Background A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors among adult drug resistant tuberculosis patients in the Amhara Regional State, Ethiopia. Methods An institution based cross-sectional study was conducted on all adult drug resistant tuberculosis patients who initiated treatment from September 2010 to December 2017. Data were collected from patient charts, registration books, and computer databases using abstraction sheets. The data were entered using Epi-info version 7 and exported to SPSS version 20 for analysis. Summary statistics, like means, medians, and proportions were used to present it. Binary logistic regression was fitted; Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was also computed. Variables with p -value < 0.05 in the multi-variable logistic regression model was declared as significantly associated with treatment delay. Results The median time to commence treatment after drug resistant tuberculosis diagnosis was 8 (IQR: 3–37) days. Being diagnosed by Line probe assay [AOR = 5.59; 95% CI: 3.48–8.98], Culture [AOR = 5.15; 95% CI: 2.53–10.47], and history of injectable anti-TB drugs [AOR = 2.12; 95% CI: 1.41–3.19] were associated with treatment delays. Conclusion Treatment delay was long, especially among patients diagnosed by Culture or LPA and those who had a prior history of injectable anti-TB drugs. That suggested that the need for universal accesses to rapid molecular diagnostic tests, such as Gene Xpert and the PMDT team were needed to promptly decide to minimize unnecessary delays.

Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94-20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.

Introduction: Human immunodeficiency virus (HIV)-positive patients struggle with numerous social problems; they are vulnerable to repeated opportunistic infections that withdraw them from regular work, which further leads to economic problems and reducing their overall quality of life. Therefore, the aim of this study was to assess health-related quality of life (HR-QoL) and associated factors among HIVpositive individuals on antiretroviral therapy at

Background Appointment spacing model (ASM) of care is crucial for HIV patients receiving antiretroviral therapy in order to improve service quality, and patient’s clinical outcomes including viral suppression. However, there is a paucity of information about the effectiveness of ASM on viral suppression. Therefore, this study aimed to assess the level and trends of virological suppression and associated factors among clients on antiretroviral therapy enrolled into ASM in northwest Ethiopia. Methods An interrupted time-series study design was conducted among 272 adults HIV clients who were stable and enrolled in ASM. They were selected by using a systematic random sampling technique. Data were collected from the patient′s charts, registration books, and computer databases using abstraction sheets. Regression coefficients with a 95% confidence interval (CI) computed and variables having less than 0.05 P-value in the segmented regression model were considered significant predictors of virological suppression. Result This study revealed that virological suppression was decreased from the baseline of 99.22–96% after the implementation of ASM. The trends of virological suppression were significantly decreased by 1.38(95%CI: -2.2, -0.5, P-value=0.0007) after the implementation of ASM. Poor adherence was the most influential variable that caused level and trend decrements over time (P-value=0.04). Conclusion The level of virological suppression was significantly reduced after the implementation of ASM. The most significant factor associated with decreased levels and trends over time was poor adherence. It would be beneficial to assess and maintain good adherence of clients on antiretroviral therapy throughout the clinical visit during the implementation of ASM.

Introduction: Drug use evaluation (DUE) is a system of ongoing, systematic criteria based evaluation of drug use that will help ensure that medicines are used appropriately at the individual patient level. Irrational drug use is numerous and complex involving the health system, prescriber, dispenser, patient and the community. Hence, this study was focused on assessing rational drug use using WHO core drug use indicators in Dilchoral Hospital (DH), Eastern Ethiopia. Methodology: A cross sectional study design was used. Data collection formatwere developed according to WHO recommendation and validated to our context. The data was processed and analyzed using EX-Cell sheet as per WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia. Result: Majority of prescriptions had patient sex (68.00%), age (65.66%), and card number (73.50%). Only small number of prescription had patient weight (1.00%), patient diagnosis (1.16%), and dispenser's signature. Among the total prescribed medicines, (37.50%) were antibiotics, (34.61%) were injections, and more than ninety percent of drugs were written by generic name and use the hospital drug list. Conclusion: Generally according to WHO guideline recommendation, most of the prescribing indicators are lower than the standards. Hence the hospital DTC collaborated with the hospital administration and staff should address the gaps. Dilchora Hospital Drug and Therapeutic committee (DTC) should promote rational prescription and dispensing practice for improved health care service and putting policy and procedure for prescribing antibiotics.