BackgroundDespite the benefits of Antiretroviral Therapy (ART), there is a growing concern of treatment failure. This study aimed to assess viral non suppression rate and factors associated with HIV viral non suppression among adolescents and adults on ART in Northern Ethiopia.MethodsA retrospective cross sectional study was done on 19,525 study subjects. All the data in the database of Tigray Health Research Institute was exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Generalized Estimating Equation (GEE) logistic regression was used for statistical modeling of viral non suppression.ResultsA total of 5153 (26.39%; 95%CI (25.77%, 27.02)) patients had no viral suppression despite being on ART. Being male (AOR = 1.27, 95% CI: 1.18, 1.37), 15–19 years of age (AOR = 4.86, 95%CI: 3.86, 6.12), patients from primary hospital (AOR = 1.26, 95%CI: 1.05, 1.52), WHO staging II (AOR = 1.31, 95%CI: 1.10, 1.54), poor ART adherence level (AOR = 2.56, 95%CI: 1.97, 3.33), fair ART adherence level (AOR = 1.61, 95%CI: 1.36, 1.90), baseline CD-4 count of < 200 cells/micro liter (AOR = 1.33, 95%CI: 1.14, 1.54), recent CD-4 count of < 200 cells/micro liter (AOR = 3.78, 95%CI: 3.34, 4.27), regimen types: 1c (AZT-3TC-NVP) (AOR = 1.32, 95%CI: 1.22, 1.44), 2 h (TDF-3TC-ATV/R) (AOR = 1.79, 95%CI: 1.27, 2.52) and declined immunological responses after ART initiation (AOR = 1.45, 95%CI: 1.30, 1.61) were significantly associated with viral non-suppression.ConclusionsThe virological non suppression was high which makes it less likely to achieve the third 90 UNAIDS target. Being male, patients with WHO staging II and poor ART adherence level were significantly associated with viral non suppression. Therefore, intensive adherence support and counseling should be provided. It is also a high time to determine the antiretroviral drugs resistance pattern given the fact that a large number of patients had virological non suppression.
ObjectiveA good self-care practice is important for patients with diabetes to achieve the desired treatment targets and to contribute meaningfully in the management of their disease. The study aimed to assess the level of knowledge, attitude and practice of diabetes self-care and to identify the factors associated with diabetes self-care.ResultsA total of 338 patients with diabetes having mean age of 45.8 years were included in the study. Among those 70.4%, 70.4% and 25.5% of the patients had a good knowledge, attitude and self-care practices, respectively. Being male (AOR = 2.7, 95% CI 1.30–5.65), living in urban (AOR = 3.37, 95% CI 1.39–8.15) and earning medium income (AOR = 2.55, 95% CI 1.15–5.65) were significantly associated with having good knowledge of self-care while being widowed (AOR = 0.15, 95% CI 0.03–0.70) was associated with having poor knowledge. Having a higher income (AOR = 7.95, 95% CI 1.54–41.12) was significantly associated with a good attitude towards diabetic self-care. However, taking both insulin and oral hypoglycemics (AOR = 0.06, 95% CI 0.01–0.67) was associated with a poor attitude. Being Muslim (AOR = 3.14, 95% CI 1.28–7.91), living in urban areas (6.47, 95% CI 1.38–30.43) and earning high income (AOR = 3.03, 95% CI 1.10–8.35) were determinant of good self-care practice. Efforts should be made to improve self-care practices of patients in closing the gap between knowledge and practice.Electronic supplementary materialThe online version of this article (10.1186/s13104-019-4072-z) contains supplementary material, which is available to authorized users.
HIV-positive individuals are at higher risk of Methicillin Resistant Staphylococcus aureus (MRSA) colonization and its related infection. There is limited data in the nation on the prevalence and risk factors of MRSA colonization among HIV patients. The aim of this study was to address the existing knowledge gap. Cross sectional study was carried out from September 2014 to February 2015 in three selected health centers and one general hospital. A standardized questionnaire was developed for collection of socio-demographic and clinical data. A total of 498 Nasal and throat swabs (two for each patient) were collected from 249 patients, transported and processed using standard bacteriological procedures. Data was analyzed using Chi square (X2) test and associated risk factors were determined. P < 0.05 was considered statistically significant. Out of 249 study participants, S. aureus was isolated from 81 (32.5 %) patients, with MRSA colonization rate of 6 (2.4 %). MRSA isolates were resistant to Ciprofloxacin and trimethoprim-sulphamethoxazole (16.7 % each), clindamycin (33.3 %) and erythromycin (50 %). However, all MRSA isolates were 100 % sensitive to Amikacin. History of hospitalization, percutaneous device usage, patients with a household member’s hospitalization and low CD4 count (<200 cells/mm3) were significantly associated with S. aureus colonization (p < 0.05).
BackgroundThis study was aimed to assess immunological recovery, failure, and factors associated with CD-4 T-cells progression over time, among adolescents and adults living with HIV on Antiretroviral Therapy in Northern Ethiopia.MethodsA retrospective cross sectional study was done on 19,525 HIV patients on ART. Data were collected using a data retrieval checklist from a database. All eligible data in the database were exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Factors associated with recent CD-4 count were modeled by using Generalized Linear Model poison family.ResultsAmong the patients with advanced HIV infection (< 200 CD-4 T-cell/ mm3) at baseline, only 28.35%, 95% CI (27.45–29.26) of them had immunological recovery (≥ 500 T-cells/mm3). Only 2.14%, 95%CI (1.94%- 2.35%) of the patients had immunological failure. Baseline CD-4 count (Incidence Rate Ratio (IRR) = 1.0007, 95%CI = 1.00069–1.00078), patients from military health care facility (IRR = 1.11, 95%CI = 1.06–1.16), good adherence (IRR = 1.12, 95%CI = 1.04–1.21) and viral load suppression (IRR = 1.31, 95%CI = 1.28–1.33) were positively associated with recent CD-4 count in the full model. Whereas, being male (IRR = 0.85, 95%CI = 0.83–0.86), patients with on Anti-Retroviral Therapy (ART) regimen of 1e (TDF-3TC-EFV), 2f (AZT-3TC-ATV/r), and 2h (TDF-3TC-ATV/r) (IRR = 0.92, 95%CI = 0.91–0.94), (IRR = 0.65, 95%CI = 0.55–0.76) and (IRR = 0.71, 95%CI = 0.63–0.81) respectively were negatively associated with the recent CD-4 count in the full model.ConclusionsImmunological recovery was achieved by 1/3 of the patients despite being on highly active ART (HAART). Therefore, intensive adherence counseling, follow-up and support should be focused on patients with viral non suppression to enhance immunological recovery.
Background: Rabies has a worldwide distribution in continental regions of Africa, Asia and the Latin America. Globally, the case fatality rate is 100% once a clinical sign is developed. Poor public awareness towards rabies is one of the major obstacles in any prevention and control scheme of the diseases. The study aimed to assess knowledge, attitude and practice (KAP) about rabies and associated factors among household heads in Mekelle city, Northern Ethiopia, 2016. Methods: A community based cross-sectional study was conducted from October to November 2016 with a total of 633 study participants. Data were collected using a pretested structured questionnaire and entered to EPI-Info 3.5.4 and coded, cleaned and analyzed using SPSS version 20 software. Bi variable and multivariable analysis was done to identify factors associated with knowledge, attitude and practice about rabies. Variables having p< 0.05 was considered as statistically significant at 95%CI. Results: Of 633 study participants, 357 (56.4%) were females and 239 (37.8%) were 18-35 years old. Among the study participants, 56.1% (95%CI=52.2, 59.9), 56.2% (95%CI=52.4, 60.1) and 61.3% (95%CI=57.5, 65.1) had good level of knowledge, attitude and practice on the prevention and control of rabies respectively. Being female (AOR=1.50, 95%CI=1.05, 2.13), dog owner (AOR=1.68, 95%CI=1.17, 2.41) and participants who had training on rabies (AOR=2.22, 95%CI=1.53, 3.21) were found to have good knowledge. Married participants (AOR=2.19, 95%CI=1.16, 4.16), participants who owned dog (AOR=2.64, 95%CI=1.80, 3.86) and those encountered dog bite (AOR=2.24, 95%CI=1.23, 4.10) were found to have positive attitude towards rabies. Similarly, dog ownership (AOR=11.85, 95%CI=7.16, 19.6) was found to be associated with good practice. Conclusion: This study showed that more than half of the respondents had good knowledge, attitude and practice about the prevention and control of rabies. Key words: Attitude, Knowledge, Practice, House hold, Rabies
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