BackgroundRetention in care and adherence to the treatment is very important for the success of the program while access for treatment is being scaled up. Without more precise data about the rate of loss to follow up as well the characteristics of those who disengage from the treatment appropriate interventions to increase ART adherence cannot be designed and implemented. Therefore the aim of this study was to determine incidence and predictors of loss to follow up among adult ART clients attending in Karamara Hospital, Jigjiga town, Eastern Ethiopia, 2015.MethodsAn institutional based retrospective cohort study were undertaken among 1439 adult people living with HIV/AIDS and attending ART clinic between September 1, 2007 and September 1, 2014 at Karamara Hospital was undertaken. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as ‘dead’ or ‘transferred-out’. A Kaplan-Meier model was used to estimate rate of time to loss to follow up and Cox proportional hazards modeling was used to identify predictors of loss to follow up among ART clients.ResultOf 1439 patients, 830(58.0%) were females in their sex. The mean age of the cohort was 33.5 years with a standard deviation of 9.33. Around 213 (14.8%) patients were defined as LTFU. The incidence rate of loss to follow up in the cohort was 26.6% (95% CI; 18.1–29.6) per 100 person months. Patients with male sex [HR: 2.1CI;(1.3–3.4)], patients whose next appointment weren’t recorded [HR: 1.2, 95% CI; (1.12–1.36)] and patients who did not disclose their status to any one [HR: 2.8, 95% CI; (2.22–5.23)] were significantly associated with LTFU in the cox proportional model.ConclusionOverall, these data suggested that LTFU in this study was high. The ART patients’ next appointment should be documented very well and as well the clients should be advised to adhere with treatment program as per the schedule. Defaulter tracing mechanism should be operational and strengthen in the health facility. Effective control measures should be designed for at-risk population such as male patients.

BackgroundTimely initiation of breastfeeding is defined as putting the newborn to the breast within one hour of birth. Significant benefits in reducing neonatal mortality and morbidity can be attained with effective promotion of timely initiation of breastfeeding and exclusive breastfeeding during the first months of life. Therefore, this study was conducted to assess timely initiation of breastfeeding and associated factors among mothers in South Gondar, Amhara regional state, Northern Ethiopia.MethodsA community based cross-sectional study was employed. A multistage stratified sampling technique was used to select the sample of 845 mothers with 97.4% response rate. Moreover, data were collected by face to face interview using a semi structured questionnaire.ResultThe prevalence of timely initiation of breastfeeding was 48.7% (54.7% in urban and 25.1% in rural areas). The odds of initiation of breastfeeding within one hour was higher for urban mothers (Adjusted Odds Ratio [AOR] 2.1; 95% Confidence Interval [CI] 1.4, 3.3), multiparous mothers (AOR 2.8; 95% CI 2.0, 3.8), mothers who had antenatal care (AOR 3.2; 95% CI 2.0, 5.2), mothers delivered in health institution (AOR 3.1; 95% CI 2.2, 4.6) and mothers delivered vaginally (AOR 4.1; 95% CI 1.7, 9.8) than their respective counterparts.ConclusionThis study depicts the rate of timely initiation of breastfeeding was low in south Gondar zone. Factors which were positively associated with timely initiation of breastfeeding include urban residence, multiparity, having antenatal care, mother deliver in health institution and vaginal mode of delivery. Therefore, South Gondar health office and healthcare providers have to provide breastfeeding information during antenatal care by giving special emphasis to rural and primiparous mothers in which timely initiation of breastfeeding is poorly practiced. Further study is needed to assess the implementation of policies on timely initiation of breastfeeding.

Background: Significant numbers of adolescents are involved in sexual activities at an early age which exposes them to the risk of unintended pregnancy, abortion and STIs. Even though, the reproductive health problem of young people is critical among both sexes, adolescent's girls are more affected because of their biological, economic and social vulnerability. Therefore, this study was designed to assess the prevalence, consequences and associated factors of premarital sex among female students in Ambo University. Methods and materials:An institutional based crosssectional study was conducted with qualitative inquiry from January to February 2015. Quantitative data were collected from 650 randomly selected female students in Ambo University using a pretested structured questionnaire. The qualitative data were generated through focus group discussions among purposely selected discussants. Odds ratio with 95% confidence interval was estimated using multivariable logistic regression to identify independent predictors of premarital sex while thematic framework analysis was employed for the qualitative data.Results: About 90 (53.9%) of sexually active respondents reported that they started sex after joining the University. Twenty Eight (16.8%) of sexually active respondents have got pregnant prior to the study period and 15(53.6%) reported history of abortion. The proportion of respondents screened for HIV/AIDS were 56.8% and among this 1.6% had positive results. In the multivariate analysis students who didn't discussed sexual related issue with their parents [AOR: 7.16;], being alcohol consumer [AOR: 3.70; 95% CI (2.04-6.73)] and attending romantic videos/films [AOR: 9.95 (7.69-49.87)] were independent predictors of premarital sex. Conclusion:Significant number of young females had started sex very early and involved in high risk sexual behavior without condom and family planning methods. These kinds of findings call for family life time education including parent-youth communication education.

BackgroundTreatment outcomes serve as proxy measures of the quality of tuberculosis treatment provided by the health care system, and it is essential to evaluate the effectiveness of Directly Observed Therapy-Short course program in controlling the disease, and reducing treatment failure, default and death. Hence, we evaluated tuberculosis treatment success rate, its trends and predictors of unsuccessful treatment outcome in Ethiopian Somali region where 85% of its population is pastoralist.MethodsA retrospective review of 5 years data (September 2009 to August 2014) was conducted to evaluate the treatment outcome of 1378 randomly selected tuberculosis patients treated in Kharamara, Dege-habour and Gode hospitals. We extracted data on socio-demographics, HIV Sero-status, tuberculosis type, treatment outcome and year using clinical chart abstraction sheet. Tuberculosis treatment outcomes were categorized into successful (cured and/or completed) and unsuccessful (died/failed/default) according to the national tuberculosis guideline. Data was entered using EpiData 3.1 and analyzed using SPSS 20. Chi-square (χ2) test and logistic regression model were used to reveal the predictors of unsuccessful treatment outcome at P ≤ 0.05 significance level.ResultThe majority of participants was male (59.1%), pulmonary smear negative (49.2%) and new cases (90.6%). The median age was 26 years [IQR: 18–40] and HIV co-infection rate was 4.6%. The overall treatment success rate was 86.8% [95%CI: 84.9% - 88.5%]; however, 4.8%, 7.6% and 0.7% of patients died, defaulted and failed to cure respectively. It fluctuated across the years and ranged from 76.9% to 94% [p < 0.001]. The odds of death/failure [AOR = 2.4; 95%CI = 1.4–3.9] and pulmonary smear positivity [AOR = 2.3; 95%CI = 1.6–3.5] were considerably higher among retreatment patients compared to new counterparts. Unsuccessful treatment outcome was significantly higher in less urbanized hospitals [p < 0.001]. Treatment success rate had insignificant difference between age groups, genders, tuberculosis types and HIV status (P > 0.05).ConclusionThis study revealed that the overall tuberculosis treatment success rate has realized the global target for 2011–2015. However, it does not guarantee its continuity as adverse treatment outcomes might unpredictably occur anytime and anywhere. Therefore, continual effort to effectively execute DOTS should be strengthened and special follow-up mechanism should be in place to monitor treatment response of retreatment cases.

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