Introduction: Timely recognition of combined antiretroviral therapy (cART) failure in resource-constrained settings is cumbersome. This study investigated the prevalence, incidence, and predictors of first-line cART failure using the virologic (plasma viral load), immunologic and clinical criteria among HIV-infected children.Methods:A retrospective cohort study of all the children who followed in Orotta National Pediatric Referral Hospital from January 2005 to December 2020 was conducted. Predictors for cART failure from baseline and follow-up characteristics were explored in unadjusted and adjusted Cox-proportional hazard regression models.Results:Out of 724 children with at least 24 weeks follow-up 279 experienced therapy failure (TF) making prevalence of 38.5% (95% CI 35-42.2), with a crude incidence of failure of 6.5 events per 100-person-years (95% CI 5.8-7.3). In the adjusted Cox proportional hazards model, independent predictors of TF were suboptimal adherence (Adjusted Hazard Ratio (AHR)=2.9, 95% CI 2.2–3.9, p < 0.001), cART backbone other than Zidovudine and Lamivudine (AHR=1.6, 95% CI 1.1–2.2, p=0.01), severe immunosuppression (AHR = 1.5, 95% CI 1–2.4, p =0.04), wasting or weight for height z < -2 (AHR = 1.5, 95% CI 1.1–2.1, p =0.02), late cART initiation calendar years (AHR =1.15, 95% CI 1.1-1.3, p < 0.001), and older age at cART initiation (AHR =1.01, 95% CI 1-1.02, p < 0.001).Conclusions:Seven in hundred children on first-line cART are likely to develop TF every year. Efforts should be made in; exploring factors associated with suboptimal adherence, adherence support, and integrating nutritional care into the clinic. Empowering the setup with the capacity to perform viral loads regularly and studies on resistance-associated mutations (RAMs) would increase the likelihood of early detection and timely management of TF.

Background: The objective of this study was to estimate the prevalence of dyslipidemias and associated factors in adults (≥35 to ≤ 85 years) living in Asmara, Eritrea. Methods: A total of 384 (144 (%) males and 242 (%) females, mean age ± SD, 68.06±6.16 years) respondents were randomly selected after stratified multistage sampling. The WHO NCD STEPS instrument version 3.1 questionnaire was used to collect data. Measurements/or analysis including anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) were also undertaken. Results: The frequency of dyslipidemia in this population was disproportionately high (87.4%) with the worst affected subgroup in the 51-60 age band. The level of awareness was also low. In terms of individual lipid markers, the proportion were as follows: HDL-C (40 mg/dL men and 50 mg/dL females) (55.2%); TC ≥ 200 mg/d (49.7%); LDL≥130 mg/dL (44.8%); TG≥150 mg/dL (38.1%). The mean ± SD, for HDL-C, TC, LDL-C, non-HDL-C, and TG were 45.28±9.60; 205.24±45.77; 130.77±36.15; 160.22±42.09 and 144.5±61.26 mg/dl, respectively. Regarding NCEP ATP III risk criteria, 17.6%, 19.4%, 16.3%, 19.7%, and 54.7% were in high or very high-risk categories for TC, Non-HDL-C, TG, LDL-C, and HDL-C, respectively. Among all respondents, 59.6% had mixed dyslipidemias with TC+TG+LDL-C dominating. In addition, 27.3%, 28.04%, 23.0%, and 8.6% had abnormalities in 1, 2, 3 and 4 lipid abnormalities, respectively. In terms of Framingham CVD Risk scores, 12.7%, 2.8% were in the high risk and very high-risk strata. Further, the high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (71.8%), BMI≥25 kg/m2 (44.6%), dysglycemia (24.7%), hypertension (24.4%), and physical inactivity. Dyslipidemia was associated with employment status (ref: unemployed vs. employed, aOR 0.48, 95% CI 0.24–0.97, p=0.015) and self-employed (aOR 0.41, 95% CI 0.17–1.00, p=0.018); marital status (ref: not married vs married (aOR 2.35, 95% CI 1.19–4.66, p=0.009); increasing DBP (aOR 1.04 mmHg (1.00-1.09)=0.001) and increasing FPG (aOR 1.02 per 1 mg/dL, 95% CI 1.00–1.05, p=0.001). Conclusion: High frequency of poor lipid health may be a prominent contributor to the high burden of CVDs – related mortality and morbidity in Asmara, Eritrea. Consequently, efforts directed at early detection, and evidence-based interventions are warranted.