Background: In Myanmar, HIV seropositive children are being enrolled in an integrated HIV care (IHC) Program for HIV treatment and care since 2005. Objectives: To assess the: (a) attrition (death or loss-to-follow-up) rates among children (aged ≥ 18 months to < 15 years) enrolled into the programme before and after initiation of anti-retroviral therapy (ART) (pre-ART and ART periods); (b) demographic and clinical factors associated with attrition during these two periods. Methods: Children enrolled in IHC Programme and their status (death, lost to follow-up, regular follow-up or transferred out) was assessed as on 30 June 2017. Attrition rates (per 100 person-years) at pre – ART and ART periods were calculated and the association between demographic and clinical characteristics with attrition was assessed using Cox proportional hazards model. Results: Among 2,736 children enrolled, pre-ART attrition rate was 19 per 100 person-years of follow-up (95% CI: 17–21) and ART attrition rate was 4 per 100 person-years of follow-up (95% CI: 3–4) with higher levels during the initial few months of enrolment. The 36-month retention rates during pre-ART period was 75% (95% CI: 72–78) and during ART period was 87% (95% CI: 86–88). The children ‘at enrolment’ with relatively lower levels of haemoglobin, immune deficiency, underweight for age, higher WHO clinical stages, presence of hepatitis B infection had higher hazards of attrition in both periods. Conclusion: The attrition rates are high particularly among children with relatively poorer clinical, nutritional profiles at enrolment. The study suggests the urgent need for improving adherence counselling especially during the initial few months of enrolment and early ART initiation.

Gender-based violence (GBV) and poor mental health have received particular attention among healthcare professionals, policymakers, and researchers amid the COVID-19 pandemic. This paper presents a review of available literature to understand the dynamics of GBV and its mental health impact in the context of COVID-19. Confinement and control by abusive partners, social and economic disruption, and restricted access to healthcare services were identified as the main contributing factors of GBV. The paper elaborates on the contribution of broader socioeconomic determinants of health as well as cultural and societal factors of victimization in shaping GBV by placing specific populations or individuals in a more vulnerable position within the society based on their gender. Socioeconomic determinants included socioeconomic status, education, migration and racial, ethnic, or gender-based minoritisation. Cultural and societal factors of victimization are mostly related to gender-based structural power discrepancies and communication patterns. Evidence suggests a complex relationship between COVID-19 specific stressors, such as health anxiety and intolerance of uncertainty, GBV, and mental health issues. COVID-19 stressors might directly trigger the mechanism of aggression and cause physical or psychological violence and associated mental health implications in victims, or it might be mediated by pre-existing mental health issues experienced by perpetrators. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.17-25

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This study explored the effect of problem-based learning and motivation toward learning outcomes of the subject of computer routing network. Computer routing network is part of the subject of computer network design in a computer network engineering class. The purpose of this study was to examine the difference in learning outcomes between students treated with the problems based learning model and treated with direct learning model by considering students’ learning motivation. This study was categorized as quasi-experimental designed with a factorial experimental design. The sampling technique used purpose-sampling. The data were analyzed using a two-way Anava method. The results of the study showed that (1) the learning outcomes of students in the subject of routing network with problem-based learning model was better than the student treated with direct instruction learning, (2) based on the learning outcomes in the subject of routing network, a group of students with high motivation was better, and (3) there is an interaction between the application of problem-based-learning model and motivation to the students learning outcomes.