Master of Public Health

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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.
Calcium-containing Eggshell Powder Supplementation to Mitigate Toxic Effects of Excess Fluoride Intake among Women in Ethiopian Rift Valley: Efficacy, association, safety and acceptability
(Hawassa University, 2024-11) Demmelash Mulualem Zewdie
Background: Worldwide, 50 million people suffer from fluorosis, which affects not only teeth, but also bones, joints, gut and brain functions. In Ethiopia, where defluoridation requires costly infrastructure, more than 14 million individuals, mainly in the Rift Valley, are affected by fluorosis. Drinking water sources, in the Rift Valley of Ethiopia, contain fluoride (F) levels exceeding the World Health Organization (WHO) limit of 1.5mg/L. F exposure may be an added concern for women’s bone and dental health where there is low Ca intake. Studies suggest that the adverse effects of F can be reversed or lessened by providing sufficient food intake of protein, calcium (Ca), anti-oxidants and vitamin D. Of these, Ca is the most studied by ecological studies. However, there have been no intervention studies of Ca to mitigate fluorosis at the community level in Ethiopia. We therefore hypothesized that supplementation of an age old, sustainable and low cost source of Ca, i.e., eggshell, as a dietary Ca source would mitigate the toxic effects of excess F intake in women. Thus, the aim of this study was to test the efficacy of calcium-containing ESP supplementation, as a proof of concept, to reduce F absorption as measured by urinary F excretion (a primary outcome measure) and mitigation of fluorosis symptoms (secondary outcomes) in women living in a fluorosis-affected area. The overall objective of this PhD research was to assess efficacy, association and safety and acceptability of calcium-containing eggshell powder supplementation to mitigate toxic effects of excess fluoride intake among women in Ethiopian Rift Valley. Methods: Women (n=270) from two villages provided clinical and questionnaire data for the cross-sectional survey. Dental fluorosis examination was done using Dean’s Index, and skeletal and non-skeletal fluorosis assessment was carried out using physical tests and clinical symptoms. Daily Ca intake was estimated by a food frequency questionnaire. Food, drinking water and beverage samples were analyzed for F level. Eighty-two women (41 Intervention Group, IG; 41 Control Group, CG) were recruited for the Phase II clinical trial; 39 in each group completed the trial. Morning spot urine was collected for testing fluoride (F), calcium (Ca) and creatinine concentrations, before (baseline, BL) and after (endline, EL) the intervention that was 6-months daily supplementation with 2.4 gram calcium-containing eggshell powder/ESP (providing ~1000 mg of calcium). Dental, skeletal and non-skeletal fluorosis assessments were carried out at BL and, except for dental, at EL. For the purpose of safety and acceptability assessment, body retention of iron and zinc were measured using blood levels, prior to and after the calcium containing ESP supplementation among the study subjects. Occurrence of side effects such as nausea, vomiting, constipation, and abdominal bloating and gas related to excess calcium intake in the Phase II trial were assessed using checklists on a monthly period. In addition, blood tests for malaria, hemoglobin and hematocrit were done immediately in the field. Descriptive statistics, bivariate and multivariable logistic regression, relative risk (RR), paired samples t-test and two independent samples t-test, linear generalized estimating equation (GEE) and multivariate analysis of the GEE model were used to analyze and compare outcomes between groups. Results: Many subjects (56.3%) exhibited dental fluorosis. Women having ≤ 400 mg/day Ca intake had ~3 times greater odds of developing skeletal rigidity with joint pains [AOR=2.8, 95%CI: 1.6, 5.0] and muscular weakness [AOR=2.9, 95%CI: 1.3, 6.3] compared to those with higher intakes. At EL, women in the IG had about six-fold lower urinary F excretion [β = - 6.1 (95% CI: -7.1, -5.1)] compared to women in the CG. The risk of developing skeletal fluorosis tested using the ability to bend body and touch floor or toe [RR = 0.21 (95% CI: 0.07, 0.69)], and stretch and fold arms to touch back of head [RR = 0.18 (95% CI: 0.04, 0.77)] were significantly reduced in the intervention group by 79% and 82% respectively compared with the control. Majority of the women in IG reported mitigation of pain and muscular symptoms of non-skeletal fluorosis ranging from lowest RR = 0.17 (95% CI: 0.05, 0.52) to highest RR = 0.59 (95% CI: 0.39, 0.88) after the calcium-containing ESP supplementation than in CG. Conclusion: Signs and symptoms of dental, skeletal and non-skeletal fluorosis were prevalent in women of child-bearing age in this area of the Rift Valley of Ethiopia. As low dietary Ca intake was significantly associated with symptoms related to skeletal and non-skeletal fluorosis, this warrants nutritional intervention on calcium intakes in this setting. A significant reduction in urinary F excretion and reduction in many fluorosis symptoms were observed among women supplemented with calcium-containing ESP, thus providing evidence for using this dietary calcium (ESP) source for mitigation of fluorosis. Safety and acceptability assessments conducted as part of the study indicated that calcium-containing eggshell powder supplementation was generally accepted, well-tolerated and did not pose significant risks to the health of participants. The potential feasibility, sustainability and safety of using home prepared crushed eggshells in areas where fluorosis is endemic need to be studied. Clinical trials registration: NCT03355222 Keywords: Calcium; Fluoride; Fluorosis; Eggshell powder; Safety; Acceptibility; Women; Ethiopia; Rift Valley.
Clinical outcomes and associated factors of acute poisoning among patients admitted to Hawassa University Comprehensive specialized Hospital, Sidama Regional State, Ethiopia
(Hawassa University, 2024-09) Kindalem Worku
Background: Acute poisoning is a worldwide public health concern as well as a medical emergency that can arise from exposure to high concentrations of any substance that has toxic consequences and manifests within hours of exposure. It’s a common reason for emergency room admission, which leads to mortality and morbidity. Ethiopia is among the countries that don’t have a dedicated toxicology center which is important for treating poison cases. Objective: The purpose of this study was to assess the Clinical outcomes and associated factors of acute poisoning among patients admitted to Hawassa University Comprehensive Specialized Hospital Emergency Department, Hawassa, Ethiopia from December 2018 to December 2023. Methods: It was a retrospective cross-sectional hospital record-based study of acute poisoning cases admitted to HUCSH ED during the study period. The data were collected using a structured questionnaire, entered, coded and cleaned using Kobo data collection toolbox software and exported to SPSS version 25 software. The data were analyzed for descriptive statistics and statistical analysis was performed using bivariate for those variables having a P value of < .25 multivariable logistic regression analysis was done to identify factors associated with the death of acute poisoning cases. The result is presented in the form of tables, figures, and text using frequencies and summary statistics such as mean, SD, median and percentage. The statistical significance was declared at a P value less than 0.05. Result: In this study, a total of 212 acute poisoning cases were retrospectively analyzed. From the total cases majority of the cases were males accounting for 110 (51.9%). With a median age of 22 years the number of deaths in this study was 20(9.4%) at 95% (CI: 6.15%, 14.20%) and organophosphate being the common agent at 66(31.1%) as well as the common agent ascribed to death. Multivariable logistic regression analysis showed that the independent factors associated with death were hospital stay of more than two days [AOR: 1.009(.00, .18)); p-value of: .002]. Conclusion: Patients with acute poisoning had a high fatality rate in poisoning cases. A longer hospital stay of more than 48 hours, the presence of medical complications after admission and in patients who are more than 26 years old were found to be associated with death.
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
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.
DETERMINANTS OF PODOCONIOSIS IN NORTHERN ZONE OF SIDAMA REGION, ETHIOPIA: AN UNMATCHED CASE- CONTROL STUDY
(Hawassa University, 2024-08) MELKAMU UGAMO
Background: Podoconiosis is a type of elephantiasis caused by long-term barefoot exposure to red clay soil. It is a debilitating disease that leads to disability and stigma. Despite the widespread prevalence of podoconiosis, the determinants of it remain largely unexplored, especially within the context of the Sidama region. The findings will contribute to a comprehensive understanding of the determinants, facilitate the development of targeted prevention strategies in the specified region, and bridge the existing knowledge gap pertaining to determinants in southern Ethiopia. Objective: To identify the determinants of podoconiosis in the Northern Zone of Sidama Region, Southern Ethiopia, in 2024. Methods: An unmatched case-control study design was employed in selected districts within the northern zone of the Sidama Region. The cases comprised 191 randomly selected individuals with clinically confirmed podoconiosis and a negative filarial test. The controls consisted of 383 randomly selected individuals who exhibited no signs or symptoms of podoconiosis. Data were collected through structured interviews conducted using the KoBo mobile application. Both bivariable and multivariable logistic regression analyses were performed to evaluate the associations between potential determinants of podoconiosis. Statistical significance was declared at a p-value of less than 0.05. The magnitude of the association was presented using the adjusted odds ratio (AOR) with a 95% confidence interval. Results: A total of 574 (191 cases and 383 controls) participants were included in the study. Age ≥50 years (AOR=2.61; 95% CI: 1.22, 5.58), no formal education (AOR=3.04; 95% CI: 1.06, 7.73) , primary education (AOR=3.67; 95% CI: 1.32, 10.20), not wearing shoes (AOR=4.10; 95% CI: 1.72, 9.79), having unclean feet (AOR=4.80; 95% CI: 2.84, 8.11), purchasing no or a pair of shoes in a year (AOR=2.61, 95% CI: 1.48-4.61), poor knowledge (AOR = 3.52; 95% CI: 2.14, 5.78) and negative attitude (AOR = 1.80; 95% CI: 1.11-2.94) were significantly associated with podoconiosis. Conclusions: The study identified older age, lower educational attainment, not wearing shoes, poor foot hygiene, buying no shoes or a pair of shoes in a year, poor knowledge, and poor attitude as significant factors for podoconiosis. Multifaceted interventions on awareness- creation education, consistent shoe use and foot hygiene, and changing attitudes towards podoconiosis are crucial to mitigating this neglected tropical disease in endemic regions.
DETERMINANTS OF PODOCONIOSIS IN NORTHERN ZONE OF SIDAMA REGION, ETHIOPIA: AN UNMATCHED CASE- CONTROL STUDY
(Hawassa University, 2024-06) MELKAMU UGAMO (BSC)
Background: Podoconiosis is a type of elephantiasis caused by long-term barefoot exposure to red clay soil. It is a debilitating disease that leads to disability and stigma. Despite the widespread prevalence of podoconiosis, the determinants of it remain largely unexplored, especially within the context of the Sidama region. The findings will contribute to a comprehensive understanding of the determinants, facilitate the development of targeted prevention strategies in the specified region, and bridge the existing knowledge gap pertaining to determinants in southern Ethiopia. Objective: To identify the determinants of podoconiosis in the Northern Zone of Sidama Region, Southern Ethiopia, in 2024. Methods: An unmatched case-control study design was employed in selected districts within the northern zone of the Sidama Region. The cases comprised 191 randomly selected individuals with clinically confirmed podoconiosis and a negative filarial test. The controls consisted of 383 randomly selected individuals who exhibited no signs or symptoms of podoconiosis. Data were collected through structured interviews conducted using the KoBo mobile application. Both bivariable and multivariable logistic regression analyses were performed to evaluate the associations between potential determinants of podoconiosis. Statistical significance was declared at a p-value of less than 0.05. The magnitude of the association was presented using the adjusted odds ratio (AOR) with a 95% confidence interval. Results: A total of 574 (191 cases and 383 controls) participants were included in the study. Age ≥50 years (AOR=2.61; 95% CI: 1.22, 5.58), no formal education (AOR=3.04; 95% CI: 1.06, 7.73) , primary education (AOR=3.67; 95% CI: 1.32, 10.20), not wearing shoes (AOR=4.10; 95% CI: 1.72, 9.79), having unclean feet (AOR=4.80; 95% CI: 2.84, 8.11), purchasing no or a pair of shoes in a year (AOR=2.61, 95% CI: 1.48-4.61), poor knowledge (AOR = 3.52; 95% CI: 2.14, 5.78) and negative attitude (AOR = 1.80; 95% CI: 1.11-2.94) were significantly associated with podoconiosis. Conclusions: The study identified older age, lower educational attainment, not wearing shoes, poor foot hygiene, buying no shoes or a pair of shoes in a year, poor knowledge, and poor XIII attitude as significant factors for podoconiosis. Multifaceted interventions on awareness- creation education, consistent shoe use and foot hygiene, and changing attitudes towards podoconiosis are crucial to mitigating this neglected tropical disease in endemic regions.
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.
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.
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.
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.
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
INTENTION TOWARDS FEMALE GENITAL MUTILATION AMONG WOMEN OF REPRODUCTIVE AGE GROUP, USING BEHAVIORAL INTENTION APPROACH ATOTEHULO DISTRICT, HALABA ZONE, CENTRAL ETHIOPIA, 2024
(Hawassa University, 2024-09) DAGMAWIT GIRMA
Introduction: female genital mutilation /cutting are a deeply rooted harmful traditional practice, affecting millions of girls and women globally which have serious physical and psychosocial consequences. Understanding the intentions and attitude towards Female genital mutilation among women of reproductive age is crucial however there is only limited research in Ethiopia to have comprehensive understanding of the problem. Therefore, this study was aimed to asses intention towards Female genital mutilation is highly valuable. Methods and materials: Embedded mixed study design was conducted among reproductive age group between April 1 and April 30, 2024. A total 497 women were selected for the quantitative data using a multi-stage sampling procedure. Data was collected using a structured questionnaire with Kobo collect application. Then, SPSS version 25 was used to clean, to code and analyze of the data. Variables that had a p-value of less than 0.25 in the bivariable logistic regression were selected as candidate variables for the multivariable logistic regression model, and a P value of less than 0.05 at a 95% confidence interval was considered statistically significant. Finlay, the findings were presented using tables, charts and graphs accordingly, for qualitative data, semi structured interview was used among 8 participants and thematic analysis was done by using ATLAS ti.version 24 software Result: - prevalence of intention towards the practice in this study was 54.1%. the odds of intention to continue were 2 times higher on women who had Favorable attitude than their counterparts (AOR= 2.4: 95% CI= 1.37-4.3: P=0.002), odds of Favorable subjective norm (AOR=4.91, 95%CI: 2.76-8.63, P=0.000)were about 5 times higher intend to continue than their counterparts also, Circumcision history of women (AOR=2.76, 95%CI=1.2-6.3, P=0.017) and Child with circumcision (AOR= 5.75, 95% CI= 2.2-14.7, P=0.000) were found to be significantly associated with intention. For qualitative part 3 themes were extracted from total respondents including, attitude, subjective norm and intention to continuation. Conclusion: According to this study 54.1 of the participant had intended to continue the practice. Attitude, subjective norm, child circumcision history, mother circumcision history as a child was associated with intention. For qualitative part. Participant’s attitude, Subjective norm and intention to continue were the themes extracted from analysis, which support our quantitative findings.
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.
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
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
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.
PELVIC ORGAN PROLAPSE AMONG WOMEN IN SIDAMA REGION, ETHIOPIA: PREVALENCE, RISK FACTORS, AND EFFECT OF PELVIC FLOOR MUSCLE TRAINING
(Hawassa University, 2025-04) MELESE SIYOUM DESTA
Background: Pelvic organ prolapse (POP) is a condition characterized by the descent of pelvic vaginal compartment and the surrounding organs. It’s impact on a woman's quality of life can be substantial, resulting in psychological distress, social isolation, and physical complications. POP is a prevalent condition affecting millions of women worldwide. Despite its widespread occurrence, the true prevalence remains uncertain due to inconsistencies in diagnostic methods and reporting practices. Pelvic floor muscle training is a recommended first-line treatment for managing POP, but its effectiveness in low-income setting is understudied. Objectives This study aimed to enhance the understanding of pelvic organ prolapse symptom assessment, its prevalence and risk factors, and the management of mild to moderate pelvic organ prolapse among women in the Sidama Region, Ethiopia. Methods A total of 100 women with symptomatic prolapse completed the POP-SS questionnaire during the first round of interviews, with 61 completing a second round for test-retest reliability assessment. Content validity was evaluated using the content validity index and the construct validity was assessed through exploratory factor analysis. Known group validity was determined using the Kruskal-Wallis test. Internal consistency reliability was assessed using Cronbach's alpha, and test retest reliability was evaluated using the intraclass correlation coefficient to assess the stability of the questionnaire over time (Paper I). A community-based cross-sectional survey was conducted in the Dale-Wonsho Health and Demographic Surveillance Site from March to October 2023. A multi-stage stratified cluster sampling method was employed to select a representative sample of 816 women. Anatomical prolapse was diagnosed using the standardized pelvic organ prolapse quantification (POP-Q) method. Symptomatic prolapse was assessed through patient-reported symptoms, allowing for the identification of women experiencing significant discomfort or functional impairment. A complex survey-based modified Poisson regression was used to identify risk factors associated with prolapse (Paper II).Furthermore, a parallel-groups, two-arm cRCT was conducted in the Dale-Wonsho Health and Demographic Surveillance Site. A total of 187 women with symptomatic POP stages I-III from eight kebeles/clusters were randomized by cluster to receive either midwife-led pelvic floor muscle training plus lifestyle counselling (intervention group) or lifestyle counselling alone (control group). The primary outcomes included changes in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear models were utilized to determine the effect of pelvic floor muscle training on prolapse symptoms and prolapse quality of life (Paper III). Results The pelvic organ prolapses symptom score questionnaire was successfully translated into Sidaamu Afoo, demonstrating good content validity (0.88) and high internal consistency (α= 0.79). Test retest reliability was also strong (ICC = 0.83). Exploratory factor analysis revealed two factors (physical and functional) explaining 70.6% of the variance, with significant loadings for each item. Known group validity showed a significant difference in median prolapse symptom scores across different prolapse stages (Kruskal-Wallis χ2 = 17.5, p < 0.001) (Paper I). In Paper II, among the 815 women surveyed, 779 (95.6%) underwent pelvic examinations. Anatomical prolapse (stages II-IV) was observed in 241 (30.90%, 95%CI: 24–38.7%) participants, The overall prevalence of symptomatic prolapse in the total sample was 189 (24.27%, (95% CI: 19.98–29.16%). Significant risk factors for anatomical prolapse included higher parity (APR: 1.17; 95%CI: 1.1-1.24), prolonged heavy lifting (APR: 1.26; (95%CI: 1.14-1.4), and prolonged labor (APR: 1.32; 95%CI: 1.1-1.56). Factors associated with symptomatic prolapse included early childbirth (APR for age at first birth < 18 years: 1.29 (95%CI: 1.1-1.52) and prolonged heavy lifting (APR: 1.16 (95%CI: 1.10-1.28). In the intervention study (Paper III), 187 women were randomized to the intervention (n=86) and control (n=101) groups. At six months, the intervention group showed significantly greater improvements in prolapse symptoms compared to the control group, with a mean change difference of -4.11 (99% CI: -5.38, -2.83). Significant improvements were also observed in the intervention group across various domains of the prolapse quality of life scale: -8.86 (99% CI: 13.84 -3.89) in physical domain; -11.18 (99% CI: -15.03, -7.32) in psychological domain, and 9.01 (99% CI: -10.49 -5.54) in personal relationship domain. A higher proportion (83.72%) of women in the intervention group perceived their condition as "better" after the intervention, compared to 41.57% in the control group. Conclusions The Sidaamu Afoo version of the POP-SS tool is valid and reliable for assessing pelvic organ prolapse symptoms. The prevalence of anatomical and symptomatic prolapse is notably high in the Sidama Region, with identified risk factors necessitating community-based education and interventions. Moreover, midwife-led PFMT combined with lifestyle counselling significantly improves symptoms and quality of life in women with mild to moderate POP, highlighting its potential for integration into maternal and reproductive health programs in low-resource settings. In addition, routine screening and campaigns are needed to identify the cases early.
PREVALENCE AND ASSOCIATED FACTORS OF INTIMATE PARTINER VIOLENCE AMONG HIV-POSITIVE WOMAN ATTENDING ART CLINICS HAWASSA CITY PUBLIC FACILITIES, SIDAMA, ETHIOPIA, 2024.
(Hawassa University, 2024-09) ENDRIYAS SAMATO
Background: Intimate partner violence against women is a global public health issue, causing harm to close friends or intimate partners. One in three women has experienced violence, but it's underreported. This study aims to fill this gap by examining the prevalence and associated factors of intimate partner violence among HIV-positive women. Methods: Facility based cross-sectional study with quantitative data collection methods was applied at Hawassa City public Healthcare facilities from March to April; 2024.The sample size will be determined by using openEpi. The facilities were selected by simple random method, and the sample. Data was collected by trained data collectors and collected by face to face interview by using electronic materials. Data was collected by Kobo toolbox and exported to SPSS version 26 and STATA version 16 for analysis. Both bivariate and multivariable logistic regression analyses and to analysis was applied. In the multiple logistic regression analysis, a less than 0.05 P-value was considered statistically significant. Result: A total of 554 women responded completely, for a response rate of 98.75%. The mean age of the respondent was 36.08 (SD±7.58) years. In the past 12 months prevalence IPV, who had experienced one of the physical, emotional or sexual questions among HIV positive women was 40.3% (95 CI 36.3, 44.6). Psychological/emotional violence was the most common form, with prevalence of 36% (95%CI 32.9- 41.0%), followed by sexual violence 26 %( 95% CI 22.9- 30.1%) and physical violence 23.8 %( 95% CI 20.2-27.4%). Associated factors among HIV positive women include: disclosing HIV status for a partner or husband [AOR= 1.99, 95%CI (1.057, 3.747), partner alcohol drunk [AOR= 2.755, 95%CI (1.428, 5.313). Conclusion: Intimate partner violence among HIV positive attending ART clinics in study areas were considered to be high and identified as a public health issue. The important factors identified as significantly associated to the IPV among HIV positive women who attending ART clinics were disclose HIV status for partner or husband, Partner who drinks alcohol, women with three or more children, family monthly income less than 2000, history of faced stillbirth and being currently married women were significantly associated. Recommendations: Policy makers and concerned stake holders need to design screening tool to identify IPV in the health facilities, and intervention program implementation should be amended at the grass root level of the community accordingly.