Acceptance of Human Papillomavirus Vaccination and Associated Factors among Girls in Arba Minch Town, Southern Ethiopia, 2020.

Background: Cervical cancer is Ethiopia's second biggest cause of cancer-related death among women. The introduction of human papilloma virus (HPV) vaccination is expected to have a significant impact on the burden of cervical cancer. In Ethiopia, particularly in our study area, little is known regarding girls' acceptance of HPV vaccination. Therefore, this study has assessed the acceptance of HPV vaccination and associated factors among girls in Arba Minch town, southern Ethiopia. Methods: A school-based cross-sectional study was conducted on January 1, 2020. Based on convenience, Arba Minch town was purposefully selected. Stratification was done to stratify private and public schools, then simple random sampling to select sample schools from each, and finally, a proportional allocation of sample size to each school. The determinants and independent variables that influence the acceptance of the human papillomavirus vaccination were determined using a multivariable logistic regression model. Results: This study's overall acceptance rate for study participants was 50.4% (95% CI) (45.9-55.2). Girls' age (AOR = 2.93, 95% CI (1.57_5.47), P value 0.001), mothers' educational level (secondary and more than secondary, AOR = 2.40, 95% CI (1.01_5.73), P value 0.048, and 3.64, 95% CI (1.61_8.25), P value 0.002, respectively), positive attitude (AOR = 5.22, 95% CI (2.96_9.19), Pvalue ≤ 0.001), good knowledge (AOR = 2.49, 95% CI (1.19_5.24), P value 0.001), and receiving childhood immunization (AOR = 14.85, 95% CI (8.58_25.72), Pvalue ≤ 0.001) were factors associated with girls' acceptance of the human papillomavirus vaccination. Conclusions and Recommendation. Only half of the study participants accepted HPV vaccination. Therefore, Arba Minch town health institutions should better boost the acceptance of HPV vaccination by improving the knowledge and attitudes of girls. Factors associated with girls' acceptance of HPV vaccination were age, mothers' educational status, positive attitude, knowledge of HPV vaccination, and receiving childhood immunization.

A qualitative assessment of challenges to tuberculosis management and prevention in Northern Ethiopia.

OBJECTIVE: To elicit Ethiopian health care providers' understanding of challenges to effectively preventing, diagnosing and treating tuberculosis (TB). DESIGN: Qualitative data were collected via in-depth interviews and focus group discussions with 73 providers, including physicians, nurses, pharmacists and laboratory technicians, in five hospitals in the Northern Ethiopian regions of Amhara and Tigray. There was no intervention. RESULTS: Focus groups and interviews shared a number of prominent common themes. Respondents identified numerous challenges associated with active case identification, infection control practices, diagnostics, including the absence of TB culture and drug susceptibility testing capacity, and the lack of infrastructure for diagnosing and treating multidrug-resistant TB. Pharmacists noted a need for improved procurement practices and pediatric dosages for TB medications. Providers shared concerns regarding isoniazid preventive therapy, health workforce challenges and the risk of contracting TB in the workplace. CONCLUSIONS: Health care providers in the Northern Ethiopian regions of Tigray and Amhara identified many challenges to effectively preventing, diagnosing and treating TB. These challenges are complicated by severe resource constraints and challenges in attracting and retaining providers in government hospitals in centers outside Addis Ababa.

Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study.

BACKGROUND: The current study was designed to examine whether a combination of three nutrients, consisting of beta-hydroxy-beta-methylbutyrate (HMB), a metabolite of leucine, L-glutamine (Gln) and L-arginine (Arg), each of which has been previously shown to slow muscle proteolysis, could synergistically alter the course of muscle wasting in patients with established acquired immunodeficiency syndrome (AIDS). METHODS: Sixty-eight human immunodeficiency virus (HIV)-infected patients with a documented weight loss of at least 5% in the previous 3 months were recruited from the HIV clinic at Nassau County Medical Center. The subjects were randomly assigned in a double-blind fashion to receive either placebo containing maltodextrin or the nutrient mixture (HMB/Arg/Gln) containing 3 g HMB, 14 g L-glutamine, and 14 g L-arginine given in two divided doses daily for 8 weeks. Body weights (BW) were recorded weekly and lean body mass (LBM) and fat mass (FM) were measured by air displacement plethysmography and by a single computerized tomography (CT) slice through the thigh at 0, 4, and 8 weeks. RESULTS: Forty-three subjects completed the 8-week protocol, (placebo, n = 21; HMB/Arg/Gln, n = 22). At 8 weeks, the subjects consuming the HMB/Arg/Gln mixture gained 3.0 +/- 0.5 kg of BW while those supplemented with the placebo gained 0.37 +/- 0.84 kg (p = .009). The BW gain in the HMB/Arg/Gln-treated subjects was predominantly LBM (2.55 +/- 0.75 kg) compared with the placebo-supplemented subjects who lost lean mass (-0.70 +/- 0.69 kg, p = .003). No significant change in FM gain was observed (0.43 +/- 0.83 kg for the group receiving HMB/Arg/Gln and 1.07 +/- 0.64 kg for the group receiving the placebo, p > .20). Similar percentage changes in muscle mass and fat mass were observed with CT scans. Immune status was also improved as evident by an increase in CD3 and CD8 cells and a decrease in the HIV viral load with HMB/Arg/Gln supplementation. CONCLUSIONS: The data indicate that the HMB/Arg/Gln mixture can markedly alter the course of lean tissue loss in patients with AIDS-associated wasting.

Anaerobic infections. The basics for primary care physicians.

Anaerobic bacteria constitute a major portion of the normal human microflora, and some of them can cause disease in contiguous body parts, especially if there is a mucosal break. Most anaerobic infections are polymicrobial. Because anaerobes are difficult to culture, diagnosis is often made on the basis of clinical clues. Thus, knowledge of the common sites, predisposing conditions, and other representative features of anaerobic infections is critical. For anaerobic infections above the diaphragm, where Bacteroides fragilis is not a common isolate, high-dose penicillin G therapy is usually sufficient. Addition of clindamycin (Cleocin) or metronidazole (Flagyl, Metryl, Protostat) may be necessary for serious infections. Cefoxitin sodium (Mefoxin) or clindamycin is adequate for most anaerobic infections occurring outside the central nervous system. Metronidazole, chloramphenicol, imipenem, or beta-lactam antibiotics combined with beta-lactamase inhibitors may be preferable for serious infections. Appropriate coverage for aerobic bacteria must be included in the treatment regimen. Drainage of abscesses, decompression of infected spaces, debridement of necrotic tissue, and removal of foreign bodies are critical in management of many anaerobic infections.

Branhamella infections. An increasingly common respiratory illness.

Branhamella catarrhalis is an important cause of acute sinusitis and otitis media in children and of acute tracheobronchitis in older persons with underlying chronic lung disease or a suppressed immune system. Clinical presentation of B catarrhalis infection varies from a mild, self-limiting disease to severe pneumonia, but most cases are mild to moderate in severity. Infection occurs sporadically, and endogenous spread from the oropharynx is the likely mechanism. The keys to diagnosis are a high index of clinical suspicion, correct interpretation of Gram's stain of sputum, and subsequent confirmation on culture. Because most strains of B catarrhalis produce beta lactamase, antibiotics that resist beta-lactamase production, eg, amoxicillin-clavulanic acid (Augmentin), erythromycin, ciprofloxacin (Cipro), are recommended. Mild infections can be self-limiting and may not require antibiotic therapy.