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Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study.

ABSTRACT: Methods:A retrospective follow-up study was conducted among clients on ART from 2012 to 2017. Data were collected using checklists. The Kaplan-Meier curve was employed to compare survival rates. The Cox proportional hazard model was applied to identify predictors of time to development of anemia. Results:A total of 490 ART patients were followed. The overall incidence of anemia was 27/100 person-years. The incidence was highest in the second year (18.7/100 PY) of starting ART when compared with the first year (13.8/100 PY) and third year (18.1/100 PY) of ART initiation. The independent predictors show an association for time to development of anemia and were as follows: being female (AHR = 2.94, 95%CI = 2.15-4.0), pulmonary tuberculosis positive (AHR = 2.98, 95%CI = 1.62-5.51), baseline weight < 60?kg (AHR = 1.51, 95%CI = 1.19-1.92), and severe acute malnutrition (AHR = 2.0, 95%CI = 1.39-2.89). Conclusion:Most of the anemia cases occurred after the first year of ART initiation. Pulmonary tuberculosis, baseline weight, nutritional status, and sex were predictors for anemia. Clients with low baseline weight and abnormal nutritional status need to get close follow-up to prevent the risk of early development of anemia.

SUBMITTER: Manaye Y

PROVIDER: S-EPMC7085871 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study.

Manaye Yibekal Y Asrat Anemaw A Mengesha Endalkachew Worku EW

BioMed research international 20200309

<h4>Methods</h4>A retrospective follow-up study was conducted among clients on ART from 2012 to 2017. Data were collected using checklists. The Kaplan-Meier curve was employed to compare survival rates. The Cox proportional hazard model was applied to identify predictors of time to development of anemia.<h4>Results</h4>A total of 490 ART patients were followed. The overall incidence of anemia was 27/100 person-years. The incidence was highest in the second year (18.7/100 PY) of starting ART when ...[more]

PMID: 32258143

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Project description:BackgroundContraception helps prevent unplanned pregnancies and mother to child Human Immune Virus (HIV) transmission among human immune virus positive women. Ethiopia has made remarkable progress in increasing contraceptive use rate but there is still a disparity of contraceptive use within the country. Although there were some studies about contraceptive use in Ethiopia, evidences about contraceptive use among sexually active HIV positive women was limited. Understanding the extent of and barriers in Ethiopia is important for learning how to best improve level of contraceptive use. Therefore, this study aimed to assess contraceptives use and associated factors among HIV positive sexually active women at anti-retroviral therapy clinic at Felege Hiwot Referral Hospital ART clinic in Bahir Dar, Ethiopia.MethodA facility-based cross-sectional study was conducted from June 01-30, 2018 among (n = 308) randomly selected HIV positive women at Felege Hiwot Referral Hospital. Data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS version 20. Survey logistic regression analysis was employed to identify determinants of contraceptive use. Statistical significance was declared at p-value <0.05.ResultsOut of three hundred eight participants, 118 (38.3%) reported contraceptive use at the time of the study. Injectable is the most preferred (43.5%) contraceptive method. Participants with age 15-34 years (AOR = 3.09, 95%CI: 1.59-5.99), disclosed their status to sex partner, (AOR = 2.7, 95%CI: 1.14-6.66), had history of contraception use; (AOR = 3.36, 95%CI: 1.68-6.74), were sexually active (AOR = 5.45, 95%CI: 2.72-10.91) had higher odds of contraceptive use. However, participants who had drinking habit (AOR = 4.35, 95%CI: 1.82-10.38) had lower odds of contraceptive use.ConclusionA significant proportion of HIV positive women had low level of contraceptive use that was lower than the national recommended level. Participants with younger age (15-34years), who disclosed HIV status to sex partner, had history of contraceptive use, and who were sexually active six months prior to the study were more likely to use contraception. However, participants who had drinking habit were less likely to use contraception. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to increase contraceptive use in the HIV positive women.

Project description:BackgroundsCongestive heart failure is a serious chronic condition when the heart's muscles become too damaged and a condition in which one or both ventricles cannot pump sufficient blood to meet the metabolic needs of the body. This study aimed to identify factors affecting the complications time of congestive heart failure patients treated from January 2016 to December 2019 at Felege Hiwot comprehensive specialized referral hospital in Bahir Dar, Ethiopia.MethodsA hospital-based retrospective data collection was collected from the medical charts of 218 randomly selected congestive heart failure patients. The Kaplan-Meier curve and the Cox proportional hazards model were used to compare and identify the factors associated with time to complication in patients with congestive heart failure.ResultsThe median complication time of congestive heart failure patients was 22 months [95% CI: 21.98-28.01]. About 194 (88.99%) of the patients were complicated. The Kaplan-Meier curve depicts the survival probability of complicated patients decreasing as the complication time increases. The hazard ratios for serum sodium concentration, left ventricular ejection fraction, patients from rural areas, age of patients, serum hemoglobin concentration, and New York heart association classes I, II, and III were given 0.94 [95% CI: 0.90-1.00], 0.74 [95% CI: 0.65-0.85], 0.75 [95% CI: 0.68-0.84], 1.28 [95% CI: 1.12-1.46], 0.89 [95% CI: 0.85-0.94], 0.44 [95% CI: 0.36-0.53], 0.54 [95% CI: 0.47-0.62] and 0.73 [95% CI: 0.65-0.81] respectively, and they are statistically associated with the complication time of congestive heart failure patients.ConclusionsThe median complication time of congestive heart failure patients was 22 months. This study strongly suggests that healthcare awareness should be strengthened earlier about the potential complications for patients with lower serum sodium concentrations below the threshold and aged congestive heart failure patients to reduce the risk of developing complications.

Project description:BackgroundUrinary tract infections (UTIs) are among the most common bacterial infections in humans, both in the community and hospital settings. It is a serious health problem affecting millions of people each year and is the leading cause of Gram-negative bacteremia. We previously conducted a study on "Urinary Bacterial Profile and Antibiotic Susceptibility Pattern of UTI among Pregnant Women in North West Ethiopia" but the study did not address risk factors associated with urinary tract infection so the aim of the study was to assess associated risk factors of UTI among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia.MethodsA total of 367 pregnant women with and without symptoms of urinary tract infection(UTI) were included as a study subject from January 2011 to April 2011. Midstream urine samples were collected and processed following standard bacteriological tests. Data concerning associated risk factors were collected using structured questionnaires and were processed and analyzed using Statistical Package for Social Science (SPSS version 16).ResultBivarait analysis of socio-demographic characteristics and associated risk factors of UTI showed that family income level (family monthly income level ≤ 500 birr($37.85); P = 0.006, OR = 5.581, CI = 1.658, 18.793 and 501-1000 birr ($37.93-$75.70), P = 0.039, OR = 3.429, CI = 1.065, 11.034), anaemia (P = 0.003, OR = 4.388, CI = 1.776, 10.839), sexual activity (P = 0.032, OR = 3.520, CI = 1.197,10.363) and past history of UTI (P = 0.000, OR = 3.397, CI = 1.672, 6.902) were found to be factors significantly associated with increase prevalence of UTI. In contrast multiparity, history of catheterization, genitourinary abnormality, maternal age, gestational age and educational status were not significantly associated with UTI among pregnant women.ConclusionIn this study UTI was high among pregnant women in the presence of associated risk factor such as anaemia, low income level, past history of UTI and sexual activity.

Project description:ObjectivesThis study aimed to assess the clinical pattern and predictors of stroke treatment outcomes among hospitalised patients in Felege Hiwot comprehensive specialised hospital (FHCSH) in northwest Ethiopia.DesignA retrospective cross-sectional study.SettingThe study was conducted medical ward of FHCSH.ParticipantsThe medical records of 597 adult patients who had a stroke were included in the study. All adult (?18 years) patients who had a stroke had been admitted to the medical ward of FHSCH during 2015-2019 were included in the study. However, patients with incomplete medical records (ie, incomplete treatment regimen and the status of the patients after treatment) were excluded in the study.ResultsIn the present study, 317 (53.1%) were males, and the mean age of the study participants was 61.08±13.76 years. About two-thirds of patients (392, 65.7%) were diagnosed with ischaemic stroke. Regarding clinical pattern, about 203 (34.0%) of patients complained of right-side body weakness and the major comorbid condition identified was hypertension (216, 64.9%). Overall, 276 (46.2%) of them had poor treatment outcomes, and 101 (16.9%) of them died. Patients who cannot read and write (AOR=42.89, 95%?CI 13.23 to 111.28, p<0.001), attend primary school (AOR=22.11, 95%?CI 6.98 to 55.99, p<0.001) and secondary school (AOR=4.20, 95%?CI 1.42 to 12.51, p<0.001), diagnosed with haemorrhagic stroke (AOR=2.68, 95%?CI 1.62 to 4.43, p<0.001) and delayed hospital arrival more than 24?hours (AOR=2.92, 95%?CI 1.83 to 4.66, p=0.001) were the independent predictors of poor treatment outcome.ConclusionsApproximately half of the patients who had a stroke had poor treatment outcomes. Ischaemic stroke was the most predominantly diagnosed stroke type. Education status, types of stroke and the median time from onset of symptoms to hospitalisation were the predictors of treatment outcome. Health education should be given to patients regarding clinical symptoms of stroke. In addition, local healthcare providers need to consider the above risk factors while managing stroke.

Project description:BackgroundCompassion is the first ethical principle of health care to provide high- quality care that influences patient satisfaction and treatment outcome. However, there is limited data on the level of compassionate mental health care practice in low-resource countries like Ethiopia.ObjectivesThis study aimed to assess the level of perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, North West, Ethiopia, 2022.MethodsAn institutional-based cross-sectional study design was conducted from June 18 to July 16, 2022, at Tibebe Ghion Specialized and Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling technique was used. The level of perceived compassionate care was assessed by the validated 12-item Schwartz Center Compassionate Care Scale among 423 patients with mental illness. Epicollect-5 was used to collect data, which was then exported to the Statistical Product and Service solution version 25 for analysis. Variables with a P-value < 0.05, and 95% confidence interval (CI) were used to declare significant variables at the multivariate logistic regression analysis.ResultThe level of perceived good compassionate care was 47.5% (95% CI 42.6%-52.4%). Factors including urban residence (AOR = 1.90; 95%CI 1.08-3.36), duration of illness < 24 months (AOR = 2.68; 95% CI 1.27-5.65), strong social support (AOR = 4.43; 95%CI 2.16-9.10), shared decision making (AOR = 3.93; 95% CI 2.27-6.81), low perceived stigma(AOR = 2.97; 95% CI 1.54-5.72) and low patient anticipated stigma (AOR = 2.92; 95% CI 1.56-5.48) were positively associated with good compassionate care.Conclusion and recommendationLess than half of the patients had received good compassionate care. Compassionate mental health care needs public health attention. Policymakers should emphasize on compassionate care continuity by including it in the health care curriculum and design appropriate policies to strengthen compassionate care.

Project description:BackgroundAlthough antiretroviral therapy (ART) significantly improves the survival status and quality of life among human immunodeficiency virus (HIV)-infected children, loss to follow-up (LTFU) from HIV-care profoundly affecting the treatment outcomes of this vulnerable population. For better interventions, up-to-date information concerning LTFU among HIV-infected children on ART is vital. However, only a few studies have been conducted in Ethiopia to address this concern. Thus, this study aims to identify the predictors of LTFU among HIV-infected children receiving ART at Debre Markos Referral Hospital.MethodsAn institution-based retrospective follow-up study was done among 408 HIV-infected children receiving ART at Debre Markos Referral Hospital between 2005 and March 15, 2019. Data were abstracted from the medical records of HIV-infected children using a standardized data abstracted checklist. We used Epi-Data Version 3.1 for data entry and Stata Version 14 for statistical analysis. The Kaplan-Meier survival curve was used to estimate the survival time. A generalized log-rank test was used to compare the survival curves of different categorical variables. Finally, both bi-variable and multivariable Cox proportional hazard regression models were used to identify the predictors of LTFU.ResultsOf 408 HIV-infected children included in the final analysis, 70 (17.1%) children were LTFU at the end of the study. The overall incidence rate of LTFU among HIV-infected children was found to be 4.5 (95%CI: 3.5-5.7) per 100-child years of observation. HIV-infected children living in rural areas (AHR: 3.2, 95%CI: 2.0-5.3), having fair or poor ART drug adherence (AHR: 2.3, 95%CI: 1.4-3.7), children started ART through test and treat approach (AHR: 2.7, 95%CI: 1.4-5.5), and children started protease inhibiter (PI)-based ART regimens (AHR: 2.2, 95%CI: 1.1-4.4) were at higher risk of LTFU.ConclusionThis study found that one in every six HIV-infected children lost form ART follow-up. HIV-infected children living in rural areas, having fair or poor ART drug adherence, started ART based on test and treat approach, and taking PI-based ART regimens were at higher risk of LTFU.

Project description:BackgroundDespite remarkable progress in the reduction of death in under-five children, neonatal mortality has shown little or no concomitant reduction globally. It is also one of the most common causes of neonatal death in Ethiopia. Little is known on predictors of neonatal sepsis. Risk based screening and commencement of treatment appreciably reduces neonatal death and illness. Therefore, the main aim of this study was to identify predictors of neonatal sepsis in public referral hospitals of Northwest Ethiopia.MethodsInstitutional based unmatched case-control study was conducted among a total of 231 neonates in Debre Markos and Felege Hiwot referral hospitals from March 2018- April 2018. Neonates who fulfill the preseted criteria for sepsis were considered as cases and neonates diagnosed with other medical reasons except sepsis were controls. For each case, two consecutive controls were selected by simple random sampling method. Data were collected using structured pretested questionnaire through a face to face interview with index mothers and by reviewing neonatal record using checklist. The collected data were entered into Epi data version 3.1 and exported to STATA/ SE software version 14. Binary and multivariable logistic regression analyses were employed. Statistical significance was declared at P<0.05.ResultMultivariable logistic regression analysis showed that, duration of rupture of membrane ≥ 18hours was significantly associated with sepsis (AOR = 10.4, 95%CI = 2.3-46.5). The other independent predictors of neonatal sepsis were number of maternal antenatal care service ≤3 (AOR = 4.4, 95%CI = 1.7-11.5), meconium stained amniotic fluid (AOR = 3.9, 95%CI = 1.5-9.8), urinary tract infection during pregnancy (AOR = 10.8, 95% CI = 3.4-33.9), intranatal fever (AOR = 3.2, 95% CI = 1.1-9.5), first minute APGAR score <7 (AOR = 3.2, 95% CI = 1.3-7.7), resuscitation at birth (AOR = 5.4, 95% CI = 1.9-15.5), nasogastric tube insertion (AOR = 3.7, 95% CI = 1.4-10.2).ConclusionNeonatal invasive procedures, ANC follow up during pregnancy, different conditions during birth like meconium stained amniotic fluid, low APGAR score and resuscitation at birth were the independent predictors of neonatal sepsis.

Dataset Information

Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study.

Publications

Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study.

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