The Effect of Integrated Pharmaceutical Logistic System on User Satisfaction and Logistics Performance of HIV/AIDS Commodities: Evidence form Public Hospitals in Ethiopia

Abstract Background Suicide is the act of intentionally causing one's own death. HIV/AIDS continues to be associated with an under-recognized risk for suicidal behavior. Suicidal behavior among people living with HIV/AIDS is not only a predictor of future attempted suicide and completed suicide, but it is also associated with poor quality of life and poor adherence with antiretroviral therapy. Objective The aim of this study was to assess the prevalence of suicidal ideation and attempt and associated factors among people living with HIV/AIDS in selected public hospitals of Amhara region, central Ethiopia. Methods Institutional based cross-sectional study design was employed. The study was conducted in four public hospitals in North Shewa Zone from May to December 2017. Study population comprised all HIV-infected individuals from Antiretroviral Therapy (ART) clinic. A total of 348 study subjects were recruited using systematic random sampling and 326 completed the interview. Suicidality module from Composite International Diagnostic Interview (CIDI) was modified to assess suicidal behavior. Crude and adjusted OR was analyzed using logistic regression and the level of significance of association was determined at P value < 0.05. Result A total of 326 (93.7%) study subjects were interviewed. The magnitude of suicidal ideation and attempt was found to be 16% and 7.1%, respectively. Low monthly income, living alone, suicidal thought before knowing seropositive status, family history of suicide, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes in the last 12 months of the study period due to HIV status and ever use of khat (a psychoactive substance) was statistically significant associated factor with suicidal ideation. And low monthly income, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes and often in the previous 12 months of the study period due to HIV status and using alcohol currently were significantly associated factors with suicidal attempt. Conclusion Suicidal ideation and attempt among people living with HIV/AIDS (PLWHA) in this study were higher than prevalence in the general population. This shows suicidal ideation and attempt is a mental health concern of PLWHA and it needs great attention in Ethiopia.

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Food insecurity and associated factors among people living with HIV/AIDS on follow up receiving anti-retroviral therapy at public hospitals of Wollega zones, Oromia, Ethiopia, 2019

10.21203/rs.2.19587/v1 ◽

2019 ◽

Author(s):

Adugna Oluma ◽

Muktar Abadiga ◽

Getu Mosisa ◽

Werku Etafa ◽

Ginenus Fekadu

Keyword(s):

Cigarette Smoking ◽

Food Insecurity ◽

Associated Factors ◽

Dietary Diversity ◽

Public Hospitals ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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.

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Logic models from an evaluability assessment of pharmaceutical services for people living with HIV/AIDS

Ciência & Saúde Coletiva ◽

10.1590/s1413-81232011001300032 ◽

2011 ◽

Vol 16 (12) ◽

pp. 4833-4844 ◽

Cited By ~ 6

Author(s):

Angela Esher ◽

Elizabeth Moreira dos Santos ◽

Thiago Botelho Azeredo ◽

Vera Lucia Luiza ◽

Claudia Garcia Serpa Osorio-de-Castro ◽

...

Keyword(s):

User Satisfaction ◽

Evaluation Model ◽

Lessons Learned ◽

Pharmaceutical Services ◽

Free Access ◽

People Living With Hiv ◽

Theoretical Evaluation ◽

Evaluability Assessment ◽

Living With Hiv ◽

Hiv Aids

Brazil was the first developing country to provide people living with HIV/AIDS (PLWA) with comprehensive, universal, free access to antiretroviral medicines (ARV). Pharmaceutical services are considered a strategic action that has the goal of providing access to rational use of quality medicines while also promoting user satisfaction. User satisfaction is a complex concept, and evaluation models for pharmaceutical services for PLWA were not found in the literature. Therefore, an evaluation approach to help assess this issue had to be developed. This article seeks to describe a theoretical evaluation model of user satisfaction with the dispensing of ARV, developed as part of an Evaluability Assessment (EA). It presents a brief review of the EA and user satisfaction and describes the development of models created during the EA. The lessons learned in the process are presented as a conclusion.

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Malnutrition as predictor of survival from anti-retroviral treatment among children living with HIV/AIDS in Southwest Ethiopia: survival analysis

BMC Pediatrics ◽

10.1186/s12887-019-1823-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Abdu Oumer ◽

Mina Edo Kubsa ◽

Berhanu Abebaw Mekonnen

Keyword(s):

Treatment Outcome ◽

Confidence Interval ◽

Nutritional Status ◽

Survival Time ◽

Public Hospitals ◽

Hiv Positive ◽

Southwest Ethiopia ◽

Under Nutrition ◽

Living With Hiv ◽

Hiv Aids

Abstract Background Approximately 70% of HIV positive people live in Africa where food insecurity and under nutrition are endemic. However the impact of malnutrition on treatment outcome is not clear. This study assessed the effect of under nutrition on Anti-Retroviral Therapy treatment outcome among pediatric age group living with HIV/AIDS in Public Hospitals, Southwest Ethiopia. Method A retrospective cohort study was conducted on records of 242 pediatric children in Guraghe zone Public Hospitals. Also median, mean, standard deviation and interquartile range were calculated. Life table, hazard function and survival function were plotted. Log rank test with 95% confidence interval of mean survival time was done. The nutritional status data were managed via WHO Anthros plus and BMI for age Z score was calculated. To assess effects of nutritional status on mortality, both Bivariate and multivariate cox proportional hazard regression was conducted with crude (CHR) and adjusted hazard ratio (AHR) (95% confidence interval and p value). P value of less than 0.05 was used as cut off point to declare statistical significance. Results A total of 243 records of pediatric ART records with mean age of 11.6 (± 3.8 years) were reviewed. About 178 (73.3%) have got therapeutic feeding on the course of ART treatment. Whereas significant number of children, 163 (67.1%) reported to had eating problems. A total of 13 (5.3%) children were dead with incidence density of 11.2 deaths per 1000 person years. There is significantly higher survival time among well nourished (11.1 years with 95% CI: 10.8 to 11.4) as compared to underweight children (9.76 with 95% CI: 9.19 to 10.32 years). Underweight children had almost three fold increase incidence of death (AHR = 3.01; 95% CI: 0.80–11.4). Similarly children with anemia had higher incidence of death than children without anemia (AHR = 1.55; 95% CI: 0.49–4.84). Conclusions Low nutritional status at the start of ART evidenced by underweight and anemia were found to be predictors of survival among HIV positive children. There should be improved, sustained and focused nutritional screening, care and treatment for children on ART follow up.

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Nutritional risk and user satisfaction with the food service of public hospitals of Uruguay

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.09.202 ◽

2020 ◽

Vol 40 ◽

pp. 473

Author(s):

F. Ceriani ◽

M. De León ◽

A. texeira ◽

C. quiroga

Keyword(s):

User Satisfaction ◽

Food Service ◽

Public Hospitals ◽

Nutritional Risk

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Caregivers’ Experiences with Caring for a Child Living with HIV/AIDS: A Qualitative Study in Northern Ghana

Global Pediatric Health ◽

10.1177/2333794x211003622 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110036

Author(s):

Gideon Awenabisa Atanuriba ◽

Felix Apiribu ◽

Adwoa Bemah Boamah Mensah ◽

Veronica Millicent Dzomeku ◽

Richard Adongo Afaya ◽

...

Keyword(s):

Family Dynamics ◽

Sampling Technique ◽

Phenomenological Approach ◽

Deficiency Syndrome ◽

Public Hospitals ◽

Northern Ghana ◽

People Living With Hiv ◽

Face To Face ◽

Living With Hiv ◽

Hiv Aids

With the advent of Anti-Retroviral Therapy, Human Immune Virus, and Acquire Immuno-Deficiency Syndrome is increasingly becoming a chronic disease as life expectancy among People Living With HIV/AIDS has increased. For Children Living With HIV/AIDS the role of the caregivers becomes essential as caregivers’ decisions affect CLWH health. However, the experiences of these caregivers are often unnoticed while all interventions are directed at PLWH. This study aimed at exploring the experiences of caregivers of CLWH in some selected hospitals in northern Ghana. This study employed a qualitative descriptive phenomenological approach. Purposive sampling technique was used to recruit 9 participants from 3 public hospitals in the Tamale Metropolis of Ghana. Data was manually analyzed using the approach of Collaizi and the findings were presented in themes and sub-themes. We conducted individual face to face interviews in English and Dagbani from September to November 2019. These interviews were conducted at the convenience of the participants in hospitals and at their homes. They were introduced to the study while awaiting to take antivirals for their CLWH. Five themes emerged: changed family dynamics, discovery of diagnosis, reaction to diagnosis, disclosure, stigma and discrimination, and burden and challenges of care. Caregivers were severely impacted by caring for CLWH and traumatized by changed family dynamics which exposed them to many difficulties. Stigma was widely perpetrated by immediate family members and majority reacted badly to their children HIV-positive status with fear, shame, guilt and even suicidal ideation.

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Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study

10.21203/rs.2.11281/v2 ◽

2019 ◽

Author(s):

Amrachu Bekele Asfaw ◽

Aderajew Nigusie Tekelehaimanot ◽

Tamirat Shewanew ◽

Esayas Kebede Gudina ◽

Masrie Getnet ◽

...

Keyword(s):

Highly Active Antiretroviral Therapy ◽

Case Control Study ◽

Public Hospitals ◽

Urban Residents ◽

First Line ◽

Southwest Ethiopia ◽

Highly Active ◽

Poor Treatment ◽

Control Study ◽

Hiv Aids

Abstract Background: Highly Active Antiretroviral Therapy (HAART) has substantially declined morbidity and mortality related to Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS). Despite this fact, first-line ART failure has emerged as a growing concern. However, factors associated with first-line ART failure are not well empathized and studied. Hence, we aimed to identify the determinants of first-line ART failure among patients attending ART in Public Hospitals Jimma, Southwest Ethiopia. Methods: A case-control study was conducted in March 2018 on a sample of 384(288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). Cases were HIV patients aged 15 years or older who were on first-line ART regimens with documented therapeutic failure. Controls were HIV patients aged 15 years or older who were on first-line ART regimen but without evidence of therapeutic failure. Data were extracted from electronic databases and supplemented by data collected through interviewer-administered questionnaires. Bivariate and multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence intervals were used to report independently associated factors at P-value<0.05. Results: In this study, higher odds of first-line ART failure was experinced among urban residents (AOR:2.2;95%CI: 1.1, 3.6), smokers (AOR:5.9; 95%CI:3.2, 10.8), Khat users (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherents (AOR:2.2; 95%CI: 1.1,4.5), tuberculosis coinfection (AOR:3.9; 95%CI:2.2, 6.8), prior exposure to ART (AOR:3.8; 95%CI:1.7, 8.1), zidovudine based regimen (AOR:4.8; 95%CI: 2.5,9.0) and longer duration on ART more than 73 months (AOR:1.9; 95%CI:1.2, 3.3). Conclusions: This study evidenced that being an urban resident, TB co-infection, poor treatment adherence, and zidovudine-based regiment were positively and independently associated with first-line ART failure. Thus, enhanced adherence counseling should be provided for those urban residents as well as substance users to improve adherence to ART; early screening and management of tuberculosis is highly recommended. Moreover, close follow up of adverse effects of ARVs must be strengthened. Keywords : determinants, first-line ART failure, HIV/AIDS, Jimma Zone, Public hospitals

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Predictors of stunting among pediatric children living with HIV/AIDS, Eastern Ethiopia

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v9i2.20422 ◽

2020 ◽

Vol 9 (2) ◽

pp. 82

Author(s):

Dawit Gezahegn ◽

Gudina Egata ◽

Tesfaye Gobena ◽

Berhanu Abebaw

Keyword(s):

Low Income ◽

Statistical Significance ◽

Multivariable Analysis ◽

Public Hospitals ◽

Sub Saharan Africa ◽

Low Income Countries ◽

P Value ◽

Eastern Ethiopia ◽

Living With Hiv ◽

Hiv Aids

Globally, there were about 3.4 million pediatric children (<15 years of age) who were living with HIV/AIDS. Ethiopia has one of the highest rates of malnutrition in Sub-Saharan Africa. As of 2013, there were about 160,000 pediatric children living with HIV/AIDS in Ethiopia. Even though undernutrition makes it difficult to combat HIV/AIDS, there is paucity of information on the magnitude of stunting and its predictors among seropositive pediatric children in low-income countries like Ethiopia. Institution based quantitative cross sectional study design was employed on 414 randomly selected pediatric (5-15 years) children living with HIV/AIDS in Harari Region and Dire Dawa City Administration Public Hospitals, Eastern Ethiopia. Pretested interviewer administered questionnaire and patient card review was held to collect data. Data were entered through Epi-data and exported to SPSS for analysis. The WHO Anthros plus software was used to calculate the anthropometric indices. Bivariate and Multivariable analysis along with 95%CI were done to identify predictors of stunting. Level of statistical significance was declared at P-value <0.05. The prevalence of stunting was found to be 30.9% (95%CI: 26.0-36.0%). Rural residence [AOR=4.0, (95%CI: 2.22, 7.17)], family monthly income of ≤500 ETB [AOR=5.79, (95%CI: 2.82, 11.60)], being anemic [AOR=3.17, (95% CI: 2.13, 4.93)] and the presence of diarrhea [AOR=6.21, 95% (CI: 3.39, 9.24)] were predictors of stunting. Thus, collaborative measures should be undertaken (to decrease frequent infections and to improve the economic status) to combat chronic malnutrition during HIV/AIDS treatment.

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