HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.

Background: In countries with limited resources, including Ethiopia, HIV is diagnosed using a rapid serological test, which does not detect the infection during the window period. Pregnant women who test negative for HIV on the first test may seroconvert throughout pregnancy. Women who are seroconverted during pregnancy may not have received interventions, as they are considered HIV-negative unless they are retested for HIV at the end of their pregnancy. Due to limited data on HIV seroconversion, this study aimed to measure the extent of HIV seroconversion and to identify associated factors among seronegative pregnant women attending ANC in Ethiopia. Methods: Institution-based cross-sectional study was conducted among HIV-negative pregnant women attending the ANC in Ethiopia between June and July 2020. Socio-demographic, clinical, and behavioral data were collected through face-to-face questionnaires and participants' records review. HIV retesting was performed to determine the current HIV status of pregnant women. The data collected were entered into Epi data version 4.4.1 and were exported and analyzed by SPSS version 25. A p-value < 0.25 in the bivariate analysis was entered into multivariable logistic regression analysis and a p-value of < 0.05 was considered statistically significant. Result: Of the 494 pregnant women who tested negative for HIV on their first ANC test, six (1.2%) tested positive on repeat testing. Upon multivariable logistic regression, pregnant women who have had a reported history of sexually transmitted infections [AOR = 7.98; 95% CI (1.21, 52.82)], participants' partners reported travel history for work frequently [AOR = 6.00; 95% CI (1.09, 32.99)], and sexually abused pregnant women [AOR = 7.82; 95% CI (1.194, 51.24)] were significantly associated with HIV seroconversion. Conclusion: The seroconversion rate in this study indicates that pregnant women who are HIV-negative in early pregnancy are at an ongoing risk of seroconversion throughout their pregnancy. Thus, this study highlights the benefit of a repeat HIV testing strategy in late pregnancy, particularly when the risk of seroconversion or new infection cannot be convincingly excluded. Therefore, repeated testing of HIV-negative pregnant women in late pregnancy provides an opportunity to detect seroconverted pregnant women to enable the timely use of ART to prevent mother-to-child transmission of HIV infection.

Birth preparedness, complication readiness and other determinants of place of delivery among mothers in Goba District, Bale Zone, South East Ethiopia.

BACKGROUND: Ethiopia is one of the countries with the highest maternal mortality ratio 676/100,000 LB and the lowest skilled delivery at birth (10%) in 2011. Skilled delivery care and provision of emergency obstetric care prevents many of these deaths. Despite implementation of birth preparedness and complication readiness packages to antenatal care users since 2007 in the study area, yet an overwhelming proportion of births take place at home. The effect of birth preparedness and complication readiness on place of delivery is not well known and studied in this context. METHODS: A community based case control study preceded by initial census was conducted on a total of 358 sampled respondents (119 cases and 239 controls) who were selected using stratified two stage sampling technique. A pre-tested and standardized questionnaire with a face-to-face interview was used to collect the data, and then data was cleaned, coded and entered in to SPSS version-21 for analysis. Binary logistic regression models were run to identify predictors of place of delivery and Odds ratio with 95% CI was used to assess presence of associations at a 0.05 level of significance. RESULTS: The mean (± Standard Deviation) age of respondents was; 27.41(±5.8) and 28.84(±5.7) years for the cases and the controls respectively. Two third (67.1%) of the childbirths took place in the respondents house while only (32.9%) gave birth in health facilities. Great proportion (79.7%) of the cases and two third (34.0%) of the controls were well-prepared for birth and complication. Maternal education, religion, distance from health facility, knowledge of availability of ambulance transport and history of obstetric complication were significantly associated with place of delivery (P-value <0.01). Birth preparedness and complication readiness practice had an independent effect on place of delivery (AOR =2.55, 95% CI: 1.12, 5.84). CONCLUSION: The study identified better institutional delivery service utilization by mothers who were well-prepared for birth and complication. Strategies that increase the preparedness of mothers for birth and complication ahead of childbirth are recommended to improve institutional delivery service utilization.

Perspectives on optimization of vaccination and immunization of Ethiopian children/women: what should and can we further do? Why and how?

BACKGROUND: Vaccination and immunization of children and child-bearing women, in particular, is uniquely important public health intervention Ethiopia inclusive. In spite of the promising progresses, much is desired toward the ultimate optimization, effectiveness and protection. OBJECTIVES: This analytical discourse-recourse piece of work aimed at flagging the optimization perspectives on the basis of readily available information. CONTEXT, MATERIALS AND METHODS: The study emerged consequent to the review and capacity enhancement workshop of experts on Reaching Every District (RED) strategy of the Eastern and Southern African countries which was hosted by the WHO Afro Country Support Team for Eastern and Southern Africa in Harare, Zimbabwe, 28 February, - 03, March 2012. The study, essentially, is a qualitative analytical review of the pertinent literature with a particular focus on Ethiopia. Both peer reviewed and published and gray (unpublished) pertinent literature were solicited and reviewed systematically. The analytical discourse focused on performance progresses, achievements, opportunities, gaps/shortcomings, challenges and threats and perspectives. Vaccination-immunization performance evidences which were consolidated by the WHO Afro Country Support Team served the starting point to the central analytical discussion. KEY FINDINGS AND REFLECTIONS: Without underestimating the progresses and successes registered thus far, however, there indeed are quite many areas that warrant further discourse and/or recourse in Ethiopia in particular. Compared with other member countries, the size of the unimmunized, reporting quality, fragileness of systems, weak capacity, resource limitation, and others in particular respect to Ethiopia deserve further concerted attention. Districts with under 80% DPT3 coverage were still too many for Ethiopia by 2010/11. Whilst the challenges appeared prevalent, but more so effective and maximal use of the readily available opportunities appeared even more crucial. CONCLUSIONS: Further and dynamic optimization is desired more than ever before. Presumably promising and realistic enough recommendation perspectives are duly highlighted.