Introduction: Efforts have been made to reduce HIV/AIDS-related mortality by delivering antiretroviral therapy (ART) treatment. However, HIV patients in resource-poor settings are still dying, even if they are on ART treatment. This study aimed to explore the factors associated with HIV/AIDS-related mortality in Southwestern Ethiopia. Method: A non-concurrent retrospective cohort study which collected data from the clinical records of adult HIV/AIDS patients, who initiated ART treatment and were followed between January 2006 and December 2010, was conducted, to explore the factors associated with HIV/AIDS-related mortality at Jimma University Specialized Hospital (JUSH). Survival times (i.e., the time from the onset of ART treatment to the death or censoring) and different characteristics of patients were retrospectively examined. A best-fit model was chosen for the survival data, after the comparison between native semi-parametric Cox regression and parametric survival models (i.e., exponential, Weibull, and log-logistic). Result: A total of 456 HIV patients were included in the study, mostly females (312, 68.4%), with a median age of 30 years (inter-quartile range (IQR): 23–37 years). Estimated follow-up until December 2010 accounted for 1245 person-years at risk (PYAR) and resulted in 66 (14.5%) deaths and 390 censored individuals, representing a median survival time of 34.0 months ( IQR: 22.8–42.0 months). The overall mortality rate was 5.3/100 PYAR: 6.5/100 PYAR for males and 4.8/100 PYAR for females. The Weibull survival model was the best model for fitting the data (lowest AIC). The main factors associated with mortality were: baseline age (>35 years old, AHR = 3.8, 95% CI: 1.6–9.1), baseline weight (AHR = 0.93, 95% CI: 0.90–0.97), baseline WHO stage IV (AHR = 6.2, 95% CI: 2.2–14.2), and low adherence to ART treatment (AHR = 4.2, 95% CI: 2.5–7.1). Conclusion: An effective reduction in HIV/AIDS mortality could be achieved through timely ART treatment onset and maintaining high levels of treatment adherence.
BackgroundThe identification of epidemiological pattern of infection with Plasmodium falciparum and Plasmodium vivax in malaria-endemic area, where multiple episodes are common, is important for intervention programmes.MethodsA longitudinal cohort study based on weekly house-to-house visits was conducted between July 2008 and June 2010 in 2040 children less than 10 years of age, living nearby the Gilgel-Gibe hydroelectric power dam reservoir in order to determine factors associated with increased P. vivax and P. falciparum incidence. Two types of multivariate frailty models were applied (using time-to-first malaria episode data and time-to-recurrent malaria episode data), allowing the estimation of adjusted hazard ratios (AHR) of potential risk factors (gender, age, proximity to the dam reservoir, and season) for species-specific malaria incidence.ResultsOf 2040 children in 96 weeks of follow up, 864 children experienced at least one malaria episode: 685 due to P. falciparum in 548 children, and 385 due to P. vivax in 316 children. Plasmodiumvivax and P. falciparum malaria incidence rates were 8.2 (95 % CI: 7.3–9.1) and 14.6 (95 % CI: 13.4–15.6) per 1000 children per month, respectively. According to the time-to-recurrent event models, children aged ≥7 years had a lower risk of presenting P. vivax episodes (AHR = 0.6; 95 % CI: 0.4–0.9), but a higher risk of P. falciparum episodes, when compared with children under ≤3 years (AHR = 1.2; 95 % CI: 1.1–1.6). In addition, P. vivax (AHR = 2.7; 95 % CI: 2.2–3.5) and P. falciparum (AHR = 16.9; 95 % CI: 14.3–20.2) episodes were respectively 2.7 and 16.9 times more frequent in the dry season than in the long rainy season.ConclusionsThe analysis of all malaria episodes (first and recurrent episodes) in the malaria cohort suggests different species-specific patterns of malaria disease in children, with mild seasonality in the incidence of P. vivax episodes mostly observed in younger age groups, and with marked seasonality in the incidence of P. falciparum episodes mainly seen in older children.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1253-2) contains supplementary material, which is available to authorized users.
BackgroundThis paper studies the effect of mosquito abundance and malaria incidence in the last 3 weeks, and their interaction, on the hazard of time to malaria in a previously studied cohort of children in Ethiopia.MethodsWe model the mosquito abundance and time to malaria data jointly in a Bayesian framework.ResultsWe found that the interaction of mosquito abundance and incidence plays a prominent role on malaria risk. We quantify and compare relative risks of various factors, and determine the predominant role of the interaction between incidence and mosquito abundance in describing malaria risk. Seasonal rain patterns, distance to a water source of the households, temperature and relative humidity are all significant in explaining mosquito abundance, and through this affect malaria risk.ConclusionAnalyzing jointly the time to malaria data and the mosquito abundance allows a precise comparison of factors affecting the spread of malaria. The effect of the interaction between mosquito abundances and local presence of malaria parasites has an important effect on the hazard of time to malaria, beyond abundance alone. Each additional one km away from the dam gives an average reduction of malaria relative risk of 5.7%. The importance of the interaction between abundance and incidence leads to the hypothesis that preventive intervention could advantageously target the infectious population, in addition to mosquito control, which is the typical intervention today.
Nitrogen (N) availability under no-till intercropping systems has not been widely investigated in diverse agro-ecological regions in Limpopo Province. Two seasons of rainfed experiments were conducted during 2018/19 and 2020/21 in a 2 × 4 × 2 factorial design to measure the biological nitrogen fixation (BNF) ability of cowpea in an intercropping system with four grain sorghum cultivars at two test locations, Ofcolaco and Syferkuil, of Limpopo Province using the natural abundance technique. The cowpea nitrogen isotope composition (δ 15N‰) ranged from 0.2 ‰ to 4‰ at Ofcolaco, whereas at Syferkuil, the range was 2 ‰ to 7 ‰. The N derived from air (Ndfa) was from 35% to 92% at Ofcolaco and 4% to 70% at Syferkuil during the two cropping seasons. The amount of N2 fixed across locations and seasons ranged from 1 kg ha−1 to 71 kg ha−1. In the intercropping system, cowpea fixed more N at higher densities compared with lower densities at the two experimental sites. Biomass was significantly correlated with N accumulated by cowpea (r2 > 0.9) at all locations and across seasons. N accumulated in sole cultures was 30% more at Ofcolaco and 36% more at Syferkuil compared with binary cultures. Furthermore, the treatment combination, cowpea density, as well as cropping system, significantly affected N fixation and accumulation. For high productivity, cowpea intercrop with grain sorghum cultivar Enforcer is recommended, as both crops complemented each other when intercropped. The research should investigate further the root distribution and biomass production of sorghum and cowpea, as well as their impact on N intake.
Climate change is severely disrupting ecosystem services and crop productivity, resulting in lower crop growth and yields. Studies have emphasized the importance of assessing conservation practices through crop modelling to improve cropland productivity. There is a lack of accurate information in the performance of conservation practices as well as data for improved crop modelling. No-tillage sorghum–cowpea intercrop experiments were established to assess the productivity of four sorghum cultivars and cowpea at two densities of 37,037 and 74,074 per plants and generate data for improved crop modelling. The leaf area index (LAI) varied in sorghum cultivars and cowpea densities during the two growing seasons. Cultivars Enforcer and NS5511 produced the highest grain yields of 4338 kg per ha and 2120 kg per ha, respectively, at Syferkuil. Ofcolaco’s Enforcer and Avenger were the highest yielding cultivars at Ofcolaco, with mean yields of 2625 kg per ha and 1191 kg per ha, respectively. At Syferkuil, cowpea yield was 93% and 77% more in sole compared to binary cultures during the growing seasons at Syferkuil. At Ofcolaco, sole yielded approximately 96% more grain than binary. The findings confirm that for the sorghum–cowpea intercrop to improve overall system productivity, cowpea density should be increased.
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