Harla Journal of Health and Medical Science

Prevalence of Risky Sexual Behavior and Associated Factors Among Secondary School Students in Dire Dawa:

2025-12-04T08:40:42-08:00

Background: Risky sexual behavior (RSB) among adolescents, including early sexual debut, multiple partners, and inconsistent condom use, poses a major public health challenge in low-income countries like Ethiopia, increasing risks of HIV/AIDS, STIs, and unintended pregnancies. Despite interventions, RSB remains prevalent among Ethiopian secondary students, warranting further research. Studies in Dire Dawa often used small, non-representative samples and inconsistent RSB measures, limiting generalizability. This study aimed to assess the prevalence of risky sexual behavior and its associated factors among secondary school students in Dire Dawa City, Ethiopia.

Methods: A school based cross-sectional study was conducted from November 2024 to January 2025 among 602 secondary school students in Dire Dawa, Ethiopia. Data were collected using structured, self-administered questionnaire adapted from Centers for Disease Control and Prevention (CDC), Youth Risk Behavior Surveillance System (YRBSS), previous related studies and Oslo Social Support Scale (OSSS-3). Multi-stage sampling was used to select participants, and data were analyzed using SPSS version 26. Bivariate and multi-variate logistic regression analyses were performed to identify factors associated with risky sexual behavior, with significance level set at P < 0.05.

Results: The study found that 200 students, representing 33.2%, engaged in risky sexual behavior. Older students had 1.6 times higher odds of risky behavior (AOR=1.63, 95% CI:1.19, 2.24). Social support showed protective effects: moderate support (AOR=0.20, 95% CI:0.07, 0.56) and strong support (AOR=0.03, 95% CI:0.01, 0.09) reduced odds. Family substance uses increased odds 6.5 times (AOR=6.46, 95% CI:2.65, 15.73), peer pressure 5 times (AOR=4.96, 95% CI:1.83, 13.40), and easy post-pill access 7.7 times (AOR=7.67, 95% CI:2.96, 19.89). Good risk perception reduced odds significantly (AOR=0.07, 95% CI:0.03, 0.16).

Conclusion: Risky sexual behavior is prevalent among secondary school in Dire Dawa, Ethiopia, and influenced by combination of individual, familial, and environmental factors. Intervention should focus on strengthening social support system, improving access to sexual health education and services. Additionally, policies should address the easy availability of emergency contraceptive without consultation which may contribute to risky sexual behavior.

Post-Operative Mortality Prevalence and Associated Factors Among Adult Patients Admitted to Surgical Ward in Hiwot Fana Comprehensive Specialized Hospital:

2025-12-04T08:48:10-08:00

Background: Post-operative mortality is a critical factor in evaluating the quality of surgical care and its outcomes within healthcare facilities. No surgical procedure is without risk, as complications following surgery can lead to disability, extended hospital stays, or even death. Despite increasing research on post-operative mortality in Ethiopia, significant gaps remain especially regarding the Harari Region. Although national statistics offer a broad overview, locally focused studies are essential to inform targeted interventions.

Methods: A retrospective cross-sectional study design was employed from January 10 to February 10, 2025. A total of 602 participants were selected using a simple random sampling technique. Data were collected using Kobo Toolbox and subsequently exported to SPSS statistical software for analysis. Variables that showed associations in the bivariate analysis were entered into multivariate logistic regression. Statistical significance was determined at a p-value < 0.05, with adjusted odds ratios and 95% confidence intervals reported. Model fitness was evaluated using the Hosmer and Lemeshow goodness-of-fit test, and multicollinearity was assessed via the Variance Inflation Factor.

Results: This study shows that, prevalence of post-operative mortality in Hiwot Fana Comprehensive Specialized Hospital (HFCSH) was 14 (2.3%). The odds of death among patients with a low platelet count were five times higher (AOR = 5.71; 95% CI: 1.12, 29.17) than those with normal platelet counts. Similarly, the odds of death among patients admitted to the ICU were fourteen times higher (AOR = 14.45; 95% CI: 3.22, 64.70) than those not admitted to the intensive care unit.

Conclusion: The magnitude of postoperative mortality in this study was higher than the global average but lower than that reported in some African countries and national studies. ICU admission and low platelet count were significantly associated with increased postoperative mortality. These findings emphasize the need for thorough preoperative assessments particularly focusing on platelet count and underscore the importance of providing optimal care in the ICU to improve surgical outcomes.

Magnitude of Under Nutrition and Associated Factors Among Children and Adolescent with Tuberculosis on Directly Observed Treatment at Public Health Facilities in Harar and Dire Dawa City, Eastern Ethiopia

2025-12-04T08:54:18-08:00

Background: Tuberculosis (TB) remains a leading cause of mortality in developing countries, including Ethiopia, and has a bidirectional relationship with malnutrition. Malnutrition is more severe in patients with active TB, yet evidence and standardized protocols for nutritional support in Ethiopia particularly for children are limited.

Methods: A cross-sectional study was conducted from February 1 to March 16, 2025, among 253 children with TB on DOT in urban health facilities of Harar and Dire Dawa, selected by simple random sampling. Data on sociodemographic, nutritional, and clinical factors were collected using interviewer- administered questionnaires, and nutritional status was assessed with WHO Anthro and Anthro Plus software (version 1.0.4). Data were entered into EpiData 3.1.1 and analyzed in SPSS v. 26. Bivariate and multivariate logistic regression were used to identify factors associated with nutritional status, with significance set at p < 0.05 and results presented as crude and adjusted odds ratios with 95% CI.

Results: Among 249 children under 15 years on directly observed TB treatment in Harar and Dire Dawa, pulmonary TB was predominant 213 (85.5%), and more than half 143 (57.4%) had received treatment for two months or less. The prevalence of the undernutrition was 96 (38.6%), (95% CI: 32.4– 44.9), although nearly all children 238 (95.6%) maintained a working functional status. Multivariate analysis showed that undernutrition was significantly associated with lower paternal education (AOR = 0.16; 95% CI: 0.03, 0.73), marital status (AOR = 3.44; 95% CI: 1.38, 8.62), higher wealth index (AOR = 0.04; 95% CI: 0.01, 0.16), and rural residency (AOR = 0.31; 95% CI: 0.11, 0.86).

Conclusion: The study shows that undernutrition is highly prevalent among children on TB treatment, with parental education, marital status, wealth, and residence significantly influencing nutritional outcomes. Strengthening nutritional support and addressing social determinants are crucial to improve health and treatment success in pediatric TB patients.

Magnitude of Poor Dietary Diversity and Associated Factors Among High School Adolescent Girls in Dire Dawa City, Eastern Ethiopia

2025-12-04T09:01:39-08:00

Background: Adolescence, which lasts from the ages of 10 to 19 years, is a period of rapid growth, cognitive development, and reproductive health readiness. However, in urban areas such as Dire Dawa thedietarydiversityandcontributingfactorsof adolescentgirlshavereceivedlessattention.Therefore, this study was conducted with the major aims to assess the magnitude of poor dietary diversity and associated factors among high school adolescent girls in Dire Dawa, Eastern Ethiopia.

Methods: A cross-sectional survey using stratified multistage random sampling was conducted in February and March of 2025 on 517 high school girls in Dire Dawa ages 13 to 19. An FAO Minimum food Diversity for Women (MDD-W) style 24-hour food memory test was one of the questionnaires used to gather data and analyzed by SPSS version 26. We identified the factors associated with MDDs in bivariable and multivariable logistic regression. Adjusted odds ratio with 95% confidence interval was reported. A significance level of p<0.05 was applied. The findings were shown using 95% CIs for adjusted odds ratios (AOR).

Results: The results showed that, 274 (53%) of the high school girls (95% CI: 0.487-0.573) were able to achieve adequate dietary diversity. Adolescent girls aged 13–16 had significantly higher likelihood of eating inadequately compared to those aged 17–19 (AOR = 1.60; 95% CI: 1.04, 2.46; p=0.031). Students attending public schools were around four times more likely than those attending private schools to have inadequate dietary diversity (AOR = 3.95; 95% CI: 1.82, 8.57; p=0.001). The considerably higher likelihood of low dietary diversity for girls from homes without home gardens (AOR = 22.1; 95% CI: 10.5, 46.6; p<0.001) were significantly factors associated with minimum dietary diversity score.

Conclusion: The prevalence of poor dietary diversity was high in study area. Age group, school type, and home gardening were identified as factors associated with the dietary diversity of high school girls. These results emphasize the need of school based and community level initiatives that promote home gardening and target younger adolescents in public schools in order to enhance food choices and minimize nutritional deficiencies in this vulnerable population.