http://ir.haramaya.edu.et//hru/handle/123456789/97 2026-04-09T11:53:06Z http://ir.haramaya.edu.et//hru/handle/123456789/8396 HEPATITIS B INFECTION PREVENTION PRACTICE AND VACCINATION STATUS AMONG HEALTHCARE WORKERS IN HARGEISA CITY, SOMALILAND MOHAMED IBRAHIM JAMA (BSc); Admas Abera (MSc, Assistant Professor); Abebe Tolera (MPH, Assistant Professor) Background: Hepatitis B Virus (HBV) infection is an important global public health challenge, with sub-Saharan Africa disproportionately affected. Healthcare workers faced an increased risk of hepatitis B infection due to their exposure to bodily fluids. However, evidence on hepatitis B infection prevention practices and vaccination status among healthcare providers remains limited in Somaliland. Objective: This study aimed to assess hepatitis B infection prevention practices and hepatitis B vaccination status among Healthcare Workers in Hargeisa City, Somaliland. Methods: An institution-based cross-sectional study was conducted among randomly selected 348 healthcare workers from 14 health facilities in Hargeisa, Somaliland. A structured, interviewer-administered questionnaire was used to assess hepatitis B infection prevention practices and vaccination status. Multivariate logistic regression was used to assess factors associated with infection prevention practice and vaccination status at a 5% significance level. Result: Nearly half 48% (95% CI: 46.7%–57.3%) of healthcare workers demonstrated good HBV prevention practices, and only 35.1% (95% CI: 30.0%–40.1%) were vaccinated. Poor prevention practice was significantly associated with poor knowledge (AOR = 2.07, 95% CI: 1.18–3.62), unfavourable attitudes (AOR = 2.30, 95% CI: 1.18–4.48), lack of personal protective equipment (PPE) (AOR = 4.68, 95% CI: 2.26–9.71), and vaccine unavailability (AOR = 3.78, 95% CI: 1.72–8.31). Regarding vaccination status, HCWs were significantly less likely to be vaccinated if they lacked access to PPE (AOR = 0.37, 95% CI: 0.17–0.81), lacked access to vaccines at their facility (AOR = 0.19, 95% CI: 0.09–0.44), were not offered free vaccination (AOR = 0.43, 95% CI: 0.21–0.90), did not adhere to preventive guidelines (AOR = 0.33, 95% CI: 0.14–0.76), or possessed poor knowledge regarding the vaccine (AOR = 0.36, 95% CI: 0.20–0.63). Conclusion: A significant proportion of health professionals were having good hepatitis B virus infection prevention practices, while slightly more than one-third were vaccinated. Overall, there is a lack of best practices and low vaccination rates for hepatitis B prevention. Limited knowledge, unfavourable attitude, lack of personal protective equipment, absence of hepatitis B vaccines, and not adhering to HBV preventive guidelines were found to be significantly associated with hepatitis B infection prevention practices and vaccination status. 69 2025-09-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8395 MAGNITUDE OF TOBACCO USE AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE AT PUBLIC HEALTH FACILITIES IN HARAR TOWN AND DIRE DAWA ADMINISTRATION, EASTERN ETHIOPIA: A MIXED METHODS STUDY WINI ABDI (BSc); Mr. Assefa Tola (MPH, Assistant professor); Dr. Shiferaw Letta (Ph.D., Assistant professor) Background: Tobacco use during pregnancy is one of the most important modifiable risk factors that can seriously and adversely affect the health of both women and their newborns. However, there is limited information on the magnitude of tobacco use and its associated factors among pregnant women in Ethiopia, particularly in the context of the specific study setting. Objective: To assess the magnitude of tobacco uses and associated factors among pregnant women attending antenatal care at selected public health facilities at Harar Town and Dire Dawa City Administration, eastern Ethiopia from June 15 – August 15, 2024. Method: An explanatory mixed-methods study was conducted among 796 pregnant women attending ANC at seven public health facilities in Harar Town and Dire Dawa. The quantitative cross-sectional survey used a pretested Kobo Toolbox questionnaire and was analyzed in Stata MP v17 (p < 0.05). The embedded qualitative component included 15 tobacco-using women purposively selected for in-depth interviews, which were transcribed, translated, coded, and analyzed thematically. Results: This study revealed that the magnitude of tobacco use during pregnancy among women attending antenatal care was 12.05% (95% CI: 9.9, 14.5). Urban residence (AOR = 8; 95% CI: 2.2–32.1), lack of tobacco-related advice during ANC (AOR = 6.1; 95% CI: 2.5–14.8), chronic comorbidities (AOR = 3.7; 95% CI: 1.6–8.5), khat chewing (AOR = 11; 95% CI: 3.5 40), and prior tobacco use (AOR = 13; 95% CI: 6.5–28) were significantly associated with tobacco use. Qualitative themes included habitual smoking, stress-related coping, limited awareness of the harms of tobacco, family and social normalization, peer influence, and environmental cues, all of which highlighted the contexts that sustain tobacco use during pregnancy. Conclusion: This study highlights a high magnitudeof tobacco use among pregnant women attending ANC and its key risk factors, including urban residence, chronic comorbidities, khat chewing, and prior tobacco use. Tobacco-related counseling during ANC helps reduce use, emphasizing the need for routine screening and culturally sensitive cessation support to protect maternal and newborn health. 99 2025-08-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8315 TIME TO RECOVERY FROM ECLAMPSIA, AND ITS PREDICTORS AMONG PREGNANT AND POSTPARTUM MOTHERSADMITTED TO SELECTED PUBLIC HOSPITALS OF HARARI REGION AND DIRE DAWA CITY ADMINISTRATION, EASTERN ETHIOPIA Nano Belama (BSc, MSc); Adisu Birhanu (MPH, Assistant Professor); Dumessa Edessa (MSc, Assistant Professor) Background:Eclampsia is defined by a sudden onset of generalized tonic-clonic convulsions in a patient having signs and symptomsof preeclampsia. Mothers with eclampsia can face potentially fatal complications such as acute renal failure, aspiration pneumonitis, abrupt placenta abruption, liver rupture, intracerebral hemorrhage, and acute pulmonary edema.Even though there is a high burden of eclampsia, there is limited evidence on the time to recover from eclampsia and its predictors in EasternEthiopia. Objective:This study aimed to assess the time to recovery from eclampsia, and its predictors among pregnant and postpartum women admitted to public hospitals of Harari Region and DireDawa Administration from January 1, 2017, to December 31, 2022. Methods:An institution-based retrospective cohort study was conducted among 475 eclamptic women and data was collected by reviewing their records. A simple random sampling method was used to select cards of patients. The data were entered using Epidata version 4.6 and analyzed by STATA 17. The probability of time to recovery was estimated using the Kaplan-Meier failure curve, and the equivalence of failure functions across explanatory variables was tested using the log-rank test. A Weibull PH regression model was used to identify the predictors of time to recovery. A multicollinearity was checked using the variance inflation factor (VIF= 3.30).Factors significantly associated with the outcome variable in bi-variable analysis at a p-value less than 0.25 were included in the multivariable analysis. Statistically significant associations were measured by the adjusted hazard ratio with a 95% confidence interval at a p-value less than 0.05.The goodness of fit of the model was assessed by using the Cox–Snell residual technique. Results:The study found that nine in ten mothers admitted with eclampsia recovered, corresponding to an incidence density of 11.24 per 100 mothers' hours. The median duration of eclampsia of the mothers was 8 hours (IQR: 6, 10). Lack of ANC visits (AHR=0.780, 95%CI: 0.640- 0.9524), being aged ≥ 35 (AHR=0.429, 95%CI: 0.276-0.665), giving birth by cesarean (AHR=0.699, 95%CI: 0.561-0.872), labor started by induction (AHR=1.404: 95%CI: 1.145-1.721), and being a rural resident (AHR=0.732, 95%CI: 0.587-0.913) were independent predictors of time to recovery for eclamptic mothers. Conclusions: The median recovery time from eclampsia among mothers admitted with eclampsia in Eastern Ethiopia is low (8 hours) relatively low based on the previous study. We xiii found that several factors, including age≥ 35 years, being a rural resident, lack of ANC visits, and cesarean delivery, contributed to the extended recovery time for eclamptic mothers in eastern Ethiopia. However, labor induction led to a faster recovery time. To improve the recovery time from eclampsia special focus should be given to mothers who had no ANC visits, rural dwellers, old age, and who gave birth by cesarean. 56 2024-06-01T00:00:00Z http://ir.haramaya.edu.et//hru/handle/123456789/8267 VIROLOGICAL TREATMENT FAILURE AND ASSOCIATED FACTORS AMONG ADULTS ON FIRST-LINE ANTIRETROVIRAL THERAPY IN DIRE DAWA, EASTERN ETHIOPIA: A HEALTH-FACILITY BASED CROSS-SECTIONAL STUDY Kenesa Tesema Dibaba; Melkamu Merid (MPH, Assistant Professor); Dumessa Edessa (MSc, Assistant Professor) Background: First-line antiretroviral therapy (ART) failure reduces the benefits of the ART program and leads to switching to more expensive and the challenging implementation of second-line ART. Routine viral load monitoring is recommended as the gold standard for identifying ART failure and has been fully implemented in Ethiopia since 2017. However, there is limited information available regarding the virological failure of first-line ART in Ethiopia, notably in Dire Dawa. Objective: The aim of this study was to determine the magnitude and assess factors affecting virological treatment failure among adults initiated on first-line ART between January 2017 and December 2019 in Dire Dawa. Methods: A facility-based cross-sectional study was conducted utilizing routine ART data from all health facilities providing the service in the Dire Dawa. Stratification by the year of ART initiation with proportional allocation to the patient load was used to randomly draw 272 records. The data were collected using a record review checklist prepared in the English language. EpiData version 3.02 was used for data entry while analysis was conducted using Stata version 15 software. To identify factors associated with virological ART failure, both bivariable binary logistic regression (with a p-value ≤ 0.25), and then multivariable binary logistic regression (with 0.05 significance level) that computed adjusted odds ratio (AOR) and 95% confidence intervals (CI) was used. Results: A total of 257 ART patients’ records were reviewed. The magnitude of first-line ART virological failure was 11.28% (95% CI: 7.69, 15.80). Baseline under-nutritional status (AOR = 3.717: 1.051, 13.139), serostatus nondisclosure (AOR = 4.453: 1.340, 14.793), early (≤ 30 days) ART initiation (AOR = 0.235: 0.064, 0.859), history of missed daily ART dose (AOR = 3.156: 1.007, 9.891) and dolutegravir (DTG) based regimen (AOR = 0.275: 0. 085, 0.895) were statistically associated with virological failure of first-line ART. Conclusion: The healthcare providers should focus on an accelerated ART (preferably DTG based regimen) initiation, and supplemental nutritional therapy for under-nutrition. To enhance the virological outcome, Dire Dawa Administration Health Bureau and pertinent partners should work to promote the initiation or substitution of DTG and facilitate access to facilities for viral load testing. 57 2023-12-01T00:00:00Z