Risky sexual practice and associated factors among adult people living with HIV/AIDS in public hospitals of Kembata Tambaro Zone, Southern Ethiopia: a cross-sectional study.

OBJECTIVE: This study assessed the magnitude of risky sexual practices and associated factors among adult people living with HIV (PLHIV) attending antiretroviral clinics in public hospitals in Kembata Tembaro Zone, southern Ethiopia. DESIGN: A cross-sectional study was conducted. SETTING: A hospital-based study was conducted among adult PLHIV in the Kambata Tambaro Zone, southern Ethiopia. PARTICIPANTS: 300 men and women aged 15 years and older who had been receiving HIV/AIDS care and support in four public hospitals participated in this study. STUDY OUTCOME: Risky sexual practice was the study outcome. It was defined based on responses to four items: multiple sexual partnerships, casual sex, consistent condom use and sex under the influence of alcohol. Risky sexual practice was defined based on a 'yes' response to any of the four items. RESULTS: Of the adult PLHIV who were sexually active in the 6 months preceding the survey, 75.7% (95% CI: 70.5% to 80.2%) engaged in at least one risky sexual practice, with 3.3% (95% CI: 1.8% to 6.1%) engaged in three or more. A positive attitude towards condom use and being on antiretroviral therapy for over 10 years were correlated with low odds of risky sexual practices. There was a higher likelihood of risky sexual behaviour among those who kept their HIV status secret and did not bring up using a condom before sexual contact. Whereas, those with a positive attitude towards condom use had a reduced risk of engaging in risky sexual practices. CONCLUSION: A considerable proportion of adult PLHIV engage in risky sexual practices. Efforts directed at removing barriers to disclosing HIV status to partners and promoting condom use discussion among sexual partners could reduce the burden of risky sexual practices and the onward transmission of HIV.

Active case detection and treatment of malaria in pregnancy using LAMP technology (LAMPREG): a pragmatic randomised diagnostic outcomes trial-study protocol.

INTRODUCTION: Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design. METHODS AND ANALYSIS: A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight. ETHICS AND DISSEMINATION: The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO's Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT03754322.

Predictors of Service Satisfaction Among Clients Receiving Antiretroviral Therapy Services at Public Hospitals in Eastern Ethiopia.

BACKGROUND: The issue of service satisfaction with antiretroviral therapy services needs more attention as it indicates the outcome of quality health services. Although different studies have been conducted on client satisfaction in different countries, there is limited evidence on the major predictors of client satisfaction with ART services in Ethiopia. OBJECTIVE: To assess the predictors of service satisfaction among clients receiving antiretroviral therapy services at a public hospital in Harar Town, Eastern Ethiopia. METHODS: A hospital-based cross-sectional study design was employed among 413 antiretroviral therapy clients from February to March 2018. The data were cleaned and entered into EpiData version 3.1 and exported to SPSS version 21 for analysis. A five-point Likert scale was used to assess client satisfaction with the ART services. Clients who scored ≥75% of the items were categorized as "satisfied" and those who scored <75% of the items were categorized as "dissatisfied". Independent variables with a p-value of ≤0.25 in the binary regression analysis were included in the multivariate logistic regression analysis to control confounding factors. Statistical significance was set at a p-value less than 0.05. RESULTS: The overall client satisfaction with ART services was 76.9% (95% CI: 72.6, 80.6). Regarding the predictors, clients who were not attending formal education [(AOR=3.7, 95% CI: 1.75,8.12)] and primary education [(AOR=3.9, 95% CI: 1.66,9.32)], low wealth index [(AOR=2.8, 95% CI: 1.27, 6.28)], longer duration of treatment [(AOR=2.7, 95% CI: 1.46, 5.5.20)], shorter waiting time [(AOR=5.4, 95% CI: 2.52, 11.57)], disclosure of serostatus of HIV [(AOR=3.7, 95% CI: 1.59, 8.49)], seen by the same health care providers repeatedly [(AOR=2.0, 95% CI: 1.06, 3.82)], loss of medical records [(AOR=0.26, 95% CI: 0.13,0.50)] and social supports [(AOR=2.3, 95% CI: 1.12,4.63)] were significantly associated with service satisfaction on antiretroviral therapy services. CONCLUSION: Overall client satisfaction with ART services was relatively low in the study area. However, not attending formal and primary education, low wealth index, longer duration of treatment, shorter waiting time, disclosure of serostatus, seen by the same health care providers, loss of medical records, and social support were independent predictors of client satisfaction.