Compliance with research ethics in epidemiological studies targeted to conflict-affected areas in Western Ethiopia: validity of informed consent (VIC) by information comprehension and voluntariness (ICV).

BACKGROUND: The conduct of research is critical to advancing human health. However, there are issues of ethical concern specific to the design and conduct of research in conflict settings. Conflict-affected countries often lack strong platform to support technical guidance and monitoring of research ethics, which may lead to the use of divergent ethical standards some of which are poorly elaborated and loosely enforced. Despite the growing concern about ethical issues in research, there is a dearth of information about ethical compliance in conflict areas. Valid and ethically informed decision-making is a premier pact with research participants in settling possible ethical issues before commencing the research, which is ensured by gaining informed consent from prospective participants of the research. AIMS: This research aimed to explore compliance with research ethics and consent validity in community-based epidemiological research conducted previously. METHODS: Research participants were recruited in the western part of Ethiopia in three districts subjected to conflicts. A community-based cross-sectional study design was utilized, and 338 residents were enrolled as study participants. All participants had previously been enrolled as research participants in epidemiological studies. Data was collected using a questionnaire that was pilot-tested before the commencement of the main data collection. The questionnaire focused on participants' experiences of the informed consent process followed when they were recruited for an epidemiological study and covered themes such as essential information provided, level of comprehension, and voluntarism of consent. RESULTS: Over half of the study participants, 176 (52%), were not provided with essential information before consenting. And 135 (40%) of them did not comprehend the information provided to them. One hundred and ninety (56%) participants freely and voluntarily agreed to partake in one of these epidemiological studies, with over a quarter (97; 28.7%) of them reporting they were subjected to undue influence. Written consent was obtained from only 32 (9.4%) of the participants.

Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis.

BACKGROUND: The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS: Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS: Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION: The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia.

Background: The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia. Methods: A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value <0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value <0.05 were used to declare statistical significance. Results: A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2-68.8]. Urban dwellers (AOR = 3.93 (95% 1.96-7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54-10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71-21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37-3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10-3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0-5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08-5.518)), and with BMI ≥25 kg/m2 (AOR = 2.18 (95% CI: 1.05-4.52)) were significantly associated with same-day ART initiation. Conclusion: Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.

HIV sero-status disclosure and associated factors among HIV positive women in East Africa: Systematic review and meta-analysis. Implications for prevention of mother-to-child HIV transmission.

Background: Women's HIV-positive disclosure plays a pivotal role to achieve the goal of preventing mother-to-child transmission (PMTCT) among pregnant women in particular. Although several primary studies were conducted in the different countries of East Africa, no study concluded the prevalence of women's HIV status disclosure and associated factors in East Africa. Therefore, the current study aimed to assess the pooled prevalence of disclosure status and associated factors among women in East Africa. Objectives: To assess the pooled prevalence of HIV sero-status disclosure and associated factors among women in East Africa. Methods: HINARI, PubMed, and Cochrane Library databases were searched. The data were extracted using a Microsoft Excel spreadsheet and STATA v 14.1 was used for the analysis. The Funnel plots and Egger's statistical test was used to check publication bias. Heterogeneity was assessed by conducting sensitivity and subgroup analyses. Result: The pooled prevalence of sero-status disclosure among women in East Africa was 73.77% (95%CI 67.76, 79.77). Knowing partner's sero-status (OR = 10.04(95%CI 3.36, 31.84), married (OR = 2.46 (95%CI 1.23, 4.89), smooth relationship (OR = 3.30 (95%CI 1.39, 7.84), and discussion on HIV before the test (OR = 6.96 (95%CI 3.21, 15.05) were identified determinants of HIV sero-status disclosure. Conclusion: The current systematic and meta-analysis revealed that nearly one-fourth of women had not disclosed HIV sero-status to at least one individual. Knowing the partner's HIV sero-status, being married, having a smooth relationship, and discussing on HIV before the test were determinants of disclosure status. Therefore, disclosure of HIV-positive sero-status among women living with HIV needs to be strengthened.

Pregnant women's knowledge, attitudes, and associated factors toward physical exercise during pregnancy among those attending antenatal care at Bahir Dar city, Northwest Ethiopia.

Background: Exercise during pregnancy is among the cost-effective options that can significantly reduce the burden of chronic metabolic diseases leading to an adverse birth outcome. Despite the negative consequences of sedentary life among pregnant women, little is known about the pregnant mothers' knowledge, attitude, and associated factors toward exercise during pregnancy in Ethiopia, particularly in the study area. Objective: To assess knowledge, attitude, and associated factors toward exercise during pregnancy among women attending antenatal care at Bahir Dar city, Northwest Ethiopia, 2020. Methodology: A health facility-based cross-sectional study design was employed among 475 pregnant women from March 12 to May 12, 2020. A systematic random sampling technique was used to select the study participants. Interviewer-administered questionnaire was used to collect the data from pregnant women attending the antenatal care unit. Data were coded and entered using Epidata version 3.1 and analyzed by Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regressions were used to identify possible determinants and an odds ratio was used to measure the strength of associations at a p-value of <0.05. Result: The study showed that 55.8% (95% CI: 48.45-59.12) of pregnant women were knowledgeable about benefits and contraindication of exercise during pregnancy; 53.3% (95% CI: 49.05-57.62) of them had positive attitudes toward exercise during pregnancy. Educational status adjusted odd ratio (AOR) = 3.95 (95% CI: 1.712-9.108), practicing physical exercise before becoming pregnant AOR = 3.64 (95% CI: 1.091-12.118), and women who heard about exercise during pregnancy AOR = 4.74 (95% CI: 2.563-8.756) were found to have statistically significant association with knowledge of women about exercise during pregnancy. Women who were knowledgeable about exercise during pregnancy AOR = 4.45 (95% CI: 2.39-8.29) and women who heard about exercise during pregnancy AOR = 4.2 (95% CI: 2.19-8.08) were more likely to have a positive attitude toward benefits of exercise during pregnancy. Conclusion: The level of mothers' knowledge and attitude toward exercise during pregnancy in the study area was low. Educational status, physical exercise before pregnancy, ever heard about exercise during pregnancy were independent determinants of women's knowledge, while ever heard and knowledgeable about exercise during pregnancy were determinants of favorable attitude toward exercise during pregnancy. Empowering women through health education about physical exercise during pregnancy should get due attention.

First-line virologic-based ART treatment failure and associated factors among adult HIV Positives in Southwest Shoa, Central Ethiopia.

Background: The function of antiretroviral therapy is to enhance immunity and prevent the occurrence of opportunistic infection. But antiretroviral therapy showed a failure to manage infection after a time. Nowadays, an accepted criterion to confirm Antiretroviral therapy (ART) treatment failure is a virologic failure. Regarding this virologic failure, there are no well-addressed findings, especially in this study area. Therefore in this research, the magnitude and factors that contribute for virological ART treatment failure have been identified. Methods: Facilitybased cross-sectional study was conducted on adult patients taking ART. Data entry was conducted using Epi Data Version3 and exported to Stata SE version 14 for analysis. Bivariable logistic regression was used to find covariates significantly associated with firs line ART treatment failure. In this case, variables with P-value ≤ .25 were a candidate for multiple logistic regressions. A backward logistic regression model was used. Finally, variables with P-value ≤ .05 were considered as factors significantly associated with first-line ART treatment failure and the result was presented with a description, graph, and tables. Results: In this study, three hundred and fifty peoples were a candidate for the study and all have been involved. The magnitude of first-line ART treatment failure based on virologic criteria was 20.85%. Greater than three-fourth (84.29%) of study participants have support from somebody. Those patients who have initiated first-line ART with NVP based regimen have 1.83 times more likely to face first-line ART treatment failure as compared with those who have started with Efeverence (EFV) based regimen [AOR = 1.83, 95% CI (1.035, 3.245)]. Patients who have initiated first-line ART at the health center were 3.093 times more likely to face first-line ART treatment failure as compared those who have initiated ART at hospitals [AOR = 3.093, 95% CI (1.101, 8.685)]. Patients who have not developed a common opportunistic infection after ART initiation was 47.3% less likely to encounter first-line ART treatment failure as compared with those who have opportunistic infection [AOR = 0.527, 95% CI (0.289, 0.961)]. Conclusion: Based on virologic criteria, NVP based ART initiation, having history recorded opportunistic infection after ART initiation, being male, Institution where initiate ART, are significantly associated with the occurrences of first-line ART treatment failure. The action has to be directed on those identified factors to maintain the patient stay on First-line ART by concerned stakeholders.

Incidence and predictors of death from COVID-19 among patients admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia: A retrospective cohort study.

INTRODUCTION: Currently, COVID-19 contributes to mortality and morbidity in developed as well as in developing countries since December 2019. However, there is scarcity of evidence regarding the incidence and predictors of death among patients admitted with COVID-19 in developing country including Ethiopia, where the numbers of deaths are under-reported. Hence, this study aimed to assess the incidence and predictors of death among patients admitted with COVID-19 in Wollega University Referral Hospital (WURH), western Ethiopia. METHODS: An institution based retrospective cohort study design was conducted among 318 patients admitted with COVID-19 in WURH treatment center. Patients who were tested positive for COVID-19 by using rRT-PCR test and admitted with the diagnosis of severe COVID-19 cases from September 30, 2020 to June 10, 2021 were a source population. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with mortality from COVID-19. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of mortality from COVID-19 at p-value < 0.05. RESULTS: A total of 318 patients were included in final analysis with mean age of 44 (SD±16.7) years and about two third (67.9%) were males. More than half (55.7%) of patients had no comorbidity on admission. The majority, 259 (81.45%) of patients recovered from COVID-19 and 267 (84%) of patients were censored at the end of follow up. The incidence rate of mortality was 14.1 per/1000 (95%CI: 10.7, 18.5) person days observation. Age ≥ 59 years (AHR: 5.76, 95%CI: 2.58, 12.84), low oxygen saturation (AHR: 2.34, 95% CI: (2.34, 4.17), and delayed presentation (AHR: 5.60, 95%CI: 2.97, 10.56) were independent predictors of mortality among COVID-19 patients. CONCLUSION: The mortality rate of COVID-19 pandemic was high in the study area, and most of death was happened during the first 10 days. Being old age, low oxygen saturation and delayed presentation were factors which predict mortality due to COVID-19. Hence, strengthening the health care delivery system to satisfy the need of the patients should get due attention to reduce the incidence of mortality from COVID-19 cases.

Acute respiratory distress syndrome among patients with severe COVID-19 admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia.

BACKGROUND: Acute respiratory distress syndrome is a life-threatening condition that has a significant effect on the occurrence of morbidity and mortality among patients with severe Coronavirus disease 2019 (COVID-19). To the best of researchers' knowledge, there is no Study on ARDS of COVID-19 in Ethiopia. Therefore, this study aimed to identify the prevalence of ARDS and associated factors among severe COVID-19 patients at Wollega University Referral Hospital. METHODS: An institution-based retrospective cross-sectional study was conducted from September 20, 2020, to June 10, 2021. Real-Time Reverse transcription-polymerase Chain Reaction (rRT-PCR) test was used to test Patients for COVID-19. Epi-data version 3.2 was used for data entry, and the final data analysis was through STATA version 14. After checking the assumption P-value<0.25 in the bivariable analysis was used to select a candidate variable for multi-variable analysis, and a p-value of <0.05 was used to declare statistical significance. RESULTS: In this study, the prevalence of ARDS was 32%. Almost all the patients had the clinical feature of cough (93.7%), followed by shortness of breath (79.9%), fever (77.7%), and headache (67%). Age older than 65 years (AOR = 3.35, 95%CI = 1.31, 8.55), male gender (AOR = 5.63, 95%CI = 2.15, 14.77), and low oxygen saturation level (AOR = 4.60, 95%CI = 1.15, 18.35) were the independent predictors of ARDS among severe COVID-19 patients. CONCLUSION: The prevalence of ARDS among patients with severe COVID-19 was high in the study area. Therefore, elders and patients with critical conditions (low oxygen saturation) better to get special attention during COVID-19 case management to enhance good care and monitoring of the patients.

Nurses are leaving the nursing profession: A finding from the willingness of the nurses to stay in the nursing profession among nurses working in selected public hospitals of Wollega Zones, Oromia, Ethiopia.

Background: The willingness of nurses to stay in nursing profession is nurses stay in the nursing profession without having intention to shift their works to other professions. In healthcare systems, nurses are currently leaving their work. To give quality of health, nurses have to stay in their work. The aim of this study was to find the willingness of the nurses to stay in the nursing profession and associated factors. Methods: An institution-based cross-sectional study was employed among nurses in selected hospitals. After checking for completeness, the data were interred into Epi Data version 3 and exported to Stata SE version 14 for analysis. Then, the descriptive statistics were computed. To find association, logistic regression was computed. Covariates from binary logistic regression were a candidate for multivariate logistic regression at p-value ⩽ 0.25. Variables in the final model were selected by the stepwise backward selection procedure. In the end, variables with a p-value ⩽ 0.05 were considered as statistically significant. Results: In this study, 349 nurses have participated with a 100% response rate and more than half of the participants were male 188 (53.87%). The proportion of nurses who have the willingness to stay in the nursing proportion is 54.44% (95% confidence interval = 0.491, 0.59). Getting relatively high salary (adjusted odd ratio = 1.81 (95% confidence interval = 1.05, 3.11)), no presence of support among colleagues (adjusted odd ratio = 0.10 (95% confidence interval = 0.05, 0.22)), not having participation in training (adjusted odd ratio = 0.49 (95% confidence interval = 028, 0.86)), having relative low experience in nursing profession that is less than 6 years (adjusted odd ratio = 0.46 (95% confidence interval = 0.26, 1.81)), having good autonomy in the nursing profession (adjusted odd ratio = 0.41 (95% confidence interval = 0.23, 0.70)), and having a good sense of self-calling for the nursing profession among nurses (adjusted odd ratio = 2.85 (95% confidence interval = 1.64, 4.97)) are the factors related with willingness of the nurses to stay in the nursing profession. Conclusion and recommendation: To bring development in the nursing profession, it is a must to staying experienced nurses in the nursing profession. Therefore, to increase the willingness of nurses in the nursing profession, it is better to increase the salary of nurses, giving frequent training for the nurses, initiate the nurses to support one another, and encourage the nurses to have sense of self-calling for nursing profession. This is accomplished if there is a harmonious relationship between the governments, nurses, and other stakeholders in the healthcare delivery system.

Are the Things Told to Care Providers Kept Confidential?: Perceived Breaches of Confidentiality and Associated Factors Among HIV/AIDS Clients on ART at Nekemte Specialized Hospital, Western Ethiopia, 2021.

INTRODUCTION: HIV clients' mistrust in providers' handling of their medical information can be a reason for them not to utilize services. Compromised confidentiality of HIV clients can affect the entire community, as other people may become reluctant to seek HIV testing and counseling. In Ethiopia, there are few data on perceived breaches of confidentiality among HIV/AIDS clients. Thus, this study aimed to assess perceived breaches of confidentiality and associated factors among people living with HIV (PLHIV) on anti-retroviral therapy (ART) at Nekemte Specialized Hospital, Western Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 423 HIV/AIDS clients at Nekemte Specialized Hospital from January 15 to February 20, 2021. Data were collected by an investigator-administered questionnaire. Collected data were entered into EpiData version 3.1, and Stata version 14.0 was used for analysis. Bivariable and multivariable logistic regression analyses were performed. Variables with a P-value of <0.2 in the bivariable analysis were exported to the multivariable analysis. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) and P-values of <0.05 were used to report significantly associated variables. RESULTS: A total of 423 PLHIV were included in the study. Nearly one-fourth of the respondents (23.60%) had perceived breaches of confidentiality (95% CI 19.8-27.9%). Delayed ART start [(AOR 1.97) 95% CI (1.05-3.71)], being female [(AOR 4.03) 95% CI (2.14-7.59)], being widowed [(AOR 4.11) 95% CI (1.50-11.20)], college education and above [(AOR 10.89) 95% CI (3.93-30.14)], normal BMI [(AOR 2.72) 95% CI (1.06-6.99)], substance use [(AOR 1.93) 95% CI (1.04-3.58)], not knowing other ART user(s) [(AOR 2.89) 95% CI (1.53-5.47)], and CD4 count ≤200 cells/mm3 [(AOR 2.63) 95% CI (1.22-5.68)] were significantly associated variables. CONCLUSION: One in four HIV/AIDS clients reported experiencing perceived breaches of confidentiality. Thus, early ART initiation, further HIV serostatus disclosure, and encouraging patients to decide on the type of care and information they want need to be strengthened in order to reduce breaches of confidentiality.

Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat.

BACKGROUND: HIV continuum of care demands early ART initiation for all HIV-infected individuals. Early ART initiation reduces onward HIV transmission facilitating rapid viral suppression. Despite this, delayed ART use is a challenge among newly diagnosed HIV-positive individuals, and there is limited evidence on time to ART initiation among this group in Ethiopia. Thus, this study aimed to assess time to ART initiation and its predictors among newly diagnosed HIV-positive individuals in Nekemte town, Western Ethiopia. METHODS: An institution-based retrospective follow-up study was conducted on 518 newly diagnosed HIV-positive people from September 5, 2016 to December 20, 2020 at Nekemte town, Western Ethiopia. Data were collected from ART intake forms, registration log books and patient charts. The collected data were entered into Epi Data version 3.1 and STATA version 14.0 was used for analysis. Survival probability was checked graphically by Kaplan-Meier curve and statistically by Log rank test. Both bivariable and multivariable Cox Proportional hazards regression models were conducted to identify the predictors of ART initiation. Hazard ratio with 95% CI and p-value of <0.05 was used to declare a statistical significance. RESULTS: By the end of the follow-up, 371 (71.6%) individuals had initiated ART with an overall incidence rate of 51.9 per 1000 [95% CI: 54.07-66.32] person days; median time to ART initiation was 4 [IQR: 1-9] days. Being female (AHR = 1.33, 95% CI: 1.06-1.67), urban dwellers (AHR = 2.02, 95% CI: 1.37-2.97), having baseline OIs (AHR = 1.62, 95% CI: 1.60-4.30); being tested via VCT (AHR = 1.33, 95% CI: 1.02-1.74); linked from OPD (AHR = 0.64, 95% CI: 0.47-0.85); disclosing HIV sero-status (AHR = 2.07, 95% CI: 1.17-3.68); and college and above education level (AHR = 1.43, 95% CI: 1.00-2.0) were identified as significant predictors of early initiation of ART. CONCLUSION: The proportion and incidence of ART initiation was high; a short median time to ART initiation was revealed in this study. Strictly screening OIs, encouraging HIV sero-status disclosure and voluntary HIV testing are recommended to increase early ART initiation.

Neonatal Mortality and Its Associated Factors among Neonates Admitted to Wollega University Referral Hospital Neonatal Intensive Care Unit, East Wollega, Ethiopia.

Ethiopia has a high neonatal mortality rate in spite of dearth of study. Therefore we aimed to assess magnitude and associated factors of neonatal mortality among neonates admitted to neonatal intensive care units of Wollega University Referral Hospital. Accordingly, a facility based cross-sectional study was conducted on 289 by reviewing medical records of neonates admitted to neonatal intensive care unit. The collected data were entered in to Epi data version 3.1 and Stata version 14 used for analysis. Variables with P-value < 0.25 at with 95% confidence interval in binary logistic regression analysis were taken to the multiple logistic regression analysis. Finally, variables with Likewise, variable with P-value < 0.05 at 95% confidence interval in multiple logistic regression analysis were considered as statistically significant. Among 289 neonates admitted to neonatal intensive care unit, 53 (18.34 %) were died. Majority 42(79.25%) of those deaths occurred at ≤ 7 days of birth. Preterm [AOR 4.15, 95% CI (1.67-10.33)], neonates faced birth asphyxia [AOR 3.26, 95% CI (1.33-7.98)], neonates who developed sepsis [AOR 2.29 95% CI (1.01-5.20)] and neonates encountered with jaundice [(AOR 11.08, 95% CI (1.03-119.59)] were more at risk to die. In general, the magnitude of neonatal mortality among neonates admitted to neonatal intensive care unit was high. Gestational age (maturity of new born), birth asphyxia, neonatal sepsis and neonatal jaundice were predictors of neonatal mortality. Neonates admitted to neonatal intensive care unit with sepsis, jaundice, and birth asphyxia demand special attention to reduce neonatal mortality.

High Perceived Stigma Among People Living with HIV/AIDS in a Resource Limited Setting in Western Ethiopia: The Effect of Depression and Low Social Support.

BACKGROUND: Antiretroviral therapy (ART) is only one part of a successful range of care among people living with HIV/AIDS (PLWHA). Stigma and low social support are emerging issues worsening the success of ART for PLWHA. This study thus aimed to investigate the level of perceived stigma among PLWHA. METHODS: An institution-based cross-sectional study was conducted in Nekemte, western Ethiopia. A multivariable logistic regression model was used to identify associations between perceived stigma and low social support, depression, and other potential predictor variables using SPSS version 24.0 and adjusted odds ratios (AORs), considering statistical significance at p<0.05. RESULTS: A total of 418 study participants were included in the study, with a response rate of 100%. About 48.6% of PLWHA had experienced perceived stigma, and more than two-fifths had poor social support. The following factors were associated with perceived stigma among PLWHA: age (18-29 years) (AOR=4.88, 95% CI:1.76-13.5), female sex (AOR=2.10, 95% CI 1.15-3.82), <12 months on ART (AOR=2.63, 95% CI 1.09-6.34), depression (AOR=1.86, 95% CI 1.08-3.19), social support (poor: AOR=3.45, 95% CI 1.65-7.23; medium: AOR=2.22, 95% CI 1.09-4.54), and non-disclosure of HIV status (AOR=2.00, 95% CI 1.11-3.59). CONCLUSION AND RECOMMENDATION: The magnitude of perceived stigma among PLWHA was high, highlighting the importance of integrating social and mental health support within standard ART for PLWHA.

HIV serostatus disclosure and associated factors among HIV positive pregnant and lactating women at Nekemte public health facilities, western Ethiopia.

BACKGROUND: Disclosure of Human Immune Virus (HIV) serostatus by pregnant and lactating women is crucial for the successful prevention of mother to child transmission of HIV/AIDS. However, little has been studied regarding the prevalence and factors associated with HIV status disclosure among HIV positive pregnant and lactating women in Ethiopia. METHODS: An institution-based cross-sectional study was conducted in the Nekemte Public Health facilities among 380 pregnant and lactating women enrolled in universal antiretroviral therapy (ART) treatment from January 2015-December, 2019. The data were collected by using a checklist, developed from Prevention of Mother to Child Transmission (PMTCT) logbook, ART intake forms, and medical cards of the patients. Epidata version 3.2 was used for data entry, and then the data were exported to STATA version 14 for further analysis. The binary logistic regression model was employed to determine factors associated with the disclosure status among HIV positive pregnant and lactating women. Adjusted Odds Ratio (AOR) with 95% confidence intervals was computed and statistical significance was declared when it is significant at a 5% level (p-value < 0.05). RESULTS: A total of 380 women have participated in the study. Two hundred seventy-six (73.4%) of women had disclosed their HIV status to at least one individual. The study found living in urban (OR = 1.83, 95% CI: 1.04, 3.20), married women (OR = 4.16, 95% CI: 1.87, 9.24), higher educational status (OR = 2.35, 95% CI: 1.31, 5.51), positive HIV status of partner (OR = 2.35, 95%CI: 1.17, 4.70), and being multipara (OR = 4.94, 95% CI: 2.29, 10.66) were independent determinants of HIV status disclosure. CONCLUSIONS: HIV status disclosure among pregnant and lactating women in the study area was sub-optimal. Empowering women through education, encouraging partners for HIV testing, and enhancing active male involvement in HIV treatment and control programs should get due attention.

Prevalence and Factors Associated with Delayed Initiation of Antiretroviral Therapy Among People Living with HIV in Nekemte Referral Hospital, Western Ethiopia.

BACKGROUND: Ethiopia has adopted the "Universal Test and Treat" strategy to its national policy in 2016 to put all people living with HIV/AIDS (PLHIV) on antiretroviral therapy (ART) regardless of their World Health Organization (WHO) clinical stage or CD4 cell count level. A significant percentage of PLHIV start therapy has been delayed despite the availability of ART, which results in poor treatment outcomes including HIV-related morbidity and mortality, and continued HIV transmission. METHODS: This cross-sectional study was conducted to determine the magnitude and associated factors of delayed ART initiation among PLHIV at ART Clinic, Nekemte Referral hospital, Western Ethiopia between January 1, 2020 and March 31, 2020 for the time period of January 1, 2016 to December 31, 2019. A consecutive sampling method was used to recruit 417 study subjects. The collected data were entered into Epi data version 3.1 and exported to STATA version 14 for statistical analysis. Logistic regression analysis was used to identify associated factors with delayed ART initiation among PLHIV. P-values<0.05 were used to declare significant association. RESULTS: A total of 417 PLHIV were included in the study. The mean age of study subjects was 33.49 (SD±9.81) years. The majority of participants attended formal education (77%) and were urban dwellers (82%). One-third (34%) of them initiated ART delayed, beyond 7 days of confirmed HIV diagnosis. Subjects with normal nutritional status (BMI=18.5-24.9kg/m2) (AOR=3.12, 95% CI=1.29-7.57; P=0.012), CD4 count ≥351cells/mm3 (AOR=2.89, 95% CI=1.27-6.58; P=0.011), tuberculosis (TBC) co-infection (AOR=2.76, 95% CI=1.13-6.70; P=0.025), use of traditional treatment (AOR=4.03, 95% CI=2.03-8.00; P<0.001) and did not know other ART user(s) (AOR=2.86, 95% CI=1.52-5.37; P=0.001) were significantly associated with delayed ART initiation. CONCLUSION: Early HIV testing mechanisms and timely linkage to HIV care by advocating "Test-and-Treat" should be strengthened.