Background: Rabies is one of the fatal animal diseases with significant public health issue. Local dogs are the main reservoir and source of this disease, especially, in developing countries. Even though rabies is a highly fatal disease, it is a preventable disease. Community awareness about rabies is one of the key components for prevention. Therefore, the main objective of this study was to investigate predictors for the level of knowledge, attitudes and practices among rural community towards the prevention of rabies disease in North Wollo zone, Ethiopia.
Methods: A cross sectional study was conducted from June 2022 to September 2022. A structured questionnaire was used to collect the data for face to face interviews among 206 respondents. The data were analyzed using SPSS software version 27.
Results: The current study indicated that about half of the participants (50.6%) did not have awareness about the way how the disease (rabbis) is transmitted. Among the respondents, about 50% of them said that rabies is considered to be a fatal disease, while 52.8% of the respondents did not believe that the disease is preventable using vaccine. About half of the participants did not know that salvation and madness were described as a major clinical sign of rabies in animals. Only 39.3% of the participants stated that they washed the wounds with water and soap. Among those individuals contacted with dogs and cats, about half 46% did not have a habit of washing hand after contact. Among the participants, 130 (63.1%) of them stated that, go to the traditional healer is the first choice to cure from the disease and only 30.1% of the participants prefer health center to be free from the viral disease. The findings in the current study indicates that marital status, educational status, household size, dog ownership and family exposure to dog bite had statistically significant association with attitude about rabies at 5% level of significance.
Conclusion: The level of knowledge, attitude and practice of the rural households regarding to rabies and its means of transmission in the study area is very low. Especially, the practice of using regular vaccination for domestic dogs and cats in the study area is very low. Hence, health related education is recommended to the rural community on how the disease can be prevented, sources of infection for the disease, mode of transmission and measures to be taken after contamination.
Background: The availability of medication related to HIV treatment in the world is one of the substantial improvements for reaching USAID’s 90-90 targets. Among the 90% of patients who have awareness about their disease, 90% of them are accessing their treatment and patients who got appropriate treatment have a suppressed viral load and improved CD4 cell count. Therefore, the main objective of the current study was to investigate the drug resistance and quality of life and associated factors for people living with HIV at first-line regimens at public hospitals in the Amhara region, Ethiopia.
Methods: A retrospective cohort study design was conducted on 700 adult HIV-infected patients under treatment at first-line regimes, who were followed up in 17 public hospitals in the Amhara region. A multivariate linear regression analysis was used for current study.
Results: Of the 700 patients included in the current analyses, 59.5% (n=358) reported no impairment in self-care, while 63.1% (n=380) were extremely anxious/depressed. The overall expected EQ-5D utility score and Visual Analog Scale (EQ-VAS) scores were 0.388 0.41 and 66.20 17.22 respectively. The current study indicated that the covariates sex, age of patients, level of education, visiting times, disclosure status of the disease, and substance use significantly affected the quality of life of people living with HIV and under treatment at first-line regimens. Hence, the higher the CD4 cell count and the less detectable viral load lead to the good quality of life of people living with HIV.
Conclusions: This study indicates that certain covariates have been identified as statistically significant predictors for the variable of study (quality of life) of HIV-positive people. The findings obtained in the current investigation help policymakers to revise the current
Awoke Seyoum Tegegne*, Godada Keleb, Molalign Tarekegn Minwagaw, Haile Mekonnen, Denekew Bitew Belay, Abay Kassa Tekile, Lijalem Melie, Eyerus Asmare and Muluwork Ayele
Background: One of the sub-Sahran African countries with high number of people living with HIV is Ethiopia. Among the regions in Ethiopia, Amhara region is the one in which many people are under HIV medication treatment. This research has been conducted with objective to detect variable significantly affected the level of adherence under cART in Government Hospitals throughout Amhara region.
Methods: A cohort secondary data found from a random sample of 1540 HIV-positives under cART were used for current investigation. A binary logistic regression modeling was conducted in data analysis. The study was conducted in 18 government hospitals in Amhara region, Ethiopia.
Results: The predictors like patients’ age (AOR=1.020, 95% CI: 1.001, 1.1200), baseline CD4 cell count (0.980, 95% CI: 0.764, 0.991), visits of health institutions (AOR=0.9900, 95% CI: 0.6723, 0.9990), patients living without their partner (AOR=1.01, 95% CI: 1.003, 1.112), male patients (AOR=1.01, 95% CI: 1.001, 1.021), patients living in urban area (AOR=0.98, 95% CI: 0.96, 0.99), educated patients (AOR=0.950, 95% CI: 0.92, 0.98), socially violated patients (AOR=1.012, 95% CI: 1.008, 1.234), opportunistic adult patients (AOR=1.062, 95% CI: 1.049, 1.191), patients who did not disclosed their disease (AOR=1.062, 95%CI: 1.038, 1.254) had significant effect on non-adherence to medication. Similarly, WHO stages significantly affected on the variable of interest.
Conclusions: Socio-demographic variables such as age, baseline CD4 cell count, patients living without their partners, male patients, rural patients, patients faced social violence, opportunistic adult patients, patients who did not disclosed their disease status need espetial attion. Health related education is recommended for non-adherent patients to be adherent for the prescribed treatment.
Wohabie Tsega Gessesse* and Awoke Seyoum Tegegne
Background: Customer satisfaction and quality of service rendered are leading components in the system of external relations for each business organization delivering services and plays a significant role in its competitiveness. The main purpose of the study was to assess the effect of service quality on customer satisfaction in the Ethiopian Pharmaceutical Supply Agency (EPSA), case study Bahir Dar branch.
Methods: The study was conducted in Ethiopian pharmaceutical supply agencies (Case study Bahir Dar branch). A cross-sectional study design was conducted in the current study. Hence, both descriptive and inferential statistics were used to investigate the effect of quality of service on customer satisfaction. Both primary and secondary sources of data were used for current investigation. Participants in the current study were selected randomly using systematic random sampling approaches. The two well-known models SERVQUAL and SERVPERF were used to investigate the service quality in different service sectors. Result: The SERVQUAL model result depicted that among the dimensions of quality of services empathy, assurance, tangibility, and responsiveness had a statistical positive effect on the level of degree of customer satisfaction. Hence, as the dimension of quality of service increased, the corresponding level of customer satisfaction also increased.
Conclusion: The overall satisfaction analysis result showed that majority of EPSA's customers was dissatisfied by service delivery and concluded that service quality dimensions have positive relationship with customer satisfaction in different significant levels.
Recommendation: The current study recommended that EPSA should develop Customer satisfaction strategy to get opportunities for improvement, provide more training about service quality to customer serving staffs. Service providers should understand the changing needs of customers, their aspirations and expectations to create value by creating effective and continuous feed backing system. Service providers should also have a strong customer relationship management. Service providers at EPSA should provide personalized attention to its customers and provide an immediate response to all customer complaints.
Awoke Seyoum Tegegne*, Melaku Tadege and Emebet Abich
Background: Human immune deficiency virus is a virus that causes acquired immunodeficiency syndrome by reducing a person’s ability to fight infection. In the whole world, approximately 37.6 million people were infected by the human immune deficiency virus. Therefore, the main objective of the current investigation was to assess knowledge/awareness and associated factors of HIV/AIDS among Awi zone high and preparatory school students.
Method: About 2049 respondents were considered as respondents/participants. In this investigation, a cross-sectional study design was conducted to assess the knowledge of students about the different ways of transmission of HIV/AIDS from HIV positive to negative people. Chisquare tests of association and binary logistic regression analysis were applied to test the association and to identify the factors related to the cause of having insufficient knowledge about HIV/AIDS. SPSS version 23 software was implemented.
Results: From all students, 78.9% of all had adequate knowledge. Among students who have ever sex, only 12.9% of students were used a condom whereas 87.1% of students were not used a condom during sexual intercourse. More surprisingly, only 14.7% of the entire students knew their HIV AIDS result.
Conclusion: The knowledge of students on ways of transmission of HIV/AIDS was good but the practice was poor. Advanced strategies to prevent HIV/AIDS are highly recommended. A health related education should be conducted to students on using the AIDS club; especially awareness should be created on use of condom during sexual intercourse.
Merhawit Atsbha Abera*, Mengistu Hagazi Tequare, Ephrem Berhe, Abadi Leul Wolderufael, Feseha Berhane Gebru, Hiluf Ebuy Abraha and Mohamedawel Mohamedniguss Ebrahim
Introduction: Diabetes mellitus is being related with developing communicable and non-communicable diseases. Patients on highly active antiretroviral therapy are at increased risk of developing diabetes mellitus than those who are treatment Naïve. Hyperglycemia has been mentioned as the side effect of some ART regimens. We assessed the incidence of hyperglycemia among patients taking Dolutegravir-based regimen in ACSH.
Method: A hospital-based prospective cross sectional study was conducted. The total sample size was 423. A simple random sampling technique was employed using excel function to select study participants. Four categories of data were collected, namely socio-economic, clinical and immunological, regimen type and outcome variables.
Results: A total of 421 HIV patients were included in the study. More than one-third (36.1%) of the subjects had an exposure to TDF+3TC+DTG drug therapy, either as a first therapy or a change to the first line triple therapy. 62 (14.7%) had hyperglycemia from the study participants. Our finding showed that taking Dolutegravir-based ART has no effect on the blood sugar level of patients, while adjusting for age, sex, and weight at HAART initiation (AOR=1.04, 95% CI: 0.55-1.95, p=0.896).
Conclusion: Dolutegravir-based ART regimen has no effect on the blood sugar level of patients.
Timothy J. Howze*, Christian J. Phillips, Susan D. Carr, Tiffany M. Nason and Nehali D. Patel
Background: Adherence to oral Antiret Roviral Therapy (ART) can be challenging for children and youth living with HIV. While demographic factors have been identified as influencing adherence, limited research has explored whether the mode of HIV transmission—vertically (perinatally) vs. horizontally (behaviorally or through other means)—affects adherence outcomes. Objective: To evaluate the impact of HIV mode of transmission and use of a specialty pharmacy on adherence to oral ART among patients under 24 years of age. Methods: A single-center, retrospective cohort analysis was conducted on 38 patients aged 2 to 23 years living with HIV, spanning the period from July 1, 2019, to July 1, 2021. This timeframe was selected to capture one year of data prior to and one year following the implementation of a specialty pharmacy model. Prior to July 2020, oral ART was dispensed through a traditional hospital outpatient pharmacy. In July 2020, all patients were transitioned to receive ART through specialty pharmacy services. Patients were grouped by mode of HIV transmission: vertically acquired (n=20) and horizontally acquired (n=18). Adherence was assessed using the Proportion of Days Covered (PDC). HIV viral load data were obtained from routine laboratory monitoring as part of standard clinical care. All statistical analysis was performed with R (Version 4.4.2). Results: Mean PDC increased after enrollment in specialty pharmacy services for both vertically (85.4% vs. 83.4%, P=0.09) and horizontally (78.8% vs. 76.8%, P=0.08) acquired patients, but the changes were not statistically significant. Mean viral loads decreased for all patients in the horizontal group with 88.9% having undetectable viral loads (<200 copies/mL) (p<0.001). Mean viral loads increased for patients in the vertical group with only 10.0% having undetectable viral load (p<0.001) over the two-year period. Conclusion: Children and youth living with HIV may adhere better to ART when using a specialty pharmacy compared to a traditional outpatient pharmacy. Finally, the higher viral loads observed in patients with vertically acquired HIV, despite higher adherence, may suggest more complex treatment challenges in this population, potentially due to earlier ART exposure or other clinical factors.
Endalkachew Mekonnen Eticha* and Workineh Diriba Gemechu
Background: Cases of COVID-19 have been increasing in number and spread globally. Pharmacists are an important part of the health care system and their role is critical in completing the management cycles of Coronavirus outbreak surveillance.
Methods: A multi-centric cross-sectional study was conducted on 84 pharmacy professionals recruited from both community and hospital pharmacies in Jigjiga City to assess the knowledge, attitude and practice towards COVID-19. Self-administered questionnaires were developed and distributed to the participants. All extracted data were cleaned, coded and entered into the Statistical Package for the Social Science software version 20 and subsequently analyzed. Binary logistic regression analysis was used to identify determinants of knowledge, attitude and practice towards COVID-19.
Results: All of the respondents had already heard about COVID-19. More than 90% of the participants had adequate knowledge regarding typical symptoms, etiological causes, modes of transmission, measures to protect the infection, risky patients and primarily affected organ system by COVID-19. The majority of the respondents (71.4%) had adequate knowledge regarding COVID-19. The finding indicated that pharmacists had 8 times higher odds (AOR=8.34 95% CI (1.33-36.04)) of adequate knowledge than the pharmacy technicians. Greater than half of the study participants (53.6%) had a positive attitude towards COVID-19. More than 4 out of 5 participants were confident that Ethiopia can win the battle against the pandemic. Participants with less than five years of experience had 6 times greater odds (AOR=6.16; 95% CI (1.52-24.86)) of a positive attitude than their comparator. A low number of participants (16, 22.6%) exercised adequate practice to prevent and control the novel coronavirus spread.
Conclusion: The community and hospital pharmacists had good knowledge but had a poor attitude and practice towards the COVID-19. The majority of the participants perceived that they can play a great role in this pandemic.
Vian Namanya*, Dickens Owamaani and Edmund Byamukama
DOI: DOI: 10.37421/2155-6113.2022.13.891
HIV remains a global human threat with about 39 million people infected and it has claimed the lives of over 25 million over the last 25 years. Over 80% of these are in sub-Saharan Africa. As of 2019, Uganda had an estimated population of 41.5 million, of whom 1,915,533 live with HIV/AIDS with HIV incidence among susceptible individuals at 1.4%, the ultimate highest. About 53000 people were infected with HIV in 2018 whereas 23000 died of the illness in Uganda in 2018. In Uganda, 84% of the people living with HIV knew their status, 72% were on ART and 64% were virally suppressed. Among adults (15-64 years, the most sexually active), the prevalence is 6.2%. In western Uganda, the prevalence stands at 7.9% slightly below western Nile with the highest at 8%.
Vian Namanya* and Kalema Bashir Amza
DOI: DOI: 10.37421/2155-6113.2022.13.892
Introduction: Worldwide the efficacy and safety of Azithromycin and 4-Aminoquinoline regimen in the treatment of COVID-19 has remained uncertain in both pregnant and other mothers. Pregnancy complications studies are still lacking, although a high preterm birth rate due to the combination of this regimen has been reported which is mostly caused by iatrogenic preterm birth owing to the diagnosis of COVID-19 principally preterm cesarean deliveries and perinatal transmission may occur but seems rare. There is lack of evidence reporting an increase in the incidence of congenital abnormalities, an increase in stillbirth or neonatal death (miscarriages), Fetal Growth Restriction (FGR) among pregnant mothers with COVID-19.
Aim: This study aimed at systematically reviewing studies regarding the use of Azithromycin and 4-Aminoquinoline based regimens in COVID-19 positive pregnant mothers.
Methods: This was asystematic literature review. A systemic search of articles was done on PubMed, TRIP, EPPI COVID Living Map, Web of Science, and medRxiv databases until 2020 using the keywords “COVID-19”, “SARS-CoV-2”, “coronavirus”, “hydroxychloroquine”, and “mortality”. Relevant articles were chosen for further evaluation based on a review of their titles and abstracts. In vivo and in vitro studies were included assessing the safety and effectiveness of Azithromycin and 4-aminoquinline for treatment of COVID-19 pregnant mothers.
Results: A total of 438 articles were screened and 12 eligible clinical studies (seven peer-reviewed and published studies and five non-peer-reviewed studies from pre-print servers were included) selected. A number of studies have established very good virological and clinical outcomes with 4-Aminoquinoline in particular HCQ therapy alone or in combination with Azithromycin among COVID-19 pregnant mothers. However, some studies have shown negative results with combination of HCQ treatment and Azithromycin among COVID-19 pregnant mothers.
Conclusion: In this systematic review, we have found that the results of effectiveness and safety of Azithromycin and 4-aminoquinoline combination in COVID-19 pregnant mothers as obtained from 12 eligible clinical studies, is not satisfactory, although many of these studies had major methodological limitations. Stronger evidence from well-designed robust randomized clinical trials is required before conclusively determining the role of Azithromycin and 4-aminoquinoline combination regimen in the treatment of COVID-19. Clinical prudence is required to advocate of Azithromycin and 4-aminoquinoline combination regimen as an unmitigated therapeutic armamentarium in pregnant mothers with COVID-19. Also, the potential of HCQ as a chemo-prophylactic agent against COVID-19 needs to be explored.
Vian Namanya* and Ubaldo Sobimana
DOI: DOI: 10.37421/2155-6113.2022.13.872
Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality Worldwide. The risk of maternal death is much more common in developing countries than developed countries. Therefore it is necessary to recognize the signs and symptoms to predict the disease before it threatens the survival of both mother and fetus since it complicates about 3% of all pregnancies. Health workers like midwives, clinicians and doctors are the primary care givers in treating, understanding and explaining preeclampsia, its diagnosis, risk factors and complications as delay in diagnosis and prompt initiation of treatment could result in disastrous consequences for both the mother and the baby. The risk of maternal death is very high in lower health centers where there no enough trained doctors and other HWs. There is also inadequate supply of drugs used in management of preeclampsia. The study seeks to ascertain whether there are gaps in knowledge and practices by health workers in Bushenyi district contributing to the nationally high mortality rate in rural areas due to pre-eclampsia.36 health workers handling preeclampsia mothers in Bushenyi district were randomly selected and administered a questionnaire to assess their skills and knowledge. Study found that most health workers knew about preeclampsia, its risks but 46% knew less about HELLP syndrome. This study also finds that 52% of the health workers could not adequately prescribe magnesium sulphate and 46% could not signs of magnesium toxicity.
The researchers recommend more refresher course for health workers in Bushenyi and Uganda at large as well as emphasizing use of preeclampsia phone applications and strengthening hands on training for students in health training institutions.
Vian Namanya and Isaac Mugume*
DOI: 10.37421/2155-6113.2022.13.889
Gaspard Tekpa, Sylvain Honore Woromogo*, Eudes Gbangba Ngai, Valentin Fikouma, Larissa Eleonor Kpengougna, Prince Wilikoe and Boniface Koffi
DOI: DOI: 10.37421/2155-6113.2022.13.906
Background: Haematological manifestations during HIV infection in Bangui are common and poorly documented. The objective of our study was to evaluate the frequency of anaemia before and during antiretroviral treatment in people living with HIV (PLHIV) and to identify associated factors.
Methods: This was a retrospective analytical study covering the period from 1 January 2012 to 31 December 2016. PLHIV who were naive or had been treated with ARVs for more than six months and whose medical records included a blood count and a CD4 T-cell count were included. Sociodemographic and clinicobiological characteristics were collected using an anonymous questionnaire. The prevalence of anaemia was measured before and at the sixth month of antiretroviral treatment. Multiple logistic regressions were used to identify associated factors.
Results: We included 532 patients of whom 149 were men (28%). The average age was 37.5 ± 9.4 years. The patients were seen in stages 3 and 4 of the WHO classification of HIV infection in 70.81% of cases. The mean CD4 T cell count increased from 201 ± 175/mm3 before antiretroviral therapy (ART) to 361 ± 182/mm3 after six months of ART. Risk factors for anaemia in PLHIV before ART were CD4 200/mm3 (p=0.0391) and thrombocytosis (p=0.0083); on ART, anaemia was associated with cotrimoxazole use (p=0.0285) and thrombocytosis (p=0.0212).
Conclusion: Anemia in PLWH is common and has multiple risk factors, some of which are preventable, such as late treatment and tuberculosis. Better knowledge of risk factors, early detection and management could help reduce anaemia-related morbidity and mortality.
DOI: DOI: 10.37421/2155-6113.2022.13.907
Background: Knowledge about HIV and AIDS is important in promoting safer sexual behaviour. Given that there is no vaccine or cure for HIV and AIDS, knowledge about HIV and AIDS is an important enabler in the prevention efforts. The aim of the study is to investigate HIV and AIDS knowledge and predictors among students at Nelson Mandela University in South Africa.
Methods: The study was conducted using cross-sectional and quantitative research methodology among students at Nelson Mandela University. Stratified sampling was employed to select 884 undergraduate students. A self-administered questionnaire was used to collect data analysed using SPSS version 26. A bivariate and multivariable binary logistic regression model was employed to identify predictors of HIV and AIDS knowledge. The p-value <0.05 and odds ratio with 95% confidence interval were used to determine statistical significance of the findings.
Results: Findings show that 52.5% of the students had good knowledge about HIV and AIDS. Having a monthly stipend >2000 rand from parents/relatives (AOR=2.71 (1.35–5.49)), being in the third year level of study and higher up (AOR=5.35 (2.93–9.77)), and being in the health science faculty (AOR=16.29 (8.22–32.29)) were significant predictors of good level of HIV and AIDS knowledge.
Conclusion: Almost half of the students reported poor knowledge about HIV and AIDS. There were misconceptions about HIV transmission routes among students. Monthly income, level of the study, and faculty of study were reported to be significant predictors of HIV and AIDS knowledge. This study calls for the need to provide students with more HIV and AIDS education to address HIV and AIDS knowledge gaps and promote behavioural change.
DOI: 10.37421/2155-6113.2023.14.928
Background: The rate of prevalence of HIV among adults has been increasing in Sub-Saharan African countries over the last decade. The objective of this study was to identify the joint predictors of cART adherence and disclosure of HIV status among HIV infected adults at Felege Hiwot teaching and specialized hospital, North-West Ethiopia.
Methodology: A retrospective cohort of longitudinal data was conducted on 792 randomly selected patients in the study area. A joint model was used to identify predictor variables. The two response variables under the current investigation were cART adherence and disclosure of HIV status. Binary logistic regression was conducted for separate models.
Results: Among the predictors, the age of patients (AOR=1.020, 95% CI: (1.016,1.191); p-value=0.005), the number of follow-ups (AOR=1.014, 95% CI: (1.023, 1.030); p-value<0.0001). CD4 cell count (AOR=0.981; 95% CI: (0.765, 0.971), p-value<0.01), marital status (AOR=1.013; 95% CI: (1.002, 1.015), p-value=0.006), female patients (AOR=1.014; 95% CI; (1.001, 1.121), p-value<0.007), rural (AOR=0.982; 95% CI; (0.665, 0.998), p-value=0.004), non-educated adult patients (AOR=0.950, 95% CI; (0.92. 0.98). p-value=0.003), non-existence of social violence (AOR=1.012, 95% CI: (1.008, 1.234), p-value<0.01), an adult with non-opportunistic diseases (AOR=1.021, 95% CI; (1.002, 1.042). p-value=0.001) significantly affected the two response variables jointly.
Conclusion: Several variables that affected both disclosures of HIV status and adherence to cART had been identified in the current investigation. Due attention should be given to younger patients, rural residents, and non-educated patients to disclose the disease status and to have a long life with the virus.
Awoke Seyoum Tegegne* and Awoke Fetahi
DOI: 10.37421/2168-6113.2023.14.929
Background: Hepatitis B is the most common liver infection in the world which is caused by the Hepatitis B Virus (HBV). The virus can attack and injure the liver. The infection of hepatitis B virus leads to chronic viral hepatitis infections in hundreds of millions of people in worldwide. The objective of current study was to identify factors that affect the progression rate of hepatitis B virus in patients’ liver who were treated at Felege-Hiwot teaching and specialized hospital, during treatment period.
Methods: The data for this study was obtained from hepatitis B patients chart registered for treatment during January 2013 to December 2016 at chronic hepatitis B patients’ clinic at Felege-Hiwot teaching and specialized hospital, Bahir Dar, Ethiopia. A retrospective study design was conducted in current investigation. The estimation of the model parameters was done by Restricted Maximum Likelihood (REML) procedures.
Results: From the linear mixed effect model, main effects like visiting time (p-value<0.001), sex (p-value=0.0332), age (p-value<0.001), vaccination history (p-value=0.0141), marital status (p-value=0.0032), alanine aminotransferase (p-value=0.0057), genotype, A (p-value=0.0154), genotype, B (p-value=0.0183), genotype, C (p-value=0.0143) and albumin (p-value=0.0329) significantly affected the variable of interest. Similarly, interaction effects of time with marital status (p-value=0.0042) played statistically significance role on the progression rate of hepatitis B virus in the liver of patients.
Conclusion: A certain groups which are at maximum risk and needs intervention have been identified. Highly concrete evidences have been increased from time to time for certain population with chronic HBV infection being at great risk for progression of liver disease. Hepatitis B virus infected patients at the study area should have information about factors that can affect the progression rate of HBV. Ministry of health or health staff should aware the community to take vaccination that helps to protect individuals from hepatitis B virus.
Gebru Gebremeskel Gebrerufael* and Zeytu Gashaw Asfaw
DOI: 10.37421/2155-6113.2024.15.968
Background of the study: The Acquired Immune Deficiency Syndrome (AIDS), which has caused the world's worst heartbreak and danger, is caused by the Human Immunodeficiency Virus (HIV), which is a virus. The purpose of this inquiry was to pinpoint the key joint predictor factors and their relationships, two of which were the progression of CD4 cells and the time to death for HIV/AIDS patients starting ART at Mekelle General Hospital (MGH) in Northern Ethiopia.
Methods: A longitudinal retrospective cohort follow-up study involving 216 HIV positive individuals was used to look into the progression of CD4 cells and the time to mortality in these patients. The primary joint predictor variables and their association with time-to-mortality for HIV/AIDS patients who started ART were found using a joint model analysis approach. In the general hospital's records, 216 HIV positive patients were selected systematically at random. The JM package and R 3.6.1 version procedure were used to examine the secondary data.
Results: The findings showed that there was a statistically significant negative relationship between the two response variables, CD4 cell count progression and time to mortality (α=-9.4; and p<0.0001*). Being co-infected with (β=-0.125; and p<0.001*), as well as the follow-up visit duration (β=-0.005 and p<0.001*), had a statistically significant impact on the likelihood that the CD4 cells count would increase. Additionally, patients who were WHO stage-III or IV (AHR=1.7; and p<0.0384*), or co-infected with TB (AHR=3.63; and p<0.002*) had statistically been linked to a higher risk of mortality.
Conclusion: In order to simultaneously study the important effects of predictor factors on the change in CD4 cell count progression and the risk of patient mortality, the authors used that statistical joint model, which provides a flexible framework. The association parameter change of CD4 cell progression on the chances of mortality events was also evaluated by this combined model analysis.
Jun Tao1*, Hannah Parent2, Harrison Martin2, Jhanavi Kapadia3, Amy Nunn4, Leandro Mena5, Brandon D. L. Marshall6, Henry Raymond7, Nancy Barnett3 and Philip A. Chan
HIV continues to be a significant health challenge in the United States, disproportionately affecting Black/African American (B/AA) and Hispanic/ Latino (H/L) Men who have Sex with Men (MSM). Pre-Exposure Prophylaxis (PrEP) is an effective HIV prevention pharmaceutical strategy, but its uptake among these populations has been suboptimal. Peer-Driven Interventions (PDIs) have demonstrated promise in increasing HIV prevention engagement, including PrEP services. This paper shares insights from a study aimed at promoting PrEP uptake among MSM using a PDI approach. The study recruited 39 peer educators through clinical outreach, LGBTQ+ community organizations and local nightlife venues, email outreach and collaboration with Community Health Workers (CHWs). Despite moderate success in peer educator recruitment, challenges arose in motivating peer educators to refer social network members for PrEP counseling sessions with our study team. Factors such as low referral incentives, time constraints, and lack of consistent engagement were identified as barriers. To address these challenges, future PDIs may benefit from integrating Artificial Intelligence (AI)-based tools to extend outreach and support both peer educators and their social networks. Additionally, hiring part-time peer educators and providing them with more in-depth training could improve recruitment and retention. The authors also emphasize the importance of a comprehensive approach to promoting PrEP uptake, combining peer support with professional services and care to improve PrEP outcomes, such as long-term adherence. These findings highlight the need for innovative solutions to optimize HIV prevention efforts in disproportionately affected populations.
Yalemwork Desta Dagnachew* and Awoke Seyoum Tegegne
Background: Anemia and underweight are public health problems affecting both developed and developing nations worldwide with a significant consequence of health and economic growth. Thus, this study aimed to identify factors affecting anemia and underweight in under five children in Ethiopia.
Method: This study was done using 2016 EDHS data considering a sample of 8,439 under-five children. The study was conducted across the country using the cross-sectional survey. Hemoglobin level <11 g/dl and Z-score below -2 SD were used to investigate anemia and underweight respectively.
Result: The prevalence of anemia and underweight in this study was 57.5% and 25.4% respectively. This study also revealed that the spatial distribution of anemia and underweight were random in Ethiopia with Moran’s index statistics -0.012288 and -0.025832 with corresponding pvalue of 0.956670 and 0.801798 respectively. In bivariate binary logistic regression analysis, variables such as children who had large size at birth (AOR=0.861, 95% CI: (0.510, 0.873)), Children from rich families were less likely to be anemic (AOR=0.690, 95% CI: (0.486, 0.957). Children from educated families were less likely to be anemic (AOR=0.802; 95% CI: (0.594, 0.949) and such children were also less likely to be underweight (AOR=0.661; 95% CI: (0.619, 0.898).
Conclusion: Child age, size of child at birth, birth type, fever, parent’s education, wealth index, and region were significant factors affected for severity of anemia and underweight status of under-five children in the study area. Health related education should be conducted for those households with anemic and underweight children.
Godada Keleb and Awoke Seyoum Tegegne*
Objective: Preterm birth refers to the birth of a baby that occurs before 37 completed weeks of gestation. The main objective of current study was to identify predictors for the death of preterm neonates admitted to neonatal intensive care unit at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia.
Methods: Institutional retrospective secondary data was conducted on 300 neonates admitted in the neonatal intensive care unit. Specific death rate and binary logistic regression models were used for data analysis.
Results: The current investigation revealed that; the stay in hours in NICU (AOR= 0.960, p-value=0.028), preterm neonates delivered in hospitals (AOR=0.329, p-value=0.029), preterm birth delivered at health facility (HC, HP) (AOR=0.435), weight of preterm neonates (AOR=0.141, p-value=0.000), a preterm neonate born from multiple pregnancy mothers (AOR=1.104), and HIV infected preterm neonate (AOR=1.328, p-value=0.002) were statistically significant predictors for the death of preterm neonates in NICU.
Conclusions: Small weight neonates, very preterm gestation age, short waiting time of neonates in neonatal intensive care unit and neonates born from mother with multiple pregnancies, HIV infected neonates and those lived in rural areas are risk groups and more attention should be given for such groups.
Awoke Seyoum Tegegne* and Getu Degu Alene
Background: Treatment failure a current issue that is related to patients to transfer from one regimen to a more advanced and a costly treatment result to the progress of HIV/AIDS control. Many HIV patients in the world transferred from first-regimen to the second-regimen because of treatment failure. This leads the program to be more resource intensive and needs to identify predictors for treatment failure at second line regimen. Therefore, the purpose of this study was to investigate the prevalence of treatment failure and the associated factors among HIV/AIDS under second line ART regimen in Amhara region, Ethiopia.
Materials and methods: An institutional based repeated follow ups of 700 HIV positive individuals, who were switched to second line regimen from January 2020 to December 2022 in 17 government hospitals in Amhara region was conducted. Inferential statistics including the Chisquare test and multivariable logistic regression analysis was applied to investigate factors associated with treatment failure. Associations between treatment failure and the predictors was based on a P-value of less than 5% and confidence intervals level of 95%.
Results: Among the covariates, age of the patients (AOR=1.122, 95% CI: 1.013, 2.234), baseline CD4 cell count (AOR=0.888, 95% CI: 0.714, 0.945), patients living without their partner (AOR=1.212, 95% CI: 1.051, 1.123), females under treatment (AOR=0.786, 95% CI; 0.564, 0.845), non-opportunistic diseases (AOR=0.865, 95% CI: 0.731, 0.938), patients not disclosed their HIV status (AOR=1.241, 95% CI: 1.087, 2.341), rural patients (AOR=1.135, 95% CI: 1.032, 1.453, patient with no education (AOR=1.125, 95% CI: 1.056, 1.546), patients with low adherence (AOR=1.225, 95% CI: 1.191, 2.453), bedridden patients (AOR=1.223, 95% CI: 1.131, 1.521), ambulatory patients (AOR=1.156, 95% CI:1.091, 1.267), non-smoker patients (AOR=0.854, 95% CI: 0.686, 0.935) significantly affected on the variable of interest. Similarly, alcohol intake, drug toxicity and baseline clinical WHO stages significantly affected for the development of tuberculosis in HIV-positive patients under treatment.
Conclusion: In this study, baseline CD4 cell count, female patients, non-opportunistic diseases, and non-smoking status were negatively associated with the development of TB, whereas, age of patients, living without partners, patients with no education, patients with low adherence, bedridden and ambulatory patients were positively associated to the development of TB in HIV patients. The findings obtained in this study are important for both service providers to conduct health-related education and patients to take care of their medication adherence. More attention should be given to those positively associated variables to response variables. The regional health bureau should open TB/HIV co-infection subsections like ART sections in each hospital.
Journal of AIDS & Clinical Research received 5264 citations as per Google Scholar report
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