Prevalence and assemblage of Giardia duodenalis in a case-control study of children under 5 years from Jimma, Southwest Ethiopia.

Giardia duodenalis is a common pathogenic intestinal protozoan parasite with high prevalence in developing countries, especially among children. The distribution of giardia assemblages among humans and their clinical relevance remains controversial. This study aimed to determine the prevalence and assemblage of Giardia among children under 5 years of age in Jimma, Southwest Ethiopia. Employing a case-control design, 606 children presenting with diarrhea at Jimma university medical center and Serbo Health Center were enrolled from December 2016 to July 2018 along with 617 matched controls without diarrhea. Giardia was detected and typed using real-time PCR. Univariate and multivariate regression analysis was performed. The total prevalence of Giardia was 41% (501/1223) and did not differ significantly between cases and controls (40% vs 42%). Prevalence increased by age, with the highest prevalence seen in children aged ≥ 25 months. Children without diarrhea with a history of diarrhea during the last month were more likely to be Giardia positive compared to children with no history diarrhea (OR 1.8 and 95%CI; 1.1-2.9). Regardless of current diarrhea symptoms, assemblage B predominated with 89%, followed by assemblage A (8%) and mixed infection assemblage A and B (3%). We report a high prevalence of Giardia by PCR detection in Jimma, Ethiopia, with assemblage B being predominant. There was a similar distribution of Giardia assemblages between children with and without diarrhea. Increasing age was a risk factor for Giardia infection. Community-based prevention and control strategies need to be employed to decrease the risk of giardia infection.

Evaluation of the Diagnostic Performance of the LINEAR Cromatest and Laboquick URS 10-T Dipsticks Among Urinary Tract Infection Suspects in Addis Ababa, Ethiopia: A Cross-Sectional Study.

Background: Urinary tract infections (UTIs) bring a significant and serious health-related problem. Repeated infections may lead to the development of renal scarring and end-stage renal dysfunction. Therefore, balancing the choices of UTI diagnostic tools depending on the costs versus accuracy can minimize false results that may subject patients to wrong treatments. Objective: The objective of the study was to evaluate the diagnostic performance of LINEAR cromatest and Laboquick URS 10-T dipsticks against conventional urine culture at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Methods: A similar cohort of UTI-suspected patients from our previous study, who were prospectively enrolled from Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia, were considered for this analysis. Data analysis was performed using SPSS version 26. The sensitivity, specificity, and predictive value of different dipsticks were calculated using culture as a gold standard. ROC curve analysis was also used to determine diagnostic performance. A test with a P-value of <0.05 was considered statistically significant. Results: Out of 446 urine samples processed, bacterial growth was observed in 141 (31.6%). Of this figure, 105/141 (74.5%) and 36/141 (25.5%) were from female and male participants, respectively. The sensitivity and specificity of the LINEAR Cromatest dipstick were 83.7% and 67.9%, respectively (P-value <0.001). The Laboquick URS 10-T dipstick showed sensitivity and specificity of 87.9% and 68.5%, respectively (P-value <0.001). The ROC analysis showed an AUC of >0.7 for both dipsticks. Conclusion: In a setting where there is no access to urine culture, the urine dipstick may be considered an alternative diagnostic tool in the diagnosis of UTIs.

Accuracy of Diagnostic Tests for Detecting Schistosoma mansoni and S. haematobium in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Introduction: Schistosomiasis is causing high morbidity and significant mortality in endemic areas. Kato-Katz stool examination and urine filtration techniques are the conventional methods for the detection of intestinal and urinary schistosomiasis. The most appropriate diagnostic tools for the detection of schistosomiasis especially in low-prevalence settings should be used. Therefore, this study is aimed at investigating the diagnostic accuracy of S. mansoni and S. haematobium diagnostic tools in sub-Saharan Africa. Methods: Electronic databases such as PubMed, PubMed Central/Medline, HINARI, Scopus, EMBASE, Science Direct, Google Scholar, and Cochrane Library were reviewed. The pooled estimates and heterogeneity were determined using Midas in Stata 14.0. The diagnostic accuracy of index tests was compared using the hierarchical summary of the receiver operating characteristic (HSROC) curve in Stata 14.0. Results: Twenty-four studies consisting of 12,370 individuals were tested to evaluate the accuracy of antigen, antibody, and molecular test methods for the detection of S. mansoni and S. haematobium. The pooled estimate of sensitivity and specificity of CCA was 88% (95% CI: 83-92) and 72 (95% CI: 62-80), respectively, when it is compared with parasitological stool examination for S. mansoni detection. On the other hand, ELISA showed a pooled estimate of sensitivity and specificity of 95% (95% CI: 93-96) and 35% (95% CI: 21-52), respectively, for the examination of S. mansoni using stool examination as a reference test. With regard to S. haematobium, the pooled estimate of sensitivity and specificity of polymerase chain reaction was 97% (95% CI: 78-100) and 94% (95% CI: 74-99), respectively. Moreover, the sensitivity and specificity of urine CCA vary between 41-80% and 55-91%, respectively, compared to urine microscopy. Conclusion: The effort of schistosomiasis elimination requires accurate case identification especially in low-intensity infections. This study showed that CCA had the highest sensitivity and moderate specificity for the diagnosis of S. mansoni. Similarly, the sensitivity of ELISA was excellent, but its specificity was low. The diagnostic accuracy of PCR for the detection of S. haematobium was excellent compared to urine microscopic examination.

Prevalence of Bacterial Urinary Tract Infection, Associated Risk Factors, and Antimicrobial Resistance Pattern in Addis Ababa, Ethiopia: A Cross-Sectional Study.

Background: Urinary tract infections (UTIs) brought a significant and serious health-related problem that may lead to the subsequent development of serious indications with the challenge of the emergence of antibiotic resistance. Therefore, the choice of antibiotics depends on the accuracy of the diagnostic tool of UTIs to minimize false results that may subject patients to wrong treatments. This study aimed to determine the prevalence of bacteriuria, associated factors, and AMR pattern of UTI-suspected patients. Methods: A cross-sectional study was conducted from March to May 2022, at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Species identification and isolation from bacterial colonies were characterized by gram stain and biochemical properties followed by antibiotic susceptibility testing using the Kirby-Bauer method on Muller-Hinton agar. Logistic regression analysis was carried out to determine the association between the independent variables and significant bacterial growth to identify factors that affect the prevalence of UTI. A test is considered statistically significant that has a P value less than 0.05. Results: Out of 141 (31.6%) which yielded significant bacteriuria, 16 different species of bacterial uropathogens were identified. A total of 105/446 (91 Gram-negative and 14 Gram-positive) of bacterial growth in the female gender and 36/446 (33 Gram-negative and 3 Gram positive) in male were observed with a P value of 0.03. The most predominant bacteria were E. coli followed by Klebsiella pneumoniae. Amoxicillin had shown the highest resistance rate (100%) followed by Ampicillin (98.9%). Females and participants with previous infections were shown to be associated with significant bacterial growth. Conclusion: Based on our study finding, the ordinarily used antibiotics seem to face emerging resistant strains, which needs considerable and due attention to the impact of UTI in developing countries including Ethiopia. History of previous UTIs and female gender were shown to be possible risk factors associated with UTIs.

Prevalence and intensity of soil-transmitted helminths infection among individuals in model and non-model households, South West Ethiopia: A comparative cross-sectional community based study.

Soil-transmitted helminths (STH) is a term used to refer to infections caused by intestinal worms mainly due to A. lumbricoides, T. trichiura, and hookworm species which are transmitted through contaminated soil. This study was conducted to assess the prevalence and intensity of STHs infection among individual members living within the selected household heads (HHs) certified either as a model HHs or non-model HHs based on the implementation level of a training program known as the Health Extension Program (HEP). A community-based comparative cross-sectional study was conducted from April to June 2018 at Seka Chekorsa Woreda, Jimma zone. Model and non-model HHs were selected systematically from each of the randomly selected district villages employing a multistage sampling technique. Sociodemographic and risk factors data associated with STHs infections were collected using a pre-tested structured questionnaire. Parasitological stool sample microscopic examination was done using saline wet mount and Kato Katz thick smear technique. Data analysis was performed using SPSS software version 20 for descriptive statistics, comparison, and logistic regression at a p-value < 0.05 for statistical significance. Overall, 612 individuals were recruited in the study from 120 randomly selected HHs. The prevalence of STHs infections was found to be 32.4%. A total of 45 (14.7%) model and 153 (50.0%) non-model individual participants were positive for at least one species of STHs showing a significant difference between individuals in model and non-model HHs (AOR: 6.543, 95% CI; 4.36-9.82, P<0.001). The dominant STHs were T. trichiura (21.6%) followed by A. lumbricoides (6.4%) and hookworms (2.3%). The intensity of T. trichiura and A. lumbricoides infection have shown a significant difference (p<0.05) while hookworm species infection was not significantly different (p>0.05) for the individuals in the HHs groups. On the other hand, the households training status, age of participants, and latrine use pattern were found significant predictors of STHs infection prevalence in the multivariate analysis (P<0.05). Therefore, the prevalence and intensity of STHs infection was higher among individuals living in a non-model HHs than model HHs.

Oocyst Shedding Dynamics in Children with Cryptosporidiosis: a Prospective Clinical Case Series in Ethiopia.

Knowledge on the duration of Cryptosporidium oocyst shedding, and how shedding may be affected by subtypes and clinical parameters, is limited. Reduced transmission may be a secondary benefit of cryptosporidiosis treatment in high-prevalence areas. We conducted a prospective clinical case series in children of <5 years presenting with diarrhea to a health center and a hospital in Ethiopia over an 18-month period. Stool samples were collected repeatedly from children diagnosed with cryptosporidiosis for up to 60 days. Samples were examined, and Cryptosporidium shedding was quantified, using auramine phenol, immunofluorescent antibody staining, and quantitative PCR (qPCR). In addition, species determination and subtyping were used to attempt to distinguish between new infections and ongoing shedding. Duration and quantity of shedding over time were estimated by time-to-event and quantitative models (sex- and age-adjusted). We also explored how diarrheal severity, acute malnutrition, and Cryptosporidium subtypes correlated with temporal shedding patterns. From 53 confirmed cryptosporidiosis cases, a median of 4 (range 1 to 5) follow-up stool samples were collected and tested for Cryptosporidium. The median duration of oocyst shedding was 31 days (95% confidence interval [CI], 26 to 36 days) after onset of diarrhea, with similar estimates from the quantitative models (31 days, 95% CI 27 to 37 days). Genotype shift occurred in 5 cases (9%). A 10-fold drop in quantity occurred per week for the first 4 weeks. Prolonged oocyst shedding is common in a pediatric clinical population with cryptosporidiosis. We suggest that future intervention trials should evaluate both clinical efficacy and total parasite shedding duration as trial endpoints. IMPORTANCE Cryptosporidiosis is an important cause of diarrhea, malnutrition, and deaths in young children in low-income countries. The infection spreads from person to person. After infection, prolonged release of the Cryptosporidium parasite in stool (shedding) may contribute to further spread of the disease. If diagnosis and treatment are made available, diarrhea will be treated and deaths will be reduced. An added benefit may be to reduce transmission to others. However, shedding duration and its characteristics in children is not well known. We therefore investigated the duration of shedding in a group of young children who sought health care for diarrhea in a hospital and health center in Ethiopia. The study followed 53 children with cryptosporidiosis for 2 months. We found that, on average, children released the parasite for 31 days after the diarrhea episode started. Point-of-care treatment of cryptosporidiosis may therefore reduce onward spread of the Cryptosporidium parasite within communities and households.

Performance of rapid diagnostic tests, microscopy, loop-mediated isothermal amplification (LAMP) and PCR for malaria diagnosis in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Rapid accurate diagnosis followed by effective treatment is very important for malaria control. Light microscopy remains the "golden standard" method for malaria diagnosis. Diagnostic test method must have sufficient level of accuracy for detecting malaria parasites. Therefore, this study aimed to investigate the diagnostic accuracy of rapid diagnostic tests (RDTs), microscopy, loop-mediated isothermal amplification (LAMP) and/or polymerase chain reaction (PCR) for the malaria diagnosis in Ethiopia. METHODS: Data bases such as PubMed, PubMed central, Science direct databases, Google scholar, and Scopus were searched from September to October, 2020 for studies assessing the diagnostic accuracy of RDTs, microscopy, LAMP and PCR methods for malaria diagnosis. RESULTS: A total of 29 studies published between 2001 and 2020 were analysed using review manager, Midas (Stata) and Meta-disc. The sensitivity and specificity of studies comparing RDT with microscopy varies from 79%-100% to 80%-100%, respectively. The sensitivity of LAMP (731 tests) was 100% and its specificity was varies from 85 to 99% when compared with microscopy and PCR. Considerable heterogeneity was observed between studies included in this meta-analysis. Meta-regression showed that blinding status and target antigens were the major sources of heterogeneity (P < 0.05). RDT had an excellent diagnostic accuracy (Area under the ROC Curve = 0.99) when compared with microscopy. Its specificity was quite good (93%-100%) except for one outlier (28%), but lower "sensitivity" was observed when PCR is a reference test. This indicates RDT had a good diagnostic accuracy (AUC = 0.83). Microscopy showed a very good diagnostic accuracy when compared with PCR. CONCLUSIONS: The present study showed that microscopy and RDTs had high efficiency for diagnosing febrile malaria patients. The diagnostic accuracy of RDT was excellent when compared with microscopy. This indicates RDTs have acceptable sensitivities and specificities to be used in resource poor settings as an alternative for microscopy. In this study, LAMP showed an excellent sensitivities and specificities. Furthermore, the need of minimum equipment and relatively short time for obtaining results can made LAMP one of the best alternatives especially for accurate diagnosis of asymptomatic malaria.

Intestinal parasitic infections and associated factors among street dwellers and prison inmates: A systematic review and meta-analysis.

BACKGROUND: Intestinal parasitic infections are closely associated with low household income, poor personal and environmental sanitation, and overcrowding, limited access to clean water, tropical climate and low altitude. Street dwellers and prisoners are forced to live in deprived situations characterized by inadequate facilities. Therefore, this study aimed to estimate the pooled prevalence and associated factors of intestinal parasitic infections among street dwellers and prison inmates. METHOD: Study searches were carried out in Electronic data bases such as PubMed/Medline, HINARI, EMBASE, Science Direct, Scopus, Google Scholar and Cochrane Library. Studies published only in English and have high quality Newcastle Ottawa Scale (NOS) scores were included for analysis using Stata version 14 software. Random-effects meta-analysis model was used for analysis. Heterogeneity was assessed using the Cochrane's Q test and I2 test statistics with its corresponding p-values. Moreover, subgroup, sensitivity analyses and publication bias were computed. RESULT: Seventeen eligible studies consist of 4,544 study participants were included. Majority of the study participants were males (83.5%) and the mean age of the study participants was 25.7 years old. The pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was 43.68% (95% CI 30.56, 56.79). Sub-group analysis showed that the overall pooled prevalence of intestinal parasitic infections among prison inmates and street dwellers was 30.12% (95%CI: 19.61, 40.62) and 68.39% (95%CI: 57.30, 79.49), respectively. There was statistically significant association between untrimmed fingernail and intestinal parasitic infections (AOR: 1.09 (95%CI: 0.53, 2.23). CONCLUSION: In this study, the pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was relatively high. Fingernail status had statistically significant association with intestinal parasitic infection. The prevention and control strategy of intestinal parasitic infection should also target socially deprived segment of the population such as street dwellers and prison inmates.

Soil-Transmitted Helminthic Infections and Geophagia among Pregnant Women in Jimma Town Health Institutions, Southwest Ethiopia.

BACKGROUND: Pregnancy is a key step for human's reproduction and continuity of generation. Pregnant women are among at risk groups for the infection of soil-transmitted helminths (STHs). STHs are highly prevalent in low- and middle-income countries due to the deprived environmental sanitation and personal hygiene. Eating soil (geophagia) is also commonly practiced by pregnant women, particularly in developing countries. The aim of this study was to determine the prevalence of STHs and geophagia, and to assess associated factors among pregnant women in Jimma, Southwest Ethiopia. METHODS: A cross sectional study was conducted among 407 pregnant women attending antenatal care (ANC) at different health facilities located in Jimma Town. Data related to sociodemographic and geophagia practice was collected using a structured questionnaire and STH infections status was determined by using McMaster technique. RESULTS: A total of 407 pregnant women were included in this study. The overall prevalence of any STHs was 19.7% (80/407). Ascaris lumbricoides was the most prevalent 45(56.2%), followed by Trichuris trichiura 19(23.8%) and hookworms 12(15%). There were 4(5%) of double infection with A. lumbricoides and T. trichiura. Overall, 71 (17.4%) of the pregnant women responded to practice geophagia. STHs infection was significantly higher among geophagic pregnant women (p<0.01) and pregnant women who practiced geophagia were 3 times more likely (OR 2.9, 95% CI 1.3-4.2) to have the STHs compared to non-geophagic. Out of those who claimed soil eating habits, 59.1% preferred reddish soil type. Geophagia practice was significantly higher during the third trimester as compared to first and second (p<0.05). CONCLUSION: Geophagia is a risky behavior and this study showed a significant association of geophagia practice with STH infections, although the causal relation could not be established.

Performance and operational feasibility of two diagnostic tests for cryptosporidiosis in children (CRYPTO-POC): a clinical, prospective, diagnostic accuracy study.

BACKGROUND: Cryptosporidiosis is a common cause of diarrhoea in young children (aged younger than 24 months) in low-resource settings but is currently challenging to diagnose. Light-emitting diode fluorescence microscopy with auramine-phenol staining (LED-AP), recommended for tuberculosis testing, can also detect Cryptosporidium species. A lateral-flow test not requiring refrigerator storage (by contrast with most immunochromatographic lateral-flow assays) has also recently been developed for Cryptosporidium spp detection. We aimed to evaluate the diagnostic accuracy and operational feasibility of LED-AP and the lateral-flow test strip for cryptosporidiosis in children. METHODS: We did a prospective diagnostic accuracy study in two health-care facilities in Ethiopia, in a consecutive series of children younger than 5 years of age with diarrhoea (three or more loose stools within the previous 24 h) or dysentery (at least one loose stool with stains of blood within the previous 24 h). Stool samples were tested for Cryptosporidium spp by LED-AP and the lateral-flow test strip; accuracy of each test was estimated by independent and blind comparison with a composite reference standard comprising quantitative immunofluorescent antibody test (qIFAT), ELISA, and quantitative PCR (qPCR). Quantitative cutoff values for diarrhoea-associated infection were established in an embedded case-control substudy, with cases of cryptosporidiosis coming from the 15 districts in and around Jimma and the eight districts surrounding Serbo, and community controls without diarrhoea in the previous 48 h recruited by weekly frequency matching by geographical district of the household, age group, and enrolment week. FINDINGS: Stool samples from 912 children with diarrhoea or dysentery and 706 controls from the case-control substudy were tested between Dec 22, 2016, and July 6, 2018. Estimated reference-standard cutoff values for cryptosporidiosis positivity were 2·3 × 105 DNA copies per g of wet stool for qPCR, and 725 oocysts per g for qIFAT. LED-AP had a sensitivity for cryptosporidiosis of 88% (95% CI 79-94; 66 of 75 samples) and a specificity of 99% (98-99; 717 of 726 samples); the lateral-flow test strip had a sensitivity of 89% (79-94; 63 of 71 samples) and a specificity of 99% (97-99; 626 of 635 samples). INTERPRETATION: LED-AP has high sensitivity and specificity for cryptosporidiosis and should be considered as a dual-use technology that can be easily integrated with existing laboratory infrastructures in low-resource settings. The lateral-flow test strip has similar sensitivity and specificity and provides an alternative that does not require microscopy, although purchase cost of the test strip is unknown as it is not yet available on the market. FUNDING: Norwegian Research Council GLOBVAC fund, The Bill & Melinda Gates Foundation, Norwegian Society for Medical Microbiology, University of Bergen, and Vestfold Hospital Trust.

Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis.

BACKGROUND: Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) amongpreschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia. METHODS: The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14. RESULTS: Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48%(95%CI: 42 to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5 to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997-2002, 2003-2008, 2009-2014 and > 2014 was 71% (95% CI: 57 to 86%), 42% (95% CI: 27 to 56%), 48% (95% CI: 40 to 56%) and 42% (95% CI: 34 to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13 to 19%,) of the cases. CONCLUSION: Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed significant decreasing trends in prevalence of IPIs among preschool and school-ageEthiopian children over the last two decades. Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020.

Zingiber Officinale Roscoe and Echinops Kebericho Mesfin Showed Antiplasmodial Activities against Plasmodium Berghei in a Dose-dependent Manner in Ethiopia.

BACKGROUND: The emergence and spread of Plasmodium falciparum resistance to antimalarial drugs necessitated the search for new drugs from natural products. Zingiber officinal Roscoe and Echinops Kebericho Mesfin are traditional herbal medicines widely used for the treatment of malaria in Ethiopia. The aim of the study was to assess the toxicity profile and in vivo antiplasmodial activities of 70% methanol crude extracts of both plant materials against Plasmodium berghei. METHODS: Healthy male Swiss Albino mice of age 4-5 weeks and weight 25-36 g were infected by P. berghei. The extracts were administered orally at doses 5000, 2500 and 1250 mg/kg for acute toxicity of E. kebericho Mesfin. Graded doses at 1000, 500 and 250 mg/kg used for four days suppressive studies. Parasitemia, body weight, packed cell volume (PCV) and survival time were determined. SPSS Version 20 was used for the analysis of data of parasitemia, body weight, PCV, and survival times. Statistical significance was determined by one-way ANOVA. Independent t-test was used to compare results. Results were presented as a mean ± standard error of the mean (M ± SEM). All data were analyzed at a 95% confidence interval (α= 0.05). RESULTS: At the dose of 5000 mg/kg, E. kebericho Mesfin showed no toxic effects. The LD50 of extract could go beyond the dose used. In vivo antiplasmodial activity of extracts showed excellent chemo suppression at 500 and 1000 mg/kg in a dose dependent manner compared with the negative control. The chemo suppressions of the 1000 mg/kg of both plant extracts were 49.53 ± 1.90% and 32.83 ± 1.03%, respectively. The survival times of P. berghei infected mice were also a dose dependent manner while failed to prevent weight loss. CONCLUSION: The extracts of both medicinal plants showed antiplasmodial activities against P. berghei. It confirmed the literature findings and their traditional uses.

Behavioral and emotional problems among children aged 6-14 years on highly active antiretroviral therapy in Addis Ababa: a cross-sectional study.

Children infected with human immunodeficiency virus (HIV) are at particular risk for psychological disturbance. Little is known about the mental health status of children on highly active antiretroviral therapy (HAART). A hospital-based cross-sectional study of 318 children aged 6-14 on HAART in Addis Ababa was conducted. Behavioral and emotional problem was assessed using the child behavior check list (CBCL/6-18). Logistic regression analysis was done to select the best subset of predictor variables and determine their association with behavioral and emotional problems. Of the 318 caregivers of children aged 6-14 on HAART, 39.3% of the children had behavioral and emotional problems. Low family monthly income (AOR, 3.44, 95% CI, 1.89-6.25), older age (AOR, 2.27, 95% CI, 1.34-3.83), and parental loss (AOR, 1.89, 95% CI, 1.10-3.25) were found to be determinants of behavioral and emotional problems in the multivariate logistic regression. There is high prevalence of behavioral and emotional problems in children on HAART in Addis Ababa. More support is needed to children from families of low income and those who lost their parents. Further research should be carried out to enhance better understanding and appropriate response to behavioral and emotional problems.