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A Study on Electroencephalography (EEG): Its Indications, Findings, and Predictors of Abnormal Results In Pediatrics Age group at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia
(Mekelle University, 2024-10-01) Freweini Gebremeskel (MD)
Background: Electroencephalography, often referred to as EEG, is a non-invasive electrophysiological imaging technique used to record the brain’s electrical activity. In Ethiopia, particularly Tigray, there is no study a specific study on EEG study among pediatric age group, its indications, and findings at Ayder Comprehensive Specialized Hospital (ACSH) in Mekelle, Northern Ethiopia. Objective: To study the indications for EEG, the prevalence of abnormal EEG results, and identify predictors of EEG abnormality in pediatrics age group at ACSH. Methods : A cross-sectional study was carried out on 439 pediatric patients who underwent EEG study at ACSH for a range of neurological disorders from October 2019 to September 2024. Data were collected using a checklist, with the data source being electronic EEG records. The ODK collect mobile application was used for simultaneous data collection and entry. After exporting data to SPSS 27, both descriptive and inferential statistics were applied. Binary logistic regression was fitted to identify predictors of EEG abnormality. A p-value less than 0.05 was used to declare statistical significance. Result: The mean age of the study participants is 7.9 years and about two-third (63.6%) were male. More than three-fourths (77.0%) were right-handed and the most common clinical diagnosis wa generalized epilepsy (62%) and 89% of the participants had seizure history. The most prevalent EEG finding was generalized epileptiform (43.1%). Overall, two-thirds (66.5%) of the EEG studies exhibited abnormality. The odds of abnormal EEG findings were almost five times higher in children not on remission (AOR=4.6, 95% CI: 1.9 to 11.2, p=0.001). The odds of abnormal EEG were seven times higher in children with history of seizure (AOR=7.0, 95% CI: 3.4 to 14.3, p<0.001). The odds of abnormal EEG findings were found to increase by 20% as duration of epilepsy rises by one year (AOR=1.2, 95% CI: 1.1 to 1.4, p=0.001). The odds of abnormal EEG results were 12.6 times higher among children who had no febrile seizures than their counterparts (AOR=12.6, 95% CI: 1.4 to 111.3, p=0.022). Conclusion and Recommendations: In the present study, the prevalence of abnormal EEG results was higher compared to other Ethiopian studies due to different reasons. Factors remarkably related to EEG abnormality are duration of seizure/epilepsy, febrile seizure, seizure history, and remission status. Therefore, more emphasis should be given to children with an ongoing seizure (not on remission) and long history of seizure. Further research on the relationship between EEG abnormality and febrile seizure should be conducted and supported by concerned bodies.
ADHERENCE TO ART AND ASSOCIATED FACTORS AMONG HIV INFECTED CHILDREN ON FOLLOW-UP AT MEKELLE GENERAL HOSPITA
(Mekelle University, 2025-02-01) Selam Gebreslassie Weldetatyos
Introduction: Adherence to antiretroviral therapy (ART) is a significant factor for the success of HIV treatment. The challenges are particularly serious in Sub-Saharan countries as the high rates of HIV/AIDS lead to greater numbers of affected individuals. The magnitude of this challenge remained large in developing countries like Ethiopia. In Tigray, though high rates of patient’s poor adherence are expected which is resulted from the war and associated siege there is limited evidence on adherence to ART particularly among children. Objective: to assess the level of adherence to ART and the factors associated among HIV infected children in Mekelle General hospital. Method: Using hospital based cross-sectional study design a total of 136 children age under 18 who was on ART. Census method of data collection was used. Then, the collected data was analyzed using SPSS27. Dependent variable was dictomized, then a descriptive, bi-variate and multivariate logistic regression analysis was performed to see the frequency, measure the level of adherence and identify the determinate factor of good / poor adherence. The research was done on April 2024 by September 2024. Result and discussion: A total of 136 study participants were included. The level of ART adherence among children was 115 (84.6%). Majority of children are in the age of 10-18 years 98[72%] of all female are dominant number than male 80[58.8%] majority resides in Mekelle 122[87.9%]. No variable is found significant factor affecting adherence. Care givers of lower economic status [AOR=5.711(0.532-61.350)], self-care-giver type [AOR=3.332(0.356-31.227)], and those who were aware of their HIV serio status [AOR=1.202(0.433-3.334)] were more likely to adhere to ART treatment. On the other hand, the study showed the Sex of the child [AOR=0.922(0.360-2.361)], sex of the caregiver [AOR=0.493(0.181-1.341)] and caregivers with other occupation [AOR=0.450(0.050-4.036)], were less related to Adherence of ART medication. Caregiver’s forgetfulness (28.7%) and stigma of children (25%) were more likely the main reasons for missed doses. Conclusion and recommendation: The level of adherence to antiretroviral therapy was poor. This study indicated the level of adherence (84.6%) showed a difference with WHO requirements, 95%
Antenatal care services satisfaction and related factors, among pregnant women attending antenatal clinic in Public general hospitals of central zone of Tigray region, Ethiopia; 2024: hospital based cross-sectional study design (mixed)
(Mekelle University, 2025-04-28) KIDU GEBREYOHANES
Introduction: Antenatal care (ANC) is care offered by skilled healthcare professionals to pregnant women to guarantee the greatest possible health for both the mother and the baby. In Tigray, 78% of health posts, 72% of health centers, and 80% of hospitals had been destroyed during the war according to the Tigray Regional Health Bureau. As a result, ANC coverage decreased from 94% to 16% during the war. Since there is no related research done in the study area, it necessitates undertaking this research. Objective: This study aims to assess ANC services satisfaction and related factors in public general hospitals of central zone of Tigray region, Ethiopia, 2024. Methods: A hospital-based cross-sectional study involving both qualitative and quantitative approaches of data collection was used from September 10 to November 15, 2024. Data were gathered from systematically selected 420 individuals via interviewer administered face-to-face interviews using Kobo toolbox. Data from the kobo toolbox was exported to and analyzed using the Statistical Package for Social Sciences (SPSS) software version 27. Bivariate and multivariable logistic regression analyses were used to identify the factors associated with the outcome variable. For the qualitative part, convenience sampling was used to select respondents, and data were collected through in-depth interviews. Then, inductive thematic analysis was used to manually review qualitative data. Results: Pregnant mothers’ satisfaction with ANC service was found 44.8%. Type of pregnancy, tone of pregnancy, ANC start time, waiting time to see a doctor, getting additional clinical examination, counseling on self-care and on birth preparedness and complication readiness plan and availability of free laboratory service were among the significant predictors of ANC satisfaction. The qualitative findings also highlight that early initiation of ANC, friendly and respectful care, easily accessibility of the institution, etc were frequently raised as a favorable contributors for a satified care. Conclusion and recommendation: pregnant mothers’ satisfaction with ANC was low in this study. Concerned bodies are recommended to undertake continues monitoring, improve financing for health care, staffing and making comprehensive counselling accessible at each service contacts.
Assessment and Comparison of Serum Electrolyte Level among Pulmonary Tuberculosis Patients with and without HIV Co-infection at Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia, 2023/2024
(Mekelle University, 2025-01-25) Tsegay G/her Birhane
According to a World Health Organization report from 2021, tuberculosis is a primary cause of morbidity and one of the top causes of mortality globally. It has been discovered that electrolyte and fluid imbalances, which are common in tuberculosis and HIV/AIDS, have a significant role in morbidity and mortality. The aim of this study was to assess and compare serum electrolyte level among pulmonary tuberculosis patients with or without HIV co-infection at Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia. A comparative cross-sectional study utilizing a convenience sampling technique was used to sample 50 pulmonary tuberculosis patients with or without HIV co-infection at Ayder Comprehensive Specialized Hospital in the period from October 2023 to December 2024. HIV-PTB co-infected patients and PTB without HIV co-infection who fulfilled the inclusion criteria were included in the study. Socio-demographic and clinical data were collected using an interviewer administered structured questionnaire and medical record review. K-Light electrolyte analyser automachine analyser was used to determine the serum electrolyte status of pulmonary tuberculosis patients with or without HIV co-infection directly by taking 3 milliliters of venous blood. After checking for completeness and cleaning, the data were entered into Epi-data version 4.5 and exported into the SPSS software version 25 package for analysis, and the different variables were analyzed. Linear Regression was used to assess the relationship of anti-TB and ART Rx duration with serum electrolyte level. This study found that serum sodium levels were significantly higher in pulmonary tuberculosis (PTB) patients compared to those co-infected with HIV (132.65±4.15 vs. 130.28±4.09 mEq/L; p = 0.047). Conversely, serum potassium levels were significantly elevated in HIV-PTB coinfected patients (5.05±0.75 vs. 3.83±0.59 mEq/L; p = 0.000), and serum chloride levels were higher in PTB patients without HIV co-infection (103.42±3.16 vs. 100.61±5.10 mEq/L; p = 0.023). The study highlights the significantly higher level of serum sodium in pulmonary tuberculosis (PTB) patients without HIV co-infection compared to those co-infected with HIV. This study also showed a significantly higher level of serum potassium in HIV-PTB co-infected patients and significantly higher chloride level in PTB patients without HIV co-infection.
Assessment of Blood Glucose Level and Lipid Profiles among Hormonal Contraceptive Users in Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia, 2024
(Mekelle University, 2024-12-25) Seare Teklay
Hormonal contraceptives have been observed to affect and induce changes in blood glucose level and lipid profiles. Studies have been shown that hormonal contraceptive is suggested to trigger changes in blood glucose level and lipid profiles.To assess blood glucose level and lipid profile among hormonal contraceptive users at Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia, 2023/2024. Comparative cross-sectional study design was carried out on 57 hormonal contraceptive users and 57 age-matched non-users, in Ayder Comprehensive Specialized Hospital from July 2023 to October 2024. Fasting blood samples for the estimation of TC, TG, HDL-c, LDL-c and FBS levels were collected. Data was entered using Epi-data software version 4.5 and analyzed using SPSS software version 25. Student's independent t-test was used to compare the results. A one-way ANOVA was used to identify the variation in the lipid profile and FBS between oral contraceptive pills, DMPAs and implant users. Simple linear regression was used to determine the changes in blood glucose and lipid profile in relation to the duration of hormonal contraceptive use. The mean serum levels of TC, TG, LDL-c, and FBS were significantly greater in hormonal contraceptive users than in non-users (P =0.005, P =0.000, P =0.003, and P =0.012, respectively), and the mean serum HDL-c level was significantly lower than that in controls (P =0.002). The mean serum levels of TG, LDL-c, and HDL-c were significantly different between DMPA, implant, and OCP users (P =0.000, P =0.031, and P =0.001, respectively). Compared with OCP and implant users, DMPA users had the highest mean serum levels of TC, TG, and LDL-c but had the lowest mean serum levels of HDL-c. As the duration of oral contraception and DMPA use increased the serum levels of TG and LDL-c increased (P = 0.017 and P = 0.014 respectively), whereas the serum level of HDL-c decreased (P = 0.01). The serum levels of LDL-c increased as the duration of implant use increased (p = 0.017). As the duration of DMPA use increases, the serum level of FBS moderately increases (p =0.000). Over all, hormonal contraceptive use results in changes in the mean serum lipid profile and FBS level. DMPA produces more change on mean serum lipid profiles and FBS than the other types are, and implants have a minimal effect on the level of all lipid profiles.
Assessment of Magnitude and Determinants of Prediabetes among Commercial Bank Workers in Shire Endaslasie Town, Tigray, North Ethiopia, 2023/2024
(Mekelle University, 2025-03-25) Kibrom Tamene Berhe
Globally, the prevalence of prediabetes across various occupational groups and its relationship with an occupational factor is a topic of recent interest. Physical inactivity, long working hours, and workload stress were mentioned to play a big role in the development of prediabetes. Thus, bank workers who are always subjected to physical inactivity, long working hours, and workload stress are at risk of developing prediabetes. The aim of this study was to assess magnitude and determinant of prediabets among Commercial Bank of Ethiopian workers at Shire Endaslasie Branch between November 2023 and April 2024. A cross-sectional study was conducted using a systematic random sampling technique. The study populations were all Commercial Bank of Ethiopia workers at Shire Endaslasie town who had worked at least one year and above as bank workers. The total sample size for the study was 111. The data were collected using a semi-structured questionnaire, physical examinations, and blood samples by using the WHO stepwise approach. Data were entered into SPSS version 20.0. The entered data were cleaned and analyzed. Frequency distributions, percentages, tables, and charts were used to show the results of univariate analysis. Cross-tabulation, chi-square tests, and 95% confidence intervals are used to present results of bivariate analysis. Multivariate logistic regression analyses were done to control for potential confounding variables. Out of 111 eligible subjects, 105 (93.3%) commercial bank of Ethiopia workers participated in this study. Of the total subjects tested for fasting blood glucose level, the prevalence of impaired glucose (IFG) was 21.4% and 3.6% were undiagnosed diabetes. The history of alcohol intake (P = 0.041, AOR 14.6 (1.11-191.1)), having a history of physical inactivity (P = 0.014, AOR = 60 (2.29-159.3)), hypertension (P = 0.013, AOR = 1.694 (1.116-2.572)), and body mass index (P = 0.013, AOR = 1.694 (1.116-2.572)) were found to have statistical significance association with the prevalence of impaired fasting glucose among the study participants. in this study nearly one in five commercial banks employees have prediabetes, in addition to this Unhealthy lifestyle such as heavy alcohol use , physical inactivity and related derangements like elevated BMI and hypertension had significant associations with prediabetes. Hence, education on lifestyle modification and provision of targeted care & support is imperative to reduce the risk.
Assessment of Reproductive Health Service Utilization & Associated Factors Among youths in Selected Schools, Tigray, Ethiopia
(Mekelle University, 2025-06-25) GIRMAY TOLOSA
Introduction: Youths (15–24 years old) worldwide are at risk, particularly women, for unsafe abortions, poor contraceptive services, high rates of unwanted pregnancies, and STIs. Students in secondary schools, especially in our country, are more vulnerable to several reproductive health problems. In Tigray, due to the war, there is no clear information on reproductive health service utilization in secondary schools. Additionally, there are many new cases of HIV/AIDS, early pregnancies, illegal abortions, and poor utilization of family planning. Therefore, this study aims to investigate how youths in Mekelle secondary schools utilize these services and identify factors that influence their use. Objective: To assess reproductive health service utilization and associated factors among youths attending secondry schools in Mekelle, Tigray, Ethiopia 2024. Methods: An institutional-based cross-sectional study was conducted on 630 secondary school students in Mekelle town from December to March 2024/25. A structured interviewed questioner was used to collect the data. The samples were distributed proportionally to each school, and participants from each school were selected by systematic random sampling technique. Bivariate and multivariable logistic regression was carried out to assess the association between dependent and independent variables. Level of significance was declared from p-value < 0.05 and adjusted Odds ratio with 95% confidence interval for the predictors of reproductive health service utilization. Result: Among the 630 students who participated in this study, 279 (39.4%) reported utilizing reproductive health services. Among these, most of the respondents (400 (63.5%)) were from governmental school. Most of the respondents (480 (76.2%)) were from urban areas. About 364 (57.8%) were females. the majority of the respondents (351(55.7%)) were within the age group of 15–19 years (Table 1). And the mean age of the participant were 18.96. And the predictors of reproductive health service utilization included the availability of an RHS facility in school (AOR = 2.203, 95% CI (1.507, 3.222)), the mother's educational status, prior awareness of Reproductive Health services, and knowledge of Reproductive Health services delivery facility. Conclusion and Recommendation: Reproductive health service utilization is the prevalent public health problem in our study area. Predictors which are availability of an RHS facility in school, mother's educational status, prior awareness of Reproductive Health services, and knowledge of Reproductive Health services delivery facility can be minimized by establishing reproductive health service centers within schools and stakeholders should work to scale up the service utilization in schools by considering the students’ background.
Assessment of Schistosoma mansoni Infection and Associated Risk Factors Among Elementary School Children in Gembella and Feleg-Daero, Mekelle City, Ethiopia
(Mekelle University, 2025-04-25) Abeba Teklu
Schistosomiasis is a widespread parasitic infection transmitted through contact with contaminated water, posing a major global public health challenge, particularly in developing countries. It affects individuals of all ages, with children being among the most vulnerable. Identifying the prevalence, associated risk factors, and high-risk populations is crucial for designing and implementing effective prevention and control strategies. This study aimed to assess Schistosoma mansoni infection and the associated risk factors among elementary school children in Gembella and Feleg-Daero (Adis Alem) elementary schools, in Mekelle City, Ethiopia. A cross-sectional study was conducted from January to September 2024, employing a purposive sampling technique to select schoolchildren. A total of 308 stool samples collected from elementary school children aged 7 to 20 years were examined using the wet mount and Kato-Katz techniques. A pre-tested questionnaire was utilized to gather socio-demographic information and associated risk factors. The data was coded, entered, and analyzed using descriptive statistics, bivariate and multivariate logistic regression and the significance level was set at p < 0.05 with 95% confidence interval. The overall prevalence of Schistosoma mansoni infection was 51.0% (157/308), with a median infection intensity of 192 eggs per gram of stool (EPG) among infected individuals. Among the infected children, 26.1%, 49.7% and 24.2% had light, moderate and heavy infections respectively. Significant risk factors for Schistosoma mansoni infection included swimming (AOR: 4.89; 95% CI:1.35, 17.75, P<0.001), washing clothes in rivers or streams (AOR:3.72; 95% CI: 1.12,12.37, P<0.001), engaging in irrigation activities (AOR:1.03;95%CI: 0.28,3.77, P<0.022), and bathing in river (AOR: 2.19,95% CI, 0.17-28.76, P< 0.001) and water contacts with flowing river (AOR:1.41; 95%CI: 0.23, 8.50, P<0.001). Schistosoma mansoni infection among children in this study was alarmingly high, with nearly half of the infected cases classified as having moderate intensity. These findings underscore the urgent need for targeted interventions, including health education, improved access to safe water, and regular deworming programs, to effectively reduce the disease burden and its associated risks.
Availability, price, and affordability of anti-cancer medicines in children in Mekelle, Tigray, Ethiopia
(Mekelle University, 2024-09-01) Teklebirhan Hailu
Background: Childhood cancer is a significant public health concern, particularly in low and middle-income countries (LMICs). Access to effective anti-cancer medicines is crucial for improving survival rates and quality of life. There is a lack of data on the availability and pricing of anti-cancer medicines for children in LMICs, including Ethiopia. This study aims to evaluate the availability, price, and affordability of anti-cancer medications for children in Mekelle, Tigray, Ethiopia. Methods: The study was cross-sectional using a modified form of the World Health Organization and Health Action international methodology of measuring medicine price, availability, and affordability of childhood anti-cancer drugs in purposeful Ayder Comprehensive Specialized Hospital, purposefully selected 7 private pharmacies, and a RedCross pharmacy found in Mekelle, Tigray, Ethiopia, from April to September 2024. The study includes 24 cytotoxic medications listed in the WHO essential medication list for children and was collected in the form of lowest-priced generics and originator brands from the health sectors found in Mekelle. The data were entered and analyzed using WHO/HAI data entry in a in a Microsoft Excel (V 15.0)-customized program to enter and analyze the data collected and analysis form. Result: The overall availability of anti-cancer medication in all sectors was found to be low (38.45%). The availability of LPGs was 41.7% and 37.49% in the public and private sectors, respectively. Anti-cancer medications were totally unavailable at Red Cross Pharmacy. The median MPR of LPG for the public sector and private sector was 1.293 and 2.8925, respectively. The prices of cytotoxic medications available in the private sector were higher than in the public. All anti-cancer medicines for the treatment of the most common cancers in Mekelle were unaffordable. Conclusion: Medicines for cancer treatment are unavailable, and the few available medicines are unaffordable in Mekelle. Based on this, we recommend subsidies for essential childhood cancer medicines and importation of cancer medicines by the government. Improvement in price transparency, health insurance schemes for childhood cancers to be affordable
Bacterial Urinary Tract Infections, Antimicrobial Susceptibility Patterns and Associated Risk factors Among Fistula patients at Hamlin Fistula Hospital, Mekelle, Tigray, North of Ethiopia
(Mekelle University, 2025-06-28) KASECH FITSUM TEDLA
Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in humans, both in the community and hospital. UTIs are a significant cause of hospital admissions, a widespread concern, affecting millions of people worldwide and causing significant morbidity, mortality, and serious healthcare costs. Patients with obstetric fistula usually suffer from urinary and stool incontinence that can predispose them to frequent infections with urinary tract infection. Despite this fact, there is lack of data on the prevalence, causative pathogens, and antimicrobial susceptibility patterns of UTIs, particularly in lower resource settings like Tigray, Ethiopia. Objective: The study aimed to assess the prevalence of bacterial urinary tract infection, evaluate antimicrobial susceptibility patterns and identify associated risk factors among fistula patients at Hamlin Fistula Hospital in Mekelle, Tigray, Ethiopia. Method: A cross-sectional study was conducted from January to May 2025 at Hamlin Fistula Hospital in Mekelle, Tigray. Socio-demographic characteristics and other urinary tract infection related risk factors were collected from study participants using structured questionnaires. The mid-stream urine was collected and cultured on Cysteine lactose electrolyte deficient agar, and MacConkey agar. Bacterial isolates of gram negative and gram positive were characterized using series of biochemical tests. Antimicrobial susceptibility was determined using the disc diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI2020) guidelines. The data was entered and analyzed using SPSS version 27. Results: Out of the 151 patients sampled, 104 (68.8.6%) were found to have significant bacteria infecting the urinary tract. Isolation of significant bacteriuria was strongly associated with the history of previous UTI and history of catheterization (p=0.01). Eight different species of bacterial uropathogens were identified from the samples. The bacteria isolated were 94.2 % gram negative and 5.8% gram positive. The most predominant bacteria identified were E. coli followed by P.vulgaris. The isolated bacteria had shown the highest resistance rate (72.2%) to Tetracyllin followed by Ampicillin (69.2%) and highest susceptibility to Amikacin (100%) followed by Meropenem (98.1%). Twenty-six of the isolated bacteria (98) were found to be ESBL-producing gram-negative bacteria. Conclusion and recommendation: The overall prevalence of urinary tract infection among fistula patients is high. The predominant pathogen of UTI isolated was E. coli followed by P.vulgaris and K. peumoniae. All the bacterial isolates have shown multiple antibiotic resistance pattern. Based on the findings of the present study, routine screening, urine culture and antimicrobial susceptibility testing are recommended for all fistula patients.
CHALLENGES AND BARRIERS OF GLYCEMIC CONTROL AMONG ADULTS WITH DIABETES IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL
(Mekelle University, 2025-04-25) Filmon Beyenne Demoz
Diabetes mellitus is a public health concern in developed and developing countries. Currently, attaining the intended glycemic control in adult patients with diabetes is challenging more in lower income countries. This study aimed to evaluate the challenges and barriers of controlling glycated hemoglobin among adult patients with diabetes in diabetes clinic, Ayder Comprehensive Specialized Hospital, Mekelle University. The study also aimed to evaluate associated factors of knowledge, medication adherence, and self-care practice of the same patients. A cross-sectional study was conducted in diabetes clinic, Ayder comprehensive specialized hospital Mekelle University from May to June 2024. Structured tools were used to collect data about socio-demographics, knowledge, medication adherence, and self-care practices. The data was analyzed using the software Statistical Package for Social Science (SPSS) version 27.0. Binary logistic regression was performed to determine associated factors with poor glycemic control and poor self-care practice whereas ordinal logistic regression was applied to determine factors associated with knowledge and medication adherence. Statistical consideration was given for bivariate binary logistic regression at p-value<0.25 and a p-value <0.05 was considered statistically significant for mult-variate and ordinal logistic regression. Out of 338 study participants nearly three-fourth (73.4%) had poor glycemic control. Secondary educational level (AOR = 5.1, P<0.02), diabetes duration [(AOR = 3.1, p<0.002), AOR = 3, p<0.01), AOR = 5.1, p<0.02)], moderate adherence (AOR = 0.28, p<0.001), high knowledge levels (AOR = 3.3, p<0.007), and good self-care practice (0.26, p< 0.001) were found associated with poor glycemic control. Single (AOR = 3.3, p<0.018) and married (AOR = 2.4, p<0.03) marital status, levels of knowledge [(low, AOR = 0.3, p<0.001), (average, AOR = 0.4, p<0.03)] and presence of comorbidities (AOR = 0.56, p<0.03) and high knowledge level (AOR = 2.1, p<0.01) were associated with counterparts of knowledge, adherence, and self-care practice. Glycemic status was observed uncontrolled in participants with secondary educational level, long diabetes duration, poor adherence and self-care practice. Thus, the study recommends patients to overcome the problems discussed through strictly following the advice offered by physicians and stick to their prescribed medication.
CLINICAL PROFILE, TREATMENT AND OUT COME PATTERN OF INFLAMATORY BOWEL DISEASE OF PATIENTS VISITING GASTRONTESTINAL CLINIC OF AYDER COMPREHENSIVE SPECIALLIZED HOSPITAL AND HIWOT SPECIALITY CLINIC FROM 2019 -2024.
(Mekelle University, 2024-09-01) Beriha Belay
BACKGROUND: inflammatory bowel disease (IBD) denotes a group of disorders Crohn’s disease (cd), ulcerative colitis (uc), and other forms known as indeterminate colitis (ic). These are characterized by chronic intestinal inflammation. IBD can cause significant morbidity and lead to complications such as strictures, fistulas, infections, and cancer. Though there were sufficient data gathered worldwide on IBD and a few more in the continent of Africa, to date there is scarcity reports from Ethiopia at a nationwide or hospital levels about the clinical profile and treatment pattern of IBD. OBJECTIVE: The purpose of this study is to describe the socio-demographic features, clinical characteristics and treatment pattern of inflammatory bowel disease in patients seen in GI clinic at ASCH and Hiwot specialty clinic 2019_2024, Mekelle, Tigray, Ethiopia. METHODS: A five-year retrospective cross sectional descriptive study was conducted to describe the socio-demographic features, clinical characteristics and treatment pattern of IBD in patients attending the GI clinic, at ASCH and Hiwot specialty clinic. RESULT; A total of 114 patients with IBD, 54 from ACSH and 70 from the private clinic were included in this study. Ulcerative colitis patients 74(64.9) were slightly higher than CD patients 40(35.1%). The mean age of patients was 39.48 ± 16.37(range 18-85) and the mean age at diagnosis was 35.8± 16.7(range 14-80) and there was no significant difference between the two groups. Majority, 43(58.1%) of UC and 26(65.0%) of CD patients were on the 18-40 age category and there was no significant difference between UC and CD, (P=0.795) CONCLUSION; Ulcerative colitis was more common than CD with a ratio of 1.85:1, and the mean age at diagnosis was in the mid-thirties for both groups. Both of these disease entities were slightly common in males, M:F ratio 1.19:1. Most of patients, (53.8%) with IBD presented within 6-12 months after symptom onset, yet medically responsive. Left-side colitis in UC and ileacolon involvement in CD are the predominant disease phenotypes. The major hindering factor in caring for these patients remains the availability of major drugs, biologics among others.
CLINICOPATHOLOGIC PATTERN AND TREATMENT OUTCOME OF COLORECTAL CANCER AT AYDER COMPREHENSIVE SPECALIZED HOSPITAL FROM 2017 to 2024.
(Mekelle University, 2025-03-28) FEVEN MEKONENN
Background - Colorectal cancer (CRC) is a broad term and a major public health problem which includes tumors arising from colonic, rectum and anus. CRC is the most common cancer representing 13% of all malignant tumors in the gastrointestinal tract. In Ethiopia, colorectal cancer is among the leading causes of cancer morbidity and mortality in both sexes. Adenocarcinoma is the commonest histologic type with relatively better prognosis. Commonest presentation is abdominal pain and rectal bleeding. In CRC, the primary treatment options are surgery, chemotherapy (CT), targeted agents, and radiotherapy (RT). The predictors of mortality in CRC patients are Age, marital status, CEA level, cancer stage and comorbidities. Objective: The purpose of this study is to assess the clinicopathologic patterns and treatment outcomes of colorectal cancer patients at Ayder Comprehensive Specialized Hospital from 2017 to 2024. Methods: A retrospective institution-based cross-sectional study was done on total of 304 CRC patient who visited ACSH from 2017 to 2024.Trained physicians/residents using an ODK tool collected secondary data from patient charts that was retrieved from archive. Data entered to SPSS, Patient demographics, clinical features, tumor characteristics, treatment modalities, and outcomes were analyzed. Descriptive statistics, cumulative incidence, incidence density, median survival time, and adjusted hazard ratio were calculated to describe variables. Result: A total of 304 patients were recorded in this study. The mean age of presentation was 51.1years (SD=15). The most common chief complaint was rectal bleeding (33.9%), followed by abdominal pain (23%). Metastatic symptoms were detected in 41(13.5%) of patients at presentation. The most common being back pain (6.3%), cough, vaginal bleeding (2%).112(36.8%) of patients had anemia .73.4% (47) had low albumin. CEA> 5 ng/ml value was seen in 44(48.9%) of patient.211 (69.4%) had pre op colonoscope and 145(68.7%) had ulcerative lesion. The most Common site was lower rectum found to be 95(46.6%) and lowest incidence was at transverse colon 7(3.4%) both with imaging US/CT and colonoscope. from the preoperative biopsy result adenocarcinoma 192(76.5%) and 14(5.6%) were poorly differentiated. 56 (35.2%) presented advanced. stage 4, 33(20.8%) stage 3C. 87 patients (28.6%) received neoadjuvant chemotherapy. With FOLFOX 53 (60.9%), CAPOX 14(16.1%). mean number of chemo cycle provided was 6(SD=4). nineteen (21.8%) had radiological, clinical, CEA response. out of 364 patients 168(55.3%) were operated, subsequently 98(32.2%) received adjuvant chemotherapy, 2 (0.7%) received radiotherapy and 74(24.3%) did not receive any treatment due financial, personal and social reasons. Of the total patients XI 23(7.6%) died at discharge. Of the 168 patients operated 199 procedures done 67.3% were done on elective basis. Of which 44.8% Ro resections were done. Of all most common procedure done was colostomy 76(38.2%), followed by segmental resection 36(18.1%), APR (14.1%), right hemicolectomy (11.1%). Total of 18(9%) intraoperative accidents were recorded. The most common intraoperative complication was adjacent organ injury (61.1%) followed by tumor rupture and fecal spillage (16.7%). There was 1 intraoperative death recorded. There were 61 (30.7%) post operative complications, SSI was the most common complication (32.8%), anastomotic leak (13.1%). for which 15(7.5%) required surgical intervention /reoperations.30 days post operative mortality was 6%. At the 5yr follow up 70 out of 304 were deceased. Out of 168 operated 44 were deceased. Conclusion: The clinical presentation of the CRC patients was similar to other studies conducted in Ethiopia and other LMICs with rectal bleeding being the most common chief complaint. Rectal cancer is more common than colon cancer. Most patients present at advanced stages, often from rural areas outside Mekelle, indicating limited access to early diagnostic services. One-fifth of the patients were younger. The most common histological type is well-differentiated adenocarcinoma, aligning with global CRC pathology trends. Assessing the clinic pathology pattern and treatment of study area is important to understand and initiate early detection, screening and treatment for better outcome
COVID-19 VACCINE UPTAKE AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN OF MEKELLE CITY, TIGRAY, ETHIOPIA: A MIXED STUDY DESIGN
(Mekelle University, 2025-02-21) MEKONEN G/MESKEL
Background: Adhering to the prevention practices for COVID-19 is paramount than treating the patients. The World Health Organization recommends different prevention and control measures for COVID-19. This study set out to assess COVID-19 vaccine uptake and associated factors among pregnant women in Tigray. Objective: To assess COVID-19 vaccine uptake andassociated factors among pregnant women attending antenatal care in selected public health facilities of Mekelle, Tigray, Ethiopia 2024. Methodology: An institutional-based cross-sectional study design supplemented by a qualitative method was conducted among 228 pregnant women from December to February 2025. A systematic random sampling technique was used to select study participants for the quantitative study, and purposive sampling was used for the qualitative part. Data were collected by trained nurses and midwives using a structured questionnaire. The quantitative data were analyzed using IBM SPSS 27. The qualitative data were analyzed using thematic analysis. A binary logistic regression model was used to assess the association between the dependent and independent variables. Statistical significance was declared at a P value of < 0.05. Result: The mean age of the respondents was 30.3 years, and 54.2% of them were multigravida. Good knowledge and positive attitude about the COVID-19 vaccine were found in 57.5% and 58.9% of the women, respectively. The magnitude of COVID-19 vaccine uptake was 14.5%, and all who took the vaccine reside in urban areas. The odds of uptake were about 6 times higher among pregnant women who attended formal education up to college/university (AOR=5.7, 95% CI: 1.6 to 21.2). The odds of uptake were 4-fold higher among pregnant women who had a history of contact with a confirmed COVID-19 case (AOR=4.1, 95% CI: 1.3 to 13.0). The odds of uptake were 3.6 times higher among pregnant women who had a positive attitude towards the COVID-19 vaccine (AOR=3.6, 95% CI: 1.3 to 9.8). Conclusion and recommendation: This study found that COVID-19 vaccine uptake among pregnant women in Mekelle was low. Hence, health education and discussion about the benefits and safety of COVID-19 vaccination, ensuring that COVID-19 vaccines are readily available and accessible, and conducting outreach COVID-19 vaccination programs can improve uptake of COVID-19 vaccine among pregnant women.
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 EXTERNALLY VISIBLE BIRTH DEFECTS AMONG NEWBORNS DELIVERED IN PUBLIC GENERAL HOSPITALS OF TIGRAY, ETHIOPIA, 2025 G.C
(Mekelle University, 2025-06-28) BIREY YEMAR
Background: Birth defects are a series of functional and structural abnormalities resulted from disruption of the normal human embryonic development. Regardless of the interventions and targets to reduce neonatal mortality, the burden of birth defects remains high especially in low and middle income countries such as Ethiopia. In Tigray the neonatal mortality showed significant increment during the war crisis and birth defects takes a significant role with limited studies before the war and no studies conducted after the war. Studies on determinants of birth defects are timely essential to manage their burden and will be a guide on the postwar health care reform. Objective: To asses determinants of externally birth defects among newborns delivered in public general hospitals of Tigray, Ethiopia, 2024/25 Methodology: Institutional based unmatched case control study design was conducted from December 1 to December 30, 2024 among 388 subjects (97 cases and 291controls) in public general hospitals of Tigray. Subjects were selected using systematic random sampling method after proportional allocation to each randomly selected five hospitals. Cases and controls were newborns that had at least one visible minor or major birth defect and without externally visible birth defect, respectively delivered from November 1, 2023-Octeber 30, 2024 in the selected public general hospitals. A structured checklist was used to extract data from maternal medical charts. Data was entered through Epi data and transported to SSPS version 25 for analysis. Multivariate Logistic regression model was used to identify factors associated with birth defects at p value less than 0.05. Results; more than half the mothers (51.5% and 58.4% of cases and controls respectively) fall in between 25 and 35 age category). Rural residence [AOR=1.95; 95% CI:(1.04, 3.667);p-value=0.037], lack of folic acid intake [AOR=2.77;95%CI: (1.464,5.24); pvalue=0.002], history of acute illnesses[AOR=5.118;95%CI:(1.389,18.865);p-value=0.014],male sex [AOR=2.4;95%CI:(1.322,4.364);p-value=0.004],and Prematurity [AOR=11.74; 95%CI :( 2.598, 53.05); p-value=0.001] were significant predictors of birth defects. Conclusion and recommendations; Rural residence, lack of folic acid intake, acute illnesses, newborn sex and prematurity, were significant predictors of birth defects. So that it’s vital to address the modifiable factors such as folic acid intake, acute illnesses, awareness creation and service delivery in rural setting.
Determinants of First-Line Antiretroviral Treatment Failure among HIV Patients Enrolled in ART after Post-war at Alamata General Hospital in Southern Tigray, Northern Ethiopia, 2024
(Mekelle University, 2025-01-28) HABTU BERIHUN
Introduction: Antiretroviral therapy (ART) has revolutionized HIV management by targeting different stages of the HIV lifecycle. However, first-line ART failure remains a significant challenge globally, affecting both patients and the healthcare system. In Sub-Saharan Africa, where the HIV epidemic is disproportionately burdened, achieving viral suppression remains a challenge. Factors contributing to ART failure include poor adherence, advanced HIV disease, co-infections, and limited access to viral load monitoring. This can lead to virus replication and resistance, compromising the effectiveness of the initial drug regimen. The recent conflict in Tigray, Ethiopia, has exacerbated the issue, putting a greater strain on the healthcare system and increasing costs. Objective: The aim of this study is to assess the determinants of first-line antiretroviral treatment failure among HIV patients after post-war enrollment in ART at Alamata General Hospital in southern Tigray, in 2024. Methods: An unmatched case control study was conducted among 689 HIV clients enrolled in ART at Alamata General Hospital from May 2024 to September 2024. The study population includes all HIV positive adult patients who were on first-line treatment and controls who met the study criteria. The study will use systematic sampling techniques and structured questionnaires to gather data from medical records and registers of patients on ART. Adherence variables will be categorized into poor, fair, and good adherence. Data quality control established through pre-testing and validation of questionnaires. Data was analyzed using Epi data version 4.2.Softwareand will be exported to SPSS for analysis and a binary logistic regression model to identify variables determining first-line antiretroviral failure. Variables will interpret as having a statistically significant association when the p-value is< 0.05. Results: A study found that a significant number of HIV patients and controls aged 25-34 years were enrolled in antiretroviral therapy (ART). Most were female, married, illiterate, self-employed, and lived below the poverty line. Most patients were on TDF-based ARV regimens at baseline, with a higher proportion in WHO clinical stage 3. A higher proportion of cases developed tuberculosis after starting ART. A significant proportion of cases exhibited poor adherence to ART, with 44.6% being regular coffee drinkers while taking ARV pills. Treatment started with partners, with 59% of cases and 67% of controls starting treatment six months apart. Support groups were involved in 67.4% of cases and 67.4% of controls. Treatment failure rates are higher in individuals aged 25-34, male patients, rural residents, WHO stage III/IV patients, patients with a baseline CD4 count <100 cells/mm³, and those with a BMI <16.5 kg/m². Poor adherence to ART is associated with a 3.6-fold increased risk of failure. Conclusion: In conclusion, this study identified several important determinants of first-line ART failure among HIV patients in post-war settings. Addressing these factors through comprehensive interventions, including early diagnosis, timely initiation of ART, adherence counseling, nutritional support, and conflict-mitigation strategies, is crucial to improve treatment outcomes and reduce the burden of HIV in affected populations.
DETERMINANTS OF INCOMPLETE VACCINATION AMONG CHILDREN AGED 12-23 MONTHS IN NAEDIER WOREDA, CENTRAL ZONE, TIGRAY, ETHIOPIA, 2024/2025 COMMUNITY BASED UNMATCHED CASE CONTROL STUDY
(Mekelle University, 2025-02-21) GEBERZIHER GEBERSLASSIE
Background: Vaccination is among the most cost-effective health interventions and has been responsible for substantial reductions in mortality and morbidity, especially for those under five. Globally, around 67 million children are only partially immunized. Neglecting to protect children from vaccination can lead to severe outcomes such as permanent disability, child mortality, and vaccine-preventable disease outbreaks. In Africa, an estimated 12.7 million children, 1.4 million children in Ethiopia and 41% of children in Tigray are partially immunized. The reasons behind these incomplete vaccinations haven't been extensively studied. Therefore, this study aimed to identify the determinants of incomplete vaccination among children aged 12-23 months in Naedier Woreda, Central Zone, Tigray, Ethiopia, 2024 /2025 Methods: A community-based unmatched case-control study design was implemented with a total sample size of 294 among children aged 12 to 23 months in Naedier Woreda, Central Zone of Tigray, Ethiopia, from August to October 2024. A participant was selected from 12 Kebeles by a simple random sampling technique. Data was collected from mothers/caregivers using a pretested, structured questionnaire. Data were entered into Epi Info 7 and analyzed using the Statistical Package for Social Sciences version 27. Multicollinearity was checked using the variance inflation factor, and the model of fitness was checked by Hosmer Lemeshow. Multivariable logistic regression analysis was used to control confounding variables at the p-value < 0.05, and the strength of the statistical association was measured by using adjusted odds ratios and ` 95% confidence intervals. Result: This study revealed that children born to mothers/caregivers who did not receive antenatal care follow-up (AOR = 4.58, 95% CI: 1.23-17.1), households not visited by health workers (AOR = 2.53, 95% CI: 1.23-5.17), mothers/caregivers who were not informed about the types of vaccines received (AOR = 3.209, 95% CI: 1.29-8.0), were not informed about potential side effects of vaccines (AOR = 2.92, 95% CI: 1.36-6.31), and were not given information about the next vaccination date (AOR = 3.76, 95% CI: 1.8-7.42) were the determinants to default on completing their vaccination. Conclusions and Recommendations: From this study, suggested several determinants contributing to children aged 12-23 months failing to complete their full vaccination schedule are no antenatal care follow-up, absence of home visits by healthcare workers, and no information on vaccinations, including potential side effects and subsequent vaccination schedules. To address those factors, health offices and healthcare workers should prioritize providing detailed information about the specific vaccines administered, including expected side effects and the timing of future vaccinations, and reinforce the importance of consistent antenatal care for both maternal and child health.
DETERMINANTS OF LATE INITIATION OF ANTENATAL CARE CONTACT AMONG PREGNANT WOMEN IN HEALTH FACILITIES OF MEKELLE, TIGRAY, NORTHERN ETHIOPIA, 2024
(Mekelle University, 2025-02-25) GENET TESFAMICHAEL
Background: Late antenatal care is the most common issue in developing countries, including Ethiopia. In Ethiopia, 72% of pregnant women come late for their first antenatal care contact. Late antenatal care initiation is more likely to be linked to poor perinatal health outcomes. Where the effects of late antenatal care initiation are significant in Ethiopia, a scarcity of data hinders for understanding of its determinants. Objective: To identify determinants of late initiation of antenatal care contact among pregnant women in health facilities of Mekelle, Tigray, Northern Ethiopia,2024. Method: Facility based unmatched case control study was conducted in health facilities of Mekelle, Tigray, Northern Ethiopia, from 7 August -5 September, 2024. The data were collected using pre-tested structured questionnaire. In this study 592 study participants (296 cases and 296 controls) were selected using systematic random sampling technique. Cases to controls ratio was 1 to 1. Bivariate and multivariable logistic regression analysis were used to identify determinants of late antenatal care initiation and adjusted odds ratio with corresponding 95% confidence interval was used to measure strength of association. Statistical significance was declared at 𝑃-value <0.05. Result: A total of 592 study participants were included in the study with 98% response rate. Low educational level [AOR=5.60;95%CI:2.766-11.357], recognizing pregnancy by missed period [AOR=2.552; 95%CI:1.588-4.102], unplanned pregnancy [AOR=3.216; 95%CI:1.934-5.347], not accompanied by their husband to ANC contact [AOR=4.306; 95%CI:2.757-6.726] and poor knowledge of the mothers about ANC [AOR=2.049; 95%CI: 1.326-3.168] were identified as determinants of late initiation of ANC among pregnant women. Conclusion and recommendation: Low educational level, recognizing pregnancy by missed period, unplanned pregnancy, not accompanied by their husband to ANC contact and poor knowledge of the mothers about ANC were identified as determinants of late initiation of ANC among pregnant women. Therefore, Health offices and healthcare providers should focus on increasing awareness to improve women's knowledge on ANC services, and to support spouse involvement in ANC.
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.