College of Health Science

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    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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    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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    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.
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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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    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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    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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    Assessment of Knowledge, Attitude, Practice, and Associated Factors Toward Enhanced Recovery After Surgery Protocol Among Health Care Professionals: Multicenter Cross-Sectional Study
    (2025-05-01) Ermias Asefa
    Abstract Background: Enhanced Recovery After Surgery (ERAS) is an evidence-based multidisciplinary approach designed to decrease surgical stress, enhance recovery, and improve postoperative outcomes. Despite global adoption, its implementation remains limited in our settings. Assessing healthcare professionals’ knowledge, attitudes, practices, and associated factors regarding ERAS is crucial for effective integration and better perioperative care. Objective: To assess the Knowledge, Attitudes, Practice, and associated factors of ERAS among healthcare professionals across three selected hospitals from June to October,2025. Methods: A multicenter, institutional-based, cross-sectional study was conducted across three hospitals, involving 423 participants. Data were analysed after cleaning in Excel and exported to SPSS version 26 for descriptive and inferential analysis. Chi-square and logistic regression analysis revealed factors related to Knowledge, Attitude, and Practice regarding ERAS protocols, with a significance level of p<0.05. Result: Of the expected 423 participants, 382 healthcare professionals completed the questionnaire, which yielded a 90% response rate. The prevalence of good knowledge, positive attitude, and good practice toward ERAS was 73.3% (95 % CI: 68.9%, 77.8%), 82.2% (95% CI: 78.4%, 86.0%), and 35.6% (95% CI: 30.8%, 40.4%), respectively. Factors significantly associated with outcome variables were: good knowledge included being from AHMC (AOR=2.07, 95% CI 1.07-3.98) & from GRTH (AOR=1.63,95% CI 1.67-2.96), having work experience >10 years (AOR=0.19, 95% CI 0.06-0.59) and unfamiliarity with ERAS (AOR=2.58, 95% CI 1.33-4.99), with positive attitude being nurse (AOR=3.12, 95% CI 1.97-10.05) and not familiar with ERAS (AOR=3.20, 95% CI 1.51-6.81), and with good practice being nurse (AOR=0.281,95 % CI 0.13-0.60), prior training of ERAS (AOR=0.43, 95%CI 0.20-0.95) and familiarity with ERAS (AOR=4.12,95% CI 2.08-8.47) Conclusion & Recommendations: Overall, healthcare professionals (HCPs) had good knowledge and a favourable attitude toward ERAS; however, their actual level of practice remains optimal. Integrate ERAS protocols into institutional perioperative care guidelines and provide ongoing education and training for all HCPs. Key Words: Knowledge, Attitude, Practice, ERAS, ERAS Protocol
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    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.
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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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    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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    CLINICAL PATTERN AND EARLY SURGICAL OUTCOMES OF INGUINAL HERNIA REPAIR IN ADULTS ADMITTED TO SURGICAL WARDS AT ASELLA TEACHING AND REFERRAL HOSPITAL, ASELLA, ETHIOPIA
    (2025-05-01) Bedru Mohammed
    ABSTRACT Background: Inguinal hernia is one of the most common general surgical conditions worldwide. In low- and middle-income countries, delayed presentation and limited access to elective surgical care contribute to a higher burden of complicated hernias and poorer postoperative outcomes. In Ethiopia, there is limited evidence regarding the clinical pattern and early surgical outcomes of inguinal hernia repair. Objective: To assess the clinical pattern and early surgical outcomes of inguinal hernia repair among adult patients at Asella Teaching and Referral Hospital, Ethiopia. Methods: An institutional-based cross-sectional study was conducted from July 2022 to July 2025 among adult patients who underwent inguinal hernia repair. Patient charts were retrieved using medical record numbers from operation theater logbooks and surgical ward admission registers. Data were entered into Kobo Toolbox, then coded, cleaned, and exported to the latest version of SPSS for analysis. Bivariate analysis was performed to assess associations between independent variables and postoperative outcomes. Variables with a p-value ≤ 0.25 in the bivariate analysis were entered into a multivariable logistic regression model. Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs) were calculated, and variables with a p-value ≤ 0.05 were considered statistically significant. Results: A total of 114 patient records were analyzed. Most patients were male (73.7%), with a median age of 47 years. The majority of hernias were primary (91.2%), and indirect (75.4). Elective repairs accounted for 88.6% of cases, while 11.4% were emergencies. Tissue repair techniques predominated, with Desarda repair performed in 68.4% of patients. Postoperative complications occurred in 16.7% of cases, with surgical site infection being the most common (4.3%). On multivariable analysis, emergency presentation (AOR = 11.9; p = 0.001) and comorbidities (AOR = 10.6; p < 0.001) were independent predictors of adverse postoperative outcomes. Conclusion: Early postoperative outcomes were generally acceptable. However, emergency presentation and comorbid conditions significantly increased the risk of complications. Optimizing comorbidities and strengthening elective surgical services may improve outcomes in our settings. Keywords: Inguinal hernia; clinical pattern; early surgical outcomes; hernia repair; Ethiopia.
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    CLINICAL PROFILE, SHORT-TERM OUTCOMES AND ASSOICITED FACTORS OF NON-SURGICALLY MANAGED CONGENITAL HEART DISEASES IN PEDIATRICS PATIENTS AT ASELLA TEACHING AND REFERRAL HOSPITAL, ETHIOPIA
    (2025-05-01) Kasim Benka
    Abstract Background: Congenital heart disease (CHD) is a leading cause of morbidity in children, particularly in low-resource settings where surgical intervention is limited. Understanding the clinical profile and short-term outcomes of non-surgically managed CHD is essential to guide care. Methods: A retrospective cohort study was conducted at Asella Teaching and Referral Hospital, Ethiopia, from March 2020 to February 2025 among 156 pediatric patients with CHD. Data on demographs, clinical presentation, CHD types, comorbidities, anthropometric status, hospital admissions, medical management, and six-month clinical outcomes , further reclassified poor outcome(Death and / or DAMA) and good outcome (improved discharged and / or referred after stabilization) were collected from medical records. Descriptive statistics summarized the findings, and multivariable logistic regression identified factors associated with poor outcomes. Results: The majority of patients were infants (<1 year, 46.8%) and from rural areas (69.2%), with slight male predominance (54.5%). Most were symptomatic (91.7%), presenting with fast breathing (75.2%) and feeding difficulties (55.9%). Acyanotic CHD predominated (82.1%), with ventricular septal defect most common (41.7%); cyanotic CHD accounted for 17.9%, predominantly Tetralogy of Fallot (15.4%). Moderate or severe malnutrition affected 50% of patients. Hospital admission occurred in 82.7%, mainly for heart failure (79.8%) and pneumonia (53.5%). Medical management, primarily furosemide (73%) and spironolactone (69.5%), was provided in 76.9% of cases. At six months, 76.9% had good outcomes, while 23.1% had poor outcomes. Down syndrome (AOR = 4.63, 95% CI: 1.15–18.61, p = 0.031, short (≤3 days) (AOR = 6.01, 95% CI: 1.02–35.54, p =0.049) or prolonged (>14 days) hospital stay (AOR = 7.41, 95% CI: 1.08–50.93, p = 0.042), and loss to follow-up (AOR = 0.13, 95% CI: 0.04–0.41, p = 0.001)were independent predictors of poor outcomes. Conclusion: Pediatric CHD patients managed non-surgically are mostly infants with high rates of malnutrition. Continuous follow-up, nutritional support, and attention to comorbidities such as Down syndrome are essential to improve survival and functional outcomes.
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    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
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    Comparing the effectiveness of US-guided thoracic paravertebral block versus erector spinae plane block as postoperative analgesia in adult patients undergoing elective open upper abdominal surgery under general anesthesia at two tertiary governmental hospitals, Ethiopia, 2025 G.C. multicenter prospective cohort study
    (2025-05-01) Kelil Musa
    ABSTRACT BACKGROUND: Managing pain well after surgery is an important part of perioperative care because untreated pain can have serious effects on the body, mind, and ability to function. Ultrasonography-guided thoracic paravertebral block and erector spinae plane block have become popular for their safety and ability to help avoid opioid use. However, there is still no agreement and local evidence comparing these methods in resource-limited settings. The purpose of this study was to compare the effectiveness of ultrasound-guided thoracic paravertebral block and erector spinae plane block as pain relief methods for adult patients who had elective open upper abdominal surgery. METHODS AND MATERIALS: A multicenter prospective cohort study conducted at two tertiary hospitals in Ethiopia involved 76 adult patients who underwent scheduled open upper abdominal surgery under general anesthesia from July to October 2025 G.C. Participants were split into either the thoracic paravertebral block group or the erector spinae plane block group, based on the clinical assessment of the attending anesthetist. Data were gathered through interviews and structured questionnaires and analysed using SPSS version 26. The statistical methods utilised include chi-square or Fisher's exact test for categorical variables and Shapiro-Wilk and Levene's tests for assessing normality and variance homogeneity, respectively. Independent two-sample t-tests for group comparisons. A repeated measures ANOVA was employed to compare variations in visual analogue scale scores between groups over time. RESULTS: The postoperative visual analogue scale scores at several time points at rest or during movement were comparable at several time points, specifically at 0h, 2h, 6h, and 24h, in the ESPB group compared with the TPVB group (except at 12h, p < 0.001). The time to first rescue analgesic was significantly lower in the ESPB group compared with the TPVB group (774.1±25.73 min, 748.1±32.99 min, p<0.001). Similarly, total analgesic consumption was lower in the ESPB group (38 mg [IQR9]) compared with the TPVB (38 mg [IQR37]), with a statistically significant difference (p=0.001). The incidence of postoperative nausea and vomiting was comparable between the two groups (p>0.05). CONCLUSION: ESPB and TPVB provided comparable postoperative pain scores both at rest and during movement, except at the 12-hour mark. ESPB had a longer duration of analgesia before the first rescue analgesic and reduced total analgesic consumption within 24 hours compared with TPVB. KEYWORDS: Erector Spinae Plane Block, Postoperative Pain, Thoracic Paravertebral Block, Visual Analog Scale, Upper Abdominal Surgeries
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    COMPARISON OF POSTOPERATIVE ANALGESIA EFFECTIVENESS OF SPINAL BUPIVACAINE ALONE AND IN COMBINATION WITH TRAMADOL AND FENTANYL DURING CESAREAN DELIVERY AT ARSI UNIVERSITY TEACHING AND REFERRAL HOSPITAL. PROSPECTIVE COHORT STUDY
    (2025-05-01) DULA ABABA
    ABSTRACT Background: Cesarean section is a common obstetric procedure that is usually performed under spinal anesthesia with bupivacaine being the most commonly used local anesthetics. Adjuvants added to bupivacaine during the single shot spinal anesthesia helps in extending postoperative analgesia duration and minimize side effects. Existing studies on intrathecal tramadol and fentanyl reported conflicting results on the postoperative analgesia duration; some reported fentanyl is effective while other may support tramadol. Objective: To compare the postoperative analgesia effectiveness of spinal bupivacaine alone with that of bupivacaine combined with adjuvants tramadol and fentanyl for elective cesarean section at Arsi University Referral and Teaching Hospital from July to September, 2025. Methods: An institutional-based prospective cohort was conducted on 93 parturients. Systematic sampling technique was employed. Data was collected with chart review, intraoperative observation and postoperatively patient interview. Shapiro wilk test was used to assess normality of the data. For normally distributed, analysis of variance (ANOVA) while Kruskal Wallis test was applied for not normally distributed data. Time to event variable was analyzed by using Kaplan Meir’s survival function. P value less than 0.05 with a power 90% was considered statistically significant Results: A total of 93 parturients (31 in each group) were included in the final analysis. The duration of postoperative analgesia was significantly longer in the bupivacaine tramadol group to (420.63 ± 14.43 minutes) compared to the bupivacaine fentanyl group (283.83 ± 19.28 minutes) and the bupivacaine alone (154.07 ± 24.63 minutes), P < 0.0001. Total postoperative Analgesia consumption was significantly lower in the bupivacaine tramadol group, (p < 0.0001). The total obstetric quality of recovery score was highest in the bupivacaine tramadol group 72 (66 -81), followed by bupivacaine fentanyl group 69.5 (54 – 79) and bupivacaine alone 60 (45 -71), P < 0.0001. Conclusion: Addition of preservative free Tramadol to bupivacaine as adjuvants in spinal anesthesia for elective cesarean section increased analgesia duration, decreased 24-hour analgesia consumption, prolong time to first analgesia requests and improved obstetric quality of recovery. Key Words: Spinal anesthesia, Postoperative pain, Tramadol, Fentanyl
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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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    Depression Burden and Determinants among Middle-Adolescent Students in Asella, Ethiopia: A Cross-Sectional Study 2025
    (2025-05-01) Firegenet Gossa Ayele
    Abstract Introduction: Depression is a growing public health concern among adolescents worldwide, affecting nearly 10-20% globally. In low- and middle-income countries for the majority of adolescents mental illnesses go undetected and untreated due to limited mental health services. In Ethiopia, evidence on adolescent―in particular depression ―remains scarce. Generating local data is important for designing tailored interventions. Objective: To assess the magnitude of depression and its associated factors among middle adolescent students in three selected schools in Asella, Oromia, Ethiopia in 2025. Methods: A school-based cross-sectional study was conducted from May 9th, 2025, to January 5th, 2026, among 590 students from three selected schools in Asella town, Oromia Regional State, Ethiopia. Students were selected by a multi staged stratified sampling technique based on grade and sex. Data were collected using a structured, self-administered questionnaire prepared in English, Amharic and Afaan Oromoo and analyzed in Statistical Package for Social Sciences (SPSS) version 29 using descriptive statistics and binary logistic regression. Statistical significance was set at p-value <0.05. Results: The magnitude of depression among middle adolescents was 30.5%. Significant determinants included academic pressure (AOR = 2.45, 95% CI: 1.41,4.26, very highly significant at p < 0.001), social-exclusion bullying (AOR = 2.64, 95% CI: 1.4,4.73, very highly significant at p < 0.001), living with mother only (AOR = 1.87, 95% CI: 1.10,3.16, highly significant at p < 0.05) or living alone (AOR = 2.61, 95% CI: 1.08,6.34, significant at p < 0.05), lower maternal education (AOR = 2.17, 95% CI: 1.02,4.63, significant at p < 0.05), and perceiving the school environment as stressful (AOR = 1.81, 95% CI: 1.09,3.03, highly significant at p < 0.05). Conclusion and Recommendation: The magnitude of depression was 30.5%, with key determinants including academic pressure, social-exclusion bullying, living with mother only or living alone, lower maternal education, and a stressful school environment. Schools should integrate mental-health promotion programs and peer-support, parents should provide supportive homes, and the health and education sectors must implement
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    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.
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    Determinants of delay in timely treatment seeking for diarrheal diseases among mothers with under-five children in public health facilities of Asella town, Oromia, central Ethiopia: a case - control study
    (2025-05-01) Abdisa Gonfa
    Abstract Background: Early treatment of diarrheal disease reduces morbidity and mortality among under-five children. However, in many low-income countries, mothers and caregivers often fail to seek care promptly or do not seek care at all. Delayed treatment may result in chronic diarrhea, malabsorption, malnutrition, growth retardation, and long-term impairment. Factors such as maternal knowledge, type of diarrhea, and distance to health facilities influence treatment-seeking behavior. This study aimed to identify determinants of delayed treatment seeking for diarrheal disease among under-five children attending public and private health facilities in Asella town, Oromia region, central Ethiopia. Methods: An institutional-based unmatched case–control study was conducted from October 1 to November 30, 2025, among 324 under-five children (162 cases and 162 controls). Three government and two private health facilities were selected, and the sample size was proportionally allocated to each facility. Data were collected using a pretested questionnaire and analyzed using SPSS version 27. Variables with a p-value ≤0.25 in bivariate analysis were entered into multivariable logistic regression. Statistical significance was declared at p-value <0.05 with 95% confidence intervals. Results: A total 324 participants were included, giving a 100% response rate. Children under 24 months were more likely to experience delayed treatment seeking than those aged ≥24 months (AOR = 2.19; 95% CI: 1.23–3.99). Living more than 10 km from the nearest health facility increased the likelihood of delayed treatment (AOR = 2.67; 95% CI: 1.67–4.27). Children of mothers or caregivers with poor knowledge were also more likely to delay seeking treatment (AOR = 2.60; 95% CI: 1.50–4.43). Conclusion and recommendation: Delayed treatment seeking was significantly associated with younger child age, long distance to health facilities, and poor mothers/caregivers knowledge. Strengthening community-based health education and improving access to health services are essential. Targeted interventions for high-risk families are necessary to reduce diarrhea-related morbidity and mortality among under-five children. Keywords: Diarrhea, Ethiopia, treatment delay, under-five
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    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