Unmatched Case-control Study Research Articles

Determinants of underweight among lactating mothers in public health facilities, Siraro District, Southern Ethiopia: unmatched case–control study

BackgroundEthiopia is reported to have one of the highest prevalence of underweight among lactating mothers in Africa. In our study setting, the nutritional report from the district health office showed a high number of underweight lactating mothers and recurrent malnutrition problems. However, the determinants of underweight among lactating mothers were not well understood in our study setting. The study aimed to assess the determinants of underweight among lactating mothers in public health facilities of Siraro District, Southern Ethiopia.MethodsUnmatched case control study was conducted among 390 (130 cases and 260 controls) lactating mothers in public health facilities of Siraro District from April 30 to May 30/2022. Cases were lactating mothers with BMI < 18.5 kg/m2 and controls were mothers whose BMI was ≥ 18.5 kg/m2. To identify the determinants of underweight, bivariate and multivariable binary logistic regression analysis were carried out. The final model was interpreted using adjusted odds ratio (AOR), along with a 95% confidence interval (CI). Significance was declared at p-value < 0.05.ResultMultivariable logistic regression analysis revealed that having; antenatal care visits [AOR = 0.43, 95% CI (0.26,0.72)], latrine availability [AOR = 0.50,95% CI (0.27,0.93)], poor food consumption score [AOR = 5.40, 95% CI (3.15,9.27)], inadequate dietary diversity score [AOR = 1.66, 95% CI (1.20,2.78)], medium [AOR = 3.34, 95% CI (1.52,7.33)] and poor wealth index [AOR = 6.32, 95%CI(3.12,12.81)] were significantly associated with being underweight among lactating mothers.ConclusionAntenatal care visits, latrine availability, poor food consumption scores, inadequate dietary diversity score, medium and poor wealth index were the determinants of underweight. A multi-sectoral approach focusing on latrine construction, economic empowerment and food diversification, as well as ongoing awareness creation, is essential to increase the nutritional status of lactating mothers and break the vicious cycle of malnutrition.

Poor Adherence and Limited Treatment Support are Risk Factors for Second Line Treatment Failure among HIV Children Under 15 Years, 2022: A Case Control Study

Title: Poor adherence and limited treatment support are risk factors associated with second line treatment failure among children under 15 years at Victoria Chitepo provincial hospital, 2022: a case control study. Background: New HIV resistance mutations have been emerging and frequently changing. HIV positive people switching to third line have been increasing in Manicaland Province. Third line anti-retroviral therapy (ART) combinations are not always available. We sort to determine the factors associated with second line treatment failure among HIV positive patients. Methods: We conducted a 1:1 unmatched case-control study among 107 case-control pairs. A case was any HIV positive individual with treatment failure confirmed by 2 viral load of ≥1000 copies/ml while a control was any HIV positive individual with a viral load of &lt;1000/ml copies; on second line therapy at Victoria Chitepo Provincial Hospital (VCPH), in 2022. Systematic random sampling was used to select cases and controls from the line-list. Administered questionnaires were used to ascertain risk factors to second line treatment failure. Patient booklets were reviewed for demographic and clinical characteristics. Frequencies, means, medians and odds ratios were generated. Multivariate analysis and stratified analysis was performed to identify independent risk factors. Permission to proceed was sought from relevant authorities and all ethical considerations were observed. Results: Defaulting treatment (aOR=2.42, 95% CI: 1.03-5.93), missing a viral load test (aOR=5.52, 95% CI: 2.30-13.26) and being under 15 years of age (aOR=6.18, 95% CI: 1.46-26.20) were independent risk factors associated with second line treatment failure. Having a treatment support was an independent protective factor (aOR=0.30, 95% CI: 0.10-0.86). Conclusion: Poor adherence is the key drive to second line treatment failure. Good adherence is critical in children under 15 years. Treatment support promotes viral load suppression.

Determinants of puerperal sepsis among postpartum women admitted to hospitals in Dire Dawa, Ethiopia: an unmatched case-control study

Determinants of puerperal sepsis among postpartum women admitted to hospitals in Dire Dawa, Ethiopia: an unmatched case-control study

Determinants of Hepatitis B Viral Infection among Pregnant Women in Greater Monrovia, Liberia

Background: The global prevalence of hepatitis B virus infection is estimated to affect over 2 billion individuals, with a notable proportion ranging from 6% to 25% residing in the Sub-Saharan African region. The prevalence of hepatitis B virus (HBV) in Liberia, Guinea, and Sierra Leone has been estimated to be approximately 2%. However, current understanding of the actual risk factors associated with HBV in the Greater Monrovia remains unclear. Consequently, this study aimed to identify the factors associated with hepatitis B viral infection among pregnant women residing in Greater Monrovia, Liberia. Methods: An unmatched case control study of 141 cases of HBV infected pregnant women and 141 controls was conducted. Data on socio-demographic characteristics, lifestyle activities and medical related risk factors were collected for both groups with a structured questionnaire. Bivariate and multivariate analyses established associations between the HBV infection and risk factors studied. Results: In all, 141 cases of HBV infected pregnant women and 141 controls participated in this study. The mean age of cases was 35.6 years (SD ±9.5) and 36.1 years (SD ±8.4) for controls. Low-income level &lt;100 dollars [aOR 13.0 (4.48-37.82, p&lt;0.001)], employment [aOR 0.04 (0.09-0.18) p&lt;0.001], STI history [aOR 5.19 (1.68-16.02, p=0.004)] and living with a HBV infected person [aOR 35.11 (4.24-58.90), p=0.001] were factors associated with HBV infection among pregnant women in Greater Monrovia. Conclusion: The risk factors of HBV infection among pregnant women in Greater Monrovia were engagement in formal employment, low-income level, history of sexually transmitted infections (STIs), and residing with an individual infected with hepatitis B virus (HBV). Control efforts by designated state institutions should include advocacy and awareness creation on HBV status identification, safe sex, and vaccination of uninfected individuals.

Dietary Habits and Determinants of Overnutrition Among Secondary and Preparatory School Adolescents: A Multi-Center Unmatched Case-Control Study

Dietary Habits and Determinants of Overnutrition Among Secondary and Preparatory School Adolescents: A Multi-Center Unmatched Case-Control Study

Determinants of neonatal hypoglycemia among neonates admitted to neonatal intensive care units of public hospitals in Wolaita Zone, Southern Ethiopia, 2023: An unmatched case-control study.

Globally, neonatal hypoglycemia is a common child health problem and significantly contributes to morbidity and mortality, with its impact being particularly detrimental in developing countries. Although being a prevalent metabolic condition, it is frequently overlooked. Furthermore, the problem is not adequately studied in Ethiopia, as seen by a few published studies on the topic, highlighting the lack of knowledge about its determinants. This study aims to assess the determinants of neonatal hypoglycemia among neonates admitted to neonatal intensive care units of public hospitals in Wolaita Zone, Southern Ethiopia, 2023. An institution-based unmatched case-control study design was conducted among 249 (83 cases and 166 controls) participants. Data were collected from 29 March to 23 May 2023 using a pretested chart review extraction tool/checklist. A consecutive sampling method was used for participant selection. Data were analyzed using Statistical Package for Social Science version 25. Binary logistic regression analysis was used to identify the determinants of neonatal hypoglycemia, and statistical significance was declared at P < 0.05. A total of 83 cases and 166 controls were included in the study. The following factors were significantly associated with neonatal hypoglycemia: preterm neonates [adjusted odds ratio (AOR) 4.888 (95% confidence interval, CI, 1.113-21.478)], age of the neonate at admission (3-5 h) [AOR 4.205 (95% CI 1.852-9.547)], hypothermia [AOR 5.485 (95% CI 2.360-12.748)], late initiation of breastfeeding [AOR 6.229 (95% CI 2.665-14.599)], mode of delivery [AOR 5.034 (95% CI 1.688-15.011)], and small for gestational age [AOR 3.645 (95% CI 1.286-10.330)]. In the current study, numerous determinants of neonatal hypoglycemia have been identified. Therefore, it is crucial to give due emphasis to providing comprehensive health education to mothers regarding effective breastfeeding methods, strategies to avoid neonatal hypoglycemia, and the various factors that heighten its likelihood. In addition, healthcare professionals should emphasize implementing preventive measures to prevent this grave condition.

Determinants of preeclampsia among women who gave birth at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia: a case–control study

Pre-eclampsia and eclampsia are the second leading causes of maternal mortality and morbidity. It also results in high perinatal mortality and morbidity. Since eclampsia is preceded by preeclampsia and shows the progression of the disease, they share the same pathogenesis and determining factors. The purpose of this study was to determine determinants of preeclampsia, since it is essential for its prevention and/or its associated consequences. An unmatched case–control study was conducted from September 1–30, 2023 among women who gave birth from June 1, 2020, to August 31, 2023, at Hiwot Fana Comprehensive Specialized University Hospital. Women who had preeclampsia were considered cases, while those without were controls. The sample size was calculated using EPI Info version 7 for a case–control study using the following assumptions: 95% confidence interval, power of 80%, case-to-control ratio of 1:2, and 5% non-response rate were 305. Data was collected using Google Form, and analyzed using SPSS version 26. Variables that had a p-value of < 0.05 on multivariable logistic regression were considered statistically significant, and their association was explained using an odds ratio at a 95% confidence interval. A total of 300 women (100 cases and 200 controls) with a mean age of 24.4 years were included in the study. Rural residence (AOR 2.04, 95% CI 1.10–3.76), age less than 20 years (AOR 3.04, 95% CI 1.58–5.85), history of hypertensive disorders of pregnancy (AOR 5.52, 95% CI 1.76–17.33), and no antenatal care (AOR 2.38, 95% CI 1.19–4.75) were found to be the determinants of preeclampsia. We found that living in a rural areas, previous history of preeclampsia, no antenatal care, and < 20 years of age were significantly associated with preeclampsia. In addition to previous preeclampsia, younger and rural resident pregnant women should be given attention in preeclampsia screening and prevention.

Predictors of Adolescent Pregnancy among 13-19 Years Old Girls in Karongi District: unmatched case-control study, 2021

Predictors of Adolescent Pregnancy among 13-19 Years Old Girls in Karongi District: unmatched case-control study, 2021

Determinants of preterm birth among mothers who gave birth at Shiek Hassan Yabare Referral Hospital in Jigjiga town, Eastern Ethiopia: Unmatched case-control study

Determinants of preterm birth among mothers who gave birth at Shiek Hassan Yabare Referral Hospital in Jigjiga town, Eastern Ethiopia: Unmatched case-control study

Patient socio-demographics and clinical factors associated with malaria mortality: a case control study in the northern region of Ghana

BackgroundGhana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures.MethodsAn unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of < 0.05 was considered statistically significant.ResultsIn all, a total of 95 cases and 190 controls participated in this study. The median ages of cases and controls were 4.1 years (IQR = 21.6) and 5.7 years (IQR = 18.2), respectively. Fifty-four (56.8%) cases were females, while 93 (49.0%) of the controls were females. Factors associated with malaria mortality included: duration of hospital stay less than 24 h [aOR: 12.0, 95% CI (5.9–24.6)], severe pallor [aOR: 2.3, 95% CI (1.1–4.6)], children under 5 years [aOR: 2.8, 95% CI (1.4–5.6)], oral Artesunate/Amodiaquine administration [aOR: 0.4, 95% CI (0.2–0.9)] and sepsis as an additional diagnosis [aOR: 4.1, 95% CI (1.8–9.5)].ConclusionPredictors of malaria mortality in the Northern region include children under 5 years, severe pallor, sepsis as an additional diagnosis, and use of oral anti-malarial. Patients with severe pallor and sepsis as co-morbidities should receive proactive management. The NMEP and its partners should implement measures to strengthen the referral system, anaemia prevention and management, and retrain health workers on malaria case management. Malaria control interventions targeted at under five children in the region should be reviewed and enhanced.

Determinants of stillbirth among deliveries conducted at west Shoa zone public hospitals, central Ethiopia: a case–control study

ABSTRACTBackgroundGlobally, 2.6 million stillbirths are estimated to occur each year. The causes of stillbirth are often unknown but can be attributed to various causes. Therefore, identifying the determinants of stillbirth is quite important for applying further meaningful interventions. The purpose of this study was to identify the determinants of stillbirth among deliveries conducted at selected public hospitals in the West Shoa Zone, Oromia, Ethiopia.MethodsA hospital-based unmatched case‒control study with a 1:4 ratio was conducted. A total of 431 (87 cases and 344 controls) participants were involved. A systematic random sampling method was used for control selection. Data were collected using interview administered questionnaire and analysed using SPSS version 26 software. Binary logistic regression analyses were performed for the independent variables and outcome variables. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated to assess the strength of the associations, and statistical significance was declared at P value < 0.05.ResultsIn this study, 428 mothers who delivered (85 patients and 343 controls) participated, for a 99.3% response rate. Preeclampsia/eclampsia (AOR = 13.43, 95% CI: 5.67–31.82), other health conditions (AOR = 5.39, 95% CI: 2.34–12.46), mal-presentation (AOR = 3.42, 95% CI: 1.50–7.76), umbilical cord accidents (AOR = 2.57, 95% CI: 1.11–5.93), meconium-stained amniotic fluid problems (AOR = 5.01, 95% CI: 2.15–11.67) and low birth weight (AOR = 2.91, 95% CI: 1.28–6.59) were identified as determinant variables of stillbirth.ConclusionsLow birth weight, referral status, meconium-stained amniotic fluid problems, umbilical cord accidents, mal-presentation and preeclampsia/eclampsia were identified as independent determinants of stillbirth. Therefore, hospitals and health workers are recommended to focus on identifying and preventing these factors.

FOXP3 serum concentration; a likely predictor of CIN and cervical cancer: Secondary analysis from a case control study at a clinic in South western Uganda

Biomarkers including Forkhead/winged-helix transcription factor box P3 have been proposed in immunohistochemical techniques to diagnose cervical lesions, but can be objectively quantified and measured in blood using methods that can be standardised. In this study we quantified the serum FOXP3 concentrations and assessed their association with cervical lesions at the cervical cancer clinic of Mbarara Regional Hospital (MRRH) Southwestern Uganda.We performed secondary analysis on archived serum samples from a previous unmatched case control study in which we recruited 90 cervical cancer (CC) cases, 90 cervical intraepithelial neoplasia (CIN) cases before any form of treatment and 90 controls. Clinical and demographic data were recorded. We measured FOXP3 concentrations using quantitative ELISA. We performed descriptive statistics and logistic regression in STATA 17 and took P-values of < 0.05 as statistically significant.The mean concentration of FOXP3 was higher in serum samples from CC cases compared with CIN cases and controls, and this difference was statistically significant (P value < 0.001). More than half (52/90,58 %) of serum samples from CC cases had FOXP3 concentrations greater than 0.0545 ng/ml (P value < 0.001). Increase serum FOXP3 expression was not associated with CIN. Increase in serum FOXP3 concentrations were observed to increase the chances of CC by 2 times (OR: 2.094, P value 0.038, 95 % CI: 1.042–––4.209).Serum FOXP3 is likely associated with cervical lesions especially CC in our study population. Serum FOXP3 testing may be useful in resource limited settings to aid detection of such lesions given the challenges associated with cytology and VIA. We recommend diagnostic utility studies for circulating FOXP3 as a biomarker for detection of cervical cancer.

Malnutrition is a risk factor for tuberculosis disease among household contacts: A case-control study in Uganda

ObjectiveHousehold contacts (HHCs) of persons with tuberculosis (TB) including rifampicin-resistant or multi-drug-resistant TB (RR/MDR-TB) are at risk for TB infection. We investigated whether index patient-level clinical and socio-demographic factors of persons with MDR-TB are associated with TB disease among their HHCs in Uganda. MethodsWe designed an unmatched case-control study. Cases were HHCs of persons with MDR-TB that had TB disease while controls were a random sample of HHCs of persons with MDR-TB that had no TB disease. The case-to-control ratio was 1:3. We identified the factors that significantly differed between the cases and controls in a multivariable binary logistic regression analysis and reported the odds ratio (OR) and 95% confidence interval (CI). ResultsWe found similar demographic and clinical characteristics among the 11 cases and 33 controls. In a multivariable analysis, malnutrition was significantly associated with being a case than a control (adjusted OR 5.01; 95% CI 1.18-24.83). ConclusionTherefore, TB Control Programs should focus on identifying malnutrition among persons with MDR-TB and providing nutritional counseling and support to improve recovery, and potentially reduce household TB transmission and optimize treatment success. Additionally, rapid screening for TB and preventive therapy should be prioritized to reduce transmission.

Association between metabolic syndrome and cervical cancer among women in Southwestern Uganda: A case-control study

ObjectiveTo determine the association between MetS and its components with cervical cancer among women in South-western Uganda. MethodsWe conducted an unmatched case-control study on 470 participants in a 1:2 case-to-control ratio among women in southwestern Uganda. We recruited 157 women with cervical cancer as cases and 313 women without cervical cancer as controls at the Mbarara Regional Referral Hospital Cervical Cancer Clinic. We assessed for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We used a multivariable binary logistic regression analysis to determine the association between MetS and its components with cervical cancer adjusted for potential confounders. We reported the adjusted odds ratios (aOR) and 95% confidence intervals (CI). ResultsCases were significantly older than controls: 52.4 ± 13.15 versus 41.9 ± 11.9 respectively, p < 0.001. We found MetS was independently associated with cervical cancer (aOR 1.66; 95 % CI 1.07–2.57). Age ≥ 50 years (aOR-2.20; 95 % CI 1.35–3.56), HIV infection (aOR 2.51, 95 % CI 1.56–4.05), increasing parity (aOR 1.16, 95 % CI 1.06–1.26), and a lack of formal education (aOR 6.41, 95 % CI, 1.33–30.86) were also associated with cervical cancer. However, none of the components of MetS was associated with cervical cancer. ConclusionIn Ugandan women, MetS was associated with a higher likelihood of cervical cancer. We, therefore recommend combined screening for MetS and cervical cancer in order to reduce morbidity and mortality from both Mets and cervical cancer.

Association between dyslipidemia and cervical intraepithelial neoplasia: A case-control study in south-western Uganda.

Altered lipid levels may be associated with the development of a number of malignancies, including cancer of the cervix. However, there is limited understanding of this relationship in the rural Ugandan context. We investigated the connection between dyslipidaemias and cervical intraepithelial neoplasia (CIN) among women attending the cervical cancer clinic at Mbarara Regional Referral Hospital in south-western Uganda. This unmatched case-control study was conducted between December 2022 and February 2023 and included women with CIN (cases) and women without intraepithelial lesions (controls) in a 1:1 ratio. Participants were selected based on cytology and/or histology results, and after obtaining written informed consent. Demographic data were collected, and venous blood was drawn for lipid profile analysis. Dyslipidaemia was defined as: total cholesterol > 200 mg/dL, low-density lipoprotein > 160 mg/dL, triglycerides > 150 mg/dL, or high-density lipoprotein < 40 mg/dL. At diagnosis, cases were categorised as either CIN1 (low grade) or CIN2+ (high grade). Among the 93 cases, 81 had CIN1, while 12 had CIN2+. Controls had a 13.9% (13/93) prevalence of high triglycerides and cases had a prevalence of 3.2% (3/93; p = 0.016). Reduced high-density lipoprotein was the most prevalent dyslipidaemia among cases (40.9%; 38/93). Statistically significant associations were found between high serum triglycerides and CIN (odds ratio: 1.395, 95% confidence interval: 0.084-1.851, p = 0.007). A notable association was observed between triglyceride dyslipidemia and CIN. Further studies into biochemical processes and interactions between lipids and cervical carcinogenesis are recommended through prospective cohort studies. This research provides additional information on the potential role of lipids in cervical carcinogenesis among women in rural Uganda. It also presents the possible prevalence of multimorbidity involving cervical cancer and cardiovascular diseases, particularly in low-resource settings lacking preventive measures against the increasing prevalence of dyslipidaemia.

Determinants of thinness among school adolescents in Legehida district, Amhara region, north east Ethiopia: an unmatched case-control study

BackgroundAdolescence is a critical stage of human growth and development, and adolescent nutritional status is a significant predictor of health outcomes. However, adolescents in developing countries, including Ethiopia, have received little attention from nutrition-related programs in recent decades. Consequently, malnutrition among adolescents is a widespread issue in these regions.ObjectiveThe study aimed to identify the determinants of thinness among school adolescents in the Legehida district of South Wollo Zone, Northeastern Ethiopia.MethodsA school-based, unmatched case-control study was conducted from January 20 to February 2, 2019. A total of 525 school-aged adolescents (175 cases and 350 controls) from the Legehida district were enrolled using a multistage sampling technique. Data were collected through interview-administered questionnaires and anthropometric measurements. EpiData version 3.1 was used for data entry, while Anthroplus software was employed for anthropometric measurement entry and analysis. The data were then exported to SPSS version 25 for further analysis. Bivariate and multivariable logistic regression analyses were performed to assess the determinants of adolescent thinness.ResultsIn this study, thinness among school adolescents was significantly associated with several factors: the absence of a latrine at home [AOR = 8.2, 95% CI (3.8, 8.17)], meal skipping per day [AOR = 3.1, 95% CI (1.2, 7.3)], inadequate consumption of fruits and vegetables [AOR = 7.5, 95% CI (3.9, 14.5)], having more than four household members [AOR = 13.6, 95% CI (7.1, 26)], and the consumption of unsafe water [AOR = 7.7, 95% CI (3.8, 15.6)].Conclusions and recommendationsThe absence of latrines and access to clean water, dietary factors, and family size emerged as significant contributors to adolescent thinness in this study. Addressing the nutritional challenges faced by adolescents will require collaborative efforts across sectors.

Determinants of virological failure among HIV clients on second-line antiretroviral treatment at Felege-hiwot and University of Gondar comprehensive specialized hospitals in the Amhara Region, Northwest Ethiopia: A case-control study.

Second-line HIV treatment failure has become increasing worldwide, mainly in sub-Sahara Africa including Ethiopia. Even though the problem becomes increasing, inadequate information was available about its magnitude and associated factors in the current study area. To assess the factors of second-line Anti-Retroviral Treatment virological failure among second-line ART users. Institutional-based unmatched case-control study design was conducted from September to December 2021 at Felege Hiowt and University of Gondar Comprehensive Specialized Hospitals; Amhara region, Northwest Ethiopia. A total of 216 patients (60 cases and 156 controls) were recruited by a simple random sampling technique with a 1:3 cases-to-controls ratio. Patients who had two viral load results >1000 copies/ml within a 3-month interval after taking ART drugs for at least 6 months were cases and those who had ≤1,000 copies/ mL were controls. The sample size was calculated by using Epi-Info version 7.2.4. Structured questionnaires were used to gather the required information. SPSS version 26 was used to summarize the findings. In bivariate logistic regression model, Variables with two-tailed P-value ≤ 0.25 at 95% confidence interval were transferred into multivariate binary logistic regression model and P value at ≤ 0.05 was set as statistically significant. Out of 216 patients recruited, 212 have participated with a response rate of 98.2%. From these participants, 117(55.2%) were males and 187(88.2%) were urban dwellers. Among the total respondents, 208(98.1%) had age > 24 years, 200(94.3) were at HIV clinical stage I, 72(34%) had poor ART adherence and 112(52.8) did not disclose their HIV status. Likewise, most of the patients 147(69.37) didn't use condoms. The associated factors were not disclosing HIV status (AOR = 3.4, 95% CI: 1.52-7.79), medium adherence (AOR = 3.7, 95% CI = 1.3-10.7), poor adherence level (AOR = 5.27, 95% CI: 2.2-12.5), not using condoms (AOR = 4.47, 95% CI: 1.63-12.2) and Viral load (>150 copies/ml) when switched to second-line ART (AOR = 3.56, 95% CI: 1.5-8). Non-disclosure, poor or medium adherence, not using condoms and high Viral load (>150 copes/ml) when switched to second-line ART were the main factors for second-line Anti-Retroviral Treatment virological failure. Disclosure about HIV status, using condoms and improving treatment adherence level are crucial to reduce second-line virological failure.

Impact of Infancy Conditions on Physical Growth of Children Under-five

Children under five years old is the age group most vulnerable to several health problems. It is important to evaluate the impact of infancy condition on their physical growth. This research aimed to examine the impact of infancy condition on the physical growth of children under-five years old. The unmatched case-control study was conducted in Puskesmas Griya Antapani areas, Bandung from May to July, 2023. A total of 112 children aged under 5 years were included in this study (56 cases and 56 control). The analysis used multivariate logistic regression to determine adjusted odds ratios (OR). The results showed that the variables associated with the children growth are infection or illness in infancy (OR is 0,138 95 percent CI 0,51 until 0,375), feeding patterns in infancy (OR is 11,000 95 percent CI 4,566 until 26,503), birth weight (OR is 0,170 95 percent CI 0,036 until 0,818) and economic status (OR is 0,062 95 percent CI 0,14 until 0,280). Multivariate logistic regression showed that economic status was the most dominant factor for children physical growth (OR is 6.701 95 percent CI 1,323 until 33,944). Education for families is needed in choosing food that is rich in nutrition and economical by utilizing alternative sources of protein, the amount of food, and the schedule of meals according to the needs of children according to their age.

Risk Factors Associated with Cutaneous Reactions Following COVID-19 Vaccine Immunisation: A Registry-Based Case-Control Study.

In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors. This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression. Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001). Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.

Determinants of virologic failure among adult HIV patients on first line antiretroviral treatment in Oromia, Central Ethiopia: 2022 a case-control study

BackgroundEthiopia’s viral suppression rate was less than 90% by 2020, and more than 10% of adult clients on ART in Woliso Town were unsuppressed at the end of March 2022. This study aims to identify determinants of virologic failure among adult clients on ART at health facilities in Oromia region of Ethiopia.MethodsA facility-based unmatched case-control study was conducted at health facilities in Oromia region from August 1 to September 1, 2022. The study cases were clients with virologic-confirmed first-line ART failure, while controls were clients on first-line ART with a suppressed viral load. A total of 135 cases and 268 control participants were selected using simple random sampling techniques, and data were collected by reviewing the client’s document. Epi-Info7 was used for data entry and SPSS version 20 for data analysis. Variables having a P-value of less than 0.25 in the bi-variable analysis were included in multivariable logistic regression. Determinants of virologic failure were determined based on an adjusted odds ratio using 95% CI and a P-value of < 0.05.ResultIn this study, clients with an age ≥ 35 years (AOR = 3.4, 95% CI: 1.6, 7.0), clients with a baseline regimen of AZT + 3TC + NVP (AOR = 3.5, 95% CI: 1.4, 8.8), clients with a base-line CD4 count < 350 mm3 (AOR = 2.3, 95% CI: 1.1, 4.5), being single marital status (AOR = 3.7, 95% CI: 1.4, 10.5), TB-HIV coinfection (AOR = 2.58, 95% CI: 1.3, 5.1), and having opportunistic infection other than TB in the last six months (AOR = 3.06, 95% CI: 1.5, 6.3) were factors significantly associated with virologic failure while clients within the appointment spacing model (AOR = 0.05, 95% CI: 0.03, 0.10) is inversely associated with virologic failure.ConclusionThis study showed that age ≥ 35 years, being single, baseline ART regimen with (AZT + 3TC + NVP), baseline CD4 cell count < 350 mm3, Tb-co infection, and opportunistic infection in the last 6 months were factors associated with virologic failure. Involvement in the appointment spacing model was found to be protective.