Jimma University Medical Center Research Articles

Pioneering Microsurgery Services in Low-income Countries: Insights from a Plastic Surgeon’s Experience in Ethiopia

Background: Microsurgery, a revolutionary tool in reconstructive procedures, has historically faced challenges in implementation within resource-limited settings. This article presents the journey of establishing microsurgery services at Jimma University Medical Center (JUMC) in Ethiopia, a nation where a significant portion of the population lacks access to microsurgery. The objective was to provide a guide for establishing a microsurgery center in resource-limited settings and share experiences, challenges, and successes encountered during the establishment of the microsurgery unit at JUMC. Methods: The methodology involved a needs assessment, collaboration with Operation Smile, training and capacity building, team and system building, and infrastructure and equipment setup. Strategies included identifying the demand for microsurgery services, collaborating with Operation Smile for resource acquisition, conducting training initiatives in India, and forming a multidisciplinary team. Results: The article introduces the initial series of free flap procedures conducted at JUMC, marking a significant milestone in the region’s surgical capabilities. Cases include forearm dermatofibrosarcoma protuberans, postburn exposed calcaneal bone, and buccal squamous cell carcinoma, demonstrating the diversity and complexity of cases that necessitate microsurgical intervention. Conclusions: The journey of establishing microsurgery services at JUMC represents a significant milestone. Lessons learned provide valuable insights for other centers in developing countries aiming to initiate or enhance their microsurgery programs. Recommendations include continuous training, expanding collaborative networks, advocating for sustainable resource allocation, research and outcome monitoring, incorporating microsurgery into formal curricula, and adapting protocols based on local realities. Implementing these recommendations can contribute to the growth and sustainability of microsurgery initiatives in resource-limited settings.

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low-resource setup: A retrospective cohort study at Jimma University Medical Center.

Bowel obstruction is a mechanical or functional blockade of intestinal contents from evacuation to the adjacent distal bowel or external environment. It poses significant morbidity and mortality in both high-income and low-to-middle-income countries. Ileosigmoid knotting is a special form of obstruction where the small bowel often ileum wraps around the sigmoid colon or vice versa. It is the severest form of bowel obstruction, involving both the small and large bowels in a compound manner. It is common where sigmoid volvulus is common and geographic areas with a bulky diet. An institution-based retrospective cohort study was employed among purposively selected 40 surgical patients with ileosigmoid knotting records from July 2020 to July 2023 at Jimma University Medical Center. To estimate and compare the survival probabilities, the Kaplan-Meir method and log-rank test were used. A Cox-regression analysis was fitted to identify independent predictors of time to death. Among a cohort of 40 patients followed for 347 person-days at Jimma University Medical Center, 11 (27.5%) had died. The overall incidence rate of death was 3.2 (95% CI 1.8, 5.7) per 100 person-days. In multivariable Cox-regression analysis, age (AHR=1.15; 95% CI: 1.04-1.28), shock at presentation (AHR=30.50: 95% CI 1.25-742.54), comorbidities (AHR=5.81; 95% CI 1.19-28.23), pulse rate intraoperatively (AHR=1.19; 95% CI: 1.01-1.40), postoperative pulse rate (AHR=1.07; 95% CI: 1.01-1.14) were independently associated with time to death. The incidence of death among surgical patients with ileosigmoid knotting was high and also had a shorter median survival time. Age, shock at presentation, comorbidities, pulse rate intraoperatively, and postoperative pulse rate were found to be statistically significant predictors of time to death and outcome among surgical patients with Ileosigmoid knotting.

Burden and risk profile of acute kidney injury in severe COVID-19 pneumonia admissions: a Finding from Jimma University medical center, Ethiopia

Background Acute kidney injury (AKI) is a serious complication of the Corona Virus Disease of 2019 (COVID-19). However, data on its magnitude and risk factors among hospitalized patients in Ethiopia is limited. This study aimed to determine the magnitude of AKI and associated factors among patients admitted for severe COVID-19 pneumonia.Methods An institution-based retrospective cross-sectional study was conducted among 224 patients admitted to Jimma University Medical Center in Ethiopia for severe COVID-19 pneumonia from May 2020 to December 2021. Systematic random sampling was used to select study participants. Medical records were reviewed to extract sociodemographic, clinical, laboratory, therapeutic, and comorbidity data. Bivariable and multivariable logistic regressions were performed to examine factors associated with AKI. The magnitude of the association between the explanatory variables and AKI was estimated using an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and significance was declared at a p-value of 0.05.ResultsThe magnitude of AKI was 42% (95% CI: 35.3–48.2%) in the study area. Mechanical ventilation, vasopressors, and antibiotics were required in 32.6, 3.7, and 97.7% of the patients, respectively. After adjusting for possible confounders, male sex (AOR 2.79, 95% CI: 1.3–6.5), fever (AOR 6.5, 95% CI: 2.7–15.6), hypoxemia (AOR 5.1, 95% CI: 1.4–18.9), comorbidities (AOR 2.8, 95% CI: 1.1–7.0), and severe anemia (AOR 10, 95% CI: 1.7–65.7) remained significantly associated with higher odds of AKI.ConclusionThe burden of AKI among patients with severe COVID-19 pneumonia is high in our setting. Male sex, abnormal vital signs, chronic conditions, and anemia can identify individuals at increased risk and require close monitoring and prevention efforts.

Patterns and management outcomes of intracranial extra-axial hematomas in low-resource setup: a 6-month prospective observational study at Jimma University Medical Center, Ethiopia

IntroductionIntracranial hematoma is the collection of blood in various intracranial spaces. Knowledge of patterns, origins, causes and outcomes of ICH conditions is important for decision-making for urgent surgical interventions such as craniotomy and hematoma evacuations. No prior study was conducted in our setup. Hence, this study aimed to assess the patterns and management outcomes of intracranial hematomas in low-resource setting and tailored our management approach at Jimma University Medical center.MethodsAn institution-based prospective observational study was conducted at Jimma University Medical Center, Ethiopia, for six consecutive months from June to December 2020. Different data sources and interview methods were used and analyzed using SPSS version 24. A bivariate and multivariate logistic regression was conducted to determine the association between the variables.ResultsA total of 91 eligible patients were recruited during the study period, with a mean age of 34 years. The majority of patients were males [73 (80.2%)] and more common in reproductive age groups (62.6%), from rural areas (50.5%). About 93.4% of patients reported a history of trauma, and road traffic accidents & fighting account for 63.8% of the trauma cases. Sixty-five percent of patients arrive in the hospital within 24 h. Upon presentation, there were loss of consciousness (48.4%), convulsion (11%), aspiration (9.9%) and increased ICP (12%). The majority (49.5%) of the patients had a mild head injury. The focal neurologic deficits were hemiparesis (29.7%) and hemiplegia (5.5%). Acute epidural hematoma (68.1%) was a common finding, followed by sub-acute subdural hematoma. Of the total study participants, 11% had died. All the surviving patients were accessed at 30 days after discharge and re-assessed, 66 patients had good neurologic recovery (62 upper and 4 lower good recovery), 11 patients had moderate disability (7 lower and 4 upper-moderate disabilities), two patients had a severe disability, and two patients (among those with severe disability) had died.ConclusionTrauma was invariably the cause of intracranial hematoma, and patients with low GCS, papillary abnormalities, aspiration and increased ICP had an increased risk of dying from their illness. It is good to formulate policies to enhance injury prevention and bring about health-oriented behavioral change.

Serum Lipid Profiles, Blood Glucose, and High-Sensitivity C-Reactive Protein Levels Among People Living with HIV Taking Dolutegravir and Ritonavir-Boosted Atazanavir-Based Antiretroviral Therapy at Jimma University Medical Center, Southwest Ethiopia, 2021.

Long-term use of antiretroviral therapy, especially dolutegravir and boosted-atazanavir, raises concerns about cardiovascular disease. Thus, this study aimed to assess lipid profiles, blood glucose, and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir and ritonavir-boosted atazanavir-based therapy. An institutional-based comparative cross-sectional study was conducted from November 4, 2021, to January 4, 2022. An equal number of dolutegravir- and ritonavir-boosted atazanavir-treated patients (n = 64 each) was enrolled. A consecutive sampling was used to select participants. The Chi-square, Student's t-test, Mann-Whitney U-test, and logistic regression were used as appropriate statistical tests using SPSS Version 25.0. Statistical significance was set at p < 0.05. Dyslipidemia was found in 67.2% (43/64) of ritonavir-boosted atazanavir group and 48.4% (31/64) of dolutegravir group. The dolutegravir group had significantly higher mean and median values of high-density lipoprotein and random blood sugar, respectively, as well as lower median triglyceride and high-sensitivity C-reactive protein levels than the ritonavir-boosted atazanavir group. Ritonavir-boosted atazanavir-based regimens (AOR=3.4, 95% CI: 1.5, 8) and age >40 years were predictors of dyslipidemia, while BMI ≥25 kg/m2 (AOR=3.7, 95% CI: 1.3, 10.8) and dolutegravir-based regimens (AOR=4.6, 95% CI: 1.5, 14) were predictors of hyperglycemia. Ritonavir-boosted atazanavir-based regimens (ARR=3, 95% CI: 1.3, 8) and BMI ≥25 kg/m2 (ARR=2.5, 95% CI: 1.1, 6) were associated with increased high-sensitivity C-reactive protein by 1-3 mg/L. The risk of increased high-sensitivity C-reactive protein by >3 mg/L was greater in those patients with a CD4 cell count of <500 cells/mm3 (ARR=5, 95% CI: 1.1, 24). When compared to ritonavir-boosted atazanavir-based regimens, dolutegravir had favorable lipid profiles and high-sensitivity C-reactive protein but unfavorable blood glucose levels. Therefore, baseline blood glucose, lipid profiles, and high-sensitivity C-reactive protein levels should be routinely measured in patients on these regimens.

Prevalence and factors associated with depression among cancer patients attending chemotherapy at Jimma University Medical Centre, Jimma, Southwest Ethiopia

BackgroundCancer is a chronic, life-threatening disease that causes depression, stigma, and economic cost in developing countries and most common mental problem among cancer patients on chemotherapy. ObjectivesTo assess the prevalence and factors associated with depression among cancer patients attending chemotherapy at JUMC. MethodsAn institution-based cross-sectional study was conducted. A simple random sampling method was used to select 300 participants and they were interviewed from March 01 to April 01, 2022. Data was collected by using a pretested questionnaire and patient card review. The collected data were coded and entered into Epi Data Manager 4.6 and SPSS version 26 was used for analysis. Those variables with a p-value of 0.25 were candidates for multivariable logistic regressions with a p-value of 0.05, and the association was finally determined by a 95% confidence interval. ResultThe prevalence of depression was 170 (56.6 %), (95 % CI = 50.92, 62.28). Patients who live in urban (AOR = 0.47, 95 % CI: 0.29, 0.78), chewing khat (AOR = 2, 95 %CI: 1.17, 3.53), patients on their first chemotherapy (AOR = 2.8, 95 %CI: 1.17, 6.64), on the second chemotherapy cycles (AOR = 3.51, 95 %CI: 1.57, 7.60), and duration starting chemotherapy for 1–3 months (AOR = 0.36, 95 %CI: 0.18, 0.72) were significantly associated with depression. Conclusion and RecommendationAccording to the findings of this study, depression was highly prevalent among patients on chemotherapy so Jimma Medical Centre should give awareness creation and health education about cancer for the rural community, risks of chewing khat, chemotherapy treatment, and duration of starting chemotherapy.

Assessment of Prevalence and Associated Factors of Oral Lesions among HIV/Aids Patients Attending in Jimma University Medical Center, ART Clinic, Jimma, Oromia, South Western of Ethiopia

Background: HIV/AIDS constitutes a main health problem in worldwide. Oral lesions are among the earliest and most important indicators of infection with human immunodeficiency virus (HIV). The presence of oral lesions has a significant impact on the physical and mental health of the HIV/AIDS patients. Oral lesions in HIV/AIDS are associated with adverse effect on the quality of such as pain, difficulty during eating bad breath, and altered taste. Objective: To assess the prevalence of oral lesions and its associated factors among HIV/ AIDS patients attending in JUMC, ART Clinic 2023. Methods: Institutional based cross- sectional study was conducted with convenient sampling technique in JUMC, ART clinic from June 15- July 15GC, Data was collected by means of Observations, clinical examination, completing questionnaire and also reviewing patient’s medical records to find oral lesions. Results and Discussion: A total of 96 HIV/AIDS patients were examined, the overall prevalence of oral lesions was found to be 46.9% (95% confidence interval). The result indicates that most prevalent oral lesions were pseudomembranous candidiasis 11(11.5%) followed by Oral hairy leukoplakia 8(8.3%) and necrotizing ulcerative periodontitis 6(6.2%). Poor oral hygiene status, mouth rinse practices, smoking cigarette, alcohol usage and chat chewing habits were significantly associated with the prevalence of oral lesions. Conclusion and Recommendation: The study revealed that nearly half of the study participants had oral lesions, with respect to the resulted prevalence in this study (46.9 %), early detection of oral lesions must be emphasized on the diagnosis and early management of HIV/ AIDS patient’s

Survival Analysis of Recovery of Weight Among Low Birth Weight Infants in Jimma University Medical Center, Jimma, Ethiopia

Background: Globally, it has been known that around 15.5% of infants were below the normal level of weight at their birth and 95% of these infants lived in developing countries. Objectives: The study aimed to model time to normal weight from low weight among low weight infants delivered at Jimma University Medical Center Methods: The retrospective data from all the admitted follow up of low birth weight (LBW) infants, from September 1,2020 to March 30,2022 in JUMC is used in this study. By assessing the overall goodness of fitted models, log-logistic accelerated failure time model which can fit the data well and had smallest akaike information criterion value were selected as the appropriate fit model. Results: Out of 325 LBW infants 286 (88%) were recovered from LBW and 39 (12%) censored. The most important predictors of time to normal weight at 0.05 level of significance were place of residence [φ =0.877 (95% CI: 0.808-0.952)], multiple birth [φ =1.459 (95% CI: 1.316-1.617)],gender [φ =0.870 (95% CI: 0.809-0.936)], history of abortion [φ =1.296 (95% CI: 1.165-1.441)],preterm birth [φ =1.172 (95% CI: 1.070-1.285)], maternal age 20-34 [φ =0.813 (95% CI: 0.727-0.909)] and maternal age &gt;34 [φ =0.798 (95% CI: 0.694-0.917)], ANC follow up [φ =0.816 (95%CI: 0.755-0.883)] and weight at birth 1000-1500 gm [φ =0.773 (95% CI: 0.658-0.910)] and weight at birth 1500-2500 gm [φ =0.700 (95% CI: 0.602-0.815)]. Conclusion: Log-logistic AFT model fits the data well in analyzing time to normal weight among LBW infants data. The duration of time to normal weight of LBW infants significantly affected by the infants’ place of residence, birth status, history of abortion of mothers, gender, preterm, maternal age, number of ANC visits and weight at birth. Therefore, special emphasis should be given for infants who are female, rural place of residence, multiple birth, prematurely birth, infants born from teenage mothers, mother have an abortion, mother have not regular ANC follow up and infants who had &lt;1000 gm birth weight to improve the duration of LBW. The estimated median duration of LBW was 10 days.

Prevalence and assemblage of Giardia duodenalis in a case-control study of children under 5 years from Jimma, Southwest Ethiopia

Giardia duodenalis is a common pathogenic intestinal protozoan parasite with high prevalence in developing countries, especially among children. The distribution of giardia assemblages among humans and their clinical relevance remains controversial. This study aimed to determine the prevalence and assemblage of Giardia among children under 5 years of age in Jimma, Southwest Ethiopia. Employing a case-control design, 606 children presenting with diarrhea at Jimma university medical center and Serbo Health Center were enrolled from December 2016 to July 2018 along with 617 matched controls without diarrhea. Giardia was detected and typed using real-time PCR. Univariate and multivariate regression analysis was performed. The total prevalence of Giardia was 41% (501/1223) and did not differ significantly between cases and controls (40% vs 42%). Prevalence increased by age, with the highest prevalence seen in children aged ≥ 25 months. Children without diarrhea with a history of diarrhea during the last month were more likely to be Giardia positive compared to children with no history diarrhea (OR 1.8 and 95%CI; 1.1–2.9). Regardless of current diarrhea symptoms, assemblage B predominated with 89%, followed by assemblage A (8%) and mixed infection assemblage A and B (3%). We report a high prevalence of Giardia by PCR detection in Jimma, Ethiopia, with assemblage B being predominant. There was a similar distribution of Giardia assemblages between children with and without diarrhea. Increasing age was a risk factor for Giardia infection. Community-based prevention and control strategies need to be employed to decrease the risk of giardia infection.

Application of parametric survival analysis to women patients with breast cancer at Jimma University Medical Center

Public health systems in both industrialized and undeveloped countries continue to struggle with the worldwide problem of breast cancer. In sub-Saharan African countries, notably Ethiopia, it is the form of cancer that strikes women the most commonly. Despite the extreme difficulties, the causes of mortality in Ethiopia have not yet been identified. In addition, little study has been done in this area. Therefore, the major objective of this analysis was to pinpoint the factors that were most responsible for the decreased life expectancy of breast cancer patients at the University of Jimma Medical Center. 552 women who had been treated for breast cancer at Jimma University Medical Center between October 2018 and December 2022 were included in this study, which used a retrospective cohort study design and five-year follow-up data. The most frequent and widely used test for comparing the probability of survival curves between several categorical independent variables was the log-rank test. Next, semi-parametric methods for multivariable analysis using the Cox proportional hazards model were used. Furthermore, a parametric strategy that includes fully parametric survival models better achieves the goal of the analysis. Among covariate, age of patient (ϕ = 254.06; 95% CI (3.95, 7.13), P-value = 0.000), patient live in urban (ϕ = 0.84; 95% CI (-0.35,-0.00), P-value = 0.047), preexisting comorbidity (ϕ = 2.46; 95% CI (0.39, 1.41), P-value = 0.001), overweight women cancer patient (ϕ = 0.05; 95% CI(-4.41,-1.57), P-value = 0.000, positive Axillary Node status cancer patient (ϕ = 0.04; 95% CI(-4.45,-1.88), P-value = 0.000), both surgery and chemotropic baseline treatment patient (ϕ = 0.53; 95% CI(-1.12,-0.16), P-value = 0.009) significantly affected the survival of women breast cancer. Age of breast cancer patient, patient education level, place of residence, marital status, pre-existing comorbidity, axillary node status, estrogen receptor, tumor size, body mass index at diagnosis, stage of cancer, and baseline treatment were found to have a significant effect on time to survive for women with breast cancer at the University of Jimma Medical Center, Oromia region, Ethiopia. However, the covariate histologic grade, number of positive lymph nodes involved, and type of hormone used were insignificant to the survival of breast cancer patients.

Modeling Survival Time to Death among Stroke Patients at Jimma University Medical Center, Southwest Ethiopia: A Retrospective Cohort Study.

Stroke is a life-threatening condition that occurs due to impaired blood flow to brain tissues. Every year, about 15 million people worldwide suffer from a stroke, with five million of them suffering from some form of permanent physical disability. Globally, stroke is the second-leading cause of death following ischemic heart disease. It is a public health burden for both developed and developing nations, including Ethiopia. This study is aimed at estimating the time to death among stroke patients at Jimma University Medical Center, Southwest Ethiopia. A facility-based retrospective cohort study was conducted among 432 patients. The data were collected from stroke patients under follow-up at Jimma University Medical Center from January 1, 2016, to January 30, 2019. A log-rank test was used to compare the survival experiences of different categories of patients. The Cox proportional hazard model and the accelerated failure time model were used to analyze the survival analysis of stroke patients using R software. An Akaike's information criterion was used to compare the fitted models. Of the 432 stroke patients followed, 223 (51.6%) experienced the event of death. The median time to death among the patients was 15 days. According to the results of the Weibull accelerated failure time model, the age of patients, atrial fibrillation, alcohol consumption, types of stroke diagnosed, hypertension, and diabetes mellitus were found to be the significant prognostic factors that contribute to shorter survival times among stroke patients. The Weibull accelerated failure time model better described the time to death of the stroke patients' data set than other distributions used in this study. Patients' age, atrial fibrillation, alcohol consumption, being diagnosed with hemorrhagic types of stroke, having hypertension, and having diabetes mellitus were found to be factors shortening survival time to death for stroke patients. Hence, healthcare professionals need to thoroughly follow the patients who pass risk factors. Moreover, patients need to be educated about lifestyle modifications.

Cataract Surgery Visual Outcome and Associated Factors Among Adults Attended Jimma University Medical Center, Jimma, Southwest Ethiopia.

Cataract is the leading cause of blindness and the second leading cause of visual impairment worldwide, accounting for 51% and 33% of all cases, respectively, in low- and medium-income countries bearing a disproportionately high burden. Hence, this study aimed to assess the visual outcome of age-related cataract surgery and identify factors associated with patients' postoperative visual outcomes in Jimma University Medical Center, Southwest Ethiopia. An institution-based cross-sectional study design was conducted among 386 cataract surgery patients from January 1, 2016, to December 30, 2017. The study participants were selected using a systematic random sampling technique. Data were collected by reviewing the selected patients' medical records using a pre-tested checklist, entered into EpiData version 3.1, and exported to SPSS 20 for analysis. Proportions, summary statistics, and tables were used for presentations of the findings. Binary logistic regression was carried out to identify independent predictors of visual outcome. Findings were presented with adjusted odds ratios and their 95% confidence interval. A p-value <0.05 was used to declare a statistically significant association. About 231 individuals (59.8%) had poor visual results following cataract surgery. Furthermore, age >70 (AOR = 3.64; 95% CI[1.35-9.82]), preoperative ocular co-morbidities (AOR = 2.34; [1.32-4.15]), incision-based cataract surgery (AOR = 7.11; [3.16-16.02]), compared phacoemulsification operated by resident surgeons (AOR = 2.19; [1.23-3.89]), presence of intraoperative complication (AOR = 3.41; [1.47-7.92]), lens remnant (AOR = 2.91; [1.11-4.92]), ocular inflammation (OR = 2.56; [1.34-4.92]), and striate keratopathy/corneal edema (AOR = 1.91; [1.07-3.44]) were significantly associated with poor visual outcome. The visual outcome following cataract surgery fall below WHO recommendation. In this study,age, ocular co-morbidities, surgical method, surgeon status, intraoperative complication, SK, and ocular inflammation associated with post-operative Uveitis and anterior chamber reaction wereassociated with a poor visual outcome.

Risks of Early Mortality and Associated Factors at Adult Emergency Department of Jimma University Medical Center.

Mortality in the emergency department is still high in developing countries with resources scarce. Most of emergency department mortality occurred within the first three days; the majority of these deaths are avoidable with proper intervention. Therefore, the purpose of this study was to assess the mortality risks and therapeutic benefits of early and late death. Case-control study approach with 87 cases and 174 controls (case to control ratio of 1:2) was used on 261 study participants. Data were extracted from the patient charts using a pretested extraction tool. Then, checked data were entered into Epi-data manager 4.6 versions and analyzed using SPSS 25 versions. Binary logistic regression was used to construct bivariate and multivariable analyses following the descriptive analysis. Finally, a predictor variable in the multivariate logistic regression was deemed to have a significant association if its P-value was less than 0.05 at a 95% confidence level. Patients who were triaged into the red zone had a 2.3-fold greater risk of dying early than those who were placed in another triage category [(AOR=2.3; 95% CI: 1.10, 5.55) P=0.001]. Besides, having cardiovascular disease (AOR=4.79; 95% CI: 1.73, 13.27), age ≥65 years [(AOR=3.2; 95% CI: 1.74, 7.23) P=0.003)], having rural residency (AOR=6.57; 95% CI: 1.39, 31.13), and having been diagnosed with respiratory failure [(AOR=3.2; 95% CI: 1.04, 7.69), P=0.013)] were associated with early mortality. The common causes of early mortality were respiratory failure, cardiovascular disease, and road traffic accident. Being aged, having rural residence, being triaged into red zone, and diagnosed for respiratory failure and cardiac failure increase early mortality compared with late death.

Process Evaluation of Health System Responsiveness Level and Associated Factors Among Mothers Gave Birth at Obstetric Ward in a Tertiary Hospital, Southwest of Ethiopia: Mixed Study Methods.

The term responsiveness emerged during the World Health Organization (WHO) report in 2000 as new and essential goals of the health systems to meet the needs of people to their expectations from different services being given in healthcare systems. Obstetric violence and childbirth mistreatment are global problems, but the worst obstetric violence usually occurs in underdeveloped countries. Thus, the main objective of this study was to evaluate the responsiveness of obstetric service at Jimma University Medical Center. A single-case study design with quantitative and qualitative data collection was employed. Availability with 17 indicators and health system responsiveness with 24 indicators were used. Consecutive sampling technique was used to select the clients and qualitative data were collected from key informants. SPSS version 25 was used for the analysis of quantitative data, whereas thematic analysis was conducted for qualitative data. A multiple linear regression model was fitted after all assumptions were checked and fit to ensure the relation of the dependent variable with independent variables. The overall evaluation was 75.6% and judged good. The resource availability and health system responsiveness were 85.5% and 69.7%, which were judged very good and fair, respectively. A stethoscope and thermometer were not available, while 40% glucose, dexamethasone, and intravenous fluid were the most frequently stocked-out supplies. Dignity (72.1%), confidentiality (71.4%), and prompt attention (70%) were the top three good scores for the health system's responsiveness. Health system responsiveness significantly associated with the following: Not attending formal education, attending college and above, place of delivery (health center), mode of delivery (cesarean section), and being merchant. The health system responsiveness of delivery service in study setting was good. All stakeholders should work for improving the health system's responsiveness in delivery service.

Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study.

Stroke is the leading cause of cardiovascular disease death in sub-Saharan Africa and the second leading cause of mortality worldwide. In 2016, 6.23% of all fatalities in Ethiopia were stroke-related. To assess survival status and predictors of mortality among adult stroke patients admitted to Jimma University Medical Center from April 1/2017 to March 31/2022. A retrospective cohort study was conducted on 480 adult stroke patients selected by simple random sampling from patients admitted to the Jimma University Medical Center Stroke Unit from April 1, 2017 to March 31, 2022. Data were extracted from May to June 2022 and entered Epi-data v.3.1 and analyzed by R v.4.2. The Kaplan-Meier curve with Log rank test was used to estimate survival time and to compare survival experience between categories of explanatory variables. The Cox regression model was computed to identify predictors of survival status in stroke patients. Then the 95% CI of the hazard ratio was set with corresponding p-value < 0.05 to declare statistical significance. During 4350 person-days of follow-up; 88 (18.33%) patients died; resulting in an incidence mortality of 20.23 per 1000 person-days, with a median survival time of 38 days. Glasgow coma score <8 on admission (AHR = 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR = 3.96; 95% CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95% CI: 1.23-4.26), and increased intracranial pressure (AHR = 4.27; 95% CI: 2.33, 7.81), were the independent predictors of the time until death. The incidence of stroke mortality was higher at the seven and fourteen days. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and aspiration pneumonia were independent predictors of mortality.

"Jimma University Medical Center, South-West Ethiopia: Evaluation of Blood Pressure Control Among Hypertensive and Diabetic Hypertensive Patients"

"Jimma University Medical Center, South-West Ethiopia: Evaluation of Blood Pressure Control Among Hypertensive and Diabetic Hypertensive Patients"

Expressed Emotion and Selected Patients’ Clinical Factors Among Caregivers of Schizophrenic Patients Visiting Jimma University Medical Center Psychiatry Out Patient Unit, South West Ethiopia (lay summary)

Expressed Emotion and Selected Patients’ Clinical Factors Among Caregivers of Schizophrenic Patients Visiting Jimma University Medical Center Psychiatry Out Patient Unit, South West Ethiopia (lay summary)

Pattern, Cause of Childhood Burn injuries and their Management Outcome At Jimma Medical Center, Jimma Zone, Oromia Region, Southwest Ethiopia.

Burn injuries are prevalent worldwide, especially in developing countries; and there are significant pediatric burn injuries in Ethiopia. This study was performed to analyze the pattern, cause, and management outcome of burn injuries in Jimma Medical Center. A hospital‑based retrospective cross‑sectional study was conducted at Jimma university medical center burn unit. Data were collected through chart review of pediatric patients aged 0 to 14 years who were admitted to the burn unit with a burn injury. A total of 92 hospitalized children were studied from Jan 1, 2020 to Dec 31, 2021 GC. Data were analyzed using SPSS version 25. The statistical significance was determined using odds ratio (OR) with a 95% confidence interval (CI) and the corresponding P-value of less than 0.05. The majority of the patients were males (52.2%). Scald burn was the most common cause of burn in 57(62.0%). The TBSA of majority of the patients (52.2%) was found to be between 11% and 20%. After adjusting for possible confounders in the multivariate analysis, preexisting illness and time of presentation to care were found to have a statistically significant association with the outcome of burn at discharge (P= 0.007) (P= 0.021) respectively. The most common cause of burn in our setup was scald burn; upper extremities were also the most affected site. According to our study, the factors associated with the outcome of burn injury were preexisting illness and late presentation to health facilities.

Abstract 7: Assessment of Baseline Nutritional Status of Pediatric Cancer Patients Treated in the Pediatric Oncology Unit of Jimma University Medical Center: A Cross-Sectional Study

Abstract Purpose: Childhood cancer becomes a public health problem in developing countries which aggravates the burden of childhood mortality through infectious diseases and malnutrition. Even though it has been shown that malnutrition affects the clinical outcome, survivability and quality of life of cancer patients, studies are still scarce to explore the magnitude of nutritional status and its determinants among pediatric cancer patients in Ethiopia and the study area in particular. Therefore the purpose of this study was to assess the prevalence of malnutrition and its associated factor among pediatrics cancer patients. Methods: A 1-Year retrospective study was carried out among all patients less than 15 years old admitted between May 2016 to October 2017 to the pediatric oncology unit of Jimma University Medical Center, southwest Ethiopia. Medical charts were reviewed. Sociodemographic and anthropometric measurements were taken. Data were entered into Epidata and analyzed using SPSS version 20 statistical package. Results: A total of eighty-nine pediatrics cancer patients were admitted at Jimma University Pediatric Oncology and Hematology Unit (POHU). From this, thirty-one (34.8%) were ⇐5 years, and 65.2% were between 6 and 15 years with the mean age of 8 years. Majority, forty eight (53.9%) of pediatrics cancer patients were male. Fourty (44.9%) had hematologic malignancy, thirty six (40.4%) had solid tumors and other Malignancies were about thirty (14.6%). eleven (12.4%), nine (10.1%) were moderately and mildly wasted, respectively based on MUAC and WFH. Fourty (44.9%) of the patients were underweight based on BMI and WFA and twenty (22.5%) were stunted based on HFA. From the total of 27 SAM patients, sixteen (18.0%) were non edematous type of malnutrition, six (6.7%) were edematous types of malnutrition and five (5.6%) were Marasmic kwashakor. Conclusion: considerable cases of malnutrition were observed among the study population. Therefore Further studies are required to examine the effect of malnutrition on patient prognosis and its effect over the various cancer medications. Strengthening the pediatric oncology unit to identify malnourished children on admission, providing nutritional supplements and identifying and treating infection that could result in malnutrition, early intervention of cancer and creating awareness about malnutrition for the parents could minimize the burden and improve survival of cancer patients. Citation Format: Rediet Gebremedhin, Melku Tsefaye Abebe. Assessment of Baseline Nutritional Status of Pediatric Cancer Patients Treated in the Pediatric Oncology Unit of Jimma University Medical Center: A Cross-Sectional Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 7.

Stress and resilience during pregnancy: A comparative study between pregnant and non-pregnant women in Ethiopia.

Stress during pregnancy is associated with perturbances in maternal psychology and physiology, and results in adverse pregnancy and birth outcomes. However, little attention has been given to understand maternal stress and its potential negative consequences in many low- and middle-income countries. We aimed to investigate whether pregnancy is associated with greater stress and lower psychological resilience among women living in Jimma, Southwest Ethiopia. An institution-based comparative cross-sectional study design was implemented in Jimma University Medical Center and Jimma health centers from 15 September to 30 November 2021. Women attending antenatal care and family planning services were invited to participate in the study. Participants were interviewed using the Perceived Stress Scale (PSS-10), Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food Insecurity Access Scale (HFIAS). Linear regression analysis was used to test associations between pregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjusting for potential confounders. Stress and resilience were mutually adjusted for one another in the final model. A total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0 SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increased stress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models, pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) and lower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women. In this low income setting, pregnancy is associated with greater vulnerability in the mental health of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve the health and wellbeing of mothers, with potential benefits for their offspring.