Hawassa University Comprehensive Specialized Hospital Research Articles

Abstract LB418: Time to adjuvant chemotherapy and its predictors among postoperative breast cancer patients at Cancer Treatment Center of Hawassa University Comprehensive Specialized Hospital in Hawassa, Ethiopia in 2022: A retrospective follow-up study

Abstract Background The incidence of breast cancer is rising and is becoming a major public health problem in Ethiopia, posing a substantial threat to countries with limited oncology centers. Adjuvant chemotherapy is the most important treatment option for breast cancer initiated after definitive surgical management. Adjuvant chemotherapy decreases the risk of breast cancer mortality, reduces the recurrence rate, and improves the long-term overall survival. The time between surgery and the first adjuvant chemotherapy appears to have an impact on the overall survival (OS) and disease-free survival (DFS) in patients with breast cancer. Objective This study aimed to determine the time to start adjuvant chemotherapy and its predictors in post-operative breast cancer patients at oncology center of Hawassa University Comprehensive Specialized Hospital between September 2020 and March 2022. Method This institution based retrospective follow-up study was conducted at the Hawassa University Comprehensive Hospital Cancer Treatment Center between September 2020 and March 2022, among all women with breast cancer. All eligible patients whose medical records were available and accessed in the hospital during the study period were enrolled. The checklists were prepared using Google Forms. The data were then exported to Excel and sent to SPSS software version 26 for data analysis. A stratified Cox regression model was used to identify potential predictors. The adjusted hazard ratio (AHR) with 95% confidence interval (CI) was reported to indicate the strength of the association. This study was conducted between February 22 and April 8, 2022. Result In this study, the median time to adjuvant chemotherapy was 69 days Interquantile range (IQR)=26) with a range of 28-157 days. Twenty (12.9%) patients started chemotherapy in less than 30 days, 36 (23.2%) patients waited for 31-60 days, 68 (43.9%) patients initiated chemotherapy within 61-90 days while 31 (20%) patients took more than 90 days to start their adjuvant chemotherapy. Patients who experienced surgical complications were 1.5 times more likely to initiate adjuvant chemotherapy earlier than those without such complications, with an adjusted hazard ratio (AHR) of 1.512 (95% CI: 1.287-3.140). Patients with a BMI classified as underweight were1.5 times high likely to receive adjuvant chemotherapy earlier (AHR 1.569, 95% CI: (1.336-3.887)). Post-operative breast cancer patients with co-morbidity had a 25% lower likelihood of receiving adjuvant chemotherapy earlier than those without comorbidity (AHR=0.751,95%CI: 0.474-0.817), and illiteracy (AHR=0.829, 95% CI: (0.458-0.950)) was also a significant predictor of time to adjuvant chemotherapy. Conclusion The duration of initiation of the adjuvant chemotherapy was longer than the recommended initiation time. Body Mass Index, presence of surgical complications, presence of comorbidity, and educational status were predictors of delayed time to adjuvant chemotherapy Citation Format: Adugna Getahun Deboch. Time to adjuvant chemotherapy and its predictors among postoperative breast cancer patients at Cancer Treatment Center of Hawassa University Comprehensive Specialized Hospital in Hawassa, Ethiopia in 2022: A retrospective follow-up study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB418.

Predictors of neonatal mortality among neonates admitted to the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital, Sidama regional state, Ethiopia

BackgroundDespite promising efforts, substantial deaths occurred during the neonatal period. According to estimates from the World Health Organization (WHO), Ethiopia is among the top 10 nations with the highest number of neonatal deaths in 2020 alone. This staggering amount makes it difficult to achieve the SDG (Sustainable Development Goals) target that calls for all nations to work hard to meet a neonatal mortality rate target of ≤ 12 deaths per 1,000 live births by 2030. We evaluated neonatal mortality and it’s contributing factors among newborns admitted to the Neonatal Intensive Care Unit (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH).MethodsA hospital-based retrospective cross-sectional study on neonates admitted to the NICU from May 2021 to April 2022 was carried out at Hawassa University Comprehensive Specialized Hospital. From the admitted 1044 cases over the study period, 225 babies were sampled using a systematic random sampling procedure. The relationship between variables was determined using bivariate and multivariable analyses, and statistically significant relations were indicated at p-values less than 0.05.ResultsThe magnitude of neonatal death was 14.2% (95% CI: 0.099–0.195). The most common causes of neonatal death were prematurity 14 (43.8%), sepsis 9 (28.1%), Perinatal asphyxia 6 (18.8%), and congenital malformations 3 (9.4%). The overall neonatal mortality rate was 28 per 1000 neonate days. Neonates who had birth asphyxia were 7.28 times more probable (AOR = 7.28; 95% CI: 2.367, 9.02) to die. Newborns who encountered infection within the NICU were 8.17 times more likely (AOR = 8.17; 95% CI: 1.84, 36.23) to die.ConclusionThe prevalence of newborn death is excessively high. The most common causes of mortality identified were prematurity, sepsis, perinatal asphyxia and congenital anomalies. To avert these causes, we demand that antenatal care services be implemented appropriately, delivery care quality be improved, and appropriate neonatal care and treatment be made available.

The Burden of Dyslipidemia and Determinant Factors Among Type 2 Diabetes Mellitus Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.

Diabetes is a global health challenge with escalating prevalence rates. Cardiovascular complications represent the leading cause of mortality among individuals with diabetes. Notably, dyslipidemia stands as a prominent risk factor for cardiovascular disease in Type 2 diabetes mellitus (T2DM) patients. Timely detection and management of dyslipidemia in these patients hold the potential to deter its progression and substantially reduce the risk of cardiovascular-related morbidity and mortality.This study was aimed at assessing the burden of dyslipidemia and determinant factors among T2DM patients who were being followed at the Endocrinology clinic of Hawassa University Comprehensive Specialized Hospital (HUCSH). An Institutional- based retrospective cross-sectional study was conducted, and samples of 228 patients were selected using a systematic random sampling technique. Data were collected through structured face-to-face interviews using a questionnaire. Bivariate logistic analysis was utilized, and variables with a p-value < 0.25 in this analysis were considered candidates for multivariate logistic analysis. Multivariate logistic regression was employed to identify factors associated with the prevalence of dyslipidemia, with a significance threshold set at p < 0.05. The research revealed an overall prevalence of dyslipidemia among the study participants at 75.9%. The specific manifestations of dyslipidemia were observed as follows: hypertriglyceridemia in 43%, hypercholesterolemia in 25%, elevated low-density lipoprotein in 59.2%, and reduced high-density lipoprotein in 33.3% of the study participants. Factors significantly associated with dyslipidemia included longer diabetes duration, poor physical activity, elevated HbA1C, and obesity. This study underscores a notably high prevalence of dyslipidemia among T2DM patients. The findings highlight the advocate for clinicians to prioritize routine screening, and effective treatment concerning dyslipidemia and its associated risk factors among individuals with T2DM. It is worth mentioning that this study was conducted in a specific hospital setting and limited time, and hence the findings, and generalizability to other healthcare facilities should be taken cautiously.

Magnitude and Factors Associated with Catheter Associated Urinary Tract Infection, and Antimicrobial Susceptibility Profile at Hawassa, Sidama Regional State, Ethiopia: A prospective Cross-sectional Study

Introduction: The use of urinary catheter benefit patients who are unable to urinate for various medical reasons. Despite its use, a urinary catheter during its application may introduce bacteria to the urinary tract and result in Urinary tract infection (UTI). Even though  the burden of catheter-associated UTI is expected to be high in resource-limited countries, there is limited data. The aim of this study was  to determine the magnitude of culture- confirmed catheter-associated urinary tract infection (CAUTI), associated factors, and  antimicrobial susceptibility profiles of bacteria.&#x0D; Methods: This prospective cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital (HUCSH),  Sidama region, from May-August 2022. One hundred forty-nine catheterized patients at HUCSH were included. Socio-demographic,  clinical, and laboratory data were collected using structured questionnaire. Urine specimens were cultured on blood and MacConkey  agar. Culture-confirmed catheter-associated urinary tract infection was established if &gt;1 X 105 colonies of bacteria per milliliters of urine  was detected. The disc diffusion method was used for antimicrobial susceptibility testing. For data analysis, SPSS version 26 was used.  Factors associated with culture-confirmed CAUTI were assessed using binary logistic regression.&#x0D; Results: The magnitude of culture  confirmed CAUTI was 30.2% (n=45; 95% CI=22.8−37.6). The most common bacterial isolates were Escherichia coli (n=12; 26.7%), followed  by Klebsiella species (n=10; 22.2%), and Staphylococcus aureus (n=6; 13.3%). Duration of catheterization (AOR=9.6, 95% CI=3.8−24.2) and  comorbidities (AOR=4.1, 95% CI=1.7−9.8) were significantly associated with culture-confirmed CAUTI. Most Gram- negative bacteria were  resistant to commonly prescribed antimicrobial agents.&#x0D; Conclusions: The magnitude of culture-confirmed CAUTI at HUCSH was high. E. coli was the leading bacteria and most of them were resistant to various types of antimicrobial agents. Duration of catheterization and  comorbidities were significantly associated with culture- confirmed CAUTI. 

High Gastrointestinal Colonization Rate of Vancomycin-Resistant Enterococci among Hospitalized Patients: Potential Source for Resistant Gene.

Vancomycin-resistant Enterococci (VRE) is a global health problem and responsible for healthcare-associated infections (HAIs) in patients with prolonged hospital stay, severe underlying disease, and previous broad-spectrum antibiotic therapy. These bacteria can cross-resist and transfer drug-resistant genes to other potentially pathogenic bacteria. Therefore; this study was aimed to determine the gastrointestinal colonization rate of VRE, its antimicrobial susceptibility profile, and associated factors among hospitalized patients. Prospective cross-sectional study was conducted using stool samples from 223 patients admitted to different wards at Hawassa University Comprehensive Specialized Hospital, from April 1 to June 30, 2021. Patients admitted to the hospital for more than 48 hours for various medical conditions were included. Sociodemographic and clinical characteristics were collected using a structured questionnaire. Fecal specimens were cultured on Enterococci selective media. Enterococcus species were identified using their growth and mannitol fermentation properties. Vancomycin resistance was screened using both the Kirby-Bauer disk diffusion method and a vancomycin E-test strip. Data were entered and analyzed using SPSS version 25. Descriptive and logistic regressions were used to determine the frequency and association of factors with the VRE colonization rate. A p value of <0.05 was considered statistically significant. A total of 223 fecal specimens were collected and processed, and 141 (63.2%) them were positive for Enterococci. The predominant species was E. faecalis 65 (46.1%) followed by E. faecium 76 (53.9%). In this study, the gastrointestinal colonization rate of VRE was 15 (6.7%) and all the species belong to E. faecium. Study participants who had no formal education (AOR = 4.26, 95% CI: 1.01, 18.06), hospitalized patients for >2 weeks (AOR = 4.10, 95% CI: 1.08, 15.57), and those who had a history of treatment with vancomycin (AOR = 4.77, 95% CI: 1.26, 18.09) were more likely to be colonized with vancomycin-resistant Enterococci. More than 95% of Enterococci isolates were susceptible to linezolid, whereas 70.2%, 63.1%, 56.7%, and 53.9% were resistant to tetracycline, erythromycin, penicillin, and ampicillin, respectively. Among the total Enterococci isolated, 141 (54.6%) were multidrug resistant. In our study, high proportion of vancomycin-resistant Enterococci was found. Previous exposure to antibiotics and hospital stay were significant factors for VRE gut colonization. The isolated Enterococci showed variable degrees of resistance to commonly prescribed antibiotics which leads to a worldwide problem multidrug resistance. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics, and implementing infection prevention protocols may reduce colonization by VRE.

Hepatitis B Prevalence and Risk Factors in Chronic Liver Disease Patients at Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia

Hepatitis B Prevalence and Risk Factors in Chronic Liver Disease Patients at Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia

Magnitude and associated factors of benign prostatic hyperplasia among male patients admitted at surgical ward of selected governmental hospitals in Sidamma region, Ethiopia 2021

BackgroundBenign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men, and it affects more than 50 % of men over 60 years of age globally. MethodsBetween October 15 and November 15, 2021, 143 male patients admitted to the surgical wards of the Hawassa University Comprehensive Specialized Hospital (HUCSH), the Adare General Hospital (AGH), and the Yirgalem General Hospital in Hawassa City were involved. Data were gathered utilizing a pretested, structured, interviewer-administered questionnaire and patient review checklist employing a purposive sample technique. A binary logistic regression model, which examines the relationship between the dependent and independent variables, was used to analyze the data using SPSS version 20. ResultsThe magnitude of benign prostate hyperplasia (BPH) was 27 (18.9 %). Old age >=75 years (AOR = 0.07; 95 % CI: 0.005–1.024), being smokers (AOR = 0.261; 95 % CI: 0.078–00.871), positive familial history of BPH (AOR = 0.13; 95 % CI: 0.038–00.428), patients with renal disease (AOR = 5.724; 95 % CI: 1.669–19.631), and patients with a history of difficulties with sexual activity (AOR = 0.17; 95 % CI: 0.034–00.830) were found to be statistically associated with the presence of BPH. ConclusionsIn conclusion, the findings of this study revealed that BPH was a prevalent disease among men. Factors that could potentially increase the risk of benign prostatic hyperplasia were old age, positive family history, smoking, renal disease, and difficulties with sexual activities.

Observational Assessment of Pre-Analytical Errors in Request Format and Phlebotomy Practice in Hematology Tests at Hawassa University Comprehensive Specialized Hospital in Sidama Zone, Southern Ethiopia

Observational Assessment of Pre-Analytical Errors in Request Format and Phlebotomy Practice in Hematology Tests at Hawassa University Comprehensive Specialized Hospital in Sidama Zone, Southern Ethiopia

Prevalence of Bradycardia After Induction of General Anesthesia and Associated Factors Among Surgical Pediatric Patients. A Prospective Observational Study.

Heart rate is the main determinant factor of the child's cardiac output in the first year of life. Thus, bradycardia decreases cardiac output leading to fatal cardiac arrhythmias, cardiac arrest, and even death. The objective of this study is to determine the prevalence of bradycardia and its associated factors after induction of general anesthesia among pediatric patients operated at Hawassa University Comprehensive Specialized Hospital (HUCSH). Prospective observational study was employed at HUCSH by using a systematic random sampling technique. Pediatric surgical patients less than 6 years old were included in the study. Data were entered into Epi data statistical software (version 4.6.0.) and exported to SPSS (version 25.0). Categorical data were analyzed using chi-square statistics, and continuous data were analyzed using Student's t-test. Bivariable logistic regression was used to select candidate variables for multivariable logistic regression. The prevalence of bradycardia among 205 pediatric patients included in this study was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (halothane), difficult intubation, intraoperative complications, and significant surgical blood loss were independently associated with bradycardia. The prevalence of bradycardia after induction of general anesthesia was 19.5%. Preoperative risk of hypoxia, opioids premedication, inhalational induction (particularly with halothane), difficult intubation, intraoperative complications such as hypoxia, and significantblood loss were significantly associated with bradycardia.

Predictors of caregiver burden among primary caregivers of cancer patients at Hawassa oncology center Northern, Ethiopia, 2022: institution-based cross-sectional study

BackgroundApproximately 60,960 people are diagnosed with cancer each year, and more than 44,000 people die from it. Family caregivers face a range of difficulties because cancer affects many facets of life, such as nursing care, communication, financial issues, and emotional conflicts. Consequently, family caregivers are more susceptible to developing demanding physical and mental conditions. Despite these problems, cancer remains the most neglected and underfunded health problem in Ethiopia. Therefore, this study aimed to assess the caregiver burden experienced by family caregivers of patients with cancer; as well as its associated factors.MethodsAn institutional-based cross-sectional study was employed among 347 family caregivers of cancer patients who attended Hawassa University Comprehensive Specialized Hospital Oncology Center from May 30 to July 30, 2022. The data were checked for completeness and consistency and then coded. The coded data were entered into Epi-data version 4.6 and then exported into Statistical Package for Social Science (SPSS) version 25 for analysis. The caregiver’s burden was assessed by a short form of Zarit burden Interview. The explanatory variables, like clinical and care-related factors, were assessed by a structured questionnaire. Family caregivers’ perceptions of social support were assessed by the multidimensional scale of perceived social support. Binary logistic regression was used to assess the strength of the association between outcome and explanatory variables. Each explanatory variable was entered separately in the bivariate analysis, and a variable with a p-value less than 0.25 goes further for multivariate analysis to control the possible confounding. The statistical significance of the factors influencing the outcome variable was declared in multivariate logistic regression analysis using an adjusted odds ratio at a 95% confidence interval when a p-value < 0.05.ResultsThe response rate of the caregiver was 100%. This study reported that 66.6% (95% CI 61.5–71.5) of the caregivers had a high caregiver burden. Being female, caring hours, previous history of hospitalization, and sleeping hours were significantly associated with the caregiver’s burden.ConclusionIn this finding, more than two-thirds of the caregivers had a higher caregiver burden. This suggested that there is a need to focus on and give more attention to caregivers to decrease their burden by including caregiver burden in routine nursing activities by the oncology unit, and further study should be done at the national level using other study designs.

Burden of Anemia among Human Immunodeficiency Virus-Positive Adults on Highly Active Antiretroviral Therapy at Hawassa University Compressive Specialized Hospital, Hawassa, Ethiopia.

Anemia is the most common hematologic abnormality associated with human immunodeficiency virus (HIV)-infected patients and affects 60% to 80% of patients in late-stage disease. It has a considerable impact on the progression of HIV to advanced stages. This study aimed at assessing the burden of anemia in adult HIV-infected patients who are on highly active antiretroviral therapy (HAART) and have follow-up at Hawassa University Comprehensive Specialized Hospital (HUCSH) Antiretroviral therapy (ART) clinic. A hospital-based retrospective study was conducted among HIV-positive adults on HAART at Hawassa University Compressive Specialized Hospital. The systematic sampling method was used to choose a total of 244 study participants. Data on demographic characteristics, related factors of anemia, latest hemoglobin, CD4, and ART regimens were collected using a structured data abstraction format. The data were cleaned and analyzed using SPSS version 21.0 after being manually checked for completeness. Multivariable logistic regression was carried out to detect elements associated with anemia. A P value of <0.05 was used as a cutoff point to announce statistical significance. The records of 244 patients were examined in total. Anemia was present in 29.9% (95% CI 23.8-35.2) among adult HIV patients. Female sex (AOR: 2.576, 95% (CI: 1.295-5.127)), having tuberculosis (TB) (AOR: 4.873, 95% (CI: 1.534-15.484)), taking a zidovudine (ZDV)-containing ART regimen (AOR: 5.216, 95% (CI: 1.239-21.962)), having clinical WHO stage IV and III diseases (AOR: 3.077, 95% CI (1.244-7.612)), having body mass index (BMI) <18.5 kg/m2 (AOR: 2.391, 95% (CI: 1.138-5.023)), and taking cotrimoxazole prophylaxis (AOR: 3.860 95% (CI: 1.097-13.576)) were substantially linked to the development of anemia among adult HIV patients. Conclusion and Recommendation. This study showed that anemia is still a problem among HIV patients on HAART. The burden of anemia was found to be high among patients with advanced WHO clinical stages, having a BMI less than 18.5 kg/m2, TB/HIV coinfection, being on AZT-based ART regimens, and taking cotrimoxazole preventive therapy (CPT). Consequently, it is suggested that early preventative interventions, such as serial hemoglobin follow-up, iron supplementation, and education about dietary consumption, be undertaken targeting the aforementioned groups. In addition, the preferred first-line ART regimen as per the latest national and WHO guidelines is recommended, especially for the above groups.

Determinants of unmet physical and psychological supportive care needs among adult cancer patients in Southern Ethiopia

ObjectiveThe main objective of this study was to assess the prevalence of unmet physical and psychological supportive care needs and associated factors among adult patients with cancer in Southern Ethiopia.MethodsA...

Predictors of Uterine Rupture After One Previous Cesarean Section: An Unmatched Case-Control Study.

Uterine rupture is a rare occurrence but has catastrophic complications during pregnancy. The incidence is relatively higher in scarred uteri because there is a promotion of labor after cesarean section. There is a scarcity of evidence from low-income countries regarding the predictors of uterine rupture after trial labor. To assess factors determining uterine rupture during labor after the previous cesarean section among mothers delivered at Hawassa University Comprehensive Specialized Hospital from September 2017 to September 2022. A facility-based unmatched case-control study was done by reviewing 105 patients, which included 35 cases and 70 controls in a 1:2 case-to-control ratio. The association between dependent and independent variables was sought with running binary and multivariate analyses by using the cut point of a p value < 0.05 and 95% CI. The prevalence of uterine rupture is 1.6%. The factors significantly associated with uterine rupture after trial of labor are fetal weight >3.8 kg (AOR: 5.21), antenatal care 4 (AOR: 3.6), labor duration >15 hours (AOR: 10.7), and previous successful vaginal delivery (AOR: 3.4). Poor fetal-maternal outcomes like 91.4% fetal death, 29 hysterectomies, 22 blood transfusions, and 1 death. The prevalence is relatively higher than in developed countries. The number of antenatal care, labor duration, and lower fetal weight are not common findings associated with uterine rupture after trial of labor across the literature, so large-scale studies are needed to develop guidelines for the Ethiopian setup. Improving the quality of obstetrics care given in each level of health system.

Incidence and factors associated with deep vein thrombosis among hospitalized adult patients at Hawassa university comprehensive specialized hospital Hawassa city, Sidama, Ethiopia: retrospective cohort study.

Deep vein thrombosis is a public health problem with substantial morbidity and mortality globally. In Ethiopia, death due to complications of DVT is very significant however its incidence, risk factors, and preventive methods are not well studied. To assess the incidence and factors associated with deep vein thrombosis among hospitalized adult patients at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. Intuitional-based retrospective study design was employed in July1-August 30, 2022 in 660 randomly selected patients' record cards. The patients' record cards were reviewed from 2012 to 2014 at Hawassa University Compressive Specialized Hospital. The data entry and analysis were done by using Epi Info and SPSS version 24. After adjusting covariates at a 95% confidence interval, an independent variable with a P value < 0.05 was declared significantly associated with deep vein thrombosis. An odds ratio was calculated to measure the strength of the relationship independent variable and deep vein thrombosis. The overall incidence of DVT was 10.6% [95% CI: 8.5%, 13.1%]. After adjusting for covariates, orthopedic trauma; AOR = 2.6 (95% CI (1.2-5.4), corona virus; AOR = 2.5 (95%CI (1.07-5.1), and hospital stay > 15days; AOR = 2.2 (95% CI (1.25-3.94) were significantly associated with deep vein thrombosis. DVT incidence is high among hospitalized patients. An orthopedic trauma, a recent infection of the coronavirus, and a hospital stay above 15days were a risk to acquire deep vein thrombosis. Early identification and detection of patients at high risk of developing DVT and provision of prophylaxis are recommended.

Neural Tube Defect in a Resource Limited Setting: Clinical Profile and Short Term Outcome.

There is a huge burden of neural tube defect (NTD) in Ethiopia, and surgical management is not readily available. We aimed to assess the clinical profile and hospital outcome of children with NTD that were operated in Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. A retrospective cross-sectional study on 250 children with NTD that were treated in a tertiary hospital from March 2016 to May 2020 was conducted to describe the clinical profile and treatment outcome at discharge. Logistic regression analysis was carried out to evaluate factors that determine mortality. Out of the 250 children, 50.4% were male. Myelomeningocele was the most common type of NTD (77.2%) followed by meningocele (10.4%). Only 3 mothers (1.2%) received periconceptional folic acid. Prenatal diagnosis of NTD was made in only 22 (8.8%) cases. 52.8% of the NTDs were ruptured at presentation and 50.8% had associated sepsis. At presentation, 42.4% were ≤72 hours of age and only 18 neonates (7.2%) were operated within 72 hours of admission. 54% had associated hydrocephalus, 31.6% had Chiari II malformation and 19.6% had club foot. Surgical site infection, post MMC repair hydrocephalus, and meningitis were seen in 8%, 14% and 16.8% of the participants, respectively. The mean duration of hospitalization was 24 ± 14.4 days. Twenty patients (8%) died before discharge from hospital. Prematurity [AOR: 26 (95% CI: 8.01, 86.04), P < 0.001] and the presence of meningitis [AOR: 3.8 (95% CI: 1.12,12.9), P = 0.03]were determinants of mortality. NTDs are substantial health problem in this part of the country. Periconceptional folic acid supplementation is almost non-existent. Prenatal detection of NTDs is very low and management is delayed in the majority of cases. Myelomeningocele is the most common type of NTD. There is high in-hospital mortality, and prematurity and the presence of meningitis are its determinants.

Treatment outcome from severe acute malnutrition among children 6 to 59 months admitted to Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

Background:  Malnutrition continues to be a long-term year-round phenomenon, threatening under 5 children unacceptably the most. It  is responsible for 25,000 children’s hospitalization per month and nearly 50% of all under-5 mortalities in Ethiopia. The national burden  of SAM highlights the importance of addressing predictors of recovery rates.&#x0D; Methodology: An institution-based retrospective cohort study was implemented from a period of august 2020- august 2021. Data were  collected using a structured questionnaire and entered and analyzed using SPSS 25. The output of both bivariate and multivariate logistic  regression analysis was presented using an odd ratio and 95% CI. A p-value of less than 0.05 was taken as statistically significant.&#x0D; Results: Among the total study cases of 241 children, 192(79.7%) records were recovered, 15 (6.2%) died, and 20(8.3%) were defaulted.  The majority of the children, 155(64.3%) had nonedematous malnutrition. The independent predictors of mortality were pneumonia  (AOR=6.57), hypovolemic shock (AOR=0.05), presence of both pneumonia and gastroenteritis (AOR=4,463), getting third-line antibiotics  (AOR=0.23), fourth-line antibiotics (AOR=0.15) and hospital stay more than 28 days (AOR=0.12).&#x0D; Conclusion: The finding of this study  attested that recovery and death rates are within the national standard. As many of the death occurred within the first week of admission,  due attention should be given to SAM patients from the first minutes of arrival. Reduction in length of the hospital stays, and  early recognition and management of complications have been unveiled to further upgrade the recovery rate.  

Utilization of palliative care and its associated factors among adult cancer patients in Hawassa University Comprehensive Specialized Hospital Oncology Center, Hawassa, Ethiopia, 2021: a cross-sectional study

Objective To assess the utilization of palliative care(PC) and its associated factors among adult cancer patients in Hawassa University Comprehensive Specialized Hospital (HUCSH) oncology center, Hawassa, Ethiopia, 2021. Methods An institution-based cross-sectional study was conducted among adult cancer patients. A randomly selected adult cancer patients (≥ 18 years of age) attending their treatment at HUCSH oncology center PC unit were included. Data was collected from June to August, 2021. It was aimed to interview 185 patients. A structured questionnaire was used to collect the data. Data entry was done using Epi-Data version 4.6 and bivariate and multivariate logistic regression models were used in SPSS for analysis. Result Out of 180 study respondents, 66% of participants were aged 50 years or older. Sixty-three percent were characterized to have a better utilization of PC services. Patients aged below 50 years (adjusted odds radio (AOR): 2.7; 95%-CI (1.13-6.63)), higher educational status (grade 9 to 12 or college/university graduation (AOR: 1.46; 95%-CI (0.41-5.21)) and AOR: 3.23; 95%-CI 0.98-10.61)) respectively, higher income >5500 Birr (AOR: 2.7; 95%-CI (0.51-5.76)), and good accessibility of PC services (AOR: 2.99; 95%-CI (1.21-3.28)) were significantly associated with better utilization of PC services. Conclusion The current study revealed two thirds of patients had better utilization of PC services. Older patients with low educational status and income, and those living in rural areas had worse access to PC services. It is recommended to improve information provision about PC especially for older patients and patients with low education and to improve accessibility for patients in suburban and rural areas.

Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia.

Neonatal sepsis (NS) is a serious blood bacterial infection in children of 28 days or younger, manifested by systemic signs and symptoms of infection. Neonatal sepsis has become one of the leading causes of admission and death in developing countries like Ethiopia. Understanding different risk factors for neonatal sepsis is essential for early diagnosis and treatment. So, this study aimed to assess the risk factors for neonatal sepsis among neonates at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia. A case-control study design was employed on 264 neonates (66 cases and 198 controls) in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital from April to June 2018. Data were collected by interviewing the mothers and reviewing neonates' medical records. The data were edited, cleaned, coded, and entered into Epi info version 7 and were transported and analyzed using SPSS version 20. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the significance of the associations. A total of 264 neonates (66 cases and 198 controls) with 100% response rate. The mean (±SD) age of mothers was 26 ± 4.042 years. The majority (84.8%) of the cases were found in children under 7 days, with a mean age of 3.32 days ± 3.376 SD. Factors such as prolonged rupture of the membrane [AOR = 4.627; 95% CI (1.997-10.72)], history of the urinary tract or sexually transmitted infections [AOR = 2.5; 95% CI (1.151-5.726)], intrapartum fever [AOR = 3.481; 95% CI (1.18-10.21)], foul smelling liquor [AOR = 3.64; 95% CI (1.034-12.86)], and low APGAR score in the fifth minute [AOR = 3.38; 95% CI (1.107-10.31)] were the independent predictors of neonatal sepsis. Prolonged rupture of the membrane, intrapartum fever, urinary tract infection, foul-smelling liquor, and low APGAR score were independent risk factors of neonatal sepsis, and this study also observed that the onset of neonatal sepsis was higher in the first week of a neonate's life. Routine sepsis evaluation must focus on neonates born with the aforementioned characteristics and make interventions for babies born with these risk factors.

Factors affecting cervical cancer screening service uptake among clients visiting the ART clinic at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia: A cross-sectional study

BackgroundAnnually, around half a million new cases of cervical cancer and 250,000 deaths occur worldwide. It is the second-leading cancerous cause of death after breast cancer among women. Repeated infection and prolonged persistence with human papilloma virus is common among HIV-positive women due to their immune status. A one-visit screen and treat strategy for cervical cancer prevention was instituted in 2010 nationwide in 14 selected hospitals. So, assessing service uptake and associated factors among ART clients is mandatory. MethodFrom December 2015 to March 2016 G.C., a cross-sectional study was conducted. An interviewer-administered, semi-structured questionnaire was used to collect data. The data were entered, cleaned, and analyzed using IBM SPSS version 20 software. A statistically significant association of variables was determined based on an adjusted odds ratio with a 95 % confidence interval and a p value of 0.05. ResultCervical cancer screening service uptake among the 647 interviewed participants was 59 %. Study participants accounting for 19 % (N = 123) were 18–29 age group, 56.6 % (N = 366) were 30–39 %, and 24.4 % (N = 158) were in 40–64 age group. Of 647 participants, 43.7 % (N = 283) were illiterate and educated less than secondary level of education, 36.0 % (N = 233) had a secondary level of education, and 20.2 % (N = 131) had an education above secondary. Being encouraged by others to get screened for cervical cancer (AOR = 1.88, 95 % CI: 1.25, 2.82), knowing another woman who got screened, and getting information from the media (AOR = 0.4, 95 % CI: 0.27, 0.60) were associated with the uptake of cervical cancer screening. ConclusionThe uptake of cervical cancer screening among ART clients attending the clinic was not satisfactory. Encouragement to get screened, knowing other screened women, and getting information from the media were important predictors of CCS service uptake. Exploring more information on the attitudes of clients to improve service uptake is mandatory.

Nutritional Treatment Outcomes of Therapeutic Feeding Program and Its Predictors Among HIV Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa City, Sidama, Southern Ethiopia: A Retrospective Cohort Study.

HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia. Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval. The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure. Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.