ADAMA HOSPITAL MEDICAL COLLEGE

FIRST ANNUAL RESEARCH CONFERENCE

Book of Abstracts
MAIN THEME: EPIDEMIOLOGICAL, DEMOGRAPHIC AND
NUTRITIONAL TRANSITIONS AS HEALTH CONCERNS IN
ETHIOPIA: EVIDENCE TO INFORM POLICIES AND PRACTICES

AUGUST 25, 2023

1
   Session One: Opening & preliminary session
Program
No. Activities Time Presenter Rapporteur
Leader/Chairperson
1 Registrations 8:30-9:00 a.m. Conference organizing committee
2 Program Introduction 9:00-9:15 a.m. Mrs. Meyrema Abdo
3 Welcoming speech 9:15-9:25 a.m. Dr. Endashew Abebe Dr. Zeleke Amana
4 Opening speech 9:25-9:50 a.m. Dr.Bekana Lemmessa
5 Key Note from Board and OHB presentation 9:50-10:15 a.m. Dr. Mengistu Bekele
Epidemiological, demographic & nutritional transitions as
7 health concerns in Ethiopia: evidences to inform policies and 10.15-10:45 a.m. Professor Tefera Belachew Dr. Godana Jarso Mr. Ephrem
practices Mannekulih
8 Discussion 10:45-11:00 a.m. Participants Participants
9 Tea break & poster presentation 11:00-11:30 a.m. Organizers Organizers
10 Selected paper presentation 11:30-11:45 a.m.   Dr.Abebe Megerso
11 Discussion 11:45-12:30 a.m. Participants Participants
12 Lunch 12:30-2:0 p.m. Organizers Organizers
Session Two: Oral Presentations
Thematic area: Non Communicable disease. Syndicate Room 1
No. Abstract Titles Time Presenter Chairperson Rapporteur
Effect of change in fasting blood sugar on incident ischemic
heart disease and its predictors among type two diabetes
1 2:00-2:15 p.m. Gebiso Roba
mellitus: A Joint modeling of survival and longitudinal
analysis
Postpartum depression and associated factors among
2 postpartum women in Ethiopia: a systematic review and meta- Getahun Fetensa
analysis, 2020 2:15-2:30 p.m.
The magnitude of central obesity and associated factors among Mr. Alem
Dr. Tesfaye Getachew
3 adult patients attending public health facilities in Adama town, Mihiret Shawel Deksisa
Oromia region, Ethiopia,2022 2:30-2:45 p.m.
Cardiovascular disease risk among hypertensive patients and 2:45-3:00 p.m. Genanew Kassie
4 associated determinants in Addis Ababa, Ethiopia

5 Discussion 3:00-3:30 p.m.  

6 Tea break along with poster presentations 3.30-4:00 p.m.  

2
 Thematic area: Infectious Diseases. Syndicate Room 2
No. Abstract Titles Time Presenter Chairperson Rapporteur
A systematic review and meta-analysis of antimicrobial Beshada Zerfu
resistance knowledge, attitudes, and practices: current evidence
1 2:00-2:15 p.m.
to build a strong national antimicrobial drug resistance
narrative in Ethiopia
Emergence of β-Lactam resistant Group A Streptococcus in Alene Geteneh
2 2:15-2:30 p.m.
Ethiopia: A Systematic Review and Meta-analysis
High Non-Compliance Rate among Presumptive Tuberculosis Habtamu Milkias Mr. Worku
Dr. Abebe Megerso
3 Cases Referred from Peripheral Health Facilities in Silti 2:30-2:45 p.m. Dhugassa
District of Southern Ethiopia: A Mixed Methods Study
Prevalence of asymptomatic malaria and associated factors Fufa Balcha
4 among pregnant women at Boset District in East Shoa Zone, 2:45-3:00 p.m.
Oromia Region, Ethiopia: a cross-sectional study
5 Discussion 3:00-3:30 p.m.  
6 Tea break along with poster presentations 3.30-4:00 p.m.      
 Thematic area: Reproductive Health. Syndicate Room 3
No. Abstract Titles Time Presenter Chairperson Rapporteur
Number of antenatal care utilization and associated factors Mastewal Arefaynie Mr. Ephrem
among pregnant women in Ethiopia: zero-inflated Poisson Mannikulih
1
regression of 2019 intermediate Ethiopian Demography Health
Survey 2:00-2:15 p.m.
Hotspot areas of tetanus unprotected births and its associated Anteneh Mengist
2 factors in Ethiopia: Evidence from Ethiopian Demographic and
Health Survey Data 2:15-2:30 p.m.
Distribution of vernix caseosa and associated factors among Seble Mesfin Mrs. Meyrema
3 newborns delivered at, Adama Hospital Medical College, Abdo
Ethiopia in 2022: Cross-sectional study 2:30-2:45 p.m.
Barriers to access and utilization of sexual and reproductive Daniel Bekele
4 health services among adolescents in Arsi zone, Ethiopia: A
sequential mixed method study design 2:45-3:00 p.m.
5
Discussion 3:00-3:30 p.m.  
6 Tea break along with poster presentations 3.30-4:00 p.m.      
 

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Thematic area: Nutrition. Syndicate Room 4
No. Abstract Titles Time Presenter Chairperson Rapporteur
Dereje Tsegaye
Effect of a theory-based nutrition education intervention during
1 pregnancy through male partner involvement on newborns’ 2:00-2:15 p.m.
birth weights in Southwest Ethiopia: A three-arm community-
based Quasi-Experimental study
Moderate acute malnutrition and its association with muscle Melese Sinaga
2 strength of children 5 to 7 years of age in Jimma Town,
Southwest, Ethiopia: a comparative cross-sectional study 2:15-2:30 p.m. Dr. Godana
Undernutrition among Pregnant Adolescent, A Scoping Adane Tesfaye Dr. Haji Aman
Arero
3 Systematic Review
2:30-2:45 p.m.
Major dietary patterns of community-dwelling adults and their Mr.Birhanu Abebaw
4 associations with impaired blood glucose and central obesity in 2:45-3:00 p.m.
Eastern Ethiopia: diet-disease epidemiological study
5 Discussion 3:00-3:30 p.m.  
6 Tea break along with poster presentations 3.30-4:00 p.m.      
Session Three: Closing program
No. Activities Time Presenter/performer Chair person Program leader
1 Summary presentations on sub-thematic areas 4:00-4:10 p.m. Dr. Haji Aman
Dr.Zeleke
2 Certificate award 4.10-4:40 p.m. Dr.Endashew Abebe
Dr.Bekana Lemmessa Amena
3 Closing speech 4.40-4:50 p.m.

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Effect of a theory-based nutrition education intervention during pregnancy through male
partner involvement on newborns’ birth weights in Southwest Ethiopia: A three-arm
community-based Quasi-Experimental study

Dereje Tsegaye

Background: The global estimates of low birth weight ranges from 15% to 20% of all births.
According to the Ethiopian demographic health survey report, the prevalence of Low Birth
Weight rose from 11% in 2011 to 13% in 2016. The high proportion of birth weight in Ethiopia
is hypothesized to be due to inadequate maternal diet which is associated with poor nutrition
education during pregnancy. This study aimed to assess the effect of theory-based nutrition
education during pregnancy through male partner involvement on birth weight in southwest
Ethiopia.
Methods: A community-based quasi-experimental study was conducted among 403 pregnant
women who were randomly selected from 22 rural kebeles in Ilu Aba Bor Zone, Southwest
Ethiopia from June to December 2019. Participants were assigned to one of the three study arms:
Couple group:-husband and wife received nutrition education together, women alone: pregnant
women received nutrition education alone and comparison group: - received routine care during
Antenatal care. Birth weight was measured within 24 hours of birth. Analysis of variance, linear
mixed-effects model, and mediation analysis were used to assess the effect of the intervention on
birth weight.
Results: The mean birth weight of babies born to women from the couple group was 0.42 kg
greater than that of newborns born to women in the comparison group (3.34 vs 2.92 kg, p<
0.001). The linear mixed effect model showed that the average birth weight of babies born from
women in the couple group was 0.40 kg higher than that of the comparison group (β = 0.400,
PP<0.001). The direct effect of the intervention on the birth weight of babies born from women
in the couple group was 0.23 (β = 0.227, P<0.001) whereas the indirect effect mediated by
maternal dietary diversity practice was 0.18 (β = 0.178, P<0.001), accounting for 43.9% of the
total effect of the intervention.
Conclusion: Nutrition education interventions during pregnancy through male partner
involvement resulted in improved birth weight. Maternal dietary diversity mediated the effect of
nutrition education on birth weight. The findings highlight the implication of improving pregnant
women’s nutrition education through male involvement and the use of theories to improve birth
weight.

5
 Cardiovascular disease risk among hypertensive patients and associated determinants in
Addis Ababa, Ethiopia

Genanew Kassie

Background: Cardiovascular diseases are the leading cause of global death, and hypertension is
the major modifiable cardiovascular risk factor. Assessment of baseline cardiovascular risk is the
most important step in the management of hypertension. In low-resource settings where skilled
manpower, such as cardiologists, is in short supply, it is important to use prediction charts like
the WHO prediction chart. Therefore, the aim of this study was to assess the level of
cardiovascular disease risk and associated factors among hypertensive patients having follow-up
at selected hospitals in Addis Ababa, Ethiopia, in 2022.
Methods: A cross-sectional study was conducted involving 326 hypertensive patients selected
using a systematic random sampling technique. Descriptive statistics were used to describe the
socio-demographic and clinical characteristics of the study participants. A WHO prediction chart
was used to assess the ten-year risk of developing cardiovascular disease risk for the study
participants, and logistic regression was used to identify the risk factors for high cardiovascular
disease risk among hypertensive patients.
Results: The prevalence of a high predicted ten-year cardiovascular disease risk level was 28.2%
(95% CI: 10.34%–33.2%) among the study participants. A higher cardiovascular disease risk
level was found to be associated with age [AOR: 4.2 for age 64–74, 95% CI: 1.67, 10.66], being
male [AOR: 2.1, 95% CI: 1.18, 3.67], unemployment [AOR: 3.2, 95% CI: 1.06–6.25], and stage
2 systolic blood pressure [AOR: 11.32; 95% CI: 3.43–37.46].
Conclusion: The study showed that a significant proportion of hypertensive patients had a high
predicted CVD risk level (28.2%). The respondent's age, gender, occupation, and high systolic
blood pressure were determinant factors for cardiovascular disease. Therefore, routine screening
for the presence of CVD risk factors and assessment of CVD risk are recommended for
hypertensive patients for CVD risk reduction.
Keywords: Hypertension, cardiovascular disease, risk factors, Ethiopia

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 DISTRIBUTION OF VERNIX CASEOSA AND ASSOCIATED FACTORS AMONG
NEWBORNS DELIVERED AT, ADAMA HOSPITAL MEDICAL COLLEGE,
ETHIOPIA IN 2022: CROSS-SECTIONAL STUDY.

Seble Mesfin

INTRODUCTION: Vernix caseosa is a complex proteolipid material synthesized partly by fetal

sebaceous glands during the last trimester of pregnancy. Understanding the structure and
function of newborn skin is crucial for determining optimal thermal support, infection control,
and skin moisturization. So far, in Ethiopia, there is no research done related to the distribution
of vernix caseosa and associated factors on newborn skin. Doing such research could give
awareness about factors associated with the distribution of vernix caseosa on newborns' skin and
to take necessary protective measures for those that may be affected.

METHODOLOGY: Hospital-based cross-sectional study design was conducted from

November to December 1, 2021, at Adama hospital medical college. Four hundred twenty-two
eligible newborns were selected by a systematic sampling method. Data were collected by
pretested questionnaires. The distribution of vernix caseosa was assessed, by observing the
newborn skin at different regions. Data entry was done by EPI data version 4.6 and analyzed by
using SPSS version 25. A logistic regression of P-value of <0.25 during bivariate and P<0.05
during multivariate analysis at a 95% confidence level was considered statistically significant.

RESULTS: Out of 422 study participants 231 (54.7%) with 95% CI (49.8, 59.8) babies had
vernix caseosa. Being primiparous with (AOR=1.9, PV=0.013, 95%CI:1.141,2.92), being
multiparous with (AOR=1.98, PV=0.04, CI:1.29,3.225), being females with (AOR=2.1,
PV=0.001, CI:1.39,3.18), being preterm with(AOR=2.98, PV=0.036,95%, CI:1.08,10.72), non-
diseased new-borns with(AOR=1.6, PV=0.046, 95%, CI: 1.07, 2.7)were identified as associated
factors for the distribution of vernix caseosa on the newborns skin.

CONCLUSION: This study showed that the distribution of vernix caseosa on the skin of new-
borns was associated with parity, sex, gestational age, and absence of disease.

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A systematic review and meta-analysis of antimicrobial resistance knowledge, attitudes,
and practices: current evidence to build a strong national antimicrobial drug resistance
narrative in Ethiopia

Beshada Zerfu Woldegeorgis,

Background: Antimicrobial resistance (AMR) is a silent pandemic that has claimed millions of
lives, and resulted in long-term disabilities, limited treatment options, and high economic costs
associated with the healthcare burden. Given the rising prevalence of AMR, which is expected to
pose a challenge to current empirical antibiotic treatment strategies, we sought to summarize the
available data on knowledge, attitudes, and practices regarding AMR in Ethiopia.

Methods: Articles were searched in international electronic databases. Microsoft Excel

spreadsheet and STATA software version 16 were used for data extraction and analysis,
respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020
checklist was followed. The methodological quality of the studies included was assessed by the
Joana Briggs Institute critical appraisal checklists. The random-effect meta-analysis model was
used to estimate Der Simonian-Laird’s pooled effect. Statistical heterogeneity of the meta-
analysis was checked through Higgins and Thompson’s I2 statistics and Cochran’s Q test.
Publication bias was investigated by funnel plots, and the regression-based test of Egger for
small study effects with a P value < 0.05 was considered to indicate potential reporting bias. In
addition, sensitivity and subgroup meta-analyses were performed.

Results: Fourteen studies with a total of 4476 participants met the inclusion criteria. Overall, the
pooled prevalence of good AMR knowledge was 51.53% [(95 % confidence interval (CI): 37.85,
65.21). The pooled prevalence of favorable attitudes and good practices were 63.43 % [(95 % CI:
42.66, 84.20), and 48.85 % [(95 % CI: 38.68, 59.01) respectively.

Conclusion: There is a significant knowledge and practice gap on AMR among the general
public, patients, and livestock producers. As a result, we call for greater educational
interventions to raise awareness and build a strong national AMR narrative.

Keywords: antimicrobial resistance, attitude, awareness, knowledge, practice, meta-analysis

8
Effect of change in fasting blood sugar on incident ischemic heart disease and its predictors
among type two diabetes mellitus: A Joint modeling of survival and longitudinal analysis

Gebiso Roba

Background: Due to the increasing number of people with type 2 diabetes (T2DM), ischemic
heart disease (IHD) continues to be the primary cause of morbidity and mortality. Fasting plasma
glucose (FPG) levels can fluctuate over time, and their long-term patterns of change may predict
the risk of IHD. Despite this fact, a growing body of research on the relationship between
longitudinal changes in FBS and the incident IHD has become very limited. Thus, the purpose of
this study was to assess the effect of change in FBS on incident IHD while also assessing its
predictors using joint modeling of longitudinal and survival analysis.

Methods: a retrospective cohort study was conducted on a sample of 782 patients with T2DM
from a tertiary healthcare setting of southwest Ethiopia. The T2DM patients who did not have
IHD at baseline were recruited from September 9, 2013, to November 30, 2015, and were then
followed until May 2022. R version 4.0.5 was used for analysis after data were entered using
Epi-Data version 4.6. Joint modeling of Weibull proportional hazard and linear mixed model was
fitted to assess the effect of change in FBS on IHD and its predictors after controlling for
important covariates at 0.05 level of significance.

Results: During the 70.92 months of the median follow-up period, 12.67% had incident IHD
with an incidence rate of 1.86/1000PM, 95% CI [1.53, 2.26]. We found a significant effect of
change in FBS on incident IHD in multivariable joint modeling (6.18 [4.23, 9.03]). Moreover,
older age (AHR= 2.63, 95%CI: [ [1.45, 4.77]]), having HTN (AHR= 2.00, 95% CI: [1.08,
3.68]), TC/HDL-C ratio (AHR= 1.13, 95%CI: [1.10, 1.40]) and LDL-C >100 mg/dl (AHR=1.82,
95% CI [1.01, 3.28]) and borderline (AHR=2.54, 95% CI [1.19, 5.42]) and high (AHR=2.26,
95% CI [1.17, 4.37]) TG at baseline significantly predicts the future likelihood of developing
IHD in T2DM patients.

Conclusion: The current study first indicated that elevated levels of longitudinal FBS
significantly increase the risk of IHD among T2DM patients. Moreover, the baseline TC/HDL-C
levels significantly predict incident IHD and may be used in clinical practice for early detection
of potential IHD. Finally, old age, HTN, high LDL-C, and TG at the time of T2DM diagnosis
predict the future risk of IHD in T2DM.

Keywords: Longitudinal FBS, ischemic heart disease, type two diabetes mellitus, joint
modeling

9
Moderate acute malnutrition and its association with muscle strength of children 5 to 7
years of age in Jimma Town, Southwest, Ethiopia: a comparative cross-sectional study
Melese Sinaga
Background: Malnutrition remains a major public health problem for school-age children in
developing countries. Acute childhood malnutrition impairs not only physical growth but also
motor development. No previous study has addressed the association between moderate acute
malnutrition (MAM) and muscle strength among Ethiopian children.
Objective: This study aimed to determine the association between MAM and muscle strength of
children 5-7 years of age living in Jimma Town, Ethiopia.
Methods: A school-based comparative cross-sectional study was conducted between June to
July 2022, among children 5-7 years selected using stratified random sampling. Data on socio-
demographic characteristics, food security, and early childhood health-related characteristics
were collected using a structured questionnaire through face-to-face interviews with caregivers.
Weight, height & muscle strength were measured following standard procedures. An
independent sample t-test was used to compare well-nourished (WN) muscle strength and
children with moderate acute malnutrition (MAM). Multivariable linear regression was
employed to identify the independent predictors of muscle strength.
Results: MAM and normal children had a significant difference in muscle strength for all muscle
groups (p<0.001). The mean and standard deviation (SD) of handgrip strength (HGS) were
4.15±2.56 for MAM (n=198) for children and 5.6±2.04 for normal children (n=198). Muscle
strength for elbow flexion was 34.3±7.34 for MAM children and 48±11.69 for normal children.
Similarly, quadriceps strengths were 49.4±10.6 and 70.7±18 for MAM and normal children,
respectively. Gastrocnemius sup flexor strength was 30.1±6.9 for MAM children and 45.1±9.7
for normal children. On multivariable linear regression, after adjusting for background
characteristics, well-nourished children had 1.38 times higher grip strength (β=1.38, p<0.001),
11.22 times higher elbow flexor muscle strength (β=11.22, p<0.001), 16.70 times higher
quadriceps muscle strength (β=16.70, p<0.001), and 12.75 times higher gastrocnemius muscle
strength (β=12.75, p<0.001) than MAM children. For an increase of age by one year, grip
strength increased by 1.41 s (β=1.41, p<0.001) elbow flexion by 4.69 (β=4.69, p<0.001)
quadriceps by 7.2 (β=7.2, p<0.001), and gastrocnemius by 3.58 (β=3.58, p<0.001).
Conclusion: Children with MAM had significantly lower muscle strength than their well-
nourished counterparts showing the negative effect of moderate wasting on muscle mass. Low
muscle strength among MAM children was also associated with maternal educational status,
household food security, and age of the child, sex of the child, birth weight, and immunization
status of the child implying the need for a multi-sectoral intervention to alleviate low muscle
strength associated with wasting among Ethiopian children.
Keywords: MAM, muscle strength, moderate acute malnutrition, MAM, school-aged children,
Ethiopia.

10
 Undernutrition among Pregnant Adolescent, A Scoping Systematic Review

Adane Tesfaye

Background: In pregnant adolescents, it is hypothesized that there is ‘nutrient partitioning’, a

competition for nutrients between the still-growing adolescent mother and her rapidly developing
fetus resulting in a compromised nutrition status of both. This scoping review examined the
prevalence of undernutrition, associated factors, and outcomes of adolescent pregnancy.

Methods: We used a five stages framework of Arksey & O`Male (2005) to carry out this
scoping review. Published articles, reviews and reports were identified through a complete
search. We included articles published in the English language from 2000 to 2020. We
summarized the prevalence, associated factors, and health outcomes of pregnancy during
adolescence.

Results: 25 studies met the inclusion criteria. 32% of the studies are on dietary intake, 20% of
them reported nutritional status and associated factors and 48% of studies discussed the effect of
poor nutrition on the outcome of Pregnancy during adolescence. Only 4 of the studies are
community based and 21 are facility based. The magnitude of undernutrition among pregnant
adolescent girls ranged from 23.5% to 34%; Social determinants of health such as poor access to
antenatal care visits, low educational status of partners, poor dietary intake, early marriage, rural
residency, young age and having multiple pregnancies are associated with poor nutritional status.
Pregnant adolescents have also more risks of poor pregnancy outcomes compared with pregnant
women. These include fetal complications like prematurity, low or very low birth weight
perinatal mortality, major congenital defects; hypertensive pregnancy disorders, abortion, urinary
infections, and premature rupture of the fetal membranes.

Conclusion: A higher magnitude of undernutrition, less dietary intake, and more risks of poor
pregnancy outcomes were observed from reviewed studies. This review demonstrated an absence
of comprehensive literature which might be explored through a population-based prospective
study.

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Keywords: Pregnant Adolescents, malnutrition, dietary intake, scoping review

BARRIERS TO ACCESS AND UTILISATION OF SEXUAL AND REPRODUCTIVE

HEALTH SERVICES AMONG ADOLESCENTS IN ARSI ZONE, ETHIOPIA: A
SEQUENTIAL MIXED METHOD STUDY DESIGN

Daniel Bekele
Introduction: Despite the global agreements on adolescents’ rights to access and utilization of
sexual and reproductive health services (SRHS). Adolescents in Ethiopia face many barriers to
accessing and using the services. This study aimed to investigate and explore the barriers to
access and utilization of SRHS among adolescents.
Method: An explanatory sequential mixed design was used. The study was conducted at five
secondary schools in Arsi zone. In both quantitative and qualitative methods adolescents aged
15–19 were participated. For the quantitative phase a systematic random sampling technique was
used to select 800 adolescents while 24 involved in 4 focus group discussion during qualitative
phase. The data were collected using a pretested questionnaire. The collected data were entered
into Epi info version-3.1 and then exported to SPSS 25 for analysis. A bivariate and multivariate
regression was performed to identify factors associated with SRHS utilization. Statistical
significance was declared at a p < 0.05 along with 95% CI. The qualitative data was analyzed
thematically using Atlas.ti.8.1
Results: The study shows that 26.1% of adolescents utilized SRHS. Being aged 17–19 years
(AOR 3.44, 95% CI 2.15 to 5.51), Attending grades 11 and 12 (AOR 2.70, 95% CI 1.22 to 2.32),
having sexual contact (AOR 3.04 CI 95% CI 2.15 to 4.29) and having knowledge on the services
(AOR 1.47, 95% CI 1.05 to 2.05) were factors affecting the service utilization. Also, barriers to
access and use of SRHS were found at the facility level, health care provider, community, and
personal level.
Conclusion The research found a low proportion of SRHS utilization and poor access among
adolescents due to several factors. Therefore, it is recommended to policymakers, and regional
and federal health offices to develop relevant interventions which are needed to promote healthy
practices of adolescents to avoid the barriers.
Keywords: Adolescents, Barriers, Sexual and Reproductive health, Ethiopia

12
Number of antenatal care utilization and associated factors among pregnant women
in Ethiopia: zero-inflated Poisson regression of 2019 intermediate Ethiopian Demography
Health Survey.

Mastewal Arefaynie

Introduction: The frequency of antenatal care utilization enhances the effectiveness of maternal
health programs to maternal and child health. The aim of the study was to determine the number
of antenatal care and associated factors in Ethiopia by using 2019 intermediate EDHS.

Methods: Secondary data analysis was done on the 2019 intermediate EDHS. A total of 3916.6
weighted pregnant women were included in the analysis. Zero-inflated Poisson regression
analysis was done by Stata version 14.0. The incident rate ratio and odds ratio with a 95%
confidence interval were used to show the strength and direction of the association.

Result: About one thousand six hundred eighty-eight (43.11%) women were attending four and
more antenatal care during their current pregnancy. Attending primary education (IRR=1.115,
95% CI: 1.061, 1.172), secondary education (IRR=1.211, 95% CI: 1.131, 1.297) and higher
education (IRR=1.274, 95% CI: 1.177, 1.378), reside in poorer household wealth index
(IRR=1.074, 95% CI: 1.01, 1.152), middle household wealth index (IRR=1.095, 95% CI: 1.018,
1.178), rich household wealth index (IRR=1.129, 95% CI: 1.05, 1.212) and richer household
wealth index (IRR=1.186, 95% CI: 1.089, 1.29) increases the number of antenatal care
utilization. The frequency of antenatal care was less likely to become zero among women
attending primary (AOR=0.434, 95% CI: 0.346, 0.545), secondary (AOR=0.113, 95% CI: 0.053,
0.24), higher educational level (AOR=0.052, 95% CI: 0.007, 0.367) in the inflated part.

Conclusion: The number of antenatal care utilization is low in Ethiopia. Being rural, the poorest
household index, being uneducated, and being single women were factors associated with a low
number of antenatal care and not attending antenatal care at all. Improving the educational
coverage and wealth status of women is important to increase the coverage and frequency of
antenatal care.

13
Postpartum depression and associated factors among postpartum women in Ethiopia: a
systematic review and meta-analysis, 2020

Getahun Fetensa
Introduction: The postpartum period is recognized as a high-risk period for the
development of various mood disorders like postpartum depression. In Ethiopia, even
though there are different primary studies conducted on postpartum depression, there is
no nationally representative evidence. Therefore, the aim of this systematic review and
meta-analysis was to estimate the pooled prevalence and associated factors of
postpartum depression in Ethiopia.
Methods: Published and unpublished articles from various electronic databases and
digital libraries were accessed. This systematic review included studies that were
conducted on the magnitude and factors associated with postpartum depression among
postnatal women in Ethiopia. A random-effects model was used to estimate the pooled
magnitude of postpartum depression with a 95% confidence interval (CI). Inverse
variance (I2 ) was used to visualize the presence of heterogeneity, and a forest plot was
used to estimate the pooled magnitude of postpartum depression. Publication bias was
assessed by funnel plots and Egger’s statistical tests. A meta regression and subgroup
analysis were computed to minimize underlying heterogeneity.
Result: Initially, a total of 764 studies were accessed. Twenty-eight full articles were
assessed for eligibility criteria, of which twelve studies fulfilled inclusion criteria and
were included in the final meta-analysis. The overall pooled magnitude of postpartum
depression was 22.89% (95% CI 17.75%, 28.03%) with the lowest (12.20%) and
highest (33.82%) in the Southern nations region. Unplanned pregnancy, domestic
violence, lack of social support, previous history of depression, infant loss, and
dissatisfaction in marriage showed a statistically significant association with postpartum
depression.
Conclusions: In the current analysis, the prevalence of postpartum depression was high
as compared with other developing countries. Routine screening of mothers in the
postpartum period and integrating mental health with maternal health care is highly

14
recommended.
Keywords: Postpartum depression, Systematic review, Ethiopia

Prevalence of asymptomatic malaria and associated factors among pregnant women at

Boset District in East Shoa Zone, Oromia Region, Ethiopia: a cross-sectional study

Fufa Balcha

Background: Malaria infection during pregnancy is a significant public health problem that
puts pregnant women at risk. Interruption of transmission of asymptomatic malaria among a
population remained a challenge and the host serves as a reservoir for the malaria parasite; and
is also recognized as a major barrier to malaria elimination. This study aimed to assess the
prevalence of asymptomatic malaria and associated factors among pregnant women in the
Boset District, East Shoa Zone, Oromia, Ethiopia.
Methods: A community-based cross-sectional study was conducted to assess the prevalence of
asymptomatic malaria and associated factors in pregnant women from February to March
2022. Using multistage sample techniques, 328 asymptomatic pregnant women were enrolled.
Data were collected using a structured questionnaire. A rapid test and Giemsa-stained blood
smear microscopy were used to diagnose Plasmodium infections. Epi info version 7 was used
to code, enter, and clean data before being uploaded to SPSS version 25.0 for analysis.
Bivariable and multivariable binary logistic regression was employed to find the associated
factors. Variables in the multivariable model with a p-value < 0.05 were considered
significantly associated with asymptomatic malaria.
Results: Of the total 328 pregnant women who participated in this study, 9(2.74%) and
10(3.05%) were confirmed to be infected with Plasmodium species by microscopy and rapid
diagnostic tests, respectively. Asymptomatic malaria during pregnancy was found to be
significantly associated with not using an insecticide-treated bed net [(P = 0.002, AOR: 9.61;
95% CI (2.22–41.53)], lack of consultation and health education about malaria prevention
during Antenatal care attendance [(P = 0.04, AOR: 4.05; 95% CI (1.02, 16.05)], and living
close stagnant water [(P = 0.02, AOR: 4.43;
95% CI (1.17, 16.82)].

Conclusions: The current study showed that asymptomatic malaria is prevalent in pregnant
women. Not using insecticide-treated bed nets, inadequate health education during antenatal
care, and living close to stagnant water are significantly associated with malaria infection.
Thus, using insecticide-treated bed nets, health education, and avoiding stagnant water from
residential areas could play significant roles in preventing asymptomatic malaria among
pregnant women in the study area.
Keywords: Asymptomatic Malaria, Pregnancy, Associated factors, Prevalence, Ethiopia
15
The emergence of β-Lactam resistant Group A Streptococcus in Ethiopia: A Systematic
Review and Meta-analysis

Alene Geteneh

Background: Due to the rising incidence of resistance to macrolides and lincosamides, the high
burden of diseases in low-income and underdeveloped settings, and even the emergence of
penicillin-macrolide-resistant GAS companion animals, it is very crucial to assess the burden and
response of GAS to commonly prescribed medications in Ethiopian context for immediate
action. Thus, the current review offers evidence on the tonsillo-pharyngitis-specific
epidemiology and antibiotic resistance profile of GAS in Ethiopia.

Methods: PubMed, HINARI, Web of Science, and Google Scholar were searched (from 2000 to
April 25, 2023) to identify the relevant studies. The pooled prevalence and level of antibiotic
resistance with 95% confidence interval were estimated using the random effects model. The I 2
and egger’s test was applied for heterogeneity and publication bias assessment, respectively.

Results: 109 of the 1003 Ethiopians suspected of having streptococcal tonsillopharyngitis were
determined to contain GAS, with a pooled estimate of 10.63% (95% CI, 8.72, 12.54). Reports
based on the Kirby-Bauer disc diffusion method indicated that penicillin is still the treatment of
choice for tonsillo-pharyngitis in Ethiopia. However, except for a study in Jimma, macrolides
and lincosamides have demonstrated up to 41.2% and 57.1% resistance, respectively. The
resistance to third and fourth-generation cephalosporins; the most effective β-lactam drugs used
to treat penicillin-resistant streptococcal infections; varies between 14.3% and 35.7%. Despite
the fact that vancomycin is the last-resort antibiotic for the treatment of multidrug-resistant
Gram-positive bacterial infections, resistance rose up to 35.7%. Further investigations are
recommended to determine the genetic determinants of vancomycin resistance, and inspect the
potential of GAS as a reservoir of resistance in Ethiopian setup. Different regions of Ethiopia
were found to have different rates of GAS tonsillo-pharyngitis. Thus, routine antibiotic

16
susceptibility testing for commonly prescribed antibiotics, and strengthening prevention efforts
are warranted for a better outcome of tonsillopharyngitis.

Keywords: GAS, tonsillopharyngitis, antibiotic resistant-GAS, Ethiopia

Hotspot areas of tetanus unprotected births and its associated factors in Ethiopia: Evidence
from Ethiopian Demographic and Health Survey Data

Anteneh Mengist

Background: Neonatal tetanus persists as public health problems in many developing countries.
In Ethiopia, neonatal mortality has been increasing, and around 9% of neonatal deaths in 2019
were due to tetanus, which was 4.5 per 1000 live births. Maternal TT vaccination is a
cornerstone to preventing neonatal tetanus. However, its prevalence is very low in Ethiopia, and
little has been devoted to its spatial epidemiology and associated factors. Hence, this study aimed
to explore the spatial pattern and factors affecting tetanus-unprotected births in Ethiopia.

Methods: A further analysis of the 2016 Ethiopia Demographic and Health Survey data was
conducted, and a total weighted sample of 7590 women who gave birth within five years
preceding the survey was used for analysis. ArcGIS and SaTScan software were used for spatial
analysis. Global Moran’s I statistic was employed to test the spatial autocorrelation, and Getis-
Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect spatial
clusters of tetanus unprotected births. A multiple logistic regression model was fitted to identify
factors and variables with a p-value ≤0.05 were considered as statistically significant.

Result: In this analysis, 54.13% (95% CI: 53.01, 55.25) of births were not protected against
neonatal tetanus, and spatial clustering of tetanus unprotected births was observed (Moran’s I =
0.144, p = 0.028). The primary SaTScan clusters was detected in Northeastern Tigray, Eastern
Amhara, and almost the entire Afar region (RR=1.34 & LLR=66.5, P<0.01). Tetanus
unprotected births were higher among women without formal education (AOR=1.63; 95% CI:
1.29, 2.04), those from poor households (AOR=1.27; 95% CI: 1.12, 1.45), have no antenatal care
contact (AOR=6.97; 95% CI: 6.21, 7.88), and those who were not exposed to media (AOR=1.26;
95% CI: 1.09, 1.47).

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Conclusion: In this study, spatial clustering of tetanus-unprotected births was observed in
Ethiopia, and hotspot clusters were detected in Afar, Amhara, Tigray, Somali, and western
border of Gambela region. Hence, tetanus unprotected birth hotspots require priority
interventions, and it is good if the targeted interventions consider the identified factors.

Keywords: Associated factors, Ethiopia, Spatial, and Tetanus unprotected birth

High Non-Compliance Rate among Presumptive Tuberculosis Cases Referred from

Peripheral Health Facilities in Silti District of Southern Ethiopia: A Mixed Methods Study

Habtamu Milkias

Background: For presumptive Tuberculosis (TB) case referral to be effective, most of the
referred cases need to present themselves to health facilities for assessment and testing.
Otherwise, cases of TB could be missed, and these cases are at an increased risk of delayed
diagnosis, complications and death. Further, their care incurs significantly higher costs. This
study assessed referral compliance as well as factors attributable to compliance/non-compliance
to the referral of presumptive TB cases in the Silti district, Southern Ethiopia.

Methods: We applied a mixed design involving both quantitative and qualitative methods. A
randomly selected sample of 384 presumptive TB cases referred between January 2014 and July
2021 was included in this study from the records of 12 health posts. Purposefully selected
presumptive TB cases and Health Extension Workers were also interviewed to get in-depth
information on the reasons for compliance and non-compliance to referral. STATA version 14
was employed to model the data using logistic regression. Qualitative data were analyzed using
thematic content analysis.

Results: Of the 384 referred presumptive TB cases, close to 49% did not present themselves to
the referral facilities. About 66% (n=249) of the referred cases were women, and 62% (n=119) of
those who complied with referral were women. In multivariate analysis, cough [AOR=3.4,
95%CI: 1.54-7.32], and chest pain [AOR=2.7, 95%CI: 1.45-5.05] were independent predictors of
compliance to referral. Nearly 5.5% (n=21) of TB cases of all types were identified. The
qualitative data analysis revealed that severe disease symptoms, HEW’s recommendations, and
social issues as reasons for improving compliance while personal and social factors, financial

18
problems, lack of awareness about TB, and transportation were reasons impeding compliance to
referral.

Conclusion: Our study showed a high level of non-compliance to referral among referred
presumptive TB cases. We also found that more women were referred and also complied with
the referral. Strengthening community awareness about the disease symptoms and the existence
of free treatment, addressing misconceptions about TB, supporting the elderly and disabled, and
checkup house visits after referral could improve compliance to referral.

MAGNITUDE OF CENTRAL OBESITY AND ASSOCIATED FACTORS AMONG

ADULT PATIENTS ATTENDING PUBLIC HEALTH FACILITIES IN ADAMA TOWN,
OROMIA REGION, ETHIOPIA,2022

Mihiret Shawel

Introduction: Central obesity is excessive accumulation of fat around the abdomen which is
associated risk of coronary heart and cerebrovascular diseases. This study determined the
magnitude of central obesity among adult patients using the waist-to-hip ratio which has a
superior capacity to measure the risk of developing non-communicable diseases compared to the
body mass index used in previous studies in Ethiopia.
Methods: Institutional-based cross-sectional study was conducted among a sample of 480 adults
from April 1 to May 30, 2022. A systematic random sampling technique was used to select the
study participants. Data were collected by using interviewer-administered structured
questionnaires and anthropometric measurements. The data were entered into EPI INFO version
7 and analyzed by Statistical Software for Social Science Version 25. The associations between
independent and dependent variables were checked using bivariate and multivariate logistic
regression analyses. Adjusted odds ratio and 95% confidence interval were used to measure of
strengths of the association. Statistical significance was declared at a P-value of less than 0.05.
Results: The magnitude of central obesity in this study was 40 % (51.2% and 27.4% among
females and males respectively (95% CI: 36 - 44%). Being a female (AOR= 9.5, 95% CI: 5.22-
17.9), age range 35-44 (AOR= 7, 95% CI: 2.9-16.7), 45-64 years (AOR= 10.1, 95% CI:4.0-
15.2), married (AOR= 2.5, 95% CI: 1.3-4.7), high monthly income (AOR= 3.3, 95% CI: 1.5-
7.3), high consumption of milk and milk products (AOR= 0.3,95% CI: 0.1-0.6), family history

19
of obesity (AOR= 1.8, 95% CI: 1.1-3.2) were significantly associated with central obesity among
the study participants.
Conclusion: The magnitude of central obesity was higher in the study area. Sex, age, marital
status, monthly income, consumption of milk and milk products, and family history of obesity
were independent determinants of central obesity. Therefore, it is important to raise awareness
about central obesity through behavior change communication that targets the high-risk
population

Major dietary patterns of community-dwelling adults and their associations with impaired
blood glucose and central obesity in Eastern Ethiopia: diet-disease epidemiological study

Berhanu Abebaw

Backgrounds: Unhealthy dietary intake is an important preventable risk factor for obesity and
impaired blood glucose (IBG). When compared to individual food intakes, dietary patterns are a
stronger predictor of health outcomes and should be systematically evaluated where such
evidence is lacking. This study evaluated dietary patterns and their association with central
obesity and IBG among adults.

Methods: A community-based survey was conducted among 501 randomly-selected adults from
Eastern Ethiopia. Data was collected using a semi-structured questionnaire during a face-to-face
interview that included sociodemographic and lifestyle factors, as well as a validated 89-item
food frequency questionnaire (collected over one month). Principal component analysis was used
to derive the dietary pattern. While central obesity was assessed using waist and/or hip
circumference measurements, fasting blood sugar was used for IBG. A multivariable logistic
regression model was fitted with an odds ratio, 95% confidence intervals, and p-values reported.
Results: Five major dietary patterns explaining 71% of the total variance were identified:
“nutrient-dense foods”, “high fat and protein”, “processed foods”, “alcohol drinks”, and “cereal
diets”. While 20.4% (17.0–24.2%) had IBG, 14.6% (11.8–17.9) were centrally obese, and 94.6%
(92.3–96.3) had an increased waist-to-hip circumference ratio. Central obesity is associated to
being wealthier (AOR=6.92; 2.91–16.5), physical inactivity (AOR=21.1; 2.77–161.4), nutrient-
dense foods (AOR=1.75; 0.75–4.06), processed foods (AOR = 1.41; 0.57–3.48), and cereal diets
20
(AOR = 4.06; 1.87–8.82). The burden of IBG was associated with upper wealth status
(AOR=2.36; 1.36–4.10), physical inactivity (AOR=2.17; 0.91–5.18), nutrient-dense foods
(AOR=1.35; 0.62–2.93), fat and protein diet (AOR=1.31; 0.66–2.62), and cereal diet
consumption (AOR = 3.87; 1.66–9.02).
Conclusion: IBG and central obesity were prevalent and predicted by upper tercile consumption
of nutrient-dense foods, high fat and protein diets, processed foods, and cereal diets, which could
guide dietary interventions.

Keywords: central obesity; dietary intake; dietary pattern; impaired blood glucose; prediabetes
Coverage and Determinants of HIV Testing and Counseling Services among Mothers
Attending ANC in Sub-Saharan African Countries: A Multilevel Analysis
Temam Beshir
Background: HIV/AIDS is one of the top global public health threats that cause significant
cases, deaths, and socioeconomic impact. Even though, both HIV testing and counseling are
identified as essential HIV interventions during pregnancy, a large population-representative data
show the services coverage and determinants are limited. Therefore, this study aimed to assess
the coverage and determinants of HIV testing and counseling services (HTC) among pregnant
mothers attending antenatal care (ANC) follow-up in Sub-Saharan African countries using
different nationwide data.
Methods: This study was conducted on large national-representative data from Demographic
Health Survey (DHS) using multilevel analysis. Data extraction, cleaning, coding, and statistical
analysis were performed using STATA version 17 software. Weighting was used to ensure the
representativeness of the sample and to obtain reliable estimates and standard errors. The
multivariable multilevel logistic regression model was used to identify the determinants of HTC
during the ANC visit.
Results: A total of 83,584 women attending antenatal care were included in this study. HTC
coverage in Sub-Saharan Africa was found to be 62.87% with 95% CI (62.54-63.19). The HTC
determinants included being in the age group of 35-49 (AOR=1.28; 95%CI; 1.18-1.38),
secondary and above education levels (AOR=1.50; 95%CI; 1.41-1.60), having at least four ANC
visits (AOR = 1.85; 95% CI; 1.68-2.02), living in urban area (AOR=1.41; 95% CI; 1.30-1.52),

21
living in countries such as Rwanda (AOR=6.28; 95%CI; 5.27-7.48) and Mauritania (AOR=0.02;
95%CI; 0.01-0.03).
Conclusion: This study revealed that the HTC coverage was 62.87% in Sub-Saharan Africa.
Factors affecting the HTC coverage were age, education, frequency of ANC visits, residence
area, and living in Rwanda and Mauritania. Therefore, to increase HTC coverage in SSA,
policymakers on maternal health and other stakeholders should work as an integrated approach
with other sectors, and give prior attention to modifiable factors such as promoting women’s
education and comprehensiveness of ANC follow-up services during the follow-up.
Keywords: Coverage, Determinants, Counseling, HTC, HIV, Testing, ANC, Women, Sub-
Sahara

Distribution Width of Red Blood Cells and Related Factors among Patients with End-Stage
Renal Disease in Addis Ababa, Ethiopia

Daniel Molla

Background: RDW is critical to the clinical diagnosis and progression of ESRD. There is
currently little data on the relationship between RDW and ESRD in sub-Saharan Africa. Because
of this, the present study evaluates RDW in patients with ESRD and associated factors in Addis
Ababa, Ethiopia.

Methods: The hospital-based cross-sectional study design was conducted on a total of 83

patients. RDW, MCV, SCR, BUN, GFR, FBS and serum albumin were determined. Blood
pressure (mmHg), weight (kg), height (m), MUAC (cm) and BMI (kg/m2) were also measured.
Data entry was via Epi-data version 3.4 and analyzed with SPSS version 26.0. A multivariate
logistic regression analysis with a p-value < 0.05 at a 95% confidence interval was used to
identify the associated factors of RDW.

Results: A total of 83 ESRD patients participated, with a response rate of 95.4%. RDW ranged
from 15.5% to 23.6% with a mean of 17.40% + 1.46%. Anisocytosis was present in 98.8% of
patients. Of 83 patients, 66.3% were hypertensive, 20.5% had diabetes, and the remaining 13.3%

22
had other conditions (glomerulonephritis and peripheral vascular disease). The mean GFR value
was 5.20 mL/min/ 1.73 + 1.58. RDW showed a significant association with GFR (AOR: 4.6,
95% CI [1.27, 20.74], P = 0.047), alcohol consumption (AOR: 13.4, P = 0.012, 95% CI [1.97,
22.62]), recurrent kidney disease (AOR=25.6, P=0.016, 95% CI [1.85, 53.71]) and use of
medication (AOR=00.2, P=0.044), 95% CI [0.03, 0.95]).

Conclusion: RDW showed a significant association with GFR, recurrent kidney disease, alcohol
consumption, and medication use in hemodialysis-dependent ESRD patients. The mechanisms of
RDW disruption in ESRD patients need further investigation.

Post-abortion contraceptives uptake and its associated factors among clients visiting
abortion care services in public hospitals in West Shewa Zone, Oromia Regional State,
Ethiopia

Leta Hinkosa

Background: Post-abortion contraception is initiating and using post-abortion contraceptive

methods immediately after an abortion. It is a critical approach for preventing unwanted
pregnancy, alleviating its complications, and avoiding repeated abortions by promoting
immediate post-abortion contraceptives provision.

Objective: To assess post-abortion contraceptive uptake and associated factors among clients
visiting abortion care services in public hospitals in West Shewa Zone, Oromia Regional State,
Ethiopia.

Methods and Materials: Institutional based cross-sectional study was conducted in public
hospitals in the West Shewa zone from March 1, 2021, to May 30, 2021, among 227
proportionally allocated clients based on the proportion of the client served in the previous three
months of the study period. Data was collected through face-to-face interviews using semi-
structured and pre-tested questionnaires from women who received abortion services. Bivariable
and multivariable logistic regression was used to assess the association of independent variables

23
with post-abortion contraceptive uptake. Findings with a p-value of 0.05 at 95% CI were
considered statistically significant.

Results: The overall post-abortion contraception uptake among abortion service clients in public
hospitals was 164 (74%) while about 42% of them used long-term contraceptive methods. Post-
abortion contraceptive uptake was significantly associated with media exposure to post-abortion
family planning information [AOR: 3.4 (95% CI: 1.03, 11.27)] and counseling on post-abortion
family planning [AOR: 20.48 (95% CI: 5.02-83.64)].

Conclusion: The level of post-abortion contraceptive method uptake in West Shewa was low
compared to the national target. Greater attention should be given to providing post-abortion
contraceptive counseling to increase the post-abortion contraceptive uptake. Keywords: Post-
abortion contraceptive uptake, public hospitals, West Shewa Zone, Oromia Regional state,
Ethiopia

Minch Health and Demographic Surveillance Site, southern Ethiopia: Interpretive

Husserlian phenomenological study
Shitaye Shibiru
Introduction: Premature birth complications are the leading cause of under-5 child mortality,
accounting for 18%. More attention is needed for premature babies in low and middle-income
countries. Myths, misconceptions, and negative attitudes make premature births invisible and
slow prevention and care efforts. In Ethiopia, studies were conducted on premature birth and
associated factors. However, there is a lack of evidence regarding the perceived causes of
premature birth, caring aspects, and community challenges. As a result, this qualitative study
aimed to fill those research gaps in the study setting.

Methods: Interpretive Husserlian phenomenological study was conducted from January 1-30,
2022. The purposive sampling method was used to recruit the study participants. Four focus
group discussions were conducted with a total of 32 participants, which involved women (n=11),
grandmothers (n=7), grandfathers (n=6), and men (n=8). Ten key informants were involved in
the in-depth interview, which involved a traditional birth attendant (n=2), a traditional healer
(n=2), women (n=4), and men (n=2). The qualitative information was analyzed by using NVivo
12 Plus software. A thematic content analysis approach was used to analyze the collected data.

Results: In this study, the participants recognized premature babies by physical features such as
transparent and bloody bodies, small and weak bodies, a limited range of motion, and bizarre
behaviors. Being young, carrying heavily loaded materials, accidents, illnesses, sin, social
influence, and witchcraft were the perceived causes of premature birth. Participants provide
warmth by wearing cotton wool, making skin-to-skin contact, exposing to sunlight, and
24
wrapping themselves in clothes. They also feed boiled alcohol, muk, and formula to fresh cow
milk and butter. They frequently bathe the baby, wash and change clothes, limit visits, and
provide physical protection. The main challenges that the women faced were difficulty feeding
and bathing, limited social participation, psychosocial and economic impact, spirituality, and
husband negligence. Policymakers and program planners will use these findings to design
appropriate strategies in the community related to care practices for premature babies.

Conclusions: The community has a gap in providing care for premature babies, and women with
premature babies face a challenge. As such, attention and awareness should create to avoid
misconceptions about causes and caring practices, and there is a need to share the burden of
women.

Keywords: Premature babies, preterm care, perceptions, and experiences

The dietary practice among cohort pregnant women who gave birth to neonates with and
without neural tube defect: a comparative cross-sectional study

Anteneh Berhane

Introduction: Despite the high burden of neural tube defects (NTDs) in eastern Ethiopia, there
is no evidence that it is related to maternal dietary practice. The aim of the present study was to
compare dietary practice between women who gave birth to newborns with and without NTDs.
Methods: A comparative cross-sectional study was performed on a total of 276 (138 in each
group) mothers who delivered neonates with and without NTDs. Study participants were selected
from Adama hospital college, Hiwot fana specialized hospital and Dil-Chora referral hospital
that found in the eastern part of Ethiopia. The dietary practice was determined using the
indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and
consumption of animal source food (ASF) generated from the dietary data collected using
validated and pre-tested Food Frequency Questionnaire (FFQ). X 2 test, independent sample t-test
and multivariable logistic regression model were used to determine any statistically significant
differences and to isolate independent predictors of dietary practices respectively.
Results: The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There
was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P =

25
0·045) between the two groups. In multivariable logistic regression, mothers who delivered
without NTDs (AOR = 2·1, 95 % CI 1·07, 4·1), were more likely to have a good dietary practice.
Mothers from a rural (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI
0·03, 0·8) were less likely to have a good dietary practice.
Conclusion: The present study found that dietary practice is associated with the development of
NTDs. Nutrition education, food fortification and supplementation are needed to address this
issue, and further research is needed to explore the mechanism.

Prevalence and socio-demographic correlates of suicide among patients visiting the adult
emergency department of Adama hospital medical college, Adama, Oromia Regional State,
Ethiopia

SISAY MEGERSA

INTRODUCTION: Suicide is a global problem. It is an important cause of death across the

human lifespan. In addition to the impact on individuals who attempt and die from suicide, the
powerful ripple effect that suicide has on families, friends, communities, and countries is far-
reaching. However, it is a neglected public health issue in middle and low-income countries
especially practically in Ethiopia.

Methods: The hospital-based cross-sectional study method was conducted from February 1-
30/2018 involving 275 patients visiting EOPD through face-to-face interviews using a structured
questionnaire. Data were summarized using different summary formats and binary logistic
regression was computed to determine factors that are related to suicidal ideation and attempt.

26
Result: A total of 275 subjects participated with a response rate of 100%.The prevalence of
suicidal ideation was 18.9% [males=53.7%, females=46.3%] and the prevalence of suicidal
attempt were 12.4% [males=47.1%, females=52.9%]. Being, harmfully using alcohol, and
having a family history of suicide are seemed to be associated with suicidal Ideation. Drinking
alcohol, having a mental illness, and having a family history of suicide were positively
associated with suicidal attempts; but having a mental illness was not associated with suicidal
ideation. Seventy-five percent of males used hanging as a method of attempting suicide. But
poisoning was preferred by females (63.6%). Thirty-nine patients (13.7%) were identified to be
at increased risk of committing suicide; of whom 18 (46.1 %) had imminent risk and 21(53.9%)
were found to be at a potential risk.

Conclusion: The prevalence of suicide ideation and attempt were high and were associated with
preventable risk factors which show a significant health issue among emergency visiting patients
that requires a great emphasis.

Detection of treatable bacteria and Malaria among blood culture-negative samples of

febrile patients from a tertiary hospital in a high-altitude setting, Ethiopia: implications for
clinical management and public health.

Tafese Beyene

Background: Febrile illnesses contribute significantly to morbidity and mortality in sub-Saharan

Africa, but the lack of diagnostic facilities and the broad spectrum of pathogens can lead to
inadequate clinical management. The timely and reliable identification of the causative
pathogens in febrile patients is the basis for the administration of optimal treatment. We aimed to
evaluate the performance of a multiplex PCR among blood culture-negative patients presenting
with febrile diseases in Central Ethiopia.
Methods: From April 2016 to June 2018, we collected blood samples from adults and children
≥1 year of age admitted with febrile diseases to the Asella Referral and Teaching Hospital, which
is located at an altitude of 2400m above sea level in Central Ethiopia. Total nucleic acids were
extracted from frozen plasma samples using a MagnaPure96 instrument (Roche, Mannheim,
Germany). The multiplex PCR assays were used in combination with LightCycler Multiplex

27
DNA master mix (Roche) on a LightCycler 480 instrument (Roche). We used the pathogen-
specific assays for Plasmodium spp., Borrelia spp., Rickettsia spp., Leptospira spp., Salmonella
spp., and Arboviruses.

Results: We tested plasma samples of 511 patients and found positive results for Plasmodium,
Borrelia, and Rickettsia species in 6.3% (n=32). Residence in urban areas (9% vs. 4%; p=0.03),
male sex (9% vs. 3%; p=0.006), and not taking antibiotics (10% vs. 3%; p=0.005) were
identified as factors being associated with a positive PCR result.

Conclusion: Molecular testing using a multiplex-PCR can contribute to pathogens diagnosis in a

significant proportion of patients with febrile illnesses in the highland part of Ethiopia and help
to improve clinical management. We strongly recommend the expansion of molecular testing in
tertiary hospitals in the country.

Keywords: Febrile illness, sub-Sahara Africa, multiplex PCR, non-cultivable pathogens, high
altitude

Zinc agronomic biofortification of staple crops as a cost-effective strategy to alleviate zinc

deficiency in Ethiopia
Abdu Oumer

Background: Inadequate dietary zinc (Zn) supplies and Zn deficiency (ZnD) are prevalent
globally. Zinc agronomic biofortification (ZAB) of staple crops through the application of Zn
fertilizers may contribute to alleviating ZnD. However, large-scale promotion and adoption of
ZAB requires evidence of the feasibility and public health benefits. This paper aimed to quantify
the potential cost-effectiveness of ZAB of staple crops for alleviating ZnD in Ethiopia.

Methods: Current burden of ZnD among children in Ethiopia was quantified using a disability-
adjusted life years (DALYs) framework. Evidence on baseline dietary Zn intake, cereal
consumption, and fertilizer response ratio was compiled from existing literature and secondary
data sources. Reduction in the burden of ZnD attributable to ZAB of three staple cereals (maize,
teff, and wheat) via granular and foliar Zn fertilizer applications was calculated under optimistic
and pessimistic scenarios. The associated costs for fertilizer, labor, and equipment were

28
estimated in proportion to the cropping area and compared against DALYs saved and the
national GDP capita-1.

Results: An estimated 0.55 million DALYs are lost annually due to ZnD, mainly due to ZnD-
related mortality (91%). The ZAB of staple cereals via granular Zn fertilizer could reduce the
burden of ZnD by 29% and 38% under pessimistic and optimistic scenarios, respectively; the
respective values for ZAB via foliar application were 32% and 40%. The ZAB of staple cereals
via granular fertilizer costs US$ 370 and US$ 685 to avert each DALY lost under optimistic and
pessimistic scenarios respectively; the respective values for ZAB via foliar application were
US$117 and US$359. Foliar Zn application in combination with existing pesticide use could
reduce costs to US$124–217 for each DALY saved.

Conclusions: ZAB of staple crops via granular or foliar applications could be a cost-effective
strategy to address ZnD, which can be integrated with the existing fertilizer scheme and pesticide
use to minimize the associated costs.

29