Department of Adult Health and Emergency Nursing

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DEPARTMENT OF ADULT HEALTH NURSING DETERMINANTS OF HYPERTENSION AMONG DIABETES MELLITUS PATIENTS IN PUBLIC HOSPITALS OF CENTRAL ZONE TIGRAY, ETHIOPIA 2024 (CASE-CONTROL STUDY)
(Mekelle University, 2025-02) GEBREZGABHER HAGOS
Background: Hypertension is defined as a persistent elevation of blood pressure with systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg. Poor diabetes management is a major significant of macrovascular and microvascular complications, as well as death. The gaps were inconsistent in study design and impact of war on health care. Objective: The objective of this study was to identify the determinants of hypertension among diabetes mellitus patients attending in public hospitals of the Central Zone of Tigray, Ethiopia 2024. Methods and materials: An institution-based unmatched case-control design was conducted, among a total sample size of 379 on clients from August 10, October 2024. Systematic random sampling was employed. Data were entered into Epidata version 4.6 and exported to SPSS version 22.0 for analysis. Variables with a p-value < 0.2 in bivariable logistic regression were included in the multivariable logistic regression. A p-value < 0.05 and a 95% confidence interval for the adjusted odds ratio were considered statistically significant determinants of hypertension. Ethical clearance was acquired from Mekelle University College of Health Science's ethical review committee. Results: A total of 379 participants with 1:3, case to controls ratio (95 cases and 284 controls) were included in the study achieving a 100% response rate. The significant factors for the development of hypertension among diabetic were age ≥ 50 years (AOR =6.266, CI 1.777-22.093), long duration of DM (greater than 10 years) (AOR=2.924, CI 1.100-7.771), family history of hypertension (AOR=3.819, CI 1.918-7.605), poor glycemic control (AOR=2.522, CI 1.212- 5.245), high waist to hip ratio (AOR=2.960, CI 1.408-6.220), physicaly inactive (AOR=2.121, CI 1.069-4.211) and poor knowledge about DM (AOR=4.5561, CI 2.308-8.990). Conclusion and Recommendations: Age ≥ 50 years, long duration of DM (above 10 years), Family history of hypertension, Higher waist-to-hip ratio, Poor glycemic control, physicaly inactive and poor knowledge of diabetic mellitus were determinants of hypertension among diabetes mellitus patients. We recommend to health professionals to give health education (about the relationship between obesity, physical inactivity, hypertension, and diabetes).We recommend to the participants to promote physical activity. We also recommended to Tigray Health Bureau to raise awareness among health professionals about the need to monitor patients with diabetes.
DETERMINANTS OF POOR GLYCEMIC CONTROL AMONG ADULT PATIENS WITH TYPE 2 DIABETES MELLITUS ON FOLLOW UP AT THE DIABETIC CLINIC OF REFERRAL HOSPITALS OF TIGRAY, ETHIOPIA, 2025
(Mekelle University, 2025-05-28) GIRMAY TEKLE
Background: Poor glycemic control remains a major public health concern among individuals with type 2 diabetes mellitus. In Ethiopia, the prevalence of uncontrolled blood glucose has been reported to range from 45.2% to 73.5%, including findings from studies in the Tigray region. Despite this substantial burden, there is limited research on the specific determinants of poor glycemic control, particularly in the Tigray region. Moreover, most existing studies in Ethiopia have utilized cross-sectional designs, which are limited in establishing temporal relationships between risk factors and glycemic control. A case-control study design offers a more robust approach for identifying these determinants. Therefore, investigating the factors associated with poor glycemic outcomes through a case-control design is essential to guide targeted interventions and strengthen diabetes management strategies. Objectives: The aim of this study was to identify the Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus on follow up at the diabetic clinic of referral hospitals of Tigray, Ethiopia 2025. Methods: An institution-based unmatched case-control study design was conducted between January 15, and February 15, 2025. A total of 250 participants were included, consisting of 84 cases and 166 controls with case-to-control ratio of 1:2. Systematic random sampling was used to recruit cases and controls. Data were collected using an interviewer-administered structured questionnaire via KoBo Toolbox. In bivariable analysis those variables having a P-value of 0.25 were subsequently included in the multivariable. In multivariable analysis at a P-value of 0.05 with 95% confidence interval were considered statistically significant. Descriptive statistics were performed first, with the results summarized using tables, text, and figures. Ethical clearance was secured from the Institutional Review Board of the College of Health Sciences at Mekelle University. Result: This study revealed that inadequate dietary adherence (AOR = 2.59; 95% CI (1.187-5.684)), poor medication adherence (AOR = 2.96 95% CI (1.417–6.207)), presence of comorbidities (AOR = 2.72, 95% CI (1.30–5.69)), and having polypharmacy (AOR = 2.25, 95% CI (1.088- 4.691)) were significantly associated with poor blood sugar control. Conclusion and recommendation: Inadequate dietary adherence, poor medication adherence, co morbidity and having polypharmacy were determinant factors of poor glycemic control. Therefore, we recommend that patients should regularly follow their diet and medication.
MAGNITUDE AND ASSOCIATED FACTORS OF TB/HIV CO INFECTION AMONG HIV INFECTED PATIENTS ATTENDING IN MEKELLE PUBLIC HOSPITALS, TIGRAY, ETHIOPIA 2024/25
(Mekelle University, 2025-05-21) KAHSU TSEGAY
Introduction: -Tuberculosis is a contagious air born disease caused by Mycobacterium tuberculosis species and the leading causes of morbidity and mortality among people living with HIV/AIDS worldwide accounting for about 25% of all causes of the deaths. HIV infected clients are more susceptible to Tuberculosis infection. The World Health Organization Global Tuberculosis report of 2018 estimated that 10.0 million new cases of Tuberculosis occurred in 2017, of which over 82% of Tuberculosis deaths occurred in low- and middle-income countries. Evidence from this study helps to develop policies that address TB and HIV in an integrated, cost-effective manner and more efficient use of funds and resources. Objective: - The aim of this study was to assess the Magnitude and its associated factors of TB/ HIV co-infection among HIV infected patients in public hospitals of Mekelle, Tigray, Ethiopia 2025. Methods and materials: - Institutional based cross-sectional study was conducted and the period of data collection was from November to December 2024 G.C among ART patients. Systematic sampling technique was used to select 394 participants from the total source population. Data were collected using a pretested, interviewer, administered questionnaire and reviewing the medical record of the patient (CD4 cell count, hemoglobin level, BMI, WHO clinical stage, diagnosis of opportunistic infections, and TB). Data collection tool was pretested in 5% of total sample size in Wukro General Hospital. Data were coded and entered in to Epi data and was exported to statistical package for social science version 27 for statistical analysis. Descriptive statistics were performed. Both bivariate and multivariable logistic regression analyses were used to determine the association between independent variable and dependent variable. Variables having p value less than 0.25 in the bivariate analysis were exported in to multivariate logistic regression in multivariate logistic regression, p value <0.05 with 95% confidence interval (CI) was considered statistically significant. The Hosmer- Lemeshow goodness-of-fit model coefficients tests procedure was used to test for model fitting. Result – The magnitude of TB/ HIV co-infection was 18.8% and confidence interval (18.761 – 18.839). Marital status being widowed (AOR and 95% CI 0.238 (0.062, 0.903), hemoglobin level less than 11 (AOR and 95% CI 4.937 (1.884, 12.943), low CD4 count (200 cells mm3) (AOR and 95% CI 3.405 (1.174, 9.872), suspected TB patients in the household AOR and 95% CI 2.59 (1.026, 6.562) opportunistic infection without TB AOR and 95% CI (6.169 (2.272, 16.747), ambulatory AOR and 95% CI 22.906 (4.918,106.697), Bedridden AOR and 95% CI 11.436 (3.461, 37.79), poor drug adherence AOR and 95% CI 3.767 (1.389, 10.221), alcohol consumption AOR and 95% CI 15.129 (5.232, 43.748), raw/un cook foods consumption AOR and 95% CI 3.255 1.094, 9.682. were significant determinants of TB/HIV co-infection among HIV clients. Conclusion and recommendation The prevalence of tuberculosis among ART patients was high and this study indicated that marital status, hemoglobin level, CD4 count, presence of suspected TB patients in the household, presence of opportunistic infection without TB, functional status, drug adherence, alcohol consumption, utilization of raw/un cook foods were found significantly associated with TB/HIV co-infection. Providing counseling and health education regarding drug adherence, alcohol consumption and chat chewing to ART patients, and government should give priority on TB/ HIV confection.
RISK FACTORS OF HEART FAILUR AMONG HYPERTENSIVE PATIENTS IN AYDER AND AXUM COMPREHENSIVE SPECIALAZED REFARRAL HOSPITALS, TIGRAY, ETHIOPIA, 2024
(Mekelle University, 2025-05-21) BERHE BERIHUN
Background: Heart failure is a chronic condition characterized by the inability of the heart to pump adequate blood to meet the demands of the body and/or doing so at increased filling pressures. The current worldwide magnitude of heart failure is 64.34 million cases. There is a research gap this research was important to assess risk factors heart failure among hypertension patients. Objective: The objective of this study was to identify the determinants of heart failure among hypertension patients attending in Ayder and Axum Comprehensive Specialized Referral Hospitals, Tigray, Ethiopia, in 2024. Methods and materials: An institution-based unmatched case-control study design was conducted, among a total sample size of 176 on clients from December 20, 2024- April 2025. Systematic random sampling was employed. Data were entered into Epidata version 4.6 and exported to SPSS version 25.0 for analysis. Variables with a p-value < 0.25 in bivariable logistic regression were included in the multivariable logistic regression. A p-value < 0.05 and a 95% confidence interval for the adjusted odds ratio were considered statistically significant determinants of heart failure. Ethical clearance was acquired from Mekelle University College of Health Science's ethical review committee. Results: A total of 176 participants (59 cases and 117 controls) were included in the study achieving a 100% response rate. The significant factors for the development of heart failure among hypertension were age group ≥ 60 years (AOR=3.946, 95%CI 1.458-10.675), long duration of HTN (greater than 10 years) (AOR=4.003, 95% CI 1.444-11.098), non-adherencet to diet (AOR=5.023, 95% CI 2.157-11.697), non-adherencet to physical exercise (AOR=6.170, 95% CI 2.599-14.653) and use of alcohol (AOR=3.359, 95%CI 1.408-8.014). Conclusion: Age ≥ 60 years, long duration of HTN (above 10 years), non-adherent to diet, non adherent to physical exercise and alcohol drinking were determinants of heart failure among hypertension patients. Recommendations: Therefore, we recommend that patients should to adhere hypertensive diet and physical exercises. We also recommend that the federal ministry of health to encourage public hospitals to introduce community based hypertension care centers. We also recommend to clients to adhere their hypertensive diet and physical exercises (as ordered by the concerned health professional).