ABSTRACT
OBJECTIVES@#This meta-analysis investigated the risk of congenital anomalies among infants of human immunodeficiency virus-infected pregnant women who were exposed to antiretroviral therapy (ART). @*METHODS@#Cohort studies, case-control studies, randomized controlled trials, and controlled clinical trials were reviewed by searching MEDLINE/PubMed, Embase, Web of Science, Scopus, AIDSLINE, CINAHL, Cochrane Library, and Google/Google Scholar. Methodological quality was assessed using the GRADE evaluation. A DerSimonian and Laird random-effects model was used. Subgroup analyses and meta-regression were used to investigate heterogeneity. @*RESULTS@#The electronic searches yielded 765 items. After quality assessment and grading, 30 studies were suitable for metaanalysis. In total, 1,461 congenital anomalies were found among 53,186 births. Children born to women receiving combined antiretroviral therapy (cART) had an approximately 10% higher risk of developing congenital anomalies (relative risk [RR], 1.09; 95% confidence interval [CI], 1.04 to 1.14). A subgroup analysis found no significant difference in the risk of congenital anomalies between cART and efavirenz users. However, zidovudine and protease inhibitor (RR, 1.09; 95% CI, 1.00 to 1.19) users were found to have a 10% increased risk of congenital anomalies, and integrase inhibitor users had a 60% increase in risk (RR, 1.61; 95% CI, 1.60 to 2.43). The subgroup results should be interpreted cautiously because of the moderate heterogeneity (I2 =58%). @*CONCLUSIONS@#The use of protease inhibitors, integrase inhibitors, zidovudine, and newer drugs should be carefully considered in pregnant women. Further studies are needed to address environmental, nutrition, and adherence factors related to ART. Establishing a congenital anomalies surveillance system is recommended.
ABSTRACT
OBJECTIVES@#This meta-analysis investigated the risk of congenital anomalies among infants of human immunodeficiency virus-infected pregnant women who were exposed to antiretroviral therapy (ART). @*METHODS@#Cohort studies, case-control studies, randomized controlled trials, and controlled clinical trials were reviewed by searching MEDLINE/PubMed, Embase, Web of Science, Scopus, AIDSLINE, CINAHL, Cochrane Library, and Google/Google Scholar. Methodological quality was assessed using the GRADE evaluation. A DerSimonian and Laird random-effects model was used. Subgroup analyses and meta-regression were used to investigate heterogeneity. @*RESULTS@#The electronic searches yielded 765 items. After quality assessment and grading, 30 studies were suitable for metaanalysis. In total, 1,461 congenital anomalies were found among 53,186 births. Children born to women receiving combined antiretroviral therapy (cART) had an approximately 10% higher risk of developing congenital anomalies (relative risk [RR], 1.09; 95% confidence interval [CI], 1.04 to 1.14). A subgroup analysis found no significant difference in the risk of congenital anomalies between cART and efavirenz users. However, zidovudine and protease inhibitor (RR, 1.09; 95% CI, 1.00 to 1.19) users were found to have a 10% increased risk of congenital anomalies, and integrase inhibitor users had a 60% increase in risk (RR, 1.61; 95% CI, 1.60 to 2.43). The subgroup results should be interpreted cautiously because of the moderate heterogeneity (I2 =58%). @*CONCLUSIONS@#The use of protease inhibitors, integrase inhibitors, zidovudine, and newer drugs should be carefully considered in pregnant women. Further studies are needed to address environmental, nutrition, and adherence factors related to ART. Establishing a congenital anomalies surveillance system is recommended.
ABSTRACT
Objective To assess the knowledge, attitude and practice of the community related to cutaneous leishmaniasis (CL) in an endemic area Ochello, Gamo Gofa Zone, South Ethiopia. Methods We conducted community based cross-sectional survey among residents in Ochello from November to December 2014. The study area was purposely selected based on previous reports on endemicity of CL. Using simple random sampling technique, a total of 392 household participants were selected in the study area Ochello. Structured questionnaire was used to collect the data. Regarding the responses given to knowledge, attitude and practice, a score of 1 was given for each right response and 0 for unsure responses. Data were double entered and analysis was conducted using SPSS version 20 statistical software. Descriptive statistics that include frequency and percentage were used to analyze the results. Results In total, 392 individuals were participated in our study where 225 (57.4%) of the participants were males and 167 (42.6%) were females. Of all the total participants, 265 (67.6%) had heard of the disease, and 127 (32.4%) responded that they did not know CL. Based on the scoring results, 265 (67.6%) participants were knowledgeable about CL. Out of 265 participants who heard about CL, most of them [215 (54.8%)] had the attitude that CL was a problem in their area and had no positive attitude towards the treatment of CL. Approximately, 215 (54.8%) replied that CL was preventable. Majority of the respondents did not sleep outdoors and did not practice sleeping near vegetation with or without bed net. Conclusions The current finding indicated that the inhabitants of Ochello developed good awareness and encouraging attitude regarding CL. However, their prevention and control practice was very low. Hence, the result of this study calls for organized community awareness creation through various means.
ABSTRACT
OBJECTIVES: Associations between khat (Catha edulis) chewing and different adverse oral-dental health conditions have been reported, yet evidence is still lacking. This study was designed to investigate the association between long-term regular khat chewing and self-reported oral symptoms. METHODS: A cross-sectional study was conducted on a sample of 1,255 university students in southern Ethiopia. Data on khat chewing status, a range of oral symptoms and other pertinent variables were collected using self-administered questionnaires. The association between long-term regular khat chewing and oral symptom count was investigated using negative binomial regression. RESULTS: The mean oral symptom count among long-term regular khat chewers was 1.75 (standard deviation [SD], 2.18; standard error [SE], 0.31), whereas that among those who were not long-term regular khat chewers was 1.18 (SD, 1.68; SE, 0.10). After adjustment for other variables, long-term regular khat chewers had approximately 50% more oral symptoms than those who were not long-term chewers did (adjusted count ratio, 1.53; 95% confidence interval, 1.12 to 2.10). CONCLUSIONS: Long-term khat chewing negatively affects the oral health of young university students.
Subject(s)
Humans , Catha , Cross-Sectional Studies , Ethiopia , Mastication , Oral Health , Surveys and QuestionnairesABSTRACT
Background: The outcome of antiretroviral treatment; survival patterns and associated determining factors in public hospitals are not well known. Thus a longitudinal study is vital to understand the pattern of survival and treatment outcome. Objective: To assess the outcome of antiretroviral treatment in rural public hospitals in South Nations; Nationalities and Peoples Region; Ethiopia. Method: A historical retrospective cohort study design was used for patients visiting hospitals from January 1; 2005 to January 31; 2009. A total of 5;664 patient records were examined from eight randomly selected public hospitals. Kaplan-Meier models were used to estimate mortality and Cox proportional hazards models to identify predictors of mortality. Results: The median age was 30 years and 73.6were in the age group 25-40 while the higher HIV risk age group 14-24 covered only 12.8. The proportion of females was 56.3. The cumulative proportions of survivals were 92; 90; 88and 86at months 6; 12; 24 and 36 respectively. The hazard of death was higher in male (AHR: 1.632; CI: 1.309-2.034) and those who had a baseline CD4 cell count 50 cells /ml compared to these with a count of above 200(AHR: 3.176; CI: 2.304- 4.434). Patients with WHO stage IV at baseline had a higher risk of death compared to these with a WHO stage I (AHR: 5.603; CI: 1.753-17.905).Conclusions: There is an indication of improvement of survival in the patient population. An advanced disease stage; Low CD4 cell count; gender and timing of ARV regimen combinations had significant contribution in determining a longer survival time. Priority should thus be given to identify HIV-infected individuals and start ART earlier in thecourse of their illness. [