Epidemiology

Incidence and Predictors of Tuberculosis among Adult People Living With Hiv At Tarcha General Hospital, Dawuro, Southwest Ethiopia2023: A Retrospective Cohort Study Using Survival Analysis.

Thu, 06 Apr 2023 00:00:00 GMT

Incidence and Predictors of Tuberculosis among Adult People Living With Hiv At Tarcha General Hospital, Dawuro, Southwest Ethiopia2023: A Retrospective Cohort Study Using Survival Analysis. Umaye Shamena; Zerihun Kura; Addis Birhanu Background: Tuberculosis (TB) is the most frequently diagnosed oportunistic infection among people living with human immunodeficiency virus (PLHIV). It remains one of the world’s leading causes of mortality among PLHIV. Despite the provision of ART and other medication that is used to prevent opportunistic infection, the incidence of TB among HIV patients remains high. Objective: To assess the incidence and predictors of Tuberculosis among adult people living with HIV at Tarcha general hospital, Dawuro, Southwest Ethiopia, 2023. Method: An institution-based retrospective cohort study was conducted among 318 randomly selected adult HIV patients who initiated antiretroviral therapy at Tarcha General hospital between December 2018 - January 2022. Simple random sampling techinque was used to select the study populations. The checklist was compiled in English was used to extract the data. Two ART-trained nurses who worked in the Tarha General Hospital ART clinic gathered the data. The data were entered into Epi Data version 4.6 and then exported and analyzed by STATA version 14. Kaplan Meier survival estimate was used to show the over all survival probability of patient living with HIV (human immunodeficiency virus). Variables with p-values ≤ 0.25 in bivariable analysis will be taken to multivariable cox regression. On a multi variable cox regression analysis, variables with a P-value ≤ 0.05 will be declared as statistically significant factors associated with outcome variables and reported with adjusted hazard ratio along with 95% confidence interval. Result: - A total of 318 HIV-positive adults were included in the study, of whom 46(14.5%) developed TB at the same time of the follow-up period. This study found that the incidence of TB was 13.6 (95% CI: 12.36-8.28) per 100 person-year of observation. The median survival time was 30 months (IQR: 21.96 - 39.96). Patients who have not updated family matrix (AHR 2.85, 95% CI: 2.23-6.61), Patients with ambulatory status ( AHR 5.23, CI 95%: 2.07-13.8), base line OIS status (AHR,3.3 CI 95% 1.02-10.65), Baseline BMI less than 18kg/m2 (AHR: 4.63 95% CI, 1.68 13.24), WHO stage IV (AHR, 4.55, CI 95%: 1.26-16.29), baseline Hgb less than 10mg/dl (AHR 5.94, CI 95%: 2.23-15.81), OIS after HAART started (AHR, 3.26 CI 95%: 1.24-7.45) and patients who did not completed IPT (AHR, 3.32 CI 95%: 1.08 -10.8) were found to be the predictors of tuberculosis. Conclusion: - The incidence of TB among PLHIV was higher in this study. Not updating the family matrix, advanced WHO stage, low Hgb, and BMI, not completing IPT, and OIS after HAART initiation were found to be the significant predictors of TB. Therefore, health workers and iii other stakeholders are encouraged to made early screening and prevention of TB in PLHIV as TB can occur in any course of HIV treatment.

Incidence and Predictors of In-hospital Mortality among First-ever Stroke Patients at Jimma University Medical Center, Ethiopia: A Retrospective Cohort Study

Thu, 11 Dec 2025 00:00:00 GMT

Incidence and Predictors of In-hospital Mortality among First-ever Stroke Patients at Jimma University Medical Center, Ethiopia: A Retrospective Cohort Study Temesgen Mulugeta; Solomon Birhanu; Guta Kune Background: Stroke is a major cause of death and disability worldwide, with a disproportionate burden in low and lower-middle-income countries. Determining in-hospital mortality among first ever stroke indicates the quality of acute care provide and the ability to prevent immediate complications. According to the available evidence, research on in-hospital mortality among first ever stroke is limited in Ethiopia. Objective: This study aimed to determine time to in-hospital mortality, incidence rate, and predictors of in-hospital mortality among first-ever stroke patients admitted to the stroke units of Jimma University Medical Center (JUMC) between September 1, 2021, and September 1, 2023 Methods: This was a retrospective cohort study. A systematic sampling technique was used to select 210 first-ever stroke patients from three years of hospitalization records. Data were abstracted from medical records using a standardized data extraction form. All patients were followed up throughout their hospital stay. The outcome of the study was in-hospital mortality. Data analysis was conducted using Stata version 17. Continuous data were presented as means (±SD) or medians (IQR), and categorical data as frequencies and percentages. Kaplan–Meier survival analysis was used to describe survival to in-hospital mortality. The Cox proportional hazards model was used to identify predictors of time to in-hospital mortality. The results from the Cox models were presented as hazard ratios (HR) along with their 95% confidence intervals. Statistical significance was set at P < 0.05. Results: In this study, 210 stroke patients (ischemic stroke 51.9%) were included. The mean age of participants was 55.18 ± 14.83 years, and 63.3% were male. During 1,703 patient-days of follow-up, the incidence rate of in-hospital mortality was 1.76 per 100 patient-days, with a median time to death of 3 days (IQR: 2, 5). Independent predictors of in-hospital mortality were Glasgow Coma Scale scores at admission (aHR = 0.87, 95%CI: 0.78-0.96), and the occurrence of in-hospital complications (aHR = 6.58, 95%CI: 1.48-29.26). Conclusions and Recommendations: A lower GCS at admission and complications during hospital stay significantly increased the risk of in-hospital mortality. Thus, the prevention of acute stroke complications may improve the outcomes of patients with first-ever stroke.

Prevalence of Cesarean Section Delivery and Its Associated Factors among Mothers Who Gave Birth at Hargeisa Hospitals, Hargeisa, Somaliland, 2025 an Institution Based Cross Sectional Study

Thu, 06 Nov 2025 00:00:00 GMT

Prevalence of Cesarean Section Delivery and Its Associated Factors among Mothers Who Gave Birth at Hargeisa Hospitals, Hargeisa, Somaliland, 2025 an Institution Based Cross Sectional Study Mohamed Ali Aden; Chaltu Fikru; Mohamed Jihad Background: Many countries have exceeded WHO recommended a population-level of C section rate of 10–15%, leading to both health and economic implications to mothers around the world. There is Knowledge and geographical gap about cesarean section (C/S) in Hargeisa, Somaliland. Hence, this will fill the knowledge by finding the prevalence and associated factors of cesarean section among mothers who gave birth in Hargeisa, Somaliland. Objective: The study aims to assess the prevalence of cesarean section delivery and its associated factors among mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland, 2025. Methods: An institution-based cross-sectional study design was employed among systematic randomly selected 580 mothers who gave birth at Hargeisa hospitals, Hargeisa, Somaliland from 01-30 May, 2025. A kobo collect incorporated with structured questionnaire is used to collect data. After data exploration, it was entered in STATA V.17. Descriptive statistics was employed to estimate frequency and prevalence. Bivariable and multivariable logistic analyses is carried out to identify independent associated factors of cesarean section. Model fitness and Multi collinearity has been done. Result: The prevalence of cesarean delivery among mothers was 35.0% (95% CI: 31.2% 38.9%). Factors associated with cesarean delivery included being housewife (AOR = 0.87, 95% CI: 0.21–0.87), husband’s with primary education (AOR = 0.47; 95% CI: 0.26–0.86), had history of previous cesarean section (AOR = 9.51; 95% CI: 6.07–14.89), multiple pregnancy (AOR = 2.00; 95% CI: 1.42–2.85), and being multi-parity (AOR = 0.53; 95% CI: 0.32–0.89). Conclusion: Cesarean section delivery was high among mothers in Hargeisa. Key associated factors included maternal occupation, husband’s education, previous cesarean section multiple pregnancy, and parity. Targeted prenatal wellness programs, standardized cesarean counseling, and specialized VBAC clinics should be implemented, alongside enhanced monitoring for multiple pregnancies and structured support for first-time mothers are recommended to reduce unnecessary cesarean sections and improve maternal and neonatal outcomes.

Covid-19 Vaccine Acceptance among Population in Gambella Town, South West Ethiopia. Cross -Sectional Study

Fri, 11 Apr 2025 00:00:00 GMT

Covid-19 Vaccine Acceptance among Population in Gambella Town, South West Ethiopia. Cross -Sectional Study Mark Koang Dow; Kifle Woldemichael; Desta Bekele Background: Globally it is anticipated that vaccination of the population with effective and safe vaccine would prevent the transmission of COVID 19 virus among community. The community has a low level of trust in vaccine efficacy and high hesitancy. However, the evidence from some studies around the world report determinants of COVID 19 vaccine acceptance variation from place to place. Little known is about the determinants of Covid-19 Vaccine acceptance in Gambella region, southwest Ethiopia Objective: To assess the determinants of covid-19 vaccine acceptance the age of 12 years old and above in Gambella town, south west Ethiopia. Methods: Cross sectional study design was conducted. Case was a participant who is eligible for COVID 19 vaccination and Control was a participant who is not eligible for COVID 19 vaccination and living in the area for the last six months prior to study. The total Sample Size is 266 individuals (90 vaccine acceptance and 176 non vaccine acceptance). Study participants were selected by using Multi-stage sampling techniques. An interviewer administered to face to face structured questionnaire which is adapted from studies done on similar topics were used to collected data. The data were entered and cleaned using Epi data version 3.1. Analyzed by using SPSS version 25. Variables that had a P-value < 0.25 in the bivariate logistic regression analysis were entered into a multivariable logistic regression model. Finally, p-value < 0.05 was used to claim statistical significance. Result: The mean and standard deviation (± SD) of 29.60 and ± 13.46 for Cases and 31.48 and 14.51 for Controls respectively. Vaccinated against any disease (AOR=1.114, 95% CI: (0.443-2.80) were found to be the determinants for Covid-19 vaccine acceptance. Conclusion: Most of the factors influencing covid-19 vaccine acceptance have been shown to be controllable. Thus, it is planning to address hesitancy of covid-19 vaccine acceptance and increase the awareness of vaccinated against any disease, are recommended.