HIV-infected adolescents have low adherence to antiretroviral therapy: a cross-sectional study in Addis Ababa, Ethiopia.
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ABSTRACT:
SUBMITTER: Firdu N
PROVIDER: S-EPMC5554655 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:To determine the prevalence of syphilis and its risk factors among people with HIV at a hospital in Ethiopia.A hospital-based cross-sectional study.This study was conducted at one of the largest public hospitals in Addis Ababa , Ethiopia.A consecutive 306 HIV-positive patients were recruited prospectively from January to March 2010. For comparative purposes, 224 HIV-negative consecutive attendees at the voluntary counselling and testing centre in the same period were also included. Participants under 15 years of age and treated for syphilis and with a CD4 T-cell count below 50 cells/mm(3) were excluded.Blood samples and data on sociodemographic and risk factors for syphilis were collected. Sera were screened for syphilis using rapid plasma reagin (RPR) test, and those positives were retested using Treponema pallidum haemagglutination assay (TPHA) test.The seroprevalence of syphilis among HIV-infected individuals was 9.8% compared with 1.3% among HIV-uninfected individuals, OR 8.01 (95% CI 2.4 to 26.6; p=0.001). A comparable rate of syphilis was found among men (11%) and women (8.9%) with HIV infection. Syphilis prevalence non-significantly increased with age, with the highest rate in 40-49 years of age (16.9%). Except a history of sexually transmitted infections, which was associated with syphilis OR 2.25 (95% CI 1.03 to 4.9; p=0.042), other risk factors did not raise the odds of infection.The high prevalence of syphilis among people with HIV infection highlights the need to target this population to prevent the transmission of both infections. Screening all HIV-infected people for syphilis and managing those infected would have clinical and epidemiological importance.
| S-EPMC3641471 | biostudies-other
Project description:Both under- and over-nutrition may occur among human immunodeficiency virus (HIV)-infected individuals and impact on the course of the acquired immune deficiency syndrome (AIDS) and its management due to the close interaction between immunity and nutrition. We investigated occurrence of undernutrition, excess weight and lipid abnormalities among antiretroviral naïve HIV-infected adults in Addis Ababa, Ethiopia.A cross-sectional study on 594 antiretroviral therapy (ART) naïve HIV-infected adults was conducted in four hospitals in Addis Ababa from February to September 2013. Hematological parameters (CD4+ T cell count and hemoglobin concentration), fasting serum glucose, total cholesterol (TC) and triglycerides (TG) were determined. Information on socio-demographic, anthropometric and World Health Organization (WHO) clinical stages was collected from patient clinical records, and triangulated by structured questionnaire. Height and weight measurements were taken and body mass index (BMI), undernutrition (BMI <18.5 kg/m2) and excess weight (BMI ?25 kg/m2) determined. Statistical comparisons were made to identify significant factors associated with nutritional status and lipid profiles.The prevalence of undernutrition was 15.1%, and the prevalence of excess weight was 22.1%, including 5.4% who were obese. The prevalence of hypercholesterolemia was 16.6% and it was higher in women (18.9%) than in men (11.0%) (p<0.05). However, the prevalence of hypertriglyceridemia was 29.8%. There was significant positive Spearman correlation between CD4+ T cell count and serum TC (r = 0.210, p<0.001), but no correlation was observed between CD4+ T cell count and TG (r = -0.007, p>0.05). Age categories 30-39 and 40-79, and WHO clinical stages III/IV for undernutrition; age categories 30-39 and 40-79, WHO clinical stages III/IV and TC ?200 mg/dL for excess weight; and being female, age categories 30-39 and 40-79, and hypertriglyceridemia for hypercholesterolemia were found to be independent predictors by binomial logistic regression analysis.Undernutrition, excess weight, hypercholesterolemia and hypertriglyceridemia were variably prevalent in ART naïve HIV-infected populations. This emphasizes the need for targeted nutritional programs as an integral part of HIV/AIDS care. Lipid levels need to be monitored regularly in patients whether on or off ART. In addition, improvement on household income and positive change in lifestyle and/or nutritional treatment to reduce morbidity and mortality are necessary interventions in HIV/AIDs patient management.
| S-EPMC5908150 | biostudies-literature
Project description:BackgroundVertical transmission of HIV remains one of the most common transmission modes. Antiretroviral therapy (ART) decreases the risk of transmission to less than 2%, but maintaining adherence to treatment remains a challenge. Some of the commonly reported barriers to adherence to ART include stress (physical and emotional), depression, and alcohol and drug abuse. Integrating screening and treatment for psychological problem such as depression was reported to improve adherence. In this study, we sought to determine the prevalence of depression and its association with adherence to ART among HIV-positive pregnant women attending antenatal care (ANC) clinics in Addis Ababa, Ethiopia.MethodsWe conducted a cross-sectional survey from March through November 2018. Participants were conveniently sampled from 12 health institutions offering ANC services. We used the Patient Health Questionnaire-9 (PHQ-9) to screen for depression and the Center for Adherence Support Evaluation (CASE) Adherence index to evaluate adherence to ART. Descriptive statistics was used to estimate the prevalence of depression during third-trimester pregnancy and nonadherence to ART. A bivariate logistic regression analysis was used to get significant predictors for each of the two outcome measures. The final multivariable logistic regression analysis included variables with a P<0.25 in the bivariate logistic regression model; statistical significance was evaluated at P<0.05.ResultsWe approached 397 eligible individuals, of whom 368 (92.7%) participated and were included in the analysis. Of the total participants, 175(47.6%) had depression. The participants' overall level of adherence to ART was 82%. Pregnant women with low income were twice more likely to have depression (AOR = 2.10, 95%CI = 1.31-3.36). Women with WHO clinical Stage 1 disease were less likely to have depression than women with more advanced disease (AOR = 0.16, 95%CI = 0.05-0.48). There was a statistically significant association between depression and nonadherence to ART (P = 0.020); nonadherence was nearly two times higher among participants with depression (AOR = 1.88, 95%CI = 1.08-3.27).ConclusionWe found a high prevalence of depression among HIV-positive pregnant women in the selected health facilities in Addis Ababa, and what was more concerning was its association with higher rates of nonadherence to ART adversely affecting the outcome of their HIV care. We recommend integrating screening for depression in routine ANC services.
| S-EPMC8775187 | biostudies-literature
Project description:BackgroundOne way of addressing malnutrition among HIV/AIDS patients is through the Food by Prescription program (FBP) and many studies have explained the treatment outcomes after therapeutic food supplementation, though available evidences on adherence levels and factors associated with these sorts of programs are limited. The findings of this study would therefore contribute to the existing knowledge on adherence to Ready-to-Use Therapeutic/Supplementary Food (RUF) in Ethiopia.MethodsA facility-based, cross-sectional study supplemented with qualitative methods was conducted among 630 adult HIV + patients. Their level of adherence to RUF was measured using the Morisky 8-item Medication Adherence Scale (MMAS-8). The total score on the MMAS-8 ranges from 0 to 8, with scores of <6, 6 to <8, and 8 reflecting low, medium, and high adherence, respectively. Patients who had a low or a moderate rate of adherence were considered non-adherent.ResultsThe level of adherence was found to be 36.3% with a 95.0% response rate. With the exception of the educational status, other socio-demographic variables had no significant effect on adherence. Those who knew the benefits of the FBP program were 1.78 times more likely to adhere to the therapy than the referent groups. On the other hand, patients who were not informed on the duration of the treatment, those prescribed with more than 2 sachets/day and had been taking RUF for more than 4 month were less likely to adhere. The main reasons for non-adherence were not liking the way the food tasted and missing follow-up appointments. Stigma and sharing and selling food were the other reasons, as deduced from the focus group discussion (FGD) findings.ConclusionThe observed level of adherence to the FBP program among respondents enrolled in the intervention program was low. The major factors identified with a low adherence were a low level of education, poor knowledge on the benefits of RUF, the longer duration of the program, consuming more than two prescribed sachets of RUF per day, and not being informed about the duration of the treatment. Therefore, counseling patients on the program's benefits, including the treatment plans, would likely contribute to improved adherence.
| S-EPMC4101708 | biostudies-literature
Project description:BackgroundHematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with a variety of bleeding disorders. However, its magnitude and related factors have not been well-characterized in the era of highly active antiretroviral therapy (HAART) in Ethiopia. Therefore, this study aimed to assess the prevalence of thrombocytopenia before and after initiation of HAART among HIV positive patients attending Black Lion Specialized Hospital, Addis Ababa, Ethiopia.MethodsA cross sectional study was conducted from February to April 2017 in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. A total of 176 patients on HAART were selected using simple random sampling techniques. Socio-demographic and clinical characteristics of the study patients were collected using structured questionnaire. Measurements of platelet counts and CD4 + T cell counts were made using Sysmex XT 2000i hematology analyzer and BD FACS Count CD4 analyzer, respectively. Statistical analysis of the data (Paired T- test and binary logistic regression) was done using SPSS version 20. P-value < 0.05 was considered as statistically significant.ResultsA total of 176 patients (Age > 18 years old) were enrolled in this study and had a mean age of 40.08 ± 9.38 years. There was significant increase in the mean values of platelet counts (218.44 ± 106.6 × 103/μl vs 273.65 ± 83.8 × 103/μl, p < 0.001) after six months of HAART initiation compared to the baseline. Prevalence of thrombocytopenia before and after HAART initiation was 25 and 5.7% respectively. HIV patients whose CD4 counts < 200 Cells/μl were more likely to have thrombocytopenia than HIV patients whose CD4 count ≥350 Cells/μl. However, it was not statistically associated with prevalence of thrombocytopenia.ConclusionsThis study has shown that the prevalence of thrombocytopenia after HAART initiation was decreased significantly. Based on our results, a number of study participants still had thrombocytopenia after initiation of HAART. Therefore, continuous screening for thrombocytopenia among HIV infected patients should be performed to decrease the risk of morbidity and mortality.
| S-EPMC5944097 | biostudies-literature
Project description:Background Adherence to self-care recommendations in heart failure (HF) patients is essential to improve the patients’ quality of life, prevent hospital admission, and reduce mortality and morbidity. Nevertheless, poor adherence to self-care recommendations remains to be an extensive problem for HF patients. Thus, the aim was to assess adherence to self-care recommendations and associated factors among HF patients in public hospitals, Addis Ababa, Ethiopia, 2021. Methods An institutional-based cross-sectional study was conducted among adult HF patients from February 15 to April 15, 2021, in five public hospitals, in Addis Ababa, Ethiopia. A total of 294 adult HF patients completed an interviewer-administered questionnaire in the Amharic language. The Revised HF Compliance Questionnaire was used to measure the adherence to self-care recommendations of HF patients. Data was collected using the Revised HF Compliance Questionnaire, the Japanese heart failure knowledge scale, the multidimensional scale of perceived social support, and the chronic diseases self-efficacy scale. Study participants were selected through a systematic random sampling technique. Data were entered into Epi-info version 7.1 and then exported to SPSS Version 25 for analysis. Descriptive and logistic regression analyses were performed and the statistical significance of associations between the variables was determined using ORs with 95% CI and p-values < 0.05. Results Adherence to self-care recommendations among adult HF patients in public hospitals, in Addis Ababa, Ethiopia was 32.70%. Being female (AOR 4.66, 95% CI 1.58–13.67), patients who had high family monthly income (AOR 10.32, 95% CI 2.00–5.13), NYHA class III (AOR: 7.01, 95% CI 2.18–22.57) and class IV (AOR: 6.30, 95% CI 1.01–39.22), who had good self-efficacy (AOR 7.63, 95% CI 2.64–21.97), and who had good knowledge about HF (AOR 3.95, 95% CI 1.56–9.95) were more likely to have good adherence to self-care recommendations, p-value < 0.05. Conclusion This study revealed that 32.70% of adult HF patients had good adherence to self-care recommendations. Factors associated with adherence to self-care recommendations of adult HF patients are sex, family monthly income, NYHA classification, self-efficacy, and knowledge about HF. Therefore, interventions focused on sex, family monthly income, NYHA classification, self-efficacy, and knowledge about HF are required to improve adherence to self-care recommendations of adult HF patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02717-3.
| S-EPMC9206252 | biostudies-literature
Project description:ObjectiveTuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. Smear positive tuberculosis patients are responsible for up to 90% of transmission occurring in the community. However, little is known about pulmonary tuberculosis preventive practices among bus users in Ethiopia. This study aimed to assess the level of Pulmonary Tuberculosis (PTB) preventive practices and associated factors among bus users at Addis Ababa.ResultsCommunity based cross-sectional study was conducted among bus users at Addis Ababa. Participants were selected using systematic sampling technique. Overall, 50.5% of bus users had good practices on prevention of PTB at Addis Ababa. The odds of practicing prevention of PTB among participants who were attended secondary school (AOR?=?4.63; 95% CI 2.62, 11.17) and higher education (AOR?=?2.86: 95% CI 1.13, 7.73), resided at Addis Ababa (AOR?=?2.51; 95% CI 1.61, 5.21), knowledgeable about PTB (AOR?=?4.12; 95% CI 3.14, 5.70), and using mass media (AOR?=?2.14; 95% CI 1.78, 4.27) as a source of information were higher than the odds of their respective counterparts. The overall practice of pulmonary tuberculosis prevention among city bus users in the study area was low. Therefore, enhancing educational opportunity and increase community awareness about the causes, risk factors and means of transmission using mass media might improve the practices of PTB prevention during bus transportation.
| S-EPMC6390587 | biostudies-literature
Project description:Background Fasting before anesthesia is mandatory in children to reduce the complications of regurgitation, vomiting, and aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children, because high fluid turnover quickly leads to dehydration, hypotension, metabolic disturbances, and hypoglycemia, resulting in poor anesthetic outcomes. Aims This study aimed to assess adherence to preoperative fasting guidelines and associated factors among pediatric patients undergoing elective surgery in Addis Ababa public hospitals in Ethiopia in 2020. Methods A cross-sectional survey was conducted in Addis Ababa, which selected public hospitals in Ethiopia, in 2020. A total of 279 pediatric patients aged <17 years scheduled for elective surgery were included in the study. Data analysis was performed using SPSS V.21, and the values of the variables and factors were checked for associations using logistic regression. Statistical significance was determined at P -value of <0.05. The results are presented in text, tables, charts, and graphs. Results A total of 279 pediatric patients responded to the analysis, with a 98.6% response rate. The majority of the participants (n = 251, 89.96%) did not follow the guidelines for preoperative fasting. The mean fasting time for clear liquids was 10 ± 4.03 (2–18 h) for breast milk 7.18 ± 2.26 (3.5–12 h), and for solid foods 13.5 ± 2.76 (8–19 h). The reasons for which the preoperative fasting delay was due to incorrect order were 35.1%, prior case procedures took longer times 34.1%, and changing sequence of schedule was 20.8%. Conclusion Most children had prolonged fasting. The staff's instructions and schedules were challenged to follow international fasting guidelines. Highlights • Fasting practice in children still challenged.• Fasting orders should be clearly led by organized body.• Care givers should have basic information to fasting protocol.
| S-EPMC9207049 | biostudies-literature
Project description:ObjectiveThe aim of this study was to assess levels of triage skill and associated factors among emergency nurses in Addis Ababa, Ethiopia, 2017.ResultsAbove half of the participants (52.9%) had a moderate level of triage skill. A strong positive relationship was found between nurses' level of triage knowledge and skill (r?=?.68, p .01). Knowledge about triage, educational level and training experience had a significant relationship with triage skill with (B?=?1.09, CI (1.41, 1.77), p?=?.002), (B?=?-?19.96, CI (-?30.208, -?9.715), p?=?.001), (B?=?.55, CI .16, .94), p?=?.006) respectively. This study revealed that most triage nurses had a moderate level of skills. Therefore, the ministry of health and hospitals should provide training and education to improve triage skill.
| S-EPMC6131741 | biostudies-literature
Project description:ObjectiveTo assess where the delays occur in the referral chain of most maternal health outcomes in Addis Ababa, Ethiopia, based on the three-delay model.DesignThe study was a facility-based, cross-sectional study.SettingTwo public and tertiary hospitals in Addis Ababa.ParticipantsAll pregnant women who were referred only for labour and delivery services after 28 weeks of gestation between December 2018 and February 2019 in Zewditu and Gandhi Memorial Hospitals.Primary and secondary outcome measuresThe primary outcome was the type of delays, from the three-delay model, which met operationally defined time. The secondary outcome was maternal health outcomes based on the three-delay model.ResultsA total of 403 pregnant women referred for delivery to the study hospitals were included in the study. Three-fourths (301, 74.7%) of the referred pregnant women experienced the third delay (delay in receiving appropriate care); 211 (52.4%) experienced the first delay (delay in making a decision to seek care). Overall 366 (90.8%) pregnant women had experienced at least one of the three delays and 71 (17.6%) experienced all three delays. Twenty-nine (7.2%) referred women had severe maternal outcomes. The leading causes/diagnoses of severe maternal outcomes were blood transfusion (17, 58.6%), followed by postpartum haemorrhage (15, 52%) and eclampsia (9, 31%). In addition, women who experienced severe maternal outcomes were 2.9 times more likely to have experienced at least one of the three delays.Conclusion and recommendationThis study highlights the persistence of delays at all levels, and especially the third delay and its contribution to severe maternal outcomes. We recommend strengthening the health referral systems and addressing specific health system bottlenecks during labour and birth in order to ensure no mother is endangered. We also recommend conducting a qualitative method of study (focus group discussion and indepth interview) and observing tertiary hospitals' set-up and readiness to manage obstetric emergencies.
| S-EPMC7312330 | biostudies-literature