Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: a case control study in Northern Ethiopia.

BACKGROUND: Adherence to antiretroviral treatment is critical for suppression of viral replication, reduced destruction of CD(4) cells, prevention of viral resistance, promotion of immune reconstitution and slowed disease progression. This study sought to determine the effect of nutritional factors on adherence to ART among HIV-infected adults on ART. METHODS: Matched case control study design (matched by age and sex) was employed. Data was collected from ART registration chart, pre-tested structured data extraction format, anthropometric measurements and by interview. Conditional logistic regression was used to compute the relevant associations among the variables by STATA version 10. RESULTS: From 174 paired subjects participated in the study 80 (46%) pair were males and 94 (54%) pair were females on ART for at least one year prior to the survey. The mean age (±SD) for the non-adherent was 38.4 ± 8.1 years and for the adherent subjects was 38.5 ± 8.4 years. Malnutrition with BMI less than 18.5 Kg/m(2) in the adherent group was 14 (8%) and that of the non-adherent group was 74 (42.5%) which was associated with non-adherence to ART (AOR 10.0, 95%CI 4.3 - 54.7). Inability to get enough and quality food was also associated with non-adherence to ART (AOR 2.1, 95%CI 1.1 - 11.5). CONCLUSIONS: Malnutrition, inability to get enough and/or quality food and consumption pattern which is less than three meals per day were significantly associated with non-adherence to ART. Therefore, the capacity to effectively manage the food and nutrition implications of ART adherence is a critical factor in the success of antiretroviral therapy in resource limited settings.

Adherence to Antiretroviral Therapy and Associated Factors Among HIV-Infected Children in Public Health Institutions of Adwa, Axum, and Shire Towns of Tigray, Northern Ethiopia: A Cross-Sectional Study.

Background: Antiretroviral therapy (ART) provision was among the major challenge of treatments. Maintaining the optimal level of adherence among children living with HIV/AIDS is a pivotal step towards achieving treatment success. However, there are limited studies on child's ART adherence. Therefore, this study aimed to assess the level of adherence to antiretroviral therapy and associated factors among HIV-infected children in health institutions of Adwa, Axum, and Shire towns, Tigray, Northern Ethiopia. Methods: An institutional-based cross-sectional study was conducted among human immunodeficiency virus (HIV)-infected children in between February and April, 2016. A total of 255 children who were taking antiretroviral therapy in the randomly selected three health facilities from Adwa, Axum and Shire towns were included. Data were collected using pretested and structured questionnaires using a face-to-face interview. The collected data were entered into Epi Info version 7 and then exported to SPSS version 21 for analysis. Bivariate and multivariate binary logistic regression models were used to determine the factors associated with adherence to antiretroviral therapy among HIV-infected children. Results: A total of the 255 study participants were included in the study. The level of ART adherence among HIV-positive children was 212 (84.8%). Knowledge of caregivers about ART treatment (AOR = 2.78, 95% CI: 1.18, 6.53), occupational status (AOR = 4.78, 95% CI: 1.26, 18.91), appointment to ART less than two months (AOR = 3.05, 95% CI: 1.21, 7.70) and use of memory aids (AOR = 4.58, 95% CI: 1.73, 12.13) were independently associated with adherence to ART. Conclusion: The level of adherence to antiretroviral therapy was low. Healthcare providers should reinforce adherence intervention and counseling sessions during follow-up and address the proper use of medication reminders to help children take their drugs appropriately.

Magnitude and Determinant Factors of Surgical Site Infection in Suhul Hospital Tigrai, Northern Ethiopia: A Cross-Sectional Study.

BACKGROUND: Surgical site infections (SSIs) are the most common hospital-acquired infection among surgical patients and remains a major clinical issue. In Ethiopia, despite many studies, the magnitude and associated factors of SSIs are not well documented and differ among regions. The aim of this study was to identify the magnitude and associated factors of SSIs in Suhul Hospital, Northern Ethiopia. METHODS: An institution-based cross-sectional study was conducted from February 2-March 31, 2016, in Shire Suhul Hospital. A total of 280 post-operative patients were included and were selected using simple random sampling. A pre-tested interviewer administrated the questionnaire used to collect relevant information. Data were cleaned, entered, and analyzed using SPSS Version 20. Bivariable and multivariable logistic regression was employed to identify the predictors at p < 0.05. RESULTS: Of the 281 potential study subjects, 280 participated. The mean age of the study subjects was 34.5 years (standard deviation [SD} ±15.6). The prevalence of SSI was 11.1% (95% confidence interval [CI] 7.34-14.67), and in the multivariable logistic regression analysis, four independent determinants emerged as associated with SSI: post-operative hospital stay from 8-14 days (odds ratio [OR] 7.97; 95% CI 1.70-37.38); history of alcohol use (OR 0.04; 95% CI 0.004-0.43); use of local anesthesia (OR 8; CI 1.010-63.398); and dirty incision classification (OR 17; CI 1.249-232.362). CONCLUSION: The magnitude of SSI was high. A hospital stay for more than a week, a history of alcohol consumption, use of local anesthesia, and dirty incision classification were associated independently with a higher risk of SSI. Due attention should be given to infection prevention control methods; and more has to be done to manage dirty and contaminated sites, maintain a strict sterile environment and aseptic surgical techniques, and implement the World Health Organization surgical safety protocol. Efforts should be made to improve appropriate and timely discharge among surgical clients. Prospective longitudinal studies ought to be conducted considering SSI after hospital discharge.

Desire for birth spacing or limiting and non-use of long acting and permanent contraceptive methods among married women of reproductive age in Aksum Town, North Ethiopia.

BACKGROUND: Long acting and permanent contraceptive methods are the most effective family planning (FP) methods to prevent pregnancy and thereby averting adverse consequences of too many and ill-timed pregnancies. However, long acting and permanent contraceptive methods (LAPMs) are underutilized in Ethiopia for little documented reasons. Therefore, this study is aimed to assess magnitude and factors associated with desire for birth spacing for at least 2 years or limiting child bearing and non-use of LAPMs among married women of reproductive age in Aksum town, Northern Ethiopia. METHODS: A community-based cross-sectional study was conducted in Aksum town, North Ethiopia from May to June, 2015 among 779 randomly selected married women of reproductive age. Data were collected using interviewer administered pre-tested questionnaire. Data were entered using Epi-Info version 6.04 and exported to SPSS version 16 for analysis. Multivariate logistic regression models were fitted to identify factors associated with desire for birth spacing or limiting and not using LAPMs. RESULTS: The total desire for birth spacing or limiting was 69 % and amongst those women 85.2 % were not using LAPM. Education, occupation, husband's attitude towards LAPMs, age, number of pregnancy, regular media exposure and decider on the number of children to bear were significantly associated with desire for birth spacing or limiting. Moreover; education, occupation, husband's attitude towards LAPMs, discussion on family planning with husband, knowledge, attitude and intention to use LAPMs were significantly associated with not using LAPMs. CONCLUSION: Desire for birth spacing or limiting and not using LAPMs is very high in the study area. Therefore, increasing access to family planning information and services with special emphasis on LAPMs and male involvement in the program are very important.