Speciality in Internal Medicine

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Level of Satisfaction and Associated Factors Among Clients Enrolled In The Community Based Health Insurance Scheme At Asella Referral And Teaching Hospital, Ethiopia
(2025-05-01) Wondwosen Mulatu
Abstract Background: Client satisfaction is a key indicator of healthcare quality and a determinant of the sustainability of Community-Based Health Insurance (CBHI) schemes. Evidence on satisfaction levels and associated factors remains limited in Ethiopia, particularly in referral hospital settings. Objective: To assess the level of client satisfaction and identify associated factors among CBHI-enrolled clients at Asella Referral and Teaching Hospital (ARTH), Arsi Zone, Ethiopia. Methods: An institution-based cross-sectional study was conducted from August 11 to November 30, 2025, among 402 CBHI-enrolled clients. Data were collected using a structured interviewer-administered questionnaire, with satisfaction measured on a 5-point Likert scale. Binary and multivariable logistic regression analyses were performed. Variables with p < 0.20 in bivariate analysis were included in the multivariable model, and statistical significance was set at p < 0.05. Results: The overall client satisfaction level was 75.9% (mean score = 3.84 ± 0.59). Most respondents intended to renew CBHI membership (99.3%) and reported high satisfaction with staff courtesy and hospital cleanliness (> 95%). However, major service gaps were identified: 69.2% of clients did not receive all prescribed medications, and 71.4% did not obtain all requested laboratory services, resulting in the lowest satisfaction score for out-of-pocket payments (mean = 2.90 ± 1.32). Clients aged 18 – 29 years (AOR = 0.33; 95% CI: 0.12 – 0.90) and 30 – 44 years (AOR = 0.38; 95% CI: 0.15 – 0.95) were less likely to be satisfied compared to those aged ≥ 60 years. Lower educational status, longer CBHI enrollment (≥5 years), and participation in CBHI meetings (AOR = 1.70; 95% CI: 1.00 – 2.91) were associated with higher satisfaction. Conclusion: Although overall satisfaction and intention to renew CBHI membership were high, significant dissatisfaction related to the availability of essential drugs and diagnostic services persisted. Client satisfaction was influenced by age, education level, duration of enrollment, and scheme engagement. Improving the availability of medicines and laboratory services, strengthening communication, and addressing the expectations of younger and more educated clients may enhance satisfaction and support the sustainability of the CBHI program. Keywords: community based health insurance, client satisfaction, associated factors, hospital services, ethiopian cbhi scheme
MAGNITUDE OF POST-TUBERCULOSIS LUNG DISEASES AND ASSOCIATED FACTORS AMONG ADULT PATIENTS ADMITTED TO ASELLA REFERRAL AND TEACHING HOSPITAL, ETHIOPIA
(2025-05-01) MISHA BONKA SHAMANA
Abstract Introduction: Globally an estimated 155 million tuberculosis (TB) survivors were alive in 2020, of whom approximately 27 million people could be identified and evaluated for ‘post-tuberculosis lung disease’ (PTLD). The post-TB lung disease is a chronic respiratory disease that persists even after successful completion of treatment for primary tuberculosis. Its global prevalence may reaches up to 59% among patients with history of TB treatment. However, data on its prevalence and associated factors is lacking in Ethiopia. Methodology: An institution based cross-sectional study was conducted on patients who had a history of pulmonary tuberculosis treatment and were admitted to the medical ward over six years, from January 1, 2019, to December 31, 2024, to assess the magnitude and associated factors of post-tuberculosis lung disease. A total of 181 participants were selected by simple random sampling. Data were collected from logbooks and patient charts using checklists on koboToolbox and analyzed using SPSS version 31. Descriptive statistics were carried out, and categorical variables were reported as frequencies and percentages, whereas mean and median reporting was used for numerical variables. Crude odds ratios with their 95% confidence intervals (CI) were estimated in the bivariate logistic regression and those variables with a P value < 0.25 in the bivariate logistic regression were fitted into the multivariable logistic regression analysis. The strength of association was reported using adjusted odds ratios with 95% CI, and P value < 0.05 was declared as statistically significant. Results: Among the 181 studied individuals, one-third (33.7%) had bacteriologically confirmed pulmonary tuberculosis. The overall prevalence of PTLD was 65.19% (95% CI: 58.25-72.13%). Age older than 60 years (AOR = 20.22, 95% CI: 3.64-112.21, p = <0.001), rural residence (AOR = 7.05, 95% CI: 1.8-27.1, p = 0.005), cigarette smoking (AOR = 182.98, 95% CI: 4.11-813.08, p = 0.007), history of PTB recurrence (AOR = 8.27; 95% CI: 1.40-48.68, p = 0.020), and poor compliance with previous PTB treatment (AOR = 8.62; 95% CI: 1.66-44.80, p = 0.010) were independently associated with developing PTLD. However, HIV seropositivity was associated with reduced risk of PTLD (AOR = 0.073, 95% CI: 0.017-0.310, p < 0.001). Conclusion: This study revealed that PTLD is 65.19% among admitted patients and significantly associated with age 60 years or older, recurrent tuberculosis, poor adherence to prior tuberculosis treatment, cigarette smoking, and rural residence. Keywords: Post-tuberculosis lung disease, PTLD prevalence, Asela Referral and Teaching Hospital, Ethiopia.
ASSESSMENT OF ANTIBIOTICS PRESCRIPTION PATTERN AND ASSOCIATED FACTORS AMONG PATIENTS ADMITTED TO MEDICAL WARD OF ASELLA REFERRAL AND TEACHING HOSPITAL SOUTHEAST, ETHIOPIA
(2025-05-01) NAHOM PAULOS
ABSTRACTS Background: Antibiotics are vital for treating bacterial infections and reducing morbidity and mortality worldwide. However, widespread misuse and inappropriate prescribing have led to significant antibiotic resistance. In response, the WHO and national health authorities promote antimicrobial stewardship to optimize antibiotic use. Generating local evidence on prescribing practices is crucial for developing context-specific stewardship interventions. This study assessed antibiotic prescribing patterns and associated factors among patients admitted to the medical ward of Asella Referral and Teaching Hospital, Southeast Ethiopia. Objective: To assess antibiotics prescription pattern and identify factors associated with inappropriate antibiotic use among patients admitted to medical ward of Assela Referral and Teaching Hospital Methodology; An institution-based retrospective cross-sectional study was conducted at Assela Referral and Teaching Hospital medical ward. A total of 228 patient charts were reviewed in the study period. Data analysis was done using SPSS version 27. Descriptive statistics were performed to show the prevalence and frequencies of the collected variables. Those variables that show associations with the dependent variable at p <0.25 in the bi-variate analysis were entered into the multiple logistic regression. Adjusted odds ratios with their corresponding 95% confidence intervals and p-values were used to assess the strength of the associations. Variables with p-values of less than 0.05 in the multiple regressions were finally considered as statistically significant. Result: Of the 228 patient records reviewed, 50.9% were male, and 54.8% were aged 31–64 years. Community acquired pneumonia was the most common diagnosis (20.6%). Ceftriaxone was the most frequently prescribed antibiotic (22.8%) of all prescriptions. Overall, 33% of participants received inappropriate prescriptions. In multivariable logistic regression, patients who do not have culture result show significant rate of inappropriate prescription pattern (AOR = 8.79; 95% CI: 1.98–39.05). Receiving two or more antibiotics was independently associated with higher odds of inappropriate prescription (AOR = 2.42; 95% CI: 1.15–5.10) and patients whose antibiotics was not de-escalated were associated with inappropriate antibiotics use (AOR = 2.40; 95% CI: 1.01–5.70). Conclusion: One third of antibiotic prescriptions for medical inpatients were inappropriate. Culture result, Receiving two or more antibiotics and antibiotics de-escalation were independently associated with higher odds of inappropriate prescription. These findings highlight the need for routine antimicrobial stewardship interventions, prescriber education, and evidence based antibiotics treatment. Key words: antibiotic prescribing pattern; inappropriate antibiotic use; medical ward; WHO prescribing indicators; Ethiopia
PREVALENCE OF ACUTE KIDNEY INJURY AND ASSOCIATED FACTORS AMONG ACUTE HEART FAILURE PATIENTS ADMITTED AT ASELA REFERRAL AND TEACHING HOSPITAL, ARSI UNIVERSITY, ASELLA, CENTRAL ETHIOPIA
(2025-05-01) MELAKU ABDUREHMAN
ABSTRACT Introduction: Heart failure often leads to hospitalization and can directly impact other organs, such as the kidneys. Acute kidney injury (AKI) is a common complication in patients hospitalized for acute decompensated heart failure (ADHF) and is associated with worse outcomes. However, there are limited data on the magnitude of AKI among hospitalized ADHF patients in resource-limited settings such as Ethiopia. Objective: To assess the prevalence of acute kidney injury and associated factors among acute heart failure patients admitted at Asela Teaching and Referral Hospital, central Ethiopia, from May to December 2025. Methodology: An institution-based cross-sectional study was conducted to determine the prevalence of acute kidney injury and associated risk factors among acute heart failure patients at Asela Teaching and Referral Hospital. A total of 180 admitted patients were included. Data were collected using structured questionnaires and analyzed using EPI Info and SPSS version 27. Descriptive statistics were summarized using frequencies, percentages, and medians. Bi-variate logistic regression was performed to identify candidate variables (p < 0.2), which were entered into multivariable logistic regression. Associations were reported using adjusted odds ratios with 95% confidence intervals, and p < 0.05 was considered statistically significant. Results: A total of 121 patients admitted with acute decompensated heart failure were included in the study. Acute kidney injury occurred in 29 patients, giving a prevalence of 24% (95%CI17.2-32.3%. In multivariable logistic regression analysis, diabetes mellitus (AOR=67.74; 95%CI: 6.53-702.34; p<0.001), presence of infection (AOR=27.78; 95%CI: 3.40-227.28; p=0.002) , and atrial fibrillation (AOR=17.75;95%CI 3.09-101.81;p=0.001) were independently associated with the development of AKI. Conclusion: Acute kidney injury was a common complication among patients admitted with acute decompensated heart failure. Diabetes mellitus, infection, and atrial fibrillation were identified as independent predictors of AKI. Keys- acute decompensated heart failure, acute kidney injury
BARRIERS TO EFFECTIVE INSULIN THERAPY IN ADULT PATIENTS WITH POORLY CONTROLLED TYPE 1 DIABETES MELLITUS: A STUDY AT ASELLA REFERRAL AND TEACHING HOSPITAL, ARSI UNIVERSITY, ETHIOPIA (2025).
(2025-05-01) GEMECHU MERIBO
Abstract Background: Poor glycemic control remains a major challenge in the management of diabetes mellitus and is associated with increased morbidity and mortality. This study aimed to assess the barriers to effective insulin therapy in adult patients with poorly controlled type 1 diabetes mellitus attending Asella Referral and Teaching Hospital, Ethiopia. Objective: To assess the barriers that hinder effective insulin therapy in adult patients with poorly controlled T1DM attending the diabetic follow-up clinic at Asella Referral and Teaching Hospital, Asella, Ethiopia in 2025. Methodology: A cross-sectional study was conducted among 273 type 1 adult diabetes patients on follow-up at ARTH. Data was collected by kobotool box and was entered using and analyzed by SPSS version 27. Descriptive statistics was carried out, and categorical variables were reported as frequencies and percentages whereas; median and interquartile range (IQR) was used for continuous variables. Binary logistic regression analysis was applied to identify barriers associated with poor glycemic control in adult patients with type 1 DM. P value < 0.25 in the bivariate logistic regression was fitted into the multivariable logistic regression analysis. The level of significance was declared at a p-value of <0.05. Results: Out of 273 type 1 diabetes patients included in the study, 157 (57.5%) had poor glycemic control.The factors associated with poor glycemic control were depression (AOR = 2.92; 95% CI: 1.39–5.95.15; p = 0.004), lower monthly income (AOR=1.54;95% CI[1.30-2.96];p=0.049),basal-only insulin regimens (AOR = 2.045;95%,CI :1.055-3.964; p = 0.034), and good adherence (AOR = 0.39; 95% CI: [0.16–0.97]; p=0.04). Conclusion:The occurrence of poor glycemic control is high among adult patients with diabetes who visit ARTH.The results emphasize the view that ideal glycemic control must be an integrated methodology that covers mental health, socioeconomic issues, and compliance with therapy, in addition to clinical management Key words: Type 1 diabetes mellitus, Glycemic control, ARTH, Ethiopia
PREVALENCE AND DETERMINANT FACTORS OF CARDIOVASCULAR AUTONOMIC NEUROPATHY AMONG ADULT PATIENTS WITH DIABETES MELLITUS AT ASELLA REFERRAL & TEACHING HOSPITAL, ETHIOPIA
(2025-05-01) GADISA TADESE
ABSTRACT Background: Diabetic cardiovascular autonomic neuropathy (CAN) is a serious but often missed diabetes complication, damaging nerves that control heart and blood vessel functions. In Ethiopia, data on CAN is limited, screening protocols are lacking, and awareness is low, calling for research to improve diabetes care. Objective: To assess the prevalence of cardiovascular autonomic neuropathy and identify determinant factors among adult patients with diabetes mellitus attending follow-up at the diabetic clinic of Asella Referral and Teaching Hospital, Asella, Ethiopia. Method: An Institution-based cross-sectional study was conducted at Asella Referral & Teaching Hospital from July 1 to December 30, 2025. A systematic random sampling technique was employed to select 392 participants. Data were collected by trained data collectors using pretested, structured, interviewer-adminstred questioners and standardised tests (CARTs). The collected data was exported to SPSS version 27.0 for comprehensive statistical analysis. A bivariate and multivariable logistic regression was applied to asses associations between dependent and independent variables. The odds ratio with a 95% CI was used to declare the strength of associations between dependent and independent variables. p-values less than 0.05 were considered statistically significant. Results were summarized and presented through texts, tables, and figures. Result: Among 392 diabetic patients, CAN was prevalent in 66.1% (n = 259), with 35.0% exhibiting early CAN, 25.3% definite CAN and 6.1 severe CAN according to Ewing’s severity score. Multivariable logistic regression identified female sex (AOR = 1.773, 95%CI: 1.008-3.117, p-value = 0.047), unemployment (AOR = 2.237, 95%CI: 1.026-4.876, p-value = 0.043), longer diabetes duration (≥10 years; AOR = 6.562, 95% CI: 3.38–12.739, p-value < 0.001), poor glycaemic control (3 month average FBS >130; AOR = 4.452, 95% CI: 2.548–7.779, p-value < 0.001), and hypertension (AOR = 2.817, 95% CI: 1.332–5.957, p-value = 0.007) as independent risk factors for CAN. Conclusion and Recommendation: These findings highlight the substantial burden of CAN in this population and the critical role of modifiable risk factors. Routine screening for CAN using standardized autonomic testing should be incorporated into diabetes care, particularly for patients with prolonged disease duration, suboptimal glycaemic control, or hypertension. Keywords;CARTs, Ewing’s battery tests, cardiovascular autonomic neuropathy
Characteristics and prognostic outcomes of central nervous system tuberculosis among adults at Asella referral and teaching hospital
(2025-05-01) Dinka fikadu
ABSTRACT Background Central nervous system (CNS) tuberculosis (TB) is among the relatively uncommon yet most devastating forms of human mycobacterial infection. The estimated mortality of CNS-TB is approximately 42% in hospitalized patients (based on meningitis related deaths). However, hospital outcomes of CNS-TB and its predictors are not well studied in the study area. Objectives To Asses Clinical Characteristics, treatment outcomes and its associated factors of central nervous system tuberculosis among adults at Asella referral and teaching hospital. Methodology: Institutional based Cross-sectional study was conducted on CNS TB Patients who presented to Asella referral and teaching hospital during the study period. Data were collected from the patient’s’ medical records using a checklist created on kobo toolbox. A total sample size of 130 was included and analyzed using Statistical Package for Social Science (SPSS) version 27. Bivariate and multivariate logistic regression analysis was applied to assess associations between dependent and independent variables. The odds ratio with a 95% confidence interval was used to declare the strength of associations between dependent and independent variables. P values less than 0.05 was considered statistically significant. Results: A total of 130 participants were included in the study. Among them, 74 (56.9%) were male. The mean age of participants was 43.22 ± 14.98 years. The clinical presentation of CNS TB revealed that headache, fever, and neck rigidity were reported by 125 participants (96.15%). Regarding treatment, only 4 participants (3.08%) did not receive TB treatment, while 126 (96.92%) did. The initiation of drug therapy occurred in less than two weeks for 60 participants (46.2%). At discharge, 111 participants (85.38%) showed improvement, although there were 11 deaths (8.46%), and 3 referrals (2.31%). In the multivariable logistic regression models, age, duration of drug initiation, and HIV status were statistically significant predictors of poor treatment outcomes for CNS TB. Age emerged as a critical risk factor, especially for those over 65 years, who faced a significantly increased risk of poor treatment outcomes (AOR 3.23, 95% CI 2.62-7.21, p < 0.001). Patients whose treatments initiated after more than two weeks had poor treatment outcomes (AOR 4.56, p < 0.001), and those with reactive HIV tests faced a higher risk of poor treatment outcomes (AOR 2.66, p = 0.002). Conclusion: A significant majority of the participants were male, with an average age of around 43 years. Notably, classic symptoms such as headache, fever, and neck rigidity were predominant among patients, with severe neurological complications like seizures and cognitive impairments documented. The diagnosis of TB meningitis was the most common. However, a concerning 8.46% of cases resulted in death. Age, timing of drug initiation, and HIV status as significant predictors of poor treatment outcomes. Particularly alarming was the increased risk in patients over 65 years and those who delayed treatment. Key words: clinical characteristics, Central Nerve system TB and treatment outcome
Assessment of clinical profile, treatment outcome, and associated factors among aluminum phosphide poisoning patients at Asella referral and teaching hospital, Arsi university
(2025-05-01) Fitsum Mola
ABSTRACT Background: Aluminum phosphide (AlP) is an economical, widely utilized rodenticide and solid fumigant associated with an exceptionally high case fatality rate. In Ethiopia, AlP poisoning has emerged as a significant public health issue, marked by elevated mortality and a lack of extensive local research. Because no specific antidote exists, identifying clinical predictors is essential for improving survival through optimized supportive care. Objective: To assess the clinical profile, treatment outcomes, and associated factors among aluminum phosphide poisoning patients presented to the adult emergency department of Asella Referral and Teaching Hospital (ARTH), central Ethiopia. Methods: An institution-based cross-sectional study was conducted analyzing 116 eligible cases presented between August 2020 and 2025. All eligible AlP poisoning cases were included to maximize statistical power. Data were extracted from medical registries using a structured tool and analyzed via SPSS version 26. Descriptive statistics will be conducted to characterize the study population. Bivariate and multivariable logistic regression models were employed to identify independent predictors of mortality, with statistical significance set at p < 0.05. Results: Among the 116 cases, the majority were female (58.8%), rural residents (79.3%), and young adults with a mean age of 26 years. All instances (100%) were identified as intentional self-harm. The most common clinical manifestations were vomiting (100%), epigastric pain (93%), and initial hypotension (40.5%). Despite medical management, including the use of magnesium sulfate and calcium gluconate in nearly half of the cases, the overall mortality rate was 31%. Multivariable analysis identified two independent predictors of the mortality: initial hypotension (SBP ≤ 90 mmHg) (AOR = 264.946; 95% CI: 1.175, 5.9x10⁴, p = 0.044), and a hospital stay of less than two days (AOR = 167.269; 95% CI: 4.282, 6534.394, p = 0.006). Conclusion: Aluminum phosphide poisoning remains a highly lethal method of self-harm. Hemodynamic instability and a hospital stay of less than two days—serve as the primary determinant of mortality. These findings underscore the need for rapid hemodynamic support. Keywords: Aluminum phosphide, Clinical profile, Mortality, Associated factors, Ethiopia
MAGNITUDE OF POST-STROKE DEPRESSION AND ASSOCIATED FACTORS AMONG STROKE SURVIVORS ON FOLLOW-UP AT NEUROLOGY AND MEDICAL REFERRAL CLINICS AT ASELLA REFERRAL AND TEACHING HOSPITAL, ARSI UNIVERSITY, ASELLA, ETHIOPIA
(2025-05-01) Denebo Bulbula
Abstract Background: Post-stroke depression is among the most common neuropsychiatric complications in stroke survivors, affecting approximately one-third of stroke survivors at any point in time after stroke. Clinicians often under-recognize and under-treat post-stroke depression. Studies on post-stroke depression have been done in various countries. However, there are limited studies done in the Oromia region, and no studies have been done in the study area in particular. Objective: To assess the magnitude of post-stroke depression and associated factors among stroke survivors on follow-up at neurology and medical referral clinics at ARTH from June 1, 2025, to December 31, 2025. Methods: An institution-based cross-sectional study was conducted based on a structured questionnaire, patient interviews, and a review of patient charts All the necessary data were collected from patients on follow-up at neurology and medical referral clinics using the pre-developed data collection format by Kobo Toolbox. A systematic random sampling method was used to identify the participants’ charts. After data collection was completed, data on kobo Toolbox were downloaded as Excel and exported to the SPSS 27 version software database for analysis. Bivariate logistic regression analysis was used to identify the candidate variables at p value <0.25, and multivariable logistic regression analysis was employed to identify significant factors at p value <0.05 Results: A total of 148 stroke survivors participated in the study, with a response rate of 97.4%. The overall prevalence of post-stroke depression was 33.1%(95% CI:25.5%- 40.7%). It was significantly associated with the degree of disability, marital status, occupation, and diabetes mellitus. Conclusion: The study showed that one-third of stroke survivors in our study area had post-stroke depression. It had a strong association with the degree of disability, marital status, occupation, and diabetes mellitus, with the degree of disability showing the strongest and most independent association with post-stroke depression. Routine screening and early management of depression should be integrated into post-stroke follow-up care. Keywords: Stroke, post-stroke depression, Prevalence, Associated factors, Neurology Clinic, Asella
KNOWLEDGE TOWARDS STROKE AND DETERMINANT FACTORS AMONG PATIENTS WITH HYPERTENSION AND DIABETIES ATTENDING CHRONIC FOLLOW UP CLINIC AT ASELLA REFERRAL AND TEACHING HOSPITAL (ARTH)
(2025-05-01) DENEBO JEBESO
Abstract Background: Stroke is a leading cause of death and disability worldwide, with an increasing burden in sub-Saharan Africa. Hypertension and diabetes mellitus are the primary modifiable risk factors for stroke. Adequate knowledge of these risk factors, warning signs, and appropriate responses is essential for prevention and early treatment; however, data on high-risk patients in southeastern Ethiopia is scarce. Objective: To assess knowledge of stroke and its determinants among patients with hypertension and/or diabetes attending the chronic follow-up clinic at Asella Referral and Teaching Hospital. Methods: A cross-sectional study was conducted from May 2025 to January 2026 at Asella Referral and Teaching Hospital. A total of 407 adult patients with hypertension and/or diabetes were selected using convenience sampling. Data were collected through a structured interviewer-administered questionnaire and analyzed using SPSS version 27. Bivariate and multivariable logistic regression analyses identified factors associated with stroke knowledge, with a p-value <0.05 considered statistically significant. Results: Among the study participants, 76.9% (95% CI: 73.0–81.3) had good overall knowledge of stroke, while 23.1% had poor knowledge. Good knowledge of stroke risk factors was observed in 88.9% (95% CI: 85.7–91.9) of participants, and 88.5% demonstrated good knowledge of stroke signs and symptoms. Regarding planned response to stroke, 62.4% reported that they would seek medical care immediately. Factors significantly associated with good stroke knowledge included urban residence (AOR = 2.25; 95% CI: 1.19–4.25), higher educational status, higher monthly income, and good knowledge of stroke risk factors (AOR = 5.85; 95% CI: 2.81–12.17). Conclusion: While most patients with hypertension and/or diabetes exhibited good knowledge of stroke, significant gaps exist among rural residents and those with lower educational attainment. Enhancing targeted health education during follow-up visits is crucial for improving stroke prevention and timely healthcare seeking. Keywords: Stroke, Hypertension, Diabetes Mellitus, Knowledge, Ethiopia
THE EVOLVING BURDEN OF LIVER DISEASE IN THE ART ERA: MAGNITUDE AND DETERMINANTS AMONG HIV SERO-POSITIVE PATIENTS AT ASELLA REFERRAL AND TEACHING HOSPITAL, ETHIOPIA, 2026
(2025-05-01) YOHANES ZEBENU
ABSTRACT Background: Liver disease remains a significant cause of morbidity and mortality among people living with human immunodeficiency virus, even in the era of widespread antiretroviral therapy. Multiple factors, including demography, clinical status, and treatment related effects, may contribute to liver disease in this population. However, data from resource limited settings like Ethiopia remains limited. Objective; To determine the magnitude of liver disease and associated factors among human immunodeficiency virus sero-positive patients on follow up at Asella referral and teaching hospital, Arsi Zone, Ethiopia. Methods: An institution-based cross-sectional study was conducted from October to December, 2025. Data on socio-demographic, behavioral, and clinical characteristics were gathered using a structured questionnaire and a thorough review of medical records. Liver disease was defined based on biochemical criteria. Data were entered and analyzed using SPSS version 27. Variables with a P-value < 0.25 in the bivariate analysis were entered into the multivariate model, and statistical significance was declared at a p-value < 0.05. Results: A total of 288 participants were included in the final analysis, with a mean age of 45.6 years. Females represented 61.1% (n=176) of the cohort. The overall prevalence of liver disease was 27.4% (95% CI: 0.222 – 0.326). In multivariable logistic regression analysis, male sex was significantly associated with higher odds of liver disease (AOR = 2.698; 95% CI: 1.340 - 5.431). Participants with a history of tuberculosis had nearly four-fold increased odds of liver disease (AOR = 3.944; 95% CI: 2.044 - 7.611), while under nutrition was the strongest predictor of hepatic injury (AOR = 4.996; 95% CI: 2.373 - 10.518). Other factors, including age, viral load, CD4 count, and ART regimen, were not significantly associated with liver disease. Conclusion: This study identified a high prevalence of liver disease (27.4%) among adults living with HIV in Asella. Male sex, under nutrition, and a history of tuberculosis were identified as the key determinants of hepatic complications. These findings suggest that liver health monitoring and nutritional support should be prioritized for these specific high-risk subgroups to improve long-term clinical outcomes. Key Words; Liver disease, HIV patients, Hepatotoxicity, ART, Viral hepatitis, Ethiopia

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