BackgroundAccess to free antiretroviral therapy in Sub-Saharan Africa has been steadily increasing. The success of large-scale antiretroviral therapy programs depends on early initiation of HIV/AIDs care. The purpose of the study was to examine factors associated with late presentation to HIV/AIDS care.MethodsA case-control study was conducted in Dessie referral and Borumeda district hospitals from March 1 to 31, 2010, northern Ethiopia. A total of 320 study participants (160 cases and 160 controls) were included in the study. Cases were people living with HIV/AIDS (PLHA) who had a WHO clinical stage of III or IV or a CD4 lymphocyte count of less than 200/uL at the time of the first presentation to antiretroviral treatment (ART) clinics. Controls were PLHA who had WHO stage I or II or a CD4 lymphocyte count of 200/uL or more irrespective of clinical staging at the time of first presentation to the ART clinics of the hospitals cases and controls were interviewed by trained nurses using a pre-tested and structured questionnaire. In-depth interviews were conducted with ten health workers and eight PLHA.ResultsPLHA who live with their families [OR = 3.29, 95%CI: 1.28-8.45)], lived in a rented house [OR = 2.52, 95%CI: 1.09-5.79], non-pregnant women [OR = 9.3, 95% CI: 1.93-44.82], who perceived ART have many side effects [OR = 6.23, 95%CI:1.63,23.82)], who perceived HIV as stigmatizing disease [OR = 3.1, 95% CI: 1.09-8.76], who tested with sickness/symptoms [OR = 2.62, 95% CI: 1.26-5.44], who did not disclose their HIV status for their partner [OR = 2.78, 95% CI: 1.02-7.56], frequent alcohol users [OR = 3.55, 95% CI: 1.63-7.71] and who spent more than 120 months with partner at HIV diagnosis[OR = 5.86, 95% CI: 1.35-25.41] were significantly associated with late presentation to HIV/AIDS care. The qualitative finding revealed low awareness, non-disclosure, perceived ART side effects and HIV stigma were the major barriers for late presentation to HIV/AIDS care.ConclusionsEfforts to increase early initiation of HIV/AIDS care should focus on addressing patient's concerns such as stigma, drug side effects and disclosure.

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Introduction Hypertension is the leading cause of morbidity and mortality and accounts for 13% of all deaths and 7% of the disease burden in the world. Although the importance of controlling hypertension has been recognized for many years, the majority of patients with hypertension remain uncontrolled. Studies indicate a very low adherence to lifestyle modifications among patients in the study area. Hypertensive patients face set of problems associated with adherence to antihypertensive drugs and healthy lifestyle modifications. Objective The objective of the study was to explore barriers to hypertension treatment and control from healthcare workers’ perspective and experiences at Dessie Referral Hospital, Ethiopia. Methods Seven healthcare workers actively involved in managing hypertensive individuals at Dessie Referral Hospital were recruited for the study. Participants were purposively selected from outpatient, inpatient, and pharmacy departments. The required data were collected by the principal investigator on exit interviews. An interview guide was developed by reviewing previous literature. Interviews were semi-structured, 8–20 minutes in duration, and designed to elicit healthcare workers’experiences and perceptions and conducted until data saturation was reached. All interviews were recorded, transcribed verbatim, and thematically analyzed. Each theme was supported by using the participants’ quotes. Results Three themes emerged. The major barriers impacted patients’ medication adherence and healthy lifestyle modifications were common use of diets during social settings, low level of awareness, lack of resources, misconceptions about hypertension, use of traditional medicines, inadequate physical activities, and high cost of drugs. Conclusion Patients’ misconceptions about hypertension, common use of diets during festivals, and inadequate physical activities were factors associated with inadequate blood pressure control. Healthcare workers should better understand the problems that hypertensive patients’ face, thus achieving better control.

Globally, tuberculosis (TB) and anemia are public health problems related with high morbidity and mortality. Furthermore, anemia is frequently manifested among people with TB in Africa, prevalence ranging from 25 to 99%. The presence of anemia is associated with an increase in individuals’ susceptibility to TB and poor treatment outcomes. Studies have reported heterogeneous estimate of prevalence of anemia among people with TB in Africa. This review aimed to estimate the prevalence of anemia among newly diagnosed people with TB n Africa. We searched studies in Medline/PubMed, Cochrane library, ScienceDirect, JBI database, the Web of Science, Google Scholar, WorldCat, Open Grey, Scopus, Agency for Healthcare Research and Quality, ProQuest, and African Journals Online that reported the prevalence of anemia at TB diagnosis. Two reviewers performed data extraction with pre-defined inclusion criteria. A random-effects logistic regression model was used to pool the prevalence of anemia and levels of anemia with a 95% confidence interval (CI) in STATA version 14. Heterogeneity and publication biases were explored. A total of 1408 studies were initially identified, and seventeen studies with 4555 people with TB were included in the analysis. The prevalence of anemia among people with TB in Africa was 69% (95% CI 60.57–77.51). The pooled prevalence of anemia of chronic disease was 48% (95% CI 13.31–82.75) and normocytic normochromic anemia was 32% (95% CI 13.74–50.94) while mild anemia was 34% (95% CI 20.44–46.86). Females were more anemic than males at TB diagnosis in Africa (74% vs. 66%). The finding indicates that anemia is a common co-morbidity present among people with TB, especially among females. Mild anemia and normocytic normochromic anemia were more common at TB diagnosis. The finding indicates that anemia is a common co-morbidity present among people with TB in Africa region. Hence, it is recommended to instigate a routine anemia screening at TB diagnosis to improve treatment outcomes.