College of Medicine and Health Science

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    INCIDENCE AND PREDICTORS OF LOSS TO FOLLOW UP AMONG ADULTS ON ANTIRETROVIRAL THERAPY AT PUBLIC HEALTH FACILITIES IN HAWASSA, SIDAMA REGION, ETHIOPIA, 2024
    (hawassa universty, 2024-06) RUTH TESFAYE
    Background: Despite significant progress in treatment and prevention, the global HIV/AIDS pandemic remains a serious threat to public health. HIV-related mortality and morbidity have greatly decreased as a result of ART, transforming HIV into a chronic, manageable condition. However, loss to follow-up hinders efforts to manage the HIV pandemic and is a substantial challenge. Objectives: The objective of this study was to determine the incidence and predictors of loss to follow up among adults on ART in Hawassa, Sidama, Ethiopia 2024. Methods: An institution-based retrospective follow up study was conducted. The study utilized data from four selected ART clinics, collected retrospectively on 459 study participants from September 11, 2018 to September 11, 2023. A simple random sampling technique was employed. Data were extracted from patients' charts and registration books using KOBO Toolbox and exported to SPSS for analysis. The incidence of LTFU was calculated using cumulative incidence and incidence density rates. Kaplan-Meier survival curves were employed, providing insights into LTFU patterns. Predictors of LTFU were determined using multivariable Cox proportional-hazard regression. Result: A total of 459 participants were included in the study, contributing 1386 person years of follow-up. The cumulative incidence of loss to follow-up (LTFU) was 16.6%, with an incidence density rate of 5.48 per 100 person-years [95% CI: 4.37- 6.86]. Significant predictors of LTFU included younger age groups (AHR 2.77, 95% CI: 1.06 - 7.19), lack of education (AHR 4.08, 95% CI: 1.34 - 12.43), WHO stage III (AHR 3.06, 95% CI: 1.04 - 8.99), WHO stage IV (AHR 4.64, 95% CI: 1.82 - 11.85), and being bedridden (AHR 3.63, 95% CI: 1.42 - 9.32). These factors were identified as significant predictors of LTFU in this cohort of ART patients in Hawassa, Ethiopia. Conclusions: This study found that the incidence of LTFU was moderate relative to certain global and local findings. Age, education, WHO clinical stage, functional status and CPT treatment are found significant predictors of LTFU. These findings highlight the need for targeted interventions to address the specific challenges faced by the identified vulnerable groups.
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    PREVALENCE OF BODY IMAGE DISSATISFACTION AND ASSOCIATED FACTORS AMONG HIGH SCHOOL ADOLESCENT IN HAWASSA CITY, ETHIOPIA, 2023
    (hawassa universty, 2023-11) GEMEDA BILLO
    Background: Adolescence is a period wherein multiple intense bio-psychosocial maturation, physical appearance, and psychological changes happen rapidly and individuals at this stage are more concerned with their body image than any other age group. However, little is known about the prevalence of body image dissatisfaction and the factors associated with body image dissatisfaction. Objective: To assess prevalence of body image dissatisfaction and identify associated factors among high school adolescents in Hawassa City, 2023. Methods: A school-based cross-sectional study was conducted among 421 participants from April 20 to May 20, 2023, in Hawassa City. A stratified sampling technique was employed to select the study participants. A structured self-administered questionnaire was used to collect data. Anthropometric measurements of weight and height were taken to the nearest 0.1 kg and 0.5cm using SECA digital balance and height measuring tape in a standing position. The data was entered into Epi-data version 3.1 and exported and analyzed using the statistical package for social sciences (SPSS), version 24. A logistic regression model was fitted and used to identify the associated factors of body image dissatisfaction and statistical significance was declared at P<0.05. Result: The overall prevalence of body image dissatisfaction was 18.5% with [95% CI (14.8 22.2%)]. In this study being overweight/obese [AOR=7.8, 95% CI;(2.58-23.83)], engaging in a small amount of exercise [AOR=3.66, 95% CI; (1.34-10.0)], having moderate depression [AOR=3.6,95% CI:(1.25-10.40)], having severe depression [AOR=6.8, 95% CI; (1.94 24.22)], being at late age of adolescent [AOR=1.9, 95% CI; (1.07-3.39)], and having family pressure [AOR=2.2, 95% CI; (1.28-4.04)] were significantly associated with body image dissatisfaction. Conclusion: According to this study, there is a high prevalence of body image dissatisfaction among high school adolescents. Therefore, encouraging physical activity and providing constructive family feedback would be appropriate strategies to address body image dissatisfaction.
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    MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
    (hawassa universty, 2023-11) GELANE GELETO (BSc)
    Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.
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    PALLIATIVE CARE PRACTICE, PERCEIVED BARRIERS, AND ASSOCIATED FACTORS AMONG NURSES WORKING IN SELECTED PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA ETHIOPIA
    (hawassa universty, 2023-11) BEYENE FELEKE ASHAGRE (BSc)
    Background: Palliative care is a comprehensive approach that enhances the quality of life of patients and their families facing problems related to life-threatening illnesses. Since nurses play an active role in managing patients' disease diagnosis and treatment in clinical palliative care practice, identifying their practice level is critical. However, there is a lack of data regarding palliative care practice, barriers, and associated factors among nurses in the study area. Objective: To assess the palliative care practice, perceived barriers, and associated factors among nurses working in selected public hospitals in Hawassa, Sidama, Ethiopia. Methods: An institutional-based cross-sectional study design using quantitative supplemented by qualitative data collection methods was employed among 319 nurses and 8 key informants, respectively, at a selected public hospital in Hawassa City, Sidama, Ethiopia, from March 15 to July 30, 2023.Simple random sampling techniques and purposive sampling techniques were used to collect data. Data were collected using pretested, self-administered questionnaires and an in-depth interview. Epi-Data and Statistical Program for Social Sciences software were used for data entry and analysis. Descriptive, bivariate, and multivariable logistic regression analyses were utilized. A p-value of <0.05 on multivariate logistic regression was declaredfor the associated variable. For qualitative data, thematic analysis was used. Results:The response rate among the 313 nurses who completed the questionnaire was 98%. Around three-fourths,76.6% [95% CI, 72–81] of participants had poor palliative care practices. Type of hospital, age, education level, experiences, and training were significantly associated with overall palliative care practices. This study explored four main themes in qualitative findings: knowledge deficit, negative patient attitudes, spiritual care, and modern medicine clash, issues with healthcare providers, and inadequate hospital facilities. Conclusion and recommendations: Overall, nurses had poor palliative care practices. Type of hospital, age, education level, experiences, and training were factors associated with practice towards palliative care, anda sub-category of themes emerged from a qualitative study. Therefore, it is necessary to provide basic education and continue on-the-job training for nurses to bridge the gap of poor practice.
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    MAGNITUDE AND ASSOCIATED FACTORS OF EARLY MORTALITY AMONG DEATHS IN ADULT EMERGENCY DEPARTMENT, AT PUBLIC HOSPITALS, HAWASSA, SIDAMA, ETHIOPIA,2023.
    (Hawassa University, 2023-11) GELANE GELETO
    Background: early mortality defined as death with 72 hours of emergency department presentation. In low-income countries with limited resources, adult emergency department mortality remains high. The majority (59.8%) of those deaths occur within the first three days of admission to the emergency department in Ethiopia. Previously, only single-center studies at tertiary hospitals were conducted in Ethiopia. Objective: to assess the magnitude and associated factors of early mortality among deaths in adult emergency departments at selected public hospitals in Hawassa, Sidama, Ethiopia, from January 2021 to December 2022. Methods: An institutional-based cross-sectional study design was applied. A systematic random sampling technique was used to select 369 charts of patients who died in adult emergency departments of selected public hospitals in two years. The data was collected using a pre-tested data abstraction tool entered into the Kobo toolbox, then entered into EpiData version 4.6.0 and exported to SPSS version 27 for analysis. By using binary logistic regression Bivariate and multivariate analyses were run. Finally, statistical significance was declared at p-value <0.05, and an adjusted odds ratio with a 95% confidence interval was used to report the strength of the association Result: This study result shows that 50.2% of the participants were between the ages of 25-54 with mean average 40.6 ± 17.5 and 67.7% were male. 288 (78%) died within 72 hours. Lack of prehospital care [(AOR = 4.2; 95% CI: 2.23, 7.87), P = 0.007], road traffic accidents [(AOR = 4.1; 95% CI: 1.403, 12.076), P = 0.013], red triage categories [(AOR = 3.9; 95% CI: 1.6, 9.4), P = 0.003], had lack of investigation[(AOR = 3.4; 95% CI: 1.2, 9.4), comorbid illness [(AOR = 3.2; 95% CI: 1.558, 6.49), P = 0.001] and delayed initial intervention [(AOR = 2.338; 95% CI: 1.259, 4.339), P = 0.007] were significantly associated with early mortality. Conclusion: In this study, a greater early mortality rate was detected. Early morality was increased by a lack of prehospital treatment, road traffic accidents, a red warning score, a lack of investigation, comorbidity, and a delay in the first intervention.
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    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.
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