Introduction There is an expansion and advancement of antiretroviral therapy. However, attrition of patients from HIV care is one of the major drivers of poor performance of HIV/AIDS programs, which leads to drug resistance, morbidity and mortality. The study aimed to assess the incidence of attrition and its predictors among adults receiving first-line antiretroviral therapy. Methods An institution-based retrospective cohort study was conducted among 634 adults receiving antiretroviral therapy, and study participants were selected using a simple random sampling technique. Data were cleaned and entered into Epi Data version 3.1 and exported to STATA 14.1 for further analysis. The predictors of attrition were identified using bivariable and multivariable Cox Proportional hazard models; then, variables at a p-value of less than 0.25 and 0.05 were included in the multivariable analysis and statistically significant, respectively. Results The total time observed was found to be 1807.08 person-years of observation with a median follow-up time of 2.67 years (IQR 1.25−4.67). The incidence rate of attrition was 8.36 (95% CI: 7.12−9.80) per 100 person-years. Significant predictors of attrition were being young age [adjusted hazard ratio (AHR) =2.0, 95% CI, (1.11−3.58)], nearest calendar year of ART initiation [AHR =2.32, 95% CI, (1.08–5.01)], bedridden functional status [AHR=3.25, 95% CI, (1.33−7.96)], WHO stage III [AHR=3.57, 95% CI, (1.58−8.06)] and stage IV [AHR=5.46, 95% CI, (1.97−15.13)], viral load result of ≤1000 [AHR=0.11, 95% CI, (0.06−0.23)], disclosure status [AHR=2.03, 95% CI, (1.22−3.37)] and adherence level of poor [AHR=3.19, 95 CI, (1.67−6.09)]. Conclusion The result of this study showed that the incidence of attrition among adults receiving antiretroviral therapy was high. However, as a standard, every client who started antiretroviral therapy should be retained. Positive predictors of attrition were young age (15–24), recent year of ART initiation, baseline functional status, advanced WHO stage III and IV, no disclosure status, fair/poor adherence whereas, viral load result of ≤1000 copies/mL had a preventive effect on attrition.

Background. Drug resistance is a universal challenge to malaria control measures. As a result, the development and discovery of new chemotherapeutic agents from medicinal plants having anti-malarial traditional claims are very important. This work, therefore, attempted to evaluate the anti-malarial activity of the aqueous root extract of E. divinorum using a rodent model of malaria. Methods. The roots of E. divinorum were extracted by hot decoction using distilled water. Anti-malarial activity of various doses (100 mg/kg, 200 mg/kg, and 600 mg/kg) of the root aqueous extract was evaluated using the 4-day suppressive test as well as curative and repository tests. Parasitemia, rectal temperature, body weight, PCV, and MST were also determined. Results. The finding showed that there were a dose-related significant parasitemia chemo-suppression and increment in survival time as compared to the negative control ( p < 0.001 ) in all tests. The chemo-suppression effect was higher at 400 mg/kg extract-treated groups in the 4-day suppressive test followed by the curative test. The lowest chemo-prophylaxis effect was observed in 100 mg/kg extract-treated groups in the repository test. Regarding the other parameters, the extract prevented weight loss, temperature drop, and hemolysis in all models but not in a consistent manner. Conclusion. The current study showed that the aqueous root extract of E. divinorum possessed a varying degree of anti-malarial activity in all three tests, with greater parasitemia suppression observed in the 4-day suppressive test. The extract produced higher parasitemia chemo-suppression and longer survival time in early infections followed by established and then residual infection.

Background A major cumbersome factor in malaria control measure is the new coming antimalarial drug resistance strains. The increase of resistance to the available marketed antimalarial agents dictates the scientific community to search new alternative antimalarial agent from traditional plants. Therefore, our study assesses the antimalarial activity of the crude root extract and solvent fraction of Sesamum indicum in mice. Methods The roots of Sesamum indicum were extracted by 80% methanol and fractionated using three solvents with different polarities. The in vivo antimalarial activity was assessed at 200 mg/kg, 400 mg/kg, and 600 mg/kg of the root crude extract and solvent fraction using the 4-day suppressive test. Similarly, the n- butanol fraction extract, which showed better suppression potential in 4-day suppressive test from other fractions was also evaluated in the curative model to assess its curative potential. The % parasitemia suppression, mean survival time, body weight change, rectal temperature change, and packed cell volume change were also evaluated in both models. Results Our finding revealed that the crude extract and solvent fraction treated groups had a statistical significant parasitemia suppression and mean survival time improvement as compared to the negative control (p<0.001) in both models in a dose-dependent fashion. The higher dose n-butanol fraction treated group (600mg/kg) showed the highest suppression effect and mean survival time prolongation in both tests from the other two fractions. However, the lowest suppressive effect was observed in 200 mg/kg aqueous fraction extract-treated groups in the 4-day suppressive test. Conclusion The crude root extract and solvent fractions of Sesamum indicum possessed a dose dependent antimalarial activity and a significant change in other parameters in both models that strengthen the traditional claim.

Background Self-medication is a worldwide issue that requires special attention due to the potentially harmful effects it can have not only on pregnant women but also on the fetus. Objectives This study assessed the magnitude of self-medication practice and associated factors among pregnant women following antenatal care (ANC) in primary healthcare settings in the North Wollo Zone of Ethiopia. Methods An institutional-based cross-sectional study was conducted on 395 pregnant mothers who attended ANC follow-up in selected health centers in the North Wollo Zone of Ethiopia from April 20 to May 20, 2021. A multi-stage sampling method was employed to enroll participants. A face-to-face structured interview was conducted to collect the data. A logistic regression analysis was used to determine the factors associated with self-medication practice. A p value < 0.05 at the 95% confidence level was considered statistically significant. Results Out of a total of 444 participants approached, 395 (89%) participated in the study. Of these, 44.6% reported practicing self-medication during the current pregnancy. Age < 35 (AOR = 2.18, 95% CI 1.02–9.15; p = 0.032), rural residence (AOR = 3.01, 95% CI 1.43–10.19; p = 0.017), and previous medication use (AOR = 5.02, 95% CI 1.24–12.93; p = 0.015) were found to have a significant association with self-medication practice. Conclusion Self-medication was highly prevalent among pregnant women in the study setting and result indicates need for critical action. Younger rural women with a history of self-medication use should be provided counselling to find a prescription medication, and measures are needed to minimize self-medication related harm in pregnant women.

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