Mizan-Tepi University Teaching Hospital Research Articles

Health professionals’ knowledge and attitude of tuberculosis infection control in Mizan Tepi University Teaching Hospital, Ethiopia

BackgroundHealth professionals are the front-line agents to realize tuberculosis (TB) Infection Control (TBIC) in health facilities and in turn to achieve the targets of the End TB strategy. Despite this, evidence on their knowledge and attitude regarding TBIC is inadequate. As a result, this study aimed to investigate the knowledge and attitude of health professionals regarding TBIC, and associated factors in Mizan Tepi University Teaching hospital. MethodsAn institution-based cross-sectional study was conducted from September 1 to 30, 2019 by including eligible health professionals in the hospital. Knowledge and attitude of TBIC were the outcome variables. We have used 70% as a cut-off to categorize the knowledge and attitude statuses. Binary logistic regression was used to identify factors associated with the outcome variables. The odds ratio with its respective 95% confidence interval was used to measure the strength of association. The final significance was declared at a p-value of<0.05. ResultsThe study found that 70.2% (95%CI: 63.8%, 76.6%) and 78.3% (95% CI: 72.3%, 84%) of the respondents had good knowledge and positive attitude regarding TBIC respectively. The current profession, job location, and history of TBIC training were significantly associated with the respondents’ knowledge. Whereas, the knowledge status of the respondents was the only significant predictor of the attitude. ConclusionAlthough our study participants had satisfactory knowledge and attitude regarding TBIC to some extent, it needs due attention to achieve the target of End TB strategy. Thus, updating the health professionals through different skill-based TBIC training should be considered.

Assessment of Psychological Distress and Associated Factors among Hospitalized Patients During the COVID-19 Pandemic at Selected Hospitals in Southwest Ethiopia.

BackgroundThe aim of this study was to assess the prevalence of psychological distress and associated factors among hospitalized patients during the COVID-19 pandemic at three selected hospitals in southwest Ethiopia.MethodsAn institution-based cross-sectional study design was conducted among hospitalized patients during the COVID-19 pandemic at Mizan-Tepi University Teaching Hospital, Tepi General Hospital, and Gebre Tsadik Shawo General Hospital, southwest Ethiopia from May 10 to August 10, 2020. Sample size was computed using a single-proportion formula, and systematic sampling was employed to recruit study participants. Data were collected using a structured interviewer-administered questionnaire. Psychological distress was assessed with the Kessler Psychological Distress Scale, which has been validated in Ethiopia. SPSS 21.0 was used for analysis. Descriptive statistics were calculated to characteristize the study population. Predictors of psychological distress were identified by logistic regression analyses.ResultsAmong the 337 study participants enrolled, about 41% were aged 25–34 years. The overall prevalence of psychological distress was 57.9% (95% CI 52.8%–63.5%). Being female (AOR 3.69, 95% CI 2.08–6.55), having high (AOR 5.45, 95% CI 2.35–12.66) and medium perceived life threat (AOR 3.37, 95% CI 1.75–6.48), poor (AOR 3.97, 95% CI 1.70–9.29) and moderate social support (AOR 3.17, 95% CI 1.36–7.41), and current khat use (AOR 4.16, 95% CI 1.67–10.35) were statistically associated with psychological distress during the COVID-19 pandemic at P value <0.05.ConclusionThe prevalence of psychological distress was high among hospitalized patients during the COVID-19 pandemic. The study findings highlight the need to develop psychological support strategies to improve mental health and psychological resilience.

Performance of Integrated Emergency Surgical Officers at Mizan-Tepi University Teaching Hospital, Mizan-Aman, Ethiopia: A Retrospective Cohort Study.

Introduction Surgical physician extenders are used in Ethiopia and sub-Saharan Africa where there is a lack of surgical providers. Methods We tested characteristics associated with and outcomes of births attended by an integrated emergency surgical officers (IESOs) as compared to midwives and physician providers. Results Of 1,000 women in our convenience sample, data on birth attendant was missing on 5 women (0.5%). Of the remaining women, almost three-fourths (73.6%, n = 732) of women were attended by a midwife, almost a quarter were attended by an IESO (24.4%, n = 243), 10 women were attended by a physician with a General Practitioner level of training (1.0%), 5 women were delivered by an Ob/Gyn resident (0.5%), and 5 women were attended by an Ob/Gyn (0.5%). Women had a higher likelihood of being attended by an IESO than a midwife if they underwent forceps-assisted (RR 88.4, p < 0.05), vacuum-assisted (RR 45.2, p < 0.05), or cesarean birth (RR 161.8, p < 0.05) as compared to an unassisted vaginal birth. IESOs are performing more operative vaginal and cesarean births than other delivery providers. Outcomes of their deliveries are worse than those of midwives, but this is likely due to the acuity level of the patients and not the provider type.

Prevalence of Hepatitis B Virus Among Pregnant Women on Antenatal Care Follow-Up at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia

BackgroundHepatitis B virus(HBV) infection is a global public health problem, even though its prevalence is disproportionately high in low- and middle-income countries. Mother-to-child transmission is a major route of HBV transmission in endemic areas. This study aimed to assess the prevalence of HBV and its determinants among pregnant women attending antenatal care at Mizan-Tepi University Teaching Hospital and Mizan Health Center, Southwest Ethiopia.MethodsA cross-sectional study was conducted between January 13th 2020 and February 5th 2020 among 370 pregnant women. The sample size was proportionally allocated to each health institution according to the total pregnant women on antenatal care at the respective health institution and a consecutive sampling technique was used to select study participants. Serum hepatitis B surface antigen (HBsAg) was tested using a rapid diagnostic test. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 22. Multiple logistic regression analysis was done to identify the independent predictors of HBsAg serostatus at p-value <0.05.ResultsThree hundred seventy of the total 375 pregnant women participated in the study resulting in a response rate of 98.7%. Twenty-two (5.9%) of the pregnant women screened were found positive for HBsAg (prevalence=5.9%; 95% CI: 3.9–8.80%). History of contact with jaundice patients (AOR=9.87; 95% CI: 2.98–32.65), sharing sharp materials (AOR=3.96; 95% CI: 1.23–11.08) and history of multiple sexual partners (AOR=6.77; 95% CI: 2.44–18.78) were significantly associated with Hepatitis B Virus infection.ConclusionThe endemicity of hepatitis B virus seroprevalence is intermediate in the study settings. Factors associated with hepatitis B virus serostatus were behavioral; hence, modification of these factors may help to prevent the infection.

Service years of health professionals are associated with tuberculosis infection control practice in Ethiopian Teaching Hospital.

Introductionproper tuberculosis (TB) infection control (TBIC) practice of health professionals is one of the effective TB prevention approaches. Despite this reality, the TBIC practice of health care workers was not been well studied. This study assessed the TBIC practice of health professionals and associated factors in Mizan Tepi University Teaching Hospital, southwest Ethiopia.Methodsan institution based quantitative cross-sectional study was conducted from September 1 to 30, 2019, by including all health professionals in the hospital. Participants who answered at least 50% of TBIC practice questions correctly were categorized as having good TBIC practice. Binary logistic regression was used to identify factors associated with the practice of the participants. The odds ratio with a 95% confidence interval and p-value was used to measure the strength of association; the significant association was declared at a p-value less than 0.05.Resultsthe study found that 64.1% (95% CI: 56.6%, 70.7%) of the participants had good TBIC practice. More than half, 102(51.5 %) of study participants have service years of greater than or equal to five years. Only the service year of health professionals was significantly associated [95%CI (AOR= 2.43; 95%CI: 1.28, 4.6)] with the respondents´ TBIC practice.Conclusiononly less than two-third of health professionals had good TBIC practice which is inadequate. And also experienced staff had significantly better TBIC practice. As a result, health professionals in MTUTH should be supported to practice TBIC as routine activity and opportunities should be made for senior staffs to share their TBIC experiences with others.

Pregnancy outcomes at Mizan-Tepi University Teaching Hospital: A Comparison to the Ethiopian Demographic and Health Surveys.

Background:To compare outcomes at Mizan-Tepi University Teaching Hospital to national and regional data and to plan quality improvement and research studies based on the results.Methods:This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1, 000 women who delivered at Mizan-Tepi University Teaching Hospital.Results:Our convenience sample was young (median age 24 years) with a primarily school level or less of education (68.6%). Only about 5% of women had a history of prior cesarean birth, 2.1% reported they were human immunodeficiency virus seropositive, and the median number of prenatal visits was four. Women were commonly admitted in spontaneous labor (84.5%), transferred from another facility (49.2%; 96.8% of which were referred from a health center), and had their fetal heart rate auscultated on admission (94.7%). Only 5.2% of women did not deliver within twenty-four hours and the cesarean birth prevalence was 23.4%. Many women were delivered by midwives (73.2%; all unassisted vaginal births), 89.2% were term deliveries, and 92.5% of neonatal birthweights were 2500 grams or heavier. Less than five percent of women delivered stillbirths (4.3%) and 5.7% of livebirths experienced neonatal death by the day of discharge. There were no maternal deaths in the cohort.Conclusion:The prevalence of stillbirth and neonatal death were the most notable findings, while there was no maternal death in the cohort.

Patients' Adherence to Anti-diabetic Medications and Associated Factors in Mizan-Tepi University Teaching Hospital: A Cross-Sectional Study.

Introduction: A number of medications have been demonstrated to lower blood glucose. However, current-day management has failed to achieve and maintain the optimal glycemic level for diabetic patients. Patients’ non-adherence is among the most contributing factors. Therefore, the aim of this study was to explore the prevalence of non-adherence to anti-diabetic medications and associated factors. Methods: A hospital based cross-sectional study was conducted from November 2020 to January 2021. A systematic random sampling technique was used. Data were collected by structured questionnaire adapted from different literatures. Then, data were entered into SPSS version 25 and analyzed. To determine the association of dependent and independent variables, multiple logistic regression was done. P-value <.05 was considered statistically significant. Results: A total of 275 study participants were interviewed with a response rate of 100%. From this 53.8% were females, 59.3% were in the age group of 41-60 years, 35.3% were college/university graduates and 79.3% were not using social drugs. One hundred eighty-seven (68%) of them were adherent to their anti-diabetic medication. Factors found to be significantly associated with anti-diabetic medication adherence were age >60 years (AOR = .276, 95% CI = .124-.611) attending higher education (AOR = 6.203, 95% CI = 1.775-21.93), retired (AOR = 7.771, 95% CI = 1.458-41.427), housewife (AOR = 7.023, 95% CI = 1.485-33.215), average monthly income 1001birr-2000 birr (AOR = .246, 95% CI = .067-.911) and social drug use (AOR = 3.695, 95% CI = 1.599-8.542). Forgetfulness, not affording, side effects, misunderstanding of instructions, and poly-pharmacy were identified reasons for non-adherence. Conclusions and Recommendations: Patients’ adherence to anti-diabetic medications in the current study is sub-optimal. Age, monthly income, level of education, occupational status, and social drug use were associated with adherence. Forgetfulness, not affording, and side effects were reasons identified to contribute to non-adherence. Therefore, adherence counseling, use of alarms, and the way to mitigate non-affordability, including anti-diabetic medications into a program drug should be considered.

Characteristics and Outcomes Associated with Cesarean Birth as Compared to Vaginal Birth at Mizan-Tepi University Teaching Hospital, Ethiopia.

Introduction:The objective of this study was to observe characteristics and outcomes associated with cesarean birth as compared to vaginal birth.Methods:This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1, 000 women. Data was collected on admission, delivery, and discharge by trained physician data collectors on paper forms through chart review and patient interview.Results:Data on mode of delivery was available for 993/1000 women (0.7% missing data), 23.4% of whom underwent cesarean. These women were less likely to have labored (84.5% versus 87.4%), more likely to have been transferred (62.0% versus 45.2%), more likely to have been admitted in early labor (53.0% versus 48.6%), more likely to be in labor for longer than 24 hours (10.7% versus 3.3%) and were less likely to have multiple gestation (7.7% versus 3.9%), p < 0.05. In a Poisson model, history of cesarean (aRR 2.0, p < 0.001), transfer during labor (RR 1.5, p = 0.003), labor longer than 24 hours and larger birthweight (RR 2.7, p 0.001) were associated with an increased risk of cesarean.Conclusion:Our analysis suggests cesarean birth is being used among women with a history of prior cesarean and in cases of labor complications (prolonged labor or transfer), but fresh stillbirth is still common in this setting.

Effect of Compensation on Employee Performance: In Case of Mizan Tepi University Teaching Hospital

Compensation is very important for the performance of the employees. Therefore they are very important for the organization too. This study aimed to examine the effect of compensation on employee performance in Mizan Tepi University Teaching Hospital. The study was conducted from November 2018 to June 2019 and included all employees of the hospital. A questionnaire was designed to collect the data on the elements related to compensation like basic salary, bonus, house rent allowance, overtime policy, leave policy and employee performance. The study was used explanatory research design and both primary and secondary data was used to conduct this study. Stratified random sampling technique was used to infer the target population of the study. The data was collected from the employees of Mizan Tepi university teaching hospital. The collected data was analyzed by SPSS 20 Version. Descriptive and explanatory statistics was used to analyze the data and a sample of 213 employees was used to collect the data. However, only 200 employees responded to the questionnaires and hence, the response rate was 94 percent. Besides, descriptive statistical tools like frequency, percentage, mean and standard deviation are used to illustrate the demographic characteristics of the respondents and to assess the perception of employees from data collected through questionnaire and the study revealed that majority of the respondents feel disagreed on compensation elements of the organization. Inferential statistical methods like correlation analysis was used to assess the relationship between compensation elements and employee performance, multiple linear regression analysis also was employed to examine the influence of compensation elements on employee performance by using primary data collected through five scale likert questionnaire. Based on the findings of the study, all factors of employee performance have a positive and statistically significant correlation with employee performance. The multiple linear regression analysis (R2) implies that about 54.4% shows that compensation elements determine the variation of employee performance of Mizan Tepi university teaching hospital. Also the regression result revealed that all explanatory variables except bonus have a significant effect on employee performance. This indicated that compensation elements determine employee performance of Mizan Tepi university teaching hospital. Therefore, Mizan Tepi university teaching hospital should implement compensation elements appropriately and continuously as an indispensable tool to improve and maintain sustainable employee performance. Keywords : employee performance, basic salary, bonus, house rent allowance, overtime policy and leave policy. DOI: 10.7176/EJBM/12-31-05 Publication date: November 30 th 2020

Use of Cesarean Birth at Mizan Tepi University Teaching Hospital, Mizan Aman, Ethiopia

ObjectivesThe objective of this analysis was to review indication and utilization of cesarean birth among Robson Classification of Cesarean Birth subgroups. MethodsThis study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered Mizan Tepi University Teaching Hospital in the summer and fall of 2019. ResultsData on mode of delivery was available for 993 women, 23.4% of which underwent cesarean birth. The leading indication for cesarean birth was a fetal indication (46.2%), followed by a maternal indication (35.9%); elective cesarean birth was the indication for one cesarean birth. Robson Groups 1 and 3 (primary cesarean among nulliparous and multiparous women) accounted for the largest proportion of the overall population of women (30.2% and 36.8%), and cesarean birth rates within these groups were 19.4% and 16.1%, respectively. In all remaining groups, cesarean birth rates were at least 17.1%, ranging to as high as 100.0%. Pre-labor cesarean was highest in Robson Group 5 (multiparous women with a history of cesarean birth). ConclusionFurther analysis of risk factors associated with cesarean birth in women whose labor was induced or augmented, or those undergoing preterm birth, might offer additional target risk factors to modify.

Evaluation of Drug Use Based on the WHO Prescribing Indicator in Mizan-Tepi University Teaching Hospital, South Western Ethiopia: A Cross-sectional Study

Background: Rational drug use comprises aspects of prescribing, dispensing, and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practices based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods: An institutional-based, retrospective, cross-sectional study was conducted to evaluate the prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on the World health organization's drug use indicators using prescription papers. A total of 600 prescriptions, written for a 1-year time, dispensed through the general outpatient pharmacy of the hospital were collected by a systematic random sampling method from Mizan-Tepi University teaching hospital. Results: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital, with a range between 1 and 5. Prescribing by generic name was 97.6%, and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from the Ethiopian essential drug list. Conclusion: : Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing, and prescribing from the EDL were close to the optimal value. However, the percentage of encounters with antibiotics and injections prescribed was found to be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

Exploration of Long-term CD4 Profile in HIV Patients Under HAART at Mizan-Tepi University Teaching Hospital and Tepi General Hospital, South Western Ethiopia

Background : Currently, because of the wide availability and free service of HAART, HIV/AIDS related morbidity and mortality has decreased significantly. However, patients accessing antiretroviral treatment (ART) programmes in sub-Saharan Africa frequently have very advanced immunodeficiency and various reserches suggest that such patients may have diminished capacity for CD4 cell count recovery. The objective of this study was to investigate the long-term effect of highly active antiretroviral therapy on the CD4 lymphocyte count of HIV-infected Patients. Method : Subjects from the multicenter HAART Program cohort (from Mizan-Tepi University Teaching Hospital and Tepi General Hospital), aged 18 years or older and had an ART treatment start date in between February 1, 2017 to January 31, 2019 were enrolled in the present study and followed for a maximum of 3 years. Liner mixed model with nested random effect were used to model the longitudianl CD4 count over time. Result : The data reveal robust CD4 responses to ART that are continual over several years. Being under HAART for long period and having baseline CD4 count greater than 150 were postively associated with CD4 increment over time while starting ART at late stage (Stage 3 or 4) and being male are negatively assocted with CD4 increment over time. Conclusion : These data show strong and repetitive CD4 response to ART among patients remaining on therapy. Earlier HIV diagnosis and initiation of ART could significantly progress patient outcomes in the study area. Keywords: CD4counts, HAART, ART, Liner mixed model, Patients DOI: 10.7176/JNSR/11-19-02 Publication date: October 31 st 2020

Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia.

Background Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4. Methods This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019. Results Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by “failed induction or augmentation,” which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by “failed induction or augmentation.” In multivariable modeling of Robson Group 2, having a labor duration of “not applicable” increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)). Conclusion Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity.

Patient Satisfaction with HIV and AIDS Services in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

BackgroundThe World Health Organization and UNAIDS estimated that 36.9 million people were living with HIV in 2017 globally. In the same year, 1.8 million people became newly infected with HIV and 940,000 people died of AIDS-related illnesses. This study aimed to assess patient satisfaction with HIV and AIDS services in Mizan-Tepi University Teaching Hospital (MTUTH), Southwest Ethiopia.MethodsA cross-sectional study was conducted from December 01/2018 to January 31/2019 among 348 people living with HIV who were on highly active antiretroviral therapy (HAART). A systematic random sampling technique was applied to select the study participants. Face to face interview was employed using structured questionnaires. The questionnaire consisted of socio-demographic factors, clinical factors, and patient satisfaction indicators for HIV and AIDS services. Level of satisfaction was assessed based on 24 Likert-scale items. Logistic regression analysis was carried out to identify the independent predictors of patient satisfaction with the services given.ResultsA total of 348 respondents completed the interview, of which 213 (61.20%) were male. The mean age of the respondents was 35.67 (SD=8.40). The overall level of clients’ satisfaction with HIV and AIDS services was 55.2%. Educational status of secondary school and above [AOR 2.41, 95% CI: 1.24–4.69], duration of advice above 10 min [AOR 1.74, 95% CI: 1.09–2.79], CD4 count >500 [AOR 2.20, 95% CI: 1.37–3.54], and duration of treatment of 2 years and above [AOR 1.93, 95% CI: 1.07–3.49] were identified as factors significantly associated with client satisfaction.ConclusionOverall, 55.20% of patients were satisfied with HIV and AIDS services given at the ART clinic of MTUTH. Educational status, CD4 count, duration of advice, and duration of treatment were found to be independent predictors of patient satisfaction with ART services. Increasing client satisfaction is important through patient counseling and care.

Health related quality of life of people receiving highly active antiretroviral therapy in Southwest Ethiopia.

Highly Active Antiretroviral Therapy (HAART) is a standard of HIV management to suppress viral load and delay progression to AIDS. However, questions have been raised about the use of antiretroviral therapy and how it affects quality of life (QoL) of people living with HIV/AIDS (PLWHA). The study hence aimed to assess the QoL of PLWHA who were taking HAART at Mizan-Tepi University Teaching Hospital (MTUTH) and identify factors associated with QoL. A cross sectional study was conducted among PLWHA receiving HAART at MTUTH from March 04-April 1, 2018. Patients were recruited consecutively and interviewed with structured questionnaire. A data abstraction tool was used to extract data from patient medical records. Quality of life was assessed using the World Health Organization Quality of Life HIV- BREF (WHOQOL-HIV-BREF) standard tool. Data was entered to Epi-Info version 3.5.3 and analyzed using SPSS version 22 for windows. A multivariable logistic regression analysis was fitted to identify factors associated with QoL. A statistical significance was established at a p value <0.05. A total of 240 participants with the mean age of 35.11 (SD = 9.08) years were included in the study. This study found that 57.1% of the patients had high global score of QoL. Patients with normal current health (AOR = 3.38, 95% CI = 1.56-7.31)) and having family support (AOR = 3.12, 95% CI = 1.51-6.46) were positively associated with high global score of QoL, while patients with low HAART adherence (AOR = 0.40, 95%, CI = 0.19-0.86) were negatively associated with high global score of QoL. The study revealed that more than half of the participants had high global score of QoL. Normal current health and family support were associated with better global score of QoL, while low HAART adherence was found to be associated with the lower global score of QoL.

Prevalence of and characteristics associated with operative vaginal birth at Mizan-Tepi University Teaching Hospital.

BackgroundTo observe prevalence, characteristics and outcomes associated with operative vaginal birth (OVB).MethodsWe compared spontaneous vaginal birth with OVB.ResultsOf 993 women, 759 (76.4%) experienced vaginal birth; 716 were spontaneous (94.3%), 14 (1.8%) underwent forceps-assisted birth and 29 (3.8%) had vacuum assistance. In a multivariable model of OVB (forceps and vacuum), compared with a midwife, general practitioners (OR 5.6, p = 0.04) and integrated emergency surgical officers (OR 42.8, p = 0.001) were more likely to attend. Women experiencing OVB were more likely to receive local anesthesia (OR 3.0, p = 0.009).ConclusionOVB is used sparingly but safely at Mizan-Tepi University Teaching Hospital.

Depression and Its Associated Factors among Diabetes Mellitus Patients Attending Selected Hospitals in Southwest Ethiopia: A Cross-Sectional Study.

Background Diabetes mellitus and depression are very common diseases worldwide, and the prevalence rates of both conditions are increasing rapidly. Depression among patients with diabetes mellitus results in poor glycemic control through different mechanisms. Besides, the coexistence of a chronic medical illness with depression reduces the probability of recognizing and treating depression. The study is aimed at assessing the prevalence and factors associated with depression among adults with diabetes mellitus. Methods A hospital-based cross-sectional study was conducted among adult diabetes mellitus patients on follow-up in Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to recruit the study participants, and data were collected through face-to-face interview and medical chart review. Depression was measured using Patient Health Questionnaire-nine (PHQ-9). Binary logistic regression analysis was done and a p value of less than 0.05 was used as a level of significance. Results The prevalence of depression among study participants was 37.0% (95% CI 32.0%-42.0%). The majority (44.7%) of the patients had mild depression, while only 2% had severe depression. Being male (AOR = 1.92, 95% CI: 1.15-3.22), urban residence (AOR = 3.02, 95% CI: 1.57-5.78), single marital status (AOR = 7.72, 95% CI: 3.6-16.53), duration of diabetes mellitus 5 years and more (AOR = 2.00, 95% CI: 1.21-3.5), and having sexual dysfunction (AOR = 3.55, 95% CI: 2.13-5.91) were associated with increased odds of depression among diabetes mellitus patients. Conclusions The prevalence of depression among diabetes mellitus was high. Therefore, the patients should be thoroughly screened for this comorbid condition, and the significant factors should be addressed during routine follow-up.

Epilepsy Treatment Outcome and Its Predictors among Ambulatory Patients with Epilepsy at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

Background Epilepsy is among the most common neurological disorders which is highly treatable with currently available antiepileptic drugs at a reasonable price. In Ethiopia, despite a number of studies revealed high prevalence of epilepsy, little is known on predictors of poorly controlled seizures. Thus, the aim of this study was to assess epilepsy treatment outcome and its predictors among patients with epilepsy on follow-up at the ambulatory care unit of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Methods A hospital-based cross-sectional study involving patient interview and chart review was conducted from March 10 to April 10, 2018. Drug use patterns and sociodemographic data of the study participants were accustomed to descriptive statistics. Backward logistic regression analysis was done to identify predictors of poor seizure control. Statistical significance was considered at p value <0.05. Results From a total of 143 studied patients with epilepsy, 60.8% had uncontrolled seizures. Monotherapy (79%) was commonly used for the treatment of seizures, of which phenobarbital was the most commonly utilized single anticonvulsant drug (62.9%). The majority (72.7%) of the patients had developed one or more antiepileptic-related adverse effects. Medium medication adherence (adjusted odds ratio (AOR) = 5.4; 95% CI = 1.52–19.23; p=0.009), poor medication adherence (AOR = 8.16; 95% CI = 3.04–21.90; p=0.001), head injury before seizure occurrence (AOR = 4.9; 95% CI = 1.25–19.27; p=0.02), and seizure attacks ≥4 episodes/week before AEDs initiation (AOR = 8.52; % CI = 2.41–13.45; p=0.001) were the predictors of uncontrolled seizure. Conclusions Based on our findings, more than half of the patients with epilepsy had poorly controlled seizures. Nonadherence to antiepileptic drugs, high frequency of seizure attack before AEDs initiation, and history of a head injury before the occurrence of seizure were predictors of uncontrolled seizure. Patient medication adherence should be increased by the free access of antiepileptic drugs and attention should be given for the patients with a history of head injury and high frequency of seizure attacks before AEDs initiation.

Factors Affecting Survival Rates Among Adult TB/HIV Co-Infected Patients in Mizan Tepi University Teaching Hospital, South West Ethiopia.

BackgroundTuberculosis (TB) and human immunodeficiency virus (HIV) co-infection was responsible for approximately 300,000 deaths worldwide in 2017. Despite this burden of death, factors associated with the survival of TB-HIV co-infected patients were not adequately studied; and some of the existing evidences are inconsistent. This study was aimed to identify factors associated with survival rates of TB/HIV co-infected patients.MethodsThe current study was a retrospective analysis of data extracted from 364 TB/HIV co-infected patients treated at Mizan Tepi University Teaching Hospital, Ethiopia, during the years 2007–2017. Time to event was measured from the date of TB treatment initiation till death, loss to follow-up or completion of treatment. Since the event was death, patients lost from follow-up and those on follow-up were considered as censored. Using Cox-regression, the 95% CI of hazard ratio (HR) and P-value <0.05 were used to identify the significant variables in multivariable analysis.ResultsAll the 364 patients were followed up for 1654 person-months. There were 83 (22.8%) deaths and the majority, 38 (45.8%), were occurring within the first two months of anti-TB treatment initiation. The overall incidence rate and median survival time were 5.02 per 100 person-months (95% CI: 4.05, 6.22) and 10 months, respectively. Not using CPT (adjusted hazard ratio [AHR] =1.72; P=0.023), bedridden functional status (AHR=2.55; P=0.007), not disclosing HIV status (AHR=4.03; P<0.001) and CD4 < 200 cells/mm3 (AHR=6.05; P<0.001) were factors associated with survival rates of TB/HIV co-infected patients.ConclusionOur finding signals that care and attention should be given to the victims of these synergistic diseases. There is room to improve the survival of the patients if those with low CD4 count and bedridden functional status are closely monitored; and if CPT is promptly initiated with encouraging HIV status disclosure.

Glycemic Control, Diabetes Complications and Their Determinants Among Ambulatory Diabetes Mellitus Patients in Southwest Ethiopia: A Prospective Cross-Sectional Study.

BackgroundOver the past two decades, the prevalence of diabetes has increased faster in low- and middle-income countries than in high-income countries. Regardless of the instant growth in the prevalence of diabetes in Ethiopia, up-to-date data regarding glycemic control and related complications of diabetes is inadequate. This study aimed to identify glycemic control and chronic complications and their determinants among ambulatory diabetic patients at Mizan-Tepi University Teaching Hospital (MTUTH).MethodsWe conducted facility-based cross-sectional study from February 25 to March 25, 2019, at Mizan-Tepi University Teaching Hospital. Patients’ demographic data, diabetes complications, and treatments were collected using pretested questionnaire and data abstraction format. Data was entered by using Epidata manager 4.0.2.101, and statistical analysis was done by SPSS version 21. Bivariate logistic regression was done to see the association between independent variables and glycemic control and complication. Multivariable logistic regression analyses using backward selection were done to identify the predictors of poor glycemic control and complication at a P-value of <0.05.ResultsOne hundred ambulatory diabetic patients were included in this study. The mean duration of diabetes and the mean age of the participants were 3.95±5.85 and 46.66±15.53 years, respectively. About 71 (71%) of the studied diabetic patients had uncontrolled fasting blood glucose (FBG) level. More than half of the diabetic patients (59%) developed chronic complications of diabetes. Low medication adherence (adjusted odds ratio (AOR)=11.78, 95%CI: 1.09–17.17) and inappropriate doses in the first, second, and third clinic visits (AOR=7.70, 95%CI: 1.79–33.01; AOR=8.09, 95%CI: 1.90–34.33; AOR=4.34, 95%CI: 1.09–17.17), respectively, were independent predictors of uncontrolled FBG. No variable was found to be an independent predictor of chronic diabetic complication on multivariable logistic regression analyses.ConclusionPoor glycemic control and diabetes complications among ambulatory diabetic patients were high. Low medication adherence and inappropriate doses in the first, second, and third clinic visits were independent predictors of poor glycemic control.