Hawassa University, College of Medicine and Health Sciences

Time to death from cervical cancer and predictors among cervical cancer patients at Hawassa University Specialized and Comprehensive Hospital in Hawassa, Sidama Region, Ethiopia

Time to death from cervical cancer and predictors among cervical cancer patients at Hawassa University Specialized and Comprehensive Hospital in Hawassa, Sidama Region, Ethiopia Background: Cervical cancer is a malignant tumor of the cervix that emerges at the junction between the outer squamous cell layer and inner columnar cell lining of the cervix. Death of cervical cancer varied 18-fold between different regions of the world. In developing countries, less than 50% of women with cervical cancer survive longer than 5 years. The survival time and predictors of death from cervical cancer vary in different study settings. Therefore the aim of this study to assess the time to death from and to identify the major predictors of death of cervical cancer patients in Hawassa University specialized and comprehensive hospital. Objective: To assess time to death from cervical cancer and predictors among cervical cancer patients at Hawassa University specialized and comprehensive hospital, Hawassa, Ethiopia 2023. Methods: A facility-based retrospective follow-up study was conducted among 212 consecutively selected cervical cancer patients in HUSCH from January 1/2018 to December 31/2022. Data were extracted from the sampled patient charts by using a structured checklist which was prepared in an English version. Frequencies and proportions were used to describe the study population with relevant variables and were presented using tables, pie charts and graphs. Differences in survival among different variables were compared using the log-rank test. The assumption of proportional hazard was checked using Schoenfeld residual test. Variables having a P-value>0.05 were considered as fulfilling the assumption. Variables with a significance level below 0.25 in the bivariable Cox regression model were included in a multivariable Cox regression model analysis, where Variables with a p-value< 0.05 were considered to be statistically significant at a 95% confidence interval. Model fitness was checked by Cox-Snell residual. Results: The overall survival rate was 28.39% at 58 months. It is found that there were a significance differences in survival experience between categories of stage of cervical cancer and comorbidity being stage IV (AHR = 2.1; 95% CI: 1.068-4.068) and being comorbid (AHR=1.3; 95% CI: 0.65-1.233) were a significant predictors of death from cervical cancer. Conclusion and Recommendations: The median survival time of cervical cancer patients in this study was 6 months. Stage of disease and presence of co-morbidity were significant predictors of death for cervical cancer. Treatment of comorbidities in the early stage of cervical cancer plays a key role in maximizing the survival time of cervical cancer patients

Quality indicators in mycobacteriology laboratory at public health institute, Hawassa, South Ethiopia

Quality indicators in mycobacteriology laboratory at public health institute, Hawassa, South Ethiopia Introduction: Measuring performance indicators is a critical element of Quality Assurance for any diagnostic test as well as an ISO 15189 requirement. Targets should be set for all indicators monitored, and any unexplained change in quality indicators, such as an increase in error rates, a change in MTB positivity rate or Rifampicin resistance rate, or a significant change in volume of tests conducted, should be documented and investigated. Objective: The aim of this study was to establish and implement Quality indicators for Mycobacteriology Laboratory at PHIL, Hawassa, South Ethiopia from October 27, 2020 to February30, 2021. Method: A cross-sectional study was conducted on 229 samples from presumptive TB cases for Gene Xpert MTB/Assays and 439 specimens for MGIT and LJ Culture, to assess the Quality Indicators status of each technique. The specimens were received from Facilities under the referral network to the Mycobacteriology and processed, examined by the Mycobacteriology Lab as per the standard operating procedure and Data were tracked using real-time Gene Xpert software, Laboratory registers, and standardized formats. Fulfillment for Quality indicators was evaluated. Results: Of the 239 sputum sample processed by the Gene Xpert MTB/Assay, the M.Tuberculosis detection rate among presumptive TB cases was 37/229(16.2%), Rifampicin resistant tuberculosis was 1(2.7%) and the overall unsuccessful rate was 4/229(1.7%). The mean TAT for Gene Xpert MTB/RIF assay result is 21hrs with SD±6hours. While ,439 sputum specimens processed using both LJ and BACTEC MGIT culture methods the recovery rate for smear positive samples for both LJ and BACTEC MGIT Culture methods was 19/35(54.3%), whereas the recovery rate for smear negative samples was 19/369(5.1%) and 16/(4.2%) for BACTEC MGIT 960 and LJ methods respectively. Specimen rejection rate calculated was 0.93% (4/439).The mean TAT of mycobacteria from smear positive samples was 14.8 and 35.6, with SD±7.25 and 9.55 days for BACTEC MGIT 960 and LJ methods respectively. TAT for smear negative samples was 18.9 and 38.7 days for BACTEC MGIT 960 and LJ methods, with SD±3 and 5days respectively. The Contamination rates were 45/439(10.2%) and 42/439(9.6%) for liquid and solid cultures respectively. Non-Tuberculosis Mycobacteria detection rate was 6/439 (1.4%) Conclusion: Majority of the quality indicators are within target for specimen rejection, turnaround times for result delivery, Non-tuberculosis mycobacteria detection rates, Xpert MTB detection, and unsuccessful rates, whereas demands due attention to improve those indicators which were out of the target, low recovery rate, culture contamination rates and turnaround time to smear negative culture results.

Survival Time and Its Predictors among Hiv Infected Children on Anti Retroviral Therapy in Hawassa City Public Hospitals, Sidama Region, Southern Ethiopia: Retrospective Cohort Study

Survival Time and Its Predictors among Hiv Infected Children on Anti Retroviral Therapy in Hawassa City Public Hospitals, Sidama Region, Southern Ethiopia: Retrospective Cohort Study Background: Globally, HIV is still a major public health concern as it is a major contributor of the global disease burden among children and adults. Even though the efforts made to improve survival time of HIV-infected children have resulted in significant reductions in mortality rates among children, the presence of persistent and intolerably high numbers of child deaths shows that more work needs to be done to address the specific survival needs of children Objective: To assess survival time and its predictors among HIV infected children on antiretroviral therapy at Hawassa city public hospitals, Sidama region, Southern Ethiopia, 2023 Methods: A facility based retrospective cohort study was conducted in Adare general hospital and Hawassa university comprehensive specialized hospital among 261 children who had been on antiretroviral therapy from January 1st, 2010 to December 30, 2022. Data was collected by using ODK. The charts were reviewed from February to May, 2023. The collected data were exported to SPSS 26 and cleaned ,coded and then exported to STATA version 16 for statistical analysis. Descriptive statistics were used to describe the categorical variables A Kaplan Meier curve and long rank test were used to estimate the survival time and compare survival curves between variables. Multivariable Cox proportional hazards model was fitted to identify predictors of survival status and variables having p value < 0.05 were considered as statistically significant. Result: In this study, a total of 261 HIV children on ART were followed up with response rate of 93.4 for a total of 144 months, with a mean survival time of 133.3 months (95%CI= 128.8137.8). The overall mortality incidence rate in the cohort was 1.05/1000 child month observation. The overall Kaplan-Meir survival estimation curve showed that after last month of follow up, the survival probability of the child was 83.7%. In this study low hemoglobin level, poor adherence, Isoniazid prophylaxis, being underweight were statistically significant predictors of survival time (P <0.05). Conclusion and Recommendation: In this study, the estimated mean survival time was 133.3 months. Children with low hemoglobin level, who were underweight, not taking isoniazid ptophylaxis, and who had poor adherence were at higher risk of death. Therefore, concerned xi stakeholders should focus on above mentioned predictors of mortality and interventions should be taken to enhance survival of HIV infected children on antiretroviral therapy.

Levels of Practices of Professional Ethics and Associated Factors Among Maternal Health Care Providers in Governmental Hospitals of Sidama Region, Ethiopia, 2023

Levels of Practices of Professional Ethics and Associated Factors Among Maternal Health Care Providers in Governmental Hospitals of Sidama Region, Ethiopia, 2023 Background: Ethical practice is one of the main factors in providing quality care to women and mothers. It is also necessary for the health care personnel at any position of service to base their performance on common values which are indicators of their loyalty to the society and their profession as well. Objective: This study was aimed to assess practices of the professional ethics and associated factors among maternal health care providers in public hospitals in Sidama regional state, southern Ethiopia, 2023. Methods: A facility-based cross-sectional study was employed from April to May 2023 in hospitals of Sidama Region. The total sample size of 558 were collected from midwives, nurses and medical doctors who involved in maternal health care provision. The study was conducted by using semi- structured questionnaires. The data were entered in to Epidata and was analyzed using SPSS. Descriptive analysis such as proportions, frequency and distribution was employed, Bivariate and multivariate logistic regression analysis was computed to test strength of association. Independent variables with p-value of < 0.25 was included in multi-variable analysis. Adjusted odds ratios (AOR) with 95% CI, was estimated to assess the strength of associations and statistical significance was declared at a p-value < 0.05 Result: This study revealed that 174(33.3%) (95% CI =28.7-37.1) of maternal health care providers had good practice of the professional ethics. Age (AOR=0.42; 95% CI=0.21-0.84), type of profession (AOR=3.09; 95% CI = 1.53-6.24), substances users (AOR=0.44; 95% CI 0.28-0.68), graduated from private institution (AOR=0.40; 95% CI= 0.22-0.74) and positive attitude (AOR 2.82; 95% CI = 1.82-4.35) were factors significantly associated with the practice of health care ethics. Conclusion: This study revealed that the proportion of good practices of professional ethics among maternal health care providers was low. Age of respondent, type of profession, institution graduated from, attitude and used substance had statistical significant associated with practice of the professional ethics. Therefore, regional health Bureau should provide training on attitude of health professional ethics and Hospital admin should give emphasis on empowering nurse professionals regarding ethical practical.