Seroprevalence of HBV and HCV Among Diabetes Mellitus Patients Attending University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Hepatitis B and hepatitis C viruses are common infections and main causative agents of chronic liver diseases, cirrhosis, and hepatocellular carcinoma. The liver is the major site of hormone and glucose metabolism which have deep interconnection with diabetes. Hepatitis-B and hepatitis-C virus infection and diabetes are prevalent diseases worldwide associated with increased morbidity and mortality. High prevalence of DM, HCV, and HBV showed that there is a higher chance of coexisting in an individual. Therefore, our study tried to assess the coexistence of hepatitis viruses and diabetes mellitus among DM patients at the University of Gondar comprehensive specialized hospital. METHODS: The hospital-based, cross-sectional study was conducted from November 01 to December 30, 2019 to as-sess the prevalence and associated factors of HBV and HCV among diabetes patients attending at University of Gondar referral hospital. Sociodemographic data was collected using a semi-structured questionnaire. Four milliliters of blood were collected using an anticoagulant free test tube for measurement of biochemical parameters and detection of hepatitis viruses. HBsAg and anti-HCV antibody detection was performed using One Step Cassette Style HBsAg Rapid Test and EUGENE® anti-HCV rapid test, respectively. Binary and multivariable logistic regression models were used to evaluate associated risk factors for the outcome variable. A p-value of < 0.05 was considered statistically significant. RESULTS: A total of 288 diabetes patients were included in this study and the prevalence of HBV and HCV was 7 (2.43%) and 18 (6.25%), respectively. Hepatitis B virus showed similar prevalence for type 1 and type 2 diabetes at 2.6% and 2.3%, respectively, but HCV showed a wide variation with 17.5% and 4.3% prevalence, respectively, for both diabetes types. In a multivariable logistic regression model compared with younger age (≤ 24 years), older age ≥ 65 years (AOR: 19.545, 95% CI: 2.577 - 22.827) age groups and poor glycemic control (AOR: 18.84, 95% CI: 17.83 - 20.39) showed significant association with HBV. CONCLUSIONS: A considerably large number of diabetes patients tested positive for anti-HCV antibody as a marker of Hepatitis C virus infection. None of the variables showed significant association with active Hepatitis B virus infection whereas older ages (≥ 65 years) and diabetes patients with poor glycemic control showed significant association with anti-HCV antibody positivity.

Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia. METHODS: Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg's Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS: A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections. CONCLUSION: The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.

HIV test coverage among pregnant women in Ethiopia: A systematic review and meta-analysis.

Introduction: A human immunodeficiency virus (HIV) test during pregnancy is the gateway to the prevention of mother-to-child transmission (PMTCT) of HIV. Estimating the national uptake of HIV tests among pregnant women is an important course of action. Thus, we pooled the information about the national uptake of HIV tests and determined the significant factors among pregnant women in Ethiopia.Methods: We searched PubMed, Scopus, Web of Science, and Google Scholar databases. We also searched for cross-references to get additional relevant studies, and included cross-sectional, case-control and cohort study studies. We applied a random-effects model meta-analysis to pool the national data of uptake of HIV tests. Galbraith's plot and Egger's regression test were employed to check publication bias, and heterogeneity was assessed using I ² statistics. The protocol registered is found in the PROSPERO database with the registration number CRD42019129166.Results: In total, 22 articles with 13 818 pregnant women study participants were involved. The national uptake of HIV tests among pregnant women was 79.6% (95% CI 73.9-85.4). Living in urban areas (AOR 2.8; 95% CI 1.1-4.6), previous HIV tests (AOR 4.6; 95% CI 1.2-8.0), and comprehensive knowledge on mother-to-child transmission (MTCT) (AOR 2.61; 95% CI 1.5-3.7) and PMTCT of HIV (AOR 2.1; 95% CI 1.5-2.8) were associated with increased practice of HIV tests.Conclusion: This review showed that HIV test coverage among pregnant women was approximately 80% and substantially lower than the national recommendation. Addressing HIV-related health services for rural women and providing health information on MTCT and PMTCT of HIV to increase HIV testing coverage is required.

Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis.

BACKGROUND: Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopia. Thus, the goal of this meta-analysis was, first, to determine pooled incident TB among adult HIV positive patients, and second, to assess the association between incident TB and baseline CD4+ T cell count strata's. METHODS: We searched PubMed, Cochrane library, Science Direct and Google scholar databases from June 1 to 30, 2018. The I2 statistics and Egger's regression test was used to determine heterogeneity and publication bias among included studies respectively. A random effects model was used to estimate pooled incident TB and odds ratio with the respective 95% confidence intervals using Stata version 11.0 statistical software. RESULTS: A total of 403 research articles were identified, and 10 studies were included in the meta-analysis. The pooled incident TB among adult HIV infected patients in Ethiopia was 16.58% (95% CI; 13.25-19.91%). Specifically, TB incidence in Pre-ART and ART was 17.16% (95% CI; 7.95-26.37%) and 16.24% (95% CI; 12.63-19.84%) respectively. Moreover, incident TB among ART receiving patients with baseline CD4+ T cell count < and > 200 cells/mm3 was 28.86% (95% CI; 18.73-38.98%) and 13.7% (95% CI; 1.41-25.98%) correspondingly. The odds of getting incident TB was 2.88 (95% CI; 1.55-5.35%) for patients with baseline CD4+ T cell count < 200 cells/mm3 compared to patients with baseline CD4+ T cell count > 200 cells/mm3. CONCLUSION: High incident TB among adult HIV positive patients was estimated, especially in patients with CD4+ T cell count < 200 cells/mm3. Therefore, Early HIV screening and ART initiation, as well as strict compliance with ART and increasing the coverage of TB preventive therapy to more risky groups are important to prevent the problem. TRIAL REGISTRATION: Study protocol registration: CRD42018090802.

HIV/AIDS treatment failure and associated factors in Ethiopia: meta-analysis.

BACKGROUND: The national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal. METHODS: We accessed Ethiopian Universities' online repository library, Google Scholar, PubMed, Web of Science, and Scopus to get the research articles. We run I-squared statistics to see heterogeneity. Publication bias was checked by using Egger's regression test. The pooled prevalence was estimated using the DerSimonian-Laird random-effects model. We employed the sensitivity analysis to see the presence of outlier result in the included studies. RESULTS: The overall human immunodeficiency treatment failure was 15.9% (95% confidence interval: 11.6-20.1%). Using immunological, virological, and clinical definition, human immunodeficiency treatment failure was 10.2% (95% confidence interval: 6.9-13.6%), 5.6% (95% confidence interval: 2.9-8.3%), and 6.3% (95% confidence interval: 4.6-8.0%), respectively. The pooled effects of World Health Organization clinical stage III/IV (Adjusted Odd Ratio = 1.9; 95% CI: 1.3-2.6), presence of opportunistic infections (Adjusted Odd Ratio = 1.8; 95% CI: 1.2-2.4), and poor adherence to highly active antiretroviral therapy (Adjusted Odd Ratio = 8.1; 95% CI: 4.3-11.8) on HIV treatment failure were estimated. CONCLUSIONS: Human immunodeficiency virus treatment failure in Ethiopia found to be high. Being on advanced clinical stage, presence of opportunistic infections, and poor adherence to highly active antiretroviral therapy were the contributing factors of human immunodeficiency virus treatment failure. Human immunodeficiency virus intervention programs need to address the specified contributing factors of human immunodeficiency virus treatment failure. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence. PROTOCOL REGISTRATION: It has been registered in the PROSPERO database with a registration number of CRD42018100254.

Seroprevalence and associated risk factors for HIV, Hepatitis B and C among blood Donors in South Gondar District blood Bank, Northwest Ethiopia.

BACKGROUND: Despite the undeniable significance of blood transfusion in saving a millions life in emergencies and medical treatment, the quality of blood faced challenges from transfusion-transmitted infections (TTIs) such as HIV (human immunodeficiency virus), HBV (hepatitis B virus) and HCV (hepatitis C virus). This cross-sectional study was undertaken with the aim of determining the seroprevalence and risk factors of HIV, HBV, and HCV among blood donors. METHODS: An institutional based cross-sectional study was conducted at Debre Tabor district hospital from January 2017 to February 2018. Blood samples from volunteer donors collected; serum separated and screened with ELISA tests for detection of anti-HIV, hepatitis-B surface antigen (HBsAg) and anti-HCV. Fishers' exact test was employed to see the association between variables as well logistic regression tests were applied to identify potential risk factors. P-value of less than 0.05 was considered as statistically significant. RESULT: A total of 310 volunteer donors were included in the study. The proportion of blood donors having at least one viral-TTI was 12.6% while the magnitudes of HIV, HBV, and HCV were 2.6, 5.8 and 4.2%, respectively. Educational status and multiple sexual behaviors are significantly associated with HIV acquisition whilst marital status was significantly associated with HBsAg seropositivity. CONCLUSION: Seroprevalence of transfusion-transmissible infections was high and alarming therefore proper screening of donated blood with test methods having better diagnostic performance should be employed. Also encouragement of blood donation from voluntary donors and creating awareness on the general public regarding HIV, HBsAg and HCV transmission and prevention should be strengthen.

The protective effect of isoniazid preventive therapy on tuberculosis incidence among HIV positive patients receiving ART in Ethiopian settings: a meta-analysis.

BACKGROUND: Tuberculosis (TB) and HIV makeup a deadly synergy of infectious disease, and the combined effect is apparent in resource limited countries like Ethiopia. Previous studies have demonstrated inconsistent results about the protective effect of isoniazid preventive therapy (IPT) on active TB incidence among HIV positive patients receiving ART. Therefore, the aim of this meta-analysis was, first, to determine the protective effect of IPT on active tuberculosis incidence, and second, to assess the pooled incidence of active TB among HIV positive patients taking ART with and without IPT intervention in Ethiopia. METHODS: PubMed, Google scholar and Cochran library databases were searched from April 1 to 30, 2018. Two independent authors explored and assessed studies for eligibility, and extracted data based on predefined criteria. Studies that reported TB incidence among HIV positive patients taking ART in Ethiopia with and without IPT concomitant intervention, and with a clear stratified data on the incidence of TB based on the duration of IPT intervention were selected. A random effects model was used to estimate risk ratios and the pooled incident TB with the respective 95% confidence intervals. RESULTS: We identified 7 suitable studies in this analysis. Accordingly, IPT reduced the risk of TB incidence by 74%, risk ratio (RR) 0.26 (95% CI; 0.16-0.43%), compared to no IPT group. Moreover, IPT for 12 months reduced incident TB by 91% (RR: 0.09, 95% CI: 0.04 to 0.21), whereas 6 months IPT averted TB incidence by 63% (RR: 0.37, 95% CI: 0.26 to 0.52). The overall pooled incident TB among HIV infected patients receiving ART was 10.30% (95% CI; 7.57-13.02%). Specifically, incident TB among study cohorts with and without IPT was 3.79% (95% CI; 2.03-5.55%) and 16.32% (95% CI; 11.57-21.06%) respectively. CONCLUSION: IPT reduced the risk of incident TB among HIV positive patients receiving ART in Ethiopian settings. Moreover, the duration of IPT intervention has effect on its protective role. Thus, scaling up the isoniazid preventive therapy program and its strict compliance is necessary to avert HIV fueled tuberculosis. STUDY PROTOCOL REGISTRATION: CRD42018090804.

Current treatment of multidrug resistant tuberculosis in Ethiopia: an aggregated and individual patients' data analysis for outcome and effectiveness of the current regimens.

BACKGROUND: The programmatic management of Multidrug-resistant tuberculosis (MDR-TB) is entirely based on a WHO recommended long-term, 18-24 month lasting treatment regimen. However, growing evidence shows that low treatment success rate and high rates of adverse events are associated with this regimen. Up to date, the MDR-TB treatment outcome is not sufficiently understood in Ethiopia. Therefore, this analysis aimed to determine the pooled estimates of successful (cure, completed, or both), and poor outcomes (death, failure, and lost to follow ups). METHOD: A systematic search was performed to identify eligible studies reporting MDR-TB treatment outcomes in Ethiopia. Relevant studies for our analysis were retrieved from PubMed database search, Google Scholar and institutional repository sites of Ethiopian universities up to March 15, 2018. The primary outcome was treatment success, referring to a composite of cure and treatment completion. A random effect model was used to calculate pooled estimates. RESULTS: Six studies reporting treatment outcome on the 1993 MDR-TB patients were included in this analysis. Of the cases, the 1288 and 442 patients had a successful and poor outcome, respectively. In the pooled analysis, treatment success was observed in 59.2% (95%CI, 48.1-70.4) of patients, while 23.3% (95%CI, 19.7-27.0%) of patients had a poor outcome. in sub-group analysis,46.1% (95%CI, 34.2-58.0) were cured, 12.8% (5.7-20.0) treatment completed, 14.3% (11.5-17.2) died, 7.5% (3.7-11.3) lost to follow up, and 1.6% (1.1-2.2%) experienced treatment failure. The 25.0% (14.6-35.5) patients whose treatment outcome was not assessed (on treatment or transfer-out). CONCLUSION: The result of this study highlight treatment success among MDR-TB is below acceptable range. To update the current treatment regimen, the levels of evidence need to be replicated through meticulous surveillance systems. TRIAL REGISTRATION: Study protocol registration: CRD42018090711 .

Helicobacter pylori Infection and Its Risk Factors: A Prospective Cross-Sectional Study in Resource-Limited Settings of Northwest Ethiopia.

BACKGROUND: Helicobacter pylori (H. pylori) is implicated for the causation of gastrointestinal tract infections including gastric cancer. Although the infection is prevalent globally, the impact is immense in countries with poor environmental and socioeconomic status including Ethiopia. Epidemiological study on the magnitude of H. pylori and possible risk factors has priceless implication. Therefore, in this study, we determined the prevalence and risk factors of H. pylori infection in the resource-limited area of northwest Ethiopia. METHODS: A prospective cross-sectional study was conducted on northwest Ethiopia among 201 systematically selected dyspeptic patients. Data were collected using a structured and pretested questionnaire, and stool and serum samples were collected and analyzed by SD BIOLINE H. pylori Ag and dBest H. pylori Disk tests, respectively. Chi-square test was performed to see association between variables, and binary and multinomial regression tests were performed to identify potential risk factors. P values <0.05 were taken statistically significant. RESULT: Prevalence of H. pylori was found to be 71.1% (143/201) and 37.3% (75/201) using the dBest H. pylori Test Disk and SD BIOLINE H. pylori Ag test, respectively. H. pylori seropositivity, using dBest H. pylori Disk tests, is significantly associated in age groups <10 years (P=0.044) and married patients (P=0.016). In those patients with H. pylori (a positive result with either the Ab or Ag test), drinking water from well sources had 2.23 times risk of getting H. pylori infection (P=0.017), and drinking coffee (1.51 (0.79-2.96, P=0.025)) and chat chewing (1.78 (1.02-3.46, P=0.008) are the common risk factors. CONCLUSION: The present study discovered considerable magnitude of H. pylori among the dyspeptic patients in the study area. H. pylori infection is frequent in individuals drinking water from well sources, and thus, poor sanitation and unhygienic water supply are contributing factors. Policies aiming at improving the socioeconomic status will reduce potential sources of infection, transmission, and ultimately the prevalence and incidence of H. pylori.

Dolutegravir based therapy showed CD4+ T cell count recovery and viral load suppression among ART naïve people living with HIV AIDS: a pilot evaluation.

Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4+ T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5-732994.5) at baseline to 34 (23.5-46) at 3 months and 0.0 (0-19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5-417.5) versus 291 (132-522) versus 378 (181-632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes.

Khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia: a community-based study.

Introduction: Despite its deleterious consequences, khat chewing is escalating worldwide. However, there is a lack of evidence about the extent of khat chewing among pregnant women in Ethiopia, particularly in the current study area. Therefore, this study aimed to assess the prevalence of current khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia. Methods: This community-based cross-sectional study was conducted in Chiro district from November 1 to 30, 2022 G.C. Study participants were selected using the systematic random sampling technique. An interview-administered structured questionnaire was used to collect data through a house-to-house survey. The data were entered into EpiData version 3.1 and analyzed in STATA 14 software. Characteristics of study participants were summarized using descriptive analysis, and binary logistic regression was used to identify determinants of khat chewing. Results: A total of 409 pregnant women participated in this study, with a response rate of 99%. The overall prevalence of khat chewing was 60.4% (95% CI: 55.5%, 65.2%). Religion (AOR: 2.08; 95% CI: 1.13, 3.82), khat cultivation (AOR: 0.43; 95% CI: 0.25, 0.77), partner khat use (AOR: 5.54; 95% CI: 3.11, 9.88), pre-pregnancy khat use (AOR: 9.95; 95% CI: 5.55, 17.81), antenatal care (ANC) visit (AOR: 2.71; 95% CI: 1.41, 5.21), and mental distress (AOR: 4.89; 95% CI: 2.38, 10.02) were significantly associated with current khat chewing. Conclusion: The majority of pregnant women in the study area practice khat chewing. Thus, accessible and comprehensive pre-conception and pre-natal care incorporating the prevention and management of antenatal khat chewing is crucial to overcome this problem. Provision of mental healthcare involving partners of pregnant women is also important to reduce the extent and impacts of khat chewing during pregnancy. Further longitudinal studies triangulated with qualitative designs are recommended.

Tuberculosis and its associated risk factors among HIV-positive pregnant women in northwest Ethiopia: A retrospective follow-up study.

Background: People living with the human immunodeficiency virus have a higher risk of developing active tuberculosis disease. Human immunodeficiency virus infected pregnant women are at a much higher risk of getting active tuberculosis infection, partly due to immune modulation. However, very little is known about the epidemiology of tuberculosis among pregnant women infected with the virus, particularly in resource-limited settings where the burdens of these infections are substantial. Hence, this study aimed to estimate tuberculosis incidence and identify its risk factors among human immunodeficiency virus infected pregnant women in northwest Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted among pregnant women who were enrolled in option B+ prevention of mother to child transmission service between June 2013 and April 2021 in Pawe district. The Kaplan-Meier survival curve and Weibull regression model were used to estimate survival probability and identify risk factors of tuberculosis, respectively. The best model between the Cox and parametric models was chosen using the Akaike and Bayesian information criteria. Result: Out of 289 human immunodeficiency virus infected pregnant women included in the final analysis, 29 (10.03 %) developed active tuberculosis. The overall incidence of tuberculosis was 17.4 per 1000 person-months of observation (95 % CI: 12.1, 25.1). Lack of isoniazid preventive therapy (AHR: 6.68, 95 % CI: 2.67, 16.7), new enrollment to care (AHR: 2.62, 95 % CI: 1.14, 6.03), under-nutrition (AHR: 5.09, 95 % CI: 2.02, 12.83), low CD4 count (AHR: 2.61, 95 % CI: 1.01, 6.78), and suboptimal antiretroviral therapy adherence (AHR: 3.17, 95 % CI: 1.46, 6.86) were predictors of tuberculosis among HIV-positive pregnant women. Conclusion: This study found a high incidence of tuberculosis among human immunodeficiency virus infected pregnant women. Thus, strengthening the provision of tuberculosis preventive therapy, reinforcing adherence support, and controlling under-nutrition should be considered to decrease the risk of tuberculosis.

Adherence to option B+ PMTCT program and its predictors among HIV-positive women in Ethiopia. A systematic review and meta-analysis.

Background: Previously, few studies investigated level of adherence to option B+ lifelong antiretroviral therapy (ART) in Ethiopia. However, their findings were inconsistent. Therefore, this review aimed to determine the pooled magnitude of adherence to option B+ lifelong ART and its predictors among human immune virus (HIV)-positive women in Ethiopia. Methods: A comprehensive web-based search was conducted using PubMed, Cochrane Library, Science Direct, Google scholar, and African Journals Online databases to retrieve relevant articles. STATA 14 statistical software was used to carry out the meta-analysis. We used the random effects model to account for the large heterogeneity across included studies. Egger's regression test in conjunction with funnel plot and I 2 statistics were utilized to assess publication bias and heterogeneity among included studies respectively. Result: Twelve studies with a total of 2927 study participants were involved in this analysis. The pooled magnitude of adherence to option B+ lifelong ART was 80.72% (95% confidence interval [CI]: 77.05-84.39; I 2 = 85.4%). Disclosure of sero-status (OR 2.58 [95% CI: 1.55-4.3]), receiving counseling (OR 4.93 [95% CI: 3.21-7.57]), attending primary school and above (OR 2.45 [95% CI: 1.31-4.57]), partner support (OR 2.24 [95% CI: 1.11, 4.52]), good knowledge about prevention of mother-to-child transmission (PMTCT) (OR 4.22 [95% CI: 2.02-8.84]), taking less time to reach health facility (OR 1.64 [95% CI: 1.13-2.4]), and good relation with care provider (OR 3.24 [95% CI: 1.96-5.34]) were positively associated with adherence. Whereas, fear of stigma and discrimination (OR 0.12 [95% CI: 0.06-0.22]) and advanced disease stage (OR 0.59 [95% CI: 0.37-0.92]) were negatively associated. Conclusion: The level of adherence to option B+ lifelong ART was suboptimal. Strengthened comprehensive counseling and client education on PMTCT, HIV status disclosure, and male partner involvement are important to eliminate mother to child transmission and control the pandemic.

The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies.

Background: The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Methods: Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Results: Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). Conclusion: We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.

Tuberculosis and isoniazid prophylaxis among adult HIV positive patients on ART in Northwest Ethiopia.

BACKGROUND: Although antiretroviral therapy (ART) can avert tuberculosis (TB) incidence among human immunodeficiency virus (HIV) infected patients, the concomitant use of ART with isoniazid (INH) has a paramount effect. Despite this evidence, there is a paucity of data regarding TB incidence among HIV patients on ART with and without isoniazid prophylaxis and its predictors. Thus, this study sought to assess the incidence and predictors of TB among adult HIV positive patients on ART. METHODS: This was a hospital based retrospective study including 368 adult HIV positive patients on ART in Gondar comprehensive specialized hospital between January 1, 2016, and April 30, 2019. Data was extracted from clinical laboratory and HIV care ART follow up clinic. The bi-variable and multivariable regression models were used to ascertain predictors of incident TB. Data was analyzed using SPSS version 20 software. RESULTS: A total of 335 adult HIV positive patients were included in the analysis, of whom, 56 (16.7%) were developed incident TB. Being ambulatory and bedridden (AOR: 2.2, 95% CI: 1.1, 4.6), advanced WHO clinical HIV disease stage (III and IV) (AOR: 3.2, 95% CI: 1.6, 6.1), not taking INH (AOR: 2.8, 95% CI: 1.3, 5.9), and baseline CD4+ T cell count ≤ 200 cell/mm3 (AOR: 3.6, 95% CI: 1.8, 7.2) were found to be the predictors of tuberculosis incidence. CONCLUSION: The study indicated a high TB incidence among HIV positive patients in Gondar. Therefore, scaling up the isoniazid preventive therapy program and its strict compliance is necessary to avert HIV fueled tuberculosis in HIV endemic areas.

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors. METHODS: A comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger's regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively. RESULT: We identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68-2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92-3.14%) and 1.90% (95% CI, 0.40-3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86-5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57-2.75) in Amhara and 1.46% (95% CI, 0.69-2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12-0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15-7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35-17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60-1.01%). CONCLUSION: This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020211650.

Virological failure and associated factors among children receiving anti-retroviral therapy, Northwest Ethiopia.

BACKGROUND: Virological failure is under-recognized issue among children living with human immunodeficiency virus in developing countries. This partly may lead to failure to achieve the global goal of 90-90-90 targets in most developing countries including Ethiopia. OBJECTIVES: This study aimed to assess the virological failure and its predictors among children receiving antiretroviral therapy at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia. METHODS: An institutional based cross-sectional study was conducted among 253 study cohorts from January 2020-April 2021. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview, while detailed clinical data of the children were collected by reviewing the medical record. About 5 ml of blood were collected for the analysis of complete blood count and viral load quantification. Data were analyzed using SPSS version 20 and variables at p-value < 0.05 in the multivariable analysis were considered as statistically significant. RESULTS: In this study, the viral load suppression rate among antiretroviral therapy experienced children was 68.8%. Meanwhile, the overall virological failure among study participants was 19.4%. Children living without family (AOR = 3.63; 95%CI: 1.27-10.24), children with unemployed family (AOR = 4.95; 95%CI: 1.74-14.12), being wasted (AOR = 3.02; 95%CI: 1.19-7.67) being stunted (AOR = 2.38;95%CI:1.03-5.46), anemia (AOR = 5.50:95%CI;1.37-22.04) and being lymphopenic (AOR = 2.69:95%CI;1.04-7.75) were significantly associated with virological failure among children under treatment. CONCLUSION: Higher virological failure among children was noteworthy in the present study. Caretakers other than immediate family, unemployed family, wasted, stunted, anemia, and lymphopenia were significant independent predictors of virological failure. Hence, standard, and optimal management of children under treatment should be warranted.

Genetic Polymorphism of Tumor Necrosis Factor-Alpha, Interferon-Gamma and Interleukin-10 and Association With Risk of Mycobacterium Tuberculosis Infection.

BACKGROUND: Mycobacterium tuberculosis has become the leading cause of morbidity and death in humans worldwide. Thus, genetic variability of the host plays a major role in human susceptibility to the pathogen, among others. Therefore, the objective of this finding was to assess the association of genetic polymorphisms of cytokines with tuberculosis infection. METHOD: A cross-sectional study was conducted between January and May 2018. Five ml of whole blood was collected and extracted the genomic DNA through simple salting out method. The patterns of genetic polymorphism were determined by amplification refractory method PCR using specific primers. Finally, the PCR run on electrophoresis of agarose gel and the band was visualized under UV light. A logistical regression model has been adapted to assess the association of genetic polymorphisms with tubercular infection. In order to determine the association between the explanatory and outcome variable, the odds ratio with 95% CI was calculated. P < 0.05 is a statistically significant value. RESULT: In present study, the frequency of TNF-α -308 G allele and GG genotype OR (95% CI)= 0.20 (0.11-0.37), and OR (95% CI)= 0.29 (0.18-0.46)), respectively) and IFN-γ +874 A allele and AA genotype OR (95% CI)= 3.80 (2.11-6.86) and (OR (95% CI)= 1.61(1.13-2.28), respectively) were significantly associated with tuberculosis incidence. In contrast, there is no significant correlation between IL-10 -1082 A and AA of allele and genotype, respectively in tuberculosis patients (p > 0.05) was evident. CONCLUSION: From our finding, the genetic variability of TNF-α -308 A and IFN-γ +874 alleles are the potent host genetic risk factors associated with tuberculosis infection.

Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review.

INTRODUCTION: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV's disclosure status to sexual partners. METHODS: CRD42020149092 is the protocol's registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger's regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. RESULTS: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner's HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. CONCLUSION: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

Hypertriglyceridemia and Other Plasma Lipid Profile Abnormalities among People Living with Diabetes Mellitus in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: Dyslipidemia is one of the leading causes of cardiovascular complications in diabetes mellitus (DM) patients. Though it is a major public health problem in Ethiopia, there is no a nation-wide study to determine dyslipidemia among DM patients yet. Therefore, this systematic review and meta-analysis intended to estimate the prevalence of hypertriglyceridemia and other plasma lipid abnormalities among people living with DM in Ethiopia. METHODS: We systematically searched PubMed, Google Scholar, African Journals Online, Hinari, and direct Google. Studies conducted until May 9, 2020, that reports the prevalence of dyslipidemia among people living with DM were included. The DerSimonian and Laird random-effects model was used to determine the pooled prevalence of lipid profile abnormalities. Heterogeneity was checked using the I 2 statistic, whereas publication bias was tested by funnel plot and Egger's test. Besides, subgroup and sensitivity analyses were performed. RESULTS: We used 18 primary studies, including 4961 participants living with DM, which met the eligibility criteria for the meta-analysis of hypertriglyceridemia. The estimate of hypertriglyceridemia (≥150 mg/dl) was 48.15% (95% CI: 38.15-58.15, I 2 = 98.4%) after performing the main meta-analysis using the random-effects model. The subgroup analysis showed a higher pooled estimate of hypertriglyceridemia among T2DM (57.80% (95% CI: 50.50-65.10), I 2 = 92.5%), studies that used probability sampling technique (59.09% (95% CI: 43.58-74.59), I 2 = 98.6%, p < 0.001), and studies from primary data sources (51.43% (95% CI: 40.72-62.13), I 2 = 98.0%, p < 0.001). Moreover, the estimated pooled prevalence of the total plasma cholesterol (TC ≥ 200 mg/dl) was 34.08% (95% CI: 28.41-39.75, I 2 = 92.4%), LDL - C ≥ 100 mg/dl was 41.13% (95% CI: 27.15-55.11, I2 = 98.8%), and HDL ≤ 40 mg/dl for men and ≤ 50 mg/dl for women was 44.36% (95% CI: 31.82-56.90, I 2 = 98.8%). CONCLUSIONS: The pooled prevalence of hypertriglyceridemia and other lipid abnormalities among DM patients was relatively high in Ethiopia. It strongly suggests the need to give maximal attention to the adherence of DM management to reduce the circulatory lipid profile abnormalities and subsequent complications. Prospero Registration. CRD42020182291.