [AOR=2.20, 95% CI: 1.20-4.02], nighttime delivery [AOR=2.89, 95% CI: 1.75 4.76], prolonged facility stays [AOR=2.21, 95% CI: 1.34-3.66], and poor knowledge of mothers [AOR=2.03, 95% CI: 1.20-3.45]. Qualitative findings indicated that lack of resources, high workloads and inadequate training contributed to such behaviors by healthcare providers. Conclusion: Disrespectful and abusive maternity care is highly prevalent in Shashemene Town, with various forms of mistreatment experienced by women during childbirth. Addressing systemic issues through resource allocation, training, and enhanced support mechanisms for healthcare workers and mothers is essential for promoting respectful and high-quality maternity care services.
Schistosoma mansoni infection among preschool children in southern Ethiopia: burden, treatment, community behavior, and association with undernutrition and anaemia
(Hawassa University, 2024-06) Tafese Tadele
Introduction: Intestinal schistosomiasis presents a significant health threat, predominantly in sub Saharan Africa including Ethiopia. Preschool children (pre-SAC) are omitted from preventive chemotherapy (PC) intervention aimed at accelerating the control and elimination of this threat due to scarce evidence on the burden of the disease, its effect, and the efficacy and safety of praziquantel (PZQ) in this population group. Despite the growing spread of schistosomiasis among pre-SAC, evidence is insufficient on the knowledge, attitude, and practices (KAP) of caregivers in communities with limited access to safe drinking water and basic sanitation. Objective: The overall objective of this PhD work was to determine the extent and risk factors of S. mansoni infection among pre-SAC, to investigate the efficacy and safety of PZQ in the treatment of the disease, to assess the KAP about schistosomiasis among caregivers of pre-SAC, and to investigate the association of the disease with undernutrition and anaemia among pre-SAC in Hawella Tulla district of Sidama region, Southern Ethiopia from August to December 2021. Methods: A mix of study designs was used based on the different objectives of this dissertation. A community-based cross-sectional study was conducted for papers (I, III, and IV). A single-arm before-and-after quasi-experimental study was carried out among pre-SAC infected with S. mansoni for the second paper. A multistage sampling technique was applied and the study participants were selected by a simple random sampling technique (papers I, III, and IV). All S. mansoni-nfected participants were recruited (paper II). A multilevel logistic regression model was used to investigate the determinants of S. mansoni infection (paper I). The determinants of cure rate were assessed using a standard logistic regression model, while a log-binomial regression model was used to investigate the predictors of adverse events (AEs) following praziquantel treatment (paper II). Further, multivariable logistic regression with a cluster-robust variance estimation method was used to assess determinants of KAP (paper III); and the association between S. mansoni infection and undernutrition and anaemia (paper IV). A total of 1683 randomly selected children aged 4 to 7 years were involved in a baseline survey to establish baseline data (paper I). A structured questionnaire was used to interview mothers/ primary caregivers to obtain sociodemographic and behavioral information. Two duplicate thick slides were prepared from a single fresh stool sample and tested for S. mansoni on the same day using the Kato-Katz technique for each study participant. Efficacy and safety assessment of a single-dose 40 mg/kg PZQ was done among 240 S. mansoni-infected pre-SAC. Follow-up was carried out at day 28 post-treatment among 236 pre-SAC for efficacy, while safety monitoring was done among 234 pre-SAC at day 1, 2, and eight post-PZQ administration. KAP about schistosomiasis was assessed among 887 mothers/primary caregivers of pre-SAC. Anthropometric measurements and blood samples for haemoglobin were taken from 565 pre-SAC to investigate the association of S. mansoni infection with undernutrition and anaemia. Results: The findings of this study indicated a moderate (14.3%) prevalence of the disease among pre-SAC in the study setting. Being 6-year-old and 7-year-old had increased odds of S. mansoni infection. Accompanying others to water sources sometimes or all the time, and living within less than one-kilometer radius of the infested water source also had a significant association with S. mansoni infection. The present study detected that PZQ is effective and safe against the disease given at 40 mg/kg body weight in this population segment. In general, the egg reduction rate (ERR) was 93.3% while the cure rate (CR) was 85.2% at day 28 after treatment. A significant association was detected between baseline infection intensity and CRs. A baseline S. mansoni egg count per gram of stool (EPG) increase in 100 had reduced the odds of cure by 26%. The occurrence of AEs was 23.1% with stomachache being the most common. Pre-treatment moderate or heavy-intensity infection was a significant risk factor for AEs. A low level of good knowledge (37.0%) about schistosomiasis was detected among caregivers of pre-SAC. Only 486 (54.8%) caregivers had favorable attitude about schistosomiasis, while over half (57.8%) of mothers/primary caregivers had good practice related to predisposing factors of schistosomiasis. Being from the poorest and poorer household wealth categories had reduced odds of reporting good knowledge relative to those from the richest wealth households. Besides, study participants' age, not having formal education, and household wealth were significant determinants of attitude. Marital status and lack of information about the disease were significant determinants of practice. Overall, of the total 565 pre-SAC examined, 24.3% were stunted, 6.6% were wasted, 2.0% were underweight whereas 28.0% had anaemia. Pre-SAC having S. mansoni with soil-transmitted helminths (STH) co-infection had significantly higher odds of stunting relative to those infected only with S. mansoni. Besides, S. mansoni infection had an independent significant association with anaemia, but not stunting, wasting, or underweight. Conclusion: The study detected a moderate prevalence of the disease among pre-SAC. In S. mansoni-infected pre-SAC, a single-dose 40 mg/kg PZQ is safe and effective, and most treatment associated AEs detected were mild-to-moderate and transient. The current study detected a low level of knowledge, an unfavorable attitude, and poor practice about schistosomiasis. Further, S. mansoni with STH co-infection had higher odds of stunting, whereas S. mansoni infection had anindependent association with anaemia among the infected pre-SAC. Thus, these findings call for policymakers and other stakeholders to consider the inclusion of pre-SAC in schistosomiasis control and elimination programs to enhance the elimination efforts of the disease in endemic communities.
PREVALENCE AND FACTORS ASSOCIATED WITH SEXUAL VIOLENCE AMONG FEMALE HOUSEMAIDS ATTENDING EVENING PRIMARY PUBLIC SCHOOLS IN HAWASSA CITY, SIDAMA, ETHIOPIA: A MIXED METHOD STUDY.
(Hawassa University, 2024-06) MAEREGE HABTNEH
Introduction: Threats of rape, attempted rape, rape, sexual harassment, and coerced sexual contact are examples of sexual violence. One of the groups of workers most at risk from sexual violence worldwide is the housemaid. Sexual violence against housemaids remains usually concealed as victims cannot report such offences. This study aims to assess prevalence and factor associated with sexual violence among female housemaid attending evening public schools in Hawassa city, Sidama region, Ethiopia. Objectives. This study intended to assess the prevalence and factors associated with sexual violence among housemaids attending evening primary public schools at Hawasa 2024. Method. School-based cross-sectional study complemented with qualitative approach was conducted among 405 housemaids and 13 purposely selected participant. Simple random sampling was used for the quantitative part while purposive sampling was done to select key informants. Data were collected using an interviewer-administered questionnaire by Kobo Collect for quantitative study then exported to SPSS, while key-informant interview using semi structured interview guide was used for the qualitative study. Both bivariable and multivariable logistic regression analysis were done to assess the association between independent and dependent variables. The strength of association was determined using the adjusted odds ratio (AOR) with their corresponding 95 % confidence interval. P-values of <0.05 were used to declare statistical significance. Tables and diagrammatical presentation were used, and mean with standard deviation were used to interpret continuous variables. ATLAS.ti was used for qualitative data analysis. Finally, the finding was explained by triangulating with the quantitative findings in the result. Result: The prevalence of sexual violence among was 67.9% (95% CI: 63%-72%). The odd of sexual violence was higher among housemaids whose agreement were daily (AOR=11.173, 95% CI =1.220, 15.298), there employer drunk alcohol (4.174, 95% CI = 1.851, 9.416), housemaids origin from rural area (AOR= 2.95 (1.56, 5.55), whereas housemaid living with another housemaid in the household were less likely to face sexual violence (AOR=0.429, 95% CI = 0.218, 0.844). Conclusion: There was a high prevalence of sexual violence among housemaids. Types of agreement, origin of the housemaid, and presence of other housemaid and employers alcohol consumption were significantly associated with sexual violence.
ISOLATION AND IDENTIFICATION OF STAPHYLOCOCCUS AUREUS IN COW MILK AND MILK PRODUCTS: IT’S PUBLIC HEALTH IMPILCATION AND ANTIBIOTIC RESESITANCE IN SHASHEMENE TOWN OROMIA, ETHIOPIA
(Hawassa University, 2024-06) HASSEN JILO
A cross sectional study was conducted from May 2023 to April 2024 in Shashemene town Oromia, Ethiopia, aimed to isolate and identify Staphylococcus aureus and their resistance to different antimicrobials. A total of 220 samples were collected using a simple random sampling technique for bacteriological isolation and 120 questionaries’ were collected from farm owners, milk collection centers (MCCs) and retailer shops. A standard bacteriological and biochemical tests were used to isolate Staphylococcus aureus. Staphylococcus aureus was isolated from 35.9 % (N=79) of the total samples. The isolation rate was found higher in MCCs (43.5%) than milk retailer shop (34.9%) and farms (27.8%). All (n=79) isolates of Staphylococcus aureus were tested for antimicrobial susceptibility of 9 selected drugs. The isolates were susceptible to sulphamethoxazole-trimethoprim (95.23%), vancomycine (90.47%) and Gentamycin (80.9%); however, they were highly resistant to Ampicillin (100%), Amoxicillin clavulanic acid (76.19%), Streptomycin (76.19%), Nalidicix acid (71.4%), and Tetracycline (66.66%), and also moderately resistant to Ciprofloxacin (38.07%). Lacks of stringent regulation and monitoring in the dispensing and use of antimicrobials in the area contribute to the occurrence of high antimicrobial resistance to these drugs. Furthermore, an attempt was made by using semi structured questioaire survey that include farmers, consumers, owners and milk collectors at MCC. It revealed raw milk consumption behavior, and inadequate knowledge of milk borne disease. This study showed that Staphylococcus aureus is widespread in milk and milk products and developed multiple drug résistance. It is therefore, creation of public awareness about, pasteurization or boiling of milk prior to consumption, rational use of drugs and periodic assessment of the antimicrobial sensitivity of drugs prior to use are paramount important.