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
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    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.
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    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
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    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
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    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
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    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
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    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
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    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
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    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
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    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
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    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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    RECOMMENDED POSTNATAL CARE CONTENTS RECEIVED AND ASSOCIATED FACTORS AMONG POSTNATAL MOTHERS IN PUBLIC HEALTH FACILITIES OF ASELLA TOWN, SOUTHEAST ETHIOPIA
    (2025-05-01) GENAT NAMO
    Abstract Introduction: Postnatal care is crucial for maternal and child health, yet inadequate provision of recommended contents of care can lead to poor health outcomes and complications. Even though providing recommended postnatal care (PNC) contents is crucial to the wellbeing of the women and their babies, the level of receiving the recommended components and its influencing factors were not well studied in Ethiopia, particularly in Asella. Objective: To assess recommended PNC contents received and associated factors among postnatal mothers in Public Health Facilities of Asella Town, Southeast Ethiopia, 2024 Method: A facility-based cross-sectional study was conducted from October 12, 2024, to November 12, 2024, among 575 postnatal mothers in the public health facilities of Asella Town using a systematic random sampling technique. Data were collected using the structure and a pre-tested questionnaire. Data were entered into Epi Data version 4.6 and exported to Statistical Package of Social Science (SPSS) version 26 for analysis. Bivariable and multivariable logistic regression analyses were done to identify associated factors. The statistically significant was declared with a p-value less than 0.05, and AOR with a 95% confidence interval was used to measure the strength of association. Results: The overall magnitude of mothers who received recommended PNC contents service was 12.9% (95% CI: 10.1-15.6). Being civil servants (AOR: 2.35; 95% CI: 1.07- 5.75), multiparous (AOR: 2.21; 95% CI: 1.02-4.77), giving birth at the hospital (AOR: 2.37; 95% CI: 1.27-4.44), and giving birth by caesarean section (AOR: 1.91; 95% CI: 1.05-3.46) were found to be statistically associated with receiving all contents of postnatal care.
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    MATERNAL HEALTH LITERACY AND ASSOCIATED FACTORS AMONG PREGNANT WOMEM IN ASELLA TOWN OROMIA, ARSI ETHIOPA, 2024: A COMMUNITY-BASED CROSS SECTIONAL STUDY
    (2025-05-01) GELEAD NIGATU
    Abstract Background: Maternal health literacy is the ability of mothers to obtain, interpret, appraise, and apply women and child health information that contributes to a reduction in mortality among mothers and children. But little is known about the prevalence of maternal health literacy (MHL) and its contributing factors during pregnancy in Ethiopia, particularly in the study area. Objective: To assess prevalence of maternal health literacy and associated factors among pregnant woman in Asella town, South East, Ethiopia, 2024. Methods: A community-based cross-sectional study was conducted in Asella town from August 01, 2024, to September 30, 2024. Data were collected using an interviewer-administered valid and reliable structured questionnaire. The collected data were entered into Epidata version 4.6.0.2 and exported to SPSS version 26 for final analysis. Accordingly, a logistic regression was used to identify independent determinants of maternal health literacy among pregnant women. All variables with a p value < 0.25 in the binary logistic regression model were considered for multivariable analysis and a P-value < 0.05 at 95% CI was considered statistically significant. Result: The overall prevalence of adequate maternal health literacy was 262 (62.4%), with a 95% confidence interval (CI) of (57.6, 66.9). Several factors were associated with MHL , including enrollment in Community-Based Health Insurance (CBHI) (Adjusted Odds Ratio [AOR] = 2.68; 95% CI: (1.39, 5.16) at P-value = 0.003), a travel distance of less than 30 minutes to a health facility (AOR = 1.87; 95% CI: (1.14, 3.09) at P-value = 0.013), and attaining secondary education (AOR = 6.75; 95% CI: (3.53, 12.92) at P-value = 0.001), or a college or university degree (AOR = 5.93; 95% CI: (2.56, 13.72) at P-value = 0.001). Conclusion and Recommendation: The study shows that over half of pregnant women in Asella town have adequate Maternal Health Literacy. Education, pregnancy status, Community Based Health Insurance enrollment, Gravida and distance to health facility influence MHL. Targeted interventions are needed in order to address these issues like women's education, community enrollment, and health facility distance, through policies, mobile clinics, partnerships, and ongoing education. Key word: -Maternal, health, literacy
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    ARRIVAL TO HEALTH PROFESIONAL VISIT TIME AND ITS PREDICTORS AMOUNG LABORING MOTHERS AT ASELLA TEACHING AND REFERRAL HOSPITAL, ETHIOPIA, 2025G.C
    (2025-05-01) EYOB AMARE
    ABSTRACT Background: Arrival-to-health-professional-visit time is critical in reducing maternal and neonatal mortality, as delays in this process can lead to severe complications such as hemorrhage, neonatal asphyxia, and sepsis. In Ethiopia, maternal deaths are primarily caused by hemorrhage, hypertensive disorders, abortion, and sepsis—conditions that can be prevented with timely access to obstetric care. Delays in care from arrival to health professional visit contribute significantly to maternal deaths, which could be reduced by up to 98% with timely care. This study aims to address the data gap regarding the time from a laboring mother’s arrival to the initial health professional visit and to identify factors causing delays at Asella Teaching and Referral Hospital (ATRH). Objective: To assess the time from arrival to health professional visit and identify its predictors among laboring mothers at Asella Teaching and Referral Hospital in Arsi Zone, Ethiopia, in 2024. Methods: This institutional-based prospective cohort study was conducted from October 5 to November 15, 2024. Data were collected through direct observation and medical records, with pre-testing at Bokoji Hospital. SPSS version 26 was used for data analysis. Kaplan-Meier survival analysis was used to estimate survival functions, and the Log-rank test compared differences in wait times across groups. Cox proportional hazards regression adjusted for potential confounders, and multicollinearity was assessed using the variance inflation factor. Results: Out of 670 study participants, approximately 36.4% were seen within 10 minutes after arrival. The restricted mean arrival-to-health-professional-visit time was 26.7 minutes (95% CI: 24.94–28.51). Waiting for a bed (AOR = 0.63, 95% CI: 0.50–0.96), availability of essential resources (AOR = 0.358, 95% CI: 0.242–0.531), and availability of staff (AOR = 1.97, 95% CI: 1.34–2.88) were statistically significant predictors of delayed arrival-to-health-professional-visit times. Conclusion and Recommendation: A small proportion of mothers were seen within the recommended time frame. Delays due to waiting for a bed, limited essential resources, and insufficient staff were significant predictors of extended arrival times. Addressing these issues can help reduce delays and improve timely care for laboring mothers. Keywords: Arrival time, health professional visit, obstetric triage, predictors of delay.
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    ADHERENCE TO EIGHT OR MORE ANTENATAL CARE MODEL AND ASSOCIATED FACTORS AMONG POSTPARTUM MOTHERS AT PUBLIC HEALTH FACILITIES OF SULULTA DISTRICT, NORTH SHEWA ZONE, OROMIA, ETHIOPIA, 2024
    (2025-05-01) ANANE MULATU
    Abstract Background: To reduce pregnancy and childbirth complications, adequate antenatal care (ANC) contacts during pregnancy is vital. By recognizing basic ANC were associated with high maternal mortality, WHO revised its ANC guidelines in 2016, which recommends all pregnant women to have at least eight contacts. However, ANC coverage is low worldwide, 53.3% in East Africa including Ethiopia received the recommended care. Although there are few studies conducted in Ethiopia, information on adherence level to the 8+ ANC at health Facilities in Sululta woreda is lacking. Objective: To assess the adherence level to 8+ antenatal care model and associated factors among postpartum mothers at Sululta district public health facilities, Oromia: Ethiopia, 2024. Methods: An institutional based cross-sectional study was conducted at public health facilities of Sululta District from October 10 to November 10, 2024. A systematic random sampling technique was used to select 410 study participants. Logistic regression models were used, and odds ratios with 95% CI and p value <0.05 was used to determine the association between dependent and independent variables. Results: The overall level of adherence to new 8+ ANC model during this study was 25.4%. Residence of mother’s (AOR:3.060, 95%CI:1.166, 8.034), Previous mode of delivery (AOR: 3.329, 95%CI:1.390, 7.974), History of obstetric complication (AOR:6.162, 95%CI:2.693, 14.099), Maternal satisfaction (AOR: 6.775, 95%CI:2.460, 18.657) and type of health facility for ANC (AOR:2.945, 95%CI:1.242, 6.928) were significantly associated with new 8+ antenatal care model. Conclusion and Recommendation: The adherence level of mothers to the new 8+ ANC model among post-partum women at public health facilities of sululta district was low. Therefore, it needs a great effort by health care providers, health care managers and responsible bodies to provide quality and satisfactory service, giving special attention of pregnant women from rural residents to maximize adherence to the new 8+ ANC model. Keywords: Antenatal care, pregnancy, adherence, 8+ ANC model, Oromia Ethiopia
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    UTILIZATION OF EARLY OBSTETRIC ULTRASOUND SCAN AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE AT PUBLIC HEALTH FACILITIES IN ASELLA TOWN, ARSI, OROMIA, ETHIOPIA, 2024
    (2025-05-01) Fatuma Adem
    Abstract Background: Early obstetric ultrasound utilization remains a global challenge, particularly in developing countries. Despite WHO recommendations for routine scans before 24 weeks gestation, many women face challenges that limit utilization of ultrasound services. Addressing these issues is crucial for improving early utilization of ultrasound scan services. Objective: To assess the utilization of early obstetric ultrasound scan and associated factors among pregnant women attending antenatal care at public health facilities in Asella town, Arsi, Oromia, Ethiopia, 2024. Methods and materials: A facility-based cross-sectional study was conducted on 462 pregnant women antenatal care at public health facilities in Asella town. The Study units were selected through systematic sampling technique. Data were collected by structured questionnaires which were developed from different literatures, and entered into Epi-data 3.1 and exported to SPSS 25. To find associated factors of early obstetric ultrasound scan, bivariate and multivariate logistic regressions were performed. The presence and strength of associations were estimated using AOR with a 95% CI, and statistical significance was deemed at a p-v <0.05. Results: A total of 462 women answered to the questionnaire, yielding a response rate of 100%. Prevalence of early obstetric ultrasound utilization in the study area was 76.4%. Multivariate logistic regression analysis revealed that variables like History for obstetric ultrasound scan (AOR 4.597, 95% CI: 2.022-10.454), Information/advice during ANC visit (AOR 3.961, 95% CI: 1.786–8.784), Knowledge about early obstetric ultrasound (AOR 5.057, 95% CI: 1.353– 18.898) and ANC (AOR 5.030, 95% CI: 2.519–10.044) were predictors of early obstetric ultrasound utilization. Conclusion: The prevalence of early obstetric ultrasound utilization was relatively high in the study settings compared with previous studies. History for obstetric ultrasound scan, Information/advice during ANC contact, History for Obstetric complication, Knowledge about early obstetric ultrasound and ANC contacted were predictors of early obstetric ultrasound utilization. Therefore, Stakeholders need to improve women’s awareness on the benefits of early obstetric ultrasound screening. Keywords: utilization, early obstetric ultrasound, Referral hospitals, Asella town
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    COMPARISON OF SHORT BIRTH INTERVAL PRACTICES AND ASSOCIATED FACTORS AMONG HEALTH PROFESSIONALS AND NON-HEALTH PROFESSIONAL CIVIL SERVANTS WOMEN IN ASELLA TOWN, SOUTHEAST ETHIOPIA
    (2025-05-01) ADANECH GIZAW
    Abstract Introduction: Birth interval is the time period between two successive births. There is a limited study on short birth interval among civil servants in Ethiopia. Objective: To compare magnitude of short birth interval practice and its associated factors among health professional and non-health professional civil servant women in Asella town Southeast Ethiopia from October 12, 2024 to November 12, 2024. Methods: A comparative cross-sectional study was conducted using a simple random sampling technique to select 418 women civil servants. Data was collected using a pre-tested structured questionnaire, and entered using Epi data 4.6 and analyzed using SPSS 25. A binary logistic regression model was used to identify the association factors. AOR with a 95% CI were estimated strength of associations, and significance was declared at a p–value < 0. 05. Results: The magnitude of short birth interval of non-health professional was 35.6% (95% CI: 29-42.1%) compared to 31.9% (95% CI: 25.6-38.3%) for health professional and no difference in statistically significant. Having a female preceding child (AOR=2.30, 95% CI: 1.16-4.54), having parity two (AOR=3.01, 95% CI: 1.10-8.21) and not using contraceptives (AOR=2.13, 95% CI: 1.06-4.27) were factors associated with short birth intervals among female health professionals. Being age 25-34 (AR=2.73, 95% CI: 1.29, 5.79), having a female preceding child (AOR=2.07, 95% CI: 1.07-3.98), not using contraceptives (AOR=2.43, 95% CI: 1.10-5.37), and breastfeeding for less than 12 months (AOR=2.75, 95% CI: 1.05-7.21) were associated with short birth intervals among female non-health professionals. Conclusion and recommendation: The study shows that the magnitude of short birth interval practices was higher among in non-health professional compared to health professional women. Having a female preceding child, having two parities, and not using contraceptives were significantly associated factors among female health professionals, whereas maternal age 25-34 years, having a female preceding child, not using contraceptives, and having a duration of breastfeeding less than 12 months were significantly associated factors of short birth intervals among female non-health professionals. Therefore, awareness about modern contraceptive utilization and the importance of breastfeeding as a birth spacing mechanism are recommended. Keywords: Short birth interval, Civil servants, Health professional, Ethiopia
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    UTILIZATION OF CHLORHEXIDINE GEL FOR UMBILICAL CORD CARE AND ASSOCIATED FACTORS AMONG MOTHERS OF INFANTS AGED LESS THAN SIX MONTHS ATTENDING PUBLIC HEALTH FACILITIES IN ASELLA TOWN, OROMIA REGION STATE, ETHIOPIA
    (2025-05-01) NIGAT FANO
    Abstract Introduction: Evidence showed that umbilical cord hygiene prevents sepsis, which is one cause of neonatal mortality. The World Health Organization (WHO) recommends 7.1% chlorhexidine gluconate (CHX) application to the umbilicus for the consecutive seven days in high mortality contexts. However, there is paucity of studies on utilization of chlorhexidine gel for umbilical cord care in Ethiopia. Objective: To assess utilization of chlorhexidine gel for umbilical cord care and associated factors among mothers having infants less than six months of age attending public health facilities of Asella town, Oromia regional state, Ethiopia,2024. Methods: A facility-based cross-sectional study was conducted from October 12, 2024 to November 12,2024 among 415 mothers with infants aged less than six months in public health facilities of Asella town. A systematic random sampling technique was employed to select study participants. Data was collected using the structure and a pre-tested questionnaire. Data was entered into Epi Data version 4.6 and exported to SPSS version 26 for analysis. A binary logistic regression model was used to identify associated factors. The adjusted odds ratio with a 95% confidence interval and a p-value less than 0.05 was used to determine the statistically significant. Results: The utilization of chlorhexidine gel in this study was 30.2% (95% CI: 25.5- 34.9). Being multiparous (AOR: 2.60; 95% CI: 1.06,6.38), received counsel on cord care (AOR: 2.09; 95% CI: 1.08,4.06), having favorable attitude (AOR: 2.50; 95% CI: 1.35,4.62) and good knowledge (AOR: 2.08; 95% CI: 1.16, 3.70) were found significantly associated with an adequate utilization of chlorhexidine gel. Conclusion and recommendation: Utilization of chlorhexidine was lower than the national finding. Having good knowledge, favorable attitude, being multiparous and receiving counsel on cord care were associated with adequate utilization of chlorhexidine. Therefore, it is recommended that healthcare providers should strengthen counseling mothers during postnatal care on the benefits and importance of chlorhexidine use. Keywords: Utilization, chlorhexidine gel, umbilical cord care, Asella, Ethiopia.
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    DEVELOPMENT AND VALIDATION OF RISK SCORE PREDICTION MODEL FOR STILL BIRTH AT ASELLA TEACHING REFERRAL HOSPITAL, OROMIA, ETHIOPIA,2024
    (2025-05-01) Shilima Urge
    Abstract Back ground: - stillbirth is defined as the death of the fetus after 28 weeks of gestation or weight more than 1000 g before extraction from the uterus. A grave public health concern, stillbirth was claiming the lives of over 1.9 million children; 83.6% of all stillbirths occurred in low-income countries in 2021. The silent tragedy of stillbirth devastates women's lives, families' lives, and even nations. Even though a number of studies have been done to predict the risk of stillbirth but the problem is still underestimated. In a limited resource country like Ethiopia, the development and validation of risk score prediction is quite substantial to take further meaningful action. Objective: - To develop and validate of risk score prediction model for stillbirth at Asella Teaching and Referral Hospital, Oromia, Ethiopia. 2024G.C Methodology: - A retrospective follow-up study was conducted at Asella Teaching and Referral Hospital from 1 October 2022 to 1 October 2024. Every expectant mother giving birth at Asella Teaching and Referral Hospital served as the source population. 1,008 participants were recruited in the study by a computer-generated random sampling technique. Data were collected using kobo tool box. The logistic regression analysis used to develop the model. To assess performance, the model discrimination and calibration of the model were done. Lastly, the model was validated by the bootstrapping method. Decision curve analysis was used to evaluate clinical implication model. Result: The study found incidence of stillbirth at Asella Teaching and Referral Hospital were 10.3% and those maternal characteristics like history of stillbirth, history of anemia, history of abortion, abruptio placenta, preeclampsia, and cord accident predictors of stillbirth, with a ROC of 0.767, and a well-calibrated model. It was internally validated and has optimism of 0.0007999. the model was found to have clinical benefit. Conclusion and Recommendation: - The developed risk-score has excellent discrimination performance and clinical benefit. It can be used in the clinical settings by healthcare providers for early detection, timely decision making, and improving care quality. Utilization of model is helpful to prevent incidence of stillbirth by 10.3%. The study reveals obstetric and gynecological issues predict stillbirth, recommending Hospital's maternal health team to consider these predictors and Key words:- development, validation, stillbirth, risk score prediction
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    PREFERENCES FOR THE GENDER OF BIRTH ATTENDANTS AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINICS AT ASELLA TOWN PUBLIC HEALTH FACILITIES IN THE OROMIA REGION, ETHIOPIA, 2024
    (2025-05-01) TEFERA ASRES
    Abstract Background: Gender preference is the women’s desire for the same gender or a different gender during childbirth which is influenced by several factors, like comfort, trust, privacy, and cultural beliefs. However, in developing countries, it was not well studied including in Ethiopia. Therefore, this study aims to assess pregnant women’s preferences for the gender of birth attendants and associated factors among those attending Antenatal clinics in Asella town public health facilities. Method: A concurrent mixed-methods design was conducted from October to December 2024. Overall, 410 respondents for quantitative were selected by systematic random sampling technique, while purposive sampling was used for the qualitative data based on data saturation. Data were collected for quantitative and qualitative using face-to-face and in-depth interviews respectively. Multinomial logistic regression analysis was conducted at a 95% CI with a significance level (p=<0.05) for quantitative data while thematic analysis was used for qualitative data. Result: The study findings show that 55.8% had no specific preference, 25.9% preferred a male, and 18.3% preferred female birth attendants. In Multinomial logistic regression analysis, previous experience with male birth attendants (AOR: 2.048, 95% CI: 1.185-3.537), planned current pregnancy (AOR: 0.475, 95% CI: 0.229-0.986), and parity one (AOR: 3.393, 95% CI: 1.298-8.870) and parity two (AOR: 3.541, 95% CI: 1.290-9.725) were significantly associated to the male preference. Residence (AOR: 3.411, 95% CI: 1.447-8.039), and (AOR: 2.489, 95% CI: 1.040-5.957) were significantly associated with male and female gender preference respectively. Attitudes towards birth attendants were significantly associated with male and female preferences at (AOR: 0.081, 95% CI: 0.045-0.145), and (AOR: 0.066, 95%CI: 0.034-0.127). The thematic analysis revealed that the gender preference for birth attendants was influenced by personal experience, emotional comfort, skills, and empathy. Conclusion and recommendation: The findings of the study highlighted over half of the women had no gender preference. Previous experience, residence, and parity were associated with gender preference. The concerned bodies would focus on patient-centered care and further research for exploring factors of gender preference in wider areas. Keywords: Gender Preference, Pregnant Women, Birth Attendants