Predictors of never testing for HIV among sexually active individuals aged 15-56 years in Rwanda.

Human Immunodeficiency Virus (HIV) testing services are known as the primary step in preventing the spread of HIV. However, access to these crucial services varies across regions within continents due to disparities in healthcare infrastructure, resources, and awareness. Approximately one in every five people living with HIV (PLWH) encounters obstacles in accessing HIV testing, notably in Eastern and Southern Africa, where geographical, resource, awareness, and infrastructure limitations prevail. Consequently, HIV remains a significant public health concern in these regions, necessitating expanded testing efforts to combat the HIV/AIDS disaster. Despite these challenges, there is a lack of scientific evidence on the prevalence of HIV testing and its determining factors in Rwanda. This study determined the prevalence of never being tested for HIV and its associated factors among sexually active individuals aged 15-56 who participated in the Rwanda AIDS Indicators and HIV Incidence Survey (RAIHIS). This cross-sectional study enrolled 1846 participants. The variables were extracted from the RAIHIS dataset and statistically analyzed using STATA software version 13. Bivariate and multivariate logistic regression models were employed to identify predictors of never having undergone HIV testing, with a 95% confidence interval and a 5% statistical significance level applied. The prevalence of non-testing for HIV was 17.37%. Being aged 15-30 years (aOR 2.57, 95%CI 1.49-4.43, p < 0.001) and male (aOR 2.44, 95%CI 1.77-3.36, p < 0.001) was associated with an increase in the odds of never testing for HIV. Further, those from urban area were less likely than those living in rural areas to have never tested for HIV (aOR 0.31; 95% CI 0.38-0.67; p < 0.001). Participants who were not aware of HIV test facilitates were more likely to have never undergone HIV testing (aOR 1.75; 95% CI 1.25-2.47; p = 0.031) than their counterparts. While the prevalence of HIV non-testing remains modest, the significance of youth, male gender, lack of awareness, and rural residence as influential factors prompts a call for inventive strategies to tackle the reasons behind never having undergone HIV testing. Further exploration using mixed methodologies is advocated to better comprehend socio-cultural impacts and causation relating to these identified factors.

Factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Rwanda.

More than one million neonatal deaths occur every year worldwide, of which 99% take place in low-income countries. In Rwanda, nearly 71% of neonatal deaths are preventable and among these, 10% are due to neonatal sepsis. Nevertheless, limited information exists on neonatal sepsis and its associated factors in Rwanda. The objectives of the study were to find prevalence and factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Ngoma District, Rwanda. We used a retrospective cross-sectional study design reviewing a subset of neonatal, maternal and laboratory records from Kibungo Hospital in 2017. Data were reviewed and collected from March to May, 2018. Logistic regression and odds ratios were calculated to identify the factors associated with neonatal sepsis at 95% CI, p < 0.05. Of the 972 total neonates' medical records from 2017, we randomly selected 422 of which 12.8% (n = 54) had neonatal sepsis. When blood cultures were positive, 62% grew Klebsiella pneumoniae. Among neonates with sepsis, 38 (70%) recovered while 16 (30%) died. Neonatal sepsis was strongly associated with neonatal age less than or equal to three days (aOR: 2.769, 95% CI 1.312-5.843; p = 0.008); and gestational age less than 37 weeks (aOR: 4.149; CI 1.1878-9.167; p ≤ 0.001). Increased use of blood cultures including sensitivity testing, routine surface cultures of the neonatology and maternity wards facilities, and systematic ward cleaning are all important approaches to prevent and treat neonatal infections in additional to regular neonatal sepsis evaluations.

The Frequency and Predictors of Unsuppressed HIV Viral Load Among People with HIV in Nyaruguru District, Rwanda.

Background: By the end of 2015, epidemiological studies approximated 37 million people living with HIV (PLHIV) and 46.3% of them were initiated to antiretroviral therapies. From the 90-90-90 strategy, by 2020 at global level, 90% of all people living with HIV were expected to suppress viral load (VL). Although VL suppression is an important indicator of treatment success in PLHIV, studies on this indicator remain scarce in Rwanda where the prevalence of HIV is 3% with 9% for non-suppression. This work, thus, determined the prevalence of VL non-suppression and its associated predictors among PLHIV. Methods: A cross-sectional study was conducted among 637 PLHIV enrolled in healthcare services between 2016 and 2017 in Nyaruguru district. Socio-demographic, treatment, clinical, immunological and VL data were extracted from medical records. Bivariate and multivariate logistic regression analyses were performed to determine associated factors with VL suppression considering 95% confidence intervals and statistical significance of p<0.005. Results: More than half of participants were female (57.77%). The prevalence of unsuppressed HIV VL was 8.9% and 88.7% of respondents were satisfied with the service provided. Males were more likely to be unsuppressed HIV VL [aOR = 3.02; 95% CI (1.19-7.64), p = 0.02] than females. Higher likelihoods of VL non-suppression were among those with history of clinical failure [aOR = 3.14; 95% CI (1.70-14.03), p = 0.034] or history of treatment interruption [aOR = 8.29; 95% CI (2.60-26.42) p = 0.002]. Those with a bad perception toward the whole life treatment were more likely to be unsuppressed [aOR = 4.32; 95% CI (1.98-18.99), p = 0.049] than their counterparts. Conclusion: Sex, treatment interruption, bad perception toward the whole life treatment, clinical failure and lack of confidentiality were the major predictors of being unsuppressed. More efforts on counseling HIV patients to improve their knowledge would drop levels of VL non-suppression, so improving the quality of service should be prioritized to increase suppression.