ABSTRACT
BACKGROUND: Human immune deficiency virus (HIV) increases the susceptibility to primary infection or reinfection and the risk of tuberculosis (TB) reactivation for patients with latent TB. There was no current report on the rate of active TB infection among HIV-1 infected patients in our teaching and referral hospital. Therefore, this study was aimed to determine the prevalence and factors associated with active TB infection among HIV-1 infected patients. METHODS: Hospital-based retrospective cross-sectional study was conducted at the Anti-Retroviral Therapy (ART) chronic follow-up clinic. Systematic random sampling was used to include the patients. A structured questionnaire was used to collect data. Data were analyzed using SPSS version 25. Descriptive statistics were used to describe the findings and multivariate logistic regression was performed to identify factors associated with active TB infection. RESULT: 150 HIV-1 infected patients (female 54.7%) were included. The median (interquartile range, IQR) age of the patients was 33.5 (25.7, 40.0) years. Twenty-six (17.3%) of the patients had developed active TB infection, which was independently associated with the WHO clinical stage III and IV (AOR: 9.67, 95% confidence interval (CI); 2.21-42.37), p = 0.003). The use of isoniazid preventive therapy (IPT) (AOR: 0.123, 95CI; 0.034-0.44, p = 0.001) and having good adherence to ART medications (AOR: 0.076, 95CI; 0.007-0.80, p = 0.032) was associated with the reduced risk of active TB infection among HIV-1 infected patients. CONCLUSIONS: Advanced WHO clinical stages increased the risk of active TB infection, while the use of IPT and good adherence to ART medications reduced the risk of active TB infection. Therefore, patients with advanced WHO clinical stage should be screened for TB infection, and starting IPT for the candidate patients should be strengthened to reduce the burden of active TB incidence. ART medication adherence should also be supported.
ABSTRACT
Background: The rapid spread of COVID-19 infection has led countries across the globe to take various measures to contain the outbreak, including the closure of Universities. Forcing University students to stay at home has created enormous stress and uncertainty in their daily life. Objective: This study aimed to assess the perceived stress and coping strategies among undergraduate health science students of Jimma University amid the COVID-19 outbreak. Materials and methods: An online cross-sectional survey was conducted involving 337 undergraduate health science students from August to September 5, 2020. The perceived stress scale (PSS)-10 and Brief-COPE scale were used to assess the level of stress and coping strategies, respectively. Statistical Package for Social Science (SPSS) Version 22 was employed for data analysis. Logistic regression was conducted to identify predictors of high perceived stress. Results: The overall mean [±standard deviation (SD)] age of the participants was 22.88 (±1.78) years. The mean (±SD) PSS score was 22.16 (±1.41), and high perceived stress was reported in 121 (35.9%) participants. The overall mean (±SD) coping score was 72.34 (±12.31), and approach coping was the predominantly used strategy for coping with stress. Personal perception of being stressed by the daily number of COVID-19 cases/deaths in Ethiopia (AOR = 4.61, p < 0.01), rare online talk/chat with friends (AOR = 4.07, p = 0.01), presence of confusion due to the inconsistent strategies developed by the health/government authorities in view of the scientific recommendations (AOR = 2.22, p = 0.01), perception of self/family members being at risk of getting sick (AOR = 0.53, p = 0.03), decreased household income following the COVID-19 pandemic (AOR = 3.92, p = 0.01), practicing denial (AOR = 1.34, p < 0.01), self-blame (AOR = 1.23, p = 0.02), planning (AOR = 1.28, p = 0.01), and religion (AOR = 1.41, p < 0.01) as means of coping with stress were associated with high perceived stress. Conclusion: Over one-third of the participants had a high level of perceived stress, and the majority of them were practicing effective means of coping with stress. The authors recommend that the hosting University in collaboration with the concerned bodies develop innovative strategies to improve the psychological well-being of the students.
ABSTRACT
BACKGROUND: Apgar score is currently an accepted method for newborn infant assessment immediately after delivery. Low fifth minute Apgar score was strongly associated with the risk of neonatal and infant death. Even though much has been done, still, the levels of neonatal mortality in sub-Saharan African countries including Ethiopia were significant. Therefore, this study is aimed at identifying the risk factors so as providing strategies for decreasing the morbidity and mortality of newborns and identifying determinants of low fifth minute Apgar score among newborns delivered in Jimma University Medical Center, Southwest Ethiopia, 2018. METHOD: Institution-based cross-sectional study was conducted involving 366 neonates delivered at Jimma University Medical Center. Data was collected by using interview questionnaire. Apgar score was assessed by standard tool at the 1st, 5th, and 10th minutes after birth and only 5th minute Apgar score was used as outcome variable. Consecutive sampling technique was used to select the participants. The collected data were analyzed using SPSS version 20.0. Chi-square test was done at bivariate level and P value was used to select candidate variables for multivariate analysis. Finally, a 95% confidence interval was used to assess significance. RESULTS: A response rate of this study was 95%. The proportion of low 5th minute Apgar score in this study was 11.5%. Prolonged duration of labor (AOR = 15.18, 95% CI: 5.51-40.27), maternal history of khat use (AOR = 3.21, 95% CI: 1.26-8.85), and low birth weight (AOR = 1.65, 95% CI: 1.02-3.11) were predictors of low fifth minute Apgar score. CONCLUSION: About one tenth of newborns were having low 5th minute Apgar score. The likelihood of low 5th minute Apgar score was found to increase with prolonged duration of labor, history of mother's khat use, and low birth weight.
