Correlates of ART attrition among adults under antiretroviral therapy in Southern Ethiopia, retrospective cohort study.

High attrition rates from ART are the primary contributors to morbidity, death, hospitalisation, rising transmission rates, treatment failure, rising burden of opportunistic infections (OIs), and the evolution of HIV-virus resistance (HIVDR). In Sub-Saharan Africa, more than two-thirds of ART patients will not receive continuous care. There is little information about the correlates that contribute to attrition from ART services among ART patients in Southern Ethiopia. Hence, this study aims to identify correlates of attrition from antiretroviral therapy services for adults under antiretroviral therapy at Otona Teaching and Referral Hospital, Wolaita Zone, Southern Ethiopia. From 1 January 2013 to 31 December 2017, a retrospective cohort analysis was performed. The pre-determined 328 medical records were chosen using a simple random sampling technique using computer-generated random numbers. Epi Info version 3.5.3 was used to enter and clean the data, which were then exported to STATA version 11 for analysis. The Cox proportional hazards model, both bivariate and multivariable, was used. Variables with p-values less than 0.25 in bivariate analysis were considered candidates for multivariable analysis, and variables with p-values less than 0.05 were deemed statistically important in multivariable analysis. The intensity of the correlation and statistical significance were determined using the CHR, AHR, and 95 per cent confidence intervals. The magnitude of attrition from ART service was 21.60% (95% CI: 17.10, 26.10). The distance between home and hospital is more than five kilometres (AHR:3.84;95% CI: 1.99,7.38), no registered phone number (AHR:2.47;95%CI:1.32,4.09), have not taken isoniazid prophylaxis (AHR:2.23;95%CI:1.30,4.09), alcohol consumption (AHR: 1.77; 95% CI:1.01, 3.12), and had no caregiver (AHR: 2.11; 95% CI:1.23, 3.60) were statistically significant in the Cox proportional hazard model. Distance between home and hospital, phone number registration on follow-up chart, having a history of alcohol consumption, isoniazid prophylaxis provision, and having family support were independent correlates of attrition from antiretroviral treatment services.

Systematic review and meta-analysis protocol for development and validation of a prediction model for gestational hypertension in Africa.

Objective: Examining the development and validation of predictive models for gestational hypertension, evaluating the validity of the methodology, and investigating predictors typically employed in such models. Design: Systematic review and meta-analysis protocol. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guideline will be used to carry out the study procedure. Using the key phrases "Gestational hypertension," "prediction, risk prediction," and "validation," a full systematic search will be conducted in PubMed/MEDLINE, Hinari, Cochrane Library, and Google Scholar. The methodological quality of the included studies will be evaluated using the prediction model risk of bias assessment tool. The CHARMS (checklist for critical evaluation and data extraction for systematic reviews of prediction modeling research) will be used to extract the data, and STATA 16 will be used to analyze it. The degree of study heterogeneity will be assessed using Cochrane I2 statistics. Discussion: A subgroup analysis will be performed to reduce the variance between primary studies. To examine the impact of individual studies on the pooled estimates, a sensitivity analysis will be performed. The funnel plot test and Egger's statistical test will be used to assess the small study effect. The presence of a modest study effect is shown by Egger's test (p-value 0.05), which will be handled by nonparametric trim and fill analysis using the random-effects model. The protocol has been registered in the PROSPERO-International Prospective Register of systematic reviews, with the registration number CRD42022314601.

A Score to Predict the Risk of Major Adverse Drug Reactions Among Multi-Drug Resistant Tuberculosis Patients in Southern Ethiopia, 2014-2019.

Background: Adverse events (AE) contribute to poor drug adherence and withdrawal, which contribute to a low treatment success rate. AE are commonly reported among multi-drug resistance tuberculosis (MDR-TB) patients in Ethiopia. However, predictors of AE among MDR-TB patients were limited in Ethiopia. Thus, the current study aimed to develop and validate a score to predict the risks of major AE among MDR-TB patients in Southern Ethiopia. Methods: A retrospective follow-up study design was employed among MDR-TB patients from 2014-2019 in southern Ethiopia at selected hospitals. A least absolute shrinkage and selection operator algorithm was used to select the most potent predictors of the outcome. The adverse event risk score was built based on the multivariable logistic regression analysis. Discriminatory power and calibration were checked to evaluate the performance of the model. Bootstrapping method with 100 repetitions was used for internal model validation. Results: History of baseline khat use, long-term drug regimen use, and having coexisting disorders (co-morbidity) were predictors of AEs. The score has a satisfactory discriminatory power (AUC = 0.77, 95% CI: 0.68, 0.82) and a modest calibration (Prob > chi2 = 0.2043). It was found to have the same c-statistics after validation by bootstrapping method of 100 repetitions with replacement. Conclusion: A history of baseline khat use, co-morbidity, and long-term drug regimen use are helpful to predict individual risk of major adverse events in MDR-TB patients with a satisfactory degree of accuracy (AUC = 0.77).