Human Immune Virus Research Articles

Adherence of healthcare providers to Enhanced Adherence Counseling (EAC) intervention protocol in West Amhara Public Health Facilities, Northwest Ethiopia, 2023: mixed method evaluation

BackgroundIn Ethiopia, there were an estimated 670,906 people living with the Human Immune Virus (HIV). Implementing an HIV test and treat strategy and rapid scale-up of anti-retroviral treatment (ART) provided health facilities increased the number of the number of people living with HIV/AIDS. In the same way, the expansion of viral load monitoring in these health facilities and poor adherence to ART increase the number of high-viral load (HVL) patients. To alleviate this problem, the World Health Organization (WHO) recommended EAC intervention for HVL patients. Therefore, the aim of this research was to determine the level of healthcare providers’ adherence to the EAC intervention protocol and explore barriers and facilitators of the intervention in West Amhara, Northwest Ethiopia.MethodDescriptive cross-sectional study design with concurrent mixed-method evaluation was employed. The adherence dimension, with its sub-dimensions of content, coverage, frequency, and duration of the EAC intervention, was used with sixteen indicators. A total of 20 high-case-load public health facilities and 173 HVL patients were included in our study. Quantitative data was entered into Epi Info and exported to SPSS version 25 for analysis. Descriptive statistics are analyzed in terms of frequencies, percentages, variances, and means and presented as narrations, frequency tables, graphs, and charts. Qualitative data were transcribed, translated, coded, and analyzed thematically using Open Code version 4.0 software. The qualitative findings were used to triangulate the quantitative findings.ResultThe average adherence level of health care providers (HCPs) to the EAC intervention protocol was 55.3%, from which content, coverage, frequency, and duration of the intervention contributed 70.3%, 86.3%, 36.9%, and 27.7%, respectively. Most of the intervention contents were delivered during the session, but none of the providers developed a patient adherence plan at the end of the session. All HVL patients were linked and enrolled in the EAC intervention. But only 6% of them were tested for repeat VL.ConclusionThe average adherence level of HCPs to the EAC intervention protocol was very inadequate. The main gap identified was difficulties in completing the EAC intervention sessions based on schedules. Implementing adherence improvement strategies, assigning an adequate number of EAC providers in ART and Prevention of Mother-to-Child Transmission (PMTCT) clinics, and allowing sufficient time during EAC sessions are important.

Incidence and predictors of tuberculosis among HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.

Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia. An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics. This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726-4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence. The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.

Healthcare Workers' Perspectives on the Utilization of the International HIV Dementia Scale for the Screening HIV-Associated Neurocognitive Disorders: A Qualitative Study at TASO Centres in Central and Southwestern Uganda.

HIV-associated neurocognitive disorders (HAND) are becoming a significant public health concern in the continuum of human immune virus (HIV) treatment.These disorders range from subtle cognitive impairments to severe dementia. Despite many early-stage HAND cases being asymptomatic, healthcare workers (HCWs) rarely perform routine neurocognitive assessments. This leads to a high number of unrecognized cases and increases the risk of HAND among people living with HIV (PLWH). We aimed to explore HCWs' perspectives on integrating the International HIV Dementia Scale (IHDS) into routine care for screening HAND at The AIDS Support Organization (TASO) centres in central and southwestern Uganda. We conducted five focus group discussions with 37 HCWs from five TASO centres. Thematic analysis revealed eight key theme: 1) Impaired brain function, 2) Changes in activities of daily living, 3) Promotion of quality care perspectives, 4) Tool applicable and user-friendly, 5) Client increased self-awareness and self-confidence, 6) Integration of IHDS into routine HIV care, 7) Uncertainty about IHDS use, and 8) Continuous training for HCWs. As PLWH enjoy longer and healthier lives, their risk for HAND increases, potentially affecting their quality of life. The use of the IHDS has raised awareness among HCWs and improved decision-making through cognitive assessments, emphasizing it value in PLWH. We recommend a prospective study to assess the long-term outcomes and efficacy of increased HAND screening. Furthermore, integrating a HAND screening module into the consolidated HIV guidelines is recommended to enhance its relevance.

HIV Prevention among Young People in Sub-Saharan Africa

Purpose: The commitment to getting to epidemic control by 2030, places the prevention of Human Immune Virus at the center of the response. With the disease affecting young people disproportionately, reducing HIV infections among this group is vital. This paper seeks to review data on the different types of interventions used in the prevention of HIV amongst young people in Sub-Saharan Africa. Method: Data search was done by reviewing journals through PubMed and Google scholar. Findings: Reviews found that school based approach improved on knowledge, attitude and reduced risky sexual behaviors among young people. Adolescent-responsive strategy was seen to be effective, sustainable and scalable. The percentage of condom use increased from 32% to 45% for females (p<.05) and from 44% to 61% for males (p<.01) with regular partners among Cameroonian youths. Condom use among sexually active students decreased from 61% in 2009 to 54% in 2019.HIV testing had low rates among young people. Oral PrEP demonstrated over 90% risk reduction of HIV. Circumcised men had a 60% HIV protection effect and cash transfers reduced HIV risk significantly among adolescent girls and young women with positive behavioral outcomes. Conclusion: HIV prevention approaches when integrated can achieve maximum effectiveness, but it’s important for these interventions to be tailored towards meeting the needs of young people. Knowing that they have unique developmental needs and challenges, prevention programs should be contextualized depending on the geographical location and environment to meet specific needs.

Magnitude of consistent condom use and associated factors among people living with HIV/AIDS in Ethiopia: Implication for reducing infections and re-infection. A systematic review and meta-analysis.

The human immune virus or acquired immune deficiency syndrome, is a major threat to the health of millions of people worldwide. In Ethiopia, there were more than a million people living with HIV/AIDS. The continuous and appropriate use of condoms, particularly among those who have HIV-positive clients, is essential to a comprehensive and long-term approach to avoiding HIV and other STIs as well as unintended pregnancy. But irregular condom use is regularly reported. There is inconsistent reports of the prevalence and correlates of frequent condom use in Ethiopia. This study's goal is to provide an overview of the most recent research on magnitude condom use among people living with HIV in Ethiopia. Four databases of PubMed, Science Direct, Scopus, and Google Scholar were used. Finally, 10 studies that satisfied the eligibility criteria were included in the systematic review and meta-analysis. The data were collected using a methodical checklist for data extraction, and STATA 14 was utilized for the analysis. The consistent condom use was reported as use of condom in every sexual encounter preceding the study. The prevalence of consistent condom usage among HIV/AIDS patients was calculated by dividing the total number of patients who regularly used condoms by the total number of HIV/AIDS patients and multiplying that result by 100. The factors associated with a consistent use of condom were described using the pooled odds ratio (OR) and calculated based on binary outcomes from the included primary studies. The statistical significance was determined based on the correlation factor as their confidence level should not include 1. Subgroup analyses by region and publication years were carried out by using a random-effects model. The STATA commands of metan magnitude semagnitude, random xlab(.1,5,10) lcols (authors) by (variables)texts(120) xsize(18) ysize (14) were used to carried out the subgroup analysis. To assess the presence of publication bias, funnel plot, Egger test and Begg's test at 5% significant level were computed. The asymmetry of funnel plot and the Egger test and Begg's test P value of 0 >0.5 showed the absence of publication bias. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. The pooled magnitude of consistent condom use was 50.56% (95%CI: 38.09-63.02). The predictors of consistent condom use includes urban residence (AOR = 3.46; 95% CI: 2.24-5.35), marital status (AOR = 0.33; 95% CI: 0.18-0.61), and HIV disclosure status (AOR = 5.61;95%CI: 2.29-13.73). Half of the HIV/AIDS patients in our study regularly used condoms. According to this study, urban residency, disclosure status, and marital status were all associated with consistent condom use among HIV/AIDS patients. Therefore, health education about condom use should be provided to married couples and people living in rural regions. In addition, disclosing HIV status and the necessity of constant condom usage would be crucial for consistent condom use.

Uptake of cervical cancer screening and associated factors among human immune virus positive women attending antiretroviral therapy clinic in public health facilities, Northeast Ethiopia, 2022: A cross-sectional study.

Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia. Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia. A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer. The magnitude of cervical cancer screening was 19.2% (15.7%-22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.

Fertility desire and associated factors among antiretroviral therapy users in South Gondar Zone, Northwest Ethiopia, 2022.

There were approximately 38 million human immune deficiency virus/acquired immune deficiency syndrome cases worldwide in 2019, of which 36.2 million were adult cases, of these 25.4 million had access to antiretroviral therapy. The desire to have children among human immune virus-infected people has significant implications for the transmission of the human immune virus. In many developing countries such as Ethiopia, where the prevalence of the human immune virus is high, the risk of human immune virus transmission to the baby is inevitable. This study's objective is to evaluate fertility desire and associated factors among antiretroviral therapy users at South Gondar public hospitals, Northwest Ethiopia, 2022. A multicenter institutional-based cross-sectional study design was conducted among patients attending antiretrio viral therapy at South Gondar Zone public hospitals, from April 1 to May 30, 2022. A total of 551 study participants were selected using systematic random sampling. Data were collected through face-to-face interviews using a pretested, semi-structured questionnaire. The data were entered into Epi-Data version 4.6 and then exported to SPSS version 26 for analysis. Multivariable logistic regression analysis was performed to identify factors associated with the outcome variable, and adjusted odds ratios with 95% confidence intervals were calculated to determine the level of significance. The study included 551 participants with a 100% response rate. The prevalence of fertility desire among antiretroviral therapy users in South Gondar Zone public hospitals was 42.5% (95% confidence interval: 38.6, 46.8). Independent predictors of fertility desire included being a merchant (adjusted odds ratio = 0.06; 95% confidence interval: 0.01, 0.08), being a farmer (adjusted odds ratio = 0.21; 95% confidence interval: 0.09, 0.47), having no children (adjusted odds ratio = 20.04; 95% confidence interval: 4.7, 24.2), disclosing HIV status (adjusted odds ratio = 0.05; 95% confidence interval: 0.01, 0.30), and being diagnosed with HIV (adjusted odds ratio = 15.5; 95% confidence interval: 12.79, 20.54). The prevalence of fertility desire among antiretroviral therapy users is found to be high. It is important to improve the existing Information, Education, and Communication interventions on fertility desire among antiretroviral therapy attendants at the individual and community levels.

Lived experience of people on anti-retro viral therapy in the context of covid-19: A phenomenological study.

People living with human immune virus (HIV) are confronting multiple psychosocial and economic issues influenced by the illness. People on anti-retro viral drugs (ART) were at risk for discontinuation of medications during corona viral disease-2019 (COVID-19) pandemic. COVID-19 outbreak made people living with HIV (PLWH) to experience critical challenges and barriers to optimal care. The experience of people living with HIV such as stigma and discrimination, economic problem, psychosocial problem before the emergency of COVID-19 were studied but there is lack of understanding on the lived experience of people living with HIV in the context of COVID-19 in Ethiopia particularly in Tach Gayint. This study aimed to explore the lived experience of people on ART in context of COVID-19 in Tach Gayint district. Phenomenological study design conducted with 16 study participants from March 12-April 12/2021. Data were collected using in-depth interview using interview guide and digital recorder. The investigator took note in addition to digital record. Interviews were transcribed word for word and translated conceptually. Analysis followed Reading of transcriptions, develop and apply coding, displaying data, data reduction and interpretation. Atlas.ti-7 software used to facilitate analysis. The quality of data was assured by the principles of credibility, dependability, conformability and transferability. The study explored psychological experience, change in social interaction, and economic experience and ART drug interruption as the main themes including other sub-themes. Most participants perceived the severity of COVID-19 on them. Lack of participation in social activities due to fear of contracting and the participants experienced dying and loss of income. This extreme fear pushed some participants to interrupt their daily ART intake especially during lock down period. Personal, familial and community context contributed for these distressing experiences. This study reported participants' psychosocial, economic experiences including ART drug interruptions. The government should design policies and interventions to alleviate their personal, household and community problems, which were the caused for the mentioned hostile experiences.

Cervical cancer screening uptake and associated factors among Women Living with Human Immunodeficiency Virus in public hospitals, eastern Ethiopia

BackgroundCervical cancer, the second leading cancer in Ethiopia women, is six times higher among women infected with the Human Immune Virus 1-infected women. Its screening provides protective advantages, and is linked to a decrease in the incidence of invasive cervical cancer and mortality. Although cancer screening has great advantages for early treatment and prevention of further complications, cervical cancer screening uptake is low among women in developing countries. Cervical cancer screening uptake among Women Living with Human Immunodeficiency Virus (WLHIV) is not well known in Eastern Ethiopia. Thus, we aimed to assess cervical cancer screening uptake and its associated factors among WLHIV in public hospitals in Harar, eastern Ethiopia.MethodsAn institution-based cross-sectional study was carried out on 412 randomly selected HIV-positive women from March 20 to April 20, 2022. The results of the study were presented descriptively in percentages and analytically in odds ratio. Bivariate and multivariable logistic regression analyses were used to determine the presence and degree of association between dependent and independent variables. In the multivariable logistic analysis, a p-value of 0.05, and an adjusted odds ratio with a 95% confidence interval were considered to determine independent predictors for the uptake of cervical cancer screening.ResultsCervical cancer screening uptake among WLHIV was 57.5% (95% CI: 52.5, 62.9%). The uptake of cervical cancer screening was significantly associated with age between 20-29 years (AOR = 7.33; 95% CI: 1.98, 27.1), 40-49 years (AOR = 4.37; 95% CI: 1.48, 12.89), tertiary level of education (AOR = 0.197; 95% CI: 0.041, 0.946), good knowledge (AOR = 3.591; 95% CI: 2.123, 6.073), and monthly income of 2501(45.52 $) and above Ethiopian Birr (AOR = 0.389; 95% CI: 0.158, 0.959).ConclusionsMore than half of the participants had undergone cervical cancer screening. Age, marital status, educational status, monthly income, and awareness of cancer screening uptake were all factors related to cervical cancer screening. To maximize uptake, it is necessary to create specific counseling and education programs that target HIV-positive women.

Prevalence and factors associated with hypertension among peoples living with HIV in East Africa, a systematic review and meta-analysis

BackgroundIn recent years, improved access to effective antiretroviral therapy has meant that people living with human immune virus are living longer than before. The burden of non-communicable diseases particularly, hypertension parallels with the increase in age. Although hypertension screening is thought to be an effective indicator of overall health status and paves the way for early interventions in peoples living with human immune virus, the exact prevalence of hypertension in this population remained unknown. We aimed to report the prevalence of hypertension and examine the factors associated with hypertension among people living with human immune virus in East Africa.MethodsIn this systematic review and meta-analysis, we searched PubMed, Science Direct, Scopus, Cochrane library, and Google Scholar databases for studies published until January 1, 2023. The search period was from January 10/2023, to February 10/ 2023. Random-effect models were used to calculate the pooled prevalence of hypertension. Subgroup analyses were conducted to explore potential heterogeneity. The Funnel plot and Egger’s test were used to assess publication bias.ResultA total of 15 studies with 10,916 individuals were included in the present meta-analysis. The pooled prevalence of hypertension among people living with human immune virus was19.75% (95% CI, 16.07%-23.42%)),). The prevalence of hypertension was not differed between studies conducted 2014- 2019 and, studies conducted 2020–2022. The prevalence of hypertension was lowest in Ethiopia (16.13%) and highest in Tanzania (26.76%). Alcohol consumption (Adjusted Odds Ratio (AOR): 3.39, 95% CI: 2.35–4.43), diabetes (AOR: 2.64, 95% CI: 1.89–3.39), longer duration of HIV (AOR: 1.72, 95% CI: 1.15–2.3), male sex (AOR: 1.62, 95% CI: 1.43–1.8), obesity (AOR: 2.89, 95% CI: 1.94–3.84), and older age (AOR: 2.25, 95% CI: 2.0–2.5), were the factors associated with the presence of hypertension in people living with human immune virus.ConclusionOur study shows that one in five peoples living with human immune virus have hypertension causing symptoms and impairment, therefore requiring treatment. Designing effective health screening and hypertension management intervention programs helps to prevent the occurrence of hypertension and promotes peoples’ overall quality of life.

Dyslipidemia and Nutritional Status of HIV-Infected Children and Adolescents on Antiretroviral Treatment at the Comprehensive Chronic Care and Training Center of Jimma Medical Center.

Highly active antiretroviral treatment is beneficial to suppress human immune virus replication in infected individuals. However, dyslipidemia and other metabolic abnormalities have emerged due to antiretroviral treatment. The prevalence of dyslipidemia in children and adolescents on antiretroviral treatment varies from 20% to 70%. The lack of data on children and adolescents in Ethiopia was the rationale for conducting this study. We aimed to determine prevalence of dyslipidemia and nutritional status in children and adolescents on follow-up at Jimma medical center. A hospital-based cross-sectional study was conducted with 150 children and adolescents on follow-up at Jimma medical center. A systematic sampling technique was employed. An interview was carried out to collect socioeconomic and demographic data and a review of medical records was carried out to collect patients' clinical data. Anthropometric data were computed using the CDC growth chart. About 3-5mL of fasting blood was collected to measure lipid profile. Multivariable logistic regression was performed to find the association between risk factors and lipid profile. The overall prevalence of dyslipidemia in this study was 72%. About 72% and 21.3% of study subjects had low high-density lipoprotein and high triglyceride, respectively. Significant associations were observed between BMI for age ≤5% (AOR: 2.02, 95% CI: 1.14-3.66; P=0.015) and low high-density lipoprotein; greater than 150 months on treatment (AOR: 1.02, 95% CI: 1.00-1.03; P=0.01) and high triglyceride; and BMI for age ≤5% (AOR: 1.86, 95% CI: 1.03-1.37; P=0.04) and high triglyceride. BMI for age <5%, treatment duration of greater than 150 months, and parents' educational level were significantly associated with dyslipidemia, soit is recommended that monitoring of those variables will help to reduce dyslipidemia and its complications in children and adolescents receiving treatment.

Preventing mother-to-child transmission of human immunodeficiency virus (HIV), syphilis and hepatitis B: a secondary hospital approach in North Bali, Indonesia

Background Mother-to-child transmission (MTCT) of human immune virus (HIV), syphilis, and hepatitis B can lead to significant health burdens and even mortality in children. This study aimed to evaluate the effectiveness of triple elimination of MTCT in a secondary hospital in Buleleng, North Bali Method: This study conducted a retrospective review of 345 pregnancy case in Buleleng General Hospital from January to December 2022 Result: In this study, 98.5% of the 345 pregnant women seeking antenatal care were tested for HIV, syphilis, and hepatitis B. Among the tested patients, 100%, 99.7%, and 98.8% were tested for HIV and hepatitis B, HIV and syphilis, and syphilis and hepatitis B, respectively. The prevalence of HIV, syphilis, and hepatitis B was 1.4%, 2.1%, and 4.3 %, respectively. Antiretroviral therapy was administered to 80 % of HIV-positive patients, and 71.4 % of syphilis patients received benzathine penicillin G. Only 6.6% of hepatitis B patients received hepatitis B virus deoxyribonucleic acid (HBV DNA) &amp; hepatitis B envelope antigen (HBeAg) examination followed by Lamivudine administration. Conclusion: Early detection of HIV, syphilis, and hepatitis B in pregnant women is important for preventing MTCT. Coverage of triple elimination screening is in accordance with WHO targets, but further management of hepatitis B needs to be improved

Magnitude of opportunistic infections and associated factors among adult people living with human immune deficient virus on art at selected public hospital, mogadishu somalia: cross-sectional study.

A hospital-based cross-sectional study was conducted between 1 June and 30 August 2022 by interviewing HIV patients and reviewing case record files using a validated questionnaire containing sociodemographic, clinical, OIs history, behavioural and environmental characteristics. Logistic regression was used to determine factors associated with OIs at the significance level of a=0.05. The magnitude of OIs among people living with HIV was 37.1% (95% CI=31.6-42.2); major identified OIs were pulmonary tuberculosis 8.2%, Diarrhoea 7.9%, and Pneumonia 4.3%. Based on Multivariable logistic regression drinking non-sterilized water [adjusted odds ratio (AOR)=2.395, 95% CI: 2.010-4.168], living with domestic animals (AOR=4.012, 95% CI: 1.651-4.123), Co-morbidity of chronic disease (AOR=2.910, 95% CI: 1.761-3.450), and poor ART adherence (AOR=3.121, 95% CI: 1.532-6.309) were factors associated with OIs. Human immune deficient virus patients in Mogadishu, Somalia, suffer from OIs. The OIs reduction strategies should improve drinking water sanitation, provide special consideration for those living with domestic animals and those with a co-morbid chronic disease, and improve ART adherence.

Prevalence and Patterns of Adverse Drug Events Among Adult Patients with Human Immune Virus Infection on Dolutegravir-Based Antiretroviral Drug Regimens in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study.

Antiretroviral therapy (ART) refers to any HIV treatment that uses a combination of two or more drugs to suppress viral load and preserve immunofunction. Despite the success of ART, adverse events persist, in particular in patients with baseline viral loads >100,000 copies/mL. Apart from premarketing surveillance, the safety and risk profile of dolutegravir has not been thoroughly researched in Ethiopia. Therefore, this study aimed to assess the prevalence and patterns of adverse drug events among HIV-infected adult patients on dolutegravir-based ART regimens at Amhara comprehensive specialized hospitals, northwest Ethiopia. A retrospective follow-up study was conducted from January 1, 2019 to December 31, 2021 at Amhara comprehensive specialized hospitals, with a sample size of 423. Simple random sampling was employed and data collected using kobo tool box software by four trained BSc nurses from March to April, 2022. SPSS 25 was used for analysis. Descriptive summary statistics are used and data presented using tables and text. A total of 372 patient charts were included in the final analysis, and the prevalence of adverse events associated with dolutegravir was found to be 37.6% (95% CI 32.1%-42.1%). Nearly two-thirds (60.7%) of the participants had neuropsychiatric symptoms, followed by gastrointestinal symptoms (23.6%) and hepatic problems (7.14%). All recorded adverse events were mild. Dolutegravir adverse events were relatively low compared to previous studies. Common adverse events reported were neuropsychiatric symptoms and gastrointestinal symptoms, followed by hepatic and renal events. All adverse events were mild and none was severe or life-threatening events. Therefore, we recommend the use of dolutegravir in clinical settings.

Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study.

Although the goal of ART is to have better health, extend the life of the HIV-infected patient, and decrease HIV-related death, there is a continuation of HIV-related mortality with the use of ART. This study aimed to assess the incidence of mortality and its predictors among adult HIV/AIDS patients who were on ART follow-up at Wolaita Sodo Comprehensive specialized hospital in southern Ethiopia. A retrospective follow-up study was conducted from May 1 to June 30, 2021 among adult HIV/AIDS patients with a total of 441 adult HIV/AIDS patients in this hospital included. Kaplan-Meier failure curve and Log rank test were fitted, and Cox-proportional hazards model was also used to identify the predictors of mortality. Both crude and adjusted hazard ratios (AHR) with their 95% confidence interval (CI) were calculated to show the strength of association. The proportional assumption was conducted by using a global test based on the Schoenfeld residuals. Incidence of the mortality rate was 5.61 (95% CI, 4.2-7.3) per 100 person-years observation. In the multivariable analysis, HIV/AIDS patients were widowed (aHR; 10.9 (95% CI, 3.13-37.99), poorly drug-adhered (aHR; 5.6 (95% CI, 2.4-13.2) and fair adhered (aHR; 3.53 (95% CI, 1.58-7.87), WHO clinical stage IV (aHR; 5.91, (95% CI, 1.41-24.71), history of substance use (aHR; 2.02 (95% CI, 1.01-4.06) and history of IV drug use (aHR; 2.26 (95% CI, 1.10-4.74) independently predicted the mortality of patients. In this study, incidence of mortality was relatively high. The rate of mortality may be minimized by paying particular attention to individuals with widowing, substance use at the baseline, advanced clinical stage IV, history of IV drug use at the baseline, and those with adherence problems.

Incidence and determinants of loss to follow-up of human immune virus pre-exposure prophylaxis among key and priority population groups in Addis Ababa health centers, Ethiopia

Incidence and determinants of loss to follow-up of human immune virus pre-exposure prophylaxis among key and priority population groups in Addis Ababa health centers, Ethiopia

Married women pre-marital HIV testing status in Ethiopia: Individual and community level factor analysis.

Marriage between serodiscordant individuals accounts for 65-85% of new infections. Pre-marital Human Immune Virus (HIV) testing opens the door for HIV infection prevention and control. There are no studies that have evaluated the coverage and factors influencing pre-marital HIV testing at the community level in Ethiopia. This study was conducted using 10,008 samples of data extracted from Ethiopian demographic and health surveys (EDHS), 2016. To identify individual and community level factors a multi-level binary logistic regression model was used. Among fitted models, "full" model was taken as the best model. To declare the presence or absence of significant association with pre-marital HIV testing, a p-value < 0.05 with confidence interval (CI) was used. In Ethiopia, 21.4% (95% CI: 20.6, 22.2%) of study participants had pre-marital HIV testing. Age 35-49 years (AOR = 0.25; 95% CI: 0.09, 0.66), educated (AOR = 1.76; 95% CI: 1.17, 2.79), rich (AOR = 1.95; 95% CI: 1.13, 3.55), having media exposure (AOR = 1.54; 95% CI: 1.30, 4.71), and high community level literacy (AOR = 0.38; 95% CI: 0.22, 0.66) were factors significantly associated with pre-marital HIV testing. The low coverage of pre-marital HIV testing in Ethiopia is insufficient to have a significant influence on the HIV/Acquired Immune Deficiency Syndrome (AIDS) epidemic. Information dissemination to create awareness about human rights and public health implications of pre-marital HIV testing áre necessary while it is made mandatory.

Knowledge, attitude, and practice towards prevention of mother-to-child transmission of HIV among antenatal care attendees in Ethiopia, 2020.

In 2020, globally approximately 37.6 million people living with HIV and 700,000 children are born infected from their parents. Every day there are nearly 1800 new Human Immune Virus (HIV) infections in children, more than 90% occurring in the developing world. Approximately 90% of these infections are associated with mother-to-child transmission (MTCT). In 2019, Ethiopia had over 100,000 pregnancies in HIV-positive women and over 12,000 HIV-positive. Therefore, this study aimed to assess the knowledge, attitude, and practice of pregnant mothers toward the prevention of mother-to-child transmission of HIV.ss. An institutional-based cross-sectional study was conducted among 216 antenatal care (ANC) attendees in Gurage zone hospitals from June to July 2020. Data were collected using a structured and pre-tested questionnaire through face-to-face interviews. A Systematic random sampling technique with proportional allocation to size was used to select study subjects. Data entry and analysis were performed using Epi Data version 4.1 and SPSS version 25 respectively. The level of good knowledge, attitude, and practice towards Prevention of mother to child transmission (PMTCT) of HIV among antenatal care attendees was found to be 72.2%, 79%, and 62% respectively. This study has also shown that at the time of transmission of the virus from the infected mother to her child, 38.9% of the respondents responded that it could be through breastfeeding, 38.9% during pregnancy, 16.5% during labor and 5.7% did not know respectively. All the respondents have been tested and 0.92% was positive. Nearly half, 99 (45.8%) of the respondents had tested for HIV/AIDS with their partner/husband during their ANC follow-up. In this study, the level of good knowledge, attitude, and practice towards PMTCT of HIV among antenatal care attendees were low. This finding also suggests that healthcare providers should consider the potential risk of mother-to-child transmission of HIV while providing clinical health assessments during antenatal care visits. Thus, improvement of counseling sessions and knowledge of PMTCT for pregnant women attending antenatal care is needed to increase their acceptance and use of PMTCT for HIV services.

The usefulness and practicality of the International Medical Guide for Ships.

The third edition of the International Medical Guide for Ships (IMGS) was published in 2007 and supported a main principle of the newly adopted International Maritime Labour Convention (MLC) 2006: to ensure that seafarers are given health protection and medical care as comparable as possible to that which is available to workers ashore. In 2021, the revisions and drafting of the fourth edition of the IMGS began. Taking the COVID-19 pandemic into consideration, it was decided that a stakeholder study was necessary to ascertain the usefulness and practicality of the guide as well as provide input for which new topics to include. The study applied data triangulation, with respondents from a geographically broad sample of the International Maritime Organization's five regional areas of the world. The data was analysed using thematic analysis. The results show that the IMGS is widely known and used among persons involved in medical care on board ships, but the IMGS is not as practical as stakeholders would wish it to be. For the guide to be useful, it must be ensured that telemedical advice information is included and if possible, ensure there is one single and global medical guide. Also, there is a need for new medical information, and respondents pointed to pandemic information, medicines list, medical chest, mental health issues, a women's section, updated cardiopulmonary resuscitation instructions, human immune defect virus information (human immune defect-virus) and information on how seafarers may self-monitor and be monitored on board in relation to chronic diseases. Respondents understand a medicine chest on board is mandatory according to the MLC 2006, 98% are familiar with its content, and 86% use the IMGS.

Sputum smear conversion and treatment outcomes among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia: A 9-years data analysis.

Drug-resistant tuberculosis (DR-TB) has become a public health problem throughout the world and about one-third of deaths were attributed to DR-TB from antimicrobial resistance which contributes to 10% of all TB deaths. Sub-Saharan Africa, particularly Ethiopia accounts for a significant number of TB cases. However, the scanty evidence on DR-TB contributing factors could affect the level of this deadly case tackling program. Therefore, this study aimed to assess the factors affecting sputum smear conversion and treatment outcomes among patients with DR-TB in Health facilities in Eastern Ethiopia. A cross-sectional study design was employed from 10 October to 10 November 2021, in the health facilities providing DR-TB services in Harari Region and Dire Dawa city administration. The medical records of 273 DR-TB patients from 10 January 2013 to 27 December 2021, were reviewed using structured checklists. Data were entered into Epidata 3.1 version and exported to STATA 14 version for analysis. The outcome variables were Initial Sputum conversion (converted vs. not-converted) and treatment outcome (Unfavorable vs. Favorable). Sputum examination was performed using both Acid-fast bacillus (AFB) smear microscopy and Löwenstein-Jensen (LJ) culture technique. A binary logistic regression analysis was used to assess the association of independent variables with the first month sputum smear conversion, while a conditional logistic regression model was used to assess the association of treatment outcome with explanatory variables. The associations were reported using adjusted odds ratios (AORs) at a 95% confidence interval. A total of 273 DR-TB patients were included in this study. The unfavorable DR-TB treatment outcome was significantly associated with the history of chewing khat (AOR = 4.38, 95% CI = 1.62, 11.84), having bilateral lung cavity on baseline chest X-ray (AOR = 12.08, 95% CI = 1.80, 2.57), having greater than 2+ smear result at baseline (AOR = 3.79, 95% CI = 1.35, 10.59), and poor adherence (AOR = 2.9, 95% CI = 1.28, 6.82). The sputum smear non-conversion at first month was significantly associated with being Human Immune Virus (HIV)-negative (AOR = 0.37, 0.17, 0.82), having low baseline BMI (AOR = 0.54, 95% CI = 0.29, 0.97), baseline culture > 2++ (AOR = 0.15, 95% CI = 0.05, 0.49) and having greater than 2+ sputum smear result (AOR = 0.09, 95% CI = 0.012, 0.67). Patients with normal chest X-ray at baseline had 3.8 times higher chance of sputum smear conversion on first month (AOR = 3.77, 1.11, 12.77). The overall initial sputum smear conversion and the treatment success rate among DR-TB patients were 52.75 and 66.30%, respectively. The Baseline underweight, HIV-negative, baseline smear > 2+, baseline culture > 2++, and clear lung on baseline X-ray were associated with smear conversion and history of khat chewing, bilateral lung cavity at baseline, having greater than 2+ smear results at baseline, and patients with poor treatment adherence had hostile treatment outcomes. So, strengthening and implementing nutrition assessment and patient counseling during directly observed therapies (DOTs) service and drug compliance could result in early sputum conversion and better treatment outcomes. DR-TB patients with high bacterial load and abnormal lungs on radiologic examination at baseline could need special attention during their course of treatment.