College of Health Sciences

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    PREVALENCE AND FACTORS ASSOCIATED WITH SPONTANEOUS PRETERM BIRTH AMONG MOTHERS WHO DELIVERED IN PUBLIC GENERAL AND REFERRAL HOSPITALS OF TIGRAY REGION, NORTHERN ETHIOPIA, 2024
    (Mekelle University, 2025-01-28) PAWLOS TEKIA
    Preterm birth has been referring to as babies born alive before 37 weeks or before 259 days of gestation of pregnancy are completed. Preterm birth is the leading cause of infant morbidity and mortality throughout the world. the magnitude of PTB remains a major issue in most developing countries including Ethiopia. To assess the prevalence of spontaneous preterm birth and associated factors among women’s giving birth in Tigray region, North Ethiopia in 2024. A hospital-based cross-sectional study was undertaken from November to December 2024. A systematic sampling technique was used to select 325 mother. The data were collected using kobo toolbox by interviewing the mothers and reviewing their charts using a structured and pretested questionnaire. The outcome variable was spontaneous preterm birth. Data were export from Kobo Toolbox to Excel then to SSPS version 27. Then analyzed using SSPS version 27. Bivariate and multivariable logistic regression analyses were done to determine the risk factors associated with premature birth. Variables statistically significant in Bivariate analysis at p-value less than 0.25 were taken to the multivariable logistic regression. Multivariable logistic regression was done to identify the associated factors of spontaneous preterm birth at P-value < 0.05 were considered reliable for the analysis of this study. in this study, the prevalence of spontaneous preterm birth was 25.2 % (95% CI: 20.48, 29.92%). In multivariable logistic regression model; multiple gestation(AOR) =0.069: 95% CI 0.023–0.206), inadequate iron folate supplementation (AOR = 6.019% CI 1.568–23.105), PROM (AOR = 7.680: 95%CI 3.044–19.378), PIH (AOR = 3.554:95% CI 1.325–9.532), and UTI during pregnancy (AOR = 2.589: 95% CI 1.970–6.912) were significantly associated with preterm birth. The present study found that multiple gestation, inadequate iron folate supplementation, PROM, PIH and UTI during pregnancy were factors associated with preterm birth. Ensure that all pregnant women receive comprehensive ANC services with a focus on monitoring high risk pregnancy like multiple pregnancy, those with history of PROM, PIH, screening and treating infections such as UTI and providing adequate iron folate supplementation for at least three months during pregnancy is decisive.
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    QUALITY AND SPATIAL DISTRIBUTION OF IMMEDIATE POSTPARTUM CARE IN ETHIOPIA: A MULTILEVEL ANALYSIS USING PERFORMANCE MONITORING FOR ACTION ETHIOPIA 2023 DATA
    (Mekelle University, 2024-11-28) HAFTAAB ASHEB
    The immediate postpartum period is associated with a significantly increased risk of morbidity and mortality for both the mothers and newborns. Providing quality immediate postpartum care helps reduce negative outcomes. Most studies conducted in Ethiopia have identified factors associated with postnatal care utilization. However, no evidence links household and community data to service delivery points and their geographic distribution, which are necessary to assess the quality of immediate postpartum care. To assess the quality and spatial distribution of immediate postpartum care in Ethiopia, 2024. We used a cohort of household and facility data from the National Performance Monitoring for Action Ethiopia study, which was conducted in 2023 across four major regions (Amhara, Oromia, South Ethiopia, and Addis Ababa). A total of 1,351 postpartum women and their newborns were linked to the nearest 264 health facilities. A multilevel binary logistic regression analysis was employed to assess contextual factors. The adjusted odds ratio with a 95% confidence interval (CI) was used to measure the associations between variables, with statistical significance set at P<0.05. The SaTScan V.10.2.5 and ArcGIS V.10.8 geostatistical software were used to explore the spatial distribution and interpolation of the quality of immediate postpartum care. The quality of immediate postpartum care among women and their newborns was 29.8% (95% CI 27%- 32%), ranging from 14.1% in Southern Ethiopia to 40.9% in Addis Ababa. In the multivariable multilevel analysis, religion (AOR=0.51; 95% CI 0.31-0.83), antenatal care visits (AOR=1.78; 95% CI 1.08-2.95), cesarean delivery (AOR=0.45; 95% CI 0.27-0.76), being attended by a nurse/midwife (AOR=1.96; 95% CI 1.26-3.03), urban residence (AOR=1.85; 95% CI 1.05-3.25), birth at private hospitals/clinics (AOR=4.12; 95% CI 2.07-8.51), and higher community media exposure (AOR=2.99; 95% CI 1.76-5.06) were significant predictors of the quality of immediate postpartum care. The spatial distribution of the quality of care varied significantly across regions, with a global Moran’s I = 0.99, P=0.001. Significant hotspots of good-quality care were detected in Addis Ababa. The quality of immediate postpartum care was low in Ethiopia, with significant spatial variation across the country. Therefore, public health interventions should be designed for areas where the quality is low to reduce maternal and newborn mortality by increasing antenatal care visits, increasing community media exposure, and strengthening health systems in rural areas.
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    SOIL-TRANSMITTED HELMINTH INFECTIONS AND NUTRITIONAL STATUS OF SCHOOL AGE CHILDREN, IN MEKHONI TOWN, TIGRAY, ETHIOPIA, 2025: SCHOOL BASED CROSS SECTIONAL STUDY.
    (Mekelle University, 2025-02-01) ABEL DERES TEKA
    Background: Soil-transmitted helminths (STH) are public health challenges among school-age children in developing countries like Ethiopia. Approximately 2 billion individuals worldwide carry at least one type of soil-transmitted helminth infection. Malnutrition and soil-transmitted helminths frequently occur together in the same area, affecting the same individuals simultaneously and perpetuating each other. Therefore, this study aimed to determine the prevalence of soil-transmitted helminths, associated factors, and nutritional status of school-age children in Mekhoni town, Tigray, Ethiopia, 2025. Methods: A school-based cross-sectional study design was conducted among 277 schoolchildren in Mekhoni town, Tigray, Ethiopia, from June 2024 to July 2024. A structured questionnaire was used to collect data on demographic characteristics of study participants, and stool samples were collected and processed using direct wet mount and Kato-Katz techniques. Anthropometric measurements were taken, and anthropometric indices were generated using the WHO AnthroPlus software to determine the nutritional status of schoolchildren. Data were analyzed using SPSS 27 software. Descriptive statistics were applied to present the data using frequency, tables, figures, and bar graphs. Bivariate logistic regression was employed to show the correlation of the dependent variable with individual independent variables, and multivariate logistic regression was computed to identify the independent effect of the main explanatory variables on the outcomes of interest. A P-value < 0.05 was considered statistically significant. Results: The overall prevalence of soil-transmitted helminth infections was 16.2%, with Ascaris lumbricoides being the most identified parasite (10.1%), followed by Trichuris trichiura (6.1%) and hookworms (2.9%). Among the infected children, 31 (18.7%) were males and 14 (12.6%) were females. The number of infections was also higher among schoolchildren in the age group of 5-10 years (22, 18.4%) than 11-14 years (23, 14.65%). Statistically significant associations were observed between soil-transmitted helminth infections and family size (AOR = 2.56, 95% CI: 1.18-5.55, P = 0.017), fingernail cleanliness (AOR = 2.63, 95% CI: 1.14-6.03, P = 0.022), trimmed fingernails (AOR = 2.25, 95% CI: 1.006-5.03, P = 0.002), and hand washing practice after using the toilet (AOR = 0.29, 95% CI: 0.13-0.63, P = 0.002). The overall prevalence of undernutrition was 37.5%, with 22.2% being underweight (N = 117), 27.8% stunted, and 11.19% wasted. There was no statistically significant association between soil-transmitted helminth infection and nutritional status among study subjects. Conclusion: The prevalence of soil-transmitted helminth infections was 16.2%, with Ascaris lumbricoides being the most common species identified. The study also revealed a high prevalence of undernutrition among school-age children. Ensuring access to clean toilets and hand washing facilities in schools, emphasizing hand washing and nail care, may help reduce the burden of soil-transmitted helminths. Furthermore, introducing a school health and nutrition program may enhance the nutritional status of schoolchildren in the study area.
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    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.
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    TIME TO END STAGE OF RENAL DISEASE ASSOCIATED WITH SERUM CREATININE AMONG ADULT CHRONIC KIDNEY PATIENTS IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL: JOINT AND COPULA MODELING
    (Mekelle University, 2024-12-20) MENGSTU SURAFEL TEKULU
    Background- Chronic kidney disease (CKD) is a global public health issue and around 13.4% of people had CKD. Out of these, 14.5 million people have end stage of renal disease (ESRD) and 7.083 million needed renal replacement therapy. Paired kidney shared the same gene and comes from the same person. In Ethiopia, the incidence of CKD is estimated to be 21.71%. The war between Ethiopia federal and Tigray government leads to 70–80% of health facility dysfunctional. Objective The main objective was to determine time to ESRD associated with longitudinal serum creatinine, joint time to right and left kidney failure among adult CKD patients, and determinant factors in Ayder Comprehensive Specialized Hospital from 2019 to 2024. Methods - A retrospective cohort study conducted among 408 adult CKD patients in Ayder Comprehensive Specialized Hospital from 2019 to 2024. CKD patients without ESRD at the start of follow-up included in the study and data collected from medical card. Pretest, supervision and training used to assess data completeness. Joint and Copula Cox-proportional hazard model (CoxPH) used. Archimedean Copula model fitted to predict joint time to fail both kidney and interpretation done using hazard ratio (HR) and 95% confidence interval (C.I). Result- In the joint Cox-PH model variables with HR and 95% C.I interpreted. A unit increased in hemoglobin level the hazard of ESRD decreased by 11 %, HR= 0.89(0.7865,0.9935). A unit increased in urea the hazard of ESRD increased by HR =1.01(1.0065,1.0135) times, as estimate glomerular filtration rate increased, hazard of ESRD decreased by 2%, HR= 0.98(0.9621,0.9978). As longitudinal serum creatinine increased, hazard of ESRD increased by HR= 4.31(3.5760,5.0641) and being hepatitis, hazard of ESRD increased by HR= 2.61(1.8936,3.3264) times. In the Copula model, 86% of time to ESRD due to dependency of right and left kidney. Conclusion and Recommendation - The variables hemoglobin level and glomerular filtration rate value had a negative association, whereas urea level, longitudinal serum creatinine value and hepatitis had a significant positive effect on time to ESRD at the 5% level of significance. These factors increase the incidence of ESRD among CKD. To decrease the progression, health professional should provide early screening of chronic disease and strictly follow for laboratorial abnormality, every patient should follow appropriately for medical service and life style modification to prevent for chronic disease.
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    PREDICTORS OF TIME TO RECOVERY FROM MODERATE ACUTE MALNUTRITION AMONG 6-59 MONTHS OLD CHILDREN IN INTERNALLY DISPLACED PERSONS SITES, NORTHWEST TIGRAY, ETHIOPIA, 2024, A RETROSPECTIVE FOLLOW UP
    (Mekelle University, 2024-10-20) EFREM SHUSHAY BERHE
    Background: Moderate acute malnutrition is one of the acute malnutrition categories diagnosed with an anthropometric measurement of weight for height [-3, -2) Z-score standard deviation or/and mid upper arm circumference (12.5-11.5] cm and the child should be with-out nutritional edema. Despite the existence of targeted supplementary feeding programs, the prevalence of moderate acute malnutrition was seriously high (15.1%) and the studies conducted previously used an out dated criteria to assess their recovery status from moderate acute malnutrition. Objective: The aim of this study was to determine the recovery time and its predictors among 6- 59 Months old children with moderate acute malnutrition enrolled to targeted supplementary feeding program in internally displaced persons sites of Northwest Tigray, Ethiopia, 2024. Methods: An institutional based retrospective cohort study was conducted among 452 children with moderate acute malnutrition selected using lottery method of simple random sampling with proportional allocation of the study participants to the selected fourteen sites. Data was collected using kobo tool box and imported to Stata version 17. Variables with p-value <0.25 at the restricted mean survival time uni-variable analysis, with 95% confidence interval were considered as important variables. The recovery status of the children was measured using mid upper arm circumference with measurement of >= 12.5 cm for two consecutive visits. Result: About 244 (53.08%) were female and 265(58.6%) with an age category of 24-59 months old. The overall restricted mean survival time was 15.16 weeks and recovery rate 68.36% with a truncation time of 16 weeks. Admission mid upper arm circumference category with restricted mean survival time difference of 5.47 (95% CI 3.53:8.48), ready to use supplementary food sharing status 2.07 (95% CI 1.39:3.08), and follow up status 0.57 (95% CI 0.42:0.76) were Significant predictors of time to recovery from moderate acute under nutrition. Conclusion: The study found an overall restricted mean survival time of 15.16 weeks and a recovery rate was below the minimum acceptable international standard. Recommendation: Strategies that enhance early detection should be implemented to get the child with moderate acute malnutrition at early stage. Tracking lost to follow-ups are critical, alongside counseling caregivers to treat food as medicine.
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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.