Patients Attending ART Clinic Research Articles

Hepatitis B and C viral coinfection and associated factors among HIV-positive patients attending ART clinics of Afar regional state, northeast Ethiopia.

Hepatitis B (HBV) and C virus (HCV) coinfection are the major causes of liver-related morbidity and mortality among people living with Human Immunodeficiency Virus (HIV). The burden of hepatitis among HIV-positive individuals has not been studied in the Afar region. Therefore, this study aimed to determine the prevalence of HBV and HCV coinfection and associated factors among HIV-positive patients in Afar Regional State, northeast Ethiopia. A cross-sectional study was conducted on 477 HIV-positive patients between February 2019 and May 2019. A structured and pretested questionnaire was used to collect socio-demographic data and associated factors. Five milliliters of blood was collected, and Hepatitis B surface antigen (HBsAg) and HCV antibodies were detected using rapid test kits. Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA). Binary and multivariable logistic regression analyses were performed to identify associated factors. Statistical significance was set at P <0.05. Among the 477 study participants, 320/477(67.1%) of them were females and 157(32.9%) males. The overall prevalence of HIV-HBV and HIV-HCV coinfection was 25(5.2%) and 7(1.5%), respectively. Multi-sexual practice was significantly associated with HIV-HBV coinfection (AOR = 5.3; 95% CI: 1.2-24.4, P = 0.032). The prevalence of both HIV-HBV and HIV-HCV coinfection was intermediate. Multi-sexual practice was significantly associated with HIV-HBV coinfection. Screening of all HIV-positive patients for HBV and HCV and health education regarding the transmission modes should be considered.

Antimicrobial susceptibility patterns of urinary tract infections causing bacterial isolates and associated risk factors among HIV patients in Tigray, Northern Ethiopia

BackgroundUrinary tract infections, a prevalent global infectious disease, are clinical issues not well studied in HIV-positive individuals. UTIs have become a global drug resistance issue, but the prevalence and antibiotic susceptibility patterns of UTI-causing bacteria among HIV patients in Tigray, Ethiopia, are poorly understood. This study aims to identify the prevalence of UTI-causing bacteria, their antibiotic susceptibility patterns, and associated risk factors in HIV patients attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia.MethodClean-catch midstream urine samples (10–15 mL) were collected from HIV patients who are attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital. Samples were analyzed based on standard microbiological protocols using cysteine-lactose electrolyte deficient (CLED) agar. Pure colonies of bacterial isolates were obtained by sub-culturing into Mac-Conkey, Manitol Salt agar and blood agar plates. The bacterial isolates were then identified using macroscopic, microscopic, biochemical, and Gram staining methods. Gram-negative bacteria were identified using biochemical tests like triple sugar iron agar, Simon’s citrate agar, lysine iron agar, urea, motility test, and indol test, whereas Gram-positive isolates were identified using catalase and coagulase tests. The Kirby-Bauer disk diffusion technique was used to analyze the antimicrobial susceptibility pattern of bacterial isolates. Data was analyzed using SPSS version 25.0.ResultsAmong the 224 patients, 28 (12.5%) of them had been infected by UTIs-causing bacteria. E. coli was the dominant bacterium (16 (57%)) followed by K. pneumoniae (4 (14%)), and S. aureus (3 (11%)). Of the total bacterial isolates, 22 (78.6%) of them developed multi-drug resistance. All Gram-positive (100%) and 75% of Gram-negative bacterial isolates were found to be resistant to two or more drugs. Patients with a history of UTIs, and with CD4 count < 200 cells/ mm3, were more likely to have significant bacteriuria. Compared to male patients, female patients were more affected by the UTIs-causing bacteria. More than 93% of the UTIs-causing bacterial isolates were susceptible to nitrofurantoin, ceftriaxone, ciprofloxacin, and gentamycin; whereas they are highly resistant to ampicillin (96%), cotrimoxazole (82%) and tetracycline (71%).ConclusionsMost of the bacterial isolates were highly resistant to ampicillin, cotrimoxazole, and tetracycline. Female patients were more affected by the UTIs causing bacteria. The highest prevalence (12.5%) of UTIs in HIV patients needs special attention for better management and monitoring. Previous UTI history and immune suppression are predictors of UTIs, highlighting the need for intervention measures involving molecular studies to identify resistant bacteria genes and promote patient immune reconstitution.

Methicillin resistance Staphylococcus aureus nasal carriage and its associated factors among HIV patients attending art clinic at Dessie comprehensive specialized hospital, Dessie, North East Ethiopia.

Globally the incidence of nosocomial infections and colonization due to methicillin resistant Staphylococcus aureus (MRSA) has become greater concern. The objective of the study was to determine the prevalence and associated factors of nasal carriage of MRSA with its antimicrobial susceptibility patter among HIV patients attending ART clinic. cross-sectional study was conducted from January 01 to May 30, 2020 at Dessie comprehensive specialized hospital, north east Ethiopia. A total of 206 HIV patients were recruited by applying systematic random sampling technique. Nasal specimen was collected from both anterior nares, and inoculated directly on mannitol salt agar, MacConkey, 5% blood agar. Screening of MRSA and methicillin susceptible Staphylococcus aureus (MSSA) strain was done by using cefoxitin antibiotic disc following modified Kirby-Bauer disc diffusion technique. Bivariable and multivariable logistic regression analyses were performed to assess the associated factors with S. aureus and MRSA. study participants were in the age range between 12 and 72 years and their mean (±SD) age was 41.52 (±11.2). The rate of S. aureus and MRSA colonization was 127/206 (61.7%) and 58/206 (28.2%), respectively. Having job close contact with human [AOR = 4.41; 95% CI = 1.5-13.02; p = 0.007], picking the nose [AOR = 4.38; 95% CI = 1.34-14.29; p = 0.014] and ART failure [AOR = 7.41; 95% CI = 2.08-26.41; p = 0.002] had statistically significant association with MRSA colonization. MRSA showed resistance for tetracycline (53.4%), erythromycin (84.5%), and trimethoprim-sulfamethoxazole (86.2%). Multi-Drug Resistance (MDR) was detected among 96.5% of MRSA and 20.3% of MSSA isolates. the rate of S. aureus and MRSA nasal colonization was high and it has associated with different factors. Understanding and managing MRSA among HIV patients is mandatory and stakeholders should find out the way how to decolonize the bacteria from nasal area.

Factors associated with intention to receive COVID-19 vaccine among HIV positive patients attending ART clinic

Factors associated with intention to receive COVID-19 vaccine among HIV positive patients attending ART clinic

Factors Associated with Intention to Receive COVID-19 Vaccine Among HIV Positive Patients Attending ART Clinic in Southwest Ethiopia.

IntroductionBy the end of 2021, Ethiopia plans to vaccinate 20% of the population. The prioritized group includes people older than 65 years, health care workers, teachers, soldiers, and people living with comorbid diseases, including HIV/AIDS. However, due to a lack of intention and other reasons, only less than one percent of the population has taken COVID-19 vaccine. Therefore, this study aimed to assess the determinant factors of intention to receive the COVID-19 vaccine among HIV-positive patients attending ART clinics in southern Ethiopia.MethodsA facility-based cross-sectional study was conducted among 398 HIV-positive patients from March 1 to April 28, 2021. Data were collected using a structured questionnaire by three midwives. We entered the data into Epi InfoTM 3.5.1. Binary logistic regression was used to identify independently associated variables in bivariate and multivariate analyses using SPSS version 20.ResultsCurrently, the intention to take COVID-19 vaccine among HIV-positive patients was 33.7%. The probability of PLWHA to take COVID-19 vaccine was two (AOR = 2 (1.08–3.44)) times higher among those who have been diagnosed with chronic diseases (exclude HIV) with those with not been diagnosed. PLWHA who were male in sex were five (AOR = 5 (2.96–8.68)) times more likely to take COVID-19 vaccine than female. The study also indicated that the odds of intention to take the COVID-19 vaccine were 4.1 times (AOR = 4.1 (2.33–7.31)) times higher among those participants who had good knowledge of COVID-19 practice compared with those who had poor knowledge.ConclusionThe overall intention to receive the COVID-19 vaccine among PLWHA is low. Therefore, there is a need to improve the intention to receive the COVID-19 vaccine among HIV-positive patients to achieve the 2021 goal of Ethiopia for 20% of the population vaccination. Patients with chronic illness, knowledge of the COVID-19 vaccine, and sex were factors associated with the intention to receive COVID-19 vaccine.

Genetic Diversity and Acquired Drug Resistance Mutations Detected by Deep Sequencing in Virologic Failures among Antiretroviral Treatment Experienced Human Immunodeficiency Virus-1 Patients in a Pastoralist Region of Ethiopia.

PurposeThis study was conducted to investigate the drug resistance mutations and genetic diversity of HIV-1 in ART experienced patients in South Omo, Ethiopia.Patients and MethodsA cross-sectional study conducted on 253 adult patients attending ART clinics for ≥6 months in South Omo. Samples with VL ≥1000 copies/mL were considered as virological failures (VF) and their reverse transcriptase gene codons 90–234 were sequenced using Illumina MiSeq. MinVar was used for the identification of the subtypes and drug resistance mutations. Phylogenetic tree was constructed by neighbor-joining method using the maximum likelihood model.ResultsThe median duration of ART was 51 months and 18.6% (47/253) of the patients exhibited VF. Of 47 viraemic patients, the genome of 41 were sequenced and subtype C was dominant (87.8%) followed by recombinant subtype BC (4.9%), M-09-CPX (4.9) and BF1 (2.4%). Of 41 genotyped subjects, 85.4% (35/41) had at least one ADR mutation. Eighty-one percent (33/41) of viraemic patients harbored NRTI resistance mutations, and 48.8% (20/41) were positive for NNRTI resistance mutations, with 43.9% dual resistance mutations. Among NRTI resistance mutations, M184V (73.2%), K219Q (63.4%) and T215 (56.1%) complex were the most mutated positions, while the most common NNRTI resistance mutations were K103N (24.4%), K101E, P225H and V108I 7.5% each. Active tuberculosis (aOR=13, 95% CI= 3.46–29.69), immunological failure (aOR=3.61, 95% CI=1.26–10.39), opportunistic infections (aOR=8.39, 95% CI= 1.75–40.19), and poor adherence were significantly associated with virological failure, while rural residence (aOR 2.37; 95% CI: 1.62–9.10, P= 0.05), immunological failures (aOR 2.37; 95% CI: 1.62–9.10, P= 0.05) and high viral load (aOR 16; 95% CI: 5.35 51.59, P <0.001) were predictors of ADR mutation among the ART experienced and viraemic study subjects.ConclusionThe study revealed considerable prevalence of VF and ADR mutation with the associated risk indicators. Regular virological monitoring and drug resistance genotyping methods should be implemented for better ART treatment outcomes of the nation.

A Systematic Review and Meta-Analysis on Depression and Associated Factors among Adult HIV/AIDS-Positive Patients Attending ART Clinics of Ethiopia: 2021.

Introduction Depression is the most common mental health problem in people living with the human immune virus. It ranges from 11% to 63% in low- and middle-income countries. Depression was high in people living with HIV/AIDS in developing countries, especially in the Ethiopian context. Even though depression has negative consequences on HIV-positive patients, the care given for depression in resource-limited countries like Ethiopia is below the standard in their HIV care programs. Method International databases (Google Scholar, PubMed, Hinari, Embase, and Scopus) and Ethiopian university repository online have been covered in this review. Data were extracted using Microsoft Excel and analyzed by using the Stata version 14 software program. We detected the heterogeneity between studies using the I2 test. We checked publication bias using a funnel plot test. Results The overall pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was 36.3% (95% CI: 28.4%, 44.2%) based on the random effect analysis. Adult HIV/AIDS patients having CD4count < 200(AOR = 5.1; 95% CI: 2.89, 8.99), widowed marital status (AOR = 3.7; 95% CI: 2.394, 5.789), medication nonadherence (AOR = 2.3; 95% CI: 1.63, 3.15), poor social support (2.986) (95% CI: 2.139, 4.169), perceived social stigma (2.938) (2.305, 3.743), opportunistic infections (3.010) (2.182, 4.151), and adverse drug reactions (4.013) (1.971, 8.167) were significantly associated with depression among adult HIV/AIDS patients on antiretroviral therapy, in Ethiopia. Conclusion and Recommendation. The pooled depression prevalence among adult HIV/AIDS patients attending antiretroviral therapy in Ethiopia was higher than the general population and is alarming for the government to take special consideration for HIV-positive patients. Depression assessment for all HIV-positive patients and integrating with mental health should be incorporated to ensure early detection, prevention, and treatment. Community-based and longitudinal study designs mainly focusing on the incidence and determinants of depression among adult HIV/AIDS patients should be done in the future.

Proportion of Depression and Its Associated Factors Among Youth HIV/AIDS Clients Attending ART Clinic in Dessie Town Government Health Facilities, Northeast Ethiopia.

BackgroundDepression is the most prevalent among people living with HIV/AIDS than people without HIV/AIDS. Depression is associated with an increase in morbidity and mortality in people living with HIV/AIDS and adversely affects the adherence to antiretroviral therapy, quality of life, and health-related parameters.ObjectiveThe aim of this study was to assess the proportion of depression and its associated factors among youth HIV/AIDS patients attending ART clinics in Dessie town Government health facilities, Northeast Ethiopia.MethodsInstitutional-based cross-sectional study design was employed on 431 youth HIV/AIDS patients attending ART clinics at Dessie town Public health facilities. Data were collected by face-to-face interview using a structured questionnaire. EPI-Data software version 3.1 was used to enter the data and analysis was done using SPSS version 23. Binary logistic regression was used to identify factors associated with depression. Statistical significance was declared at a p-value of less than 0.05 in the final model.ResultsThe proportion of depression among youth HIV/AIDS patients was 26.2%. The age range between 20 and 24 years (AOR = 2.019, 95% CI: 1.143–3.566), poor medication adherence (AOR = 9.007, 95% CI: 3.061–26.500), stigma (AOR = 4.14, 95% CI: 2.08–8.26), and low social support (AOR = 1.854, 95% CI: 1.034–3.324) were associated with depression.ConclusionThe proportion of depression among youth HIV patients in the current study was found to be lower compared to previous studies. Age, HIV-related stigma, social support, lost job, and poor medication adherence were found to be independent predictors of depression. Therefore, scaling up the pediatric psychosocial support program to youth psychosocial support for all ART site health facilities, strengthening health education about the medication adherence and complication of HIV/AIDS are needed.

Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia.

BackgroundFirst-line antiretroviral treatment failure has become a public health concern in high, low and middle-income countries with high mortality and morbidity In Ethiopia, around 710,000 peoples were living with HIV and 420,000 of them were receiving ART in 2017. Little is known about the magnitude of first-line ART treatment failure and its associated factors in Ethiopia, particularly in the study area. Therefore, this study was aimed to find the magnitude of first-line ART treatment failure and its associated factors among adult patients attending ART clinic at Southwest shoa zone public hospitals.MethodsInstitutions based cross-sectional study was employed from February 1 to April 2, 2019. An interviewer administered questionnaire was used to collect data from 350 adult patients on ART using a systematic random sampling technique. The collected data were coded and entered into Epidata version 3 and exported to STATA SE version 14 for analysis. Bivariable and multivariable logistic regression was done to identify factors associated with first-line ART treatment failure. At 95% confidence level strength of association was measured using Odds ratio. Variables with a p-value of ≤ 0.25 in the bivariable analysis were considered as a candidate variable for multivariable analysis. To get the final variables step-wise backward selection procedure was used and those in the final model were selected at a p-value <0.05. Finally, texts, simple frequency tables, and figures were used to present the findings.ResultsIn this study the magnitude of first-line ART treatment failure was 33.42%. Absence of baseline opportunistic infection AOR = 0.362 (95%CI0.178, 0.735), Staying on first-line ART for <5 years AOR = 0.47 (95%CI 0.252, 0.878), Nevirapine containing ART regimen AOR = 3.07 (95%CI 1.677, 5.63), Baseline CD4 count ≥100 cells/mm3 AOR = 0.299 (95%CI 0.152 0.591), absence of opportunistic infections after ART initiation AOR = 0.257 (95%CI 0.142, .467), time taking greater than an one-hour to reach health facility AOR 1.85 (95%CI 1.022 3.367) were significantly associated with first-line ART treatment failure.ConclusionThe magnitude of first-line ART treatment failure was high in the study area. Base-line opportunistic infection, duration on first-line ART, NVP based ART, Baseline CD4 count level, OI after ART initiation, and time it takes to reach health facility were independent determinants of first-line ART treatment failure.

HIV-Positive Status Disclosure and Associated Factors among HIV-Positive Adult Patients Attending Art Clinics at Public Health Facilities of Butajira Town, Southern Ethiopia.

Background Human immunodeficiency virus-positive status disclosure is the process of informing one's HIV-positive status to others. It is the base for accessing care and treatment programs, attaining psychosocial support, reducing stigma, adhering to treatment, and promoting safer health. Even though different strategies were done in Ethiopia to increase the magnitude of HIV status disclosure among HIV-positive patients, the magnitude is still low. The magnitude of HIV-positive status disclosure was not assessed yet after initiation of the new strategy (test and treat strategy). The aim of this study is to assess the magnitude and factors associated with HIV-positive status disclosure among HIV-positive adults attending antiretroviral therapy clinic at the public health facilities of Butajira town. Methods Institution-based cross-sectional study was conducted at public health facilities of Butajira town. A total of 414 study participants were selected by systematic random sampling technique. Data were collected by using pretested interviewer-administered semistructured questionnaire. The collected data were entered into EpiData3.1 and exported to SPSS version 23. Bivariate and multivariable logistic regression analysis was used to identify factors associated with HIV-positive status disclosure. The strength of association was assessed by crude odds ratio and adjusted odds ratio for bivariate and multivariable logistic regression analysis, respectively. Statistically significance was declared at p value <0.05 and 95% CI. Results The magnitude of HIV-positive status disclosure was 90%. Discussing about safer sex (AOR: 3.5; 95% CI: 1.3, 9.4), viral load suppression (AOR: 4; 95% CI: 1.5, 10.1), having good ART adherence (AOR: 6; 95% CI: 2.4, 14.0), receiving counseling (AOR: 2.5; 95% CI: 1.01, 6.3), and perceiving stigma (AOR: 0.25; 95% CI: 0.09, 0.60) were the independent factors associated with HIV-positive status disclosure. Conclusion Although the majority of the participants (90%) of them disclosed their HIV-positive status, lack of disclosure by few people can tackle HIV prevention and control programs. Health programs could improve disclosure of HIV-positive status by providing counseling service, strengthening adherence of antiretroviral therapy, suppressing viral load, and avoiding (reducing) stigma on HIV-positive patients by their community.

Prevalence and factors associated with depression among adult HIV patients attending ART clinics: a cross-sectional study in Western Bhutan

ABSTRACT Depression is highly prevalent among people living with human immunodeficiency virus across the globe. Data regarding prevalence and factors associated with depression among HIV-infected individuals in Bhutan remained unknown. Therefore, a cross-sectional study was undertaken among 103 adult (≥18 years) HIV patients attending anti-retroviral therapy clinics located at four different hospitals in Western Bhutan. Depression was assessed using the translated and validated Bhutanese version of centre for epidemiologic studies depression scale-revised. The overall response rate of our participants was 73.6%. Age of our participants ranged from 23 to 79 (mean = 40.29, standard deviation ± 11.22) years. The overall prevalence of depression among our participants was 27.2% (95% confidence interval [CI]: 19.4–35.9). Multivariate binary logistic regression analysis showed that females (adjusted odds ratio (AOR) = 3.96, 95% CI: 1.37–11.41) and the poor perceived family support (AOR = 3.31, 95% CI: 1.20–9.10) were significantly associated with depression. Divorced, low income, drinking alcohol and CD4 <200 cells/mm3 had no associations with depression. We recommend mental health interventions to be integrated into routine HIV care in Bhutan for proper management of depression.

Prevalence and Factors Associated with Depression among HIV/AIDS-Infected Patients Attending ART Clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia.

Background HIV is a chronic life-threatening illness and, like other similar chronic and stigmatizing illnesses, can be stressful to manage. Depression is a common mental health problem that deteriorates the quality of life of people with HIV/AIDS and found to be a strong predictor for noncompliance to antiretroviral therapy treatment. Therefore, epidemiological evidence on the factors associated with depression among patients with HIV/AIDS can contribute towards effective and efficient preventive health care strategies for this population. Objectives To assess the prevalence and factors associated with depression among HIV/AIDS-infected patients attending ART clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia, in 2018. Methods This study followed an institution-based cross-sectional quantitative study design. A simple random sampling method yielded 303 participants who were interviewed from April to May 2018, using a pretested questionnaire, followed by their card review. The SPSS version 23 was used for bivariate analysis which was used to find out the significance of association. Variables that showed association in bivariate analysis at p value < 0.25 were entered to multivariable logistic regressions to control for confounders, and the significance of association was determined by 95% confidence interval and p value < 0.05. Results The point prevalence of depression was 94 (31%). Variables like sex (AOR = 0.510 (95%CI = 0.264‐0.986)), marital status (AOR = 3.610 (95%CI = 1.649‐7.901)), opportunistic infection (AOR = 3.122 (95%CI = 1.700‐5.733)), and medication adherence (AOR = 0.470 (95%CI = 0.266‐0.831)) were significantly associated with depression. Conclusion and Recommendation. From the findings of this study, it is possible to conclude that depression was highly prevalent among people living with HIV/ADS. Sex, marital status, opportunistic infection, and medication adherence were found to be associated with depression and need attention from the health professional working in the ART clinic.

An evaluation of health-related quality of life and its determinants among people living with HIV/AIDS attending tertiary care hospital of Kurnool, India

Background: HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole. Combined with ART, Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). The objective of this study is to assess health related quality of life of HIV/AIDS patients attending ART clinic Tertiary care hospital, GGH, Kurnool and to determine the association of socio-demographic and disease related variables with health related quality of life.Methods: A cross-sectional study was conducted from April 2019 to June 2019 involving 400 purposively selected HIV-positive patients of age &gt;18 years, who were taking highly active anti-retroviral therapy for the past 6months from the ART center, GGH, Kurnool. After obtaining IEC clearance and informed consent, WHOQOL-BREF instrument was used for data collection. Data analysis was performed using IBM SPSS version 26.0.Results: Out of the 400 participants, 60% were males. The mean age of the participants was 38.5±10.54 years. Overall quality of life had a mean score of 69.71. Physical (82.57) and level of independence (78.78) domains showed higher mean score when compared to psychological (63.82), environmental (61.49) and Social (60.26) domains.Conclusions: Among study subjects 15.5% had excellent QoL (≥80), nearly 69.75% had good QoL (60-79) and 14.75% had poor QoL (&lt;60). Low QoL scores were seen in the social domain, suggesting that more social interventions are required in this population.

Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study.

Background Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations.

Pulmonary Tuberculosis in HIV/AIDS Patients Attending Art Clinic in Bududa General Hospital, Bududa District, Uganda

Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB); giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.

Magnitude of Vancomycin-Resistant Enterococci (VRE) Colonization among HIV-Infected Patients Attending ART Clinic in West Amhara Government Hospitals.

Background Enterococci that colonize the intestinal tract of immunocompromised patients are an important cause of nosocomial infections. Data on the prevalence of vancomycin-resistant Enterococci (VRE) and its antimicrobial susceptibility patterns and associated factors are scarce in the present study area. Therefore, this study was conducted aimed at determining the prevalence of VRE colonization among HIV-infected patients attending ART clinic at West Amhara Government Hospitals. Methods A cross-sectional study was conducted from 1 February 2017 to 31 May 2017. A total of 349 HIV patients were included in the study. A pretested structured questionnaire was used to collect sociodemographic data and possible associated factors for VRE colonization. Identification and confirmation of Enterococci from stool sample was performed based on the standard procedures. Antimicrobial susceptibility testing was done using the Kirby–Bauer disk diffusion method on the Muller–Hinton agar plate as per the standard protocol, and resistance profile of the isolates was determined according to Clinical and Laboratory Standards Institute (CLIS). Data were analyzed using SPSS v23. Descriptive analysis was used to visualize differences within data. Moreover, the stepwise logistic regression model was done to assess factors associated with VRE colonization. P value was set at 0.05 to indicate statistical significance difference. Results The overall colonization status of Enterococci was at 63% (220/349). The VRE colonization was at 17 (7.7% (95% CI: 4.9–12.0)). Among Enterococcal isolates tested for antimicrobial susceptibility, 142 (64.5%) were found resistant to two or more antibiotics. Antibiotic treatment (for >2 weeks) and history of hospital admission in the last six month were found statistically associated for VRE colonization (AOR = 10.18, (95% CI: 1.9–53.20)) and (AOR = 20.17; (95% CI: 5.22–77.93)), respectively. Conclusions The observed VRE with multidrug resistance colonization need a periodic surveillance of antimicrobial testing to detect emerging resistance and prevent the spread of further drug resistance.

Assessment of the Prevalence and Risk Factors of HBV AND HIV CO- Infections among HIV Infected Patients Attending Art Clinic in Port Harcourt

Assessment of the Prevalence and Risk Factors of HBV AND HIV CO- Infections among HIV Infected Patients Attending Art Clinic in Port Harcourt

HIV Case Management Support Service Is Associated with Improved CD4 Counts of Patients Receiving Care at the Antiretroviral Clinic of Pantang Hospital, Ghana.

Background Factors associated with individual patient-level management of HIV have received minimal attention in sub-Saharan Africa. This study determined the association between support services and cluster of differentiation 4 (CD4) counts among HIV patients attending ART clinic in Ghana. Methodology This was a cross-sectional study involving adults with HIV recruited between 1 August 2014 and 31 January 2015. Data on support services were obtained through a closed-ended personal interview while the CD4 counts data were collected from their medical records. Data were entered into EpiData and analyzed using Stata software. Results Of the 201 patients who participated in the study, 67% (129/191) received case management support service. Counseling about how to prevent the spread of HIV (crude odds ratio (cOR) (95% confidence interval (CI)) (2.79 (1.17–6.68)), mental health services (0.2 (0.04–1.00)), and case management support service (2.80 (1.34–5.82))) was associated with improved CD4 counts of 350 cells/mm3 or more. After adjusting for counseling about how to prevent the spread of HIV and mental health services, case management support service was significantly associated with CD4 counts of 350 cells/mm3 or more (aOR = 2.36 (CI = 1.01–5.49)). Conclusion Case management support service for HIV patients receiving ART improves their CD4 counts above 350 cells/mm3. Incorporating HIV case management services in ART regimen should be a priority in sub-Saharan Africa.

CD4 Profile and Relationship with Bacterial Isolates from the Blood of HIV-1 Patients attending Art Clinic at a Tertiary Healthcare Institution in Southwest, Nigeria

The types of bacterial species present in the blood of HIV-1 positive individuals attending the Antiretroviral Therapy (ART) clinic of a Federal Medical Centre in Southwest Nigeria was evaluated in relation to the patients’ CD4 profile. Blood samples were collected from the antecubital regions of five hundred (500) confirmed HIV Patients attending the ART clinic. The collected samples were subjected to standard microbiological techniques for the isolation and identification of bacterial species present in the sample while their CD4 populations were determined using standard technique. The bacterial isolates with the highest frequency of occurrence in the group of patients with severe immunosuppression (≤ 200 cells/mm3) was Salmonella typhimurium while Enterobacter aerogenes, Streptococcus pneumoniae and Shigella dysenteriae dominated the population of bacterial isolates from the blood of HIV patients with CD4 counts of 201-300, 300 - 400 and 300 – 500 cells/mm3 respectively. Sociodemographic and socioeconomic parameters such as age, occupation and nutrition alongside ART were observed to affect the CD4 profile of the patients.

Evaluation of the Types of Bacteria in the Blood of HIV-1 Patients Attending ART Clinic at the FMC Owo, Nigeria and their Antibiogram Profile

In this investigation, the types of bacteria present in the blood of HIV-1 positive individuals attending the Antiretroviral Therapy clinic at a tertiary healthcare centre in Southwest, Nigeria and their antibiogram profile were assessed. A total number of Five Hundred confirmed HIV-1 Positive Patients were recruited for this study. Their blood was collected and subjected to standard microbiological techniques to isolate and identify the types of bacteria present and also determine the antibiogram profile of the isolates. The bacterial species identified are Klebsiella pneumoniae, Pseudomonas aeruginosa, Pseudomonas fluorescens, Staphylococcus aureus, Staphylococcus lentus, Salmonella enterica serovar Typhimurium, Salmonella enterica serovar Typhi, Salmonella enterica serovar Enteritidis, Proteus mirabilis, Proteus vulgaris, Enterobacter aerogenes, Escherichia coli, O103:H2, Escherichia coli O26:H11, Shigella flexneri, Shigella dysenteriae, Shigella sonnei and Streptococcus pneumoniae. Escherichia coli and Salmonella typhimurium were isolated from the control group of apparently healthy individuals consisting of fifty respondents. Approximately, 4% of the patients were found to have more than one type of bacterial species in their blood. The antibiogram profile of isolates revealed Ofloxacin as the most effective antibiotic against most isolated bacterial species. Only two isolates were resistant to each of Streptomycin and Chloramphenicol. Proteus mirabilis displayed the highest level of resistance while other bacterial isolates exhibited resistance to Cotrimoxazole, Augmentin, Amoxycillin, Cloxacillin and Erythromycin.