Thesis and Dissertations

Risk prediction model for mortality in patients receiving antiretroviral treatment at Felege Hiwot comprehensive specialized hospital: A retrospective cohort study.

Wed, 20 Aug 2025 00:00:00 GMT

Risk prediction model for mortality in patients receiving antiretroviral treatment at Felege Hiwot comprehensive specialized hospital: A retrospective cohort study. Tesfa Damtie, Endalamaw Abstract Background: Despite advancements in antiretroviral treatment (ART), a significant number of HIV patients continue to die due to the infection. In developing countries like Ethiopia, there is no prediction model to assess mortality risk in patients receiving ART. This study was designed to Develop a mortality risk prediction model in patients receiving ART at Felege Hiwot. Comprehensive Specialized Hospital (FHCSH). Methods: A retrospective-cohort study was conducted at FHCSH to develop a risk prediction. model for mortality in patients receiving ART. The sample size was calculated using the rule of thumb and included 777 participants. Secondary data were utilized, and data entry and analysis were performed using Epi-Info and R statistical software. Logistic regression analysis was conducted to identify the prognostic determinants of mortality. Model performance was assessed. using the receiver operating characteristic (ROC) curve (AUC), along with calibration plots. The Mortality risk prediction was presented in the form of a nomogram. Model accuracy and risk Estimates were assessed via internal validation using the bootstrapping method, and the clinical and The public health benefit of the model was evaluated by decision curve analysis (DCA). Results: The incidence of HIV mortality was 12.6% (95% CI: 10.2%-15.1%). Six prognostic determinants: WHO clinical staging, functional status, baseline regimen, duration of treatment, Adherence and comorbidities were used to develop the mortality risk prediction nomogram. The AUC of the original model was 0.968 (95% CI: 0.951-0.983), while the AUC of the reduced model demonstrated excellent discriminatory power at 0.967 (95% CI: 0.947-0.987), with calibration fitting well. At a cut-off value of 0.1667 (Youden index), the model achieved an accuracy of 93.3%, a sensitivity of 87.8%, and a specificity of 94.1%. The DCA highlighted its clinical and public health importance within the range of 0.1 to 0.8 thresholds. Conclusions: In this study the incidence of mortality is somewhat high as compared with the previous studies, and six prognostic determinants were used to develop the nomogram to predict risk of mortality. The AUC curve showed an excellent discrimination, with strong sensitivity and specificity, helping healthcare providers to forecast mortality risk in patients receiving ART. However, before implementing in a clinical setting, a multicenter, large-scale, prospective cohort Studies are warranted to validate its generalizability and effectiveness.

Practice Of Preventive Measures Of Covid-19 And Associated Factors Among Pregnant Women Attending Antenatal Care In Adiarkay District Northwest Ethiopia

Tue, 20 Jul 2021 00:00:00 GMT

Practice Of Preventive Measures Of Covid-19 And Associated Factors Among Pregnant Women Attending Antenatal Care In Adiarkay District Northwest Ethiopia Engidaw, Dereje ABSTRACT Back ground: Coronavirus disease-2019 is a newly emerging respiratory disease caused by a novel coronavirus or severe acute respiratory syndrome coronavirus-2. Objectives: To determine practice of preventive measures of COVID-19 and identify associated factors among pregnant women attended antenatal care in Adiarkay district health facilities Northwest Ethiopia 2021. Methods: A facility based cross- sectional study design was conducted from March to April 2021.The study population were pregnant women who attended antenatal care follow up visit during data collection time and were selected using Systematic sampling technique. Data were coded and entered into EPI data version 3.2 and exported to SPSS version 23 for analysis. Bi- variable logistic regression analysis were done. Thus, independent variables with probability value less than 0.25 were considered in the final model. The model fitness was checked by using Hosmer-Lemeshow model fitness test with probability value (0.99). Then Multivariable Logistic regression analysis was done to identify the factors associated with practice of preventive measures of COVID-19. A statistical significance level were consider at a Probability value of less than 0.05, and strength of association was explained by odds ratio. Results: A total of 458 pregnant women were participated in this study .This study, showed that 241 (52.6%; 95% CI= 48.3-55.7) of participants had good level of practice of preventive measures of COVID-19. Pregnant women who had primary education status (AOR: 4.51; 95% CI: 2.66-7.6), had secondary education status (AOR: 2.45; 95% CI: 1.05-5.66), had college and above educational status (AOR: 5.81; 95% CI: 2.48-13.58), had three antenatal care follow up (AOR 2.12; 95:1.13-3.96) had four antenatal care follow up (AOR 2.59; 95% CI: 1.03-6.5), heard information from television and radio (AOR 3.54; 95% CI: 1.36-9.22) and had good attitude (AOR: 2.3; 95% CI: 1.3-4.0) were significantly associated with good practice of preventive measures of COVID-19. Conclusion: This study finding showed that good practice of preventive measures of COVID-19 was 52.6% which was low. Pregnant women’s educational status, longer antenatal care follow up, good attitude, and heard from television and radio about COVID were statistically significant with good preventive measures of COVID-19.

Adequate fruit or vegetable consumption and associated factors among young children aged 2-5 years in Waja town, North East Ethiopia, 2025.

Tue, 20 Jan 2026 00:00:00 GMT

Adequate fruit or vegetable consumption and associated factors among young children aged 2-5 years in Waja town, North East Ethiopia, 2025. Mengesha Haile, Alie ABSTRACT Background: Adequate fruit and vegetable consumption during early childhood plays a crucial role in preventing all forms of malnutrition, supporting optimal growth and development, and reducing the risk of NCDs later in life. Despite these benefits, children’s intake often falls below recommended levels globally. In Ethiopia, no published study has specifically assessed adequate fruit or vegetable intake among young children aged 2-5 years, despite being a critical period to establish a healthy dietary habit. National data on zero fruit or vegetable consumption among children under two years indicate very low intake, suggesting that inadequate consumption may persist into the preschool years. However, evidence on the magnitude of adequate fruit or vegetable consumption and its associated factors among children aged 2-5 years remain limited. Objective: The aim of this study was to assess adequate fruit or vegetable consumption and associated factors among young children in Waja Town, North east Ethiopia, 2025. Methods: A community based cross sectional study was conducted from August 05 to September 01 2025 among mothers of young children aged 2-5 years living in Waja Town. A two stage cluster sampling technique was employed to select a total of 636 study participants and data on fruit and vegetable intake was collected using interviewer administered semi quantitative FFQ. Binary logistic regression was used; variables with p < 0.25 in bivariate analysis were included in multivariable analysis, and those with p < 0.05 were considered statistically significant. The direction and strength of association were interpreted using AOR at 95% confidence intervals. Result: The prevalence of adequate fruit or vegetable consumption was 11.8 %( 95% CI: 9.3¬-14.3%). Parental fruit and vegetable consumption [AOR =4.253, 95% CI (2.148, 8.423)], household food security status [AOR =0.257, 95% CI (0.105, 0.634)] and farm production diversification [AOR=2.566, 95% CI (1.266, 5.198)] were significantly associated with adequate fruit or vegetable consumption. Conclusions and recommendations: The prevalence of adequate fruit or vegetable consumption among young children was very low. Therefore, responsible stakeholders should strengthen interventions that improve parental fruit and vegetable consumption, farm production diversification, and household food security.

Home Remedy Practice Among Hypertension Patients In Bahirdar City, Northwest Ethiopia, 2024: A Qualitative Study

Sat, 01 Jun 2024 00:00:00 GMT

Home Remedy Practice Among Hypertension Patients In Bahirdar City, Northwest Ethiopia, 2024: A Qualitative Study Dagnew, Zenebech Background: Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Hypertension is considered one of the most challenging public health problems worldwide. Home remedies are commonly used to treat hypertension using traditional medicines in Ethiopia. These remedies are often based on traditional beliefs and practices. To the best of my knowledge there is limited research on use, types and perspectives of home remedies used to treat hypertension. Objective: The study was aimed to explore home remedy practices among hypertensive patients who live in Bahir Dar city, northwest Ethiopia, 2024. Method: This study was conducted in Bahir Dar City public and private hospitals in Amhara regional state of Northwest Ethiopia from May to June 2024. The methods followed exploratory research design method which involves qualitative data collection techniques such as in- depth interviews, focus group discussions and projective techniques. Data were collected using 11 in-depth interview, focused group discussion with 5 hypertension patients, and 4 Key informant interviews. Each interview was audio-recorded, transcribed verbatim and translated to English. Thematic analysis was performed. Study participants were those people who were on hypertensive patients and were following at least for one year and are currently on hypertension treatment in public hospitals in the city during the data collection period. All study participants were ≥18 years of age selected purposively. The data was analyzed with Atlas Ti version 7 software. Result: In this study three main themes such as traditional herbal medicine, healthy lifestyle practice and patients’ experience and perspectives were developed from eight sub-themes. The traditional herbal medicine theme had three sub-themes (types of home remedies used, source of information on home remedies, challenges and side effects). Healthy lifestyle practice had two subthemes (healthy dietary eating habit, physical exercise), and patients’ experience and perspectives had three subthemes (perceived beliefs on efficacy of home remedies, perceptions on the safety of home remedies, perceived recommendations). Most of the participants used garlic, red onion, moringa tea, Ginger, banana, bean, Lemon, Damascus leaves; Steep as home-prepared remedies treatment option for hypertension. All these remedies were prepared and taken as tea, with food or by diluting with water in empty stomach. The participants get information about home remedies from the internet, reading books, asked other patient experiences. The majority of them attempted to engage in planned physical activity to avoid weight gain. Patients also felt that since traditional made home remedies are unproven, they should only be used in combination with prescription drugs. Conclusion: The participants used different types of home-prepared remedies as a treatment option for hypertension. The types used by patients are moringa tea, ginger, lemon, garlic, red onion, green tea, Rumex abyssinicus, flaxseed, banana, bean, coriander, nettles, turmeric, Bitter leaf juice, black cumin tea, and Ruta chalepensis, white lupin, damascus leaves, dill, Garden Cress, and Calpurnia Aurea. Therefore, to prevent misunderstandings, health care practitioners and other stakeholders should provide accurate information on the proper dietary habit, causes and treatment options for hypertension patients by using different health communication methods. Researchers shall conduct clinical trials about home remedies used for treating HTP for their efficacy, side effects, dose, preparation, and frequency related issues. Key words: Home remedies, Hypertension, Ethiopia