scholarly journals Cotrimoxazole Prophylaxis Treatment Adherence and Associated Factors Among Human Immunodeficiency Virus (HIV) Exposed Children in Public Hospitals in Ilubabor Zone, Southwest Ethiopia, 2018

2019 ◽  
Vol 12 (1) ◽  
pp. 184-198
Author(s):  
Dessalegn Nigatu ◽  
Negalign Getahun Dinegde ◽  
Endalew Gemechu Sendo

Introduction: Africa is the most affected region by HIV/AIDS in the world with about 26 million people living with HIV, of whom 2.3 million are children under the age of 15 years in 2015. The Human Immunodeficiency Virus (HIV) related estimates and projections for Ethiopia in 2017 revealed that 57,132 under 15 years children were living with HIV with about 1,276 children newly infected. Therefore, this study assessed cotrimoxazole prophylaxis treatment adherence and associated factors among HIV exposed children in public hospitals in Ilubabor zone, Southwest Ethiopia, 2018. Methods: The study design was a facility based, both a retrospective and descriptive study that involves a review of the records of children from PMTCT register books over the past 2 years, and the interview of health care workers and parents/guardian of all children at the follow up clinic. The study included a random sample of children born from HIV infected mothers and enrolled in the PMTCT follow up clinic. The total sample size was 293 and 99 for children (parents/guardian interviewed) and health workers, respectively, and the children’s antiretroviral therapy (ART) registration books in each health facility were reviewed. The collected data was entered into the Epi-data software version 3.1 and then exported to SPSS version 20 for further statistical analysis. Descriptive statistics, bivariate analysis and multivariable logistic regression were used for analysis. Results: Among the total participants, a considerable number (83.3%) of them did not confirm their HIV status, and the majority (88.8%) of participants indicated that they had indeed suffered from one or more opportunistic infections. The common obstacles encountered in accessing care at the health facility were: lack of drugs (33.8%), long procedures in getting drugs (31.4%), unfriendly hospital staff (26.3%), and long distance to the health facility (8.5%). The study showed a significant association between compliance to cotrimoxazole prophylaxis and unfriendly health worker (OR=0.14, CI=0.03-0.78), follow-up (OR= 0.22, CI = 0.06-0.87) and the long procedure of getting drugs (OR= 0.08, CI= 0.01-0.45). Conclusion: The study revealed that a remarkable number of the participants were found to adhered to cotrimoxazole prophylactic treatment. Unfriendly health workers, follow-up and the long procedure of getting drugs were significantly and independently associated with compliance to cotrimoxazole prophylaxis.

2019 ◽  
Author(s):  
Adugna Oluma ◽  
Muktar Abadiga ◽  
Getu Mosisa ◽  
Werku Etafa ◽  
Ginenus Fekadu

Abstract Background : Food insecurity and HIV/AIDS are intertwined in a vicious cycle through nutritional, mental health, and behavioral pathways. Food insecurity is a potentially important barrier to the success of antiretroviral treatment, increased hospitalizations, and higher morbidity among HIV-infected individuals in resource-poor settings particularly in sub-Saharan Africa including Ethiopia. Therefore, the purpose of this study was to assess the prevalence of food insecurity and its associated factors among adult people living with HIV/AIDS on follow up receiving ART at public hospitals of wollega zone, west Ethiopia. Methods : An institutional-based cross-sectional study design was conducted on a sample of 428 among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of wollega zones. Data was collected using the Household Food Insecurity Access Scale and dietary diversity scale by interviewer-administered questionnaires. The data was checked, cleaned and entered into Epi data version 3.1 and then exported into Statistical Package for the Social Sciences (SPSS) window version 21 for analysis. Descriptive statistics - cross-tabulation frequency table, mean, standard deviation, percentage, were employed. Bivariate and multiple logistic regression analyses were used with AOR at CI 95% and p<0.05 were used. Result: The overall prevalence of food insecurity among PLWHA receiving ART therapy was 68.8% which was partitioned as mild (23.32%), moderate (29.09%) and severe (16.35%) food in secured. Being single [AOR=3.507(1.377, 8.934)], illiterate [AOR=5.234(1.747, 15.686)], cigarette smoking [AOR=3.577(2.104, 6.081)], presence of anemia (AOR=2.650(1.563, 4.493)] and inadequate dietary diversity [AOR=2.870(1.088, 7.569)] were predictors of food insecurity. Conclusion : The prevalence of food insecurity was relatively high. Educational status, marital status, cigarette smoking, presence of anemia, opportunistic infection and inadequate dietary diversity were the major significant factors affecting food insecurity. We recommended Wollega Zonal Health Bureaus to effectively intervene in behavioral modification and health information dissemination (HID) which is the key strategies to improve food security.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Helina Abebe ◽  
Shegaye Shumet ◽  
Zebiba Nassir ◽  
Melkamu Agidew ◽  
Dessie Abebaw

Depression is most frequently and highly occurring common mental disorder in HIV/AIDS patients especially youth living with HIV/AIDS. This study aimed to assess the prevalence and associated factors of depressive symptoms among youth living with Human Immunodeficiency Virus (HIV) attending Antiretroviral Therapy (ART) follow-up at public hospitals in Addis Ababa, Ethiopia.Objective. To assess the prevalence and associated factors of depressive symptoms among youth living with Human Immunodeficiency Virus (HIV) attending Antiretroviral Therapy (ART) follow-up at public hospitals Addis Ababa, Ethiopia, 2016.Method. In a cross sectional study, 507 HIV-positive young people from public health hospitals were recruited by systematic random sampling technique. Beck Depression Inventory-II was used to assess depressive symptoms. Morisky medication adherence rating scale, social support rating scale, and HIV stigma scale were the instruments used to assess the associated factors.Results. Prevalence of depressive symptoms among HIV-positive youth was 35.5% (95% CI:31.3, 39.6). In multivariate analysis, age range between 20 and 24 years with (AOR=2.22, 95% CI: 1.33,3.62), history of opportunistic infection (AOR=1.94, 95% CI:1.15,3.27), poor medication adherence (AOR=1.73, 95%CI:1.13,2.64, low social support (AOR=2.74, 95%CI:1.13,2.64), moderate social support (AOR=1.75 95% CI: 1.03,2.98), and stigma (AOR=2.06, 95% CI: 1.35,3.14) were associated with depressive symptoms. The results suggest that prevalence of depressive symptoms among HIV-positive youth was high. Prevention of opportunistic infection, stigma, and counseling for good medication adherence are necessary among HIV-positive youth.


2020 ◽  
Vol 7 (9) ◽  
pp. 1339
Author(s):  
S. Bhagyabati Devi ◽  
T. Jeetenkumar Singh ◽  
Kshetrimayum Birendra Singh ◽  
N. Biplab Singh ◽  
Robinson Ningshen ◽  
...  

Background: Antiretroviral therapy (ART) have changed the outlook of people living with HIV (PLHIV) by transforming the dreaded infection to a chronically manageable disease. However, there is scant of reports which analyses quantitatively the survival benefit of PLHIV under ART. Objectives of this study were to determine the survival time of adult PLHIV who are on ARV. To analyse the factors determining survival outcome of PLHIV on ARV.Methods: This was an observational study in centre of excellence (COE) ART Centre, RIMS, Imphal from April 2004 to December 2009. Details from the data entered in documents of the ART programme were followed up every 3 months for 60 months from the date of initiation of ARV. All PLHIV above 18 years of age and undergoing antiretroviral therapy were included.Results: Survival rate following initiation of ARV was found to be significantly high among PLHIV. Higher CD4 count at the time of ARV initiation had better prognosis. Mortality was high among IDUs and they had high incidence of co-infections with HCV and HBV. The currently available ARV drugs under NACO programme have better suppression of HIV, are less toxic, low pill burden. The combined regimen used in the earlier days were not much inferior to the current ARV drugs if initiated timely with proper prophylaxis of OIs, good adherence, good nutrition and timely management of toxicities and IRIS.Conclusions: Timely treatment with ARV drugs provided under the national programme with good adherence and regular follow-up improves the survival of PLHIV.  


2021 ◽  
Author(s):  
Azezew Ambachew Tarekegne ◽  
Berhanu Wordofa Giru ◽  
Bazie Mekonnen

Abstract Background: Person-centered maternity care is respectful and responsive care to individual women’s preferences, needs, and values and ensuring that their values guide all clinical decisions during childbirth. It is recognized as a key dimension of the quality of maternity care that increases client satisfaction and institutional delivery. However, little research has been conducted about person-centered maternity care in Ethiopia. Objective: The aim of this study was to assess the status of person-centered maternity care and associated factors among mothers who gave birth at selected public hospitals in Addis Ababa city, Addis Ababa, Ethiopia, 2021.Method: A facility-based cross-sectional study was conducted at selected public hospitals in Addis Ababa city. A semi-structured questionnaire was used to collect data from post-natal mothers selected by systematic random sampling. The data was coded and entered using Epi-data version 4.6 and analyzed using SPSS version 25. Bivariate and multivariable linear regression analysis was used to identify factors associated with person-centered maternity care. The strength of association between independent and dependent variables was reported by using unstandardized β at 95% CI and p-value < 0.05 were considered statistically significant.Results: In this study 384 mothers were participated with a response rate of 99.2%. The overall prevalence of person-centered maternity care was 65.8%. Respondents who had no ANC follow-up (β= -5.39, 95% CI: -10.52, -0.26), <4 ANC follow up (β= -3.99, 95% CI: -6.63, -1.36), night time delivery (β= -3.95, 95% CI: -5.91, -1.98) and complications during delivery (β= -3.18, 95% CI: -6.01, -0.35) were factors significantly associated with person-centered maternity care.Conclusion and Recommendations: The finding of this study showed that the proportion of person-centered maternity care among mothers who gave birth in public hospitals of Addis Ababa was high as compared to previous studies. The factors affecting person-centered maternity care are manageable to interventions. Therefore, Health care providers need to provide person-centered maternity care for all mothers.


2021 ◽  
Author(s):  
Haymanot Mitiku Zeleke ◽  
Birtuka Assefa ◽  
Teshager Sergo ◽  
Nakachew Mekonnen

Abstract Background: Self-care practice is crucial for the prevention and management of Hypertension. Poorly controlled hypertension leads to cardiovascular complication as well as organ damage. Despite the availability of several effective pharmacologic and non-pharmacologic therapies, hypertension control remains suboptimal. Self-care practices allow hypertensive patients to have improved quality of life by avoiding complication and decrease health care expenditure. Objective: we assessed self-care practice and its associated factors among Hypertensive Follow up patients at East Gojjam Zone public hospitals, Northwest Ethiopia, 2020.Methods: Institution based cross sectional study was conducted by both quantitative and qualitative methods from October 1-30, 2020. Epi data version 3.1 and SPSS version 25.0 were used for data entry and for analysis respectively. Descriptive statistics and binary logistic regression analysis was employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while significance level at p value of 0.05 was determined using 95% confidence intervals. Result: Out of 480 patients included in the study 51% have Poor self-care practices. About 44.6%, 92.5%, 82.8%, 62.5% of respondents were poor adherent to antihypertensive medications, low diet quality, poor practiced to physical activity, poor practice to weight management respectively. Some of the respondents 3.3%, 9.8% were smokers and were alcohol drinkers respectively. Educational status who cannot read and write (AOR=3.153, 95% CI: 1.674-5.939), no co morbidity (AOR = 0.418, 95% CI: 0.263-0.663), uncontrolled blood pressure status (AOR = 2.141, 95% CI: 1.271- 3.609), poor social support status (AOR = 2.587, 95% CI: 1.544-4.334) and unfavorable attitude (AOR= 3.193, 95% CI: 1.951-5.225) showed significant statistical association with poor self-care practice.Conclusion: The level of hypertension self-care practices found to be low. Therefore, education towards hypertension self-care practices should be strengthened for patients living with hypertension. Special attention should be given to patients with low educational level that cannot read and write, patients with co morbidity, uncontrolled state of hypertension, poor social support and those with unfavorable attitude towards hypertension management modalities.


2017 ◽  
Author(s):  
Etheldreda Nakimuli-Mpungu ◽  
Seggane Musisi ◽  
Kizito Wamala ◽  
James Okello ◽  
Sheila Ndyanabangi ◽  
...  

BACKGROUND There is limited information on the effectiveness of task shifting of mental health services in populations with HIV. OBJECTIVE This trial aims to evaluate the effectiveness of group support psychotherapy delivered by trained lay health workers to persons living with HIV (PLWH) with depression in primary care. METHODS Thirty eligible primary care health centers across three districts were randomly allocated to have their lay health workers trained to deliver group support psychotherapy (intervention arm) or group HIV education and treatment as usual (control arm) to PLWH with depression. Treated PLWH will be evaluated at baseline, after the end of treatment, and at 6-month intervals thereafter for 2 years. Primary outcomes will be the difference in follow-up proportions of participants with Mini International Neuropsychiatric Interview criteria for major depression and difference in follow-up function scores of participants in the intervention and control arms 6 months after the end of treatment. Secondary outcomes will include measures of self-esteem, posttraumatic stress symptoms, social support, stigma, adherence to antiretroviral therapy, viral load, and number of disability days, asset possession indices, and cost-effectiveness data. Primary and secondary outcomes as well as subgroup analyses will be conducted at the individual level using multilevel random effects regression analyses adjusting for clustering in health centers. A process evaluation using mixed methods to assess acceptability, feasibility, fidelity, causal mediating processes, and contextual influences in the trial will be conducted. RESULTS The trial has been approved by the Makerere College of Health Sciences School of Health Sciences Research Ethics Committee, the AIDS Support Organization, and the Uganda National Council of Science and Technology. A data and safety monitoring board has been put in place to monitor trial progress. A total of 1140 persons living with HIV have been recruited to the trial. An analysis of baseline and 6-month data is in progress. The results of this trial will not only be presented at national and international conferences but also submitted for publication in peer-reviewed journals and as a report to the funding agencies. CONCLUSIONS This cluster randomized trial will provide critical evidence to support culturally sensitive group-based psychotherapy for depression treatment in sub-Saharan Africa. Process evaluation outcomes will provide contextual information that health care and public health stakeholders can use to guide implementation decisions for their particular setting. CLINICALTRIAL Pan African Clinical Trials Registry (PACTR): 201608001738234; http://www.pactr.org/ATMWeb/ appmanager/atm/atmregistry?dar=true&tNo=PACTR201608001738234 (Archived by WebCite at http://www.webcitation.org/ 6vUAgAQlj)


2021 ◽  
Vol 5 (1) ◽  
pp. 043-050
Author(s):  
Edmealem Afework ◽  
Ademe Sewunet ◽  
Andualem Atsedemariam

Background: Pathological and nighttime sleep deprivations have substantial adverse effects on regulation of weight, sugar and blood pressure because of endothelial dysfunction, sympathetic nervous system stimulation, regulation and activation of systemic inflammation. Thus, this study was aimed to assess quality of sleep among patients with chronic illness and its associated factors at South Wollo Zone Public Hospitals, Northeast Ethiopia. Methods and Materials: The study was conducted at South Wollo Zone Public Hospitals, Northeast Ethiopia from February 15 2019 till April 15 2019. Institutional based cross sectional study design was employed. All patients with chronic illness who are on follow up in South Wollo Zone Public Hospitals were sources of population. Sample size was calculated by using EPI info version 7 and the total sample size was 344. The study employed stratified random sampling technique and study participants were selected by systematic sampling. After taking ethical approval from College of Medicine and Health Sciences Ethical Approval Committee, permission from selected Hospitals and informed verbal consent from patients, the data were collected by a tool which has 3 parts: Sociodemographic data, Pittsburgh Sleep Quality Index and factors affecting sleep quality. Data were entered in to Epi data version 4.1 and exported to Statistical Package for Service Product 25 for analysis. Different data presentation tools and binary logistic regression were enrolled by considering 95% confidence level and p value of 0.05. Result: Among the total study participants, near to one third (31.7%) of them got sleep after 30 minutes. More than one fourth of them slept for less than 7 hours. Less than half of the study participants had habitual sleep efficiency of more than 85% however 296(86%) of them did not face day time dysfunction Conclusion and recommendations: more than one third of patients with chronic illness had poor sleep quality. One third of study participants had sleep duration of less than the recommendations(less than 7 hours). Age, educational status, residence, and perception of prognosis of disease were factors that have associations with poor sleep quality among patients with chronic illness. Health care providers who are doing in chronic illness follow up clinic should be initiated to assess and screen those patients with poor sleep quality.


2020 ◽  
Author(s):  
Meseret Belete Fite ◽  
Demeke Jabessa Aga

AbstractIntroductionHuman immunodeficiency virus (HIV), the causal agent for Acquired I Immunodeficiency Syndrome (AIDS) is the world’s greatest severe public health and development contest. Since the beginning of the epidemic, 38 million of people are living with HIV/AIDS and 1.7 million people newly infected with HIV. Increased availability and accessibility of ART has essentially improved the survival rate, through lowering the incidence of OIs among peoples living with HIV/AIDS. Risk of developing Opportunistic infections in HIV patients depend on experience to potential pathogens, virulence of pathogens, degree of host immunity and the use of antimicrobial prophylaxis. In Ethiopia, however remarkable decline of new infection (81%) for decades, since 2008 HIV incidence rate began to rise by 10% and number of new infection diagnosed each year increased by 36% among all ages and doubled among adult. There is a limited studies describing the spectrum of opportunistic infection and associated factors in the study settings. Therefore, this study was aimed to determine the spectrum of Opportunistic infections in the study area.MethodsA Facility based retrospective cross-sectional study was employed from 2015-2019 G.C. The sample size was computed using single population proportion formula. Accordingly, four hundred ninety seven (497) medical records of study participants were reviewed. Simple random sampling technique was used to select the participants included in this study. Data were extracted from the ART follow up data-base and medical records of the patients by using a standardized check list, which was adapted from Federal ministry Of Health HIV ART. The contents of check list include: Socio-demographic characteristics and clinical information’s. Data had entered Epi data version and analyzed using SPSS version 5.3.1 and analyzed using SPSS version 20. Bivariate analysis with p-value <0.2 was done to see the association between outcome variable & independent variables. Variables with p < 0.2 in bivariate analysis were entered for multiple logistic regressions. At 95% confidence interval, explanatory variables with P <0.05 in multiple logistic regression analysis were considered as significantly association.ResultThe study found that, an overall prevalence of OIs was 62%. The finding of our study documented, from deferent HIV related OIs among patients on ART follow up at Nekemte Specialized Hospital ART clinic, the common types of OIs were; Pulmonary Tuberculosis (15.7%), Oral candidiasis (14.3%), Herpes Zoster (11.3%), Cryptococcus meningitides (5.9%), upper respiratory infection (5.8%, Persistent diarrhea (5.2%), and Extra pulmonary tuberculosis (3.8%). The occurrence of OIs on adult PLHIV patients who were with baseline WHO stage of I were 53% lower as compared to those who were with advanced baseline WHO stage of II and more {AOR: 0.468, 95 % CI (0.305-0.716). Moreover, Participants of Urban residents were 1.6 times more likely to develop OIs than those rural residents. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patients.ConclusionAn overall prevalence of OIs was 62%. The prevalence of OIs is still high namely Pulmonary Tuberculosis, Oral candidiasis and Herpes Zoster are leading OIs among adult HIV infected patients. Baseline WHO clinical staging and residence were identified as independent predictors of OIs among adult HIV infected patientsRecommendationsHaving skilled health professionals, early diagnosis of OIs among HIV infected patients and having equipped laboratory diagnostic setup are mandatory to be able to deal with specific diagnosis and management of OIs. Further study is recommended to determine the relationship between residence and developing OIs among HIV patients on ART follow


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