http://ir.haramaya.edu.et//hru/handle/123456789/97 2026-06-10T10:53:15Z http://ir.haramaya.edu.et//hru/handle/123456789/8495 HEALTH-RELATED QUALITY OF LIFE AND ASSOCIATED FACTORS AMONG ADULT TYPE 2 DIABETES PATIENTS ATTENDING FOLLOWUP CARE AT PUBLIC HOSPITALS IN PUNTLAND, SOMALIA Bashir Khalif; Shiferaw Letta (PhD); Hassen Abdi (Assista Profess) Health-related quality of life is essential in managing diabetes mellitus, as compromised quality can negatively impact self-care and glycemic control, increasing complication risks. However, there is limited information on Health-related quality of life in Puntland, Somalia. Objectives: This study aimed to assess Health-related quality of life and its associated factors among adults with type 2 diabetes attending follow-up care at public hospitals in Puntland, Somalia, from July 28 to August 28, 2024. Methods: a cross-sectional study involving 403 randomly selected adult type 2 diabetic patients from public Hospitals. Data were collected through face-to-face interviews using Open Data Kit and validated instruments, including the World Health Organization Quality of Life - Brief and Diabetes Self-Care Activities Scale. Data were analyzed using StataMP 17, employing descriptive statistics, independent Ttests, one-way analysis of variances, and both bivariable and multivariable linear regression analyses. Result: The mean overall health-related quality of life score was 52.9 ± 6.90, with the highest domain score in physical health (54.9 ± 12.43) and the lowest in the environmental domain (51.38 ± 16.65). The majority of participants were under 40 years old (41.19%), male (50.87%), and resided in urban areas (79.4%). Approximately 59.31% were married. Behaviorally, 42.18% of participants reported poor self-care practices, 48.39% exhibited low patient empowerment. Clinically, 83.37% had been diagnosed with type 2 diabetes mellitus for five years or less, and 27.79% reported complications, primarily depression (28.6%). Most participants (80.89%) were on oral medications. Multivariable analysis identified several factors significantly associated with improved health outcomes among individuals with type 2 diabetes mellitus. Participants with secondary education or higher demonstrated better health outcomes (β = 1.75, p = 0.040, 95% CI: 0.084, 3.42). The absence of comorbidity was strongly correlated with better health (β = 2.62, p < 0.001, 95% CI: 1.15, 4.08). Conversely, waiting times exceeding 15 minutes negatively impacted health-related quality of life (β = -2.32, p = 0.049, 95% CI: -4.64, -0.008). Conclusion: The health-related quality of life among patients with type 2 diabetes mellitus in Puntland, Somalia is moderate highlighting the significant influence of educational, clinical, and psychosocial factors. Major barriers to improved health-related quality of life include limited access to healthcare and diabetes-related complications. 98p. 2025-03-01T00:00:00Z 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