Essential in-vitro laboratory diagnostic services provision in accordance with the WHO standards in Guragae zone primary health care unit level, South Ethiopia.

INTRODUCTION: Laboratory services are crucial parts of the health system having a great contribution to disease prevention and management. The importance of accurate and reliable laboratory test results is less recognized in developing countries like Ethiopia where most medical decisions are based on clinical judgment. It is time for countries like Ethiopia to not only increase health care coverage but also improve access to essential diagnostic tests. Hence, this proposed study aims to assess essential in-vitro laboratory service provision in accordance with the WHO standards in Guragae Zone primary health care unit level, South Ethiopia. METHODS: Health institution-based cross-sectional study was carried out. 30% randomly selected primary health care units were recruited. Each facility was visited with a WHO checklist by a trained data collector to assess the availability of essential diagnostics service provision. The proportion of available in-vitro diagnostics services was calculated. Results were presented as percentages in tables and figures. RESULT: Twenty-one primary health care facilities located in Guragae Zone were assessed between May and July 2019. All surveyed facilities had major gaps in essential test availability. Among essential diagnostic tests listed with WHO like C-reactive protein, lipid profile, Amylase and Lipase, TroponinT/I, hepatitis B e-antigen, IgM-specific antibodies to hepatitis B core antigen, Glucose-6-phosphate dehydrogenase activity, and anti-HIV/p24 rapid test were not provided in any facilities. However, essential diagnostic services like urine dipstick testing, random blood sugar, smear microscopy, and few serological tests were provided at all primary health care units. All surveyed facilities had limited major laboratory equipment and consumables. CONCLUSION AND RECOMMENDATION: The present study shows limited access to essential laboratory tests at the primary health care level. Hence, the responsible body should invest to make essential tests accessible at the primary care unit level within the framework of universal health coverage in the study area. The fact that access to essential diagnostic tests is the first key step in improving quality of care; such study has its own efforts to enable the implementation of essential diagnostic lists, and improve access to diagnostics in the country.

Therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria cases in Guragae zone southern Central Ethiopia.

BACKGROUND: Malaria continues to be a public health problem and important cause of morbidity and mortality in Ethiopia. Due to continuous interventions to combat malaria in endemic regions, a decline in malaria related deaths and morbidity has been registered. These gains, however, are threatened with the emergency of antimalarial drugs resistant strains of plasmodium parasites. This study aimed to determine therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria cases in Guragae zone, southern central Ethiopia. METHODS: A one arm prospective study with recurrence of parasitaemia and clinical conditions of patients were evaluated on days 0, 1, 2, 3, 7, 14, and 28. Patients with Plasmodium vivax malaria mono infection and eligible for study inclusion criteria were recruited. SPSS-21 used for data analysis and management. Kaplan-Meier survival probability analysis was estimated. Mean geometric parasitaemia and average haemoglobin concentration were calculated. RESULTS: Among 87 total recruited subjects, 81 of them completed the 28 days follow up. More than half of (57.5%) the study participants had a history of fever and 42.5% of them had fever at the time of enrollment. The mean body temperature on day of recruitment was 38.2 °C and 36.8 °C on day 28. Geometric mean parasitaemia calculated on day of enrollment was 2270 parasites/µl of blood. Recurrence of parasitaemia was registered from two subjects during entire follow up. The mean haemoglobin concentration of study participants on day of enrolment was 11.8 g/ dl and 13.8 g/dl on day 28. CONCLUSION: This study registered a high chloroquine efficacy rate among the study participants. Therefore, chloroquine remains efficacious for the treatment of Plasmodium vivax malaria in the study area. However, there is a need to monitor chloroquine resistance by employing molecular tools for better evaluation of treatment outcome.

Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model.

OBJECTIVE: The study was aimed to measure incidence density rate and identify perceived behavioural believes of late initiation to HIV/AIDS care in Gurage zone public health facilities from September 2015 to November 2016. RESULTS: The incidence density rates of late initiation to HIV/AIDS care were 2.21 per 100 person-months of observation. HIV positive individuals who did not perceived susceptibility were 8.46 times more likely delay to start HIV/AIDS care than their counter parts [OR = 8.46 (95% CI 3.92, 18.26)]. HIV infected individuals who did not perceived severity of delayed ART initiation were 6.13 time more likely to delay than HIV infected individuals who perceived its severity [OR = 6.13 (95% CI 2.95, 12.73)]. HIV positive individuals who didn't have self-efficacy were 2.35 times more likely delay to start HIV/AIDS care than HIV positive individuals who have self-efficacy [OR = 2.35 (95% CI 1.09, 5.05)]. CONCLUSIONS: The study revealed that high incidence density rates of delayed initiation for HIV care and variations were explained by poor wealth, and perceived threat and benefit. Therefore, interventions should be designed to initiate care at their diagnosis time.