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Determinants of Tuberculosis Infection among Adult HIV Positives Attending Clinical Care in Western Ethiopia: A Case-Control Study
Hatoluf Melkamu,Berhanu Seyoum,Yadeta Dessie
AIDS Research and Treatment , 2013, DOI: 10.1155/2013/279876
Abstract: There has been a drastic rise of tuberculosis (TB) infection across the world associated with the pandemic occurrence of HIV/AIDS. There are various determinants factors that increase the chance of TB infection among HIV positives (TB/HIV confection) that varies contextually. This study aimed to assess the determinants of TB/HIV coinfection among adult HIV positives attending clinical care at two public health facilities in Nekemte, western Ethiopia. Unmatched case-control study was conducted from December 26, 2011, to February 29, 2012. Cases were 123?TB infected HIV positives, and controls were 246 non-TB infected HIV positives. Being divorced/widowed , 95% CI (1.70, 7.88), not attending formal education , 95% CI (2.20, 14.15), being underweight ( ?kg/m2) , 95% CI (2.18, 6.87), having history of diabetic mellitus , 95% CI (1.33, 9.94), and being in advanced WHO HIV/AIDS clinical staging , 95% CI (1.32, 3.98), were determinant factors associated with TB/HIV co-infection. Having a separate kitchen , 95% CI (0.28, 0.81) showed protective role. For most of these determinants interventions can be made at individual and institutional levels, whereas, factors like education and nutrition need societal level integrations. 1. Introduction Tuberculosis (TB) is one of the world’s most common cause of death in the era of human immunodeficiency virus (HIV). It is among the leading causes of death for people living with HIV (PLWHIV) which shares about twenty-five percent of all causes of the deaths [1]. TB and HIV are called a “deadly duo” as HIV weakens the immune system and makes them more susceptible for TB infection. On the other hand, TB increases the progression of HIV to AIDS stage [2]. Globally, more than 13 million people are TB/HIV coinfected. Of these, about seventy percent are living in sub-Saharan Africa [3]. Ethiopia ranked seventh among the twenty-two high TB burden countries in the world [4]. Hospital data indicated that TB is the leading cause of morbidity and the third cause of hospital admissions in the country [5]. Studies indicated that certain HIV-infected people develop TB, while others do not. This phenomenon iterates that being HIV positive is not a mere factor for being infected with TB, and there are various determinants factors that contribute to the TB/HIV co-infection [6–8]. These factors vary contextually which necessitate conducting the present study. Therefore, the aim of this study was to identify the determinants of TB/HIV co-infection among HIV-positive adults attending clinical care at two public health facilities in Nekemte,
Determinants of Mortality among HIV Positives after Initiating Antiretroviral Therapy in Western Ethiopia: A Hospital-Based Retrospective Cohort Study
Mitiku Teshome Hambisa,Ahmed Ali,Yadeta Dessie
ISRN AIDS , 2013, DOI: 10.1155/2013/491601
Abstract: Studies revealed that there are various determinants of mortality among HIV positives after ART initiation. These determinants are so variable with context and dynamic across time with the advancement of cares and treatments. In this study we tried to identify determinants of mortality among HIV positives after initiating ART. A retrospective cohort study was conducted among 416 ART attendees enrolled between July 2005 to January 2012 in Nekemte Referral Hospital, Western Ethiopia. Actuarial table was used to estimate survival of patients after ART initiation and log rank test was used to compare the survival curves. Cox proportional-hazard regression was applied to determine the independent determinants of time to death. The estimated mortality was 4%, 5%, 6%, 7%, and 7% at 6, 12, 24, 36 and 48 months respectively with mortality incidence density of 1.89 deaths per 100 person years (95% CI 1.74, 3.62). Forty years and above AHR = 3.055 (95% CI 1.292, 7.223), low baseline hemoglobin level (AHR = 0.523 (95% CI .335, 0.816)), and poor ART adherence (AHR 27.848 (95% CI 8.928, 86.8)) were found to be an independent determinants of mortality. These determinants of mortality have to be taken into account to enhance better clinical outcomes of ART attendees. 1. Introduction HIV/AIDS remains one of the leading causes of death globally. It is projected to continue as a significant cause of premature mortality [1]. According to the joint 2011 HIV/AIDS report of WHO, UNAIDS, and UNICEF, an estimated 34 million people were living with HIV/AIDS globally with 2.7 million new HIV infections in 2010. Of these, 68% were residing in sub-Saharan Africa [2]. Ethiopia is one of the seriously affected countries in sub-Saharan Africa with a large number of people (approximately 800,000) that are living with HIV/AIDS and 44,751 AIDS-related deaths. An estimated number of 249,174 adults (86% of eligible) are on ART treatment [3–5]. The average life expectancy at birth is low,? ?51 years for males and 53 years for females. It is expected to further decline if the present HIV infection rates continue [3]. Different studies from different countries reported that WHO clinical staging, viral load, age, gender, CD4 cell count, total lymphocyte count (TLC), body mass index (BMI), ART adherence, and baseline hemoglobin level were determinants of mortality [6–10]. Even though studies had identified these determinants of mortality, they are so variable with context and dynamic across time with advancement of care and treatments as many years are being spent on highly active
Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: A cross-sectional study
Yadeta Dessie, Mulusew Gerbaba, Abdo Bedru, Gail Davey
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-422
Abstract: A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses.Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice.A considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be provided to these people at ART appointments on follow- up care. It can be provided in a one-on-one basis or through patient group educational discussions at the clinics.Ethiopia is one of the sub-Saharan countries worst affected by the HIV/AIDS pandemic. According to the Ministry of Health of Ethiopia report published in 2008, approximately 1,345,970 people were living with HIV. In 2008, the national adult HIV prevalence was estimated to be 2.1% and a total of 34,936 peop
Prevalence of Intestinal Parasitic Infection among HIV Positive Persons Who Are Naive and on Antiretroviral Treatment in Hiwot Fana Specialized University Hospital, Eastern Ethiopia
Zelalem Teklemariam,Degu Abate,Habtamu Mitiku,Yadeta Dessie
ISRN AIDS , 2013, DOI: 10.1155/2013/324329
Abstract: Background. Intestinal parasitic infection affects the health and quality of life of people living with HIV. This study was aimed to determine the prevalence of intestinal parasites among HIV positive individuals who are naive and who are on antiretroviral treatment (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Methods. A comparative cross-sectional study was conducted on 371 (112 ART-naive group and 259 on ART) HIV positive individuals. Stool specimens were collected and examined by direct wet mount, formol ether concentration technique, and modified ziehl-Neelsen methods. Results. The overall prevalence of intestinal parasitic infections was 33.7%; it was significantly higher among the study participants who were ART-naive group (45.5%) (AOR:?2.60(1.56,4.34)) and diarrheic (53.3%) (AOR:?2.30(1.34,3.96)) and with CD4 count <200 cells/μL (46%) (AOR:?2.07(1.06,4.04)). The most commonly identified parasites were Entamoeba histolytica/E. dispar (13.5%), Giardia lamblia (8.1%), Strongyloides stercoralis (4.0%), and Cryptosporidium species (2.2%). Conclusion. HIV positive individuals with diarrhea and low CD4 count and ART naive groups were more infected with intestinal parasites than their counterparts. Early stool examination and treatment of intestinal parasites for HIV/AIDS patients is essential. 1. Introduction Globally about 3.5 billion people are infected with intestinal parasite. Out of whom, 450 million are suffering from its illness [1, 2]. The prevalence of intestinal parasitic infection is high in Sub-Saharan Africa, where the majority of HIV/AIDS cases are from [2, 3]. Parasites are common infections among HIV/AIDS patients [4–7]. Diarrhea causing opportunistic parasites like Cryptosporidium parvum and Isospora belli is common among HIV positive persons with CD4 count less than 200?cells/μL [4, 5]. Antiretroviral treatment (ART) increases the length and quality of life and productivity of patients by improving survival and decreasing the incidence of opportunistic infections in people with HIV through reduction of the viral load and increasing the level of CD4 cells [8]. Nevertheless, in Ethiopia, few studies have tried to investigate the extent of intestinal parasitic infections in relation to ART experiences and CD4 count [4, 5]. Therefore, we investigated the prevalence of intestinal parasites among HIV positive persons who were naive and who were on ART in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. 2. Material and Methods 2.1. Study Setting The study was conducted in Hiwot Fana Specialized
Children Who Received PCV-10 Vaccine from a Two-Dose Vial without Preservative Are Not More Likely to Develop Injection Site Abscess Compared with Those Who Received Pentavalent (DPT-HepB-Hib) Vaccine: A Longitudinal Multi-Site Study
Yemane Berhane, Alemayehu Worku, Meaza Demissie, Neghist Tesfaye, Nega Asefa, Worku Aniemaw, Berhe Weldearegawi, Yigzaw Kebede, Tigist Shiferaw, Amare Worku, Lemessa Olijira, Behailu Merdekios, Yemane Ashebir, Takele Tadesse, Yadeta Dessie, Solomon Meseret, Gestane Ayele
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0097376
Abstract: Background The single dose pneumonia ten-valent vaccine has been widely used and is highly efficacious against selected strains Streptococcus pneumonia. A two-dose vial without preservative is being introduced in developing countries to reduce the cost of the vaccine. In routine settings improper immunization practice could result in microbial contamination leading to adverse events following immunization. Objective To monitor adverse events following immunization recommended for routine administration during infancy by comparing the rate of injection-site abscess between children who received PCV-10 vaccine and children who received the Pentavalent (DPT-HepB-Hib) vaccine. Methods A longitudinal population-based multi-site observational study was conducted between September 2011 and October 2012. The study was conducted in four existing Health and Demographic Surveillance sites run by public universities of Abraminch, Haramaya, Gondar and Mekelle. Adverse events following Immunization were monitored by trained data collectors. Children were identified at the time of vaccination and followed at home at 48 hour and 7 day following immunization. Incidence of abscess and relative risk with the corresponding 95% Confidence Intervals were calculated to examine the risk difference in the comparison groups. Results A total of 55, 268 PCV and 37, 480 Pentavalent (DPT-HepB-Hib) vaccinations were observed. A total of 19 adverse events following immunization, 10 abscesses and 9 deaths, were observed during the one year study period. The risk of developing abscess was not statistically different between children who received PCV-10 vaccine and those received Pentavalent (RR = 2.7, 95% CI 0.576–12.770), and between children who received the first aliquot of PCV and those received the second aliquot of PCV (RR = 1.72, 95% CI 0.485–6.091). Conclusion No significant increase in the risk of injection site abscess was observed between the injection sites of PCV-10 vaccine from a two-dose vial without preservative and pentavalent (DPT-HepB-Hib) vaccine in the first 7 days following vaccination.
Nitrogen Fertilizer Rate and Cultivar Interaction Effects on Nitrogen Recovery, Utilization Efficiency, and Agronomic Performance of Spring Barley
Yadeta Anbessa,Patricia Juskiw
ISRN Agronomy , 2012, DOI: 10.5402/2012/531647
Abstract:
Nitrogen Fertilizer Rate and Cultivar Interaction Effects on Nitrogen Recovery, Utilization Efficiency, and Agronomic Performance of Spring Barley
Yadeta Anbessa,Patricia Juskiw
ISRN Agronomy , 2012, DOI: 10.5402/2012/531647
Abstract: A study was carried out at Lacombe, Alberta, to develop baseline information on nitrogen recovery, utilization efficiency, and agronomic performance of spring barley. This information may enable us to understand where the inefficiencies of N nutrition may lay and determine strategies to improve nitrogen use efficiency (NUE). Three divergent cultivars, “Manley” (two-rowed, tall, late maturing), “Noble” (six-rowed, mid-height, intermediate maturing), and “Tukwa” (six-rowed, semidwarf, early maturing), were grown under low (0?kg?ha-1), moderate (50?kg?ha-1) and high (100?kg ha-1) rates of applied N fertilization. Both N recovery and utilization efficiency decreased with the increase in rate of applied N fertilizer, and NUE declined from 45?kg?kg-1N under the low N treatment to 33?kg kg-1N under the moderate treatment and 24?kg?kg-1N under the high N treatment. The test cultivars were comparable in N uptake, but Tukwa and Noble were more efficient in their utilization of the N taken up than Manley, particularly under high N. Subsequently, while grain yield of Tukwa and Noble had increased linearly with rate of N fertilizer, the grain yield of Manley showed a declining trend under high N. This implies that, where a high input condition is targeted, improvement in N utilization efficiency may need to be given due consideration. 1. Introduction The cost of N fertilizers, as tied to the cost of natural gas and other contributing factors such as inflation, has sharply increased over the years. For example, in the last two decades alone, the average price for urea, one of the most commonly used forms of N fertilizer, has increased in the United States by about 150%, from $212?Mg?1 in the spring of 1991 to $526?Mg?1 in the spring of 2011 [1]. This increase in cost of N fertilizers has certainly affected profit margins of primary producers particularly for low market value crops such as barley (Hordeum vulgare L.). In addition, there are increasing concerns about environmental pollution of excessive N from agricultural uses. Improvement in nitrogen use efficiency (NUE) may increase net returns to producers and, at the same time, reduce the amount of N lost to the environment and its negative consequences. Nitrogen use efficiency is defined as grain yield per unit of N available to the crop, and it is the product of two primary components: the efficiency of recovery of available N from soil (often called N uptake efficiency, UpE) and the amount of grain yield produced per unit of N taken up by the crop (often called N utilization efficiency, UtE) [2]. Further, UtE
Acceptance of referral for partners by clients testing positive for human immunodeficiency virus
Netsanet F, Dessie A
HIV/AIDS - Research and Palliative Care , 2013, DOI: http://dx.doi.org/10.2147/HIV.S39250
Abstract: cceptance of referral for partners by clients testing positive for human immunodeficiency virus Original Research (860) Total Article Views Authors: Netsanet F, Dessie A Published Date January 2013 Volume 2013:5 Pages 19 - 28 DOI: http://dx.doi.org/10.2147/HIV.S39250 Received: 16 October 2012 Accepted: 15 November 2012 Published: 24 January 2013 Fetene Netsanet,1 Ayalew Dessie2 1IMA World Health SuddHealth Multi Donor Trust Fund-Basic Package of Health Services Project, Juba, South Sudan; 2United States Agency for International Development, Private Health Sector Program, Abt Associates Inc, Addis Ababa, Ethiopia Background: Human immunodeficiency virus (HIV)-positive individuals who do not disclose their HIV status to their partners are more likely to present late for HIV and acquired immune deficiency syndrome (AIDS) care than those who have disclosed their HIV status to their partners. A major area of challenge with regards to HIV counseling for clients is disclosure of their HIV status to their partners. The main methods of partner notification are patient referral, provider referral, contract referral, and outreach assistance. The emphasis on a plausible and comprehensive partner referral strategy for widespread positive case detection in resource-limited countries needs to be thought out and developed. Methods: A qualitative study was conducted among newly HIV-positive clients to identify partners for notification and acceptance of referral by their partners. Health service providers working in HIV testing and counseling clinics were also provided with semistructured questionnaires in order to assess their view towards partner notification strategies for clients testing positive for HIV. Results: Fifteen newly diagnosed HIV-positive clients were counseled to provide referral slips to their partners. All clients agreed and took the referral card. However, only eight were willing and actually provided the card to their partners. Five of the eight partners of clients who tested HIV-positive and who were provided with referral cards responded to the referral and were tested for HIV. Three were positive and two were negative. Nine of 11 counselors did not agree to requesting partner locator information from HIV-positive clients for contractual referral and/or outreach assistance. The findings from the study were categorized by nine themes. A comprehensive and integrated approach of partner notification and a referral framework with active counselor involvement was developed. Conclusion: Partner notification and referral can be improved by an integrated and comprehensive framework, with active involvement of HIV counselors in the disclosure process.
Acceptance of referral for partners by clients testing positive for human immunodeficiency virus
Netsanet F,Dessie A
HIV/AIDS - Research and Palliative Care , 2013,
Abstract: Fetene Netsanet,1 Ayalew Dessie21IMA World Health SuddHealth Multi Donor Trust Fund-Basic Package of Health Services Project, Juba, South Sudan; 2United States Agency for International Development, Private Health Sector Program, Abt Associates Inc, Addis Ababa, EthiopiaBackground: Human immunodeficiency virus (HIV)-positive individuals who do not disclose their HIV status to their partners are more likely to present late for HIV and acquired immune deficiency syndrome (AIDS) care than those who have disclosed their HIV status to their partners. A major area of challenge with regards to HIV counseling for clients is disclosure of their HIV status to their partners. The main methods of partner notification are patient referral, provider referral, contract referral, and outreach assistance. The emphasis on a plausible and comprehensive partner referral strategy for widespread positive case detection in resource-limited countries needs to be thought out and developed.Methods: A qualitative study was conducted among newly HIV-positive clients to identify partners for notification and acceptance of referral by their partners. Health service providers working in HIV testing and counseling clinics were also provided with semistructured questionnaires in order to assess their view towards partner notification strategies for clients testing positive for HIV.Results: Fifteen newly diagnosed HIV-positive clients were counseled to provide referral slips to their partners. All clients agreed and took the referral card. However, only eight were willing and actually provided the card to their partners. Five of the eight partners of clients who tested HIV-positive and who were provided with referral cards responded to the referral and were tested for HIV. Three were positive and two were negative. Nine of 11 counselors did not agree to requesting partner locator information from HIV-positive clients for contractual referral and/or outreach assistance. The findings from the study were categorized by nine themes. A comprehensive and integrated approach of partner notification and a referral framework with active counselor involvement was developed.Conclusion: Partner notification and referral can be improved by an integrated and comprehensive framework, with active involvement of HIV counselors in the disclosure process.Keywords: human immunodeficiency virus, partner notification and referral, partner locator information
Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia
Legese Chelkeba,Sisay Dessie
International Journal of Research in Medical Sciences , 2013, DOI: 10.5455/2320-6012.ijrms20130802
Abstract: Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this silent killer or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence. [Int J Res Med Sci 2013; 1(3.000): 191-197]
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