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IntroductionMycobacterium tuberculosis remains the main cause of death as an infectious agent of Tuberculosis in humans, particularly in resource-poor settings. Worldwide, Tuberculosis is one of the top 10 causes of mortality.Objective of the studyThis study aims to determine the outcomes of TB treatment and assess the factors associated with unsuccessful TB treatment outcome among TB/HIV co-infected patients in Rwanda.MethodsThis was a retrospective cohort study of all TB/HIV co-infected patients reported in the national electronic TB reporting system (e-TB) by all health facilities from July 2019 to June 2020. Frequencies, proportions, bivariate and multivariate logistic regression were performed to determine factors associated with unsuccessful TB treatment.ResultsThere were 1,144 people reported in the e-TB, however, only 987 were included in the study because 157 patients did not meet the inclusion criteria.The TB/HIV co-infected patients who were not given nutritional support, OR 7.3, 95%CI [1.4, 37.6] and those who were not on ART,OR15.3, 95%CI [3.6, 69.6],were more likely to have unsuccessful treatment outcome than their counterparts.ConclusionUnsuccessful TB treatment outcomes were highly observed among TB/HIV co-infected patients. The study recommended reinforcing nutritional support and early initiation of ART among TB/HIV co-infected patients.Rwanda J Med Health Sci 2023;6(1):17-26

Background Human Immunodeficiency Virus (HIV) is among the highest health crises that humanity ever confronted and it causes progressive weakening of the immune system leading to opportunistic infections (OIs) or malignancies during the natural course of the disease. This study aimed at assessing the prevalence and factors associated with the occurrence of OIs among adult PLWHIV on antiretroviral therapy (ART) at Ruhengeri referral hospital. Methodology A cross-sectional study was performed by reviewing records of HIV-positive adult (≥ 15 years) on ART enrolled at Ruhengeri referral hospital from 1st January 2007 to 31st December 2017. Opportunistic infections were reported based on clinical diagnosis and the prevalence of OIs was determined. Results The study reviewed records from 423 PLWHIV. Thirty-nine (9.2%) PLWHIV had been diagnosed with OIs; and frequent OIs were tuberculosis (20%), oral candidiasis, pneumonia and STI (15.6% each). The independent risk factors for developing OIs were being jobless (AOR = 5.03, 95% CI = 2.13, 32.99), spending more than five years on ART (AOR = 4.34, 95% CI = 1.12-16.78) and starting ART at WHO clinical stage III (AOR = 4.88, 95% CI = 1.65-16.78). Conclusion There is a need to strengthen the management of opportunistic infections despite the use of ART at Ruhengeri referral hospital. Rwanda J Med Health Sci 2022;5(3):323-331

Background: Prior studies indicated that post-traumatic stress disorder is becoming a global health concern even though still poorly known and treated. In the aftermath of 1994 Genocide against Tutsi, studies found high rates of depressive and anxious symptoms along with PTSD among genocide survivors. Due to the highest cruelty in which the Genocide was committed, genocide survivors still need high special humanitarian services, of those including specialized health care services. The aim of this study was to assess the efficacy of psychosocial group therapies created by AVEGA Agahozo in reducing PTSD symptoms among Genocide survivors in Rwanda, 25 years after 1994 Genocide against Tutsi.Methods: We conducted a comparative cross-sectional study design with a sample of 98 genocide survivors who received group therapy by AVEGA Agahozo. We used a multi-stage random sampling method to select participants and 7 trained psychologists interviewed genocide survivors about their PTSD status before and after treatment using Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The analysis was performed using SPSS version 17.1.Results: The results showed that women were 97.96% and men presented 2.04% of all participants because AVEGA Agahozo mainly focuses on helping women survivors who lost their husbands in Genocide and previous findings also concluded that women are very prone to suffer from PTSD than men. Paired t-test results showed significant differences between symptoms, before and after treatment (P<0.001 in all pairs). Cohen's d results also showed high effect sizes (d>0.5), only in pair 8 where the difference appears to be less significant (d=0.28). The descriptive statistics showed that the severity of PTSD symptoms dramatically reduced after treatment. But this difference of severity is only statistically significant among five (5) PTSD symptoms.: (Marked physiological reactivity after exposure to trauma-related stimuli [P=0.045, x2=38.111]; inability to recall key features of the traumatic event [P<001, x2=56.309]; persistent negative trauma-related emotions [P=0.013, x2=43.184]; self-destructive or reckless behavior [P=0.041, x2=38.535]; hypervigilance [P=0.020, x2=41.596]. Conclusion: Psychosocial group therapies created by AVEGA Agahozo effectively alleviate post-traumatic stress disorder symptoms and severity among genocide survivors.