Trend analysis of malaria surveillance data in West Wallaga, West Oromia, Ethiopia: a framework for planning and elimination.

BACKGROUND: Although Ethiopia has made a remarkable progress towards malaria prevention and control, malaria remains one of the most devastating parasitic diseases affecting humans. However, the distribution and transmission of malaria varies across the country. The study aimed to describe 5 years of malaria distribution and magnitude within the West Wallaga Zone and its respective woredas. METHODS: A retrospective cross-sectional study design was conducted from April 10, 2019 to May 2019. Surveillance data collected weekly for a 5-year (2014-2018) from health facilities and private clinics that were archived in zonal PHEM database were reviewed. The checklist contained variety of variables was developed to collect data. Descriptive analysis was conducted to determine the proportion of Plasmodium species, positivity rate, mortality and fatality rate, time trend, and admission status; and presented by text, tables and figures. RESULTS: Of the total of 588,119 suspected malaria cases, 78,658 (43/1000 populations) were positive with average positivity rate of 13.4%. Among confirmed cases, 59,794 (75%) of cases were attributed to Plasmodium falciparum, 16,518 (20%) were Plasmodium vivax, and 2,360 (5%) were mixed infections. The maximum (145,091) and minimum (74,420) transmissions were reported in 2014 and 2018, respectively. There was seasonal variation in transmission; spring (from May to July) and also autumn seasons (from October to November) were found as malaria transmission peaks. Although incidence rate declined throughout the study period, the average annual incidence rate was 14.38 per 1000 populations. The average case fatality rate of 5 consecutive years was 12/78,658 (15/100,000) population. CONCLUSION: Although the malaria prevalence was decreased, the mortality due to malaria was increased in the 5-year study period, and malaria is still among the major public health problems. The dominant species of malaria parasites were P. falciparum and P. vivax. Attention is needed in scaling-up vector control tools in high malaria transmission periods.

Epidemiological, clinical and laboratory profile of patients presenting with severe acute respiratory syndrome (SARS-CoV-2) in Ethiopia.

INTRODUCTION: Data regarding patients presenting with severe acute respiratory syndrome (SARS-CoV-2) illness have not adequately been documented which provides distinct insights into low-resource settings like Ethiopia. Thus, the study aimed to compare epidemiological, clinical and laboratory profiles of patients presenting with acute respiratory syndrome illness in Addis Ababa Ethiopia. METHODS: We used a comparative cross-sectional study design among patients with SARS-CoV-2 illness at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from October 2020 to September 2021. Using a structured questionnaire a consecutive sampling technique was applied to collect socio-demographic data. Additionally, nasal swabs were collected to confirm SARS-CoV-2 infection using a Real-Time Polymerase Chain Reaction. Blood samples were also collected from the participants for laboratory profiles (hematological tests like; white blood cell count, hematocrit, and platelet count; and biochemical and enzymatic tests like; aspartate transaminase (AST), creatinine, etc) analysis. Data were entered and analyzed using SPSS version 23.0 and p-values ≤0.05 were considered as statistically significant. RESULTS: Of the total 413 participants presenting with SARS-CoV-2 illness, 250 (60.5%) participants tested positive for COVID-19 disease. COVID-19 patients were less likely to use an alcohol-based method of hand washing (12.5% vs 87.5%; p = 0.048). The COVID-19 patients had a higher proportion of headache (67.3% vs 32.7%, p = 0.001), sore throat (72.5% vs 27.5%, p = 0.001), and loss of sense of taste (74.4% vs 25.6%, p = 0.002). Patients with COVID-19 have significantly higher neutrophil than their counterparts (68.2% vs 31.8%; p = 0.001). Similarly, creatinine (64.9% vs 35.1%, p = 0.001) from renal function and alkaline phosphatase (66.8% vs 33.2%, p = 0.046) in the liver function tests were significantly higher in the COVID-19 patients. CONCLUSION: Our findings suggest the need to substantially consider headache, sore throat, and loss of taste as potential clinical diagnostic symptoms for early screening and testing. Elevation of neutrophil, creatinine, alkaline phosphatase profiles are also used for potential diagnostic biomarkers in screening and testing suspected patients.

Viral suppression rate at operation triple zero (Otz) and regular art follow-Up programs and associated factors among adolescent clients of Addis Ababa Ethiopia: a comparative cross-sectional study.

BACKGROUND: - Viral suppression is the main goal of currently available treatment and it is used as a primary indicator of successful treatment for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). This ensures a reduction in AIDS-associated morbidity and mortality and decreases the risk of both vertical and horizontal viral transmission. This study aimed to investigate the magnitude of viral suppression and its associated factors among adolescents, comparing the operation triple zero (OTZ) program to regular antiretroviral therapy (ART) follow-up programs. METHODS: - The research consisted of a comparative cross-sectional study, which included a total sample size of 446 adolescents on Active Antiretroviral Therapy (ART) - 223 enrolled in OTZ, and 223 in regular ART from public hospitals. Sociodemographic data were obtained using a self-administered semi-structured questionnaire, and clinical data were extracted from medical records. To examine the prevalence of viral suppression (VS) the latest status was used and multivariate logistic regression analysis was performed to identify factors associated with VS. RESULTS: - Overall, the adolescent viral suppression was 88.3%, with 92.4% in the OTZ group and 84.3% in the regular ART group. Among OTZ participants, the factors that significantly reduced the odds of viral suppression were having a history of admission in the last year, alcohol use, biological mother not alive, cigarette smoking, social discrimination, and current medication regimen TDF/3TC/EFZ. Among those in regular ART, factors associated with a lesser chance of viral suppression were alcohol use, social discrimination, unscheduled appointments, and current medication regimen TDF/3TC/EFZ when compared to their counterparts. When we compared the two programs, OTZ had a 26.1 times greater chance of suppressing HIV viral load (AOR = 26.1, 95% CI: 3.499-133.9; P = 0.041). CONCLUSION: - The overall VS was 88.3%, while viral suppression is better achieved through the OTZ program than through regular ART services. Alcohol use, biological mother not alive, cigarette smoking, social discrimination, and current medication regimen TDF/3TC/EFZ were identified to be factors associated with viral nonsuppression. Therefore, it is advisable to implement the OTZ program in all HIV care centers and focus on factors reducing viral suppression.

Determinants of pneumonia among under-five children in Oromia region, Ethiopia: unmatched case-control study.

BACKGROUND: Pneumonia is the single largest infectious disease that causes more under-five morbidity and mortality than any other infectious disease in the world, including Ethiopia. The aim of this study is to assess determinants of pneumonia among under-five children in the South West Shewa Zone, Oromia Region, Ethiopia, 2021. METHODS: We used an unmatched case-control study design from March 15 to April 30, 2021, in the South West Shewa Zone, Ethiopia. A sample of 398 (199 cases and 199 controls) participated in the study. Trained data collectors through a pre-tested structured questionnaire collected data. We used Epi Info to enter data and analyzed using SPSS version 23. We described our data using descriptive statistics. We identified predictors of pneumonia using logistic regression analysis. We declared predictors of pneumonia at a P-value of 0.05 or less. RESULTS: Breastfeeding for less than 6 months [AOR:3.51, 95%CI:(1.12,11.00)], lack of Vitamin A supplementation [AOR:3.56,95%CI:(1.58, 8.05)], history of URTI [AOR:9.66, 95%CI:(4.69,19.87)], family child care practices [AOR:6.46, 95%CI, (2.83,14.76)], sleeping with three to five persons in a room [AOR:2.90, 9%CI: (1.23,6.84)], having above five persons in a room [AOR: 3.88, 95%CI: 1.02,14.77), use of wood as a source of fuel [AOR = 3.02 95% CI: 1.41,6.46)] and not opening windows [AOR:2.56 95%CI: (1.21,5.41)] were independent factors of pneumonia among under five children. CONCLUSION: Pneumonia is associated with breastfeeding for less than 6 months, lack of vitamin A supplementation, history of URTI, types of childcare practice, indoor overcrowding, use of wood as a source of fuel, and not opening windows. Therefore, exclusive breastfeeding, improving vitamin A supplementation, early control of respiratory tract infection through promoting good hygiene and ventilation strategies in crowded homes, and promoting how to reduce indoor air pollution through affordable clean stoves will be relevant interventions to reduce under-five pneumonia.

Adaptation and validation of the quality of contraceptive counseling (QCC) scale for use in Ethiopia and India.

We adapted the Quality of Contraceptive Counseling (QCC) scale, originally constructed in Mexico, for Ethiopia and India to expand its utility for measurement of client experiences with counseling. Scale items were modified based on prior research on women's preferences for counseling in each country, and refined through cognitive interviews (n = 20 per country). We tested the items through client exit surveys in Addis Ababa, Ethiopia (n = 599), and Vadodara, India (n = 313). Psychometric analyses revealed the adapted scales were valid and reliable for use, and the final scales retained content validity according to the original published QCC construct definition. Specifically, confirmatory factor analysis revealed high factor loadings for almost all items on the original dimensions: Information Exchange, Interpersonal Relationship, Disrespect and Abuse. Internal consistency reliability was high in both settings (Alpha = 0.92 for QCC-Ethiopia and 0.74 for QCC-India). Final item pools contained 26 items in the QCC-Ethiopia Scale and 23 in the QCC-India Scale. Correlation analyses established convergent validity. QCC Scales and subscales fill a gap in measurement tools for ensuring high quality of care and fulfillment of human rights in contraceptive services, and consistent findings across continents suggest versatility in use across different contexts.

Prevalence and correlates of depressive symptoms among prisoners in Kaliti Federal Prison in Ethiopia: a facility based cross-sectional study.

OBJECTIVE: This study intended to examine the prevalence and correlates of depressive symptoms among inmates in Kaliti Prison Centre, Addis Ababa, Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 694 randomly selected inmates in Kaliti Federal Prison in Ethiopia. The depressive symptom was examined using the Patient Health Questionnaire (PHQ-9). A binary logistic regression model was fitted to identify correlates of depressive symptoms. A p value <0.05 was considered to declare statistical significance, and an adjusted OR (AOR) with the corresponding 95% CI was computed to determine the strength of association. Data were analysed using SPSS V.20. RESULT: The prevalence of depressive symptoms among prisoners in the current study was 56.6% (95% CI 53.2 to 60.8). Poor social support (AOR: 3.33, 95% CI 2.03 to 5.458), personal history of mental illness (AOR=3.16, 95% CI 1.62 to 6.14), physical abuse (AOR=2.31, 95% CI 1.41 to 3.78) and comorbid chronic medical illness (AOR=3.47, 95% CI 2.09 to 5.74) were independent correlates of depressive symptoms. CONCLUSION: Our study shows that around one in two prisoners screened positive for depressive symptoms. There should be a regular screening of depressive symptoms for prisoners, and those screened positive should be linked to proper psychiatric service for early diagnosis and treatment.

Knowledge, Attitude and Practices of Frontline Health Care Workers to Disaster Risk Management in Private General Hospitals in Addis Ababa, Ethiopia: Multicenter Cross-Sectional Study.

Background: Disaster is an acute dysfunction of the existing environment that requires external assistance. Although disaster has had a significant impact in Ethiopia, little is known about KAP of frontline HCW on disaster management in private hospitals. Therefore, this study will be a background for future researches and disaster management plan in private health sectors. The study was conducted to assess the knowledge, attitudes, practices and their influencing factors among frontline healthcare workers on disaster risk management in private general hospitals in Addis Ababa. Methods: The study design was multicenter cross-sectional survey that used structured closed- and open-ended questions. Multi-stage sampling technique was used. The sample size was 270 with a response rate of 98.9%. The study was conducted in frontline HCW of six private general hospitals from July 20-September 30, 2022. Epi-info version 7.0 and SPSS-25 were used for data clearing and statistical analysis. Level of KAP was calculated from the participants' scores of the questions. Associations were done by using bivariate and multivariate logistic regression. Results: Of the participants, 64% had poor level of knowledge, and 89.10% had poor level of practice while 93.6% had positive attitude. Lack of previous training, inadequate level of practice, and health experience below one year were negatively associated with good level of knowledge. Poor level of knowledge was negatively associated with good practice. Conclusion: Although the majority of the participants had positive attitude, the mean level of knowledge and practice were poor to properly handle disastrous events.

Penile size in term newborns in Addis Ababa, Ethiopia.

AIM: To determine the normative value of stretched penile length (SPL) for Ethiopian newborns and to set a cut-off point for micropenis. METHODS: A total of 221 term newborns were included in the study. Stretched penile length was measured in the first 72 h of postnatal age in neonates with a gestational age of 37-42 completed weeks. SPL < -2 SD was taken as micropenis in this study. RESULTS: The minimum and maximum penile length were 2.5 cm and 5 cm, respectively, with a mean ± SD of 3.28 ± 0.42. SPL at -2 SD and +2 SD were 2.43 and 4.12 cm respectively. A significant correlation was observed between penile length and body length (p = 0.005). Neonates born via instrumental delivery had larger SPL compared to those who were delivered by caesarean section (p = 0.01) or by vaginal delivery (p = 0.006). CONCLUSION: The mean stretched penile length in our study mirrors findings from other African studies. SPL < 2.43 cm can be considered as micropenis in our setting. Therefore, routine genital examination and interpretation at birth is crucial to identify micropenis which might herald a serious underlying condition that needs further investigation.

COVID-19 precautionary practices and associated factors among clients visiting a tertiary hospital, Addis Ababa, Ethiopia.

BACKGROUND: Despite efforts to contain the spread of COVID-19, Addis Ababa, the country's COVID-19 epicenter, is experiencing a sharp increase in the number of cases and death rate. While poor public adherence to COVID-19 precautionary practices is evident, factors associated with it are not well studied. We aimed to assess the level of practice of COVID-19 precaution and associated factors. METHODS: This was a hospital-based cross-sectional study conducted from February 1st to 15th, 2021 at Saint Paul's Hospital Millennium Medical College, a tertiary teaching hospital in Addis Ababa, Ethiopia. We used a structured questionnaire to conduct a face-to-face exit interview with clients visiting the hospital. Systematic random sampling was employed to recruit study participants. Binary and multivariable logistic regressions were implemented to examine factors associated with precautionary practices. Statistical significance was declared at p-value <0.05. The Crude odds ratio (COR) and Adjusted odds ratio (AOR) were reported with a 95% confidence interval. RESULTS: We analyzed data obtained from 262 participants. The mean age of participants was 36 (SD+12) years. The majority (207, 79%) of the study participants had a favorable attitude towards prevention and control measures of COVID-19. A little over half (116, 55.7%) of the respondents had a satisfactory level of practice of COVID-19 precautions. Living in an area with strict enforcement of COVID-19 precautionary measures [AOR: 2.25, 95% CI (1.22-4.15)], and having a favorable attitude of COVID-19 prevention [AOR: 4.88, 95% CI (2.08-11.68)] were significantly associated with satisfactory COVID-19 precautionary practices. CONCLUSIONS: The level of practice of COVID-19 precaution was unsatisfactory. Favorable attitude and stricter enforcement of COVID-19 preventive measures might have contributed more to adherence to precautionary practices. The findings highlight the need for a public health education strategy targeted at improving attitudes of the community on COVID-19 focusing on the effectiveness of preventive measures.

Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.

BACKGROUND: Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul's Hospital Millennium Medical College, 2012 to 2019. METHODS: A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. RESULTS: In this study, 61 (10%) children died making the incidence density rate of death 5.6 (95% CI: 4.4, 7.2) per 1000 child-days. Shock (Adjusted Hazard Ratio) [AHR] =3.2; 95% CI: 1.6, 6.3)), IV fluid infusion (AHR = 5.2; 95% CI: 2.4, 10.4), supplementing F100 (AHR = 0.12; 95%CI: 0.06, 0.23) and zinc (AHR = 0.45; 95% CI: 0.22, 0.93) were determinants of death. CONCLUSION: The overall proportion of deaths was within the range put forth by the Sphere standard and the national SAM management protocol. Shock and IV fluid infusion increased the hazard of death, whereas F100 & zinc were found to decrease the likelihood death. Children with SAM presented with shock should be handled carefully and IV fluids should be given with precautions.

The Effect of Long-Term HAART on the Incidence of Tuberculosis Among People Living with HIV in Addis Ababa, Ethiopia: A Matched Nested Case-Control Study.

BACKGROUND: The introduction of antiretroviral therapy (ART) significantly decreases the incidence of tuberculosis (TB) in people living with human immunodeficiency virus (PLWHIV). However, a considerable proportion is still co-infected with TB after ART initiation. Thus, this study aimed to assess the effect of long-term HAART on the incidence of TB among PLWHIV in Addis Ababa, Ethiopia. METHODS: A matched nested case-control study was conducted among PLWHIV who were enrolled in ART clinics in Addis Ababa, Ethiopia from 2013 up to 2018. Cases were HIV-TB co-infected individuals who were taking antiretroviral treatment, while controls were PLWHIV without TB who were taking antiretroviral treatment. The cases and controls are matched exactly in age and sex. Data were entered in Epi Info version 7.1 and analyzed using SPSS version 20. Bi-variable and multivariable conditional logistic regression were employed along with 95% CI. A P-value <0.05 in the multivariable analysis was considered statistically significant. RESULTS: Fifty-seven cases were compared with 114 controls. Accordingly, previous TB history (X2; 13.790, P < 0.001), baseline functional status (X2; 9.120, P = 0.010), baseline WHO clinical stage (X2; 10.083, P = 0.001), baseline hemoglobin value (X2; 6.985, P = 0.008), baseline body mass index (X2; 3.873, P = 0.049), isoniazid preventive treatment (X2; 8.047, P = 0.005), baseline CD4 value (X2; 12.741, P < 0.001) and length of stay on ART (X2; 53.359, P < 0.001) were associated with developing TB. Length of stay on ART was found to be the statistically significant determinant of TB infection after ART initiation (aOR = 5.925, 95% CI = 2.649-13.250). CONCLUSION: Advanced clinical stages at the baseline, previous TB history, and not taking IPT were associated with TB infection. The long-term ART exposure significantly decreases tuberculosis incidence in PLWHIV. Thus, retaining PLWHIV on ART would be important to decrease the incidence of TB in this group of individuals.

Impact of HIV-AIDS on tuberculosis treatment outcome in Southern Ethiopia - A retrospective cohort study.

BACKGROUND: Globally, the Tuberculosis treatment success rate was worse for HIV-positive TB patients compared with HIV- negative TB patients. This study aimed at determining the impact of HIV-AIDS and factors associated with TB treatment outcomes. METHODS: This study was a retrospective cohort study of five years of tuberculosis data from four public health facilities in Hosanna Town. A total of 604 study participants were included using a systematic random sampling technique. Descriptive analysis of ratios, rates, and proportions was done and binary logistic regression, bivariable and multivariable, analysis was also done. RESULT: A total of 604 TB patients were enrolled in this study. 302 (50%) were HIV co-infected. The overall treatment success rate was 90.1% (544/604). Treatment success rates are 86.4% (261/302) for TB-HIV co-infected patients and 93.7% (283/302) for non-co-infected patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome (Adjusted Relative Risk [ARR]: 2.7; 95% Confidence Interval [CI]: 1.4 - 5.2). The risk of unsuccessful treatment outcome is also higher among rural residents (ARR: 3.3; CI: 1.4 - 5.0), patients on the re-treatment category (ARR: 2.7; CI: 1.4 - 5.1), and with chronic disease (ARR: 3.3; CI: 1.3 - 8.1). CONCLUSION: TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, rural residents, patients on re-treatment, and patients with chronic disease. Therefore, due emphasis should be given to these high-risk groups.

Prevalence of Undernutrition and Associated Factors among Lactating Mothers of Angecha District, Kembata Tembaro Zone, Southern Ethiopia.

BACKGROUND: Major reasons for malnutrition, particularly among those who live in low- and middle-income countries, are physiological vulnerability and inadequate intake. The objective of the study was to assess the prevalence of undernutrition and associated factors among lactating mothers of Angecha District, Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted among randomly selected lactating mothers in Angecha District from March to April 2017. A pretested structured questionnaire was used to assess the prevalence of undernutrition and associated factors among lactating mothers. Undernutrition was defined as the body mass index of less than 18.5 kg/m2. A multivariable logistic regression model was fitted, and the adjusted odds ratio (AOR) at a p value less than 0.05 was used to determine a statistically significant association between predictors and outcome variables. RESULT: The prevalence of undernutrition among lactating mothers was 21.2% (95% CI: 17.52, 25.46). The odds of undernutrition were higher among lactating mothers in the younger age group (AOR 4.12 (95% CI: 1.25-13.63), compared to 36-49 years group), dietary diversity less than five food groups (AOR 2.4, 95% CI: 1.35-4.36), and not attending antenatal care (ANC) (AOR 2.90 (95% CI: 1.43-5.86), compared to those who attended ANC for 4 or more times). The odds of undernutrition among lactating women from 3rd quantile wealth index households reduced by nearly half (AOR 0.47, 95% CI: 0.23-0.98) compared to lactating mothers from 1st quantile wealth index households. CONCLUSION: Nearly one in every five lactating mothers was undernourished. Age, dietary diversity score, ANC visit, and wealth index were found to be the associated factors of undernutrition. Therefore, due attention should have to be given to increase the use of ANC.

Histological characteristics, survival pattern and prognostic determinants among colorectal cancer patients in Ethiopia: A retrospective cohort study.

BACKGROUND: The incidence of colorectal cancer (CRC) and associated mortality are rising in low- and middle-income countries. In Ethiopia, colorectal cancer is among the leading causes of cancer morbidity and mortality in both sexes. Although some studies provided estimations on the national burden and regional distribution, the histological characteristics, survival pattern and determinants among colorectal cancer patients are not well-documented. AIM: This study aimed to describe the histological characteristics, to determine the patterns of survival, and identify factors that determine mortality rate among CRC patients in Ethiopia. METHODS: A retrospective cohort study was conducted among CRC patients registered at cancer treatment center of Tikur Anbessa Specialized Hospital, from January 2012 to December 2016. Data were extracted from a total of 161 patient medical records using a pretested abstraction form and supplemented by phone calls with the patients/caregivers. To determine colorectal cancer specific survival overtime, we performed a Kaplan-Meier survival analysis and significance of variation in survival across covariates and treatment categories was tested using log-rank test. A multivariable Cox proportional-hazards model was performed to identify determinants of survival after diagnosis with colorectal cancer. RESULTS: Overall, the median survival time was 21 months [95%CI: 16-35], with two-, three- and five-year CRC-specific survival rates of 46.8%, 39.5% and 28.7% respectively. In the multivariable Cox regression model, the rate of death due to CRC is significantly higher for patients with elevated baseline carcinoembryonic antigen (CEA) level (Adjusted Hazard Ratio (AHR) = 2.31, 95%CI: 1.27-4.19), stage IV at diagnosis (AHR = 2.66, 95%CI: 1.44-4.91), and mucinous or signet-ring cell carcinoma histology type (AHR = 4.92, 95%CI: 1.75-13.80). Moreover, patients who underwent surgery showed a better survival than those who did not (AHR = 0.35, 95%CI: 0.14-0.88). CONCLUSION: In Ethiopia, patients diagnosed with CRC showed a low rate of cancer-specific survival. Histology type, stage of cancer and CEA level at diagnosis, and the type of treatment a patient received significantly determine mortality rate. Hence, cancer screening programs could help to detect the disease at an earlier stage and to initiate available treatments timely so as to extend the lifespan of CRC patients.

Incidence and predictors of extrapulmonary tuberculosis among people living with Human Immunodeficiency Virus in Addis Ababa, Ethiopia: A retrospective cohort study.

BACKGROUND: Extrapulmonary tuberculosis is an emerging public health problem among HIV positives compared to the general population. This study aimed to assess the incidence and predictors of extrapulmonary tuberculosis among people living with HIV in selected health facilities in Addis Ababa, Ethiopia, from 01 January 2013 up to 31 December 2018. METHODS: A retrospective cohort study design was employed based on data collected from 566 HIV positive individuals. Data were entered using EpiInfo version 7.1 and analyzed by SPSS version 20. The incidence rate was determined per 100 person-years. Kaplan-Meier estimates used to estimate survivor and the hazard function, whereas log-rank tests used to compare survival curves and hazard across different categories. Cox proportional hazard model was used to identify the predictors and 95%CI of the hazard ratio were computed. P-value<0.05 in the multivariable analysis was considered statistically significant. RESULTS: Five hundred sixty-six HIV positive individuals were followed for 2140.08 person-years. Among them, 72 developed extrapulmonary tuberculosis that gives an incidence rate of 3.36/100 person-years (95%CI = 2.68-4.22). The most frequent forms of extrapulmonary tuberculosis were; lymph node tuberculosis (56%, 41) followed equally by pleural tuberculosis (15%, 11) and disseminated tuberculosis (15%, 11). The majority (70.83%) of the cases occurred within the first year of follow-up. In multivariable Cox regression analysis, baseline WHO stage III/IV (AHR = 2.720, 95%CI = 1.575-4.697), baseline CD4 count<50cells/µl (AHR = 4.073, 95%CI = 2.064-8.040), baseline CD4 count 50-200 cells/µl (AHR = 2.360, 95%CI = 1.314-4.239) and baseline Hgb<10 mg/dl (AHR = 1.979, 95%CI = 1.091-3.591) were the independent risk factors. While isoniazid prophylaxis (AHR = 0.232, 95%CI = 0.095-0.565) and taking antiretroviral drugs (AHR = 0.134, 95%CI = 0.075-0.238) had a protective benefit. CONCLUSION: Extrapulmonary tuberculosis co-infection was common among HIV positive individuals, and mostly occurred in those with advanced immune suppression. The risk decreases in those taking antiretroviral therapy and took isoniazid preventive treatment. Screening of HIV positives for extrapulmonary tuberculosis throughout their follow-up would be important.

Incidence and determinants of tuberculosis among HIV-positive individuals in Addis Ababa, Ethiopia: A retrospective cohort study.

OBJECTIVE: To assess the incidence and determinants of tuberculosis (TB) among HIV-positive individuals in selected health facilities of Addis Ababa, Ethiopia, during the period January 2013 to December 2018. METHODS: Data were collected from the records of 566 HIV-positive individuals. A retrospective cohort study design was employed. Data were entered into Epi Info 7 and analyzed using IBM SPSS Statistics version 20. TB incidence density was determined per 100 person-years. Time-to-event distributions were estimated using Kaplan-Meier estimates. Survival curves and hazards across different categories were compared using log-rank tests. Determinants were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. A p-value <0.05 in the multivariate analysis was considered statistically significant. RESULTS: A total of 566 HIV-positive individuals were followed for 2140.08 person-years, giving a TB incidence density rate of 6.82/100 person-years (146, 25.8%). The highest incidence was observed within the first year of follow-up. Independent determinants were large family size (adjusted HR (AHR) 1.783, 95% CI 1.113-2.855), lower baseline CD4 (AHR 2.568, 95% CI 1.602-4.116), and baseline body mass index <18.5 kg/m2 (AHR 1.907, 95% CI 1.530-2.690). Being enrolled in antiretroviral treatment (AHR 0.066, 95% CI 0.045-0.98) and taking isoniazid prophylaxis treatment (AHR 0.202, 95% CI 0.108-0.380) had a protective effect. CONCLUSIONS: TB is still a major cause of morbidity among HIV-positive individuals. Early HIV diagnosis, enrollment on antiretroviral treatment, and isoniazid prophylaxis treatment should be considered to decrease the TB risk.

Seroprevalence of Hepatitis B virus surface antigen and factors associated among pregnant women in Dawuro zone, SNNPR, Southwest Ethiopia: a cross sectional study.

BACKGROUND: Hepatitis B is the world's most common serious liver infection. Infection by hepatitis B virus during pregnancy has high rate of vertical transmission and adverse effect on both the mother and child. Data on seroprevalence and associated factors among pregnant women in Dawuro or surrounding was scarce. Therefore, the aim of this study was to assess prevalence of hepatitis B virus and factors associated among pregnant women in Dawuro Zone. METHODS: Institution based cross-sectional study was conducted from 1st April to May 31, 2015 in Dawuro zone. Venous blood was collected, plasma was separated and hepatitis B virus surface antigen was screened using rapid test. Logistic regression was employed with 95% CI and p value of <0.05 was used as statistically significant. RESULTS: Data were collected on 289 women. The overall prevalence from this study was (p = 3.5%, 95% CI 1.4-5.6%) multivariate analysis using logistic regression showed multiple sexual partner (AOR = 6.923; 95% CI 1.685-28.441), and abortion history (AOR = 4.975; 95% CI 1.21-20.456), were significantly associated with hepatitis B virus surface antigen (HBsAg) infection. CONCLUSION: This seroprevalence was categorized as intermediate endemicity according to WHO classification criteria. Health education on sexual transmission of hepatitis B virus and inclusion of screening hepatitis b virus as routine antenatal care service is recommended.