No abstract

Background Malnutrition is very common in HIV-infected individuals. Even though data from different settings are necessary to tackle it, pieces of evidence are limited especially in the case of the nutritional status of HIV-infected children. Hence, this study aims to assess the nutritional status and associated factors among children on antiretroviral therapy. Methods An institutional-based cross-sectional study was conducted among 383 HIV-positive children in Southern Ethiopia. Data were collected using an interviewer-administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25. Bi-variable and multi-variable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values <0.05 in multi-variable logistic regression were considered as statistically significant. Results The prevalence of wasting among HIV-positive children in Southern Ethiopiaselected Hospitals was 36.3% (95% CI, 31.6–41.0) while stunting on the same study population was 5.5% (95% CI, 3.4–7.8). Rural residence, lack of maternal education, low CD4 counts (< 500), using an unprotected water source, having a non-biological mother and recurrent oral lesion were significantly associated with wasting. Furthermore, history of hospital admission, recurrent oral lesion, low CD4 counts (< 500), advanced WHO clinical stage were statically associated with stunting with p-value < 0.05. Conclusion This study found that the prevalence of under-nutrition among HIV-positive children in Ethiopia was significantly high. Therefore, timely identification and monitoring of nutritional problems should be necessary to enhance the effectiveness of ART treatment and to prevent further related complications.

Background As the use of antiretroviral therapy (ART) increases, the issue of treatment failure is still a global challenge, particularly in a resource limited settings including Ethiopia. The results of former studies in Ethiopia were highly variable and inconsistent across studies. Thus, this systematic review and meta-analysis intended to provide the pooled estimation of treatment failure and associated factors among children on antiretroviral therapy. Methods We searched international databases (i.e., PubMed, Google Scholar, Web of Science, Ethiopian Universities’ online repository library, Scopus, and the Cochrane Library) during the period of February 30 to April 7, 2021. All identified observational studies reporting the proportion of treatment failure among HIV positive children in Ethiopia were included. Heterogeneity of the studies was checked using I2 test and Cochrane Q test statistics. We run Begg’s regression test to assess publication bias. A random-effects meta-analysis model was performed to estimate the pooled prevalence of treatment failure. Results The estimated pooled prevalence of treatment failure among children in Ethiopia was 12.34 (95%CI: 8.59, 16.10). Subgroup analysis of this review showed that the highest prevalence was observed in Addis Ababa (15.92%), followed by Oromia region (14.47%). Poor ART adherence (AOR = 2.53, CI: 2.03, 4.97), advanced WHO clinical staging (AOR = 1.66, CI: 1.24, 3.21), and opportunistic infections (AOR = 2.64 CI: 2.19, 4.31 were found to be significantly associated factors with childhood treatment failure. Conclusions This study revealed that treatment failure among children on ART was high in Ethiopia. Poor ART adherence, advanced WHO clinical staging, opportunistic infections, and low level of CD4 cell counts increased the risk of treatment failure.

Background: Malnutrition is very common in HIV infected individual due to decreased food intake, altering digestion, absorption and altering metabolism and by increasing energy need. Even though data from different settings are necessary to tackle it, evidences are limited especially in case of nutritional status of HIV-infected children. Hence, this study aims to assess the nutritional status and associated factors among children on antiretroviral therapy. Methods: An institutional-based cross-sectional study was conducted among 383 HIV-positive children in Southern Ethiopia. Data were collected using interviewer administered questionnaire and anthropometry measurement. Data were coded and entered into Epi-Data Version 3.1, and analyzed using SPSS Version 25. Bivariable and multivariable binary logistic regression models were used to identify factors associated with nutritional status and variables with p-values ˂0.05 in multivariable logistic regression were considered as statistically significant factors.Results: The prevalence of wasting among HIV positive children in Southern Ethiopia selected Hospitals was 36.3% (95% CI: 31.6, 41.0), while stunting on the same study population was 5.5% (95% CI: 3.4, 7.8). Rural residence (AOR = 4.1, CI: 2.0, 8.4), lack of maternal education (AOR =9.3, CI: 5.0, 17.3), low CD4 counts (<500) (AOR =4.9, CI: 2.3, 10.4), using unprotected water source (AOR = 3.2, CI: 1.8, 5.8), having non-biological mother (AOR =4.2, CI: 1.9, 9.2) and recurrent oral lesion (AOR =2.2, CI:1.2, 4.2) were significantly associated with wasting. Furthermore, history of hospital admission (AOR =4.9, CI: 1.6, 15.0), recurrent oral lesion (AOR =3.9, CI: 1.1, 14.1), low CD4 counts (< 500) (AOR =3.5, CI: 1.0-12.0), advanced WHO clinical stage III (AOR =4.0, CI: 1.1, 14.2) were statically associated with stunting. Conclusion: This study found that the prevalence of under-nutrition among HIV-positive children in Ethiopia was significantly high. Rural residence, lack of maternal education, low CD4 count, recurrent oral lesion, having none-biological caretakers and unprotected source of water were significantly associated with childhood wasting. On the other hand, history of hospital admission, recurrent oral lesion, advanced WHO clinical stage and low CD4 counts were significantly associated with stunting of HIV positive children. Therefore, timely identification and monitoring of nutritional problems should be necessary to enhance the effectiveness of ART treatment and to prevent further related complications.

Background: As the use of antiretroviral therapy (ART) increases, the issue of treatment failure is still a global challenge, particularly in a resource limited settings including Ethiopia. The results of former studies in Ethiopia were highly variable and inconsistent across studies. Thus, this systematic review and meta-analysis intended to provide the pooled estimation of treatment failure and associated factors among children on antiretroviral therapy.Methods: We searched international databases (i.e., PubMed, Google Scholar, Web of Science, Ethiopian Universities’ online repository library, Scopus, and the Cochrane Library) during the period of February 30 to April 7, 2021. All identified observational studies reporting the proportion of treatment failure among HIV positive children in Ethiopia were included. Heterogeneity of the studies was checked using I2 test and Cochrane Q test statistics. We run Begg’s regression test to assess publication bias. A random-effects meta-analysis model was performed to estimate the pooled prevalence of treatment failure. Results: The estimated pooled prevalence of treatment failure among children in Ethiopia was 12.34 (95%CI: 8.59, 16.10). Subgroup analysis of this review showed that the highest prevalence was observed in Addis Ababa (15.92%), followed by Oromia region (14.47%). Poor ART adherence (AOR=2.53, CI: 2.03, 4.97), advanced WHO clinical staging (AOR=1.66, CI: 1.24, 3.21), and opportunistic infections (AOR= 2.64 CI: 2.19, 4.31 were found to be significantly associated factors with childhood treatment failure.Conclusion: This study revealed that treatment failure among children on ART was high in Ethiopia. Poor ART adherence, advanced WHO clinical staging, opportunistic infections, and low level of CD4 cell counts increased the risk of treatment failure.