http://ir.haramaya.edu.et//hru/handle/123456789/205 2026-06-10T08:21:14Z http://ir.haramaya.edu.et//hru/handle/123456789/8561 THE MICROBIOLOGICAL PROFILES AND OUTCOMES OF PEDIATRIC ORTHOPEDIC INFECTIONS AT HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, HARAR, ETHIOPIA DR. TESFAHUN KEBEDE NUNNE; Tekalign Tsegaye (MD, Assistant Professor of Orthopeadics and Trauma surgery, Pediatric Orthopeadics Subspecialist); Abebe Tolera (MPH, Assistant Professor of Epidemiology) Background: Pediatric orthopedic infections are a significant cause of morbidity in low-income countries, yet data from Eastern Ethiopia are limited. Objectives: To assess the microbiological spectrum, clinical outcomes, and determinants of outcome in pediatric orthopedic infections at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia. Methods: A retrospective cross-sectional review was conducted on medical records of 311 pediatric patients (≤18 years) diagnosed with orthopedic infections between January 2022 and December 2024. Data were collected using a structured checklist and analyzed with SPSS version 27. Bivariate and multivariable logistic regression analyses were performed to identify predictors of poor treatment outcomes, with statistical significance set at p<0.05 Results: Orthopedic infections accounted for 32.0% of pediatric orthopedic consultations. The mean age was 11.2 years (SD=4.86), with a predominance of males (72.0%) and rural residents (71.7%). Chronic osteomyelitis was the most common diagnosis (29.3%), followed by septic arthritis (16.4%) and acute osteomyelitis (10.6%). Cultures were positive in 58.0% of cases with Staphylococcus aureus as the predominant pathogen (45.1%). Notably, 72.3% of Staphylococcus aureus isolates were methicillin-resistant (MRSA). Resistance to commonly used antibiotics was high: ceftriaxone (69.2% resistant), ampicillin (81.5%), while Vancomycin (>90%), clindamycin (83.1%), and gentamicin (81.5%) retained good activity. Combined surgical and medical therapy was used in 97.1% of patients, but only 41.5% received culture-guided definitive antibiotics. Median time to emergency surgery was 8 hours, with 72.0% experiencing delay >6 hours. Complete recovery without complications was achieved in 60.8%, while 15.8% had complicated/unresolved infections, and mortality was 0.6%. Multivariable analysis identified late presentation >7 days (AOR=2.41; 95% CI: 1.24-4.67), multifocal involvement (AOR=2.70; 95% CI: 1.33-5.50), prior antibiotic exposure (AOR=2.75; 95% CI: 1.54-4.90), malnutrition (AOR=2.45; 95% CI: 1.26-4.79), MRSA infection (AOR=3.27; 95% CI: 1.56-6.85), and delay in emergency surgery >6 hours (AOR=1.82; 95% CI: 1.01-3.25) as independent predictors of poor outcome. Conclusion: Pediatric orthopedic infections at HFCSUH are characterized by high prevalence, advanced disease at presentation, alarming antimicrobial resistance (particularly MRSA at 72.3%), and suboptimal outcomes. Current empirical therapy (ceftriaxone-based) is inadequate. Delayed presentation, malnutrition, MRSA, and surgical delays independently predict poor outcomes. Updated local treatment guidelines, strengthened diagnostic capacity, and improved surgical access are urgently needed. 82 2026-05-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8552 PREVALENCE OF ACUTE KIDNEY INJURY AND ASSOCIATED FACTORS AMONG ADULT PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, EASTERN ETHIOPIA KALEB ABRHAM KIFLE (MD); Dr Ruth Desta (Assistant professor of ACCPM); Lemma Demisse (Assistant professor of Public Health) Background: Acute Kidney Injury is a highly prevalent condition among critically ill patients admitted to Intensive Care Units globally, significantly contributing to high morbidity and mortality. The significant gap is that there is no prior study establishing the incidence, risk factors, and outcomes of Acute Kidney Injury among Intensive care Unit patients at Hiwot Fana Comprehensive Specialized Hospital. Furthermore, the lack of early diagnostic capacity and limited local data hinder timely intervention and effective management of Acute Kidney Injury in this high-risk population. Objective: To Assess the prevalence of acute kidney injury and associated factors among adult patients admitted to the intensive care unit at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia, from October 01-30, 2025. Methods: An institutional-based retrospective cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized Hospital from September 02, 2024, to September 28, 2025. A sample size of 229 participants was determined using a single population proportion formula. Simple random sampling was employed, and data were collected using a structured data collection tool. Statistical analysis included descriptive statistics, bivariable, and multivariable binary logistic regression. Results: The magnitude of acute kidney injury among adult intensive care unit patients was 33.62% (95% CI: 27.65%–39.79%). Factors significantly associated with acute kidney injury included complications during ICU stay (AOR = 3.57, 95% CI: 1.60–8.00), assisted ventilation (AOR = 4.19, 95% CI: 1.19–14.68), and leukocytosis (AOR = 5.72, 95% CI: 2.45–13.37). Mortality (AOR = 3.09, 95% CI: 1.29–7.43) was also higher among patients with acute kidney injury. Conclusion: Approximately one-third of intensive care unit patients developed acute kidney injury. acute kidney injury was significantly associated with intensive care unit complications, assisted ventilation, leukocytosis, and higher mortality. These findings highlight the multifactorial nature of acute kidney injury in critically ill patients and underscore the importance of early risk identification, vigilant monitoring, and proactive supportive care to improve patient outcomes. 54 2026-01-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8551 DETERMINANTS OF PROLONGED ICU STAY AND ASSOCIATED COMPLICATIONS AMONG ADULTS AT HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL: A CROSS-SECTIONAL STUDY EYOBEL ABAYNEH TIRUNEH (MD); Seid Ali (Assistant Professor of Anesthesiology, Critical Care & Pain Medicine); Abebe Tolera (Mph, Assistant Professor) Background: Prolonged intensive care unit stay is a significant global public health issue, associated with increased mortality, morbidity, and healthcare costs. Despite the advancement in critical care, extended intensive care unit stay remains a problem, particularly in resource-poor settings like Ethiopia. Identification of predictors of extended intensive care unit stay and complications is important to maximize patient outcomes and resource utilization. Objective: This study aimed to assess determinants of prolonged intensive care unit stays and their complications among adult patients admitted to the intensive care unit at Hiwot Fana Comprehensive Specialized Hospital from October 01 2024 to September 29 2025. Methods: An institutional-based cross sectional study design was employed at Hiwot Fana Comprehensive Specialized Hospital. The data collection for this study took place from September 5 to September 30 2025. Data was collected using a structured checklist and medical records reviews. Data was analyzed using SPSS version 27. Descriptive statistics, Bivariable and Multivariable logistic regression, were employed. Results: Among 239 patients, the prevalence of prolonged ICU stay was 25.9%. Multivariable analysis identified several independent predictors of prolonged stay: Age (AOR = 1.02, 95% CI: 1.01–2.04, p = 0.031), those admitted from the Medical ICU (AOR = 7.50; 95% CI: 1.10–11.10), and patients presenting with High BP Stage 1 (AOR = 4.90; 95% CI: 1.55–15.45) on admission. Other significant independent predictors included comorbid illnesses (AOR = 2.70; 95% CI: 1.90–3.20), the occurrence of complications during the stay (AOR = 3.32; 95% CI: 1.41–7.80), a severely depressed GCS (AOR = 2.50; 95% CI: 1.15 5.45), and the requirement for mechanical ventilation (AOR = 2.50; 95% CI: 1.05–5.95). Conclusion and Recommendations: In this study, the prevalence of prolonged ICU stay was high, affecting approximately one-quarter of adult patients. Factors such as age, presence of comorbidities, admission from the Medical ICU, severely depressed GCS, need for mechanical ventilation, and development of in-ICU complications were significantly associated with prolonged stay. As a result, the hospital should implement early screening protocols for high-risk patients and strengthen preventive care to reduce complications and optimize ICU bed utilization. 59 2025-12-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8550 KNOWLEDGE, ATTITUDE, AND PRACTICE OF ENHANCED RECOVERY AFTER SURGERY PROTOCOL AND ASSOCIATED FACTORS AMONG HEALTHCARE PROFESSIONALS IN PUBLIC HOSPITALS OF HARAR CITY, EASTERN ETHIOPIA ADDIS BEKELE (MD, ACCPM RESIDENT); Sirak Worku (MD, Assistant professor of ACCPM); Mr. Addisu Birhanu (Assistant professor of Biostatistics) Background: The Enhanced Recovery after Surgery protocol is a systematic, evidence-based method to optimizing perioperative care, improving patient outcomes, and promoting recovery. Despite its established benefits, many healthcare settings, particularly those with limited resources, struggle to fully adhere to the protocol. In addition there is lack of evidence based information on the Knowledge, attitude, practice and factors associated with the practice of the enhanced recovery after surgery protocol among health care professionals in public hospitals in Harar, Eastern Ethiopia. OBJECTIVE: To assess knowledge, attitude, practice and factors associated with the practice of enhanced recovery after surgery protocol among health care professionals in public hospitals in Harar, Eastern Ethiopia, from September 1 to October 30, 2025. Methods: An institution-based cross-sectional study was conducted among 270 healthcare professionals who are working in public hospitals of Harar. Data were collected using Kobo Toolbox and analyzed with Stata version 17. Bivariable and multivariable logistic regression analyses were performed, and variables with p < 0.05 in the multivariable model were considered independent predictors of consistent practice. Results: Among the participants, 21% had adequate knowledge and 19% exhibited a positive attitude toward the Enhanced Recovery after Surgery (ERAS) protocol, while only 36% demonstrated consistent practice across all ERAS components. Working in referral or teaching hospitals (AOR = 1.89, 95% CI: 1.12–3.19) and having a positive attitude (AOR = 2.11, 95% CI: 1.11–4.00) were associated with higher odds of consistent practice, whereas participants with more than five years of experience had lower odds (AOR = 0.43, 95% CI: 0.24–0.79). Conclusion: Knowledge, attitude, and consistent practice of the ERAS protocol were low. Working in referral or teaching hospitals and having a positive attitude were associated with better practice, whereas longer professional experience was linked to lower adherence, underscoring the need for targeted interventions to improve ERAS implementation. 52 2025-11-01T00:00:00Z