Nationwide changes in radiation oncology travel and location of care before and during the COVID-19 pandemic

Purpose@#Patients with cancer are particularly vulnerable to coronavirus disease (COVID). Transportation barriers made travel to obtain medical care more difficult during the pandemic. Whether these factors led to changes in the distance traveled for radiotherapy and the coordinated location of radiation treatment is unknown. @*Materials and Methods@#We analyzed patients across 60 cancer sites in the National Cancer Database from 2018 to 2020. Demographic and clinical variables were analyzed for changes in distance traveled for radiotherapy. We designated the facilities in the 99th percentile or above in terms of the proportion of patients who traveled more than 200 miles as “destination facilities.” We defined “coordinated care” as undergoing radiotherapy at the same facility where the cancer was diagnosed. @*Results@#We evaluated 1,151,954 patients. There was a greater than 1% decrease in the proportion of patients treated in the Mid-Atlantic States. Mean distance traveled from place of residence to radiation treatment decreased from 28.6 to 25.9 miles, and the proportion traveling greater than 50 miles decreased from 7.7% to 7.1%. At “destination facilities,” the proportion traveling more than 200 miles decreased from 29.3% in 2018 to 24% in 2020. In comparison, at the other hospitals, the proportion traveling more than 200 miles decreased from 1.07% to 0.97%. In 2020, residing in a rural area resulted in a lower odds of having coordinated care (multivariable odds ratio = 0.89; 95% confidence interval, 0.83–0.95). @*Conclusion@#The first year of the COVID pandemic measurably impacted the location of U.S. radiation therapy treatment.

Artificial intelligence in inflammatory bowel disease: implications for clinical practice and future directions

Inflammatory bowel disease encompasses Crohn’s disease and ulcerative colitis and is characterized by uncontrolled, relapsing, and remitting course of inflammation in the gastrointestinal tract. Artificial intelligence represents a new era within the field of gastroenterology, and the amount of research surrounding artificial intelligence in patients with inflammatory bowel disease is on the rise. As clinical trial outcomes and treatment targets evolve in inflammatory bowel disease, artificial intelligence may prove as a valuable tool for providing accurate, consistent, and reproducible evaluations of endoscopic appearance and histologic activity, thereby optimizing the diagnosis process and identifying disease severity. Furthermore, as the applications of artificial intelligence for inflammatory bowel disease continue to expand, they may present an ideal opportunity for improving disease management by predicting treatment response to biologic therapies and for refining the standard of care by setting the basis for future treatment personalization and cost reduction. The purpose of this review is to provide an overview of the unmet needs in the management of inflammatory bowel disease in clinical practice and how artificial intelligence tools can address these gaps to transform patient care.

Structure-activity relationship of pyrazol-4-yl-pyridine derivatives and identification of a radiofluorinated probe for imaging the muscarinic acetylcholine receptor M4

There is an accumulating body of evidence implicating the muscarinic acetylcholine receptor 4 (M4) in schizophrenia and dementia with Lewy bodies, however, a clinically validated M4 positron emission tomography (PET) radioligand is currently lacking. As such, the aim of this study was to develop a suitable M4 PET ligand that allows the non-invasive visualization of M4 in the brain. Structure-activity relationship studies of pyrazol-4-yl-pyridine derivates led to the discovery of target compound 12 - a subtype-selective positive allosteric modulator (PAM). The radiofluorinated analogue, [18F] 12, was synthesized in 28 ± 10% radiochemical yield, >37 GBq/μmol and an excellent radiochemical purity >99%. Initial in vitro autoradiograms on rodent brain sections were performed in the absence of carbachol and showed moderate specificity as well as a low selectivity of [18F] 12 for the M4-rich striatum. However, in the presence of carbachol, a significant increase in tracer binding was observed in the rat striatum, which was reduced by >60% under blocking conditions, thus indicating that orthosteric ligand interaction is required for efficient binding of [18F] 12 to the allosteric site. Remarkably, however, the presence of carbachol was not required for high specific binding in the non-human primate (NHP) and human striatum, and did not further improve the specificity and selectivity of [18F] 12 in higher species. These results pointed towards significant species-differences and paved the way for a preliminary PET study in NHP, where peak brain uptake of [18F] 12 was found in the putamen and temporal cortex. In conclusion, we report on the identification and preclinical development of the first radiofluorinated M4 PET radioligand with promising attributes. The availability of a clinically validated M4 PET radioligand harbors potential to facilitate drug development and provide a useful diagnostic tool for non-invasive imaging.

Building capacities for universal health care in the Philippines: Development and implementation of a leadership training program for public health nurses

@#Achievement of Universal Health Care (UHC) in the Philippines requires capable health workers who can navigate changes and lead in the local implementation of health system reforms. Public health nurses are in a strategic position to lead in UHC implementation as they constitute the largest cadre of health workers in the public health setting, and core concepts of UHC intersect with principles of public health nursing practice. This paper aims to describe the development and implementation of a leadership training program for public health nurses in the Philippines, in response to UHC. Document reviews of training reports and evaluations, including course site data analytics, and evaluation of the training program were done for the four cohorts of the course. The University of the Philippines Manila College of Nursing, with support from the Department of Health, responded to the increased demand of the Philippine health system for public health nurses with strong foundations and advanced skills by designing and offering a leadership development course specific to PHNs. From November 2019 to March 2022, a total of 183 participants from 17 regions completed the training. With the COVID-19 pandemic and dynamic changes in governance, the experiences of the project highlighted the need for flexibility in delivering the training program, updating module contents according to the latest developments, and improving course duration and evaluation. Barriers to course engagement and completion must be addressed for PHNs, their workplaces, clients, and the health system to benefit the most from the training.

Treatment of Recurrent Severe Cellulitis with a Pill in Pocket Approach / 감염과화학요법

Cellulitis is a common condition that plagues healthcare systems and is associated with significant healthcare costs and resource allocations. With ample antimicrobial therapy this infectious syndrome can be easily treated but recurrence is common. Many conditions predispose patients to be at risk for recurrent cellulitis with chronic lymphoedema being a significant risk factor secondary to pooling of lymphatic fluid and impaired local immune responses. Moreover, patients with chronic lymphoedema can be at risk for acute onset of severe cellulitis requiring urgent medical evaluation and treatment. Consequently, to prevent recurrent cellulitis episodes, the use of long-term oral antibiotics has been advocated, but when recurrences occur despite long-term antibiotic use limited options are available. In this case report, a unique treatment approach for preventing severe cellulitis is discussed with a pill in the pocket approach with the use of oral tedizolid. This has thwarted the need for recurrent hospitalizations and reduced health care costs for this individual patient. Herein this treatment approach is discussed as is the rationale for using tedizolid instead of other antibiotics.

YouTube as a source of patient education information for elbow ulnar collateral ligament injuries: a quality control content analysis

Background@#While online orthopedic resources are becoming an increasingly popular avenue for patient education, videos on YouTube are not subject to peer review. The purpose of this cross-sectional study was to evaluate the quality of YouTube videos for patient education in ulnar collateral ligament (UCL) injuries of the elbow. @*Methods@#A search of keywords for UCL injury was conducted through the YouTube search engine. Each video was categorized by source and content. Video quality, reliability, and accuracy were assessed by two independent raters using five metrics: (1) Journal of American Medical Association (JAMA) benchmark criteria (range 0–4) for video reliability; (2) modified DISCERN score (range 1–5) for video reliability; (3) Global Quality Score (GQS; range 1–5) for video quality; (4) ulnar collateral ligament-specific score (UCL-SS; range 0–16), a novel score for comprehensiveness of health information presented; and (5) accuracy score (AS; range 1–3) for accuracy. @*Results@#Video content was comprised predominantly of disease-specific information (52%) and surgical technique (33%). The most common video sources were physician (42%) and commercial (23%). The mean JAMA score, modified DISCERN score, GQS, UCL-SS, and AS were 1.8, 2.4, 1.9, 5.3, and 2.7 respectively. @*Conclusions@#Overall, YouTube is not a reliable or high-quality source for patients seeking information regarding UCL injuries, especially with videos uploaded by non-physician sources. The multiplicity of low quality, low reliability, and irrelevant videos can create a cumbersome and even inaccurate learning experience for patients.

Production, recruitment, and retention of health workers in rural areas in the Philippines

@#<p style="text-align: justify;"><strong>Objective.</strong> This study aimed to examine capacities and initiatives of the local government units (LGUs) in the Philippines in producing, recruiting and retaining human resources for health (HRH).</p><p style="text-align: justify;"><strong>Methods.</strong> This 2-phase, descriptive, cross-sectional study employed multiple methods such as key informant interviews (KIIs), focus group discussions (FGDs) (for Phase 1) and surveys (for Phase 2) in rural municipalities across the country. Phase 1: We employed qualitative methods to develop a quantitative questionnaire in 22 purposefully selected municipalities. An exhaustive enumeration of responses from the guide questions of the FGDs and KIIs were then translated into a questionnaire. Phase 2: We administered the survey questionnaire from phase 1 to another 67 municipalities to obtain a greater representation of the intended study population as well as quantify results from the qualitative methods. We analyzed data with descriptive statistics.</p><p style="text-align: justify;"><strong>Results.</strong> Initiatives in HRH production were mainly on provision of scholarships. Active recruitment was not done due to lack of available pool of applicants, lack of vacant positions, financial constraints leading to utilization of deployment programs and temporary nature of employment. Recruitment was influenced by budgetary constraints, political biases, dependency on deployment programs and other hired temporary HRH, and set health worker-to-population ratios. Initiatives to retain HRH were largely financial in nature based on pertinent policies. The capacities of LGUs to produce, recruit, and retain needed HRH were strongly dependent on the internal revenue allotment (IRA), along with their local income.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Rural municipalities in the Philippines have initiatives to produce, recruit, and retain HRH. However, these are not enough to meet the needed number of competent and highly motivated HRH that are expected to respond to the unique needs of the rural municipalities. Strategies to increase the capacity of LGUs, address the shortage of HRH, and increase motivation of HRH are recommended.</p>

Fostering partnerships between the academe-government and community in the COVID-19 pandemic response in the Philippines

@#This paper describes the COVID-19 response efforts through strategic partnerships of a nursing school in the Philippines. The roles of the academe through teaching as well as continuing education and community extension services programs were particularly harnessed. Existing academe-government-community partnerships were leveraged, and personal networks mobilized to provide support on risk communication, community engagement, and capacity building. Challenges and limitations encountered serve as points for improving the academe's strategies and activities. The lessons from this undertaking highlight the crucial role of nursing schools as relevant resources in COVID-19 pandemic response initiatives. Partnerships and networks built prior to the pandemic are instrumental in providing the space and opportunities for faculty and student nurses to aid in strengthening the local response. Recommendations are outlined to enhance current roles, strategies, and activities of the academe in the COVID-19 pandemic and lay future directions for Philippine nursing schools given the increasing incidence and severity of disasters in the country.

Assessment of Nutritional Status and Dietary Pattern of Diabetes Patients Attending Out-patient Clinics in Abuja Metropolis, Federal Capital Territory

Purpose:Nutritional status and dietary pattern of 120 randomly selected type-2 diabetic patients of both sexes (age range 18 and 65 years) attending medical outpatient clinics within Abuja metropolis were assessed. Methods:A cross-sectional survey involving pre-tested and semi-structured questionnaires was used. Socio-demographic characteristics, anthropometric measurements, nutritional status and dietary pattern of the subjects were computed using standard methods. Results:The result of socio-demographic characteristics indicates that 52% are males and 48% are females. Subjects with primary education constitute 4.2%, about half of them having either secondary (48.3%) or tertiary (47.5%) education. Most (80.8%) of them are married, 32.5% fell within a monthly income range of N50,000 -N100,000 (US $139.07 -$278.14). Anthropometric indices showed that the height of 75% of the respondents was 159.9 ± 7.0 cm, 100% of the respondents’ weight, hip circumference,waist-hip ratio and waist-height ratio are 72.69 ± 16.88 cm, 104.6 ± 12.4 cm, 0.94 ± 0.1 and 0.61 ± 0.1 respectively. The nutritional status of the subjects revealed that only 25% fell within the normal BMI range, with 1.7% being underweight, 20.8% overweight and half of them (52.5%) obese and out of which 27% are morbid. Their dietary patterns showed that the food mostly consumed include cereals, processed cereals, legumes, vegetables, fruits and meat. More than a quarter of the respondents totally avoid sugar in their diet, while 33.33% rarely eat sugar. Eggs (48.33%) have a moderate frequency of consumption. Conclusion:This study concludes that the dietary practices of the respondents contribute to their poor nutritional status.

Normalizing advanced practice in public health nursing in The Philippines: A foucauldian analysis

@#<p style="text-align: justify;">This study provides a closer look to the possibility of having advanced practice in public health nursing by analyzing the power relations between nursing practice and social structures. Representatives from the public health sector, national authorities, and the private sector were invited in a round table discussion. Transcriptions were coded and later on categorized and analyzed drawing upon the concepts of Foucault. Foucauldian analysis hands an important insight on how social structures and institutions can steer the creation of an advanced practice in public health nursing in the Philippines. Various social institutions view the relevance of a master's prepared nurse according to their societal roles and functions. Requisite competencies of a master's prepared nurse in public health nursing include fulfilling the role of a clinician, leader and manager, supervisor, and a researcher. PRBON, CHED, DOH, and nursing schools need to work together to define the knowledge of an advanced practice in public health nursing, to implement appropriate surveillance mechanisms, and to establish a compliant practice.</p>

Role of the nurse in newborn screening: Integrating genetics in nursing education and practice

@#<p style="text-align: justify;">Nurses are key players in the newborn screening (NBS) program. The inherited nature of the conditions included in the NBS panel means that nurses should be competent in integrating genetics in their practice. However, studies suggest inadequate preparation of nurses in incorporating genetics in their practice. This article aims to discuss how nurses can capitalize on existing population-based genetics programs such as newborn screening to enhance their clinical practice through genetics. An overview of the newborn screening program in the Philippines is provided as well as a discussion on the roles of nurses in genetics in the context of NBS, and a brief discussion of future directions of the Philippine newborn screening program and how this may impact nursing education and research.</p>

university of the Philippines Manila position statement on proposed house Bill no. 292, “An act imposing excise tax on sugar-sweetened beverages by inserting a new section 150-A in the national internal revenue Code of 1997, as amended”

@#<p style="text-align: justify;">The Philippines, with a maximum personal income tax rate at 32%1 and a corporate income tax of 35%,1 has one of the highest income tax rates among the Association of South East Asian(ASEAN) member states.2 The new administration is now campaigning to lower the ceilings on capital and personal income tax, through a proposal originally passed in September 2016, and amended in January 2017, following public and private sector opposition for its immediate imposition.3 In its Explanatory Note, House Bill No. 292, "An Act Imposing Excise Tax on Sugar-Sweetened Beverages by Inserting a New Section 150-A in the National Internal Revenue Code of 1997, as Amended," cites this as the reason for imposing an, "excise tax of ten pesos (Php 10.00) on sugar-sweetened beverages, the rate of which shall be increased by four percent (4%) every year thereafter effective on January 1, 2017."4 According to the proposed bill, "this measure is proposed to provide additional revenue collections for our country," further claiming that, "this house bill is timely in its submission as one of the new administration's policies to pursue reforms in income tax rates.</p>

Update on Molecular Imaging in Parkinson's Disease / 神经科学通报·英文版

Advances in radionuclide tracers have allowed for more accurate imaging that reflects the actions of numerous neurotransmitters, energy metabolism utilization, inflammation, and pathological protein accumulation. All of these achievements in molecular brain imaging have broadened our understanding of brain function in Parkinson's disease (PD). The implementation of molecular imaging has supported more accurate PD diagnosis as well as assessment of therapeutic outcome and disease progression. Moreover, molecular imaging is well suited for the detection of preclinical or prodromal PD cases. Despite these advances, future frontiers of research in this area will focus on using multi-modalities combining positron emission tomography and magnetic resonance imaging along with causal modeling with complex algorithms.

Parent-child communication about congenital adrenal hyperplasia: Filipino mothers' experience

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Family communication facilitates coping a genetic condition by ensuring accurate understanding of the illness,its inheritance pattern,associated recurrence risk and risk perception.</p><p style="text-align: justify;"><strong>OBJECTIVE: </strong>This paper explores Filipino mothers' experience in communicating information about congenital adrenal hyperplasia (CAH) to their children.</p><p style="text-align: justify;"><strong>METHODS:</strong>Descriptive qualitative design was used.families affected with CAH were recruited  via a CAH support group.Semi-structure interview with mothers were done on the following topics:content and understanding information  communicated,reasons for communicating,and changes and adjustments in the family.Thematic analysis was used to analyze the data.</p><p style="text-align: justify;"><strong>RESULTS:</strong>Five families consisting 11 individuals ,including four mothers,were interviewed.finding revealed that while mother are open to communicate with their child about CAH,this is often triggered by question from the child.Mother find it challenging to discuss about the condition  and when they do discuss,this is most often done to facilitate better understanding among the siblings.There is an attempt to explain inheritance of CAH but this is also limited to the mother's understanding.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong>The findings of the study provide guidance to health professional on how they can support parents,particularly mothers,in discussing CAH with their children.</p>

Trivalent M-related protein as a component of next generation group A streptococcal vaccines

PURPOSE: There is a need to broaden protective coverage of M protein–based vaccines against group A streptococci (GAS) because coverage of the current 30-valent M protein vaccine does not extend to all emm types. An additional GAS antigen and virulence factor that could potentially extend vaccine coverage is M-related protein (Mrp). Previous work indicated that there are three structurally related families of Mrp (MrpI, MrpII, and MrpIII) and peptides of all three elicited bactericidal antibodies against multiple emm types. The purpose of this study was to determine if a recombinant form containing Mrp from the three families would evoke bactericidal antiserum and to determine if this antiserum could enhance the effectiveness of antisera to the 30-valent M protein vaccine. MATERIALS AND METHODS: A trivalent recombinant Mrp (trMrp) protein containing N-terminal fragments from the three families (trMrp) was constructed, purified and used to immunize rabbits. Anti-trMrp sera contained high titers of antibodies against the trMrp immunogen and recombinant forms representing MrpI, MrpII, and MrpIII. RESULTS: The antisera opsonized emm types of GAS representing each Mrp family and also opsonized emm types not covered by the 30-valent M protein–based vaccine. Importantly, a combination of trMrp and 30-valent M protein antiserum resulted in higher levels of opsonization of GAS than either antiserum alone. CONCLUSION: These findings suggest that trMrp may be an effective addition to future constructs of GAS vaccines.

Preconception genetic counselling in a Filipino couple with Family History of Trisomy 18

@#Preconception genetic counselling offers an opportunity for prospective parents to understand and adjust to the medical, familial, and psychosocial implications of genetic contributions to pregnancy outcomes. In this paper, we will illustrate how preconception genetic counselling made a difference to a Filipino couple with a previous child diagnosed with Trisomy 18.

Classical natural ovine scrapie prions detected in practical volumes of blood by lamb and transgenic mouse bioassays

Scrapie is diagnosed antemortem in sheep by detecting misfolded isoforms of prion protein (PrP(Sc)) in lymphoid follicles of the rectal mucosa and nictitating membranes. Assay sensitivity is limited if (a) the biopsy is collected early during disease development, (b) an insufficient number of follicles is collected, or (c) peripheral accumulation of PrP(Sc) is reduced or delayed. A blood test would be convenient for mass live animal scrapie testing. Currently approved techniques, however, have their own detection limits. Novel detection methods may soon offer a non-animal-based, rapid platform with detection sensitivities that rival the prion bioassay. In anticipation, we sought to determine if diseased animals could be routinely identified with a bioassay using B lymphocytes isolated from blood sample volumes commonly collected for diagnostic purposes in small ruminants. Scrapie transmission was detected in five of six recipient lambs intravenously transfused with B lymphocytes isolated from 5~10 mL of blood from a naturally scrapie-infected sheep. Additionally, scrapie transmission was observed in 18 ovinized transgenic Tg338 mice intracerebrally inoculated with B lymphocytes isolated from 5~10 mL of blood from two naturally scrapie-infected sheep. Based on our findings, we anticipate that these blood sample volumes should be of diagnostic value.

global cancer divide: relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

Cancer continues to rise as a contributor to premature death in the developing world. Despite this, little is known about whether cancer outcomes are related to a country's income level, and what aspects of national healthcare systems are associated with improved cancer outcomes. The most recent estimates of cancer incidence and mortality were used to calculate mortality-to-incidence ratio [MIR] for the 85 countries with reliable data. Countries were categorized according to high-income [Gross Domestic Product [GDP] > [dollar sign]15,000] or middle/low-income [GDP < [dollar sign]15,000], and a multivariate linear regression model was used to determine the association between healthcare system indicators and cancer MIR. Indicators study included per capita GDP, overall total healthcare expenditure [THE], THE as a proportion of GDP, total external beam radiotherapy devices [TEBD] per capita, physician density, and the year 2000 WHO healthcare system rankings. Cancer MIR in high-income countries [0.47] was significantly lower than that of middle/low-income countries [0.64], with a p < 0.001. In high-income countries, GDP, health expenditure and TEBD showed significant inverse correlations with overall cancer MIR. A [dollar sign]3040 increase in GDP [p = 0.004], a [dollar sign]379 increase in THE [p < 0.001], or an increase of 0.59 TEBD per 100,000 population [p = 0.027] were all associated with a 0.01 decrease in cancer MIR. In middle/low-income countries, only WHO scores correlated with decreased cancer MIR [p = 0.022]; 12 specific cancer types also showed similar significant correlations [p < 0.05] as overall cancer MIR. The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries

Clinical Anxiety among Final Year Dental Students: The Trainers and Students Perspectives

Background: The dental clinical setting; which is a significant learning environment for undergraduate dental students; may induce anxiety; which may adversely affect the clinical performance. The purpose of this cross-sectional study was to determine the factors provoking clinical anxiety in dental students from the trainers and students perspectives. Materials and Methods: This cross-sectional study was conducted among 6 th (final) year dental students of University of Benin and their clinical trainers between January and March 2012 using the 38-item modified Moss and McManus clinical anxiety questionnaire. Results: Of the 67 participants; 32 (47.8) were 6 th year dental students while 35 (52.2) were clinical trainers. According to the students; the top clinical anxiety provoking situations were inability to meet requirements before exams; inability to pass the final exams; dealing with psychiatric patients; coping with uncooperative children; getting infected by patients; fracturing a tooth during extraction; extracting the wrong tooth; discovering calculus by the supervisor after scaling; accidental pulp exposure; inadvertently hurting patients and using the high speed hand piece. There existed concordance on the top two clinical anxiety provoking situations reported by the students and their clinical trainers. However; measuring blood pressure; taking pulse; presenting in the clinic; handling a syncopal attack; and accidental pulp exposure were statistically significant contrasting clinical anxiety provoking situations from dental students and trainers perspectives. Conclusion: Data from this study revealed that clinical trainers share largely the same perspectives with the dental students on the clinical anxiety provoking situations with slight variations. Fostering a supportive learning environment conducive to dental student learning by strengthen efforts to minimize clinical anxiety is a necessity

Depression among People Living with Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome in Benin City; Nigeria: A comparative Study

Background: Depression is a common co-morbidity among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). It is associated with poor treatment adherence and higher mortality rates. Few reports have; however; emanated from developing countries where socioeconomic factors may confound this association. Materials and Methods: We conducted a cross-sectional comparative study of PLWHAs and apparently healthy staff of three LGA's. The depression module of the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN) and the Beck Depression Inventory (BDI) was used to diagnose depression and depression symptom severity; respectively. Results: Depression was commonly co-morbid among individuals with HIV/AIDS. It was five times more common in PLWHAs than in apparently healthy populations (29.3vs. 7.3; OR: 5.25; 95 CI: 2.50-11.76). A similar trend was observed for depression symptom severity. Among PLWHAs; depression was significantly more likely among females (OR: 7.91; 95 CI: 1.83-71.00; P 0.01); those unemployed (OR: 2.94; 95CI: 0.18-1.82; P 0.04); and with an illness duration 3 years (OR: 7.90; P 0.0001). Having at least one child (OR: 2.79; 95 CI: 1.25-6.16; P 0.001) and living with others (OR: 4.71; 95 CI: 1.51-15.52; P 0.003) significantly reduced depression risk. Conclusion: Depression was commonly co-morbid among PLWHAs studied. Clinicians should be aware of risk factors for depression among PLWHAs in order to improve treatment outcomes