Human Immune Deficiency Virus Research Articles

'Addressing HPV vaccine hesitancy: unveiling concerns and building trust' perspectives of adolescent girls and parents in Kisumu County, Kenya.

Human papillomavirus (HPV) causes cervical cancer, and HPV vaccination is highly effective in preventing vaccine-targeted HPV infection. However, low HPV vaccination coverage in Kisumu County, Kenya, at about 10% for the first dose, highlights the critical issue of vaccine hesitancy, particularly in low and middle-income countries. This study explores the concerns, myths and barriers to HPV vaccine uptake among adolescent girls (aged 10-14) enrolled at human immune-deficiency virus comprehensive care clinics and their parents in Kisumu County. Focused group discussions were conducted with 48 participants. Content analysis revealed limited knowledge about the HPV vaccine and widespread misconceptions regarding its safety and efficacy. Financial constraints, injection fears and negative clinic experiences emerged as additional barriers. The findings emphasise the role of effective communication strategies, including engaging parents through written materials and involving them in decision-making, to dispel myths, provide accurate information and encourage HPV vaccination. Collaborative efforts with community stakeholders are crucial to improve vaccine coverage and ultimately reduce the cervical cancer burden.

HIV outbreak in Pakistan - a wakeup call?

Human immune-deficiency virus (HIV) is a global threat with an estimated 38.6 million people being previously infected while 25 million of them have succumbed to the disease. In Pakistan, since 2004, there has been a 50-fold increase from 2700 to 130,000 in the number of people infected with HIV, while Sub- Saharan Africa alone bears the heaviest burden of HIV having 25 million infected individuals. Considering these devastating numbers, it was alarming to find that in June 2019, 751 new cases of HIV were diagnosed in Larkana, in the province of Sindh, Pakistan. Therefore, to make sure that the efforts of international institutions like The Joint United Nations Programme on HIV/AIDS (UNAIDS) which are trying to effectively reduce the spread of HIV are such regions is streamlined it is extremely important to highlight some of the underlying causes which are endemic to such regions such as re-using of blades by barbers and the practice of re-using needles by un-licensed medical practitioners offering miraculous cures. It is also equally important to suggest and re-iterate possible ways in which this situation, which is rapidly worsening, can be improved.

Factors associated with tuberculosis among PLHIV: An observational study in a Government Medical College in West Bengal, India

BackgroundTuberculosis (TB) is one of the leading causes of significant morbidity and mortality among the People Living with Human Immune-deficiency Virus (PLHIV) in India. Reducing TB burden among PLHIV is a priority area under the National TB Elimination Program (NTEP). MethodologyWe analyzed the routinely collected data from an Anti-Retro-viral Treatment Centre (ARTC) of Malda Medical College, West Bengal with an aim of identifying the factors associated with TB prevalence among the PLHIV. All 739 PLHIV who attended the ARTC during 2020–2022, were included in this study. ResultsMean age of the study participants was 34 years (SD:13). 47.9 % PLHIV received Co-trimoxazole Prophylaxis Treatment (CPT) whereas 67.7 % PLHIV received TB preventive treatment (TPT). Transgender [2.9 (1.4–6)], Males [3.7 (1.8–7.9)], Widow/Separated [2.5 (1.2–5.4)], Living with 2–4 Family members [1.6 (1–2.7)], CD4 count less than 200 [1.9 (1.1–3.2)], those who received CPT [17 (7.1–40.8)] and those who didn't receive TPT [1.6 (1–2.6)] were independently associated with increased risk of developing TB. There was no significant association of Age with TB diagnosis among the PLHIV. ConclusionsIt is evident from this study, that introduction of TPT and improving CD4 count by Anti-retroviral Treatment is the key intervention to reduce TB burden among PLHIV. The study found significant association of CPT with TB. Further study may be conducted to determine the actual reason for such association.

Tuberculosis preventive treatment uptake among people living with HIV during COVID-19 period in Addis Ababa, Ethiopia: a retrospective data review

BackgroundScreening for tuberculosis (TB) and providing TB preventive treatment (TPT) along with antiretroviral therapy is key components of human immune deficiency virus (HIV) care. The uptake of TPT during the coronavirus disease 2019 (COVID-19) period has not been adequately assessed in Addis Ababa City Administration. This study aimed at assessing TPT uptake status among People living with HIV (PLHIV) newly initiated on antiretroviral therapy during the COVID-19 period at all public hospitals of Addis Ababa City Administration, Ethiopia.MethodsA retrospective data review was conducted from April-July 2022. Routine District Health Information System 2 database was reviewed for the period from April 2020-March 2022. Proportion and mean with standard deviation were computed. Logistic regression analysis was conducted to assess factors associated with TPT completion. A p-value of < 0.05 was considered statistically significant.ResultsA total of 1,069 PLHIV, aged 18 years and above were newly initiated on antiretroviral therapy, and of these 1,059 (99.1%) underwent screening for TB symptoms. Nine hundred twelve (86.1%) were negative for TB symptoms. Overall, 78.8% (719) of cases who were negative for TB symptoms were initiated on TPT, and of these 70.5% and 22.8% were completed and discontinued TPT, respectively. Of 719 cases who were initiated on TPT, 334 (46.5%) and 385 (53.5%) were initiated on isoniazid plus rifapentine weekly for three months and Isoniazid preventive therapy daily for six months, respectively. PLHIV who were initiated on isoniazid plus rifapentine weekly for three months were more likely to complete TPT (adjusted odds ratio [AOR],1.68; 95% confidence interval [CI], 1.01, 2.79) compared to those who were initiated on Isoniazid preventive therapy daily for six months.ConclusionWhile the proportion of PLHIV screened for TB was high, TPT uptake was low and far below the national target of achieving 90% TPT coverage. Overall a considerable proportion of cases discontinued TPT in this study. Further strengthening of the programmatic management of latent TB infection among PLHIV is needed. Therefore, efforts should be made by the Addis Ababa City Administration Health Bureau authorities and program managers to strengthen the initiation and completion of TPT among PLHIV in public hospitals.

Pharmacogenetics of tenofovir drug transporters in the context of HBV: Is there an impact?

BackgroundCurrent treatments for chronic hepatitis B management include orally administered nucleos(t)ide analogues, such as tenofovir (TDF), which is an acyclic adenine nucleotide analogue used both in HBV and human immune deficiency virus (HIV). The course of HBV infection is mainly dependent on viral factors, such as HBV genotypes, immunological features and host genetic variables, but a few data are available in the context of HBV, in particular for polymorphisms of genes encoding proteins involved in drug metabolism and elimination.Consequently, the aim of this study was to evaluate the potential impact of genetic variants on TDF plasma and urine concentrations in patients with HBV, considering the role of HBV genotypes. MethodsA retrospective cohort study at the Infectious Disease Unit of Amedeo di Savoia Hospital, Torino, Italy, was performed. Pharmacokinetic analyses were performed through liquidi chromatography, whereas pharmacogenetic analyses through real-time PCR. FindingsSixty - eight patients were analyzed: ABCC4 4976 C>T genetic variant showed an impact on urine TDF drug concentrations (p = 0.014). In addition, SLC22A6 453 AA was retained in the final regression multivariate model considering factors predicting plasma concentrations, while ABCC4 4976 TC/CC was the only predictor of urine concentrations in the univariate model. InterpretationIn conclusion, this is the first study showing a potential impact of genetic variants on TDF plasma and urine concentrations in the HBV context, but further studies in different and larger cohorts of patients are required.

ИССЛЕДОВАНИЕ СЕКРЕЦИИ ЭРИТРОПОЭТИНА У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ С АНЕМИЕЙ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЙ, ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИЙ И СОЧЕТАНИЕМ ДВУХ ТИПОВ АНЕМИЙ

Aim. To compare the secretion of erythropoietin in patients with infection caused by human immune deficiency virus (HIV infection) with anemia of chronic diseases (ACD), iron deficiency anemia (IDA), and their combination. Material and methods. 125 patients with HIV infection were examined: 101 with anemia (55 males, 46 women, 39.4±9.6 years), 24 - a control group of patients with HIV infection without anemia (13 males, 11 women, average age 37.6± 7.37 years). In all patients, the number of red blood cells, the concentration of hemoglobin, ferritin, C-reactive protein (CRP), transferrin saturation index (TSI) and erythropoietin were examined. All patients with anemia after determining TSI, CRP, ferritin based on Van Santen and Worwood criteria were divided into three groups depending on the type of anemia: group 1 - 36 patients with ACD (19 males, 17 women, average age 41.7 ± 11, 8 years, TSI 16.9[IQR, 10.2-23.1]%, ferritin 638.7[IQR, 326-861] μg/l, CRP 54.5 [IQR, 4.8-103.3] mg/l), group 2 – 30 patients with a combination of ACD/IDA (18 males, 12 women, average age 41.2±10 years, TSI 13.2[IQR, 9.8-14]%, ferritin 156.2 [IQR, 123-235] mcg/l, CRP 5.9 [IQR, 0.5-8.2] mg/l), group 3 – 35 patients with IDA (18 males, 17 women, average age 35.4 ±7.1 years, TSI 11.1[IQR, 4.7-13.7]%, ferritin 29[IQR, 4.2-38.9] µg/l, CRP 2.9[IQR, 0.4 -1.6] mg/l). For quantitative indicators, the median (Me), standard error of the mean (m), and interquartile range (IQR) were calculated. The significance of differences between several unrelated groups was determined using the Kruskal-Wallis test. Results. In the ACD group, a lower number of red blood cells was detected (3.3(2.7-3.8)×1012/l), compared to the group of patients with IDA (3.8(3.7-4.1)×1012/l ). Also, in the group of patients with ACD, the maximum concentration of erythropoietin was detected (28.5[11.2-28.5], U/ml), significantly higher than the concentration of this indicator in the ACD/IDA groups (14[8.1-16.3], U/ml), IDA (15.8[6.2-27.4], U/ml) and patients in the control group (6.3[4.9-7.8], U/ml). Conclusions. In the present study, ACD in isolated form or in combination with IDA was diagnosed in 65.3% of patients with HIV infection and anemic syndrome. In patients with ACD, an increased concentration of erythropoietin is combined with the lowest number of red blood cells in comparison with other groups of patients with anemia (p&lt;0.05). The results obtained indicate a compensatory increase in erythropoietin secretion in response to suppressed erythropoiesis, or to reduced sensitivity of erythropoietin receptors. Further study of the importance of erythropoietin in the pathogenesis of chronic disease in patients with HIV infection is necessary, including to improve its treatment.

Hubungan Dukungan Sosial Terhadap Quality of Life Pada ODHA (Orang dengan HIV/AIDS)

Background: HIV or Human Immunedeficiency Virus is a disease that attacks the human immune system so that this disease causes a weakening of the immune system to fight a disease. While AIDS or Acquired Immunne Deficiency Syndrome is a collection of diseases caused by a decrease in the human immune system caused by HIV infection. A person infected with HIV / AIDS will feel depressed, unable to accept the situation, feel helpless and experience fear for the future. This is because in Asia the negative stigma of HIV/AIDS is still very high. Thus, it is very necessary to know the relationship of social support to the quaity of life for PLHIV at Bangli General Hospital. Purpose: The purpose of this study was to determine the relationship of social support to the quaity of life in PLHIV. Methods: The research method used quantitative analytics with a cross sectional approach using primary data with data collection instruments in the form of questionnaires distributed to 60 respondents where the sampling technique used was the Non Probability Sampling technique with a saturated sampling method carried out in November-January 2024 at Bangli General Hospital. Data were analyzed univariately and bivariately chi square. Results: The results showed that there was a significant relationship between social support for quality of life in PLHIV with a p value of &lt; 0.05 which means ha was accepted and h0 was rejected. Conclusion: Social support is very influential on the quality of life in PLHIV. The better the support provided, the higher the quality of life that will be owned by PLHIV.

Utilization of Female Condoms among Women Living with Human Immunodeficiency Virus (HIV) in Murang’a County, Kenya

Background: To prevent the risk of transmission of the Human Immune Deficiency Virus (HIV) and other sexually transmitted infections (STIs), as well as achieve family planning targets, the use of Female Condom, a women-initiated method, has been prioritized across the globe. Nevertheless, knowledge regarding the utilization of Female Condoms among HIV-positive women remains inconclusive. The main objective of this study was to determine the utilization of Female Condoms (FC) among HIV-positive women in Murang’a County, Kenya. Method: This study adopted a cross-sectional analytical survey design. A total of 204 women living with HIV (WLHIV) were recruited in the study. Multi-stage sampling was conducted to get three participating sub-counties and three clinics. Systematic sampling and purposive sampling techniques were used to select WLHIV. Structured questionnaires, interview schedules and focus group discussions were used to collect data. Descriptive and inferential statistics were generated using Statistical Package for Social Sciences (SPSS) version 25.0. The statistical significance of the association between categorical variables was determined using Pearson’s Chi-square test. The level of significance was fixed at a P-value of 0.05 level of significance (p ≤ 0.05). Results: 38.8% of the respondents were aged 31–40 years (Mean = 3.11; SD = 1.004). 42.2% of study participants had attained secondary education (mean = 2.05; SD = 0.899). FC use was low at 17.6% among the women living with HIV. There was a statistically significant association between the age of the respondents and the view that FC has the potential to prevent unwanted pregnancy (p = 0.002; χ2 = 17.246; df = 4). The relationship between marital status and “ever heard about FC” (p = 0.042; χ2 = 32.529; df = 5), “ever seen an FC” (p = 0.048; χ2 = 34.982; df = 5), “FC has a potential to prevent unwanted pregnancy” (p = 0.006; χ2 = 23.079; df = 5) was significant. Married women who were revealed to have seen FC were significantly associated with the current use of the FC (p = 0.001; χ2 = 12.852; df = 1). 26.5% of the participants put on FC as a measure to prevent HIV during sexual activities. Most married women did not know whether their sexual partner does not like them to use FC when having sex compared to separated, cohabiting, divorced or single WLHIV (p=0.034; χ2=7.949; df = 10). Conclusion: The relatively high knowledge among WLHIV does not translate to the use of FC for appropriate and consistent utilization of the device.

The relationship between infectious agents and juvenile dermatomyositis: a narrative update from the pediatric perspective.

Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy affecting children, being marked by chronic inflammation which mostly impacts on both skin and skeletal muscles; diagnostic criteria of JDM include an unforeseeable mixture of clinical features, while treatment modalities commonly require corticosteroids or immunosuppressant agents. Although the pathogenesis of JDM is not completely understood, several infectious triggers have been linked to its priming via anecdotal reports related to children. Pediatric cases of recent-onset JDM have been temporally associated to an infectious disease by the power of increased titers of circulating antibodies to a putative infectious agent, including parasites, and/or detectable viral RNA or bacterial DNA. With this narrative review we offer an update about JDM association with a host of infections, namely parvovirus B19, Epstein-Barr virus, Coxsackie virus, human immune deficiency virus, severe acute respiratory syndrome coronavirus 2, Mycoplasma pneumoniae and Toxoplasma gondii, as resulting from the medical literature. Few are the evidence-proved results addressing JDM as an unambiguous post-infectious disorder and available data specifically related to children are poor, highlighting the need of further research into the exploration between environmental cut-out factors and JDM.

Community Engagement in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Analysis at the Grassroots in Rural Tanzania: A Case of Visual Problem Appraisal for AIDS and Rural Development

Missed grounded analysis of Human Immune Deficiency Virus/ Acquired Immune Deficiency Syndrome Analysis (HIV/AIDS) at the grassroots level has led to the persistence of the pandemic in rural areas. This pseudo-experimental study aimed to explore the potentiality of Visual Problem Appraisal of AIDS and Rural Development (VPA A &amp; RD) in supporting grassroots capacity to make informed choices through grounded analysis of the HIV/AIDS problem. Primary data were collected through VPA A &amp; RD workshops, Focus Group Discussions (FGDs), key informant interviews, physical visits and observations. The secretariat of Matombo Division Farmers Groups’ Local Network (MVIWATAMA) was involved directly in a strategic selection of 20 (14 males and six females) workshop participants from Kifindike, Tawa, Uponda, Kiswira and Konde villages. The collected data, narratives and observations were verified and compared with relevant literature for interpretation and interrelations. The tool was found to be useful in engaging, empowering and supporting small-scale farmers’ informed choices. In addition, findings indicate that the persistence of HIV/AIDS in rural areas is due to improper analysis of the problem and review of HIV/AIDS policy. The study, among other things, recommends the establishment of an HIV/AIDS policy working paper and the incorporation of VPA potential in Tanzania universities’ curricula to enhance critical thinking among graduates.

Incidence and predictors of attrition among human immunodeficiency virus infected children on antiretroviral therapy in Amhara comprehensive specialized hospitals, Northwest Ethiopia, 2022: a retrospective cohort study

Attrition rate is higher in developing nations and it leftovers a major obstacle to enhance the benefits of therapy and achieve the 90–90–90 plan targets. Despite this fact, data on the incidence and its predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy are limited in developing countries including Ethiopia especially after the test and treat strategy implemented. This study aimed to assess the incidence and predictors of attrition among human immune deficiency virus infected children on antiretroviral therapy in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia. A retrospective follow-up study was conducted among 359 children on ART from June 14, 2014, to June 14, 2022. Study participants were selected using simple random sampling method and the data were collected using Kobo Toolbox software and analysis was done by STATA version 14. Both bi-variable and multivariable Cox regression models were fitted to ascertain predictors. Lastly, an AHR with a 95% CI was computed and variables with a p-value of < 0.05 were took an account statistically key predictors of attrition. The overall incidence of attrition rate was 9.8 (95% CI 7.9, 11.9) per 100 PYO. Children having baseline hemoglobin < 10 mg/dl (AHR 3.94; 95% CI 2.32, 6.7), suboptimal adherence (AHR 1.96; 95% CI 1.23, 3.13), baseline opportunistic infection (AHR 1.8; 95% CI 1.17, 2.96), and children who had experienced drug side effects (AHR 8.3; 95% CI 4.93, 13.84) were established to be a significant predictors of attrition. The attrition rate was relatively high. Decreased hemoglobin, suboptimal adherence, presence of drug side effects and baseline opportunistic infection were predictors of attrition. Therefore, it is crucial to detect and give special emphasis to those identified predictors promptly.

The being safe, health and positively empowered pilot randomized controlled trial: A digital multicomponent intervention for immigrant women with cumulative exposures to violence.

Pre- and postmigration exposures to violence are significant social determinants of immigrant women's health, safety, and well-being, with Black immigrant women being at high risk because of many coming from conflict-zone countries. The existing literature does not report the development and testing of a multicomponent digital intervention to address safety and health issues among immigrant women with cumulative exposures to violence. This pilot randomized controlled trial evaluated preliminary efficacy of a multicomponent digital intervention (BSHAPE) to improve health and safety outcomes for immigrant women with cumulative violence exposures, posttraumatic stress disorder and/or depression symptoms, and human immune deficiency virus (HIV) risk behaviors. The intervention was developed based on formative qualitative work and input from women. In the randomized controlled trial, 144 Black immigrant women, average age being 33.6 years, were randomly assigned to either the BSHAPE arm (n = 72) or a control arm (n = 72). Data were collected at four time points over 12 months. A generalized estimating equation analysis was performed to examine group differences in change in outcomes over time. Compared to the control arm, participants in BSHAPE showed significant improvement in multiple outcome measures (e.g., HIV/STI risk). This pilot trial of BSHAPE showed promising results for immigrant women with lifetime exposures to violence, poor mental health, and HIV risk. The study also provided useful information to further improve BSHAPE for a full-scale efficacy trial. The digital BSHAPE can be especially advantageous for violence-affected immigrant women who face numerous barriers to accessing in-person care for their safety and health needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors influencing self-efficacy for self-management among adult people with human immune deficiency virus on antiretroviral therapy in public hospitals of south-west Ethiopia.

Self-management is crucial for effective HIV management, and self-efficacy is a mechanism for achieving it, but there is limited evidence on variables that affect self-efficacy. This study aimed to identify factors influencing self-efficacy for self-management among adults on antiretroviral therapy in resource constraint settings. A cross-sectional study was conducted among 422 adult people on antiretroviral therapy in southwest Ethiopia from March to April 2022. Face-to-face interviews were used to gather data using a structured questionnaire on the self-efficacy measure. The data were then imported into Epi Data version 4.2 and exported to SPSS version 26. Descriptive statistics, independent tests, one-way analysis of variance, Pearson correlation, and multivariate linear regression were used to analyze the data. The predictors with p-value of less than 0.05 were declared statistically significant. A total of 413 adults on antiretroviral therapy were interviewed with response rate of 97.9%. The total mean score of self-efficacy for self-management was 15.12 (±2.22) out of 24. Higher age, gender of the female, divorced, duration of diagnosis, and drug side effects were negatively predictors of low self-efficacy. Higher schooling, urban residence, better income, and the use of reminders positively influenced self-efficacy for self-management. The study found low self-efficacy among adults on antiretroviral therapy and higher age, female gender, HIV duration, and presence of drug side effects were associated with lower self-efficacy, while higher schooling, better income, and use of reminder use were associated with higher self-efficacy for self-management. Further research is needed to determine the causal relationship between these variables and self-efficacy.

Polymer Delivery Systems for Long-Acting Antiretroviral Drugs.

The success of long-acting (LA) drug delivery systems (DDSs) is linked to their biocompatible polymers. These are used for extended therapeutic release. For treatment or prevention of human immune deficiency virus type one (HIV-1) infection, LA DDSs hold promise for improved regimen adherence and reduced toxicities. Current examples include Cabenuva, Apretude, and Sunlenca. Each is safe and effective. Alternative promising DDSs include implants, prodrugs, vaginal rings, and microarray patches. Each can further meet patients' needs. We posit that the physicochemical properties of the formulation chemical design can optimize drug release profiles. We posit that the strategic design of LA DDS polymers will further improve controlled drug release to simplify dosing schedules and improve regimen adherence.

The Moderating Role of HIV Stigma on the Relationship between Perceived Social Support and Antiretroviral Therapy Adherence Self-Efficacy among Adult PLHIV in South Africa.

People living with human immune deficiency virus (PLHIV) grapple with distinct challenges, including HIV stigma which affects their antiretroviral therapy (ART) adherence self-efficacy. This study investigates the interaction of HIV stigma and perceived social support on ART adherence self-efficacy among adult PLHIV in South Africa. This study utilized a cross-sectional design that involved 201 participants selected using time location sampling at a tertiary health facility in Durban. HIV stigma was significantly and negatively associated with self-efficacy (β = -7.860, t = -4.654, p = .001), with variations across different stigma levels (β = -5.844, t = -4.003, p = .001). Social support was significantly and positively associated with self-efficacy at lower HIV stigma levels (β = 7.440, t = 3.887, p = .001), in contrast to higher levels (β = -2.825, t = 1.400, p = .163). Social support significantly influences ART adherence self-efficacy, particularly at lower levels of HIV stigma, but the effect of support weakens as stigma intensifies.

Predictors contributing to the estimation of pulmonary tuberculosis among adults in a resource-limited setting: A systematic review of diagnostic predictions.

Although tuberculosis is highly prevalent in low- and middle-income countries, millions of cases remain undetected using current diagnostic methods. To address this problem, researchers have proposed prediction rules. We analyzed existing prediction rules for the diagnosis of pulmonary tuberculosis and identified factors with a moderate to high strength of association with the disease. We conducted a comprehensive search of relevant databases (MEDLINE/PubMed, Cochrane Library, Science Direct, Global Health for Reports, and Google Scholar) up to 14 November 2022. Studies that developed diagnostic algorithms for pulmonary tuberculosis in adults from low and middle-income countries were included. Two reviewers performed study screening, data extraction, and quality assessment. The study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. We performed a narrative synthesis. Of the 26 articles selected, only half included human immune deficiency virus-positive patients. In symptomatic human immune deficiency virus patients, radiographic findings and body mass index were strong predictors of pulmonary tuberculosis, with an odds ratio of >4. However, in human immune deficiency virus-negative individuals, the biomarkers showed a moderate association with the disease. In symptomatic human immune deficiency virus patients, a C-reactive protein level ⩾10 mg/L had a sensitivity and specificity of 93% and 40%, respectively, whereas a trial of antibiotics had a specificity of 86% and a sensitivity of 43%. In smear-negative patients, anti-tuberculosis treatment showed a sensitivity of 52% and a specificity of 63%. The performance of predictors and diagnostic algorithms differs among patient subgroups, such as in human immune deficiency virus-positive patients, radiographic findings, and body mass index were strong predictors of pulmonary tuberculosis. However, in human immune deficiency virus-negative individuals, the biomarkers showed a moderate association with the disease. A few models have reached the World Health Organization's recommendation. Therefore, more work should be done to strengthen the predictive models for tuberculosis screening in the future, and they should be developed rigorously, considering the heterogeneity of the population in clinical work.

Modeling Health Systems and Male-Partner Involvement Determinants of Prevention of Mother to Child Transmission of Human Immune-deficiency Virus among Women in Homa Bay County Referral Hospital, Kenya

In 2017, Homa Bay County accounted for 10% of HIV cases among children aged 0-14 years in Kenya. Additionally, it reported 8.8% of new HIV infections among children of the same age group and 9.7% of annual AIDS-related mortalities. In 2018, the County reported a mother-to-child transmission (MTCT) rate of 8.1%, higher than the 5% target set by WHO. Limited studies in Kenya have documented health systems and male-partner involvement determinants of prevention of MTCT (PMTCT) of HIV, which vary by context. Thus, this paper documents health systems and male-partner involvement determinants of PMTCT outcomes among women attending Homa Bay County Referral Hospital. We used an analytical cross-sectional study design that had a sample of 274 (Fishers et al. 1998) randomly selected from 4129 women of reproductive age ever on PMTCT follow-up. Questionnaires were used to collect data from the women on child HIV status, health systems factors, and male partner-involvement factors. The mean age of the women was 32.16 years. Results show that provision and discussion of infant diagnosis results by health care providers increased the chances of occurrence of HIV seronegative PMTCT outcome by 1.5 times (OR=1.530, 95% CI: 0.361-6.486; p&lt;0.0001). Provision of routine pre-conception counselling decreased the odds of determining PMTCT outcome by 60% (OR=0.404, 95% CI: 0.046-3.521; p=0.018). Males knowing the HIV status of their partner had higher odds of determining the occurrence of HIV seronegative PMTCT outcome (OR=6.0, 95% CI: 0.655-54.997; p&lt;0.0001). Health systems factors aligned with the provision and discussion of infant diagnosis results by healthcare provider and male-partner involvement factor related to the male partner knowing the HIV status of participant(s) demonstrated higher chances of predicting the occurrence of HIV seronegative for the child. These findings will inform the formulation of interventions geared towards reducing the high MTCT rates in Homa Bay County

Health literacy and adherence to care by people living with Human Immune Deficiency Virus (PLWHIV) in Nasarawa State

Background: Adherence to care among people living with the Human Immunodeficiency Virus (PLWHIV) has become a serious concern for healthcare practitioners. This study aimed to determine the health literacy (HL) and level of adherence to care among PLWHIV in Nasarawa State.Methodology: This was a cross-sectional study conducted on 396 HIV patients accessing antiretroviral therapy in Nasarawa State from June to July 2023. Two pretested interview-administered questionnaires were used to collect data on HL and adherence to care. Data entry and analysis were done using IBM Statistical Package for Social Science (SPSS) version 25.0. Descriptive statistics were used to describe respondent’s characteristics. Categorical variables were reported as frequencies and percentages. The association of HL domains with the level of adherence to care was determined using F-stat.Results: The dimensions of health literacy, including feeling understood and supported by healthcare providers, the ability to actively engage with healthcare providers, and navigating the healthcare system, were found to be significantly associated with the age of the respondents (p&lt; 0.05). High health literacy and a good level of adherence to care were found in 65.7% of the population. Adherence to care was significantly associated with HL, age, level of education, and marital status (p&lt; 0.05).Conclusion: The level of adherence to care by PLWHIV in Nasarawa State is significantly associated with HL. To enhance treatment adherence, healthcare professionals should boost the HL of PLWHIV in Nasarawa State by providing clearer and more accessible health information to patients during clinic visits.

Prevalence of Respiratory Failure and Associated Factors in Adult Intensive Care Unit of Saint Paul’s and Addis Ababa Burn, Emergency and Trauma Hospital, Ethiopia 2020

Purpose: to assess the prevalence of respiratory failure and associated factors among patients admitted the adult intensive care unit of Saint Paul’s Millennium Medical College and Addis Ababa Burn, Emergency and Trauma hospitals Addis Ababa, Ethiopia, from September 2014 to August 2020. Method: An institution based retrospective cross-sectional study was conducted from August 26 to September 25, 2020. Among a total of 2198 population, 384 samples were selected using systematic random sampling. A multivariable logistic regression analysis was used to identify predictors of respiratory failure using odds ratio, 95% confidence interval, and p-value &lt; 0.05 to be considered as significant. Result: The prevalence of respiratory failure in this study was 139(36.2%).The variables which were significantly associated with respiratory failure were, patients age &gt;50 (AOR =4.88(95%CI: 2.1, 11.4), Duration of stay at intensive care unit &gt;15 days (AOR=0.24(95%CI: 0.086, 0.65), prolonged obstructive pulmonary disease (AOR=2.3 (95%CI: 1.98, 4.79),Asthma (AOR=0.23(95%CI: 0.087, 0.6) , sepsis (AOR= 0.43 (95% CI:0.2,0.94) , cardiac disease (AOR= 3.01(95%CI: 1.36, 6.66)), Human Immune Deficiency Virus (AOR=4.3(95%CI: 1.34, 13.92) and trauma (AOR= 2.93(95%CI: 1.36, 6.35). Conclusion: The prevalence of respiratory failure was high. Multiple factors influence the development of respiratory failure. Older age, cardiac disease, Human Immune Deficiency Virus and trauma were at risk of developed respiratory failure Therefore, Health care professionals, policy makers and other concerned bodies should give emphasis to the factors that contribute to the development of respiratory failure. They should give priority especially for older, HIV, cardiac, and trauma patients to provide easily accessible and quality care.

Varicella-associated disseminated intravascular coagulation secondary to Henoch-Schönlein purpura with renal and gastrointestinal system involvement in a child: A case report.

Immunocompromised patients who developed varicella-zoster virus (VZV)-associated disseminated intravascular coagulation (DIC) previously included recipients of bone marrow, hematopoietic stem cell, or organ transplantations, patients with primary nephropathy receiving corticosteroid therapy, cancer patients receiving chemotherapy, and patients with human immune deficiency virus infection. The case reported here is novel because, to our knowledge, there has been no report of VZV-associated DIC after the onset of Henoch-Schönlein purpura (HSP). To report the successful treatment of a novel pediatric case with VZV-associated DIC secondary to HSP. An 8-year-old girl developed VZV-associated DIC 24 days after diagnosis of HSP with renal and gastrointestinal involvement. She was treated with methylprednisolone at a local hospital for 19 days, and suddenly developed fever starting from day 4 in our hospital. Her fever persisted with vesicular skin rashes on her back, strong abdominal and lower back pain, epistaxis, hematochezia, erosion and bleeding on her lips, in her mouth and at puncture sites on day 5. She was diagnosed with DIC with the laboratory evidence of dramatically decreased platelet count and fibrinogen, prolonged activated partial thromboplastin time and prothrombin time, and increased fibrin degradation products including d-dimers. She also developed multiple organ dysfunction syndrome. On day 7, the patient VZV nucleic acid result turned out to be positive. Methylprednisolone treatment was discontinued, and she was given a multi-modality therapy including medications of acyclovir and antibiotics, intravenous gamma-immunoglobulin, various blood product transfusions, continuous renal replacement therapy, plasma exchange, and administration of liver and gastrointestinal system protection drugs. The patient multi-organ function damage gradually recovered. After VZV control, the patient was treated with oral methylprednisolone again for HSP with nephritis. Urine analysis was normal 1 year later, and oral hormone was discontinued. No complication or relapse occurred during 2 years of follow-up. This case report, for the first time, adds HSP treated with corticosteroids to the spectrum of clinical conditions that progressed to life-threatening secondary varicella-associated DIC. Early identification of varicella infection and DIC, combined with timely antiviral, immunoglobulin transfusion, plasma exchange, and other combined therapies are essential for saving patients' lives.