2026-05-04T17:02:49Z https://nadre.ethernet.edu.et/oai2d

oai:zenodo.org:17549 2025-09-05T13:02:42Z user-007

YONAS TAKELE DESALEGN 2025-09-05 ABSTRACT Background: Lack of exclusive breastfeeding during the first half-year of life is a significant risk factor for childhood morbidity and mortality. Nowadays, formula feeding has become a more common practice but not recommended for infants aged 0-6 months it can increase the risk of respiratory infection, otitis media, allergies, gastro-enteritis, diarrhea, pneumonia, type 1 and type 2 diabetes, cancer risk of leukemia, rapid weight gain, decrease cognitive development in children, and sudden infant death syndrome with its subsequent complications and even death. Objective: To assess the prevalence of formula feeding practice and associated factors among mothers with infants 0–6 months of age in Dilla town, SNNPR, Ethiopia, January, 2022. Methods and Materials: A community based cross-sectional study was conducted from Jan 01 to Feb 16/2022. A systematic random sampling technique was used to collect data among 382 mothers with infants 0–6 months of age using interviewer-administered questionnaire. Data was entered by using Epi data version 3.1 and exported to SPSS software version 25 for analysis. Then data were processed by using descriptive analysis, including frequency distribution, and summary measures. The association was assessed using binary logistic regression analysis using OR with 95 % CI. P value < 0.05 was considered for declaring statistical significance. Result: A total of 382 participants were included, and the response rate was 100 %. The prevalence of infant formula feeding practice was 21.2 %. The association that the initiation of formula feeding were include pre-lacteal feeding was 16.01, mothers who exposed formula information/promotions was 12.07, mothers who have infants age 4-6 months were 4.19, less/no antenatal counseling was 2.53, maternal education was 1.47 were significantly associated with infant formula feeding practice. Conclusion and Recommendation: This study shows that the prevalence of formula feeding was high as compared with other studies. Mainly mothers who exposed to information from family/relatives and media/advertisement is leads mothers to had faulty perception that formula is as good as breast milk/superior to breast milk. Educating mothers about risks of pre-lacteal feeding, adopting strict regulations and enforcement for advertisers and marketing, encouraging and strengths the role of health professionals in supporting exclusive breast feeding practice and discourage formula feeding during antenatal visits and provide right information regarding infant formula considerable interventions which helps to resolve increased prevalence. https://zenodo.org/record/17549 10.20372/nadre:17549 oai:zenodo.org:17549 eng doi:10.20372/nadre:17548 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Infant formula feeding, Children age 0-6 months, Dilla Southern Ethiopia. Prevalence of Formula Feeding Practice and Associated Factors among Mothers with Infants 0 – 6 Months of Age in Dilla Town, Gedee'o Zone, SNNPR, Ethiopia: A Community Based Cross-Sectional Study. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17561 2025-09-05T12:52:05Z user-007

TEMESGEN BEKELE (BSc IN PUBLIC HEALTH) 2025-09-05 ABSTRACT Background: At the international, national, regional, and local levels, there is a clear link between cash crops and food insecurity. Poverty also has an impact on income and food access. Even though there have been numerous studies on food security in Ethiopia, there aren't many that illustrate how common it is, particularly in the districts of Gedeo zone that cultivate and don't grow coffee. Objectives: To compare food security status and its associated factor among coffee-growing and non coffee-growing households in Gedeo zone southern Ethiopia, 2022 Methods: A community-based comparative cross-sectional study design was conducted from April 1 to 30, in Gedeo zone southern Ethiopia. A multistage sampling technique was used. Two districts were selected by simple random sampling technique among six coffee-growing districts and two from non growing, nineteen kebeles (the lowest administrative unit) were selected from each district by simple random sampling, and systematic sampling techniques were used to select 541 households. Data were collected by using the Household Food Insecurity Access Scale (HFIAS) and a 24-hour dietary recall tool was used to assess household dietary diversity. The data were entered into Epi Data version 3.1 and then exported to SPSS version 26.0. Bivariate and multivariable logistic regression was used to determine the relationship between food security status among coffee-growing, and non-growing households, and associated factors. Strengths were reported by using adjusted odds ratios and association with the p-values<0.05 and 95% confidence limits. Result: The overall prevalence of food insecurity was 397(75.9%), (95%CI: 72-79%), (81.3% (95%CI: 76-87%), in non-coffee growing and 72.2 %( 95%CI: 67-77%)) in coffee growing households. Coffee growing households were 1.68 times more likely to be food insecure than non-coffee-growing households (AOR=1.678, 95%CI (1.09-2.56). In coffee-growing households, households that didn’t have farmland were 2 times more likely to be food insecure than those with farmland (AOR=2.13, 95%CI (1.09-4.19). In non-coffee growing households, households that did not produce enough crops for household consumption were 5 times more likely to be food insecure than those that produce (AOR=4.48, 95%CI (1.14-17.67). Conclusion: The common causes of food insecurity in coffee-growing and non-growing households were a lack of farmland, not producing crops, not producing enough crops, not using fertilizer and coping mechanisms, large family size, lack of off-farm income, male-headed households were factors significantly associated with food security status. Therefore, it is crucial for the government to work with regional, zone, and district administrative offices to develop small businesses, empower women and enhance family planning services to reduce the prevalence of food insecurity. Keywords: Food security status, coffee growing, non-coffee growing Gedeo zon https://zenodo.org/record/17561 10.20372/nadre:17561 oai:zenodo.org:17561 eng doi:10.20372/nadre:17560 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Food security status, coffee growing, non-coffee growing Gedeo zone, southern Ethiopia. FOOD SECURITY STATUS AND ITS ASSOCIATED FACTOR AMONG COFFEE GROWING AND NON-COFFEE GROWING HOUSEHOLDS IN GEDEO ZONE SOUTH ETHIOPIA info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17565 2025-09-05T12:59:44Z user-007

REDIET MENGESHA (BSc) 2025-09-05 ABSTRACT Background: - Children's overweight is one of the most important global public health concerns of the twenty-first century which affects every country in the world. Since 2000, the prevalence of overweight children in Africa has nearly doubled, and the problem has become a major public health concern in various countries, including Ethiopia. Therefor the aim of this study was to identify the risk factors for childhood overweight in Dilla, Gedeo zone, Southern Ethiopia, Method: - School-based unmatched case-control study was conducted among school-age children in Dilla town, Gedeo zone, Ethiopia. The sample size for this study was 288 (96 cases and 192 controls). The data was entered into Epidata and exported into SPSS for analysis. During bivariate analysis variables with a p-value < 25% were entered into multivariate logistic regression analysis. Hosmer and Lemeshow's goodness-of-fit test was used to check the model fit. Multicollinearity was checked using variance inflation factor (VIF) and tolerance, and finally a p-value of less than 0.05 was declared as factors significantly associated with child overweight. Results:-A total of 288 school-age children (96 cases and 192 controls) were selected by using a simple random sampling technique lottery method which the response rate was 98.9%. Children with a mother who worked as a merchant had an AOR of 6.900 (95% CI: 2.301–20.688), children with mothers with higher levels of education had an AOR of 8.059 (95% CI: 1.616–40.199), children with parents who owned a private vehicle had an AOR of 2.731 (95 % CI: 1.148 – 6.495), and children who read at leisure time had an AOR of 10.709 (95 % CI: 3.112–36.847) However, being male [AOR..430 (95% CI.190-.970)], not watching television while eating [AOR.139 (95% CI.050-.391)], and consuming sweating liquids less than three times per week [AOR.174 (95% CI.052-.581]] were found to be protective factors against children overweight. Conclusion: This study found that children having higher level educated mother, having a merchant mother, having parents with a private vehicle, and reading in leisure time were significant factors of overweight for school-age children but being male, drinking sweaty fluid less than three times per week, and not eating while watching television also had protective effects. https://zenodo.org/record/17565 10.20372/nadre:17565 oai:zenodo.org:17565 doi:10.20372/nadre:17564 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Child overweight, Determinants, case control, Dilla Ethiopia DETERMINANTS OF OVERWEIGHT AMONG SCHOOL AGE CHILDREN IN DILLA TOWN, GEDEO ZONE, SOUTHERN ETHIOPIA, UNMATCHED CASE-CONTROL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17597 2025-09-06T07:46:54Z user-007

ASRAT ALEMAYEHU (B.Sc.) 2025-09-06 ABSTRACT Background: Acute malnutrition is public health problem in developing countries. It is caused by deficiencies or imbalances in energy, protein and/or other nutrients. However, there is a study gap in the study area to identify the associated factors of the acute malnutrition related to the socio demographic, environmental and health services, and the child feeding practices. Therefore, identifying its determinant factors is important to intervene in the study area. Objective: To assess the determinants of acute malnutrition among children aged 6–59 months in Wondo Genet district, Sidama, Ethiopia 2022. Method: A community-based unmatched case control study was conducted among under-five children from May, 1st to June 30, 2022. The sample was drawn in proportion to 384 people, from randomly selected 8 kebeles based on the WHO 2006 reference population median. Data were collected from a mother/caregiver of the child by using a structured pre-tested questionnaire by trained data collectors. The anthropometric data was analyzed by the WHO Anthro 2010 software to generate Z-score values. Data was entered and cleaned into STATA V.15. Descriptive analysis and binary logistic regression models were analyzed. A multivariable logistic regression to indicate the association with acute-malnutrition in adjusted odds ratio (AOR). Statistical significance is declared at a p-value of ≤ 0.05. Results: This study included the 181 in the control group and 181 in the cases with response rate of the 94.3%. A child born from a poor household [(AOR = 3.265; 95% CI: 1.828, 5.829)], having more than five family members [(AOR = 1.947; 95% CI: 1.220, 3.108)], and being headed only by the husband [(AOR = 2.059; 95% CI: 1.202, 3.527)] were all associated with under-five child acute malnutrition. In addition to this, a child sick in the last two weeks [(AOR= 1.713; 95% CI: 1.015, 2.891)], having no critical time hand washing practice [(AOR= 1.939; 95% CI: 1.135, 3.312)], and inadequate dietary diversity [(AOR = 3.401; 95% CI: 1.398, 8.273)] were major determinants of the under-five children's acute malnutrition in the study area as compared with their counter parts. Conclusions: Being poor, having more than five family members, husband dominance, and child illness all contributed to under-five malnutrition. This may necessitate intervention in areas such as hand washing and insufficient dietary intake. As a result, health officials and stakeholders must work together to reduce risk factors for a child's health and future. https://zenodo.org/record/17597 10.20372/nadre:17597 oai:zenodo.org:17597 eng doi:10.20372/nadre:17596 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by determinants, acute malnutrition, under five children, Sidama, Ethiopia. DETERMINANTS OF ACUTE MALNUTRITION AMONG CHILDREN AGED 6–59 MONTHS IN WONDO GENET WOREDA, SIDAMA, ETHIOPIA: UNMATCHED CASE CONTROL STUDY. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17593 2025-09-06T07:40:06Z user-007

Asres Mengesha Biftu (BSc) 2025-09-06 "Abstract" Background: The joint work of the United Nations Children’s Emergency Fund, World Health Organization and World bank (2018) on child malnutrition states that stunting affected an estimated 150.8 million children under the age of five years globally in 2017. According to Ethiopia Mini Demographic Health survey (EMDHS) 2019, about 37% of children under the age of five years are stunted. So, identifying prevalence and associated factors of stunting in children under the age of five years is central in developing childhood nutritional problem intervention strategies. Objective: To assess the prevalence and associated factors of stunting among children under the age of five years in Wonago district, Gede’o Zone, Southern Ethiopia, 2018. Methods: A community based cross-sectional study was conducted among 615 randomly selected under five children paired with their caregivers in 7 kebeles of Wonago district. The survey was conducted from December 1/2018-December 30/2018 using structured pretested questionnaire and tools of anthropometric measurement. Data were coded and entered to EpiData version 3.1, then it was exported to SPSS version 20 for cleaning and analysis. The prevalence of stunting among children under the age of five years was analyzed by ENA for SMART 2011 software and the report was made using WHO Standard cut off point below -2 SD using z-score. All variables with p value of < 0.25 during bivariate logistic regression analysis were entered to a multivariate analysis to identify variables associated with the outcome variable at p value < 0.05 with 95% CI. Result: Prevalence of stunting among children under the age of five years was 37.7%. Family size of less than five members, being younger than 11 months old and rich wealth status of the household has protective effect against the risk of stunting. Unsafe water source, presence of two or more underfive children in the household, poor access to diversified diet and unsecured household food security status increases the risk of stunting. Conclusion: According to WHO global data base, the prevalence of stunting identified by this study is high among children under the age of five years in Wonago district. Age of the child, family size, number of underfive children in the household, wealth status of the household, source of the drinking water, access to diversified diet and household food security status are major factors associated with stunting among children under the age of five years in this study area. Thus, to reduce childhood chronic nutritional problem in this district, due emphasis should be given on intervening these factors. https://zenodo.org/record/17593 10.20372/nadre:17593 oai:zenodo.org:17593 eng doi:10.20372/nadre:17592 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Stunting, under five children, Wonago district, Gede'o zone Prevalence and Associated Factors of Stunting Among Children Under the Age of Five Years in Wonago District, Gede'o Zone, Southern Ethiopia, 2018 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17591 2025-09-06T07:24:46Z user-007

BETI DALU (BSC) 2025-09-06 "ABSTRACT" Background: The time of initiation of complementary feeding is very important for optimal growth, development, and health of a child during the first 2 years of life. Initiation of semi-solid foods to an infant’s is recommended at about six months. During this period breast milk is no longer adequate to meet nutritional need of a child to promote optimal growth. In Ethiopia, only 60% of infants start complementary feeding during the recommended period. Objective: The aim of this study was to assess timely initiation of complementary feeding and associated factors among mothers of children aged 6-12 months in Pastoralist setting of Gomolle District, Borena Zone, Southern Ethiopia, 2021. Method: A community based cross-sectional study design was employed among 612 mothers who had children aged 6-12 months. Simple random sampling technique was used to select kebeles and also used to select study participants from sampling frame. Pretested semi-structured interviewer administered questionnaire was used for data collection. The collected data was checked for completeness and consistency and then, entered into EPi Data version 3.1 and exported to SPSS version 25 for analysis. Binary logistic regression was carried out to identify factors associated with timely initiation of complementary feeding. Variables with p-value ≤ 0.2 in the bivariate analysis were selected as candidate variables for multivariate analysis to control the effect of confounders. Adjusted odds ratios with their 95% confidence intervals (CI) and p-value of less than 0.05 were considered to have significant association between the outcome and the explanatory variables. Result: The prevalence of timely initiation of complementary feeding in this pastoralist area was 59.8%. In the multi-variable binary logistic regression analysis maternal age 18 - 24 years [AOR = 0.398 (0.16 - 0.988)] P-value = 0.047, family type [AOR = 1.398 (0.75 - 2.608)] P-value = 0.032, ANC follow up [AOR = 9.252 (5.444 - 15.723)] P-value = <0.001 and knowledge about CF [AOR = 9.634 (5.662 - 16.393)] P-value = <0.001 retained statistically significant association with timely initiation of CF. Conclusion: In this pastoralist community, timely initiation of complementary feeding was lower than the World Health Organization cut-off point for good practice of complementary feeding. Timely commencing of complementary feeding was affected by maternal age, family type, ANC follow up visit and knowledge towards complementary feeding. Encourage women to attend more ANC, improving the knowledge of mothers on infant and young child feeding is crucial. https://zenodo.org/record/17591 10.20372/nadre:17591 oai:zenodo.org:17591 eng doi:10.20372/nadre:17590 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Timely initiation, Complementary feeding, Children age 6-12 months, Pastoralist setting. TIMELY INITIATION OF COMPLEMENTARY FEEDING AND ASSOCIATED FACTORS AMONG MOTHERS OF CHILDREN AGED 6-12 MONTHS IN PASTORALIST SETTING OF GOMOLLE DISTRICT, BORENA ZONE, SOUTHERN ETHIOPIA, A CROSS-SECTIONAL STUDY,2021 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17631 2025-09-08T06:17:13Z user-007

WUDINESH TAMIRU 2025-09-08 Abstract Background: Shivering is one of the commonest complications following spinal anesthesia (SA) is 50 65%. The incidence of shivering following SA for caesarian section(C/S) reported to be 40-55% that can impose physiologic, physical and psychology problem on parturient. In most operating theater and post anesthesia care unit, shivering controlled by using pharmacologic modality. However, the therapeutic superiority remains understudied. Objective: To compare prophylactic effectiveness of Pethidine, Tramadol and Ketamine for prevention of shivering following SA for parturient undergoing elective C/S at Hawassa Comprehensive Specialized Hospital, Ethiopia Methodology: In three groups of drugs, parallel-randomized control trial study conducted on 150 parturient who underwent elective CS; They were randomized to three groups group A (Pethidine 0.5 mg/kg), group B (Tramadol 0.5 mg/kg) and group C (Ketamine 0.2 mg/kg). The outcome of the study was incidence of shivering, severity of shivering and side effect drugs during follow up period. After normality checked using Skewness-Kurtosis Z-value test and Shapiro-Wilk test, parametric data analyzed using ANOVA and categorical variable using chi-square test. Statically significances stated at P value less than 0.05. Table and chart used to show the data. Result presented with percentage and mean ±SD. Result: The proportion of intra-operative shivering between group higher in Tramadol 16% than Pethidine 8% and Ketamine 10 % but no statically significance( p=0.422). In addition postoperative the proportion of shivering was lower in Ketamine group 12% compared with Pethidine 18% and Tramadol 20% (p= 0.536). Regarding severity of shivering there were no statically significance difference between groups (p= 0.539 and p=0.716) respectively during intraoperative and postoperative period. Moreover, intraoperative proportion of N/V were Pethidine 20%, Tramadol 24% and Ketamine 0% (p=0.002), N/V has statically significance difference between groups. However, incidence of sedation no statically significance difference between the group (p=0.536).Finally, in postoperative period proportion N/V were in Pethidine 8%, in Tramadol 2% and in Ketamine 0 (p=0.108). Conclusion and Recommendation: There is no difference between the groups of drugs in prevention of shivering. However, drug associated N/V were lesser with Ketamine group. We recommend that Pethidine, Ketamine or Tramadol are equally effective in prevention of perioperative shivering following C/S under SA. https://zenodo.org/record/17631 10.20372/nadre:17631 oai:zenodo.org:17631 eng doi:10.20372/nadre:17630 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by COMPARING PROPHYLACTIC EFFECTIVENESS OF PETHIDINE, TRAMADOL AND KETAMINE FOR PREVENTION OF SHIVERING FOLLOWING SPINAL ANESTHESIA FOR PARTURIENT UNDERGOING ELECTIVE CAESARIAN SECTION AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, HAWASSA, ETHIOPIA, 2020 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17633 2025-09-08T06:24:33Z user-007

Mesfin Gurmu 2025-09-08 Abstract Background: The use of cesarean sections worldwide has increased to unprecedented levels. In Ethiopia, the cesarean section delivery rate is above the rate recommended by the WHO. The postoperative pain experience is moderate to severe in most patients during their postoperative period. Administration of intravenous dexamethasone is thought to have an analgesic effect after surgery even though the analgesic profile of preoperatively administered dexamethasone is less addressed. Objective: - This study aimed to assess the postoperative analgesic effect of preoperative intravenous dexamethasone for patients undergoing cesarean delivery under spinal anesthesia at Dilla University Referral Hospital, Southern Ethiopia. Methodology: - A double-blinded RCT was done on 112 patients undergoing elective cesarean section under spinal Anesthesia that have been allocated randomly into normal saline and dexamethasone groups. A total analgesic consumption, time to first analgesic request and postoperative pain score with NRS were followed for 24hr in both groups. Shapiro wilk’s were used to check normality. Independent samples t-test was used for comparison of means between groups, Mann Whitney U test for non-normally distributed data and chi-square for categorical variables and P-value < 0.05 was considered statistically significant with a power of 80%. Result:- The finding of this study showed that the postoperative pain score of the dexamethasone group was significantly lower than the normal saline group @2hr, @4hr, @6hr, @12hr, @18hr and @24hr with a statically significant p-value<0.05. There was also significant difference in the time to the first rescue analgesic request time between the two group; with dexamethasone group (Median=347.5min) and the Normal saline (Median=230min) with p=0.001. The total consumption of tramadol and diclofenac were higher in normal saline as compared to the dexamethasone group (p <0.05). The proportion of PONV is higher in normal saline group but there was no statistically significant difference between the two groups Conclusion and recommendation:-We conclude that preoperative administration of 8mg dexamethasone prolongs the first analgesic request time, decrease postoperative tramadol and diclofenac consumption and decreases postoperative pain score. We recommend to researchers to do further RCT with a different dose of dexamethasone and in a multicenter basis https://zenodo.org/record/17633 10.20372/nadre:17633 oai:zenodo.org:17633 eng doi:10.20372/nadre:17632 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Postoperative Analgesic Effects of Intravenous Dexamethasone for Patients Undergoing Cesarean Delivery under Spinal Anesthesia at Dilla University Referral Hospital, Ethiopia, 2021: A randomized Controlled Trial. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17635 2025-09-08T06:48:58Z user-007

Mengistu Yinges 2025-09-08 Abstract Background: The outcome of patients in the intensive care unit relies on the human and material resources available at a time. The pattern of admission, determinant factors and intensive care unit outcome were too variable widely from country to country or even with region to region. Therefore, this study aimed to assess disease patterns, clinical outcomes and determinants among patients admitted to three hospitals intensive care units in southern Ethiopia. Methods: This study was a retrospective cross sectional study design conducted among 517 patients that admitted to intensive care units and selected by using systematic random sampling technique. Data were entered, coded, checked, and analyzed using SPSS version 26 software packaging. The data was checked for normal distribution using the normality graph curve test. Bivariate (p-value < 0.2, 95% CI) and multivariate analysis (p- value<0.05, 95% CI) logistic regression were used to predict the independent variables of the outcome variable. Result: Among the 517 patients, 284 (54.9%) patients were males. The most common cause of admission was cardiovascular disease (35.4%) followed by respiratory diseases (29.6%). The overall rate of mortality in intensive care unit was 46.8 % with (95% CI: 44.68%, 48.92%). Cardiac arrest, aspiration, infection, antibiotic intervention, mechanical ventilation, and length of intensive care unit stay were the independent predictors of intensive care unit mortality. Conclusion: Almost half of the patients admitted to the intensive care unit were died. This study also identifies different factors such as (cardiac arrest, aspiration, infection, antibiotic intervention, mechanical ventilation, and length of intensive care unit stay) were associated with mortality; therefore working on those identified variables with stakeholders might be important to enhance the quality of care in intensive care unit and decreases the mortality of patients. https://zenodo.org/record/17635 10.20372/nadre:17635 oai:zenodo.org:17635 eng doi:10.20372/nadre:17634 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Admission Pattern and Determinants of Clinical Outcomes among Patients Admitted to three Hospitals Intensive Care Units in Southern Ethiopia, 2020: A Multicenter Retrospective Cross-Sectional Study info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17677 2025-09-08T07:48:50Z user-007

Teshome Abebe 2025-09-08 Abstract Background: Neonatal mortality rate is deaths occurring from birth to 28 days life per1000 Live Births. The global neonatal mortality rate fell from 37 deaths per 1,000 live births in 1990 to 18 in 2017, where as it was 27deaths/1000 life birth in the Sub-Saharan. Ethiopia plans to reduce the neonatal mortality rate from 28 to 11/1,000 live births by 2020 and to end all preventable child deaths by 2035. Objective: The aim of this study was to identify risk factors associated with neonatal mortality in neonatal intensive care unit of Dilla University Referral Hospital Methods: An age matched case control study was conducted at Dilla University Referral Hospital’s neonatal intensive care unit. Two controls having age 2days before or after the case were used for matching. One hundred eighteen cases (died) and 236 age matched control (survived) neonates who were admitted to the neonatal intensive care unit during January 11, 2018 to February 25, 2020 were studied. Missed data was filled by multiple imputations. Multicollinearity was checked by variance inflation factor. Outliers were checked by cooks distance. For variables with P value <0.02 on bivariable conditional logistic regression, multivariable conditional logistic regression analysis was done to control for confounder using clogit command in a survival package to identify risk factors for neonatal mortality using R version 3.6.3. Result: Gestational age <37 weeks (Adjusted matched odds ratio-AmOR: 14.02; 95%CI: 3.68 – 53.46), having first minute APGAR score < 7(AmOR: 5.68; 95%CI: 1.76-18.31), diagnosing with perinatal asphyxia (AmOR: 4.62; 95%CI: 1.15 – 18.53) and being twin (AmOR: 6.84; 95%CI: 1.34-34.96) were significantly associated with neonatal deaths in our study. Having ante natal care following up during pregnancy (AmOR: 0.15; 95%CI: 0.04-0.53) and having a normal random blood sugar level at admission (AmOR: 0.1; 95%CI: (0.02 - 0.66) were found to be protective against neonatal mortalities in our study. Conclusion: Gestational age less than 37 weeks, first minute APGAR score <7, being a twin and diagnosing with perinatal asphyxia were significantly associated with neonatal death in neonatal intensive care unit of Dilla university referral hospital where as maternal ante natal care follow up during pregnancy and neonatal having normoglycemia at admission were found to be protective. https://zenodo.org/record/17677 10.20372/nadre:17677 oai:zenodo.org:17677 eng doi:10.20372/nadre:17676 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by neonatal mortality, case control, predictor Determinants of Neonatal Mortality in Neonatal Intensive Care Unit of Dilla University Referral Hospital, Southern Ethiopia; 2019-2020: A matched Case Control Study info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17705 2025-09-08T08:13:29Z user-007

Fetiha Mohammed 2025-09-08 Abstract Background: Pain after cesarean section is common and associated with long hospital stay, infections, less infant care and it may leads to chronic pain. Caesarean Section (CS) has been one of the most frequently performed major surgical interventions, and causes severe postoperative pain and subsequent manipulation performed through Pfannenstiel incision is associated commonly with significant degree of pain in the postoperative period, up to 79% of women experience pain at the incision site that can last for up to 2 months. Spinal opioid & abdominal field block has been investigated as effective analgesia for postoperative pain and reduce the need of systemic medications and their associated side effect. The aim of this study is to compare spinal morphine and transversus abdominis plane block for postoperative pain management. Method: In this prospective, randomized controlled trial 108 pregnant mothers scheduled for Cesarean section under spinal anesthesia was allocated randomly to receive either spinal morphine 0.1mg (group SM; n 56) or transversus abdominis plane block 20ml of 0.25% (group TAP;n 52). Patients were followed postoperatively to assess time to first analgesic request, analgesic consumption and pain intensity through numerical rating scale for the first 24 hours, at 2, 4, 6, 12, and 24 hours. Comparison of numerical variables between study groups was done using unpaired student t- test and Manny Whitney U test for symmetric and asymmetric data respectively. Time to event variable was analyzed by using Kaplan Meir survival function. P value less than 0.05 were considered as statistically significant. Result: One hundred twenty patients were screened for this prospective, randomized, doubled blind, controlled study. Of these, One hundred and fourteen patients were recruited and randomly assigned and received interventions. Among them, One hundred and eight patients completed this study. Time to first analgesic request was significantly shorter in TAP with a median (IQR) of 240 (180-390) minute vs 360 (270-480) minute in SM. Twenty four hour median morphine consumption was reduced in spinal morphine group 0 (0-4) mg compared to TAP block group 4 (0-6) mg (p<0.001). Median postoperative NRS score during movement and rest at 2nd hour, 6th hour, 12th hour and 24th hour were statistically significant different between groups (p <0.001). Conclusion: In conclusion preservative free 100µg spinal morphine for cesarean section provides prolonged postoperative analgesia time, better postoperative analgesia, and less postoperative analgesic consumption than TAP block. https://zenodo.org/record/17705 10.20372/nadre:17705 oai:zenodo.org:17705 eng doi:10.20372/nadre:17704 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Spinal morphine; TAP; analgesia; cesarean section Comparison of Spinal Morphine and Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergone Cesarean Section Under Spinal Anesthesia at Hawassa University Comphrensive and Specialized Hospital Ethiopia 2019: Randomized control trial info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17693 2025-09-08T08:01:18Z user-007

Hunde Amsalu 2025-09-08 Abstract Background: Globally emergency laparotomy is frequently performed surgery. It is a resource intensive surgical procedure with a high morbidity and mortality rates even in the best healthcare systems. Poor post-operative outcome predispose patients to prolonged recovery, increased length of stay and worsened clinical status. Limited data is available in our country regarding postoperative outcomes of emergency laparotomy therefore, this study aimed to assess outcome of emergency laparotomy. Objective: To assess post operative outcomes and predictors among patients undergoing emergency laparotomy at selected Southern, Ethiopian governmental hospitals. Methods: Multi center prospective cohort study was conducted. And data were collected at selected hospitals after obtaining ethical approval from the institutional review board. Continuous data were presented as mean, median, and standard deviation (SD) and the categorical data were presented as the percentage in each category. Data were analysed using SPSS version 26. Multivariable logistic regression analysis was conducted. The significant level of prediction was considered with P value < 0.05 and an adjusted odds ratio was calculated (AOR) at 95% confidence interval (CI). Result: The rate of post operative complication after emergency laparotomy surgery was 39.3% with a mortality rate of 8.4% and length of hospital stay 9 ± (6.5 SD) days. The predictors of post operative complication was Co morbidity (AOR=10.53, 95% CI=3.85-28.8). ASA category II, (AOR=5.09, 95% CI=1.767 - 14.67), and > ASA III (AOR=4.46, 95% CI=1.18 - 16.89), preoperative sepsis (AOR=7.1, 95% CI=2.29 - 22.03), and duration of symptoms the disease >72 hours (AOR=2.37, 95% CI=1.05-5.39). Conclusion: Our study revealed significant level of post operative complications and mortality; therefore the identified predictors should be sorted and can be applied to the preoperative optimization, risk assessment, and standardization of effective post operative care following emergency laparotomy patients individually. https://zenodo.org/record/17693 10.20372/nadre:17693 oai:zenodo.org:17693 eng doi:10.20372/nadre:17692 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Mortality, Hospital stay, emergency laparotomy, postoperative complication Postoperative Outcome and Predictors among Patients Undergoing Emergency Laparotomy at Selected Southern Ethiopian, Governmental hospitals, 2022: Multicenter Prospective cohort study info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17727 2025-09-08T08:35:44Z user-007

ASCHALEW BESHA 2025-09-08 Abstract Background: Cesarean section is an operative technique by which the fetus is delivered through abdominal and uterine incisions. Bupivacaine is a well-known local anesthetic agent that can be available in isobaric and hyperbaric forms and is commonly used during spinal anesthesia for cesarean delivery. The difference in baricity of bupivacaine affects the hemodynamic profiles, extent, and onset of sensory and motor block. Objective: To compare the effects of hyperbaric and isobaric bupivacaine on hemodynamic profiles and block characteristics among parturients undergoing elective cesarean section under spinal anesthesia at Dilla University Referral Hospital from February 10, 2022 to June 10, 2022. Method: After obtaining ethical clearance from the ethical review board, 64 pregnant mothers scheduled for elective cesarean section under spinal anesthesia were randomized to either 12.5 mg of isobaric bupivacaine(n = 32) or 12.5 mg of hyperbaric bupivacaine (n = 32). The normality of data was checked using histogram and Shapiro-Wilk normality tests. Comparisons of numerical variables between study groups were done using the independent t-test and the Mann Whitney U test for symmetric and asymmetric data, respectively. A mixed ANOVA was used for repeated measurements, and a chi-square or Fisher exact test was used for categorical variables. A P value 0.05). The median onset time of maximum sensory block was faster in the hyperbaric group 3(1) minutes than in the isobaric group 4 (2) minutes) (P<0.001). There was also a faster median onset time of maximum motor block in the hyperbaric group 4(2) minutes) compared to the isobaric group 5(2) minutes) (p<0.001). Conclusion and recommendation: We conclude that hyperbaric bupivacaine provides stable intraoperative hemodynamic parameters and an earlier onset of block than isobaric bupivacaine. We recommend to researchers to do further randomized controlled trials, with invasive blood pressure measurement and multicenter study. https://zenodo.org/record/17727 10.20372/nadre:17727 oai:zenodo.org:17727 eng doi:10.20372/nadre:17726 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Block characteristics, hemodynamics, isobaric bupivacaine, hyperbaric bupivacaine, cesarean section, Spinal Anesthesia THE EFFECTS OF HYPERBARIC AND ISOBARIC BUPIVACAINE ON POST SPINAL HEMODYNAMIC PROFILES AND BLOCK CHARACTERISTICS AMONG PARTURIENTS UNDERGOING ELECTIVE CESAREAN SECTION AT DILLA UNIVERSITY REFERRAL HOSPITAL: A RANDOMIZED CONTROLLED TRIAL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17715 2025-09-08T08:22:51Z user-007

DEJENE MOREDA 2025-09-08 Abstract Background: Inadequate treatment of postoperative pain is resulting in a delay in patients’ recovery, affects the interaction between mother and baby, longer hospital stays, and increases the incidence of chronic pain. In limited resource areas, postoperative pain management is challenging because of the inadequate administration of pain relief drugs and the high patient-to nurse ratio that limits the assessment of pain. Objective: To assess the incidence and predictors of moderate to severe postoperative pain after cesarean section undergoing spinal anesthesia at Dilla University Referral Hospital and Hawassa University Comprehensive Specialized Hospital from February 1 to June 10, 2022. Methods: A prospective single-armed cohort study was conducted at Dilla University Referral Hospital and Hawassa University Comprehensive Specialized Hospital from February 1 to June 10, 2022. A total 205 parturients who underwent cesarean sections under spinal anesthesia were included during the study period. The numeric rating scale was used to assess pain severity. Binary logistic regression was used to identify independent risk factors for postoperative pain. Variables with a p-value less than 0.25 on bivariate logistic analysis were taken to multivariate logistic regression analysis. Results: In our study, the incidence of moderate to severe post-operative pain after the cesarean section was 71.2% within the first 24 postoperative hours. On the multi-variable analysis, preoperative anxiety (AOR: 2.849, 95% CI: 1.276, 6.359), history of previous cesarean section (AOR: 3.571, 95% CI: 1.536, 8.300) and transverse incision (AOR: 6.965, 95% CI: 2.469, 19.652) were predictors for moderate to severe postoperative pain after cesarean section. Abdominal field blocks decreased the incidence of postoperative pain (AOR: 0.035, 95% CI: 0.009, 0.139). Conclusion: In this study, a large number of parturients experienced moderate to severe post cesarean pain in the first 24 postoperative hours. Preoperative anxiety, history of previous cesarean section, and transverse incision were predictors for moderate to severe post-cesarean pain. Fields blocks were reduced severity of post-cesarean pain. https://zenodo.org/record/17715 10.20372/nadre:17715 oai:zenodo.org:17715 eng doi:10.20372/nadre:17714 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by predictors of post-cesarean section pain, cesarean section, incidence of post-cesarean INCIDENCE AND PREDICTORS FOR MODERATE TO SEVERE POSTOPERATIVE PAIN AFTER CESAREAN SECTION UNDERGOING SPINAL ANESTHESIA AT DILLA UNIVERSITY REFERRAL HOSPITAL AND HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL 2022: MULTICENTER PROSPECTIVE SINGLE-ARMED COHORT STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17719 2025-09-08T08:27:56Z user-007

Beteley Bezabih 2025-09-08 ABSTRACT Background: Menstrual problems are the major gynecological problems especially among adolescent girls due to relative immaturity of the hypothalamic-pituitary-ovarian axis. It affects three forth of menstruating adolescent girls and results high school absenteeism and poor academic performance. Despite its negative influence on school performance, it gets low priority as compared with other health problems. This study helps for the better understanding of the magnitude of menstrual disorders and its predictors to prevention and management it. Objective: This study aimed to assess the prevalence of menstrual disorder, associated factors, and relationship with academic performance among female high school students of Gedeo zone, Southern Ethiopia, 2021/2022. Method: A school based cross-sectional study design was employed at 723 randomly selected high school students of Gedeo zone, Southern Ethiopia from April 11 – June 10, 2022. A multi-stage stratified sampling techniques was used. Epi-Data Version 4.6 and Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bi-variable and multivariable logistic regression analyses were employed to identify factors associated with menstrual disorder. During bi-variable analysis, variables with P-values of ≤0.25 were entered into the multivariable logistic regression analyses. In the multivariable logistic regression analyses, variables with a P value of 8 hours) to reduce the risk of developing menstrual disorder. https://zenodo.org/record/17719 10.20372/nadre:17719 oai:zenodo.org:17719 eng doi:10.20372/nadre:17718 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Menstrual disorder, academic performance, and high schools Menstrual Disorder, Its Associated Factors and Relationship with Academic Performance among Female High School Students of Gedeo Zone, Southern Ethiopia: A cross-sectional study info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17740 2025-09-08T08:43:30Z user-007

ADDISU MOSSIE 2025-09-08 ABSTRACT Background: The prevalence of abnormal electrocardiography (ECG) increases with aging, and these abnormalities may have an impact on anesthesia management. Although a normal ECG does not guarantee a healthy heart, an abnormal ECG can quickly identify a patient who is at high risk of cardiac complications. Objective: The aim of this study was to determine the prevalence and associated factors of preoperative abnormal electrocardiography among older surgical patients at selected teaching hospitals in southern Ethiopia, from February 15 to June 15, 2022. Methodology: A multicenter cross-sectional study was conducted at three randomly selected teaching hospitals in southern Ethiopia on 246 elderly surgical patients recruited consecutively. Data were entered into Epidata version 4.6, then exported and analyzed in STATA version 16. A binary logistic regression model was used to examine factors associated with abnormal ECG, and variables with a P-value < 0.2 were entered into the multivariate analysis to identify independent factors. Both crude and adjusted odds ratios were reported, and a P-value < 0.05 was considered statistically significant. The data were presented accordingly using numbers, frequencies, tables, charts, and figures. Result: In the current study, 120 (48.78%) of older surgical patients had abnormal preoperative ECGs. In terms of severity, 55.3% were classified as minor, while 44.16% were major ECG abnormalities. The most common ECG abnormalities were left axis deviation (LAD), left ventricular hypertrophy (LVH), and ST segment changes. The presence of comorbidity (AOR=3.44, P =0.001), age ≥70 years (AOR=2.5, P=0.011), history of angina (AOR=5.9, P=0.011), history of smoking (AOR=5.07, P=0.024) and urban residency (AOR=1.89, P=0.039) were the strongest risk factors for an abnormal ECG. Conclusion and recommendation: Our study showed that the prevalence of preoperative abnormal ECGs increased with age, even in asymptomatic patients with no risk factors in patients younger than 65 years. Therefore, a preoperative ECG is advisable in all older patients, including those under 65 years of age without risk factors. Further prospective cohort studies are needed to investigate the impact and outcome of patients with preoperative abnormal ECG. https://zenodo.org/record/17740 10.20372/nadre:17740 oai:zenodo.org:17740 eng doi:10.20372/nadre:17739 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Abnormal ECG, older, preoperative, surgical. PREVALENCE AND ASSOCIATED FACTORS OF PREOPERATIVE ABNORMAL ELECTROCARDIOGRAPHY AMONG OLDER SURGICAL PATIENTS AT SELECTED TEACHING HOSPITALS IN SOUTHERN ETHIOPIA, A MULTICENTER CROSS-SECTIONAL STUDY, 2022. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17732 2025-09-08T08:39:59Z user-007

KANBIRO GEDENO 2025-09-08 Abstract Introduction: Preoperative anemia is a common finding among surgical patients, and it is associated with an increased risk of perioperative morbidity and mortality. To improve the postoperative management plan and outcome status; needed to know the relationship between preoperative anemia and perioperative outcomes in patients undergoing emergency surgery. Objective:To assess the effect of preoperative anemia on perioperative outcomes among patients undergoing emergency surgery in selected Southern Ethiopia governmental teaching hospitals, from January 2022 to June 2022 GC. Method:A multi-center prospective cohort study was conducted. Data were collected at selected Hospitals, after obtaining ethical approval from the institutional review board. Continuous data were presented as mean, median, and standard deviation (SD); and the categorical data were presented as the percentage of individuals in each category. Multivariable binary logistic regression analysis was conducted. A P-value less than 0.05 were taken as significant. Result:A total of 200 patients underwent emergency surgery were included. The patients were grouped into the anemia group (100 patients) while the rest were non-anemia group. There was no statistically significant difference between the group regarding socio-demographic and intraoperative patient characteristics. Based on multivariate logistic regression, anemia groups had significant risk of perioperative transfusion requirement (RR= 4.030, p< 0.001), developing postoperative complications (RR= 1.868, p= 0.017), occurring in-hospital mortality (RR= 5.763, p= 0.045), prolong length of hospital stay (RR= 4.028, p< 0.001), and requiring postoperative intensive care unit admission (RR= 6.332, p= 0.003) compared with non-anemia groups. Conclusion:Preoperative anemia was associated with a higher rate of perioperative transfusion requirements, along with the increased postoperative complications rate, increased in-hospital mortality, increased ICU admission rate, and prolonged length of hospital stay. We recommend to adequate preoperative assessment and correction of hemoglobin concentrations to normal values to improve surgical outcomes and reduce complications. https://zenodo.org/record/17732 10.20372/nadre:17732 oai:zenodo.org:17732 eng doi:10.20372/nadre:17731 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Anemia, Transfusion, Mortality, Hospital stay, Emergency surgery, Postoperative complication THE EFFECT OF PREOPERATIVE ANEMIA ON PERIOPERATIVE OUTCOMES AMONG PATIENTS UNDERGOING EMERGENCY SURGERY: A MULTICENTER PROSPECTIVE COHORT STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17746 2025-09-08T08:47:14Z user-007

Adanech Shiferaw 2025-09-08 ABSTRACT Introduction: Postoperative sore throat is one of the common postoperative complications following general anesthesia. Postoperative sore throat causes decreased patient satisfaction, and it affects patients’ wellbeing after surgery, thus identifying its incidence and predictors help to distinguish the preventable causes of postoperative sore throat. Objective: The objective of this study was to assess the incidence and associated factors of postoperative sore throat among pediatrics patients undergoing surgery under general anesthesia at Hawassa university comprehensive specialized hospital. Methods: A prospective cohort study conducted among children with age range 6-16years old who underwent emergency and elective surgical procedures under general anesthesia. Data were entered and analyzed using SPSS version 26 software packages. Univariate and multivariate analysis were performed to investigate the independent predictors. The postoperative sore throat was assessed by using a four point categorical pain scale at 2nd, 6th, 12th and 24th hour postoperative time. Result: A total of 102 children were recruited in this study, from which 27 children (26.5%) complained of sore throat postoperatively. This study found that endotracheal intubation (P value: 0.030; AOR: 3.155; 95% CI [1.114-8.933]) and number of attempt greater than one (P value: 0.027 and AOR: 4.890; 95% CI: [1.203-19.883]) had statistically significant association with postoperative sore throat. Conclusion: The overall incidence of postoperative sore throat was 26.5%. Endotracheal intubation and number of attempt greater than one were independent factors that significantly associated with the occurrence of postoperative sore throat in this study. https://zenodo.org/record/17746 10.20372/nadre:17746 oai:zenodo.org:17746 eng doi:10.20372/nadre:17745 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by INCIDENCE OF POSTOPERATIVE SORE THROAT AND ASSOCIATED FACTORS AMONG PEDIATRICS PATIENTS UNDERGOING SURGERY UNDER GENERAL ANESTHESIA AT HAWASSA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, 2022. A PROSPECTIVE COHORT STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17756 2025-09-08T08:55:51Z user-007

ASRAT ALEMAYEHU 2025-09-08 ABSTRACT Background: Acute malnutrition is public health problem in developing countries. It is caused by deficiencies or imbalances in energy, protein and/or other nutrients. However, there is a study gap in the study area to identify the associated factors of the acute malnutrition related to the socio demographic, environmental and health services, and the child feeding practices. Therefore, identifying its determinant factors is important to intervene in the study area. Objective: To assess the determinants of acute malnutrition among children aged 6–59 months in Wondo Genet district, Sidama, Ethiopia 2022. Method: A community-based unmatched case control study was conducted among under-five children from May, 1st to June 30, 2022. The sample was drawn in proportion to 384 people, from randomly selected 8 kebeles based on the WHO 2006 reference population median. Data were collected from a mother/caregiver of the child by using a structured pre-tested questionnaire by trained data collectors. The anthropometric data was analyzed by the WHO Anthro 2010 software to generate Z-score values. Data was entered and cleaned into STATA V.15. Descriptive analysis and binary logistic regression models were analyzed. A multivariable logistic regression to indicate the association with acute-malnutrition in adjusted odds ratio (AOR). Statistical significance is declared at a p-value of ≤ 0.05. Results: This study included the 181 in the control group and 181 in the cases with response rate of the 94.3%. A child born from a poor household [(AOR = 3.265; 95% CI: 1.828, 5.829)], having more than five family members [(AOR = 1.947; 95% CI: 1.220, 3.108)], and being headed only by the husband [(AOR = 2.059; 95% CI: 1.202, 3.527)] were all associated with under-five child acute malnutrition. In addition to this, a child sick in the last two weeks [(AOR= 1.713; 95% CI: 1.015, 2.891)], having no critical time hand washing practice [(AOR= 1.939; 95% CI: 1.135, 3.312)], and inadequate dietary diversity [(AOR = 3.401; 95% CI: 1.398, 8.273)] were major determinants of the under-five children's acute malnutrition in the study area as compared with their counter parts. Conclusions: Being poor, having more than five family members, husband dominance, and child illness all contributed to under-five malnutrition. This may necessitate intervention in areas such as hand washing and insufficient dietary intake. As a result, health officials and stakeholders must work together to reduce risk factors for a child's health and future. https://zenodo.org/record/17756 10.20372/nadre:17756 oai:zenodo.org:17756 eng doi:10.20372/nadre:17755 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by determinants, acute malnutrition, under five children, Sidama, Ethiopia. DETERMINANTS OF ACUTE MALNUTRITION AMONG CHILDREN AGED 6–59 MONTHS IN WONDO GENET WOREDA, SIDAMA, ETHIOPIA: UNMATCHED CASE CONTROL STUDY. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17778 2025-09-08T09:10:40Z user-007

BINYAM BEKELE 2025-09-08 Abstract Background: Sexually transmitted infections (STIs) are a main public health tricky worldwide, affecting the quality of life and triggering serious illness and death. Achieving effective treatment-seeking behavior is a crucial component of disease prevention, early diagnosis, and management. Objective: To assess treatment seeking behavior and associated factors for sexual transmitted infections among symptomatic students in Hawassa College of Education, Southern Ethiopia, 2022 Methods: School-based mixed methods (cross-sectional quantitative and phenomenological qualitative) study design was employed. Prior to actual data collection a survey was conducted and 532 STIs symptomatic students were identified and among them representative 415 study participants were selected by Simple Random Sampling technique. 2 FGDs and 8 in-depth interviews were done and purposive sampling technique was employed in qualitative study. Data was entered into Epi-data version 3.1 then exported to SPSS version 25 for analysis. Bivariate and multivariate binary logistic regression analysis was used to identify variables significantly associated with outcome variable. Variables having significant association were identified on the basis of the Adjusted Odds Ratio (AOR) with a 95%CI, Variables with p-value 0.05 was declared as statistically significant. Results: The prevalence of treatment seeking behaviour among students in Hawassa College of education is 47.2 %( CI 42.3-52.2). Female students were 0.165 times less likely to seek treatment for STIs compared to those male students (AOR: 0.165, 95%CI, 0.059 0.459), The odds of treatment seeking behaviour for STIs were 3 times more likely among students who not retail medication easily without prescription as compared to their counterparties (AOR: 2.976, 95%CI, 1.023-8.664). Awareness, undermining the burden, Social concern, Stigma, and economic dependency were identified in qualitative study as contributing factors for treatment seeking behaviour. Conclusion: The study identified that the majority of symptomatic students for STIs were not seek treatment in formal health system for their perceived disease, rather they retail drugs from pharmacies, so the concerned body should have control pharmacies not to vender medication without a prescription. https://zenodo.org/record/17778 10.20372/nadre:17778 oai:zenodo.org:17778 eng doi:10.20372/nadre:17777 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Treatment seeking behavior, STIs, Dilla University, Southern Ethiopia. TREATMENT SEEKING BEHAVIOUR AND ASSOCIATED FACTORS FOR SEXUAL TRANSMITTED INFECTIONS AMONG SYMPTOMATIC STUDENTS. THE CASE OF HAWASSA COLLEGE OF EDUCATION, SOUTHERN ETHIOPIA, 2022: A MIXED METHOD STUDY. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17786 2025-09-08T09:13:41Z user-007

TADELE TESEMA 2025-09-08 Abstract Introduction: Puerperal sepsis is bacterial infection of genital tract that occurs at any time between the onset of rupture of membranes or labour and the 42nd days postpartum. It ranks third leading cause of direct maternal mortality in developing nations. It is the fourth leading cause of maternal death and accounts about 14.68% in Ethiopia. Although multiple interventions were done to tackle this health problem, maternal morbidities and mortality were still high. Objective: To identify the determinants of puerperal sepsis among postpartum women at public hospitals, in Gedeo zone, Southern Ethiopia 2020. Methodology: This facility-based unmatched case-control study included 252 participants from February 20– May 20/2020. Cases recruited conveniently while controls enrolled by systematic sampling. Data was collected using interviewer administered questionnaire and the collected data was entered in to Epi data version 3.1 which was then exported to statistical package for social science version 22 for analysis. The association between variables was analyzed with bivariate and multi variable logistic regression. Multicollinearity was checked by variance inflation factor. Hosmar and Lemeshow test was used for model adequacy. A statistical significance was declared at p value < 0.05, with 95% confidence interval. Result: A total number of 252 (63 cases and 189 controls) study participants involved in the present study yielding a response rate of 96.9%. Participants" age ranges from 17 to 38 years. After adjusting for the possible confounders, age <25 years [AOR=2.37, 95%CI (1.08-5.21)], rural residence [AOR=4.83, 95% CI (2.04-11.40)], no antenatal care [AOR=6.10, 95%CI (2.54-14.67)], mode of delivery (caesarean section) [AOR=4.32 95% CI (1.39-13.43)] and having referral [AOR=2.39, 95% CI (1.02-5.62)] were found to be significant determinants for puerperal sepsis among postpartum women at public hospitals in Gedeo zone, Southern Ethiopia. Conclusion- Age, residence, antenatal care, mode of delivery and referral status were found to be significant determinants for puerperal sepsis. Scaling up antenatal care for women was warranted for health extension workers. https://zenodo.org/record/17786 10.20372/nadre:17786 oai:zenodo.org:17786 eng doi:10.20372/nadre:17785 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Puerperal sepsis, Determinants, Gedeo zone, Southern Ethiopia DETERMINANTS OF PUERPERAL SEPSIS AMONG POSTPARTUM WOMEN AT PUBLIC HOSPITALS, IN GEDEO ZONE, SOUTHERN ETHIOPIA: A CASE CONTROL STUDY 2020 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17772 2025-09-08T09:06:25Z user-007

YOSEF LELAMO 2025-09-08 Abstract Background: As Antiretroviral treatments improves the health of mothers, repeated pregnancy among HIV infected women become increasing .However, in sub Saharan Africa where family planning among People Living With HIV/AIDS is not widely used, the risk of mortality due to HIV/AIDS increase as the number of pregnancy increases .The desire to have more children among these groups of people in Ethiopia is also increasing. Objective: This study was aimed to assess determinants of repeated Pregnancy among HIV positive Women on Antiretroviral Treatments in Gedeo Zone, public health facility, Southern Ethiopia 2020. Methods and materials: A facility based unmatched case control study was conducted among 76cases (women with repeated pregnancy) and 228controls (women with first pregnancy) since HIV infection for both case and controls and who are on Prevention of Mother toChild Transmission program in the selected health facilities. The participants were selected by simple random sampling technique. Data was collected using face-to face interview. Data was entered by using Epidata3.1 and exported to SPSS version 20 for analysis purpose.Bivariate logistic regression was used to see the association between one explanatory variable and outcome variable at p value<0.25. Hosmer- Lemeshow method was used to test the model fitness. Multivariable logistic regression analysis was performed to identify determinant factors which affect the dependent variable. Those variables with adjusted odd ratio and p value < 0.05, at 95%Confidence Interval were declared statistically significant in multivariable analysis. Result: The mean age of cases 25.5 (Standard Deviation: ± 3.6) was less than that of the controls 28 (Standard Deviation: ± 5). Determinants which were found to be associated with repeat pregnancies were history of abortion,[AOR=4.75, 95 %CI (2.13 – 10.57)], low educational attainment [AOR= 4.62,95%CI (1.69-12.67)] ,30-43years of age [AOR=0. 23, 95%CI,(0.10 0.56)], Employment status[AOR=0.19,95%(0.06-0.52)] AOR=0.10,95%CI(0.05 -0.22)]. and urban residence[ Conclusion: The results of this study suggest that repeated pregnancies were more common among HIV-infected women who have history of abortion, low educational attainment. Appropriate reproductive health services to be provided for HIV positive pregnant women who are and treated with ART. https://zenodo.org/record/17772 10.20372/nadre:17772 oai:zenodo.org:17772 eng doi:10.20372/nadre:17771 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by repeated pregnancy, determinants, Gedeo zone DETERMINANTS OF REPEATED PREGNANCY AMONG HIV POSITIVE WOMEN ATTENDING ANTRETROVIRAL TREATMENTS IN GEDEO ZONE PUBLIC HEALTH FACILITIES, SOUTHERN ETHIOPIA,UNMATCHED CASE CONTROL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17792 2025-09-08T09:17:12Z user-007

MULUALEM ABATE 2025-09-08 ABSTRACT: Introduction: Human immune virus Testing and Counseling (HTC) is the gateway to accessing anti-retroviral treatment. Families of Index clients as priority population groups have been largely neglected due to the number of different factors; this high-risk group constitutes a critical mass that must be reached to attain HIV epidemic control. Objective: This study aimed to determine the magnitude of HIV-tested families of index cases and associated factors among adult ART clinic attendants at Gedeo zone, southern Ethiopia, 2021. Methods and Materials: A facility-based cross-sectional study was conducted by using pretested adapted structured questioners in ART clinics of Gedeo Zone. Data were collected from adult ART Clinic attendants using a simple random sampling technique and the sample size was 398. The data was entered into Epidata Version 3.03 computer software. Finally, the whole data was exported to SPSS Version 20 for analysis, frequency percentages, and cross-tabulation of categorical data for all variables, and the association between variables have been checked using bivariate and multivariate binary logistic regression analysis. Result: A total of 384 index clients who are on ART care have participated in the study with a response rate of 96.4%.The mean age of the respondents was 36.4 years (SD ±_6.9). The prevalence of participants who are on anti-retroviral treatment and care (ART) who tested at least one member from partner and children were 258(67.2%). Of the 523 family members tested, 176 (35.7%) were partners and 336 (64.2%) were children. with HIV positivity of 98 (57%) and 23 (6.8%) for partners and children respectively. The overall HIV positivity was 23 % (121 positives out of 423 tested). Sex of index client [AOR=4.73:95% CI (2.44,9.11)]Method of first HIV test.[AOR=0.36:95% CI(0.14,0.95)], adherence[AO 0.14:95%CI(0.05,0.37] , residency distance from ART site [AOR 3.17: CI (1.67, 6.28)] , Disclosure of HIV status[AOR: 7.39, 95% CI (3.7,14.64)]are finally significantly associated . Conclusion and Recommendation The study indicated that testing the family of 'index' cases is a high-yield and efficient identification strategy in terms of positivity when compared to other testing approaches and can serve as an entry point for the identification of partners who didn't know their status and children living with HIV not identified through PMTCT program testing. Improving the accessibility of ART service, improving the adherence status of index cases, disclosure of HIV status and preference of the ART site to nearer to residency increases the coverage of index case HIV testing. This type of HIV testing approach enables parents and their children to access care together. Such approaches offer convenient services for families affected by HIV. https://zenodo.org/record/17792 10.20372/nadre:17792 oai:zenodo.org:17792 eng doi:10.20372/nadre:17791 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Index case, Index case testing, HIV testing, Partner notification service, Gedeo, Ethiopia ASSESSMENT OF FAMILY INDEX CASE HIV TESTING AND ASSOCIATED FACTORS AMONG ADULT ART CLINIC ATTENDANTS OF GEDEO ZONE, SOUTHERN ETHIOPIA A CROSS-SECTIONAL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17802 2025-09-08T10:43:40Z user-007

MEKONEN BINAYEW 2025-09-08 ABSTRACT Introduction: -Many women throughout the world experienced more than one induced abortion in their life. In Ethiopia despite the availability of modern family planning methods, repeated induced abortion remained 30% and previous studies did not address factors fully. Objective:-To identify determinants of repeated induced abortion among reproductive age group women at health facilities of Sidama region, Ethiopia 2020. Methodology:- Health facility based unmatched case-control study was done in Sidama region among 369 women assuming 1:2 case to control ratio and proportional allocation was made. Cases and controls were selected consecutively. Pretest was done at Gedeo zone and order of the questionnaire was corrected after pretest. Interviewer administered method of data collection was used and data was cleaned, coded, entered to Epidata version 3.1 and exported to SPSS version 20 for analysis. Frequencies, percentages, mean and standard deviation were calculated. Bivariate analysis was done to identify associated factors. Variables with p-value of < 0.25 in bivariate analysis were entered to multivariate analysis after checking multicollinearity effect by tolerance and variance inflation factor. Hosmer and Lemeshow test result > 0.05 (p = 0.41) indicated model was fitness to the data. In multivariate analysis model, variables with p-value of < 0.05 were considered as determinants of repeated induced abortion. Result: -A total of 108 cases and 242 controls completed the interview which made a response rate of 94.9%.Mean age of respondents was 29 years (SD ±3.7) for cases and 26 years (SD ±4.5) for controls. After adjusting for confounders being urban residents (AOR, 95% CI =4.9 [2.1 - 11.3] ), attended primary education (AOR, 95% CI = 0.21 [0.06 - 0.8] ),having multiple sexual partner (AOR ,95% CI=2 [1.1 - 3.7] ), not aware of fertility cycle (AOR ,95% CI= 6.8 [2.5 - 18.2] ) ,started sex before age of 18 years old (AOR,95% CI=4 [1.9-8.7] ) and not perceived abortion as painful procedure (AOR, 95% CI =2.5 [1.2 - 5.3] ) were determinant factors. Conclusion & recommendation: -This study identified residence, educational, number of sexual partner, age at first sex, fertility awareness and perception of abortion pain were determinant factors. Education, health information, family free discussion & reproductive health service utilization should be promoted. https://zenodo.org/record/17802 10.20372/nadre:17802 oai:zenodo.org:17802 eng doi:10.20372/nadre:17801 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Repeated induced abortion, Sidama regional state. DETERMINANTS OF REPEATED INDUCED ABORTION AMONG REPRODUCTIVE AGE GROUP WOMEN AT HEALTH FACILITIES OF SIDAMA REGION, ETHIOPIA, 2020: Case-control study. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17800 2025-09-08T09:20:52Z user-007

MELKAMU ENJAMO 2025-09-08 Abstract Background: Premature rupture of membranes (PROM) defined as breakage of the chorioamniotic membrane as a result passing a gush of fluid through birth canal before the onset of true labor. Though the prevalence of premature rupture of membrane varies country to country, it complicates 4 to 10% pregnancies worldwide. It has overwhelming effect both maternal and neonatal health. Neonates born from woman with premature rupture of membrane had high risk of respiratory distress syndrome, sepsis and prematurity. Even though many interventions implemented to tackle it the problem still persisted. Objective: This study was intended in identifying determinants of premature rupture of membrane among pregnant women who have visited labor wards of four hospitals found in Gedeo zone Southern Ethiopia. Methods: Hospital-based unmatched case control study was conducted from February 25 to May20, 2020. Data were collected among 75 cases and 223 controls using face-to-face interviews. Cases were recruited consecutively as they have arrived study hospital and every six pregnant women after the cases admitted to the ward were recruited as controls. Data were entered into Epidata 3.1 and analyzed by SPSS 20. Bivariate and Multivariable logistic regression used to check association between dependent and independent variables, statically significance declared at p-value < 0.05. Result A total of 75 cases and 223 controls were enrolled in the study. Hypertension during index pregnancy [AOR= 2.807(95% CI: 1.09-7.23)], history of abortion [AOR= 3.7(95% CI: 1.41-9.73)], history of caesarean section [AOR= 3.46(95% CI: 1.34-8.9)] and history of PROM [AOR= 4.77 (95% CI: 2.31-9.89)] were determinants of premature rupture of membranes. Conclusion hypertension during index pregnancy, history of abortion, history of PROM and history of cesarean section has an association with premature rupture of membrane. The result of the study suggests early identifying who had bad obstetric history and treatment of hypertension in pregnant women lessens the risk of premature rupture of membrane. https://zenodo.org/record/17800 10.20372/nadre:17800 oai:zenodo.org:17800 eng doi:10.20372/nadre:17799 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Premature rupture of membrane, Determinants, Southern Ethiopia, Case-control study DETERMINANTS OF PREMATURE RUPTURE OF MEMBRANE AMONG PREGNANT WOMEN VISITED LABOR WARD IN PUBLIC HOSPITALS, GEDEO ZONE,SOUTHERN ETHIOPIA: A CASE CONTROL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17866 2025-09-09T06:10:41Z user-007

Kalkidan Gezahegn 2025-09-09 ABSTRACT Introduction: Housemaids are the most vulnerable group to sexual violence due to their working condition, isolation and their school arrangements. Even though evidence suggests that sexual violence is the common phenomena of domestic work sector, it is a neglected area of research particularly in Ethiopia including the study area. Objective: To assess the prevalence and factors associated to sexual violence among housemaids attending evening school program in urban setups of Gedeo zone, Southern, Ethiopia 2019. Method: A school based cross sectional study design supplemented with qualitative inquiry was used to collect data among 394 randomly selected housemaids attending night schools in urban setups of Gedeo Zone from April to May 2019. Quantitative data was collected using face to face interview then entered using EPI DATA 3.1 and analyzed by using SPSS version 20 application software. Binary logistic regression was fitted to determine the association of each independent variable with the dependent variable. For qualitative inquiry focus group discussion, in-depth interview, key informant interviews were performed among purposively selected respondents. After the collected information was transcribed, translated, coded and categorized, thematic analysis was employed and the result was finally used to explain and augment the results of quantitative findings. Result: The study revealed that, the prevalence of life time sexual violence among house maids attending night schools in urban setups of Gedeo zone was 60.2%,of these 11.2% were raped ,19% faced an attempted rape and 58.4% were reported to have faced sexual harassment .The odds of experiencing sexual violence in working life time as housemaid were lower for those who were not involved in a relationship currently [AOR.=0.28: 95% CI ,( 0.13 , 0.57 )] ,but higher for those whose childhood residence were rural [AOR =1.97: 95 % CI ,(1.07,3.63 )] ,have less than 5 years of experience as housemaid [ AOR = 3.10 : 95 % CI , ( 1.60 , 6.00 ) ] , age 15-19 [ AOR = 3.75 :95 % CI (1.88 ,7.46 ) , used Alcohol [ AOR = 6.77 : 95 % CI,( 2.65,17.33)] and fathers did not have formal education [AOR= 2.75 :95%CI,( 1.24,6.08)]. From qualitative finding being night student, having boyfriend, being young, being new to the environment, drinking alcohol were exposing housemaids to sexual violence Conclusion and recommendation: life time Sexual violence was found to be a problem among housemaids attending night schools in urban setups of Gedeo Zone, Southern Ethiopia in this study. Involvement in a relationship, childhood residence, work experience as housemaid, age of i a housemaid, life time alcohol use by housemaid, and father educational status were factors associated with life time sexual violence. To overcome the problem Gedeo zone women, children and youth affairs, Gedeo zone labour and social affair, social Medias and non-governmental organizations should work with greatest accountability for housemaids in terms of protection. https://zenodo.org/record/17866 10.20372/nadre:17866 oai:zenodo.org:17866 eng doi:10.20372/nadre:17865 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by sexual violence; housemaids; evening school; Gedeo zone SEXUAL VIOLENCE AND ITS ASSOCIATED FACTORS AMONG HOUSEMAIDS ATTENDING EVENING SCHOOLS IN URBAN SETUPS OF GEDEO ZONE, SOUTHERN ETHIOPIA 2019: A SCHOOL BASED CROSS SECTIONAL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17874 2025-09-09T06:14:00Z user-007

Hosaena Moges 2025-09-09 ABSTRACT Introduction: Integrated Management of Neonatal and Childhood Illness strategy is a management of the most common childhood conditions, with a focus on the most important causes of death. The IMNCI has been implemented in Ethiopia for years. Nevertheless, there is limited information and evidence on its implementation status and operational constraints which has limited the development of intervention strategies in line with child mortality rate reduction. Objective: To assess implementation of Integrated Management of Neonatal and Childhood illness Guidelines among health professionals and associated factors at public health facilities in Gedeo Zone, Southern Ethiopia,2021. Methods: A cross sectional study was conducted among 286 randomly selected health professionals at Gedeo Zone. Data were collected using Self-administered questionnaire. The collected data were cleaned, coded and entered into epi-data and exported to SPSS version 21 for data analysis. Descriptive statistics was used to describe the study population in relation to socio-demographic and other relevant variables. Binary logistic regression was used to identify factors associated with implementation of IMNCI. In the variable model, covariates with p-values ≤ 0.25 were selected to be included in the multivariable model. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) and p-value of ≤ 0.05was computed to show the strength of the association. The model fitness was checked using Hosmer Reshow model with the P-value of > 0.05. Results: Data were obtained from 286 health professionals working in four districts, with a response rate of 100%. The high-level implementation of IMNCI among health professionals in selected districts of Gedeo Zone was 75.2%. Receiving IMNCI training (AOR: 2.48; 95% CI: 1.12, 5.49) and level of qualification with first degree and above (AOR: 3.31; 95% CI: 1.58, 6.95) were independent determinants of implementation of IMNCI. Conclusion: There was Good implementation of IMNCI guideline among health professionals in selected districts of Gedeo Zone. Receiving IMNCI training and level of qualification with first degree and above were independent determinants of implementation of IMNCI. https://zenodo.org/record/17874 10.20372/nadre:17874 oai:zenodo.org:17874 eng doi:10.20372/nadre:17873 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Gedeo Zone, Implementation, Integrated Management of Neonatal and Childhood Illness Implementation of Integrated Management of Neonatal and Childhood illness Guidelines among health professionals and associated factors at public health facilities in Gedeo Zone, Southern Ethiopia,2021 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17860 2025-09-09T06:06:26Z user-007

MAEREGAYEHU TIBO 2025-09-09 Abstract Background: Postpartum family planning is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months of childbirth. Globally over 9 out of 10 women want to avoid pregnancies after having birth, but 1 in 7 women aren't using family planning as a result, larger numbers of women get pregnancy within 7- 9 months of childbirth. Objective: The aim of this study was to estimate the time to initiate postpartum modern contraceptive use and associated factors among women of reproductive age group within the first 12 months of delivery in Della town, south Ethiopia 2020 G.C. Methods: Community based retrospective follow up study from March 25, 2019 up to March 25, 2020 G.C was conducted in Dilla town. Systimatic sampling technique was used to select 594 study participants. Data was collected using interviewer administered questionnaire and entered by EPI data version 3.1 then exported to SPSS version 20 for analysis. Kaplan Meier survival curve together with log-rank test used to estimate the time to initiate postpartum modern contraceptive. A Cox proportional hazards model was used to determine factors associated with time to initiate postpartum modern contraceptive use at 95% CI with P-value of < 0.05. Result: A total 576 postpartum women were participated making a response rate of 96.9%. The median time to initiate postpartum modern contraceptive use was 7 months (IQR: 6, 8). Primary education [AHR=3.01 (95% CI=1.32, 6.83)], Decide jointely with partner on family planning use [AHR=8.85 (95% CI=5.00, 15.6)], Menses resumption [AHR=9.24 (95% CI=4.95, 17.2)], good knowledge on family planning [AHR=1.56(95% CI=1.20, 2.02)], travel < Half hour to health facility [AHR=1.75, (95% CI=1.05, 2.92)], having ≥4 antnatal care vists [AHR=2.47(95% CI=1.17, 5.19)] and family planning counseling during postnatal care [AHR=2.22 (95% CI=1.46, 3.38)] were factors positively associated with time to initiate postpartum modern contraceptive. Conculsion: The time to initiate postpartum modern contraceptive use was delayed than world health organization recomendation. Factors positively associated with time to initiate postpartum modern contraceptive use were: Education level of women, Decide jointly with partner on family planning use, Menses resumption, Knowledge on family planning, Number of antnatal care vists, distance to health facility and Family planning counseling during postnatal care. https://zenodo.org/record/17860 10.20372/nadre:17860 oai:zenodo.org:17860 eng doi:10.20372/nadre:17859 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Time to initiate; Modern contraceptive; Use; Postpartum period; Ethiopia. TIME TO INITIATE POSTPARTUM MODERN CONTRACEPTIVE USE AND ASSOCIATED FACTORS AMONG WOMEN OF REPRODUCTIVE AGE GROUP WITHIN THE FIRST 12 MONTHS OF DELIVERYIN DILLA TOWN, SOUTH ETHIOPIA 2020 G.C: (A RETROSPECTIVE FOLLOW UP STUDY) info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17878 2025-09-09T06:18:06Z user-007

HAILUTAYE 2025-09-09 ABSTRACT Introduction: Gestational diabetes mellitus is glucose intolerance that is firstly confirmed during pregnancy. A pregnant women with diabetes and her unborn child are at increased risk of pregnancy complication and adverse neonatal out comes. 5 in every 200 pregnant women will develop gestational diabetes. Early identification, close monitoring and management of diabetes mellitus among pregnant women can meaningfully improve pregnancy and birth outcome. Objective: The aim of this study was to identify the determinants of gestational diabetes mellitus among pregnant women attending antenatal care service in Gedeo Zone, Southern, Ethiopia, 2020. Methods: A case control study was conducted among pregnant women visited antenatal care service in Hospital of Gedeo Zone.80 cases and 240 controls were selected and interviewed with a structured questionnaire.Data was collected by trained data collectors using pretested and structured questionnaire. The data were entered using Epi Data version 3.1 and analysis was carried out using SPSS version 20.00. Logistic regression was applied to show the association of independent variables with dependent variables. Result:A total of 320( 80 cases and 240 control) pregnant women were selected and interviewed.After adjusting variables for the confounding effect GDM is significantly associated only with family history of diabetes mellitus.[AOR 1.837; 95% CI (1.059-3.189)],history of spontaneous abortion[AOR 2.397; 95% CI 1.33-4.310), history of Still birth [AOR2.240(1.222-4.105)],history of gave macro baby birth in the previous pregnancy[1.991(1.157-3.427) ]. Conclusion:- The variables; family history diabetes mellitus , history of abortion, still birth;and macro baby were found to be possible determinants of gestational diabetes mellitus among pregnant women. Women with gestational diabetes mellitus should be followed after delivery in order to monitor hyper glycemic status and link them to treatment service https://zenodo.org/record/17878 10.20372/nadre:17878 oai:zenodo.org:17878 doi:10.20372/nadre:17877 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Determinants of gestational diabetes mellitus;Southern Ethiopia;Gedeo Zone. DETERMINANTS OF GESTATIONAL DIABETIS MELLITUS AMONG PREGNANT WOMEN ATTENDING ANC SERVICE IN GEDEO ZONE, SOUTHERN ETHIOPIA; A HOSPITAL BASED CASE CONTROLSTUDY. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17894 2025-09-09T06:41:48Z user-007

ASHENAFI AGARO 2025-09-09 ABSTRACT Background: Hand hygiene is an important measure to prevent and control infection particularly in developing countries, the identification of several risk factors associated with poor hand hygiene compliance of extreme importance. The burden of communicable diseases in developing countries mainly caused by poor personal hygiene practices. Hence, the identification of several risk factors associated with poor hand hygiene compliance is extreme importance. Objective: to assess the magnitude of hand-washing practice at critical times and associated factors among mothers of under-five children in Gedeo zone health facilities, southern Ethiopia in 2021. Method: A facility-based cross-sectional study was carried out from January 1/2021 to February 1/2021. Data was collected from 422 respondents by random sampling. The data collection tool was a pretested semi-structured questionnaire by face-to-face interview. Data were checked for completeness and consistency, then, coded and entered into Epi-data version 3.1 and the analysis was by SPSS, v 25. Descriptive statistics to describe the study variables. The association between independent variables with outcome variables were examined by using multivariable logistic regression. Finally, AORs at 95%CI and P-values<0.05 were used to declare statistical significance. Results: The magnitude of good hand washing practice at critical times was reported 183 (44.9%), (95% CI: 40.1 - 49.7). Mothers who had Primary [AOR = 3.678, 95% CI (1.808, 7.484) and Secondary and above [AOR = 4.053, 95% CI (1.871, 8.781), The household monthly income above 3342 ETB [AOR = 4.076, 95% CI (2.01, 8.24) and the desirable attitude about hand washing practice at critical times [AOR = 7.77, 95% CI (4.56, 13.27) were significantly higher as compared with their counterparts. Conclusion: hand-washing practice at critical times of the respondents in the study area was found to be low compared with other previous studies conducted by Debark, 52.2%. A significant number of mothers of under-five children have poor hand washing practices at critical times. It is necessary to increase the income access to water and the health officials, institutions and stakeholders need to work on those factors to improve knowledge and attitude of mothers to improve their hand-washing practice at critical times. https://zenodo.org/record/17894 10.20372/nadre:17894 oai:zenodo.org:17894 eng doi:10.20372/nadre:17893 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Practice, critical times hand washing, factors, Gedeo zone, southern Ethiopia. ASSESSMENT OF HAND-WASHING PRACTICE AT CRITICAL TIMES AND ASSOCIATED FACTORS AMONG MOTHERS OF UNDER-FIVE YEARS CHILDREN IN GEDEO ZONE DILLA ZURIA HEALTH FACILITIES, SOUTHERN ETHIOPIA info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17890 2025-09-09T06:37:17Z user-007

ZERIHUN WORKU 2025-09-09 ABSTRACT Background: Next to HIV, TB is the second leading cause of death from an infectious disease worldwide. The WHO declared TB as a global public health emergency in 1993 when many deaths occurred due to TB. Globally, TB has been reported to be one of the major causes of death among children. Approximately 1 million children are estimated to be infected by TB worldwide of which 75% occurs in the 22 high-burden countries including Ethiopia. In high-TB burden countries, childhood TB constitutes 20–40% case load. Objective: To assess the determinants of active tuberculosis among HIV-positive children’s currently on antiretroviral therapy in public health facilities of Guji Zone, southern Ethiopia. Methods: The study was conducted in Guji zone public health facilities, through a facility based unmatched case control study design in the year 2021/2022.By computer generated random sampling method cases and controls were selected proportional to size to the number of patients attending care in each public health facilities. About 123 TB/HIV co-infected patient were selected as cases and 246 HIV infected without TB infection were selected as controls. Data were entered into Epidata version 3.1 and analyzed by using SPSS version 25. Bi-variable and multivariable logistic regression analyses were done. A P-value of < 0.05 was used as the criterion for statistical significance. Result: Clients whose CD4 count 300 per cell (AOR 95% CI: 4.17,2.229-6.912). children who were taking TPT were 0.22 times less likely to develop TB than children who were not on TPT (AOR 95%CI: 0.22, 0.133-0.833). A child who has family history of TB was 2.66 times more likely to have tb than children who has not family history of TB (AOD 95%CI: 2.66, 1.561-4.801). Conclusion and recommendation TB was found to be high among patients with CD4 cell count <300/ml, WHO clinical stage III and IV, with hemoglobin level of less than 12 mg/dL, patients who had not received INH prophylaxis and patients who had contact history with TB patients. An overall contact tracing activities as well as INH prophylactic preventive measures should be strengthened to manage cases as early as possible. https://zenodo.org/record/17890 10.20372/nadre:17890 oai:zenodo.org:17890 eng doi:10.20372/nadre:17889 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Determinants, Tuberculosis, HIV-positives children, public health facilities, Guji zone, Southern Ethiopia. DETERMINANTS OF TUBERCULOSIS AMONG HIV POSITIVES CHILDREN CURRENTLY ON ART IN PUBLIC HEALTH FACILITIES OF GUJI ZONE, SOUTHERN ETHIOPIA: -UNMACHED CASE CONTROL STUDY. info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17898 2025-09-09T06:46:14Z user-007

ATNAFU ADEM 2025-09-09 Abstract Introduction: Globally around two and half million neonatal mortality occurred in 2017, especially in developing countries. In Ethiopia, about 87,000 neonates die each year. Also, the recent Ethiopia mini demographic health survey of 2019 indicated that 30 deaths per 1000 live births. However, there are few studies on determinants of neonatal mortality at the institution level in Ethiopian intensive care units. Objective: To assess the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia, 2020. Methods: An unmatched case-control study was conducted from February, 24 to March 6, 2020. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by SPSS Version 22. Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95% CI and P-values <0.05 were used to declare statistical significance. Result: In this study, a total of 304 cases were assessed with 100% reviewed rate. It was found that referrals from other health facilities, AORs = 2.43, 95% CI (1.14, 5.22), gestational age <37 weeks, AORs = 2.50, 95% CI (1.12, 5.58), the weight of newborn <2500g, AORs = 2.44, 95% CI (1.13, 5.28), neonates positive for sepsis, AORs = 2.45, 95% CI (1.11, 5.41) and neonates who not breastfed within first hour after delivery, AORs =5.24, 95% CI (2.42, 11.37) were statistically significant determinants to neonatal mortality. Conclusion: Referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. Therefore, most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care. https://zenodo.org/record/17898 10.20372/nadre:17898 oai:zenodo.org:17898 eng doi:10.20372/nadre:17897 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Neonatal mortality, Intensive Care Unit, determinants, Dilla, Southern Ethiopia. DETERMINANTS OF NEONATAL MORTALITY AMONG NEWBORNS ADMITTED IN NEONATAL INTENSIVE CARE UNIT AT DILLA UNIVERSITY REFERRAL HOSPITAL IN GEDEO ZONE SOUTHERN ETHIOPIA, 2020: UNMATCHED CASE CONTROL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17906 2025-09-09T06:52:49Z user-007

ALMAZ MITIKU 2025-09-09 Abstract Background: The cervical precancerous lesion is a slowly progressive disease that starts with the mild form then grows to the cancer stage[1]Cervical cancer is usually developed after prolonged phase of cervical precancerous lesion in the cervix. Therefore, early identification and treatment at its pre-invasive stage may benefit the clients and decrease the burden of morbidity and mortality resulting from cervical cancer Objective: To identify the determinants of cervical precancerous lesions among women screened for cervical cancer in Hawassa, Southern Ethiopia 2019. Methods: A facility-based unmatched case-control study design was used to identify factors associated with cervical-precancerous lesions in private and public health facilities in Hawassa city, 2019. A two-stage sampling technique was implemented to draw observation units for this study. The total sample size was293 (98 cases and 195 controls). Semi- structured questionnaire was used for data collection .Data was collected by using semi-structured questionnaire and entered into EPI Data version 3.1 and exported into SPSS version 20 application software. Bivariate and multivariate logistic regression models were used to identify independent determinants of cervical precancerous lesion Result Precancerous cervical cancer lesion among women screened for cervical cancer were significantly associated with the primary and lower level of education (AOR=0.06, 95% CI = 0.01-0.38) women with sexual partner who had history of sexual transmitted infection (AOR=8.54, 95% CI=2.42-30.11), having two or more lifetime sexual partners (AOR= 5.45, 95% CI= 1.62_18.32), sexual debut between 15-17years (AOR=0.01, 95% CI= 0.00-0.09) and history of pelvic infection (AOR=3.47, 95% CI = 1.08-11.17). Conclusion: Lower level of education (primary and never educated), age of first sex, lifetime partner of women, pelvic infection, two or more lifetime sexual partners of the husband and lifetime history of sexually transmitted infection of the husband were found to be risk factors for the cervical precancerous lesion in this study. Recommendations. I recommend to the Chief Health Promotion Officer to strengthen health education on barrier methods to prevent STIs and educate girls on the risk of cervical cancer posed by early sexual debut and having multiple sexual partners. to have screening program for all women with reproductive age group who come to the health facility https://zenodo.org/record/17906 10.20372/nadre:17906 oai:zenodo.org:17906 eng doi:10.20372/nadre:17905 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by cervical cancer, cervical precancerous lesion DETERMINANTS OF CERVICAL PRECANCEROUS LESION AMONG WOMEN SCREENED FOR CERVICAL CANCER IN PIVATE AND PUBLICHEALTH FACILITIES IN HAWASSA CITY, SOUTHERN ETHIOPIA 2019 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17908 2025-09-09T06:55:53Z user-007

ABERA HULA 2025-09-09 ABSTRACT Background: Dysmenorrhea is a gynecological medical condition which characterized by severe uterine pain during menstruation. Approximately 10–15% of females experience monthly menstrual severe pain, enough to stop normal daily functions at work, home, or school. Objectives: The aim of this study was to assess the determinants of dysmenorrhea among adolescent female students attending high school and preparatory schools in Gedeo zone, southern Ethiopia, 2019. Method: School based unmatched case control study design was conducted to assess the determinants of dysmenorrhea among adolescent female students attending high school and preparatory school in Gedeo zone. Systematic sampling techniques were used to select 552 girls from eligible schools. Data was collected using pre tested structured questionnaires. Data entered into Epi Data software version 3.1 and analyzed by SPSS version 20. Binary logistic regression was used to identify associated factors at bivariate level and variables with p-value less than 0.25 at bivariate level were candidate for multivariate logistic regression. Multivariate analyses were used to filter significant association between dependent and independent variables at 95% confidence intervals. Result: A total of 552 participants (276 cases and 276 controls) were participated in this study. The mean ages of cases were 18.3 with +3.87years SD (standard deviation) and 16.8 with +1.45 years SD for controls. The factors that are significantly associated with dysmenorrhea were early adolescent [AOR = 2.21, 95% CI; (1.22-4.005)], having/ not having family history of dysmenorrhea [AOR = 4.479, 95%, CI; (2.654 - 7.560)], duration of menstrual flow =< 2 days [AOR = 2.14, 95% CI; (1.176 - 3.897)]; and smoking cigarette [AOR = 0.01, 95%, CI; (0.046 - 0.614)]. Conclusions: Dysmenorrhea is a significant symptom for women of reproductive age. It is one of the leading causes of absenteeism from school and work. Adolescent female students with early age of menarche, having family history of dysmenorrhea, and longer duration of menstrual flow, drinking alcohol, smoking cigarette and coffee consumption are more likely to experience dysmenorrhea. Based on this study finding, the school and health workers should give attention and educate to those particular vulnerable adolescents to improve their life style. https://zenodo.org/record/17908 10.20372/nadre:17908 oai:zenodo.org:17908 eng doi:10.20372/nadre:17907 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Adolescents, Dysmenorrhea, Menarche, Cases, Controls DETERMINANTS OF DYSMENORRHEA AMONG ADOLESCENT FEMALE STUDENTS ATTENDING SECONDARY AND PREPARATORY SCHOOLS IN GEDEO ZONE, SOUTHERN ETHIOPIA, 2019 info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17902 2025-09-09T06:49:19Z user-007

AMANUEL NEGASH 2025-09-09 ABSTRACT Introduction: - Client satisfaction is defined as client reported outcome measure while the structure and processes of care can be measured by client reported experiences. Satisfaction has significant public health impact on reducing maternal and neonatal mortality substantially across the globe by giving information on the gaps of health care service from client perspective. Objective: - Aimed to determine level of maternal satisfaction with basic emergency obstetric and new born care services and associated factors among mothers who gave birth in public health facilities of Gedeo zone, Southern, Ethiopia 2020. Methods: - Institutions based cross sectional study was conducted in Gedeo zone, Southern, Ethiopia. Systematic sampling technique was used to select 413 mothers. Structured questionnaire was used to collect data. Data was entered, using Epidata version 3.1 and analyzed using SPSS version 20. Descriptive statistics was used state frequencies and percentages for categorical variables. Factor analysis was used to determine overall level of client satisfaction. After that binary logistic regression was used to identify association between dependent and independent variables. Variables which had P≤0.25 on the bivariate logistic analysis were considered as candidates’ for multivariable binary logistic regression. Model fitness was assessed using Hosmer and Lemeshow test result of 0.70. Finally, AOR at 95%CI and p-value <0.05 were considered statistically significant. Result:- Overall mothers satisfaction with basic emergency obstetric and new born care service in this study was 44.8% at 95%CI (39.7%-49.4%).Age ≥35 years and above [AOR=3.44, 95%CI(1.32,9.97, presence of birth companion [AOR=1.66, 95%CI (1.02, 2.72)], presence/absence toilets [AOR=3.61, 95%CI (2.05, 6.36)], presence/absence waiting home [AOR=2.79, 95%CI (1.09, 7.17)] were significantly associated with client satisfaction with BEMONC service. Conclusion: - The overall satisfaction of mothers with basic emergency obstetric and new born care service was sub optimal.Materanal age, presence of birth companion, availability of maternity waiting home, availability of clean and functional toilets were factors that significantly associated with mothers’ satisfaction with basic emergency obstetric and new born care services. https://zenodo.org/record/17902 10.20372/nadre:17902 oai:zenodo.org:17902 eng doi:10.20372/nadre:17901 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by Satisfaction, BEMONC, mothers, South Ethiopia MATERNAL SATISFACTION WITH BASIC EMERGENCY OBSTETRIC AND NEW BORN CARE SERVICES AND ASSOCIATED FACTORS AMONG MOTHER WHO GAVE BIRTH IN PUBLIC HEALTH FACILITIES OF GEDEO ZONE, SOUTHREN ETHIOPIA,2020:- A CROSS SECTIONAL STUDY info:eu-repo/semantics/doctoralThesis publication-thesis

oai:zenodo.org:17914 2025-09-09T07:04:38Z user-007

Workinesh Yonoka 2025-09-09 ABSTRACT Back ground: Short birth interval, defined as the number of months less than thirty-six months between two consecutive live birth. It has a critical effect on the population size and the health status of the mothers and her child. Short birth intervals have been associated with adverse health outcomes, including infant, child and maternal mortality. Closely spaced births have a potentially devastating impact on both the individual and the society. Thus, understanding the level of short birth interval and factors influencing recommended birth interval is critical for countries like Ethiopia including study area. Objective: The main aim of this study was to assess prevalence and associated factors of short birth interval among reproductive age mothers in Gedeo Zone Southern Ethiopia in Dec, 2019. Method: A community based cross sectional study was conducted in Gedio zone SNNPR from January to April 2019. multi stage sampling technique was used to select 608 participants from eligible households. SRS technique was used to select study subjects. Data was collected using pre-tested structured interviewer administered questionnaire by health extension worker. Data was entered into Epi data version 3.5.4 and analyzed by using SPSS version 20 software, Bivariate analysis was performed at p-value < 0.25 of significance level to select candidate variable for multivariable analysis, and the finding was presented by using texts, tables and graphs. Result: A total of 608 reproductive mother age mothers who have at least two consecutive live births participated in this study with response rate of 100%. Prevalence of short birth interval in Gedio zone was 44.6%. A factors that shows association with short birth interval was ANC visit during previous pregnancy (AOR=2.82 95% CI=1.32,6.04), place of delivery of previous child (AOR=2.74 95%CI=1.27,5.90), sex of index child (AOR=2.71 95%CI=1.95,3.78) and use of modern contraceptive method (AOR=17.44 95%CI=9.66,31.50) occupational status of husband(AOR=0.26,95%CI=0.09,0.77). Conclusion: This study shows that reproductive age mothers (15-49) who experience at least two or more live birth in Gedeo zone were still practicing short birth interval. Hence, based on this finding need interventions to enhance contraceptive utilization. It would be helpful to narrow the gap between recommended birth interval and short birth spacing. https://zenodo.org/record/17914 10.20372/nadre:17914 oai:zenodo.org:17914 eng doi:10.20372/nadre:17913 url:https://nadre.ethernet.edu.et/communities/007 info:eu-repo/semantics/openAccess http://www.opendefinition.org/licenses/cc-by birth interval, short birth interval,Gedio zone SHORT BIRTH INTERAL AND ITS ASSOCIATED FACTOR AMONG REPRODUCTIVE AGE MOTHER IN GEDIO ZONE SOUTHERN ETHIOPIA COMMUNITY BASED CROSS SECTIONAL STUDY 2019 info:eu-repo/semantics/doctoralThesis publication-thesis