Predictors of loss to follow up among adult clients attending antiretroviral treatment at Karamara general hospital, Jigjiga town, Eastern Ethiopia, 2015: a retrospective cohort study.

BACKGROUND: Retention in care and adherence to the treatment is very important for the success of the program while access for treatment is being scaled up. Without more precise data about the rate of loss to follow up as well the characteristics of those who disengage from the treatment appropriate interventions to increase ART adherence cannot be designed and implemented. Therefore the aim of this study was to determine incidence and predictors of loss to follow up among adult ART clients attending in Karamara Hospital, Jigjiga town, Eastern Ethiopia, 2015. METHODS: An institutional based retrospective cohort study were undertaken among 1439 adult people living with HIV/AIDS and attending ART clinic between September 1, 2007 and September 1, 2014 at Karamara Hospital was undertaken. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as 'dead' or 'transferred-out'. A Kaplan-Meier model was used to estimate rate of time to loss to follow up and Cox proportional hazards modeling was used to identify predictors of loss to follow up among ART clients. RESULT: Of 1439 patients, 830(58.0%) were females in their sex. The mean age of the cohort was 33.5 years with a standard deviation of 9.33. Around 213 (14.8%) patients were defined as LTFU. The incidence rate of loss to follow up in the cohort was 26.6% (95% CI; 18.1-29.6) per 100 person months. Patients with male sex [HR: 2.1CI;(1.3-3.4)], patients whose next appointment weren't recorded [HR: 1.2, 95% CI; (1.12-1.36)] and patients who did not disclose their status to any one [HR: 2.8, 95% CI; (2.22-5.23)] were significantly associated with LTFU in the cox proportional model. CONCLUSION: Overall, these data suggested that LTFU in this study was high. The ART patients' next appointment should be documented very well and as well the clients should be advised to adhere with treatment program as per the schedule. Defaulter tracing mechanism should be operational and strengthen in the health facility. Effective control measures should be designed for at-risk population such as male patients.

Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study.

BACKGROUND: The antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia. METHOD: We conducted a survey in community in Southern and South East zones of Tigray region from August 15 to August 31, 2016. The survey included nine Woredas. It was supported by qualitative methods. A total of 3741 individuals were enrolled from 933 households using multistage sampling. We used structured questionnaire. In-depth interview and focus group discussion were also applied. Descriptive statistics was performed using SPSS version 20.We thematically analyzed the qualitative data using Atlas 7. RESULT: The overall coverage of Zithromax MDA was 93.3%. It ranges from 90.0% in Seharti Samre to 97.9% in Endamokoni. The coverage was 93.4% for males and 93.1% for females. A higher proportion (98.3%) of children aged 5 to 15 years and 409 (87.8%) under five children took Zithromax. The coverage was 94% in rural and 91.2% in urban. Women development army (43.3%) and health extension workers (32.5%) were the main source of information. Frequent occurrence of drug side effects, rumors, lack of community and leaders' engagement in the campaign, fasting, shortage of human power and short term unavailability of supplies were barriers during the campaign. CONCLUSION: The Zithromax MDA coverage in the study zones was higher than the minimum WHO set criteria of 80%. There was a wide difference in coverage among Woredas and Kebeles. The MDA coverage was lower in urban than rural. Misconceptions and poor mobilization were common challenges. Thus, proper planning, community mobilization and uniform training will need to be done ahead of the campaign in the future.