SPHMMC Research Repository

The Institutional Research Repository of St. Paul’s Hospital Millennium Medical College (SPHMMC) serves as a centralized digital archive that preserves and showcases the scholarly output of the college community. It hosts research works produced by current and past members of SPHMMC, including undergraduate and postgraduate students as well as faculty across diverse departments.

By providing open access to theses, dissertations, faculty publications, and collaborative projects, the repository strengthens knowledge sharing, supports academic excellence, and ensures that the contributions of the college’s researchers remain accessible for future learning, innovation, and policy development.

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Recent Submissions

Magnitude and Associated Factors of Upper Airway Obstruction among Pediatric Patients in St. Paul’s Hospital Millennium Medical College.
(2024) Teshome, Chaltu
Abstract Background: Upper airway obstruction is one of the most challenging acute emergencies. Unless promptly diagnosed and managed, it rapidly progresses to hypoxia and cardiac arrest Severe upper airway obstruction accounted for 3.3 % of all pediatric intensive care unit admissions; however, there is limited information about upper air way obstruction in pediatrics and its cause particularly in the public hospitals of Addis Ababa. Objective: To assess magnitude and associated factors of upper airway obstruction among pediatric age group visited in Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2024. Methods: An institutional-based cross-sectional study was conducted at SPHMMC from March 2023 to June 2024. A random sampling technique was used to select the charts of pediatric age group who attended the SPHMMC. Data were collected by three data collectors using a pre tested structured questionnaire. The data were collected via a questionnaire developed using the Google forms web application and analyzed using SPSS version 23. Descriptive statistics were carried out and presented with narration, tabulation, and graphical presentation. Binary logistic regressions were computed to determine the association between variables. The association was determined using an adjusted Odds ratio (AOR) with a 95% confidence interval (CI) at a p-value of < 0.05. Result: Our study revealed that the Magnitude of Upper air way obstruction in the pediatric age group was 2.5 %. more than half of (57%), the participants were Male. The mean age of the participants was 5.3 years. Many of the patients (88%) had come from urban area, Age and duration of stayed in hospital were factors significantly affecting upper air way obstruction among pediatrics. Conclusion: The magnitude of upper air way obstruction among pediatrics are common in SPHMMC and the major cause was foreign body aspiration followed by Epiglottis, Bacterial tracheitis, Hyperthyroidism. Therefore, increasing awareness and education on the signs and symptoms of upper air way obstruction and ensure a safe environment for children to prevent accidental ingestion of foreign objects to minimize problems. Key words: Magnitude, pediatrics, upper airway obstruction, Emergency.
SURVIVAL STATUS AND PREDICTORS OF MORTALITY AMONG MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT AT ADDIS ABABA, ETHIOPIA, 2022: A ONE YEAR RETROSPECTIVE COHORT STUDY
(2023) ZENEBE, TADELE
Abstract Background: Globally, potential demand for invasive mechanical ventilation is increasing, and the incidence of mortality among critically ill patients after mechanical ventilation support is reported to be high, though this is not exactly figured out yet in our country's context. However, there is limited data on the extent of the problem in Ethiopia. Therefore, this study aimed to investigate the survival status and predictors of mortality in mechanically ventilated patients who were admitted to the adult ICU of a governmental hospital in Addis Ababa, Ethiopia. Objective: The objective of this study was to determine survival status and predictors of mortality among mechanical ventilated patients in ICU, Addis Ababa, Ethiopia, from July 1, 2021, to June 30, 2022. Methods: A multicenter retrospective cohort study was conducted on 382 mechanically ventilated patient charts admitted to the adult ICU of four selected government hospitals in Addis Ababa, Ethiopia. Participants were selected by using simple random sampling techniques from March 1, 2023, to March 20, 2023. The data were entered into Epi Data Manager V4.2 and exported to Stata/MP V-14 for analysis. Bi-variable and multivariable Cox regression models were fitted in the analysis to determine the predictor variables. A hazard ratio (HR) with a 95% confidence interval (CI) was computed, and a p-value 0.05 was considered statistically significant. Results: The overall mortality among mechanically ventilated patients in the adult ICU was 67.0%, with an incidence rate of 9.23 cases (95% CI, 8.14–10.46) per 100 person-days of observation, and the median survival time was found to be 6 days. Increased systolic blood pressure (AHR = 2.11, 95% CI: 1.23, 3.61), elevated diastolic blood pressure (AHR = 0.25, 95% CI: 0.12, 0.53), HIV infection (AHR = 2.81, 95% CI: 1.62, 4.88), GCS at the end of follow-up (AHR = 19.29, 95% CI: 8.46, 43.99), serum albumin (AHR = 0.66, 95% CI: 0.46, 0.96), and creatinine level (AHR = 1.17, 95% CI: 1.12, 1.35) were found to be significantly associated with mortality of mechanically ventilated patients in the adult ICU. Conclusions and Recommendation: The mortality rate of mechanically ventilated patients in the adult ICU was high. Blood pressure, HIV infection, GCS, serum albumin, and creatinine level were the identified predictors of mortality in my study. Further prospective study in the future is needed, with the inclusion of other important predictive variables like malnutrition, body mass index, smoking habit and others, is advocated for better result. Keywords: Survival, Predictors, Mortality, Mechanical ventilator, Retrospective cohort.
Prevalence of Respiratory Symptoms And Associated Factor Among Street Sweepers In Addis Abeba, Ethiopia
(2024) Andualem, Wondwosen
Abstract Background: Respiratory symptoms are manifestations of respiratory problems that are developed as the result of occupational exposures. Respiratory symptoms including cough, phlegm, wheezing, shortness of breath, and chest pain are manifestations of respiratory problems which are mainly evolved as the result of occupational exposures. They are more prevalent in developing countries, where occupational health and safety issues are less emphasized. In Ethiopia there are very few studies conducted on the respiratory health problems of road cleaners. Objective: The study was conducted to assess the prevalence of respiratory symptoms and associated factors among street sweepers in Addis Ababa. Methods: Community based Cross sectional study was conducted from March 15 –jun15, 2024. Systematic random sampling technique was used to select study participants. Data was collect through interviewer administered structured questionnaire adapted from British Medical Research Council. SPSS and Microsoft Excel applications was used for data entry, analysis and result presentation. Bivariate regression analysis was computed to select candidate variables for multivariate logistic regression analysis. Multivariate logistic regression model were fitted by using variables that had association (p < 0.25) with the dependent variable in bivariate analysis. Result From the total 365 study participants 361 were included in this study which makes the response rate 98.9%. The respondents were assessed for the presence of one or more of respiratory symptoms: cough and/or phlegm and/or wheezing and/or chest illnesses and/or shortness of breath. The study indicates the prevalence of respiratory symptom was 45.4% Conclusion and recommendation This study found that respiratory symptom was prevalent among street sweepers in AA. Use of face mask, OHS training, work experience, history of age 35-44 and energy used at home was major contributing factors for respiratory symptom to occur. There was poor awareness on occupational health and safety among street sweepers. Face mask and occupational health and safety training should be provided by the health office. Individuals who had history of past illness should get health information during enrollment. Key words street sweepers, Respiratory symptom, personal protective equpement , occupational exposure to dust.
MAGNTUDE OF RESTRICTVE LUNG DISEASE ANDT ITS ASSOCIATED FACTORS AMONG PATIENTS ATTENDED CHEST CLINC, SPHMMC, ADDIS ABABA, ETHIOPIA (2023/24)
(2024) Kebede, Gizealew
Abstract Introduction: This thesis aimed to investigate the magnitude of restrictive lung disease and its associated factors among patients seen at the Chest Clinic of St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia over a 5-year period from January 1, 2019 to December 31, 2023. Relying on a sample of 271 patient charts collected from the clinic, the researchers conducted both descriptive and analyses to examine the magnitude of restrictive lung disease and its related determinants. Objective: This study aims to determine the magnitude of Restrictive Lung Disease and Its Associated Factors Among Patients Attended Chest Clinic, SPHMMC Addis Ababa Ethiopia (2023/24). Methods: A five years retrospective study design was employed among 271 participants at SPHMMC from 1st January 2019 to 31st December 2023. Data from patient’s medical chart reviews. The collected data was analyzed using statistical software Stata version 13. Simple descriptive, binary, and multivariable logistic regressions was used to examine the data. In multivariable logistic regression a statistically significant association in a predictor variable with a p-value < 0.05 was included. Finally, the analyzed data presented using the sentence, figure, and table. Result: having history of chronic lung disease increases the magnitude restrictive lung disease from 25% goes up to 31%. (AOR=2.45; 95% CI: 1.13 to 5.34) higher for patients with history of chronic lung disease than patients with no history of chronic lung disease. Age: The adjusted odds ratio (AOR) for age is 1.06 (95% CI: 1.04-1.09), with a p-value of 0.000. This suggests that there is a statistically significant positive association between age and restrictive lung disease. Conclusion: one out of every four patients were found to have been diagnosed with restrictive lung disease. Furthermore, the study revealed a positive correlation between a history of chronic lung disease and age the likelihood of being diagnosed with restrictive lung disease. Keywords: Restrictive Lung, Pulmonary Fibrosis, Interstitial Lung Diseases, Regression Analysis, chest clinic and magnitude
Level of Asthma Control and Associated Factors among Asthmatic Adult patients who AttendedSaint Paul’s hospital millennium medical college (SPHMMC) Chest Clinic of Addis Ababa, Ethiopia, 2023.
(2023) Asfaw, Yadesa
Abstract Background: The goal of asthma treatment is to obtain and maintain a good control of symptoms. Investigating factors associated with uncontrolled asthma could help in strategies to improve asthma control. There are a few studies in this field that examine the level of asthma control using validated questionnaires like the Asthma Control Test. Objective: to determine the prevalence and factors associated with asthma control in asthma patients under St. Paul hospital millennium medical college chest clinic Addis Ababa Ethiopia. Methods: A cross-sectional study was conducted from March 2023 to May 2023. Systematic random sampling technique was used to take a total of 284 asthma patients. Physician-diagnosed asthma patients aged 18 years and above were included. A structured questionnaire was used to collect demographic data, comorbidities, and medical history of asthma. Asthma control was assessed using the standardized and validated Asthma Control Test, with a score cut points of less than 20 for uncontrolled asthma and a score greater or equal to 20 for well controlled asthma. A multivariate analysis was used to identify factors associated with uncontrolled asthma. Results: Overall, 281 patients were included in this study with 98.94% response rate. Asthma was controlled in 80(28.5%) patients and uncontrolled in 201 (71.5%). The mean duration of asthma was 22±14.8years. One hundred sixty (56.9%) patients were under controller medication while the mean ACT score was 16 .81 ±3 .43. Independent associations were found between uncontrolled asthma andseparated/divorced/widowed (AOR 6.62695% CI.1.251 – 35.084, p = 0.026),comorbidity (AOR 6.208, 95% CI 2.149-17.937, p<0.001), irregular chest clinic follow up (AOR 9.918, 95% CI 3.575 27.512, p<.001),inappropriate MDI technique (AOR 3.546, 95% CI 1.393-9.028.p< .001), and taking SABA + ICS and ICS + LABA asthma medication (AOR .017, 95%CI .003-.087, p<.001,AOR .047, 95%CI .011-.201,p<.001) was less likely to develop uncontrolled asthma when compared to patient who took SABA only. Conclusion: Asthma remains poorly controlled in a large proportion of asthma patients under SPHMMC chest clinic. Educational programs for asthma patients targeting comorbidity management, regular follow up and appropriate Metered dose inhalation technique may help in improving the control of asthma. Key words: asthma control, chest clinic, Asthma control test, Metered dose inhalation