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    Assessment of Preterm Birth and Predictive Factors at Ayder Comprehensive Specialized Hospital, Northern Ethiopia: An Ordinal Logistic Regression Analysis
    (Mekelle University, 2025-08-28) DANIEL ABATE
    Background: Preterm birth is a major public health concern due to its important impact on infant mortality and morbidity. Previous studies conducted in Ethiopia have examined the prevalence and risk factors of preterm birth, using a binary outcome of preterm birth, without considering the severity of preterm birth. Objective: -To assess Predictive Factors of Preterm Birth severity at Ayder Comprehensive Specialized Hospital, North Ethiopia from 2018 to 2020. Methods: A facility-based retrospective cross-sectional study was conducted among 2082 preterm and term neonates from February 2018 to May 2020 at Ayder Comprehensive Specialized Hospital. The minimum sample size was 538. All preterm and term neonates were included in this study. Ordinal logistic regression with partial proportional odd model (PPOM) was used to determine predictors of preterm. Parallel line assumption was tested using Brant test. Odd Ratio with 95% confidence interval was used to assess the strength of association between independent and dependent variables. Result- The overall prevalence of preterm was found to be 36.7% (95%C. I:34.67, 38.86). Being having congenital malformation the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 2.295(95% C.I :1.566,3.363) times. Being having multiple gestation the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 2.319(95% C.I:1.526,3.524) times, Being having history of preterm birth the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 10.03(95% C.I:6.803,14.788). Being having hypertension the odd having higher preterm level increased by OR= 3.835(95% C.I:2.036,7.226). Being having ANC visit the odd of having higher preterm level decreased by 91.8% OR= 0.182(95% C.I:0.039,0.841). Conclusions and Recommendations- in the PPOM, the variables congenital malformation, multiple gestation, history of preterm birth, hypertension, and malaria infection, had a positive significant association with the odd of preterm birth, whereas ANC visit had a negative significant effect. In order to decrease the probability of preterm birth, every mother should prevent chronic disease by changing life style. Health professional should provide health education, early screening of chronic disease and aware mothers to have appropriate ANC follow up during prenatal period.
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    Investigating the prevalence and risk factors of cystic echinococcosis in humans and slaughtered cattle in peri-urban dogowning smallholder farms in Mekelle zone, Tigray Region, Northern Ethiopia
    (Mekelle University, 2025-10-28) MESSELE GEBREMICAEL
    Background: Cystic Echinococcosis (CE), a zoonotic disease caused by the larval stage of Echinococcus granulosus, poses significant public health and economic challenges in Ethiopia. Despite its impact, data on its prevalence in humans, slaughtered cattle, and dogs particularly in the Tigray Regional State, remain limited. Objective: Investigating the prevalence and risk factors of cystic echinococcosis in humans and slaughtered cattle in peri-urban dog- owning smallholder farms in Mekelle zone, Tigray Region, Northern Ethiopia. Method: A cross-sectional study was carried out from March 2024 to March 2025 involving 832 human participants, 212 cattle, and 384 dogs. Human participants were selected using a stratified sampling technique, while the peri-urban smallholder farms owning dogs were purposively selected in the Mekelle Zone. Hydatidosis screening was performed using abdominal ultrasound, and laboratory analysis was conducted on specimens from slaughtered cattle and fecal samples from their dogs. Microscopic examination (40×) was used to detect hydatid cysts in cattle and taeniid eggs in dog feces. Data were analyzed using SPSS version 27, applying descriptive statistics and logistic regression to identify factors associated with CE at a significance level of p < 0.05. Result: The overall prevalence of CE from six purposively selected sub-districts of Mekelle zone was found to be 0.24% (2/832) in humans, 22.64% (48/212) in cattle, and 17.45% (67/384) in dogs. The two human cases involved a 45-year-old male, and 50-yearold women. In cattle, distribution of cysts was primarily found (68.75%) in the lungs and (25.0%) in liver and (2.08%) each in the kidneys, heart, and spleen. Fertility and viability in cattle (68.8%) in lungs and (25.0%) in liver. CE prevalence was higher in male cattle (24.52%) than in females (16.0%), and poor body condition (40.0%) compared to those with medium (22.45%), and good (17.07%). Backyard-slaughtered cattle had a higher infection rate (34.69%) than those slaughtered in abattoirs (19.01%). Factors significantly associated with CE in cattle included age, sex, body condition, and slaughter location (p < 0.05). In the multivariate logistic regression analysis adult cattle (AOR = 2.57; 95% CI:1.501,4.400; P = 0. 001), cattle with poor body condition score (AOR = 4.07; 95% CI: 2.177,7.618; P = 0.000), and cattle slaughtered at backyard slabs (AOR = 2.26; 95% CI: 1.300,3.940; P = 0.004) were more likely to acquire hydatid cysts than the others. After adjusting for potential confounders, dogs with stray roaming behavior (AOR = 2.93; 95% CI: 1.11–7.71; p = 0.029) and feed raw offal (AOR = 2.86; 95% CI: 1.38–5.93; p = 0.005) had significantly higher odds of CE infection. Conclusion: The present study showed that CE is a considerably prevalent disease in human, cattle and dogs in the study area. This emphasizes the need to avoid backyard slaughter practice, unsafe offal feeding of dogs, and proper waste disposal which requires public awareness on the use of abattoirs.
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    Determinants of parental knowledge on childhood foreign body aspiration
    (Mekelle University, 2025-08-28) BRHANU HAILE ASGEDOM
    Background: Although foreign body aspiration (FBA) is a life-threatening event with grave consequences, it is still Preventable. One of the most important risk factors for FBA-related consequences is a lack of knowledge by the caregivers. Better understanding of FBA is very essential to prevent complication and premature death due to FBA. However, there is a limited shred of evidence regarding the knowledge of FBA related among parents in Ethiopia, particularly in Tigray. Objectives: To assess determinants of parental knowledge on childhood foreign body aspiration among clients visiting ACSH. Methods: A facility-based, cross-sectional study was carried out among 423 parents attending Ayder Comprehensive Specialized Hospital from January to March, 2025. A pre-tested structured interviewer-administered 12 FBA-related items questionnaire is used for data collection. Descriptive frequency used to see the level of knowledge then binary logistic regression model was carried to see factors associated with parental knowledge of foreign body aspiration Result: From the total respondent, 271(64.07%) [95% CI, 59%-68%] had good levels of knowledge on the consequences of FBA. Parents with a college degree or higher (AOR=7.19, 95% CI: 4.21–12.29),Having more than three children (AOR=2.25, 95% CI: 1.34–3.78) Parents whose youngest child was less than one year old (AOR=4.55, 95% CI: 1.71–12.10) or between one and five years old (AOR=3.03, 95% CI: 1.23–7.44) Previous experience with FBA: parents who had encountered FBA once (AOR=2.68, 95% CI: 1.30–5.54) or twice (AOR=2.97, 95% CI: 1.44–6.11) were significantly associated with parents’ knowledge on the foreign body aspiration. Conclusion: This study revealed that a majority of parents (64.07%) possess good knowledge regarding body aspiration (FBA). Higher educational attainment, having more children, younger age of the youngest child, and previous experience with FBA were all significantly associated with better parental knowledge.
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    Unveiling the Hidden Burden of Neural Tube Defects Crisis: A Triple-Lens Investigation of Prevalence, Risk Factors and Maternal Folate Deficiency in War-Torn Tigray, Northern Ethiopi
    (Mekelle University, 2025-10-12) Birhane Alem Berihu
    Background: Neural tube defects (NTDs) are among the most severe congenital anomalies globally, with disproportionately high prevalence in low-resource settings. The Tigray regional state in northern Ethiopia, already facing one of the highest NTD burdens in sub-Saharan Africa, has endured an extensive armed conflict for several decades and as recently as in 2020, resulting in the collapse of its healthcare system, widespread famine, and profound maternal health challenges. Despite anecdotal reports of increased birth defects during the conflict, empirical data have been lacking. Objective: This dissertation aimed to assess the prevalence, and associated factors of NTDs in war affected areas of Tigray. It also evaluated maternal red blood cell (RBC) folate levels in NTD high-risk regions to explore biochemical risk factors contributing to these anomalies. Methods: A mixed-methods approach was employed across three interrelated studies. Quantitative data were obtained through hospital-based retrospective chart reviews, prospective observational assessments, and laboratory analyses of RBC folate concentrations in first-trimester pregnant women. Socio demographic, obstetric, nutritional, and biochemical variables were analyzed to identify risk factors associated with NTDs. Results: The findings revealed an alarmingly high prevalence of NTDs (262 per 10, 000 births) in the conflict-affected health facilities of Tigray, significantly exceeding national and regional estimates. Risk factor analysis of our study showed strong links between NTDs and factors such as young maternal age, rural residence, unplanned pregnancy, poor prenatal care, low education, high birth order, and lack of folic acid use. Additional risks included poor folate awareness, food insecurity, low dietary diversity, violence exposure, and limited healthcare access. Biochemical assays showed widespread deficiencies in RBC folate among pregnant women in high-risk areas, with levels frequently falling below WHO recommended thresholds for NTD prevention, with dietary diversity strongly influencing folate status, emphasizing the key role of nutrition in NTD prevention. Conclusion: This study demonstrates an alarming surge in NTDs in war-affected Tigray, primarily driven by widespread folate deficiency, poor dietary diversity, and the collapse of maternal health services. Additional risk was compounded by key socio demographic factors such as low education attainment, rural residence, and limited reproductive autonomy. These findings underscore how conflict magnifies preventable health crises through the convergence of nutritional, medical, and social failures. Hence, efforts should prioritize the restoration of antenatal care services, targeted folic acid supplementation for women of reproductive age, and community-based nutrition education to improve dietary diversity. In the longer term, food fortification with folic acid should be considered once health systems stabilize. These targeted interventions fall within the study’s evidence base and are feasible within conflict-affected and resource-limited contexts.
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    Predicting birth asphyxia in newborns via supervised machine learning: a cross sectional study in Tigray, Ethiopia 2025
    (Mekelle University, 2025-07-22) GOITOM YEMANE
    Background: Birth asphyxia, a critical condition characterized by insufficient oxygen supply to a newborn before, during, or after birth, is the second leading cause of neonatal mortality in Ethiopia. It contributes substantially to preventable neonatal morbidity and long-term neurodevelopmental impairment. The burden is especially high in low-resource regions like Tigray, where healthcare systems have been severely impacted by conflict and limited infrastructure. Early and accurate prediction of at-risk newborns is essential, and supervised machine learning (ML) offers a powerful data-driven solution to support clinical decision-making. Objective: To predict birth asphyxia in newborns using supervised machine learning: a cross sectional study in Tigray, Ethiopia (2025). Methods: An institution-based prospective study was conducted among 1014 mothers and their newborns who delivered at four selected hospitals in Tigray (Ayder, Mekelle, Quiha, and Wukro) between February 25 and April 10, 2025. A convenience sampling technique was used to recruit eligible participants. The dataset underwent thorough preprocessing, including handling missing values, one-hot encoding, normalization, hybrid feature selection approach, and class balancing. Seven ML models—logistic regression, support vector machine, decision tree, random forest (RF), naive bayes, k-nearest neighbors, and extreme gradient boosting were trained and evaluated. The data were split into 80% for training and 20% for testing, with model performance assessed using accuracy, sensitivity, specificity, F1-score, and area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. Shapley Additive Explanations was employed for model interpretability, validated across cross-validation folds. Results: Of the 1014 neonates included, 195 (19.2%) were diagnosed with birth asphyxia based on APGAR scores and physician confirmation. The random forest classifier achieved the best performance, with an AUC of 0.99 (95% CI: 0.98–1.00) and Brier score of 0.0099 (95% CI: 0.008–0.012). SHAP analysis identified fetal heart rate (38.6%), birth weight (11.2%), mal-presentation (8.1%), hypothermia (7.7%), referral status (7.5%), and prolonged labor (6.5%) are collectively contributing 79.6% to the model’s predictive capacity, consistent across folds (standard deviation of SHAP values <0.02). Conclusion: The RF model demonstrated excellent performance in predicting birth asphyxia and offered strong interpretability. Nearly 80% of the model's predictive power was explained by a small number of clinically actionable variables. These findings support the integration of interpretable machine learning tools into routine labor management to reduce birth asphyxia. Future external validation and deployment as a web-based tool are planned.
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    JOINT MODELING OF TIME TO DEVELOP TUBERCULOSIS AND CHANGE IN CD4 COUNT AMONG HIV PATIENTS UNDER ART IN MEKELLE, ETHIOPIA, 2024
    (Mekelle University, 2025-06-28) TEKLEBRHAN KINFE
    Background: In patients with HIV, tuberculosis remains the leading cause of mortality and morbidity. Little is known about the predictors and the median time to develop tuberculosis while considering for the effect of the variation of longitudinal CD4 cell count. Objective: To investigate the time to develop tuberculosis accounting for longitudinal CD4 cell count change and its predictors among HIV patients who are under ART follow-up at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia, 2024. Methodology: A facility-based retrospective follow-up study was conducted among 449 adult PLHIV under ART follow-up from March 2018 to May 2024. The study participant were selected via a simple random sampling. The secondary data were collected from the patients’ medical records via Kobocollect version 2021.2.4 and exported to STATA version 17.0. The final model was a joint random intercept Cox-proportional hazard model. A model with the lowest Akaike information criterion and Bayesian information criterion was selected. Results: The incidence density of TB disease was 6.77 cases/100 person-years with a restricted mean survival time of 60 months. The joint analysis provided an association parameter alpha with AHR=0.854; 95% CI(0.8-0.91), indicating that for a unit increase in the average √CD4 cell count , the hazard of TB infection decreased by 14.6%, keeping other variables constant. The study also revealed that advanced WHO clinical stage (AHR = 1.024, 95% CI: 1.017–1.033), sex (AHR= 1.62, 95% CI: 1.09,2.4), CPT intake (AHR= 0.55, 95% CI: 0.35,0.89), and adherence (AHR= 0.38, 95% CI: 0.28,0.52) were significantly associated with the time to develop tuberculosis. The random intercept model indicated that greater variation in CD4 counts at baseline contributed strongly to the hazard of tuberculosis. Conclusion and Recommendation: This research highlights that PLHIV with a decreasing trajectory of CD4 count, advanced WHO clinical stage, female sex, history of CPT intake, and poor adherence have a higher risk of tuberculosis. On the basis of these findings, it is strongly recommended that the government and relevant health actors working on TB/HIV should intensify activities that improve patient adherence and a regular CD4 cell measurement.
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    Magnitude and Associated Factors of Oligohydramnios Among Third Trimester Pregnant Women Attending at Mekelle Public Hospitals, Tigray, Ethiopia: Institution-Based Cross Sectional Study
    (Mekelle University, 2025-06-28) SHUSHAY TEKULU
    Background: Oligohydramnios is a condition where amniotic fluid volume is lower than expected for gestational age. It is the most common amniotic fluid disorder and the leading cause of severe fetal and maternal adverse outcomes. Despite the severity of the problem, studies regarding the magnitude and associated factors of oligohydramnios in third-trimester pregnancy were limited in Ethiopia, mainly in the study area. Objective: To assess magnitude and associated factors of oligohydramnios among women in the third trimester of pregnancy at Mekelle public hospitals, Tigray, Ethiopia, 2024/2025. Methods: A cross-sectional study was conducted from December/1/2024 to May/30/2025 in Mekelle city. We included pregnant women using consecutive sampling technique using predefined inclusion criteria. Interview using structured questionnaire was employed to collect socioeconomic and demographic, lifestyle, medical and obstetric related data. The data were analyzed using SPSS version 27. Descriptive statistics were utilized to summarize data. Binary logistic regression analysis was employed to identify factors associated with oligohydramnios in third-trimester of pregnancy. Variables with P<0.05 in multi-variable analysis were declared statistically significant & interpreted using AOR with 95% CI. Hosmer-Lemeshow test was used to assess model fitness & it was insignificant (P=0.956), indicating a good-fitted model for the data. The maximum VIF was 1.12, telling that no Multicolinearity issue among covariates. Results: The mean age of the study participant, 356 with a 100% response rate, was a 28.2±5.06 years. The magnitude of oligohydramnios in third trimester of pregnancy was 7.9% (95% CI: 5.3-11.2%). Women with a history of diabetes mellitus [AOR=4.12 (95% CI: 1.26-13.53)], hypertension [AOR=6.12 (95% CI: 1.82-20.59)], anemia [AOR=4.63 (95% CI: 1.61-13.37)], hyperemesis gravid arum [AOR=4.76 (95% CI: 1.82-12.48)], post-term pregnancy [AOR=7.22 (95% CI: 1.41-36.98)] and fetal factors, including congenital anomalies [AOR=7.60 (95% CI: 1.81-31.94)] and intrauterine growth restriction [AOR=5.87 (95% CI: 1.42-24.32)], were significantly associated with an increased odds of oligohydramnios. Conclusion & Recommendations: 7.9% of pregnant women had sustained oligohydramnios. Maternal diabetes, hypertension, anemia, hyperemesis gravid arum, post-term pregnancy, fetal congenital anomalies and intrauterine growth restriction were identified as significant risk factors for oligohydramnios. We recommend increased surveillance for oligohydramnios focusing on the identified risks, maternal life style modifications & regular antenatal checkups in pregnancy.
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    Sero-prevalence of hepatitis B virus and human immunodeficiency virus, and associated factors among pregnant women attending antenatal care in selected general hospitals of Mekelle and Eastern zone of Tigray region, Northern Ethiopia
    (Mekelle University, 2025-06-28) SENAIT KEBEDE
    Background: Hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) share common transmission risk factors and represent significant global public health challenges. They are major contributors to morbidity and mortality among pregnant women, especially in low and middle-income countries. However, there is limited local data on the burden of these infections among pregnant women in the study area collectively. Hence, this study was aimed to assess the sero-prevalence of hepatitis B viruses (HBV) and human immunodeficiency viruses (HIV), and associated factors among pregnant women attending antenatal care in selected general hospitals of Mekelle and Eastern Zone of Tigray, Northern Ethiopia. Method: A hospital based cross sectional study was conducted from December 2024 to April 2025 in selected general hospitals of Mekelle and Eastern zones of Tigray. Socio-demographic risk factors data and blood sample were collected from the 238 pregnant women. Rapid diagnostic tests were used to detect HBV and HIV. HBV confirmation with Enzyme linked immune sorbent assay (ELISA) was also performed. Data was entered and analyzed using SPSS version 27. Descriptive and Logistic regression analysis was used to assess associations between variables. A p-value of ≤0.05 was considered as statistical significant. Result: The overall seroprevalence of HBV and HIV were 9.7% and 4.2% respectively. However, no cases of HBV/HIV co-infection were identified. Among the three sites the seroprevalence of HBV and HIV were 8.9% & 3.7%, 8% & 2.7% and 11.9% & 6% in Adigrat, Wukro and Mekelle respectively. Variables like older age (AOR = 3.10, 95% CI: 1.01–9.46, P = 0.047), history of liver disease (AOR = 23.67, 95% CI: 3.55–158.01, P = 0.001), history of abortion (AOR: 0.23, 95% CI: 0.05-0.96; p=0.043), nose piercing (AOR: 4.01, 95% CI: 1.35, 11.92; p=0.013) and history of sexually transmitted infection(AOR: 5.94, 95% CI: 1.41-24.99; p=0.015) were revealed significant association with seroprevalence of HBV while knowledge about transmission of HIV (Exact OR = 0.10, 95% CI: 0.02–0.72, p = 0.0219) was the only variable significantly associated with of HIV infection. Conclusion: The overall seroprevalence of HBV among pregnant women attending antenatal care was high according to WHO classification. The current HIV prevalence lies within the range of the pooled HIV prevalence among pregnant women in Ethiopia
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    PREVALENCE OF CONGENITAL ANOMALIES AND ASSOCIATED FACTORS AMONG INFANTS OF DIABETIC MOTHERS DELIVERED IN TERTIARY HOSPITALS OF TIGRAY, ETHIOPIA: A CROSS-SECTIONAL STUDY
    (Mekelle University, 2025-06-28) DAWIT TSEGAY
    Background: Congenital anomalies, or CAs, are structural or functional abnormalities that arise during intrauterine development and can be identified at birth, later in infancy, or throughout fetal life. CAs affects approximately 3% of live births worldwide, and this rised sharply to 5– 14% among infants of diabetic mothers. CAs account for approximately 25% of infant deaths worldwide. Maternal diabetes, particularly when poorly managed during the peri-conceptional period, increases the risk of CAs through mechanisms such as oxidative stress and impaired cellular development. Despite the growing concern of CAs, has been no study on the prevalence and risk factors of congenital anomalies among infants of diabetic mothers in Tigray, Ethiopia. Objective: To assess the prevalence of congenital anomalies and associated factors among infants of diabetic mothers delivered in tertiary hospitals of Tigray, Ethiopia, Nov 2022 to Dec 2024. Methods: An institution- based retrospective cross-sectional study was conducted among 356 infants of diabetic mothers delivered at Ayder and Aksum referral hospitals between November 2022 and December 2024. The minimum sample size was 345, and all eligible infants of diabetic mothers were included. Pretesting, supervision, and training were used to control data quality. Data were collected using Kobo Toolbox and analyzed with STATA version 17. Binary logistic regression model was used and variables with p-values less than 0.25 in bivariate analysis were included in multivariable logistic regression with a 95% confidence interval. Model fitness (p value = 0.95) and Multicollinearity (VIF < 1.78) were assessed. Result: The prevalence of congenital anomalies among infants of diabetic mothers was 5.34% (95% CI: 3.24 - 8.21). Cardiovascular (42.1%) and central nervous system (31.6%) anomalies were the most common. Significant factors associated with congenital anomalies included high maternal blood glucose during pregnancy (AOR = 4.04; 95% CI: 1.36 –12.03), comorbidities in pregnancy (AOR = 3.87; 95% CI: 1.29 –11.58), prior unexplained fetal death (AOR = 3.03; 95% CI: 1.05 –8.74), and a history of macrosomic delivery (AOR = 3.78; 95% CI: 1.24 -11.49). Conclusion and Recommendation: Congenital anomalies (CAs) were present in 5.34% of infants of diabetic mothers. Congenital anomalies were significantly associated with high maternal blood glucose, comorbidities related to diabetes mellitus during pregnancy, previous stillbirth, and macrosomia. These finding emphasize the need for proactive comorbidity management, enhanced glycemic control, and comprehensive prenatal care for mothers with a history of stillbirth or macrosomia in order to decrease CAs in diabetic pregnancies. The study recommends that the underlying modifiable factors be prevented through better glycemic control during preconception and pregnancy, that oral glucose tolerance tests be used to strengthen universal diabetes screening, that special attention be given to DM mothers who have a history of macrosomic babies or stillbirths, and that comorbidities be taken seriously during pregnancy.
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    FERTILITY DESIRE AND ITS ASSOCIATED FACTORS AMONG WOMEN ATTENDING ANTIRETROVIRAL THERAPY AT PUBLIC HOSPITALS IN MEKELLE, TIGRAY, ETHIOPIA, 2024: CROSS SECTIONAL STUDY
    (Mekelle University, 2025-02-25) SOLOMON TEKLU
    Background: Fertility desire is defined as having motivation or intention to give birth by individuals in their future life irrespective the number of children. Fertility desire has undesirable effect on the transmission of human immunodeficiency virus to the partner due to unsafe sex, vertical transmission to the children and there will be also disagreement with the strategies developed for elimination of human immunodeficiency virus/acquired immunodeficiency syndrome in countries including Ethiopia. Objective: To assess the prevalence of fertility desire and its associated factors among women attending antiretroviral therapy at public hospitals in Mekelle, Tigray, Ethiopia, 2024. Methods and Materials: Institutional based cross-sectional study was conducted among 355 women and participants were selected using systematic random sampling method. The data were collected from August 1, 2024 to August 30, 2024 using pre-tested and interviewer administer questionnaire. Few variables were recorded from participant’s card. The data were analyzed using statistical package for social science version 27. Binary logistic regression method of analysis was used. All variables with P-value <0.25 in bivariate were included in the multivariable binary logistic regression analysis. The strength of the association was interpreted using an adjusted odds ratio with its 95% confidence interval. Statistically significant variable was declared at P-value < 0.05. Finally, the data were presented with texts, tables, figures, and graphs. Results: This study included 355 women, of them 345(97.2%) responded to the study. The prevalence of fertility desire was 182(52.8%, 95% CI: 46.6%-59.1%). Being single 69.3% (AOR: 0.307, 95% CI: O.111-0.84), being widowed 91% (AOR: 0.09, 95% CI: 0.038-0.214), being divorced 76.7% (AOR: 0.233, 95% CI: 0.109-0.497), number of women’s child 50.8% (AOR: 0.492, 95% CI: 0.382-0.632) and knowledge of women on prevention mother to child transmission 24.5% (AOR: 0.755, 95% CI: 0.608-0.938) were negatively associated with fertility desire. Conclusion and recommendation: This study revealed that more than half of participants had fertility desire and factors associated with it were marital status, number of women’s child, knowledge of the women on prevention mother to child transmission. All stakeholders should take into account the prevalence of fertility and its associated factors while serving the women living with human immunodeficiency virus and counsel the women to decrease their interest on the number of children and promote knowledge on the prevention of mother to child transmission.