Specialized Program

URI for this collectionhttps://rps.wku.edu.et/handle/123456789/46883

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    SPECTRUM OF CARDIOVASCULAR DISEASE ADMISSIONS, OUTCOME, AND ASSOCIATED FACTORS IN WOLKITE UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, CENTRAL ETHIOPIA: RETROSPECTIVE STUDY
    (wolkite University, 2026-06) Dr. Tarekegn Murezha
    Background: Cardiovascular diseases are the leading cause of death globally, with approximately 80% of these deaths occurring in low- and middle-income countries, including Ethiopia. Despite this growing burden, there is a significant lack of localized data on the clinical profile, outcomes, and associated factors of cardiovascular disease admissions in many regions of the country, including the study area. This study seeks to fill that gap by providing crucial evidence from a tertiary care setting. Objective: To assess the clinical spectrum, admission outcomes, and determinants among patients admitted with cardiovascular diseases at Wolkite University Comprehensive Specialized Hospital. Methods: An institution-based retrospective cross-sectional study was conducted among 357 cardiac patients admitted to Wolkite University Comprehensive Specialized Hospital from September 1, 2022, to September 1, 2025. A systematic random sampling method was applied, and all eligible medical records were reviewed from this period. Data on types of cardiovascular diseases, clinical presentation, diagnostic results (including echocardiography), treatment, and inhospital outcomes were collected using a pre-tested, structured data extraction checklist. Data were entered into Epi-Data version 4.6 and then exported to SPSS version 27 for statistical analysis. Descriptive statistics (frequencies, percentages, means, and standard deviations were used to summarize the burden and spectrum of cardiovascular disease. Bivariate analyses and multivariable logistic regression were used to identify factors associated with admission outcomes. A p-value of less than 0.05 at 95% CI was considered statistically significant. Results: A total of 357 cardiovascular disease admissions were included in the analysis. The most common cardiovascular diagnoses were Stroke, heart failure, and ischemic heart disease. The overall in-hospital mortality rate was 10.9%. Among the independent factors, hemorrhagic stroke (AOR = 7.92, P = 0.004) and ICU admissions (AOR =5.45, P = 0.020) are associated with unfavorable outcomes. Conclusion: The study area has a high prevalence of cardiovascular diseases, which significantly increases morbidity and mortality. Overall, this study demonstrates an increasing burden of stroke and heart failure among patients admitted for cardiovascular disease in Gurage zone. The majority of cardiovascular diseases involve potentially modifiable risk factors that may have stopped or slowed the disease’s progression. Among the independent variables hemorrhagic stroke and ICU admissions were associated with poor admission outcome.
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    GLYCEMIC CONTROL AND ITS DETERMINANTS AMONG TYPE 2 DIABETES PATIENTS AT PUBLIC HOSPITALS IN GURAGE ZONE, CENTRAL ETHIOPIA, 2025.
    (wolkite University, 2025-06) Dr. YONAS GIRMA
    Background: Poor glycemic control is a major public health issue among patients with type 2 diabetesmellitus and it is a significant risk factor for the progression of diabetic complications. Numerous studieshave documented the importance of glycemic control and the factors that influence it. However; as of the studies done previously in Ethiopia the result are wide in terms of magnitude and its determinants. This study aimed to assess the magnitude and its determinant factors of poor glycemic control among type 2diabetes patients public hospitals of Gurage zone, central Ethiopia. Methods and materials: A hospital-based cross-sectional study was conducted among 316 patients withtype 2 diabetes mellitus attending follow-up clinics at public hospitals in the Gurage Zone from November to December 2025. Study participants were selected using a systematic probability sampling technique, andall eligible patients who met the inclusion criteria were included. Data were collected through face-to-faceinterviews using a structured questionnaire and by reviewing patients’ medical charts. The data were entered into EpiData version 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics wereused to summarize the data, while bivariate and multivariable logistic regression analyses were performedto identify factors associated with glycemic control. Results: Among the 316 study participants, 216 (68.4%) had poor glycemic control and 100 (31.6%) hadgood glycemic control. Longer duration of diabetes (AOR = 4.12; 95% CI: 1.73–9.80), poor medicationadherence (AOR = 7.64; 95% CI: 3.59–16.28), non-adherence to dietary recommendations (AOR = 2.55;95% CI: 1.15–5.65), and older age (AOR = 6.38; 95% CI: 2.41–16.86) were independently associated withincreased odds of poor glycemic control. Access to a health care facility was associated with reduced odds of poor glycemic control (AOR = 0.25; 95% CI: 0.12–0.54). Diabetic complications, comorbidity status, and community-based health insurance were not significant in the adjusted analysis. Conclusion and Recommendations: Poor glycemic control was highly prevalent among patients with type 2 diabetes mellitus in Gurage Zone public hospitals. Longer duration of diabetes, poor medication and dietary adherence, older age, and who lack access to health care facilities were significant predictors of poor glycemic control. Strengthening patient education on adherence, improving access to chronic care services, and prioritizing high-risk groups are essential to improve glycemic outcomes
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    POOR OUTCOMES OF ILEOSIGMOID KNOTTING AND ASSOCIATED FACTORS AMONG ADULT PATIENTS OPERATED AT WOLKITE UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL: A CROSS-SECTIONAL STUDY (JANUARY1, 2020 – DECEMBER 31, 2025)
    (wolkite University, 2026-06) DR SINTAYEHU BEKELE
    introduction Ileosigmoid knotting (ISK) is a rare but unique life-threatening surgical emergency in which a loop of the ileum and the sigmoid colon wrap around each other. The aim of this study was to evaluate poor outcomes and associated factors among adult patients operated for ISK. Methods This is institution-based cross-sectional study conducted at Wolkite University Comprehensive Specialized Hospital in Wolkite, Central Ethiopia. The study reviewed medical records over a six-year period, from January 1, 2020, to December 31, 2025, and included 54 adult patients who underwent surgery for ileosigmoid knotting. Secondary data were extracted from patient medical records and analyzed using SPSS version 27. A p-value of <0.05 was considered statistically significant. ResultsOf the 54 patients, 50 (92.5%) had complete medical records and were included in the analysis. Poor postoperative outcomes occurred in 23 patients, giving a proportion of 46%(95% CI: 31.8%–60.7%). Age (AOR=2.05, 95% CI: 1.03–4.07), bowel gangrene (AOR=3.84,95% CI: 1.46–10.10), preoperative shock (AOR=4.34, 95% CI: 1.48–12.69), and prolonged duration of symptoms (AOR=11.03, 95% CI: 2.69–45.20) were independently associated withpoor postoperative outcome. Conclusions and recommendations Nearly half of the participants had poor postoperative outcome. It is associated with advance age, delayed presentation, preoperative shock, and presence of bowel gangrene. Early recognition, prompt surgical intervention, and aggressive perioperative optimization, and stoma creation in double bowel gangrene are essential to improve outcomes.
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    IN HOSPITAL OUTCOME AND ASSOCIATED FACTORS AMONG ADULT ACUTE STROKE PATIENTS ADMITTED TO WOLKITE UNIVERSITY SPECIALIZED HOSPITAL FROM OCTOBER 2023 TO DECEMBER 2025: HOSPITALBASED RETROSPECTIVE CROSS-SECTIONAL STUDY
    (wolkite University, 2026-06) SEID YESUF
    Background: Stroke is a leading cause of morbidity and mortality in low- and middleincome countries, including Ethiopia. However, evidence on in-hospital treatment patterns, complications, and predictors of outcome among hospitalized stroke patients remains limited. Methods: A hospital-based retrospective study was conducted among patients admitted with acute stroke. Data on socio-demographic characteristics, vascular risk factors, clinical presentation, laboratory and imaging findings, in-hospital treatment, complications, and outcomes were collected and analyzed. Multivariable logistic regression analysis was performed to identify independent predictors of poor in-hospital outcomes. Results: A total of 236 patients admitted with acute stroke were included in the study. The mean age was 62.1 ± 13.7 years, with a slight male predominance (51.7%). Hypertension (67.8%) was the most common risk factor, and most patients presented late after symptom onset. Ischemic stroke accounted for 59.3% of cases. Overall, 41.1% of patients experienced a poor outcome, including clinical deterioration (28.0%) and death (12.3%). In multivariable analysis, moderate to severe impairment of consciousness at admission (AOR = 6.98; p < 0.001), higher admission RBS (AOR = 2.26; p = 0.032), renal dysfunction (AOR = 2.87; p = 0.016), delayed blood pressure management (AOR = 2.89; p = 0.041), and prolonged hospital stay (AOR 3.12; p = 0.008) were independent predictors Conclusion: Poor in-hospital outcomes among stroke patients remain substantial. Admission neurological status and random blood sugar, renal dysfunction, delayed blood pressure management, and prolonged hospitalization are key associated factors of adverse outcomes, highlighting the need for early risk stratification and comprehensive inpatient care in resource-limited settings
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    FACTORS ASSOCIATED WITH OBSTRUCTED LABOR AND ITS MATERNAL AND PERINATAL OUTCOMES AMONG MOTHERS WHO GAVE BIRTH AT WOLKITE UNIVERSITY SPECIALIZED HOSPITAL: UNMATCHED CASE-CONTROL STUDY, WOLKITE, ETHIOPIA
    (wolkite University, 2026-06) MUKTAR MOHAMMAD
    Background: Global maternal mortality due to obstructed labor is responsible for 9% of all maternal deaths. About half of the maternal deaths occurred in sub-Saharan Africa alone and one third took place in South Asia. Obstructed labor contributes 13% of maternal death in Ethiopia. Women who experienced obstructed labor for prolonged time can be complicated with fistula, serious social issues of divorce, separation from religious exercises, detachment from their families which can worsen poverty and malnutrition. Objective: To assess factors associated with obstructed labor and its maternal and perinatal outcomes among mothers who gave birth in WKUSH from January, 2022 to December, 2024 Methodology: Unmatched case - control study design was employed among cases and controls who delivered in WKUSH from January, 2022 to December 2024. Total sample size calculated to be 176, 59 were cases and 117 were control. Cases of obstructed labor were selected by simple random sampling and convenience sampling was employed to enroll the control group. Bivariate analysis between dependent and independent variables was performed. Variables with a p-value of < 0.05 were used as statistically significant factors and adjusted odds ratio with 95% confidence interval was used to measure strength of association. Results: A total of 176 study subject, 59 cases and 117 control were enrolled the study. After performing multivariate logistic regression, four variables (distance from WKUSH, nulliparity, partograph utilization and place of labor follow up at health center) were the significant predictors of obstructed labor. Stillbirth, birth asphyxia, postpartum hemorrhage, obstetric fistula, SSI, longer hospital stay and maternal death were the major adverse perinatal outcome identified among cases. Conclusions: Obstructed labor was associated with increased maternal and newborn morbidity and mortality. Stillbirth, birth asphyxia, postpartum hemorrhage, SSI, longer hospital stay, obstetric fistula and maternal death were the common adverse outcomes of obstructed labor. Increasing accessibility of comprehensive obstetric care to the community, improving partograph utilization, and optimal creation of awareness in the community for birth preparedness and complication readiness may prevent occurrence of obstructed labor.
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    The Effect of Talent Management Practices on Organizational Success: Experience from Amhara Bank S.C. - Welkite Branch
    (wolkite University, 2026-06) D/r MERKEBU ABERA
    Background: Surgical site infection (SSI) is a significant post-cesarean complication affecting 3% to 15% of cases globally, resulting in substantial physical and financial burdens. Despite advancements, SSI rates remain high in low- and middle-income countries, with studies showing a pooled incidence of 12.32% in Ethiopia. This study aims to assess the incidence of and factors contributing with SSI among cesarean deliveries at Wolkite University Comprehensive Specialized Teaching Hospital (WKUCSTH). Objective: To assess the incidence of surgical site infections and contributing factors in cesarean deliveries at WKUCSTH, wolkite, central Ethiopia, 2025 G.C. Method: A facility based single armed prospective study design was carried out on patients who have undergone cesarean section delivery in WUCSTH from October 1 to December 13/2025.and each Patient was followed for 30 days. Data was collected using a standardized checklist. The Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. Binary and multi-logistic regression model with a significance threshold of P-value < 0.25 and< 0.05 respectively has been used to identify the factors contributing with the outcome variable. Results: The incidence of surgical site infection was 16.7% ((95%CI: 13.2, 19.7)). A prolonged labor exceeding 24 hours (ARR = 2.7; 95% CI: 2.43,8.91), obstructed labor (ARR = 19.2; 95% CI: 2.01,10.23), having five or more per vaginal examinations prior to cesarean delivery (AR = 5.2; 95% CI: 1.39, 9.12), and prolonged premature rupture of membranes before cesarean delivery (ARR = 2.32; 95% CI: 1.62,7.32) and number of less than 3 dose postoperative antibiotics (ARR=6.20; 95%CL:2,40,13.33) were statistically significantly contributing withsurgical site infection. Conclusion: The incidence of surgical site infection was high. Prolonged labor, obstructed labor, frequent per vaginal examinations, number of postoperative antibiotics doses and prolonged premature rupture of membranes were predictors of SSI. Strengthening intrapartum care and minimizing modifiable risk factors may reduce postoperative infections.
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    PREVALENCE OF PRETERM PREMATURE RUPTURE OF MEMBRANES AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN ADMITTED TO WOLKITE UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, WOLKITE, CENTRAL ETHIOPIA
    (wolkite University, 2026-06) DR. KEFELE DESTA
    Preterm premature rupture of membranes (PPROM) is a common obstetric complication associated with significant maternal and perinatal morbidity and mortality. This study assessed the prevalence and associated factors of PPROM among 199 pregnant mothers admitted to Wolkite University Comprehensive Specialized Hospital, Central Ethiopia, from December 2025 to January 2026. An institutional-based cross-sectional study was conducted using systematic random sampling. Data collected via interviewer-administered questionnaires and chart reviews were analyzed using multivariable logistic regression. The overall prevalence of PPROM was 11.6% (95% CI: 7.1–16.1). Factors significantly associated with PPROM included a history of abortions (AOR=5.7, 95% CI: 1.725–18.921), urinary tract infection (AOR=4.3, 95% CI: 1.074–17.4), a history of vaginal bleeding in the current pregnancy (AOR=18.07, 95% CI: 3.7–87), and residing in rural areas (AOR=3.54, 95% CI: 1.18–10.61). The prevalence of PPROM in this setting is high. To mitigate this burden, the hospital should transition toward universal, laboratorybased screening for infections and provide intensified surveillance for mothers with high-risk obstetric histories.
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    CLINICAL OUTCOME OF COMPLICATED MALARIA AND ASSOCIATED FACTORS AMONG CHILDREN LESS THAN 5 YEARS DIAGNOSED WITH MALARIA AT WOLKITE UNIVERSITY COMPREHENSIVE SPECIALISED TEACHING AND REFERRAL HOSPITAL A RETROSPECTIVE STUDY.
    (wolkite University, 2026-06) Dr.ABDULFETAH NUREDIN
    Background: Malaria is a major public health problem and a life-threatening parasitic infection, particularly among immunologically naive children who are highly vulnerable to severe complications. Objective: This study aimed to determine the clinical outcomes and factors associated with severe malaria among children under five diagnosed at WUCSRH in a retrospective study. Methods: An institution-based retrospective cross-sectional study was conducted by reviewing medical records and logbooks of children under five diagnosed with malaria. A total of 427 children were selected using systematic random sampling. Data were collected using a structured questionnaire, cleaned, coded, entered into SPSS, and analyzed using descriptive statistics and logistic regression. Results were presented in narrative form and tables. Results: Of the 427 children, 190 (44.5%) had severe malaria. The most frequent complications were severe anemia 114 (26.7%), seizures 40 (9.4%), prostration 20 (4.7%), cerebral malaria 10 (2.3%), acute kidney injury 4 (0.9%), and hypoglycemia 2 (0.5%). Treatment outcomes showed that 177 (41.9%) were discharged improved, 1 (0.2%) referred, 7 (1.6%) left against medical advice, and 3 (0.7%) died. Season of presentation, duration of illness, and patient residence were independently associated with severe malaria. Children presenting in spring had lower odds of severe malaria compared to summer (AOR = 0.23; 95% CI: 0.10–0.55). Delayed presentation of 2–7 days increased the risk of severe malaria (AOR = 44.62; 95% CI: 23.01–86.53; p < 0.001), while children living near the health acility had lower odds (AOR = 0.25; 95% CI: 0.11–0.57; p = 0.001). Conclusion: Severe malaria remains a significant cause of morbidity and mortality in children under five. Early healthcare seeking, improved access to health facilities, and preventive measures are essential to reduce its burden and improve outcomes in endemic areas
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    TIME TO DISCHARGE AND ITS PREDICTORS AMONGCHILDRENAGED 6 - 59 MONTHS WITH SEVERE ACUTE MALNUTRITIONADMITTED TO THE THERAPEUTIC FEEDINGCENTERATWOLKITE UNIVERSITY SPECIALIZED HOSPITALINSTITUITIONBASED RETROSPECTIVE FOLLOW-UP STUDY, 2026
    (wolkite University, 2026-06) D/r SHEMSU WORKU
    BACKGROUND: Under nutrition is a major public health concern, especially in low-incomesettings. It includes wasting and nutritional edema, stunting and underweight and micronutrient deficiency. Undernourished children, particularly those with severe acute malnutrition, haveahigher risk of death from common childhood illness. Children with severe acute malnutritionhave a nine-fold risk of mortality compared to well-nourished children hence the need for appropriate management. While the treatment of severe acute malnutrition is well established, achieving desired outcomes has proven to be challenging. OBJECTIVES: To assess the time to discharge and its predictors among children aged 6- 59months with SAM admitted to the therapeutic feeding center at Wolkite University Specialized Hospital (WUSH) ,Wolkite, Central Ethiopia from June 1, 2020 - May 31,2025. METHOD: Institution-based retrospective follow-up study was conducted in Wolkite University Specialized Hospital among children aged 6 - 59 months admitted to inpatient Therapeutic Feeding Center from June 1, 2020 - May 31, 2025. Participants were selected using computer generated random numbers. Time to discharge from inpatient treatment was estimated usingKaplan-Meier procedure and Log rank test was used to test observed difference between covariates. Multivariate Cox proportional hazard regression analysis model was used to identify predictor of time to discharge. RESULTS: The discharge rate was 75.8% and the median time to discharge from stabilizationcenter was 14.00 days with 95%: CI (13.35,14.65). Children who were transferred-in fromother health facilities and return from default, Hospital acquired infections, presence of de hydrationand who had vaccinated fully were predictors of time to discharge from stabilization center. CONCLUSIONS: The median time to discharge and the discharge rate fromstabilizationcenterwere within the SPHERE of standards.Transferred-in from other facilities ,return fromdefault , Hospital acquired infections , dehydration were significant predictors of time to discharge.
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    PREVALENCE OF MINIMUM DIETARY DIVERSITY AND ASSOCIATED FACTORS AMONG CHILDREN AGED 6-23 MONTHS, IN WOLKITE, ETHIOPIA, 2026
    (wolkite University, 2026-06) DR. BINIYAM GESSESE
    Background: Dietary diversity is a key of high-quality diets and an important indicator of appropriate complementary feeding. Minimum Dietary Diversity (MDD) is defined as the consumption of foods from at least five of the eight recommended food groups within a 24- hour period. Globally, only a small proportion of children receive nutritionally adequate and diversified diets, and more than two-thirds of malnutrition-related child deaths are linked to inappropriate feeding practices during the first two years of life. In Ethiopia, the prevalence of minimum dietary diversity among children aged 6–23 months remains low. Therefore, this study aimed to determine the level of minimum dietary diversity practice and identify associated factors among children aged 6–23 months in Wolkite Town, Ethiopia. Objective: To determine the prevalence of minimum dietary diversity and identify associated factors among children aged 6–23 months in Wolkite Town, Ethiopia, 2026. Methods: A community-based cross-sectional study was conducted from January 1 to January 30/ 2026 among 192 children aged 6–23 months selected using simple random sampling. Data were collected using a structured questionnaire based on World Health Organization infant and young child feeding (IYCF) indicators by google forms. Data were cleaned in Microsoft Excel and analyzed using SPSS version 27. Bivariable logistic regression identified candidate variables (p < 0.25) for multivariable analysis. Adjusted odds ratios (AOR) with 95% confidence intervals were calculated, and statistical significance was declared at p < 0.05. Results: The prevalence of minimum dietary diversity was 26.6%. The most commonly consumed food groups were grains, roots, tubers, and plantains (90.6%) and legumes, nuts, and seeds (72.9%). Maternal postnatal care attendance (AOR = 9.96; 95% CI: 4.74–20.93) and adequate maternal knowledge of IYCF (AOR = 6.07; 95% CI: 2.06–17.83) were significantly associated with achieving minimum dietary diversity. Children born with a birth interval of less than two years were significantly less likely to receive diversified diets (AOR = 0.13; 95% CI: 0.03–0.66). Conclusion: Minimum dietary diversity among children aged 6–23 months in Wolkite Town remains low. Maternal knowledge of IYCF, postnatal care utilization, and optimal birth spacing play critical roles in improving dietary diversity.