Prevalence and associated factors of scabies among schoolchildren in Dabat district, northwest Ethiopia, 2018

Abstract Background Scabies is a skin infestation caused by the mite Sarcoptes scabiei that causes a pruritic skin eruption. In Ethiopia, the disease is common especially during natural or manmade disasters such as flooding, drought, civil war and conflict, poor water supply and sanitation, and overcrowding living condition. Though scabies is becoming a major public health problem, especially in low resource settings, there has been no study that reported the prevalence of scabies in the study area. The aim of this study, therefore, was to assess the prevalence of scabies and associated factors among students in primary schools in Dabat district, northwest Ethiopia. Method An institutional-based cross-sectional study was employed to determine the prevalence of scabies and associated factors among schoolchildren in Dabat district. A total of 494 students selected by a multi-stage sampling technique were included in this study. Scabies was diagnosed by medical practitioners based on lesions observed on body surfaces after a physical examination. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20. Significance level was obtained at p value < 0.05. Result The prevalence of scabies was 9.3% (46/494) with 95% CI (5.66%, 12.94%). Among schoolchildren who were infested by scabies, 65.22% (30/46) had a mild, 28.26% (13/46) had moderate, and 6.52% (3/46) had severe lesions. Studying at a rural school (AOR = 2.99, 95% CI 1.33, 6.71), had illiterate father (AOR = 5.11, 95% CI 2.25, 11.58), being grade level 1–4 (AOR = 3.91, 95% CI 1.69, 9.05), rarely taking a bath (AOR = 3.54, 95% CI 1.36, 9.25), contact with a person with itching symptom (AOR = 2.66, 95% CI 1. 21, 5.83), a family member with itchy symptoms (AOR = 4.76, 95% CI 2.20, 10.28), not living with both parents (AOR = 2.49, 95% CI 1.02, 6.06), and using water only for hand washing (AOR = 4.38, 95% CI 1.78, 10.76) were factors associated with scabies infestation among schoolchildren. Conclusion The prevalence of human scabies among schoolchildren in Dabat district northwest Ethiopia was high. The school localization, first cycle level of education, paternal educational status, frequency of taking a bath, and contact with a person having itchy lesions, presence of a family member with itchy lesion, and type of frequently used hand washing material were the factors significantly impacting the occurrence of scabies. Special attention should be given to students at first cycle education as they are at the highest risk of infestation.

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Prevalence and Associated Factors of Tuberculosis in Prisons Settings of East Gojjam Zone, Northwest Ethiopia

International Journal of Bacteriology ◽

10.1155/2017/3826980 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Mucheye Gizachew Beza ◽

Emirie Hunegnaw ◽

Moges Tiruneh

Keyword(s):

Associated Factors ◽

Public Health Problem ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Hiv Positive ◽

Major Public Health Problem ◽

Cross Sectional ◽

Hiv Coinfection ◽

Rural Dwellers ◽

Prison Admission

Background. Tuberculosis, mainly in prisoners, is a major public health problem in Ethiopia where there is no medical screening during prison admission. This creates scarcity of TB data in such settings. Objective. To determine prevalence and associated factors of TB in prisons in East Gojjam Zone, Northwest Ethiopia. Methods. A cross-sectional study was conducted from February to May 2016 among 265 prisoners in three prison sites. Sputum was processed using GeneXpert MTB/RIF. Data were analyzed using SPSS version 20.0. Multivariable logistic regression was used; p values = 0.05 were considered statistically significant. Results. Of 265 prisoners, 9 (3.4%) were TB positive (males); 77.8%, 55.6%, and 55.6% of cases were rural dwellers, married, and farmers, respectively. Seven (2.6%) prisoners were HIV positive, and 3 (1.13%) had TB/HIV coinfection. One (0.4%) TB case was rifampicin resistant. Marriage (AOR = 1.5; 95% CI: 1.7, 13.03), HIV (AOR = 0.14; 95% CI: 0.001, 0.17), and sharing of rooms (AOR = 1.62; 95% CI: 2.6, 10.20) were predictors for TB. Conclusion. Nine prisoners were TB positive. One case showed rifampicin resistance and three had TB/HIV coinfection. Marriage, HIV, and sharing of rooms were predictors for TB. Prevention/control and monitoring are mandatory in such settings.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

10.21203/rs.2.22938/v4 ◽

2020 ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background: Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella among food handlers.Methodology: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 with a corresponding 95% confidence interval was considered statistically significant.Results: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0 %). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, hand washing after using the bathroom, hand washing after touching dirty materials, hand washing before food handling, and fingernails status were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin. On the other hand, low resistance was found for chloramphenicol, ceftriaxone, and ciprofloxacin.Conclusion: The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, drinks and could serve as a source of infection to consumers via the food chain. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

10.21203/rs.2.22938/v6 ◽

2020 ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background: Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella colonization among food handlers.Methodology: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 where a corresponding 95% confidence interval was considered statistically significant.Results: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0 %). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, no hand washing after using the bathroom, no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin, yet low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found. Conclusion: The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, and drinks and could serve as a source of infection to consumers. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

10.21203/rs.2.22938/v2 ◽

2020 ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background: Food handlers play a significant role in the transmission of foodborne infection. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem of the globe. Thus, this study was aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella among food handlers. Methodology: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Results: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0 %). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, hand washing after using the bathroom, hand washing after touching dirty materials, hand washing before food handling and fingernails status were significant associated factors identified. None of the Salmonella and Shigella isolates was sensitive to ampicillin. On the other hand, low resistance was found for chloramphenicol, ceftriaxone, and ciprofloxacin. Conclusion: The present study revealed that the prevalence of Salmonella and Shigella among food handlers found to be 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, drinks and could serve as a source of infection to consumers via the food chain. This indicates that the need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

10.21203/rs.2.22938/v5 ◽

2020 ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background: Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella among food handlers.Methodology: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 with a corresponding 95% confidence interval was considered statistically significant.Results: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0 %). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only,no hand washing after using the bathroom,no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin. On the other hand, low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found.Conclusion: The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, drinks and could serve as a source of infection to consumers via the food chain. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, northern Ethiopia, 2018

Tropical Diseases Travel Medicine and Vaccines ◽

10.1186/s40794-020-00119-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella colonization among food handlers. Methodology A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 where a corresponding 95% confidence interval was considered statistically significant. Results A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0%). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, no hand washing after using the bathroom, no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin, yet low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found. Conclusion The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, and drinks and could serve as a source of infection to consumers. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Prevalence of Malaria and Its Associated Factors Among Malaria Suspected Patients Attending at Hamusite Health Center, Northwest Ethiopia, a Cross Sectional Study, 2020

10.21203/rs.3.rs-146195/v1 ◽

2021 ◽

Author(s):

Getu Abeje Negatu ◽

Getaneh Alemu Abebe ◽

Woyneshet Gelaye Yalew

Keyword(s):

Public Health ◽

Health Center ◽

Health Problem ◽

Associated Factors ◽

Public Health Problem ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Major Public Health Problem ◽

Sectional Study ◽

Cross Sectional

Abstract BackgroundMalaria is a major public health problem which still results in illness and death. Despite efforts to reduce the mortality and morbidity of malaria, the disease is still a prominent health problem in Ethiopia. This study, therefore, was undertaken to assess the prevalence of malaria and associated factors among symptomatic patients in northwest Ethiopia.MethodA facility based cross-sectional study was conducted from February to March 2020 among 210 febrile patients attending at Hamusite health center, northwest Ethiopia. Thin and thick blood films were prepared from blood collected by finger puncture and from capillary blood buffy coat. Data were analyzed using SPSS version 20.ResultsOut of 210 malaria suspected participants, 61 (29.0%) were confirmed to be infected by Plasmodium species. Plasmodium falciparum mono-infection was detected in 41 (19.5%) participants while P.vivax mono-infection and mixed infections were detected in 10 (4.3%) participants each. Female participant and those having family members with history of malaria were at higher risk of acquiring Plasmodium infectionConclusionThe present study revealed that malaria continued to be the major public health problem in the study area. Therefore, community mobilization should be strengthening in order to improve implementation of malaria control activities.

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Prevalence of Undernutrition and Its Associated Factors among Children below Five Years of Age in Bure Town, West Gojjam Zone, Amhara National Regional State, Northwest Ethiopia

Advances in Public Health ◽

10.1155/2016/7145708 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Desalegne Amare ◽

Ayenew Negesse ◽

Baye Tsegaye ◽

Birtukan Assefa ◽

Birehanu Ayenie

Keyword(s):

Associated Factors ◽

Public Health Problem ◽

Sampling Technique ◽

Northwest Ethiopia ◽

World Health ◽

Major Public Health Problem ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Severe Stunting

Background. Malnutrition is the major public health problem over the world. Developing countries are highly affected. Asian and Sub-Saharan African countries, including Ethiopia, contribute the highest of all. The main aim of this study was to assess the prevalence of undernutrition and its associated factors among children below five years of age.Methods. Community-based cross-sectional survey was conducted on 342 study participants. Simple random sampling technique was used to select sampling kebeles and study units. Weight and height were measured using calibrated instruments. The data were entered into EpiData version 3.1 software and calculated using SPSS version 20.0 statistical software and/or World Health Organization Anthro software with aid of Stat/Transfer.Results. Overall prevalence of undernutrition was 35.5%, of which 85 (24.9%), 38 (11.1%), and 49 (14.3%) were stunting, wasting, and underweight, respectively. Male children were more affected in both severe and moderate nutritional problems compared to female children. The finding showed that 27 (7.9%) had severe stunting, 15 (4.4%) had severe wasting, and 11 (3.2%) had severe underweight, respectively.Conclusion. Undernutrition was high in Bure town among children below five years of age. Male sex, maternal educational status, low household income, preterm babies, absence of antenatal follow-up, diarrhea, and respiratory infections within one-month duration were factors affecting undernutrition.

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Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

10.21203/rs.2.22938/v3 ◽

2020 ◽

Author(s):

Haftom Legese ◽

Tsega Kahsay ◽

Aderajew Gebrewahd ◽

Brhane Berhe ◽

Berhane Fseha ◽

...

Keyword(s):

Foodborne Pathogens ◽

Antimicrobial Susceptibility ◽

Associated Factors ◽

Public Health Problem ◽

Hand Washing ◽

Control Measures ◽

Major Public Health Problem ◽

Northern Ethiopia ◽

Food Handlers ◽

Cross Sectional

Abstract Background Food handlers play a significant role in the transmission of foodborne infection. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study was aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella among food handlers. Methodology A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Results A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0%). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, hand washing after using the bathroom, hand washing after touching dirty materials, hand washing before food handling and fingernails status were significant associated factors identified. None of the Salmonella and Shigella isolates was sensitive to ampicillin. On the other hand, low resistance was found for chloramphenicol, ceftriaxone, and ciprofloxacin. Conclusion The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, drinks and could serve as a source of infection to consumers via the food chain. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

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Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy at Selected Hospitals in Sidama Zone, Southern Ethiopia: A facility-based cross-sectional study

10.21203/rs.2.17125/v1 ◽

2019 ◽

Author(s):

Demelash Wachamo ◽

Fisseha Bonja

Keyword(s):

Associated Factors ◽

Opportunistic Infections ◽

Public Health Problem ◽

Cross Sectional Study ◽

High Morbidity ◽

Major Public Health Problem ◽

Sectional Study ◽

Aids Patients ◽

Cross Sectional ◽

Hiv Aids

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

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