College of Health Science

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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
Colostrum Feeding Practices and Contributing Factors among Mothers with Infants and Young Children Under 24 Months in
(2025-05-01) Abdi Nure
ABSTRACT Background: Globally, fewer than half of newborns were breastfed within the first hour of birth, contributing to thousands of preventable infant deaths each year due to delayed colostrum intake. Colostrum, the initial milk produced after delivery, contains essential nutrients and antibodies that support neonatal immunity and reduce early health risks. Despite its benefits, colostrum avoidance remained common in settings such as Asasa Town, Ethiopia. Objective: The study aimed to assess colostrum feeding practices and associated factors among mothers of infants and young children less than 24 months living in Asasa Town, Oromia, Southeast Ethiopia, 2025. Methods: A community-based cross-sectional study was conducted from September 25 to October 30, 2025, involving 381 systematically selected mothers of infants and children under 24 months. Data were collected using a structured, pretested questionnaire and entered into Epi-Data 4.7 before analysis in SPSS version 27. Descriptive statistics were used to summarize socio-demographic characteristics, knowledge, attitude, and feeding practices. Bivariate logistic regression was performed to identify candidate variables for multivariable analysis (p < 0.25). Multivariable logistic regression was then used to determine independent predictors of colostrum feeding practice. Statistical significance was declared at p < 0.05. Results: A total of 381 mothers participated, yielding a response rate of 97.4%. In this study, the overall prevalence of colostrum feeding practice was 61.4% (CI: 95% 56.5% to 66.3%). Additionally, 73.2% of mothers demonstrated good knowledge of colostrum, and 67.5% had a favorable attitude toward colostrum feeding. Factors significantly associated with colostrum feeding practice were postpartum counseling on colostrum feeding (AOR=1.81, 95% CI: 1.08–3.02), mode of delivery (AOR=6.19, 95% CI: 2.92–13.11), and good maternal knowledge (AOR=5.26, 95% CI: 2.97–9.32). Conclusion: The prevalence of colostrum feeding practice in Asasa Town was lower than the national and global recommendations. Postpartum counseling, vaginal delivery, and good maternal knowledge were key determinants of optimal colostrum feeding. Strengthening breastfeeding counseling during antenatal care, delivery, and postnatal care; improving maternal health education; and promoting institutional delivery are essential to improve early colostrum feeding practices in the community. Keywords: Colostrum, Breastfeeding, Early initiation, Knowledge, Oromia, Ethiopia
Determinants of HIV Testing Among High School Students in Asella Town, Arsi Zone, Southeastern Ethiopia, 2025 G.C
(2025-05-01) Abel Tadesse
Abstract Background: HIV testing is a powerful tool for personal health and global public health, enabling early diagnosis, treatment, and prevention of HIV transmission. An estimated 39.9 million (36.1–44.6 million) people were living with HIV at the end of 2023, of which 1.4 million (1.1–1.7 million) children (0–14 years old). In Ethiopia, Africa’s second most populous country, only 63% of HIV-positive youth 15–24 years are aware of their HIV-positive status after being tested for the first time. Objective: This study aimed to assess the magnitude and determinants of HIV testing among high school students in Asella Town, Arsi Zone, Southeastern Ethiopia, in 2025 G.C. Method: An institution based cross-sectional study was implemented among high school students in Asella town, 2025. The target population included high school students attending schools in Asella town. With a lottery method representing schools ( one Governmental, one public and one private ) were selected and the students from grades 9-12 were the study units. With a multi stage stratified sampling technique 568 students were recruited. Data was collected using a standardized questionnaire translated into Amharic and back-translated for accuracy. Data analysis involved both descriptive and analytical statistics. After data collection, the data was coded, entered and analyzed by using Epi info 7.2.5 and SPSS version 26 software. Binary logistic regression analysis was employed to control for potential confounding factors and to identify the independent effects of the explanatory variables on HIV testing among high school students. Adjusted odds ratios with 95% confidence intervals were reported to quantify the strength of associations together with their p values. Results : Students who report experiencing peer pressure are 37 times more likely to undergo HIV/AIDS testing compared to those who do not report experiencing peer pressure ( AOR = 36.98, 95% CI 28.78, 42.72, P < 0.001 ). Being tested for HIV prior to intercourse is 22 times more likely to happen than being tested without the possibility of intercourse happening in the near future ( AOR = 22.04 , 95% CI 15.21, 28. 23, P <0.001). History of prior sexual intercourse ( AOR = 5.89, 95% CI: 2.03, 11.99, P < 0.001) and Alcohol consumption ( AOR = 3.68, 95% CI 1.25, 8.87, P = 0.008) were also found to be associated with likeliness of being tested for HIV/AIDS among high school students. Conclusion and Recommendation: HIV testing among high school students was a common occurrence (60.27%). The independent determinants that were identified here were grade level, history of prior intercourse, testing prior to having sex, alcohol consumption and peer pressure regarding HIV/AIDS. Testing prior to having sex, strong youth groups in high schools and having guidance counsellor with test kits being readily available for testing are highly recommended. Keywords: HIV testing, High school students, Ethiopia
Determinants of Breast Cancer among Women Attending Oncology Units at Asella Referral and Teaching Hospital, Southeast Ethiopia
(2025-05-01) Tafes Dejen Mersha
Abstract Introduction: Breast cancer re⁠presents a malignant growth originating in breast tissue and the most frequent cancer diagnosis among women around the world. In 2020 it shows more than 2.3 million new case and about 685,000 deaths on a globaly. The overall load seems to be climbing, especially⁠ in low and middle income countries due to late diagnoses along with poor access to treatment and fragile health setups as⁠ key reasons for this trend Objective: To identify the determinants of breast cancer among women attending Asella Referral and Teaching Hospital in Arsi Zone, Asella Town, Etiopia, in 2025. Methods: A health facility case-control study was conducted among 384 participants (cases=77 confirmed cases and controls=307) from septenber to October, 2025. A systematic random sampling for controls and consicutive sampling were used for cases. Data were collected via kobotoolbox and card review. Data accuracy was ensured through daily suporvisoin, training and pretest evaluation. Data was exported to SPSS versoin 26, for analysis. Descriptive analysis, bivariate and multivariable logistic regression analysis was conducted to assess the association of determinants factors and breasrt cancer. Adjusted Odds ratio with (95%CI) confidence interval was used to report the association. Result: Determinants of breast cancer which were significant are rural residency (AOR=2.64 (1.39,5.01), no physical ingagement practice (AOR=2.92(0.93,9.35), BMI 25-29kg/m2 (AOR=6.67(2.17,13,70), low vegetable conseptoin (AOR=1.88(1.08,4.34) postmenopausal status (AOR=1.25(1.04,3.28), history of abortion(AOR=4.01(1.65,9.74), long term usage of oral contraceptive method (AOR=2.51(1.06,5.94), history of breast trauma(AOR=4.34(2.06,8.38), and history of breast infection (AOR= 4.18(1.71,10.21) with 95% confidence interval. Others significan factors were family history of any cancer related disease (AOR=3.26(1.93, 11.5), and family history of breast cancer spencificaly (AOR=5.75(2.41, 13.5) with 95%CI. Conclusoin: Rural residence, higher BMI, low vegetable intake, post menopausal status, abortion, infection and traumatic history of breast, family history of breast and any cancers related disease were independently identified as determinants of breast cancer. Strengthening prevention and early detection method, promoting healthy life style and comprehensive reproiductive health care system were vital for reducing the burden of breast cancer. Key words: Arsi, Breast Cancer, Case-control, Determinants, Ethiopia, Womens Health.
ASSESSMENT OF UTILIZATION AND SATISFACTION OF URBAN HEALTH EXTENSION SERVICES AND ASSOCIATED FACTORS AMONG WOMEN OF CHILD BEARING AGE (15-49 YEARS) IN ASSELA TOWN, OROMIYA REGIONAL STATE SOUTHEAST ETHIOPIA, FROM SEPTEMBER 1 TO 30 IN THE YEAR 2025
(2025-05-01) GIRMA DAGIFE
Abstract Background: Urban Health Extension service utilization and satisfaction was affected by lack of knowledge and participation on packages in the study area and period. Objective: It was to assess the magnitude of utilization and satisfaction of health extension services and associated factors among women of age (15-49 years) in Assela Town, Oromia Regional state South East Ethiopia in September 2025. Methodology: A community based cross-sectional study was conducted. Using single proportion and 1.5 desinge effect formula by adoption 51.8% from a study in Hawasa Town and final sample size was 632. Sampling procedure was by stratified random sampling from all 8 kebeles 8 ketenas were selected by lottery; allocating proportionally. Urban Health extension services utilization and satisfaction was dependent variable. Independent variables related to socio demographic and behavioral factors. An adopted questionnaire was developed in Kobo toolbox. And pretest was done on 5% of the sample in Gonde Town. Ethical clearance from Public Health Department, verbal consent of each participant was obtained. Face to face interview by using close and open ended questionnaire data collection was done. Data analysis: Kobo toolbox collected data was transferred to SPSS version 27 to analyze by binary logistic regression by considering 95% CI, p-value < 0.05. The answers from open ended question was triangulated. Results: With a response rate of 98 %( 618/632) the Urban Health Extension service (UHEP) utilization and satisfaction was 28% and 41% respectively. Among associated factors with 95% CI and p-value <0.05 were knowledge about UHEP 6.7(AOR=6.7; 95% CI: 3.15-14.97), participation of women on planning of UHEP activities 5.36 higher (AOR=5.36; 95 CI: 1-19.6) than their respective counterpart. Conclusions and Recommendations: The study came with results among researches reported least utilization proportion. The associated factors were manageable by the town health office, health extension workers and kebele administers. Awareness creation, participating women in planning and best experience sharing between families on health extension activities were among the recommendations.
Utilization of Long-Lasting Insecticidal Nets and Associated Factors Among Mothers Who Have Under-Five Children in Dodota District, Southeast Ethiopia, 2025
(2025-05-01) Mohammedin Jemal
Abstract Introduction: Long-Lasting Insecticidal Nets (LLINs) are crucial for malaria prevention, particularly for children under five, who face the highest mortality rates in sub-Saharan Africa, including Ethiopia. However, there is insufficient information on maternal health service-related factors influence LLIN utilization among mothers with children under five years in Ethiopia. Objectives: To assess utilization of long-lasting insecticidal nets and associated factors among mothers who have under-five children in Dodota district, Southeast Ethiopia, 2025. Methods: A community-based cross-sectional study was conducted from October 1 to 30, 2025, among 605 randomly selected mothers of children under five in Dodota District, and was supplemented with qualitative data for in-depth investigation. A multistage sampling technique was employed to recruit the study participants. Data were collected through face-to-face interviews by using kobo toolbox and exported to SPSS software version 27 for analysis. Descriptive statistics and binary logistic regression were computed. Variables with P-value less than 0.25 in bivariate analysis were entered into a multivariate analysis. An adjusted odds ratio with a 95% confidence interval was used to measure the strength of the association and statistical significance was declared with a p-value less than 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data. Results: Utilization of LLIN among mothers of children under five years was 58.7% (95% CI: 54.7–62.6). Maternal age ≥45 years (AOR = 2.91, 95% CI: 1.09–7.69), having a family size of four or fewer members (AOR = 2.54, 95% CI: 1.67–3.85), good knowledge of LLIN use (AOR = 1.83, 95% CI: 1.24–2.72), and receiving counseling on LLIN use during antenatal care (AOR = 2.37, 95% CI: 1.49–3.75) were significantly associated with LLIN utilization. Moreover, misbeliefs, misconceptions, use the LLIN for other purposes and insufficient accessibility were the most commonly identified barriers by the qualitative data. Conclusion and recommendation: Utilization of LLINs among mothers of children under five years was below the national target. Maternal age, family size, knowledge of ITNs, and receipt of counseling on LLIN use during antenatal care were significant factors associated with LLIN utilization. Strengthening awareness creation sessions by health care providers on LLIN utilization for under-five children is recommended. Keywords: Utilization, Long-last insect nets, associated factor, under five children, Ethiopia
Under nutrition and Its Associated Factors among Adult Cancer Patients Receiving Chemotherapy: A Cross-Sectional Study at Asella Teaching and Referral Hospital, Oromia, Southeast Ethiopia, 2025
(2025-05-01) Ketema Bogale
ABSTRACT Background: Undernutrition is a major global public health issue, affecting an estimated 30–80% of cancer patients during the course of their illness. In Ethiopia, the nutritional status of adult cancer patients receiving chemotherapy remains insufficiently studied, especially in regional settings such as Oromia, with most existing evidence coming from urban centers like Addis Ababa. Objective: This study aimed to assess the prevalence of undernutrition and associated factors among adult cancer patients receiving chemotherapy at Asella Referral and Teaching Hospital, Oromia, southeast Ethiopia, in 2025. Methods: An institution-based cross-sectional study was conducted from August 11 to October 18, 2025, involving 214 adult cancer patients undergoing chemotherapy. Participants were selected using systematic random sampling. Data were collected using a structured, pretested questionnaire, the Patient-Generated Subjective Global Assessment (PG-SGA) tool, and anthropometric measurements. Completed questionnaires were entered into Epi-Data version 4.7, exported to the Statistical Package for the Social Sciences (SPSS), and analyzed using it. Descriptive statistics summarized the data. Variables with p < 0.25 in bivariate analysis were entered into multivariable logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to report associations, and significance was set at p < 0.05. Results: A total of 214 participants completed the study, yielding a response rate of 98.62%. The mean age of the respondents was 54.8 ± 13.7 years. The overall prevalence of under nutrition based on PG-SGA was 61.7% (95% CI: 55.2–68.2). Factors significantly associated with under nutrition included Stage III cancer (AOR=4.26, 95% CI: 1.14–15.99), Stage IV cancer (AOR=4.79, 95% CI: 1.30–17.71), loss of appetite (AOR=3.47, 95% CI: 1.14–10.50), vomiting (AOR=7.71, 95% CI: 2.07–28.71), diarrhea (AOR=4.10, 95% CI: 1.43–11.70), and consuming fewer than three meals per day (AOR=2.83, 95% CI: 1.20–6.66). Conclusion: Under nutrition was highly prevalent among adult cancer patients receiving chemotherapy in the study area. Advanced disease stage, inadequate meal frequency, loss of appetite, vomiting, and diarrhea significantly increased the risk of under nutrition. Strengthening routine nutritional assessment, early identification of high-risk patients, and integrating nutrition-focused interventions into oncology care are strongly recommended. Keywords: Prevalence, under nutrition, Cancer, Chemotherapy, Asella, Hospital, Ethiopia
Latrine Utilization and Associated Factors among Households in Honkolo Wabe District, Arsi Zone, Oromia, Ethiopia
(2025-05-01) Kasim Shunda Gebewo
Abstract Background: Access to proper sanitation is crucial for public health, but over 3.5 billion people globally lack it, exposing communities to preventable diseases such as diarrhea, which causes significant morbidity and mortality, especially among young children. Although some households have latrines, open defecation remains a challenge due to socio-cultural beliefs, economic limitations, and poor infrastructure. Objectives: This study assessed latrine utilization and associated factors in Honkolo Wabe District, Oromia Region, Ethiopia. Methods: A mixed study design was conducted among 502 households in Honkolo Wabe district from August 25, to September 25, 2025. A multi-stage sampling method was used to recruit study participants. Semi-structured questionnaires were used to collect data. Data were entered into the Kobo Toolbox software and analyzed by SPSS version 25. Variables with p-value ≤ 0.25 were entered into a multivariable logistic regression model. A p-value < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were considered significant. For qualitative data, four focus group discussions (FGDs) were held with eight purposively chosen participants from kebeles. Data were transcribed, translated into English, and thematically analyzed by using open code software 4.03. Results: Latrine utilization in this study was 31.4% (95%CI: 27.3%-35.7%). Significant factors associated with increased latrine use included being female (AOR = 2.03, 95%CI: 1.28–3.21), having at least secondary education (AOR = 4.42, 95%CI: 1.91–10.23), absence of children under five years (AOR = 1.87, 95%CI: 1.16–3.01), smaller family size (AOR = 2.44, 95%CI: 1.41–4.21), safe latrine access at night (AOR = 5.95, 95%CI: 3.48–10.16), and presence of a privacy wall or door (AOR = 1.63, 95%CI: 1.02–2.61). FGDs confirmed barriers: child fall fears prompting open defecation, unsafe bush-covered paths, and privacy deficits due to costs. Conclusion: Latrine utilization in Honkolo Wabe District households was low (31.4%) compared to other studies and SDG targets. Significant factors included female sex, maternal secondary education, family size <5, absence of under-5 children, safe nighttime access, and privacy walls/doors, with FGDs confirming child fall fears, unsafe paths, and privacy/cost barriers. Therefore, health education should be given on associated findings to get full coverage latrine utilization in this District.
Admission pattern, treatment outcomes, and associated factors of patients admitted to the intensive care unit of Asella Teaching and Referral Hospital. A cross-sectional study
(2025-05-01) DIDA BATU
Abstract Background: It is imperative to evaluate the admission patterns and treatment outcomes of critically ill patients admitted to intensive care units in developing nations. The availability of expertise, admission patterns, and the facilities of the intensive care unit all affect the mortality rate in these units, which varies worldwide. Objective: The main aim of this study is to assess the admission pattern, treatment outcomes, and associated factors for patients admitted to the intensive care unit of Asella Referral and Teaching Hospital. Methods: A institutional-based cross-sectional study design was conducted among 314 patients admitted to ICUs of Asella Referral and Teaching Hospital from November 1-30 2023 using a systematic random sampling technique. A data abstraction form designed for data collection was used to collect data from medical records. Collected data entered into Epi Info 7 and exported to SPSS version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to determine the association of an independent variable with the outcome variable. Factors with a p-value of less than 0.25 in bivariate logistic regression analysis was exported to multivariate analysis to see if they are independent factors for the outcome variable. The adjusted odds ratio with a 95% confidence interval and a p-value of less than 0.05 was taken as statistical significance. Result: From the total 314 admitted patients to the ICU, 219(69.7%) of them discharged alive while the rest 95(30.3%, 95% CI 25.28-35.71%) of them were dead. From the total 95 death in the ICU,41 (43.2%) of the death was related to shock followed by acute respiratory disease syndrome which accounts 24(25.3%) of death. patients admitted with a pulse rate of >100 bpm were 2.1 times higher odds of death (AOR 95% CI: 1.18, 3.75) as compared to those who have <100 bpm. Additionally, patients admitted with peripheral oxygen saturation of <90% were 1.89 times higher odds of death (AOR 95% CI: 1.08, 3.29) as compared to those who have >90% saturation. Similarly, patients with an unconscious mental status were found to be 3.32 times higher odds of death (AOR 95% CI: 1.84, 5.98) as compared to those who are conscious Conclusions and Recommendations: Significant number of patients admitted to the ICU were discharged alive, while a notable proportion did not survive their ICU stay. Factors like oxygen saturation, pulse rate, level of consciousness and Inotropes used were significantly associated with ICU mortality. Implement targeted interventions focusing on early detection and management of critical conditions to reduce mortality rates among patients in the ICU is required.
Acceptance of Index Case HIV Testing and Associated Factors among Partner and Families of ART Clients in Bekoji Town, Oromia Region, Ethiopia
(2025-05-01) Jemal Hussein Betul
Abstract Background: Index case Human Immunodeficiency Virus (HIV) testing is a good approach for addressing and improving the efficiency and yield of testing among high-risk populations such as partners and families of people living with HIV. Despite national efforts to expand HIV testing, index case testing acceptance remains suboptimal in many areas of Ethiopia. Limited data exist regarding its determinants in Bekoji Town. Objective: To assess the status of acceptance of partner and family-based index case HIV testing and its associated factors among clients receiving antiretroviral therapy (ART) at public health facilities in Bekoji Town, Ethiopia, in 2025. Methods: A facility-based cross-sectional study was conducted among 282 ART clients in public health facilities in Bekoji Town from August 1, 2025, to October 30, 2025. A systematic random sampling method was utilized to recruit the study participants. Data was collected using interviewers administered a structured questionnaire. The collected data was entered into SPSS for analysis. Binary logistic regression was used to examine the association between independent variables and outcome variables. All variables with a p-value < 0.25 in bivariate logistic regression were entered into multivariable logistic regression to identify factors independently associated with the outcome variable. Odds ratio along with 95% CI at p-value < 0.05 were used to measure the strength of the association. Result: The magnitude of HIV index case acceptance was 86.9 %(95%CI: 82.4%-90.6%). Urban (AOR = 3.92, 95%CI: 1.30–11.78), secondary education (AOR =4.36, 95%CI: 1.35–14.03), college and above education (AOR =4.50, 95%CI: 1.19–17.02), duration on ART (AOR = 3.78, 95%CI: 1.43–10.01), disclosed their HIV status (AOR = 6.06, 95%CI: 2.28–16.09), adherence to ART treatment (AOR = 2.60, 95%CI: 1.02–6.62) and good knowledge of HIV/AIDS (AOR =4.55, 95%CI: 1.86–11.16) were associated with ICHT acceptance. Conclusion: In this study, 86.9% of HIV patients accepted ICHT for their family member/partner. Urban residence, secondary and above educational, ART medication adherence, duration on ART, HIV status disclosure, and good knowledge of HIV/AIDS were significantly associated with ICHT acceptance. Therefore, health providers should provide regular health education importance of HTS, adherence to ART medication, and HIV status disclosure.

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