Effect of HIV and substance use disorder comorbidity on the placenta, fetal and maternal health outcomes: systematic review and meta-analysis protocol.

BACKGROUND: Substance use disorders and HIV infection have a bidirectional relationship. People who use illicit drugs are at increased risk of contracting HIV/AIDS, and people living with HIV/AIDS are at increased risk of using substances due to disease-related complications like depression and HIV-associated dementia. There is no adequate evidence on the effect of HIV/AIDS and substance use disorder comorbidity-related effects on placental, fetal, maternal and neonatal outcomes globally. METHODS AND ANALYSIS: We will search articles written in the English language until 30 January 2024, from PubMed/Medline, Cochrane Library, Embase, Scopus, Web of Sciences, SUMsearch2, Turning Research Into Practice database and Google Scholar. A systematic search strategy involving AND/OR Boolean Operators will retrieve information from these databases and search engines. Qualitative and quantitative analysis methods will be used to report the effect of HIV/AIDS and substance use disorders on placental, fetal and maternal composite outcomes. Descriptive statistics like pooled prevalence mean and SD will be used for qualitative analysis. However, quantitative analysis outcomes will be done by using Comprehensive Meta-Analysis Software for studies that are combinable. The individual study effects and the weighted mean difference will be reported in a forest plot. In addition to this, the presence of multiple morbidities like diabetes, chronic kidney disease and maternal haemoglobin level could affect placental growth, fetal growth and development, abortion, stillbirth, HIV transmission and composite maternal outcomes. Therefore, subgroup analysis will be done for pregnant women with multiple morbidities. ETHICS AND DISSEMINATION: Since systematic review and meta-analysis will be conducted by using published literature, ethical approval is not required. The results will be presented in conferences and published in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42023478360.

Guidelines for the establishment and functioning of Animal Ethics Commitees (Institutional Animal Care and Use Committees) in Africa.

Animals are used for scientific purposes across Africa to benefit humans, animals or the environment. Nonetheless, ethical and regulatory oversight remains limited in many parts of the continent. To strengthen this governance framework, the Pan-African Network for Laboratory Animal Science and Ethics brought together experts from 12 African countries to create an Africa-centric practical guide to facilitate the establishment and appropriate functioning of Institutional Animal Ethics Committees across Africa. The Guidelines are based on universal principles for the care and use of sentient animals for scientific purposes, with consideration of the cultural, religious, political and socio-economic diversity in Africa. They focus on 11 key elements, including responsibilities of institutions and of the Institutional Official; composition of the Committee; its responsibilities, functioning and authority; ethical application and review processes; oversight and monitoring of animal care and use and of training and competence; quality assurance; and the roles of other responsible parties. The intent is for African institutions to adopt and adapt the guidelines, aligning with existing national legislation and standards where relevant, thus ensuring incorporation into practice. More broadly, the Guidelines form an essential component of the growing discourse in Africa regarding moral considerations of, and appropriate standards for, the care and use of animals for scientific purposes. The increased establishment of appropriately functioning animal ethics committees and robust ethical review procedures across Africa will enhance research quality and culture, strengthen societal awareness of animals as sentient beings, improve animal well-being, bolster standards of animal care and use, and contribute to sustainable socio-economic development.

Physical activity and survival in chronic comorbidity among adult HIV patients in Ethiopia: a prospective cohort study.

BACKGROUND: Antiretroviral therapy enables people living with HIV to live long lives, and these advances have transformed HIV infection from an acute to a chronic disease. Many non-communicable diseases, including type 2 diabetes, heart disease, and stroke, are influenced by physical inactivity. Therefore, the aim of this study was to assess the level of physical activity and survival in chronic co-morbidity among adult people living with HIV in Ethiopia. METHODS: An institution-based prospective cohort study of adult people living with HIV was conducted between 2019 and 2021. We included 422 people living with HIV at baseline. After the baseline visit, 364 patients without hypertension or diabetes, were followed up for two years. Nine trained nurses used a pre-tested, structured questionnaire to collect data during routine care consultations in three hospitals in southern Ethiopia. STATA version 15 was used to analyze the data. To estimate the survival probability of developing chronic comorbidities, a Kaplan-Meier survival curve was used. A Cox proportional hazards model was fitted to identify the predictors of the development of chronic comorbidities. RESULT: In the current study, 39% of the participants were found to have a low level of physical activity. Those who had self-management skills to maintain physical activity (p = 0.023), considered physical activity an important aspect of their HIV management (p = 0.003), and regularly attended social support groups (p = 0.002) had significantly higher levels of physical activity. The risk of chronic comorbidity increased over time, with a rate of 10.83 chronic comorbidities per 1000 persons per month. Lack of regular exercise [AHR: 2.04; 95% CI: (1.03, 5.13)], low physical activity [AHR: 2.01; 95% CI: (1.03, 7.89)], BMI greater than 25 kg/m2 [AHR: 2.74; 95% CI: (1.31, 5.12)] and low fruit and vegetable intake [AHR = 2.57; 95% CI: (1.28, 6.49)] were all associated with the development of chronic comorbidity. CONCLUSION: The prevalence of physical inactivity is high in the study population. A physical activity program for people living with HIV should be considered, and the promotion of self-management skills should be integrated into HIV care programs.

Nutritional Treatment Outcomes of Therapeutic Feeding Program and Its Predictors Among HIV Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa City, Sidama, Southern Ethiopia: A Retrospective Cohort Study.

Background: HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia. Methods: Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval. Results: The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure. Conclusion: Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.

A qualitative study exploring perceptions of people living with HIV using antiretroviral therapy on self-management of healthy nutrition and the related healthcare service in Ethiopia.

In Ethiopia, undernutrition is a quite common health problem among people living with HIV. Unlike in developed countries, nutritional counseling for people living with HIV has not received much attention. This study aimed to explore the perception of people living with HIV on their dietary practice and the existing health care service in Ethiopia. A phenomenological qualitative study was conducted in two hospitals in southern Ethiopia from March to June 2018. A pre-tested interview guide was prepared in English and translated into the Amharic language. The data were collected using key informant interviews, focus group discussions and observations in the ART clinics by six trained nurses. The data were analyzed thematically. Almost all focus group discussion participants mentioned that a healthy diet for ART patients is very important. The majority of the participants mentioned that they were not satisfied with the counseling service given at the ART clinics. Lack of training for health care professionals on nutritional counseling was also reported as a challenge by the nurses themselves. Nutritional counseling given by health care professionals at the ART clinic was poor. Emphasis should be given to the training of healthcare professionals working in ART clinics on nutritional counseling.

Development of Hypertension and Diabetes Mellitus, and Associated Factors, Among Adult HIV Patients in Ethiopia.

Background: Medical improvements and increased access to treatment have turned HIV from a highly fatal disease into a treatable and controllable disease. With the improvement in lifespan, HIV patients face increasing morbidity and mortality from chronic comorbidities (hypertension and diabetes mellitus). There is, nevertheless, a paucity of information on the scale of HIV noncommunicable disease comorbidity and its associated factors. This study aimed to investigate the incidence and predictors of chronic comorbidity in HIV patients in a resource-limited setting. Methods: A prospective cohort study was conducted from 2019 to 2021. We included 520 HIV patients at baseline. Patients without hypertension or diabetes were followed for two years to determine the incidence of developing comorbidities. Nine trained nurses used a pre-tested structured questionnaire to collect data during routine care consultations in three hospitals in southern Ethiopia. To find predictors of these chronic comorbidities, a multivariable logistic regression analysis was used. Results: After two years, 54 out of 377 participants, or 14%, had chronic comorbidity, which is defined as having diabetes and/or hypertension. Hypertension (12%) and diabetes (4%), respectively, were observed. When compared to those who were not overweight, the risk of developing chronic comorbidity was three times higher in overweight people [AOR = 3.45, 95% CI: (1.04, 11.45), P = 0.045]. Older participants were about 6 times more likely than younger participants to have chronic comorbidity [AOR = 4.93, 95% CI: (1.56, 15.57), P = 0.007]. Those who did not engage in regular physical activity were twice as likely to develop chronic comorbidity [AOR = 2.16, 95% CI: (1.09, 4.29), P = 0.027]. Conclusion: The incidence of chronic comorbidity was high in the study population. Targeted screening for early signs of chronic comorbidity, nutritional counseling, and awareness creation in regular physical activity programs should be integrated into HIV care to prevent and control chronic comorbidity in resource-limited settings.

Antidiabetic Activity of Hot Tea Infusion of Leaves of Moringa stenopetala in Streptozotocin-Induced Diabetic Rats.

Background: Moringa stenopetala is a traditionally used medicinal plant that has been used for the management of different disorders including diabetes in Ethiopia. This study was aimed to assess the antidiabetic activity of hot tea infusion of leaves of Moringa stenopetala in streptozotocin-induced diabetic rats. Methods: Experimental animals were Wistar male rats aged 4-6 weeks weighing 200-250 gram. The animals were maintained in equal light/dark series of laboratory conditions, and the average ambient temperature was 23±2 °C. The hot tea infusion of Moringa stenopetala leaves of different concentrations (as fine and coarse powder decoction), distilled water (10 mL/kg), and 150 mg/kg body weight of metformin were administered to diabetic rats as test, negative control, and positive standard drugs, respectively. Sucrose oral challenge test was also carried out to assess the effect of Moringa stenopetala hot tea infusion on postprandial glucose level. Blood glucose level was measured at 0, 30, 60, 90, and 180 minutes. Statistical analysis was conducted by SPSS package version 23, and the p-value less than 0.05 was declared as level of statistical significance. Results: The phytoconstituents that tested positive in hot tea infusion of Moringa stenopetala leaves were alkaloids, tannins, flavonoids, saponins, and terpenoids. Different experimental groups treated with the hot tea infusion of Moringa stenopetala leaves showed significant reduction of blood glucose level after 30 minutes of hot tea infusion administration. In addition, the hot tea infusion at a different concentration for both fine and coarse powders reduced significantly raised blood glucose level. The present findings revealed that the hot tea infusion has blood glucose-lowering and antioxidant effects with wide safety margin. Conclusion: The findings indicated that the hot tea infusion of the leaves of Moringa stenopetala shows a credible reduction in blood glucose level in rats.

Laryngeal Actinomycosis -A Case of 36 Year Old Female at Hawassa University Comprehensive Specialized Hospital in Hawassa, Sidama, Ethiopia, Ethiopian Patient.

Background: Actinomycosis is a granulomatous infection produced by filamentous, gram-positive anaerobic bacteria. Due to its rarity, ambiguous symptoms, and resemblance to more frequent disorders, including cancer, Crohn's disease, and tuberculosis, it is a challenging disease to identify preoperatively. Case Presentation: Our case was a case of a 36-year-old woman from the Oromia region's West Arsi zone, who presented with a 6-month history of snoring, dysphonia, and cough, as well as significant but unquantified weight loss, fatigue, and low-grade and intermittent fever, for which she had visited various health facilities with no noticeable improvements in her symptoms. She has had diabetes for the past 5 years and is on Metformin 500 mg twice a day with poor glycemic control. The physical findings at the presentation, including the throat examination, were unremarkable. The random blood sugar level was 300 mg/dl at the time of presentation (elevated). Laryngoscopy revealed an irregular tumor on the anterior one-third of the vocal cord bilaterally, involving the anterior commissure. The biopsy result revealed actinomycotic granules with abscess formation. The patient was then started on Penicillin G, and there was a resolution of her symptoms during follow-up, and then on put on Amoxicillin for the next 6 months, which was discontinued when she had fully recovered from her symptoms and the mass had been cleared on follow-up laryngoscopy. Conclusion: Laryngeal actinomycosis closely resembles laryngeal cancer and other common inflammatory conditions like laryngeal tuberculosis. It is recommended that clinicians, particularly otolaryngologists, be aware of such rare but eerily similar disease conditions so that unnecessary interventions can be avoided on time.

Physical activity level and associated factors among adult HIV patients in Ethiopia.

BACKGROUND: People living with HIV, who take antiretroviral therapy (ART), often enjoy long and healthy lives, but this therapy has well known metabolic adverse effects. Physical activity is found to be an important factor in improving these physiological parameters. This study aimed to determine physical activity level and associated factors among HIV patients in Ethiopia. METHODS: An institutional based cross sectional study was conducted from May to June 2019. We selected a total of 422 adult HIV patients, attending antiretroviral therapy clinics in three selected hospitals in Southern Ethiopia. Data were collected at routine care consultations by nine trained nurses using a pre-tested structured questionnaire. The level of physical activity was measured by the international physical activity questionnaire (IPAQ). RESULT: The mean age of participants was 38.7 ± 9.13 years. Of the participants, 68% were physically inactive, with a higher proportion of inactive women (74%) than men (61%) [(AOR = 1.64, 95% CI (1.07, 2.53)]. In addition, urban vs. rural residents [(AOR = 2.57, 95% CI (1.16, 5.72)] and patients who were on ART for ≥ 24 months [(AOR = 1.88, 95% CI (1.15, 3.08)] had higher odds of having a low physical activity level. CONCLUSION: Most people living with HIV and receiving ART have low physical activity levels. Especially female and urban living patients and those with longer treatment duration have low levels of physical activity. More insight is needed on the reasons for physical inactivity among HIV patients and physical activity programs for HIV patients in low-income countries need to be developed.

The First Experience of Effective 3rd Line Antiretroviral Therapy - A Case of 40-Year-Old Female Retroviral-Infected Patient at Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.

BACKGROUND: Treatment failure continues to be an impediment to the efficacy of highly active antiretroviral therapy (HART) in the treatment of human immunodeficiency virus type 1 infection (HIV-1). The World Health Organization (WHO) recommends third-line antiretroviral therapy (ART) for patients who have failed second-line ART. Darunavir (DRV) boosted with ritonavir (DRV/r) has a higher genetic barrier to resistance, is active against multidrug-resistant HIV isolates, retaining virological activity even when multiple protease mutations are present, and has been shown to be cost-effective when compared to other boosted protease inhibitors (PIs). CASE SUMMARY: This is a case of a 40-year-old female known HIV/AIDS patient who has been on ART for the last 14 years with good adherence and regular follow-up, and who is now on 3rd line ART medication with TLD (tenofovir/lamivudine/dolutegravir)+DRV/r (in her 11th month) after being diagnosed with second-line treatment failure. After 6 months and 1 week of therapy, the viral load (VL) was sent, and the result was undetectable. The patient's clinical conditions had greatly improved. CONCLUSION: Third-line ART therapy, which was once thought to be a salvageable treatment, is now the primary option for second-line ART failure. TLD in combination with ritonavir-boosted darunavir is found to be effective at lowering viral loads in the blood below detectable limits. Despite a lack of data on the use of third-line ART in Ethiopia, access to third-line ART containing ritonavir-boosted darunavir is recommended because it has been shown to be an effective alternative for patients who have failed second-line ART. We recommend that more research be done with a larger sample size, and that the findings in this paper be used with caution.

A Case of Trichinellosis in a 14-Year-Old Male Child at Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.

BACKGROUND: Trichinellosis develops after ingestion of Trichinella cysts in pork meat. It is one of the most important parasitic human pathogens in the world. It is, however, underreported in part because none of the clinical manifestations are pathognomonic. The primary mode of transmission is ingestion of raw meat. Among the symptoms are muscle pain, swelling, and myopathy. High-grade fever and other systemic symptoms are not unusual. The hallmarks are ophthalmic and musculoskeletal manifestations, particularly conjunctival haemorrhage with periorbital edema and subungual splinter haemorrhage. Although the majority of infections are mild and asymptomatic, severe infections can result in enteritis, periorbital edema, and myositis. Presentation of the Case. A 14-year-old male patient from Oromia Region, Arsi Zone, West Arsi Zone, Bishan Guracha area, which is almost completely encircled by mountains, presented with a complaint of worsening easy fatigability and asymmetric right thigh enlargement lasting one month. The pertinent physical examinations on presentation were puffy face and eyes, and there was a 4 cm by 5 cm mass on the right lateral thigh with no overlying skin colour change, on-tender, and no discharge. Eosinophilia of 14% was noticed on the complete blood count. The definitive diagnosis of trichinellosis was made by muscle biopsy. He was then managed with albendazole and prednisolone and improved. CONCLUSION: Patients with periorbital edema, myositis, or eosinophilia should be evaluated for trichinellosis. Individuals who have these symptoms and a history of eating pork meat should be suspected of having trichinellosis. Before eating raw pork meat, it is recommended that it be cooked properly.

Exclusive Breast-Feeding Practice and Associated Factors among HIV-Positive Mothers in Governmental Health Facilities, Southern Ethiopia.

INTRODUCTION: Globally, over 90% of HIV infections among children are due to mother-to-child transmission and breastfeeding accounts for 5-20% of the burden. Avoidance of inappropriate feeding practices and practicing exclusive breastfeeding is recommended to reduce mother-to-child HIV transmission, but it is hardly practiced. The aim of this study was to determine the prevalence of exclusive breastfeeding practice and associated factors among HIV-positive mothers attending governmental PMTCT clinics in Southern Ethiopia. METHODS: An institution-based cross-sectional study was conducted from April to May 2019. The participants of the study were 209 HIV-positive mothers at the selected PMTCT sites. The study subjects were drawn from 10 health institutions located at 6 towns in Southern Ethiopia which constituted six hospitals and four health centers. Quantitative data were collected using the pretested structured questionnaire. Logistic regression analysis was used to determine the association between the predictors and outcome variable. RESULTS: Among the 209 participants, 81.6% (95% CI: 75.8-86.5) practiced exclusive breastfeeding and 18.4% (95% CI: 13.5-23.7) practiced mixed feeding. Mothers who had attended the recommended four antenatal visits [AOR: 3.01, 95% CI (1.1-8.28)], who had disclosed their serostatus [AOR: 3.17, 95% CI (1.12-8.99)], who had sufficient knowledge about infant feeding practice [AOR: 3.32, 95% CI (1.15-9.55)], and favorable attitude towards infant feeding practice [AOR: 5.39, 95% CI (1.65-17.6)] were more likely to practice exclusive breastfeeding. CONCLUSION: Exclusive breastfeeding was predominantly practiced. But mixed feeding was also being practice considerably. Improving maternal knowledge and attitude towards appropriate infant feeding practice through appropriate counseling on ANC visits could significantly improve EBF practice. It was also evident that promoting disclose of serostatus could empower the mothers to make an informed decision on how to appropriately feed their newborn.

Post-Traumatic Stress Disorder and its Correlates Among People Living with HIV in Southern Ethiopia, an Institutionally Based Cross-Sectional Study.

Post-traumatic stress disorder is a common psychiatric problem more highly prevalent among HIV infected individuals than the general population. This study aims to assess the probable prevalence of post-traumatic stress disorder and associated factors among individuals living with HIV in Hawassa, Ethiopia, 2018. An institution based cross-sectional study was employed. A total of 205 HIV positive individuals who attend follow-up sessions at HIV clinics were recruited for the study through systematic sampling techniques. The presence of probable post-traumatic stress disorder was assessed by using the post-traumatic stress disorder checklist -5. The potential traumatic life events and any stressful events that occurred in participants' lives were assessed by the life event checklist for DSM-5 (LEC-5). The mean age of the respondents was 32.33 years (SD ±8.67). Prevalence of post-traumatic stress disorder (PTSD) was 46.3%. Being female [AOR = 1.27, (95% CI: 1.01, 3.98)], poor social support [AOR = 1.71, (95% CI: 1.08, 4.45)], poor medication adherence [AOR = 3.87, (95% CI: 1.75, 6.79)], current alcohol use [AOR = 2.34, (95% CI: 1.32, 5.16)], HIV/TB coinfection [AOR = 1.23, (95% CI: 1.09, 6.84)] and having negative life events [AOR = 1.76, (95% CI: 1.41, 6.98)] had statistically significant association with probable post-traumatic stress disorder. The prevalence of post-traumatic stress disorder among HIV positive individuals was high. The researchers highly recommend the integration of psychiatric services to HIV clinics and develop guidelines to screen and treat PTSD among HIV patients. Further research on risk factors of PTSD and longitudinal studies should be conducted to strengthen and broaden the current findings.

The epidemiology of headaches among patients with epilepsy: a systematic review and meta-analysis.

BACKGROUND: Headache is the symptom of pain in the face, head or neck that causes disability in most people with medical and neurological disorders. It frequently co-occurs with most chronic diseases such as epilepsy and significantly impacts the quality of life. However, epidemiologic data from different studies showed different rates of prevalence. Therefore, we conducted this review to summarize the available epidemiologic evidence on the topic and formulate recommendations for future research and clinical practice. METHODS: We followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. We systematically searched the literature using popular databases such as PubMed, EMBASE, Psych-INFO, and SCOPUS. We further scanned the reference lists of the eligible studies to supplement our electronic search. The Comprehensive Meta-Analysis software version 3.0 (CMA 3.0) was used to conduct a meta-analysis. Subgroup and sensitivity analysis were performed and Cochran's Q- and the I2- test were used to assess the source of heterogeneity. The funnel plot and Egger's regression tests were used to assess potential publication bias. RESULTS: A total of 17 studies conducted both in developed and developing countries including 5564 study participants were combined in this meta-analysis. The pooled estimated prevalence of headache among patients with epilepsy was 48.4%. The pooled estimated prevalence of Inter-Ictal headache (IIH) (42.2%) and Postictal headache (PIH) (43.1%) were higher when compared to tension-type headache (TTH) (26.2%), migraine with aura (26.0%) and migraine without aura (10.4%). The pooled prevalence of headache was 50.6% and 49.5% for developed and developing countries respectively. The pooled prevalence of headache among patients with epilepsy was considerably higher among females (63.0%) when compared to males (33.3%). Moreover, the pooled estimated prevalence of headache among patients with epilepsy was ranging from 46.0% to 52.2% in a leave-one-out sensitivity analysis. CONCLUSION: The pooled estimated prevalence of headache among patients with epilepsy was considerably high (48.4%). Screening and appropriate management of headaches among patients with epilepsy are warranted.

Factors associated with scabies outbreaks in primary schools in Ethiopia: a case-control study.

BACKGROUND: Scabies is a neglected tropical disease affecting more than 200 million people worldwide every year. Scabies in school adolescents and young adults could affect their school performance. The current study investigates the factors associated with an outbreak of scabies at primary schools in southern Ethiopia. METHOD: A team of health professionals investigated an outbreak of scabies that occurred in primary schools from May 1 to 30, 2018. An unmatched case-control study was employed to assess factors which predisposed for the scabies outbreak. Cases of scabies were individuals having a skin lesion compatible with the WHO case definitions of scabies. Controls were from the same locality with no skin lesions. Data on sociodemographic and behavioral variables were collected using questionnaires. Data on clinical presentations of scabies among cases were recorded by two trained and experienced health professionals. Factors associated with scabies were assessed using bivariate and multivariate logistic regression, and strength of association was described using odds ratio (OR) and 95% confidence intervals (CIs). RESULTS: A total of 711 (237 cases and 474 controls) study subjects participated in the study. The mean age of study participants was 17.56±2.66 years. Poor knowledge about scabies, adjusted odds ratio (AOR)=4.32 (95% CI: 2.93, 6.36); male sex, AOR=2.69 (95% CI: 1.82, 3.96); and parental illiteracy, AOR =3.49 (95% CI: 2.06, 5.94) predicted scabies infestation. Additionally, socioeconomic variables like sharing clothes/beds or contact with others, AOR=3.12 (95% CI: 2.12, 4.59); low household annual income, AOR=2.13 (95% CI: 1.32, 3.44); and family size greater than five, AOR=1.77 (95% CI: 1.04, 3.01) were significantly associated with scabies infestation. Inaccessibility and poor utilization of water, AOR=1.64 (95% CI: 1.12, 2.40) and poor personal hygiene, AOR=1.69 (95% CI: 1.14, 2.51) were also factors independently associated with scabies. CONCLUSION: Modifiable risk factors such as personal hygiene and literacy level were found to be independent predictors of scabies infestation. Access to and utilization of water were also important predictors. Strategies for poverty alleviation and awareness creation on personal hygiene and efficient use of water are recommended for effective prevention of scabies infestation in closed institutions.

Prevalence and correlates of common mental disorder among HIV patients attending antiretroviral therapy clinics in Hawassa City, Ethiopia.

BACKGROUND: Common mental disorder (CMD) is a group of disorders which include depression, anxiety and somatoform disorders with significant contributions to the burden of disease. It can lead to high social, economic and individual costs because it accounts for one-third of the days missed at work and a fifth of all primary health-care appointment. This study was aimed to assess the prevalence and factors associated with common mental disorders among HIV patients in Hawassa City, Ethiopia, 2018. METHODS: The cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital, Ethiopia, among 294 HIV patients who were recruited through systematic sampling techniques. Common mental disorder was assessed through face to face interviews by trained professional psychiatry nurses using a WHO-validated 20-item version of the Self-Reporting Questionnaire (SRQ-20). Other possible risk factors of CMD were assessed using a structured questionnaire, perceived HIV stigma scale and Oslo Item 3 Social Support Scale. RESULTS: A total of 294 HIV patients participated in the study giving a response rate of 98.7%. The mean (± SD) age of the respondents was 35.86 years (± 9.23). Among the study participants, being female [AOR = 1.25, (95% CI 1.01, 2.43)], being widowed [AOR = 1.99, (95% CI 1.51, 5.28)], having poor social support [AOR = 2.44, (95% CI 1.33, 4.51)], having previous history of psychiatric illness [AOR = 3.83, (95% CI 1.89, 9.33)] and HIV-related perceived stigma [AOR = 1.97, (95% CI 1.63, 2.89)] were more likely to have common mental disorder when compared to their counterparts. CONCLUSION: The prevalence of common mental disorder was high. The Ministry of Health should develop a guideline which helps to screen and treat common mental disorders at ART clinics. Further interventional research on risk factors of common mental disorder should be conducted to strengthen and broaden the current findings.

Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross- sectional study.

BACKGROUND: Individuals living with HIV/AIDS with co-occurring harmful alcohol use may require specialized intervention or even multi-disciplinary team follow-up and management. This study was aimed to assess alcohol use disorder and associated factors among people living with HIV/AIDS in Hawassa city, Ethiopia, 2019. METHODS: A facility based cross-sectional study was conducted among 195 people living with HIV/AIDS who had follow-up visit at Hawassa University Comprehensive Specialized hospital. A systematic sampling technique was used to recruit the study participants. Alcohol used disorders identification test (AUDIT) was used to measure alcohol consumption, drinking behaviors, and alcohol-related problems. The binary logistic regression model was used to see the association between alcohol use disorder (AUD) and the independent variables. The strength of association was measured by odds ratios with 95% confidence intervals. Statistical significance declared at P < 0.05. RESULTS: The mean age of the study participants was 29.88 (±SD = 10.89) years. The magnitude of alcohol use disorder among people living with HIV/AIDS was 31.8%. Being male [AOR = 2.43, (95% CI: 1.76, 5.76)], having poor social support [AOR = 1.34, (95% CI: 1.12, 6.73)], being medication non-adherent [AOR = 1.78, (95% CI: 1.33, 6.79)], current khat chewing [AOR = 1.67, (95% CI: 1.16, 5.45)] and current cigarette smoking [AOR = 3.76, (95% CI: 2.16, 7.54)] had statistically significant association with alcohol use disorder. CONCLUSION: In the current study, magnitude of alcohol use disorder among people living with HIV was high and, calls for integrating services provided to HIV patients in HIV care and treatment clinic which enhances timely detection and management of AUD cases. This also alerts the stakeholders in HIV prevention and control programs to invest a greater efforts to retain patients in addiction treatment and rehabilitation centers. Lastly, appropriate screening and health education on consequences of alcohol use disorder is warranted.

Depression, Anxiety and Their Correlates Among Patients With HIV in South Ethiopia: An Institution-Based Cross-Sectional Study.

Background: Depressive and anxious symptoms are more regularly seen in HIV-infected people than in the general population. This investigation planned to evaluate the magnitude and factors related to depressive and anxiety symptoms among HIV patients in South Ethiopia, 2018. Methods: This was an institution-based cross-sectional study directed among 363 HIV-infected individuals who had a customary visit at Hawassa University Comprehensive Specialized Hospital and Yirgalem Hospital, Ethiopia, who were incorporated into the study through systematic sampling techniques. The hospital anxiety and depression scale (HADS) was utilized to take a look at anxious and depressive symptoms. Results: The mean age of the respondents was 37.66 years (SD ±10.03). The prevalence of depression and anxiety were 32.0% and 34.4%, respectively. Patients who were living alone [AOR = 1.94, (95% CI: 1.06, 3.56)], had poor social support [AOR = 5.57, (95% CI: 1.20, 10.84)] or had HIV-related perceived stigma [AOR = 2.35, (95% CI: 1.44, 3.84)] were more likely to have depression as compared to their counterparts. Those with a previous history of mental illness [AOR = 3.36, (95% CI: 1.31, 8.61)] and poor social support [AOR = 6.67, (95% CI: 1.47, 10.33)] were more likely to have anxiety symptoms. Conclusion: The prevalence of anxiety and depression in the current study was high. Concerned health departments of the country should create guidelines to screen and treat depression and anxiety among HIV patients. Further research on hazard factors of depression and anxiety ought to be examined to strengthen and expand these findings.

Radiologic Diagnosis and Hospitalization among Children with Severe Community Acquired Pneumonia: A Prospective Cohort Study.

OBJECTIVES: This study was designed to assess the role of chest radiography for the diagnosis of pneumonia and assess the association of clinical characteristics with radiologic findings and predictors of hospitalization among children with severe community acquired pneumonia. METHODS: A prospective study was conducted on 122 children between ages of 3 month and 14 years admitted to pediatric emergency unit with diagnosis of severe pneumonia from September 1st to November 30th, 2017. Eligible children were subjected to chest radiography which was read by two senior radiologists independently (R1 and R2). Disagreements between R1 and R2 were resolved by a third senior radiologist (R3). Level of agreement between radiologists was assessed using Cohen's kappa coefficient. Clinical and laboratory parameters which could explain the variability in the duration of hospital stay were assessed using a linear regression mode. Independent predictors were assessed using multiple linear regression. RESULTS: The median age of the cohort was 10.0 months (interquartile range (IQR): 6.75-24.0); 76 (62.3%) were male. Nearly half, 63 (51.6%) did not have radiologic evidence of pneumonia. There was low level of agreement between R1 and R2 in reporting consolidation (kappa=0.435, p-value≤0.001), haziness (kappa=0.375, p-value≤0.001), and infiltration (kappa=0.267, p-value=0.008). Children with higher recorded temperature were more likely to have radiologic abnormalities suggesting pneumonia (p-value=0.033). The median duration of hospitalization was 3 days (IQR: 1-4 days); 118 (96.7%) were discharged with improvement. Height-for-age z-score (Coef.=0.203, R2=0.041, p-value=0.027); and hemoglobin level (Coef.=-0.249, R2=0.062, p-value=0.006) explained 4.1% and 6.2% of the variability in the duration of hospital stay, respectively. CONCLUSION: Radiologic evidence of pneumonia was absent in half of the children with severe pneumonia. There was low agreement between senior radiologists in reporting chest radiographic findings, potentially necessitating harmonization activities to uniformly implement the WHO guidelines in reading chest radiographs.

Antimicrobial resistance profile of staphylococcus aureus isolates isolated from ear discharges of patients at University of Hawassa comprehensive specialized hospital.

BACKGROUND: Drug-resistant microorganism are a growing global danger. Strains of S. aureus have developed resistance to many commonly used antimicrobials due to indiscriminate use of antimicrobials, and treatment becoming a challenge. Studies assessing pattern and determinants of S. aureus resistance in ear infection in Ethiopia are very scarce. This study presents overview of pattern and determinants S. aureus resistance from samples of ear discharge in Ethiopia. METHOD: A prospective cross-sectional study was conducted on patients who visit ENT clinic of University of Hawassa comprehensive specialized hospital from February 1, 2016 to November 1, 2016. 117 specimens were collected with sterile applicator cotton swab from 117 patients with ear discharge visiting the clinic. Data was fed and then edited, cleared, entered and analyzed using SPSS version 20. RESULT: The prevalence of S.aureus infection was 28.2%. S. aureus isolates revealed up to 97.0% level of resistance pattern to the antimicrobials tested. In the determination of the susceptibility of S. aureus on nine selected antibiotics by disk diffusion technique, 97.0% of the isolates were resistant to cloxacilin and 74.2% showed resistance to vancomycin. The overall rate of MDR was 100%, all of the isolates were found to be resistant to more than two tested antimicrobials. CONCLUSION: S. aureus has gotten frighteningly resistant to many of common antimicrobials. Resistance rate to vancomyin is terrifyingly high. It urges us to take measures to delay resistance. Emergence of resistance highlights the value of prudent prescribing of antimicrobials and avoiding their irrational use. Further researches focusing on identifying dynamics promoting resistance, identifying high risk strains and molecular basis of resistance are required.