Adherence to antiretroviral therapy and determining factors in adults living with HIV receiving services at public health facilities amidst the COVID-19 crisis in Bahir Dar city, Northwest Ethiopia.

Background: The COVID-19 pandemic has presented new challenges to adhering to ART, and its influence on adherence and related factors has not been thoroughly studied. This study examines ART adherence and its associated factors during the COVID-19 pandemic. Methods: A cross-sectional study was conducted on HIV-positive individuals receiving care and treatment in public health facilities. A total of 612 participants were selected using a multi-stage sampling procedure. Data were collected through interviewer-administered questionnaires and chart reviews. We used Epi-data for data entry and Stata for data analysis. Results: Good adherence to antiretroviral therapy in this study was 76.5% (95% CI, 72.9, 79.7). Divorced marital status (AOR = 0.45,95%CI:0.22,0.90), regular follow-up (AOR = 3.01,95%CI:1.81,5.01), adherence counseling and information in the context of COVID-19 pandemic (AOR = 2.57,95%CI:1.63,4.08), and knowledge about ART (AOR = 1.81,95%CI:1.11,2.94) were significantly associated with adherence to antiretroviral therapy. Conclusion: The observed adherence rate in this study was lower than the World Health Organization recommendation and previous studies. The study highlighted the importance of addressing adherence to ART among HIV-positive adults during the COVID-19 pandemic and other upcoming emerging and reemerging outbreaks. Strategies to improve adherence should consider factors such as marital status, regular follow-up, provision of counseling and information, and enhancing knowledge about ART.

Uptake of retroviral pre-exposure prophylaxis and its associated factors among female sex workers, Northwest Ethiopia.

BACKGROUND: Pre-exposure prophylaxis is the use of antiretroviral medications by HIV-negative individuals to prevent infection before exposure. Ethiopia has made progress in reducing new HIV infections, but the burden remains high with ongoing challenges in prevention uptake. This study examined the utilization and factors associated with pre-exposure prophylaxis among female sex workers. METHODS: A community-based cross-sectional study design was conducted in Bahir Dar city administration among female sexual workers in 2022. The results were collected using a pre-tested and structured questionnaire. Epi data for data entry and social package for social science for analysis were used. RESULT: Overall, 15.9% (CI: 12.0-21.1) of female sexual workers received pre-exposure prophylaxis. Parents' living condition (only father alive [AOR = 0.23, 95% CI, 0.02-0.64], only mother alive [AOR = 0.31, 95% CI, 0.02-0.74]), marital status being single (AOR = 0.27, 95% CI, 0.06-0.94), having history of STI (AOR = 2.82, 95% CI, 1.60-4.77) were associated with pre-exposure prophylaxis uptake. CONCLUSION: This study showed low pre-exposure prophylaxis uptake. The study identified a history of sexually transmitted infections, marital status, and parent living conditions as significant factors. To increase pre-exposure prophylaxis uptake and reduce HIV incidence, an awareness campaign, tailored support, targeted interventions, and addressing concerns of high-risk groups are needed.

Household satisfaction and associated factors with community-based health insurance scheme in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Community-based health insurance (CBHI) schemes are crucial for households to avoid financial hardship, improve healthcare quality, and engage in health policies. Household satisfaction is a key indicator for assessing healthcare quality and identifying service gaps. However, research on household satisfaction with CBHI in Ethiopia is limited. Therefore, this study aimed to evaluate household satisfaction and associated factors with CBHI schemes in Ethiopia. METHODS: A comprehensive search of relevant literature was conducted using multiple databases, including PubMed, Google Scholar, Africa Journal Online, and Ethiopian Universities' institutional open-access online repositories. The search was carried out between January 25, 2023, and February 28, 2023. Twelve primary studies, including eight published and four unpublished, were identified and included in the analysis with a total sample size of 5311 participants. A protocol with the registration number CRD20531345698 is recorded on the Prospero database. Two authors, DT and MK, independently extracted the required data using a standardized form. The extracted data were then analyzed using STATA version 17 software. Heterogeneity was assessed using the Cochrane Q-test and I2 tests. Finally, a random-effect model was employed to calculate the overall household satisfaction with CBHI and to determine the associated factors. RESULTS: The meta-analysis showed that the overall household satisfaction with CBHI in Ethiopia was 62.26% (95% CI 53.25-71.21%). The study found regional variations in household satisfaction, with 63.40% in Oromia, 64.01% in Amhara, 49.58% in Addis Ababa, and 66.76% in SNNPs. The study identified several factors associated with household satisfaction and the CBHI scheme, including the availability of drugs (OR 2.13, 95% CI 1.47-2.78), friendly services (OR 3.85, 95% CI 1.60-6.10), affordability of premium (OR 2.80, 95% CI 1.97-3.63), and knowledge/awareness of CBHI (OR 2.52, 95% CI 1.73-3.33). CONCLUSIONS: The study provides valuable insights into household satisfaction with CBHI in Ethiopia, with a considerable proportion of enrolees being satisfied. The finding highlights regional variations in household satisfaction and underscores the need for tailored interventions and monitoring to enhance CBHI sustainability and effectiveness. The results suggest that healthcare providers and policymakers should prioritize the availability of drugs, friendly services, affordable premiums, and education to improve household satisfaction with CBHI schemes.

Determinants of neonatal hypothermia among neonates admitted to neonatal intensive care unit northwest, Ethiopia, case-control study.

BACKGROUND: Neonatal mortality is a global public health problem disproportionally high in developing country including Ethiopia. Hypothermia plays a significant role in neonatal mortality. This study was conducted to identify determinants of neonatal hypothermia among neonates admitted to the neonatal intensive care unit (NICU) of public hospitals. METHODS AND MATERIALS: Institutional based unmatched case-control study was conducted in Bahir Dar town public hospitals among neonates admitted in the NICUs in 2019. A total of 387 participants were included in the study. Pretested, structured questionnaire, and data extraction checklist were used to collect results. Data analysis was done by using Stata version 14 . RESULTS: Low birth weight (adjusted odd ratio (AOR)=3.01, 95%CI: 1.50-5.58), nighttime delivery (AOR = 1.90, 95%CI: 1.13-3.13), lack skin to skin contact (AOR = 2.43, 95%CI: 1.42-4.16), delayed initiation of breast feeding (AOR = 2.24, 95%CI: 1.30-3.88), not wearing cape (AOR = 1.87, 95%CI: 1.07-3.26), and low Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score (AOR = 2.17, 95%CI: 1.15-4.10) were determinant variables of the neonatal hypothermia. CONCLUSIONS: Skin to skin contact, initiation of breast feeding, birth weight, time, low APGAR score, and not wearing cape were identified as independent determinates of neonatal hypothermia.