Hiwot Fana Specialized University Hospital Research Articles

Suicidal ideation and associated factors among pregnant women attending antenatal care at public hospitals of Harari regional state, eastern Ethiopia: A cross-sectional study.

Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation. A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated. The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women. This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.

Only two in five pregnant women have adequate dietary diversity during antenatal care at Hiwot Fana Specialized University Hospital in Eastern Ethiopia

Abstract Dietary diversification is a sustainable and appealing strategy for pregnant women to ensure a balanced dietary intake. In Ethiopia, despite the implementation of various nutritional initiatives, inadequate dietary diversity remains a significant factor contributing to adverse birth outcomes. Thus, this study aimed to assess the dietary diversity and associated characteristics among pregnant women attending antenatal care in Eastern Ethiopia. Institution-based cross-sectional study was conducted from April 28 to May 28, 2021. A total of 420 pregnant women were selected using a systematic random sampling technique. We used the adjusted odds ratio (AOR) and a 95% confidence interval to estimate the strength of the association. We used a p-value of 0.05 to declare statistical significance. Only 35.0% (95% CI: 30.5, 39.5) of the 420 pregnant women involved in this study received appropriate dietary diversity. Having an educational level of college and above (AOR 3.01, 95% CI: 1.19–7.5), being an urban dweller (AOR = 3.57, 95% CI: 1.68–7.52), eating three meals and above (AOR = 7.62, 95% CI: 2.88–9.03), and having ≤4 family sizes (AOR = 9.33, 95% CI: 4.06–10.4) were significantly associated with an adequate dietary diversity score among pregnant women. This study found that pregnant women had inadequate overall consumption of a diversified diet. Increasing meal frequency, enhancing women’s education, raising awareness of dietary diversity among rural inhabitants, and offering counselling on family planning utilisation during ANC services are all beneficial in promoting dietary diversity among pregnant women.

Seizure Remission and Its Predictors Among Epileptic Patients on Follow-Up at Public Hospitals in Eastern Ethiopia: A Retrospective Cohort Study.

Epilepsy is one of the common chronic neurological disorders with varying therapeutic responses. Despite the high prevalence of epilepsy and the significant treatment gaps in developing nations, such as Ethiopia, there is a dearth of data on seizure remission and its predictors in Eastern Ethiopia in particular. This study aimed to determine seizure remission and its predictors among epileptic patients on follow-up in Hiwot Fana Specialized University Hospital (HFSUH) and Dilchora Referral Hospital (DCRH), from July 2 to 31, 2021. A retrospective cohort study was conducted among 418 newly diagnosed epilepsy patients receiving anti-seizure drugs (ASDs) between July 1, 2014, and July 31, 2019, in two public hospitals in Eastern Ethiopia. Relevant data were collected for all patients with a minimum follow-up period of two years. Data were analyzed using SPSS Version 21. Cox proportional hazards model was performed to identify predictors of seizure remission. Overall, 252 (60.3%) of the study participants have achieved seizure remission for at least one year. The mean time to achieve seizure remission was 1.9 ± 0.87 years. Regarding the seizure remission pattern, 171 (40.9%) patients achieved early remission, 81 (19.4%) achieved late remission, and 166 (39.7%) achieved no remission. Shorter pre-treatment duration (AHR = 2.36, 95% CI: 1.28-4.37); good adherence to ASDs (AHR = 2.40, 95% CI: 1.33-4.34); and monotherapy (AHR = 0.56, 95% CI: 0.32-0.98) were predictors of seizure remission. We observed that less than two-thirds of epileptic patients had achieved seizure remission. A shorter pre-treatment duration, good adherence to ASDs, and monotherapy were predictors of seizure remission. Therefore, we recommend the requirement of an integrated effort from different health disciplines that increases patients' adherence to ASDs, promotes early visits to medical facilities, and improves the health-seeking behavior of epileptic patients.

Socioeconomic And Demographic Factors And Social Dynamics Associated With Hiv Prevalence In East Hararge, Ethiopia

This paper investigates the association between socioeconomic and demographic factors, social dynamics, and HIV prevalence in East Hararge, Ethiopia, using data from Hiwot Fana Specialized University Hospital. Majority of HIV-positive individuals fell within the 19-49 age group, with males having the highest prevalence. Factors like unprotected sex, drug abuse, and limited HIV prevention access contributed to the higher prevalence in this age group. Progress in preventing mother-to-child transmission was evident, as fewer children under 12 had HIV.&#x0D; Gender disparity was observed, with males having a higher prevalence, linked to gender-based violence, restricted healthcare access, and social stigma. Most respondents displayed a healthy weight range, reflecting positive nutrition efforts. Higher HIV prevalence among married and divorced individuals might be linked to infidelity and limited prevention access. Targeting young, unmarried individuals could aid in preventing HIV transmission. Lower education levels correlated with higher HIV prevalence, indicating the need for improved prevention education for those with limited formal education. Unemployment and self-employment were associated with increased prevalence, highlighting the impact of poverty and limited access to HIV prevention services. Enhancing formal employment opportunities may aid in HIV prevention and management. In conclusion, this study highlights the significant impact of socioeconomic and demographic factors, along with social dynamics, on HIV prevalence in East Hararge, Ethiopia. Targeted interventions addressing education, employment, and housing, as well as combating poverty and gender-based violence, are crucial in curbing HIV spread and improving overall well-being in the region.

Antibiotic utilization pattern in treatment of acute diarrheal diseases: the case of Hiwot Fana Specialized University Hospital, Harar, Ethiopia

BackgroundThe vast majority of acute diarrheal diseases are self-limiting and do not require treatment on a regular basis. Empirical antibiotics should only be used to treat dysenteric and invasive bacterial diarrhea. Antibiotic misuse in the treatment of acute diarrhea is widespread in clinical practice worldwide. Hence, the purpose of this study was to examine the pattern of antibiotic use for the acute diarrheal diseases at Hiwot Fana Specialized University Hospital, Harar, Ethiopia.MethodsA retrospective, institution-based cross-sectional study was conducted to investigate the antibiotic utilization pattern for the treatment of acute diarrheal diseases from September 1 to September 30, 2022. Data were obtained retrospectively from patient cards treated for diarrheal disorders from August 1, 2021 to August 31, 2022, using standardized questionnaires, and the analysis was performed using IBM SPSS Statistics version 27.ResultsAmong 332 patients in present study, 271 (81.63%) of them received nine different types of antibiotics, with the most commonly prescribed drugs were Cotrimoxazole (30.26%), Ciprofloxacin (19.19%), and Azithromycin (17.71%). Based on the presence of blood in the stools, 14.76% of the cases were invasive bacterial in nature. Antibiotics were prescribed about 2.55 times more frequently to patients under the age of 12 than to subjects 65 and older (AOR 2.55, 95% CI 1.45–3.87). Patients who received three or more medications were 2.77 times more likely to be prescribed antibiotics (AOR 2.77, 95% CI 1.84–7.56). For every unit increase in the number of drugs prescribed, the odds of prescribing antibiotics increased by 2.44 units (COR 2.44; 95% CI 2.06–4.32).ConclusionsThe current study found that antibiotics were overused in both adults and children with acute diarrheal diseases at Hiwot Fana Specialized University Hospital. The number of antibiotics prescribed was significantly associated with the patient’s age and the number of medications prescribed. To reduce antibiotic overuse, health professionals have to follow the national standard treatment guidelines.

Fertility desires of antiretroviral therapy-attending HIV-positive women and its associated factors in Harari region, Ethiopia.

The desire to have children among mothers living with HIV remains a serious public health issue in nations with low coverage for antiretroviral therapy and the prevention of mother-to-child transmission, even if it is feasible to have an HIV-negative child. Therefore, this study aimed to assess fertility desire and associated factors among antiretroviral therapy-attending HIV-positive women at Hiwot Fana Specialized University Hospital, in Harari, Ethiopia. A facility-based cross-sectional study design was employed among 639 anti retro-viral therapy attending HIV - positive women by systematic random sampling method selected from June 15 to November 30, 2020. A binary logistic regression model was fitted to identify the associated factors with fertility desire. Descriptive results were presented in percentages, whereas analytical results were reported in adjusted ORs (AORs) with a 95% CI. At p=0.05, statistical significance was declared. A total of 639 participants were included in the study; 69.5%(95% CI 65.7 to 72.9%) of the participants had fertility desire. Younger age (<35 years) (AOR=2.35, 95% CI 1.27 to 4.35), married women (AOR=3.02, 95% CI 1.32 to 12.25), childless women (AOR=2.86, 95% CI 1.17 to 4.82) and women whose duration of HIV diagnosis was ≤5 years (AOR=0.41, 95% CI 0.20 to 0.71) were significantly associated with fertility desire. The majority of the study participants have a desire to have children. In light of the high prevalence of fertility desire among antiretroviral therapy-attending HIV-positive women, it is recommended to counsel younger women on reproductive planning and encourage partner testing.

Bacterial profile, their antibiotic susceptibility pattern, and associated factors of urinary tract infections in children at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

Urinary tract infections (UTIs) are common pediatric infections and contribute to high morbidity and mortality. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. However, there have been few studies on UTIs in children in Ethiopia, particularly in the east. This study aimed to assess the bacterial profile of urinary tract infections, their susceptibility to antimicrobial agents, and associated factors in under-five children at Hiwot Fana Specialized University Hospital, eastern Ethiopia. We conducted hospital-based quantitative study on 332 consecutively selected under-five children from March 20 to June 10, 2021. Parents and guardians were interviewed to collect data using a structured questionnaire. Random urine samples were collected aseptically, and standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into Epi Info version 7 and exported to Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive analysis, bivariate, and multivariable logistic regression analysis. The crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CI) were used to determine the significance of the predictors. A p-value at a 95% confidence interval of less than 0.05 was considered statistically significant. The overall prevalence of bacterial urinary tract infections was 80 (24.1%) 95% CI:19.40-29.00%). Most of the bacterial isolates 55 (68.75%) were gram-negative bacteria, predominantly E. coli 23 (28.75%) and K. pneumoniae 10 (12.50%). Being a rural resident (AOR: 4.10, 95%CI: 1.45 11.54), uncircumcised male (AOR: 3.52, 95%CI: 1.33, 9.39), previous history of antibiotic usage (AOR: 7.32, 95%CI: 2.11, 25.37), indwelling catheterization (AOR: 10.35, 95%CI: 3.74, 28.63), previous history of urinary tract infections (AOR: 5.64, 95% CI: 1.36, 23.38), and urinary frequency (AOR: 5.56, 95%CI: 2.03, 15.25) had higher odds of culture positive result. The majority of the isolates have shown high levels of antibiotic resistance. Meropenem, ciprofloxacin, and amoxicillin-clavulanic acid were effective against gram-negative uropathogens, whereas rifampin and ciprofloxacin were the most sensitive drugs for gram-positive isolates. From the tested bacterial isolates, 53/86 (61.6%), 11/86 (11.6%), and 2/86 (2.3%) were found to have multidrug resistance (MDR), extreme drug resistance (XDR), and pan drug resistance (PDR), respectively. About one-fourth of the children were culture-positive for many types of bacterial uropathogens; this is higher compared with most of the previous studies in Africa. Rural dwellers, uncircumcised males, indwelling catheterization, a history of antibiotic use and urinary tract infection, and frequent urination all had a higher risk of bacterial infections. Many isolates were resistant to multiple drugs, primarily beta-lactams. Urinary tract infections as well as the growth and spread of resistant bacterial pathogens should be monitor regularly.

Magnitude, associated factors, and antimicrobial susceptibility pattern of bacterial isolates among adult dental caries patients attending Hiwot Fana comprehensive specialized university hospital, Harar, Eastern Ethiopia.

Dental caries is defined as a dynamic diet microbial disease of teeth, which results in localized dissolution and destruction of the mineralized tissues of the teeth. Dental caries develops when there is a susceptible tooth exposed to pathogenic bacteria in the presence of substrate. Under these conditions, the bacteria metabolize substrate to form acid, which decalcifies teeth. Dental caries is among the top oral health problem in both developing and developed nations affecting around 20-50% of the population globally. This study was conducted to assess the magnitude, associated factors, and antimicrobial susceptibility pattern of bacterial isolates among adult dental caries patients visiting Hiwot Fana specialized university hospital dental clinic from April 23 to-June 23, 2021. An institutional-based cross-sectional study was conducted among 290 study participants. Convenient sampling techniques were used to select the study participants. Data was entered into Epi-info version 7.2.4.0 and exported to Statistical Package for the Social Sciences version 20 for analysis. The result was explained by using summary measures of texts, tables, and graphs after analysis by using bivariate and multivariate logistic regression. Statistical significance was defined at a p-value of less than 0.05. The overall magnitude of bacteria among dental caries patients was 68.3%. S mutans 74(37.4%) and Lactobacillus spp 58(29.3%) were the most predominant isolated bacteria. Lack of teeth brushing (AOR: 2.8, 95% CI:1.6, 4.6), the habit of chewing khat always (AOR:4.8, 95%CI:2.10,8.80), the habit of chewing khat sometimes (AOR: 3.8: 95% CI: 2.520,9.48) and consumption of soft drinks (AOR: 1.9, 95% CI:1.2,3.1) were significantly associated with bacterial dental caries. Almost, all bacterial isolates were susceptible to ceftriaxone and ciprofloxacin compared to Amoxicillin, Azithromycin, chloramphenicol, clindamycin, doxycycline, erythromycin, gentamycin, penicillin, tetracycline, vancomycin and tobramycin. Teeth brushing habit, consumption of soft drink and a habit of chewing khat affects dental health and they are associated with bacterial dental caries. Harari regional health bureau better to focus by giving health education to the community about dental caries based on identified associated factors with dental caries.

Treatment outcomes and associated factors among children with severe acute malnutrition at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a retrospective cohort study.

Ethiopia is one of the countries with the highest under-five child mortality rates, with malnutrition remaining the major cause of death. Overall, 10% of children in Ethiopia are wasted, and 3% are severely wasted. To assess the treatment outcomes and associated factors among children with severe acute malnutrition (SAM) at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia, data of 162 under-five children admitted from January to December, 2020, at Hiwot Fana Specialized University hospital were collected retrospectively from 1 January to 20 February 2021. Pre-tested structured questionnaire was used to extract data from medical records. The data was entered into Statistical Package for the Social Sciences version 21 for analysis. A p-value <0.05 was considered statistically significant. In this study, 162 participants were included and 54% were males. The majority (80.2%) of children were newly admitted and 49.7% had less than 7 days of hospital stay, 70.99% recovered from malnutrition, and 42.6% had marasmus. Amoxicillin and gentamycin combination (47.5%) was the most commonly prescribed intravenous antibiotics. Having diarrhoea (AOR = 22, 95% CI: 2.86-169.46), presence of comorbidities such as malaria (AOR = 103.29, 95% CI: 7.42-1437.74) and human immunodeficiency virus (HIV) (AOR = 42.72, 95% CI: 4.47-408.23) were statistically associated with poor recovery from severe malnutrition. More than 70% of children with SAM had good treatment outcomes. Child vaccination history, length of hospital stay, admission weight for height, and presence of comorbidities such as diarrhoea, pneumonia, measles, HIV, malaria, and tuberculosis were factors associated with bad malnutrition and treatment outcomes.

In-hospital treatment outcomes of acute stroke and determinant factors in a teaching hospital in eastern Ethiopia.

To assess the in-hospital mortality of acute stroke and determinant factors in a teaching hospital in eastern Ethiopia. A retrospective review of medical records of patients admitted to Hiwot Fana Specialized University Hospital was conducted. Adult patients aged 18 years and older with a diagnosis of either ischemic or hemorrhagic stroke were included. Data were analyzed using SPSS version 21.0 (SPSS Inc., Chicago, IL, USA). Multiple logistic regression analysis was used to identify predictors of in-hospital mortality. A total of 112 patients with acute stroke were included in the study and 56.0% of them were of hemorrhagic stroke. The mean age was 60.32 years and 61.6% were male. The mean length of hospitalization and the mean time of presentation from symptoms onset were 4.85 days and 33.64 h, respectively. The in-hospital mortality was 36.8% for ischemic stroke and 27% for hemorrhagic stroke. Aspiration pneumonia (35.0%), cerebral edema (17%), and seizure (14.3%) were the most common complications occurring during hospitalization. Atrial fibrillation (adjusted odds ratio = 15.45, 95% confidence interval: 1.089-219.2; p = 0.043) was the independent predictor of in-hospital mortality. Hemorrhagic stroke was predominant in the study sample. One-third of patients died in the hospital and the mortality rate was slightly higher in patients with ischemic stroke. Atrial fibrillation was the predominant risk factor for hospital mortality from acute stroke. There is a need to promote cardiovascular health, early recognition, and management of risk factors, and implement coordinated stroke care services to reduce premature death from stroke.

Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study.

Acute intussusception is the main cause of abdominal surgical emergencies worldwide in young children, with an incidence of approximately 1 to 4 per 2,000 children. An accurate estimate of the treatment outcomes of acute intussusception in children is unknown in low-and middle-income countries like Ethiopia. Hence, this study aimed to determine the clinical profile, treatment outcomes of acute intussusception and its associated factors among children admitted to Hiwot Fana Specialized University Hospital in eastern Ethiopia. An institutional-based retrospective cross-sectional study was conducted from November 01 to 30, 2021, among children admitted and managed for acute intussusception. All medical records of children admitted and managed for acute intussusception at Hiwot Fana Specialized University hospital between January 2014 and December 2020 were included. Data were collected using pretested structured checklists through a review of medical records, entered and analyzed using Statistical Package for Social Sciences version 25.0. Chi-square (χ 2) tests were applied to determine the associated factors with treatment outcome. The statistical significance was considered at a p-value < 0.05. In this chart review of children, 13.3% (95% CL: 11.8-14.8) died. The median age of the study participant was 13 months. The majority, 72% were male and 76% were less than 24 months old. Regarding the clinical profile; abdominal pain (94.7%), vomiting (93.3%), bloody diarrhea (70.7%), and abdominal distention (76.0%) were the most common clinical presentations. Age less than 24 months [X 2 = 8.13 (df = 1); p = 0.004], preoperative vital signs [X 2 = 19.21 (df = 2); p = 0.000], intraoperative findings [X 2 = 18.89 (df = 1); p = 0.000], and postoperative complications [X 2 = 14.60 (df = 1); p = 0.000] were significantly associated with treatment outcome of acute intussusception. In this chart review, the overall mortality rate in children was relatively high. One in seven children died from acute intussusception. Age less than 24 months, preoperative vital signs, intraoperative findings, and postoperative complications were significantly associated with acute intussusception treatment outcomes. Surgical management was the only treatment performed in all cases. Delayed presentation of patients and lack of other treatment modalities such as non-surgical interventions are serious concerns in this facility. The initiation of non-surgical reduction may reduce the need for surgical intervention-related complications, and child mortality.

Magnitude of episiotomy practice and associated factors among women who gave birth at Hiwot Fana Specialized University Hospital, Eastern Ethiopia.

BackgroundEpisiotomy is an intentional surgical incision made on the perineum with the aim of enlarging the introits during the second stage of labor or just before delivery of the baby. It sometimes also interferes with the mother's comfort during the postpartum period and has associated complications especially when it is done without indication. However, there is limited information regarding episiotomy practice in the study area.ObjectiveThis study aimed to determine the magnitude of episiotomy practice and associated factors among women who gave birth at the Hiwot Fana Specialized University Hospital, Eastern Ethiopia, 2021.MethodsA facility-based cross-sectional study was conducted among 408 systematically selected mothers who gave birth at the Hiwot Fana Specialized University Hospital, from 1 January to 30 December 2021. Datas were collected from delivery medical records using a pretested checklist. The extracted data were checked, coded, and entered into the Epi-data version 3.1 and exported to the STATA version 16 software for analysis. Binary logistic regression was fitted to identify factors associated with episiotomy practice. P-values < 0.05 were considered to declare the presence of statistical significance.ResultsThe overall prevalence of episiotomy practice was found to be 43.4 % (95% CI: 38.7, 48.9), and mediolateral was the most commonly practiced episiotomy type (41.4%). Parity [AOR: 6.2; 95% CI (3.8–17.6)], 1st min Apgar score [AOR: 1.6; 95% CI (1.04–2.67)], presence of maternal medical disease [AOR: 3.3; 95% CI (1.09–6.9)], and induced labor [AOR: 1.6; 95%CI (1.12, 4.13)] were significantly associated with the episiotomy practice.ConclusionThe prevalence of episiotomy practice in the study area was high. Parity, presence of maternal medical disease, induction of labor, and 1st min APGAR score were significant factors associated with episiotomy practice. Considering the presence of appropriate indications or preventing unjustifiable indications, can help to reduce the current high practice rates.

Assessment of Outcome of and Factors Associated with Gangrenous Small Bowel Obstruction

1.1. Background: small bowel obstructions account for 15% of hospital admissions for acute abdominal complaints and up to 30% of these patients will require operative intervention. Ethiopia is one of the countries where intestinal obstruction is a major cause of morbidity and mortality. 1.2. Objectives: To assess outcomeand factors associated with gangrenous small bowel obstruction among patients admitted to surgical ward of Hiwot Fana Specialized University Hospital from January 1, 2016-December 31, 2020. 1.3. Methods: A retrospective cross-sectional study was conducted on all patients with gangrenous small bowel obstruction admitted to surgical ward of Hiwot Fana Specialized University Hospital from January1, 2016-December 31,2020. For this study, a customized data abstraction form was developed for data capturing from medical records of the patients. The captured data was coded, entered to EpiINFo and exported to statistical package for social sciences software, version 22.0. for analysis. To summarize demographic and clinical characteristics of the patients considered for this study, descriptive statistics such as percent and frequency was employed. All variables with P-value &lt; 0.3, during bi-variable analyses were considered for multivariable logistic regression analyses. Odds ratio along with 95% Confidence interval were estimated to measure the strength of the association. Level of statistical significance was declared at p value less or equal to 0.05. 1.4. Results: A total of 91patiens were included and finally analyzed in this study. From these 52 (57.1%) patients have un favorable surgical outcomes of gangrenous Small bowel obstruction. Of the 52 patients with unfavorable outcome, the most common postoperative complication occurred was anastomotic leak (29.5) followed by surgical site infection (25.5%) and pneumonia (23.6%) . A total of 15 postoperative deaths were also documented as unfavorable surgical management outcomes of gangrenous Small bowel obstruction. Three factors including duration of illness before surgery, length of hospital stay after surgery and shock at presentation were significantly associated withthe surgical management outcome of gangrenous Small Bowel Obstruction. 1.5. Conclusion: In this study, the majority of patients had unfavorable surgical management outcomes of gangrenous Small Bowel Obstruction, however the proportion of patients with favorable outcomes was considerable. Thus, designing a strategy that address the factors associated with unfavorable outcomes could be helpful to further increase the likelihood of favorable surgical management outcomes of gangrenous Small Bowel Obstruction.

Treatment outcomes of penetrating abdominal injury requiring laparotomy at Hiwot Fana Specialized University Hospital, Harar, Ethiopia

BackgroundPenetrating abdominal injury (PAI) is a public health problem and accounts for significant mortality and disability in both developing and developed countries. It often causes damage to internal organs, resulting in shock and infection. In this study, we assessed the outcomes of PAI and factors associated with post-surgical outcomes including surgical site infection (SSI) and in-hospital death.MethodsAn institution-based cross-sectional study was conducted from 15 January to January 30, 2020, using a standard checklist to review the clinical charts of patients who presented to Hiwot Fana Specialized University Hospital (HFSUH) with PAI and underwent laparotomy between January 2015 and September 2019. Descriptive statistics were used to describe the characteristics of patients, and odds ratios (ORs) with a 95% confidence interval (CI) were reported for factors included in binary logistic regression. The statistical significance was declared at a P-value <0.05.ResultsA total of 352 charts of patients with PAI were reviewed. A majority of them (84.9%) were males and the mean age was 26.5 years. The anterior abdomen was the most common site of injury, accounting for 285 patients (81%), 329 patients (93.5%) suffered organ injury, 204 (62%) had a single organ injury, and 125 (38%) had more than one organ injury. The leading injured organs were small intestines 194 (55.1%), followed by the colon 88 (25%) and liver 40 (11.4%). The magnitude of SSI and hospital death was 84 (23.9%) and 12 (3.4%), respectively. Patients above 45 years of age (AOR = 2.9, 95% CI: 1.2, 9.2), with fluid collection (AOR = 2.7, 95% CI: 1.2, 5.9), colostomy (AOR = 3.9, 95% CI: 1.9, 7.8), body temperature >37.5 °C (AOR = 3.8,95% CI:1.9,7.6), and Hgb < 10 mg/dl (AOR = 7.4, 95% CI: 3.4,16.1) had a higher likelihood of SSI. Those patients admitted to the intensive care unit (AOR = 21.3, 95% CI: 1.1, 412.3) and who underwent damage control surgery (AOR = 9.6, 95% CI: 1.3, 73.3) had a higher likelihood of mortality.ConclusionsSSI and death among patients with PAI were high. Age, fluid collection, colostomy, body temperature, and hemoglobin level were statistically associated with SSI, and intensive care unit and damage control surgery were statistically associated with death. Therefore, health professionals working in surgical wards should consider these factors to alleviate SSI and prevent death. Broadly speaking, the guidelines of the World Society of Emergency Surgery (WSES) should consider these factors in their recommendations.

Magnitude and associated factors of stillbirth among women who gave birth at Hiwot Fana Specialized University Hospital, Harar, eastern Ethiopia.

INTRODUCTIONAccording to WHO, there are nearly 2 million stillbirths every year, one every 16 seconds. The objective of our study was to assess the frequency and associated factors of stillbirth among women who gave birth at Hiwot Fana Specialized University Hospital, Harar, eastern Ethiopia, 2021.METHODSAn institution-based retrospective cross-sectional study of medical records was conducted among 336 women who gave birth from 1 January 2020 to 31 December 2020. Maternal medical records were selected by systematic random sampling technique and a pre-tested checklist was used to collect data. Data entry and analysis were done using SPSS-version 20. Bivariate and multivariate logistic regressions were performed to identify factors associated with stillbirth. Adjusted odds ratios with 95% confidence intervals are reported.RESULTSThe frequency of stillbirth was 12.5% (95% CI: 8.1–14.6). Preterm delivery (AOR=8.10; 95% CI: 3.01–21.79), non-booking for antenatal care (AOR=2.8; 95% CI: 1.14–6.88), antepartum hemorrhage (AOR=3.16; 95% CI: 1.10–9.04), obstructed labor (AOR=2.56; 95% CI: 1.85–7.93) and eclampsia (AOR=2.84; 95% CI: 1.45–6.98) were found to be statistically significantly associated with stillbirth.CONCLUSIONSThe frequency of stillbirth in this study was high. Prematurity, non-booking for antenatal care, ante-partum hemorrhage, obstructed labor and eclampsia were independently associated for stillbirth. Therefore, we recommend that the health professionals should better work on prevention of preterm birth, active emergency obstetrical and neonatal care by boosting focused antenatal care follow-up with health education on danger signs.

Women’s hospital birth experiences in Harar, eastern Ethiopia: a qualitative study using Roy’s Adaptation Model

ObjectiveThe aim of the study was to explore women's birth in public hospitals in the Harari Region of eastern Ethiopia.DesignAn exploratory phenomenological qualitative study design was used.SettingTwo public hospitals (Hiwot...

Magnitude of Anemia and Its Associated Factors Among Pregnant Women Attending Antenatal Care in Hiwot Fana Specialized University Hospital in Eastern Ethiopia.

BackgroundAnemia is a significant public health issue, accounting for 20–40% of maternal deaths. Despite the government's commitment and the interventions of various stakeholders, the magnitude and major risk factors of anemia remain unabated. Though there are few documented studies on anemia among pregnant women in eastern Ethiopia in general, in the study area in particular, some of the variables such as helminthics and history of caesarian section in relation to anemia need to be studied. As a result, the purpose of this study was to determine the magnitude of anemia and associated factors among pregnant women attending antenatal care in University Hospital in eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted on a sample of 456 clients who were attending antenatal care in Hiwot Fana specialized university hospital from 01 to 30 June 2021. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaire and sample collection were used to collect the data. The data were coded, double-entered to Epi data version 3.1, cleaned, and exported to SPSS version 20 for analysis. Descriptive statistics were used to present frequency distributions. Variables with p-value < 0.25 during bivariate analysis were entered into the multivariate logistic regression models to control for all possible confounders to identify the factors associated with a magnitude of anemia. Odds ratio along with 95% CI were estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of < 0.05.ResultA total of 456 participants were interviewed, with a response rate of 96.9%. The magnitude of anemia among pregnant women was 112 [(25.3%) 95%CI: (21.5–29.2%)], of which, 27 (6.10%), 36 (8.13%), and 49 (11.08%) had mild, moderate, and severe anemia, respectively. Birth interval < 2 years [AOR: 3.24, (95% CI: (1.88, 4.32)], number of children ≥2 [AOR: 2.54, (95% CI: (1.12, 4.64)], monthly income < 1,000 birr [AOR: 2.89, (95% CI: (1.31, 5.58)], third trimester pregnancy [AOR: 2.89, (95% CI: 4.86, 12.62)], and abnormal menstrual history [AOR: 2.28, (95% CI: (1.69, 5.24)] were the factors significantly associated with anemia.ConclusionAnemia among pregnant women was relatively high compared to previous studies. Birth intervals, number of children, history of menstrual disorder, monthly income, and trimester of pregnancy were all significantly associated with anemia in pregnant women.

Stillbirth and Associated Factors Among Women Who Gave Birth at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia.

BackgroundStillbirth, which accounts for half of all the perinatal mortality, is not counted on policy, program, and investment agendas around the globe. It has been underestimated public health burden, particularly in developing countries. Ethiopia is among the top countries with a large prevalence of stillbirth in the world. However, there is a dearth of study on the current magnitude of stillbirth in the study area. Therefore, this study intended to assess the prevalence of stillbirth and its associated factors to bridge the gap.MethodsA hospital-based retrospective study was conducted from 1 to 28 February 2019 and data were collected by reviewing the chart records of all the women who gave birth in the past 2 years (January 2016 to December 2018) at Hiwot Fana Specialized University Hospital. Data were entered into EpiData version 4.2.0.0 software and transported to SPSS version 23 for analysis. Descriptive statistics such as frequency, mean, and SDs were generated. Determinants of stillbirth were analyzed using a binary logistic regression and presented by adjusted odds ratio (AOR) with a 95% CI.ResultsThe prevalence of stillbirth was 14.5% (95% CI: 11.7%, 17.6%). Low birth weight (AOR = 2.42, 95% CI: 1.23–4.76), prematurity (AOR = 2.10, 95% CI: 1.10–4.01), premature rupture of membranes (AOR = 2.08, 95% CI: 1.14–3.77), antepartum hemorrhage (AOR = 3.33, 95% CI: 1.66–6.67), obstructed labor (AOR = 2.87, 95% CI: 1.48–5.56), and preeclampsia (AOR = 2.91, 95% CI: 1.28–6.62) were an independently associated with stillbirth.ConclusionThe prevalence of stillbirth in this study was high. Low birth weight, preterm birth, premature rupture of membranes, antepartum hemorrhage, obstructed labor, and preeclampsia were independently associated with a stillbirth. Therefore, much study is needed involving different stakeholders to reduce stillbirths by improving the health status of women through the provision of quality maternal care including referral systems.

Neonatal Sepsis and Associated Factor among Neonate Admitted in Nicu at Hiwot Fana Specialized University Hospital Harar Town, Eastern, Ethiopia 2020

Background:Neonatal sepsis is a condition defined as a clinical syndrome characterized by signs and symptoms of infection in an infant 28 days of life or younger. Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. Socio-demographic, maternal, neonatal and medical factors were associated with risk of infection. The clinical signs and symptoms of neonatal Sepsis are nonspecific and the confirmation of diagnosis is challenging and time consuming. Therefore, the diagnostic approach should be depends up on consideration of risk factors. Objective: This study aimed to assess the prevalence and factors associated with neonatal sepsis among neonates admitted to neonatal intensive care unit at Hiwot Fana Specialize Hospital Harar, Ethiopia 2020. Methods: Retrospective cross sectional registered data based study was conducted from February 7- February 25/2020 G.C. A total of 292 neonates cards was selected systematically from neonates admitted to Hiwot Fana specialize hospital at NICU. Data was collected using data extraction tool and checked for completeness and consistency then entered in to SPSS windows version 20.0 for analysis. Bivariate logistic and multivariate regression analysis was used to check existence of association of each independent variable with the outcome variable and Variables significant in bi-variate analysis (P&lt; 0.25) was entered to a multivariate logistic regression model and statistical significance was declared at P &lt; 0.05. Odds ratios along with 95% Confidence interval were used to measure strength and to assess the presence of statistically significant association between independent variables and outcome variable. Result: The prevalence of Neonatal Sepsis was 52.7%. From these 92.2% and 7.8% 0f Neonates developed Early and Late Neonatal sepsis respectively. Among them 59.7% were males. The study found that, Rural residence, delivery place, Meconium stained amniotic fluid, ANC follow up, Gestational age, birth asphyxia and 5th minute APGAR score &lt;7 were significantly associated with neonatal sepsis. Conclusion: The prevalence of neonatal sepsis was 52.7%. Rural residence, Hospital delivery, Meconium-stained Amniotic Fluid, ANC follow up, Gestational Age &lt;37 weeks, birth asphyxia and 5th minute APGAR score &lt;7 were found to statistically significant with Neonatal sepsis.

Incidence and predictors of organ failure among COVID-19 hospitalized adult patients in Eastern Ethiopia. Hospital-based retrospective cohort study

BackgroundOrgan failure is incapability of at least one of the body organs to carry out a normal body functions. Identifying the predictors of the organ failure is crucial for improving COVID-19 patients’ survival. However, the evidence related to this information is not well-established in developing countries, including Ethiopia. Therefore, this study aimed to determine the incidence and predictors of organ failure among adult patients admitted to Hiwot Fana Specialized University Hospital (HFSUH) COVID-19 treatment center from 1st May 2020 to 20th August 2021, Eastern Ethiopia.MethodsA hospital-based retrospective cohort study design was implemented. Descriptive measures such as mean with standard deviation (SD), median with interquartile range (IQR), percentages, and frequencies were computed. The binary logistic regression was used to identify the association between outcome variables (organ functional status) and independent variables with an adjusted odds ratio (AOR) at a 95% confidence interval. A significance level was declared at a p-value of less than 0.05.ResultsThe mean age of study participants was 47.69 years with the standard deviation (SD) of ± 17.03. The study participants were followed for the median time of 8 days with IQR of 4, 14. The incidence of organ failure was 11.9 per 1000 person-day contribution (95% CI: 9.5, 14.9). Predictors such as age above 60 years (AOR = 1.71, 95% CI: 1.44, 4.53), smoking history (AOR = 5.07, 95% CI: 1.39, 8.15), cardiovascular disease (AOR = 5.00, 95% CI: (1.83, 11.72), and critical clinical stages of COVID-19 (AOR = 5.42, 95%: 1.47, 14. 84) were significantly associated with organ failure among COVID-19 hospitalized patients.ConclusionsThe incidence of organ failure was 11.9 per 1000 person-day contribution. Age, smoking, comorbidity, and clinical stages were significantly associated with organ failure among COVID-19 hospitalized cases. Therefore, clinicians should stringently follow the patients experiencing modifiable predictors of organ failure, especially patients with comorbidities and severe clinical stages. Moreover, the prevention programs that target elders and smokers should be strengthening to save this segment of populations before suffering from organ failure following COVID-19.