HIV1 drug resistance among patients experiencing first-line treatment failure in Ethiopia: protocol for a systematic review and meta-analysis.

BACKGROUND: The emergence of HIV drug resistance presents a substantial challenge. Current antiretroviral treatments, along with current classes, face the danger of becoming partially or entirely inactive. As a result, alternative treatment regimens are limited, and treatment choices are complicated. According to the recommendation of the WHO, nations should consider changing their first-line ART regimen if HIV drug resistance exceeds 10%. In spite of the fact that a number of primary studies have been performed on HIV drug resistance in Ethiopia, their pooled prevalence rate has not been determined in a systematic review and meta-analysis, which may provide stronger evidence. Therefore, the objective of this systematic review and meta-analysis will be to estimate the pooled prevalence rate of HIV1 drug resistance in patients with first-line treatment failure in Ethiopia. METHODS: Primary studies will be identified from PubMed/MEDLINE, Scopus, Embase, Web of Science Core Collection, and Google Scholar. The period of search will be from 01 April to 30 June 2024. Studies identified through the search strategies will first be screened by titles and abstracts. Included studies meeting established criteria will be evaluated for risk of bias using the JBI checklist. Data will be extracted, and the pooled prevalence rate of HIV drug resistance will be computed using STATA 14 software. Random effect models will be used when heterogeneity is suspected. The I2 statistic and its corresponding P value will be checked to distinguish heterogeneity. Additionally, publication bias and heterogeneity will be checked using visual funnel plots, Egger's test, trim-and-fill tests, meta-regression, and subgroup analysis. To present and synthesize the results, narrative synthesis will be performed to describe study characteristics and findings, and forest plots will be used to visually represent effect sizes and confidence intervals from individual studies. DISCUSSION: Estimating the pooled prevalence rate of HIV drug resistance through a systematic review and meta-analysis improves the reliability of the evidence, the availability of effective HIV treatment options, and the ability to assist in making decisions for both clinical practice and public health policy in Ethiopia. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024533975.

The risk of mother-to-child transmission of hepatitis B virus infection in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a predominant route of infection for children in Ethiopia. No study has so far reported a nationwide estimate of the risk of MTCT of HBV. We conducted a meta-analysis of surveys and estimated the pooled risk of MTCT of HBV in the context of human immunodeficiency virus (HIV) infection. METHODOLOGY: We searched PubMed, EMBASE, Web of Science, Africa Index Medicus, and Google Scholar databases for peer-reviewed articles. The pooled risk of MTCT of HBV was estimated using the DerSimonian-Laird technique with logit transformed proportions and statistical heterogeneity was estimated using I2 statistic, which was explored by subgroup and meta-regression analyses. RESULTS: The overall pooled risk of MTCT of HBV in Ethiopia was 25.5% (95% CI, 13.4%-42.9%). In women without HIV infection, the risk of MTCT of HBV was 20.7% (95% CI 2.8%-70.4%), and 32.2% (95% CI 28.1%-36.7%) in women with HIV infection. After excluding the outlier study, the risk of MTCT of HBV in studies that included only HIV negative women was 9.4% (95% CI, 5.1%-16.6%). CONCLUSIONS: The risk of MTCT of HBV in Ethiopia widely varied by HBV/HIV coinfection. A sustainable control and elimination of HBV in Ethiopia requires improved access to birth-dose HBV vaccine and implement immunoglobulin prophylaxis for exposed infants. Given the limited health resources in Ethiopia, prenatal antiviral prophylaxis integrated with antenatal care may be a cost-effective approach to significantly reduce the risk of MTCT of HBV.

Awareness and care seeking for long COVID symptoms among Coronavirus disease survivors in Bahir Dar City, Northwest Ethiopia: phenomenological study.

BACKGROUND: Corona Virus Disease (COVID-19) has long-term sequels that persisted for months to years and manifested with a spectrum of signs and symptoms. Presentations of long COVID-19 symptoms are heterogeneous, vary from person to person, and can reach up to over 200 symptoms. Limited studies are conducted on the awareness of long COVID-19. So, this study aimed to explore the awareness about and care seeking for long COVID-19 symptoms among COVID survivors in Bahir Dar City in 2022. METHODS: A qualitative study with a phenomenological design was used. Participants of the study were individuals who survived five months or longer after they tested positive for COVID-19 in Bahir Dar city. Individuals were selected purposively. An in-depth interview guide was prepared and used to collect the data. Open Cod 4.03 software was used for coding and synthesizing. Thematic analysis was used to analyze the transcripts. RESULTS: The themes emerged from the data were awareness, experience of symptoms and their effects, and care practices of long COVID-19. Although only one participant mentioned the common symptoms of long COVID-19 the survivors experienced general, respiratory, cardiac, digestive, neurological, and other symptoms. These symptoms include rash, fatigue fever, cough, palpitations, shortness of breath, chest pain, and abdominal pain, loss of concentration, loss of smell, sleep disorder, depression, joint and muscle pain. These symptoms brought various physical and psychosocial effects. The majority of the respondents described that long COVID-19 symptoms will go off by themselves. To alleviate the problems some of the participants had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification. CONCLUSIONS: The result of this study revealed that participants have a significant deficit of awareness about the common symptoms, risk groups, and communicability of Long COVID. However, they experienced the majority of the common symptoms of Long COVID. To alleviate the problems, they had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification.

Spatial variation and level of compliance on COVID-19 prevention strategies in Amhara region, Ethiopia: observational survey

Background: The novel Coronavirus was first detected in Wuhan, China in December 2019. In Ethiopia, The COVID-19 pandemic was expanding geopgraphically overtime. Understanding the spatial variation of the pandemic and the level of compliances towards COVID-19 prevention strategies is important to guide focused prevention and control efforts. Aim: This study aimed to explore the level of compliance and spatial variation in COVID-19 prevention strategies in major cities and towns in the Amhara region, Ethiopia. Methods: A community based observational survey was conducted from June 25 to August 10, 2020, in 16 selected cities and towns of the Amhara region. The level of compliance with hand hygiene, physical distancing and mask utilization as per the WHO recommendations were observed from 6,002 individuals and 346 transport services. Getis-Ord Gi* statistics were used to identify hot spot areas with a low level of compliance with COVID19 preventive strategies. Spatial interpolation was performed to predict the level of compliance for un-sampled areas in the region. Results: The practice of hand hygiene, physical distancing and mask utilization were 12.0%, 13% and 26%, respectively. COVID-19 prevention strategies were found to be spacially non-random in Amhara region (Global Moran's I = 0.23, z-score = 9.5, P-value < 0.001). Poor (Hot Spot Areas) COVID-19 Prevention practices were spatially clustered at Northern Amhara (Metema, Gondar, and Woghemira town) and Western Amhara (Moarkos, Enjibara, And Bahir Dar town).Southern (Shewa Robit, and Kemissie Twon) and Eastern (Dessie, Kombolcha, Wolidiya, and Kobo) parts of the Amhara region were spatially clustered as cold spots (better practice) for COVID19 prevention strategies. With regards to the practice of COVID19 prevention strategies, practices were low in northern and northwestern parts of the region ( 5%), whereas this was found to be much higher in the southern part of the region (41%). Conclusion: The level of compliance with regards to hand hygiene, physical distancing and mask utilization exhibit spatial variation across the region. Continuous community-based education using different modalities are necessary to increase the practice of hand hygiene, physical distancing and mask utilization