Millennium Journal of Health

From comprehensive health service provision to publisher of scholarly journal: The journey of St. Paul’s Hospital Millennium Medical college towards center of excellence

2026-01-14T15:13:18+00:00

Abstract

Validity of a mobile Phone-based application tool for COVID-19 self-screening

2026-01-14T15:17:08+00:00

Background: The COVID-19 outbreak is proving to be a unique disaster in many countries across the globe. Screening and diagnosis are challenges in resource-limited countries, as confirmation with reverse-transcriptase polymerase chain reaction (RT-PCR) are expensive and less accessible.
Objectives: The goal of this study was to assess the validity of a newly created mobile phone application tool as a COVID-19 self-screening approach as compared with the gold standard reverse-transcriptase polymerase chain reaction test (RT-PCR).
Methods: A cross-sectional study was conducted among 1029 individuals for validity assessment of a newly developed COVID-19 screening tool by having PCR test results as a reference. Data were collected using a structured questionnaire, maintaining all the COVID-19 prevention protocols. SPSS version 25 was used to analyze the data.
Results: A total of 1005 participants were included in the study, which made the response rate close to 97.7%. The mean age of the respondents was 37(SD=±15.62) years; 574 (57.1%) were males and 366(36.4%) were in the age category of 40 years and above. The current study identified that the internal consistency of Cronbach’s alpha was 0.769. The validity analysis
result of the tool revealed that it has a sensitivity of 77.6% with 31.6% of positive predictive value and specificity of 46.4% with 86.5% of negative predictive value. Moderate to severe symptom was significantly associated with RT-PCR test positivity with a p-value ≤0.0001 and OR of 5.259(95% CI: 3.500, 7.900).
Conclusion: The mobile application tool is found to be a reliable tool with a good level of sensitivity and specificity for use as a primary symptom-based self-screening of COVID-19. Therefore, we recommend the use of this screening test tool. It is easily accessible and hence an effective way of reaching the population affected by the disease for early detection of
symptomatic patients and taking appropriate measures.

Determinants of Diabetic Nephropathy among Diabetic patients at St. Paul’s Hospital Millennium Medical College: A case-control study

2026-01-14T15:21:45+00:00

Background: Diabetic nephropathy is one of the impending complications of Diabetes Mellitus
that might lead to end-stage renal disease and death. Though there are burgeoning reports on
diabetic nephropathy elsewhere in the world, studies regarding the determinants of the
condition within the Ethiopian context are scarce and inconsistent across different settings.
The study aimed to assess determinants of diabetic nephropathy at Saint Paul’s Hospital
Millennium Medical College, Addis Ababa, Ethiopia, in 2019.
Methods: Unmatched case-control study design with a 1:2 ratio employed to identify
determinants of Diabetic Nephropathy. All diabetic patients who developed diabetic
nephropathy were considered as cases and all diabetic patients who were free of proteinuria
were controls. The total sample size calculated by Epi info 7 software was 261, 87 cases, and
174 controls. A simple random sampling technique was applied. Samples from cases and
controls were interviewed by lottery method as they came to the clinics during data collection.
Simple binary logistic regression was used first to identify possible factors for further analysis
then factors with p-value <0.25 were entered to multiple binary logistic regression to identify
significant associations of variables with a p-value of <0.05.
Result: Among 261 study participants, 87 cases, and 174 controls, the median age was 60 and
46.5 respectively. On multiple binary logistic regression; duration of diabetes >10 years,
(AOR=3.107, 95% CI= 1.215-7.947), drinking alcohol (AOR=2.896, 95% CI= 1.531-5.480), no
adherence to regular physical exercise (AOR=4.378, 95% CI= 2.297-8.344) and presence of
systolic hypertension (AOR=2.995, 95% CI= 1.547-5.795) were significantly associated with
diabetic nephropathy.
Conclusion: Duration of diabetes, drinking alcohol, non-adherence to regular physical
exercise, and systolic hypertension were the significant factors of diabetic nephropathy. Health
education campaigns on controlling blood glucose level, blood pressure, cessation of
behavioral factors like alcohol drinking, and performing regular physical exercise shall be
designed on regular basis.

Perinatal factors affecting knowledge and utilization of preconception care among pregnant women in Addis Ababa: A cross-sectional study

2026-01-14T15:28:20+00:00

Background: In Ethiopia, preconception care service is not well established, knowledge
regarding preconception care and service utilization is low and few studies were published
about determinants of utilization and knowledge level of women.
Objectives: To identify perinatal factors affecting knowledge and utilization of preconception
care among pregnant women.
Methods: This cross-sectional study was conducted from January-March 2021, by interviewing
randomly selected 331 Ante Natal Care (ANC) attendants at selected hospitals in Addis Ababa.
The data was processed and analyzed using SPSS version 21. Bivariate and multivariable
logistic regression analyses were undergone to determine perinatal factors affecting women’s
knowledge and utilization of Preconception Care (PCC).
Results: Two hundred and twenty mothers (68.6%) were found to have a good understanding of
preconception care. Perinatal complications [AOR=3.37 (95% CI; 11.05-10.80)], postnatal care
utilization [AOR=4.64 (95%CI; 1.14-18.87)], and ever hearing about preconception health and
care [AOR=4.48 (95%CI; 2.31-8.72] were all positive predictors of preconception care
knowledge. Only four out of ten women, 40.5%, used preconception care to its full potential.
Whereas primiparity [AOR=4.76 (95% CI; 2.27-9.99)], having ever heard about preconception
health or preconception care [AOR=11.65 (95% CI; 4.51-30.06)] and having good knowledge
increase the likelihood of optimal preconception care utilization [AOR=10.32 (95% CI; 3.46-
30.71)].
Conclusion: Women's knowledge of preconception care, as well as their use of the service,
was found to be unsatisfactory. Perinatal complications, postnatal care utilization history, ever
having information about the care, and primiparity were all found to be positive predictors of a
woman's knowledge and utilization of PCC.

Anti-epileptic drug utilization pattern and control of seizure among patients with epilepsy at two tertiary hospitals in Addis Ababa, Ethiopia: A Hospitalbased cross-sectional study

2026-01-14T15:35:18+00:00

Background: Anti-epileptic drugs (AEDs) are the primary therapeutic modes for
patients with epilepsy and have been demonstrated to control seizures, which decreases
morbidity and mortality associated with epilepsy. There is a paucity of data on treatment
outcomes among epileptic patients in resource-poor settings. The study aimed to
evaluate the AED utilization pattern and control of seizures among patients with epilepsy
on follow-up at St. Paul’s Hospital Millennium Medical College and Amanuel Specialized
Mental Hospital.
Methods: A hospital-based cross-sectional study involving direct patient interviews and
medical record reviews were conducted to collect the data. Adherence of AED was
measured using a Morisky Medication Adherence Scale-8 (MMAS-8), where patients
with MMAS-8 scores of ≥6 were considered to be adherent. Factors affecting seizure
control were determined using logistic regression analysis.
Results: From a total of 454 patients, 58.6% were men. The commonest type of seizure
was generalized tonic-clonic seizure observed in 93.3% of patients. Monotherapy was
prescribed in 83.7% of patients for the management of seizures, among which
phenobarbitone was utilized in 51.3% of patients as a single anticonvulsant drug.
Majority (61%) of patients with epilepsy had poor seizure control. About 65% of patients
were adherent to their treatment and 39 % of the patients were seizure-free for at least
one year. Only 177 (39.0%) patients had good control of seizures with no attack in the
previous six months. Duration of AED therapy ≤5 years non-adherence were found to
be independently associated with poor seizure control.
Conclusion: Based on our findings, the majority of patients with epilepsy were on
monotherapy and had poor seizure control. Phenobarbitone and phenytoin were the
frequently utilized AEDs. Duration of therapy less than 5 years and poor adherence were
independently associated with an uncontrolled seizure. The findings collectively indicate
that health care providers should focus on recently diagnosed patients and adherence
to AEDs to control seizures.

Magnitude and risks of atrial fibrillation in adult cardiac patients followed at St. Paul’s Hospital Millennium Medical College, Addis Ababa: A hospitalbased cross-sectional study

2026-01-14T15:37:33+00:00

Background: Atrial fibrillation (AF) is the most common type of arrhythmia encountered in
clinical practice, for which patients are hospitalized. So far, there were few studies
conducted on AF in Ethiopia and no studies looked at the magnitude and risk factors of
atrial fibrillation among patients with cardiovascular diseases.
Methods: This is a hospital-based cross-sectional study to evaluate the prevalence and
risk factors of atrial fibrillation among patients at the cardiac clinic of St. Paul’s Hospital
Millennium Medical College from February 1st, 2017 to June 30, 2017. A standardized
questionnaire was used to collect information on demography, medical history,
electrocardiogram, echocardiogram, and use of medications via patient interview and
medical record review. Statistical Package for the Social Sciences (SPSS) version 25 was
used to analyze the data. Both binary and multivariable logistic regression was used to
determine the potential risk factors of AF.
Results: A total of 402 cardiac patients were included in the study. Of these, females
accounted for 59.7%. The mean age of the study population was 52 years. The mean
systolic blood pressure was 117 mmHg. The majority (99%) of patients were nonsmokers.
Atrial fibrillation was detected among 175 (43.5%) patients. Of these, 104 (59.4%) patients
had valvular atrial fibrillation. The most frequent causes of cardiovascular diseases among
the participants were rheumatic heart disease and hypertension observed in 50.4% and
16.0% of patients respectively. Dyslipidemia, rheumatic heart disease, and degenerative
valve disease were independently associated with AF in this population.
Conclusion: Atrial fibrillation was prevalent among patients with cardiovascular disease at
St. Paul’s Hospital Millennium Medical College. The risk factors independently associated
with AF were valvular heart disease and dyslipidemia.

Noise level in recreational areas in Mekelle, Ethiopia:ross-sectional study

2026-01-14T15:41:58+00:00

Background: Noise-induced hearing loss is the most common cause of sensorineural
hearing loss following presbycusis. Excessive noise exposure can often occur while
attending leisure activities in bars and restaurants. According to the United States
Occupational Safety and Health Agency, the noise exposure should not exceed 85
decibels (dB) in 8 hours working period per day, nor 95 decibels for just two hours.
Methods: We conducted a prospective cross-sectional study and measured the noise level
in forty-three bars, restaurants, and music clubs in Mekelle, Ethiopia. The measurement
was done around 10:00 pm and midnight in each of the selected houses.
Result: The study showed the mean loudness of 97dB for 10:00 pm while it is 101dB for
-mid-night time, with a standard deviation (SD) of 3 dB and 7 dB, respectively. The
maximum loudness measured was 107 dB and 108 dB, respectively.
Conclusion: According to international standards, many institutions locally surpass
exposure limitations. We suggest that regional and national regulations be placed to limit
exposure and protect the workforce of Ethiopia.

X-linked agammaglobulinemia (XLA) in a 7-years-old boy, Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia

2026-01-14T15:45:19+00:00

X-linked agammaglobulinemia is a rare primary immunodeficiency syndrome
characterized by absent mature B cells and recurrent infections. We report a 7-
year-old male child who was diagnosed with X-linked agammaglobulinemia and
bronchiectasis after presenting with recurrent pneumonia and otitis media.