BackgroundBecause of the shared mean of transmission, hepatitis B virus (HBV) is one of an important cause of co-morbidity and mortality in peoples living with HIV/AIDS. Hence, the aim of this study was to determine the sero-prevalence of HBV infection and associated risk factors in HIV/AIDS positive individuals attending ART clinic at Mekelle hospital, Mekelle, Northern Ethiopia.MethodsA cross sectional study was conducted from August to October 2014 in HIV/AIDS positive adult individuals. Socio-demographic data and other explanatory variables were collected from 508 study participants using pre-tested and structured questionnaire-based interviews. Serum hepatitis B surface antigen (HBsAg) was detected using commercially available rapid test and third generation enzyme-linked immunosorbent assay (ELISA). Bivariate and multivariate analysis, using SPSS V.20.0, were performed to assess the variables associated with HBV infection and P value less than 0.05 was considered as statistically significant.ResultsA total of 508 study participants, 305 females and 203 males were included in this study with the mean (+SD) age of 37.8 + 9.6. The sero-prevalence of HBsAg was 5.9 %. Male gender (AOR = 2.6, 95 % CI 1.2–5.7), multiple sexual partners (AOR = 4.2, 95 % CI 1.3–13.1) and CD4 count <200 cells/μl (AOR = 3.5, 95 % CI 1.1–11.2) were significantly associated with HBsAg positivity.ConclusionThe prevalence of HBsAg was similar to the general population. However, HIV/AIDS positive individuals with reduced CD4 count, <200 cells/μl, showed a significant association with HBsAg seropositivity. Therefore, we recommended, all HIV/AIDS positive individuals should be screened for HBsAg during their follow for better treatment outcome and minimize risks of HBV transmission.
Background Sputum culture conversion status is a cardinal index of treatment response and patient outcome for MDR TB patients on longer anti-TB drugs. But, there is limited information on time to sputum culture conversion of MDR TB patients on a longer anti-TB treatment regimen. Therefore, this study aimed to evaluate time to sputum culture conversion and its predictors among MDR TB patients in Tigray, Northern Ethiopia. Methods A retrospective cohort study was conducted from January 2017 through September 2020 among MDR TB patients in Tigray, Northern Ethiopia. Demographic and clinical characteristics including bacteriological data were extracted from the TB registration book and electronic database in Tigray Health Research Institute. Statistical analysis was performed using SPSS version 25. The time to initial sputum culture conversion was analyzed using the Kaplan–Meier method. Bivariate and multivariate Cox proportional hazards regression analyses were used to identify predictors for culture conversions. P <0.05 was considered statistically significant. Results A total of 294 eligible study participants with a median age of 30 years (IQR: 22.75–40) were included. The participants were followed for a total of 1066.7 person months. Sputum culture conversion was achieved in 269 (91%) of the study participants. The median time of sputum culture conversion was 64 days (IQR: 49–86). In our multivariate model, HIV-positive (aHR=1.529, 95% CI: 1.096–2.132, P=0.012), patients new to anti-TB treatment (aHR=2.093, 95% CI: 1.100–3.982, P=0.024) and baseline AFB smear grading of +1 (aHR=1.982, 95% CI: 1.428–2.750, P=0.001) significantly affected time to initial sputum culture conversion. Conclusion The median time of culture conversion was 64 days. Moreover, the majority of the study participants achieved culture conversion within the first six months of treatment commencement, which supports predefined standard treatment durations.
Introduction Tuberculosis disease is the leading cause of death worldwide along with HIV/AIDS. Sputum smear microscopy plays an essential role for initial TB diagnosis and treatment follow up. But, misdiagnosis of sputum smear microscopy revealed a high economical crisis and missing of active TB cases. This study was aimed to determine blinded rechecking of sputum smear microscopy performance in public health facilities in Tigray region, Northern Ethiopia. Materials and methods A cross sectional retrospective study was conducted from January, 2017 to December, 2018 year. Data was collected retrospectively using electronic and paper based in Tigray health research institute. The data was analyzed using the SPSS version 25 software. The sensitivity, specificity, positive predictive value, and negative predictive value of the smear readings were calculated using 2X2 contingency table. The reading agreement between the microscopic center and reference center was determined using kappa statistics. Results A total of 23,456 blinded rechecked smear results were reviewed. In average, the performances of sputum smear quality were 61%, 68%, 64%, 66%, 62% and 75% for specimen quality, staining quality, smear size, smear thickness, smear evenness and smear cleanliness respectively. Of the total error (0.48%) reported, 0.25%, 0.19% and 0.085% were false positive, false negative and quantification errors respectively. The concordance rate of health facilities for smear reading was increased to 90% by the end of 2018. Overall, the sensitivity, specificity, PPV, and NPV of the smear readings were 95%, 99.7%, 93% and 99.8% respectively. Likewise, the smear reading agreement was also perfect with kappa value, 0.87.
Background: With the advent of antiretroviral treatment, HIV related morbidity and mortality have tremendously decreased. However, some HIV patients on ART don’t optimally respond to the ART regimen to restore the immunity. This study was aimed to determine the pattern of CD4+ T cell recovery and determinants of HIV infected individuals receiving the ART in Mekelle Hospital, Tigray northern Ethiopia. Methods: A hospital based retrospective cross-sectional study was conducted from January, 2010 to August, July 2020 among HIV positive individuals on ART follow up. Data were collected using pre-tested structured questionnaire by trained data collector. Statistical analysis was performed using SPSS V. 20. Bivariate and multivariate analyses were performed to identify the possible predictors for immune reconstitution after ART administration. P-values < 0.05 was considered statistically significant. Results: Of the total 424 study participants, 248(58%) were females. The mean age of the study participants was 37+9 (mean + sd). The median time of ART follow up was 60 (IQR: 36-84) months and the recent median CD4+ T-cell count was 388 (IQR; 254-527) cells/µl. The CD4 cell count increment compared to pre-ART was 166 cells/µl of blood. Age ranges 25-34 years (AOR 2.62, 95%CI: 0.82-8.35), CD4+ T-cell count >200 cells/µl at baseline (AOR 3.53, 95%CI: 2.23-5.58), duration of ART follow up at 12, 48 and 49 and above months respectively (AOR 8.053, 95%CI:1.45-44.84; 4.82, 95%CI:1.16-20.11); and (AOR 6.36, 95%CI:1.63-24.77), and TDF-3CT-Efv ART regimen combination (AOR 2.29, 95%CI:1.32-3.97) were found predictors significantly associated with CD4+ T-cell recovery after long term ART uptake, which characterized by >350 cells/µl increments. Conclusions: The immune restoration of HIV positive individuals depends on the length of ART follow up time and CD4+ T-cell level during the initiation. Moreover, individuals who were taking TDF-3CT-Efv ART drug combination demonstrated a rapid CD4+ T-cell restoration than these who were taking other ART drug regimens.
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