Magnitude and associated factors of needle stick and sharps injuries among health care workers in Dessie City Hospitals, north east Ethiopia.

BACKGROUND: Work-related exposures to needle stick and sharps accidents are essential reason of infections with blood borne pathogens amongst health care employees and can cause extensive fitness consequences and psychological stress. The aim of this study was to determine the magnitude of needle stick and sharps injuries and associated factors among health care workers in Dessie town hospitals. METHOD: This institution-based cross-sectional study was conducted from March 21-April 21/2015, amongst health care people in Dessie city hospitals.Data have been collected by a structured and pre-tested questionnaire. The study included 438 health care employees who had been selected through the use of a simple random sampling technique. The gathered data have been checked, coded and entered to EPI-info version 3.5.1 and exported to SPSS model 20 for analysis. Bivariate and multivariate logistic regression analyses have been executed to identify elements related with the structured variable. RESULTS: From 457 selected study participants, 438 (95.8%) responded to the questionnaire. The magnitude of needle stick and sharps injuries in the last 12 months was 124(28.3%), of which 92(74.2%) was reported by males and the rest 32(25.8%) by females. Being male [AOR: 4.25, 95%CI:(2.43,7.41)],had no safety instructions in the work area [AOR:2.27,95%CI: (1.29,3.97)],had no training on safety and health [AOR:4.92,95%CI:(2.75,8.79)],had ≤5 years work experience [AOR:9.0,95%CI:(4.88,16.60)],recapping of used needle [AOR: 2.63, 95%CI: (1.39, 4.99)] were the variables that significantly associated with needle stick and sharps injuries. CONCLUSION: This study showed still a high magnitude of needle stick or sharps among healthcare workers. Therefore, training on work related safety and wellbeing, making safety instructions accessible and avoiding a recap of the needle after use are important to reduce the chance of such injuries among healthcare workers.

Antenatal care and mothers' education improved iron-folic acid adherence at Denbiya district health centers, Northwest Ethiopia: using pills count method.

BACKGROUND: Anemia is the leading public health problem among pregnant women worldwide. Iron-Folic Acid (IFA) supplementation is the strategy to control pregnancy induced anemia, but its adherence status was not well studied. OBJECTIVE: The aim of this study was to assess the prevalence of IFA adherence and associated factors among pregnant women attending antenatal care at Denbiya district health centers. METHODS: Cross -sectional study design was conducted in Denbiya district health centers from April 2 to May 27, 2016. A total of 395 study participants were enrolled in the study. Systematic random sampling was used to select study participants. Data were collected using the interviewer-administered technique. Adherence to IFA supplementation was assessed by the pills count method. A logistic regression model was used. RESULTS: The study revealed that the prevalence of good adherence towards IFA supplementation among Antenatal care (ANC) service users' at Denbiya district health centers were found to be 28.01% [95% CI, 24.01, 35.9]. Attending secondary school and above [Adjusted Odds Ratio (AOR) = 3.44, 95% CI: 1.09, 10.92], having two ANC visits [AOR = 2.53, 95% CI: 1.34, 4.76] and three and above ANC visits [AOR = 4.14, 95% CI: 2.14, 8.01] were significantly associated with good adherence of IFA supplementation. To the contrary, husband education status; secondary school and above reduced the odds of good adherence by 77% compared to illiterates to IFA supplementation [AOR = 0.23, 95% CI: 0.07, 0.72]. CONCLUSION: The prevalence of good adherence among pregnant women towards IFA supplementation was low. Mothers' education and having two or more ANC visits were positively associated with good adherence towards IFA supplementation.

Effect of Health Care on Quality of Life among Human Immunodeficiency Virus Infected Adults With and Without Visceral Leishmaniasis in northwest Ethiopia: A Longitudinal Follow-Up Study.

There has been a scarcity of data on the effect of health care on the quality of life (QoL) of human immunodeficiency virus (HIV)- and visceral leishmaniasis (VL)- coinfected patients over time. We sought to assess the change that health care brings about in the QoL of HIV patients with and without VL and its predictors in 6 months. A total of 465 HIV patients without VL and 125 HIV-VL-coinfected patients were enrolled in the longitudinal follow-up study from October 2015 to September 2016. Data on QoL at baseline and in 6 months were collected by trained nurses through face-to-face interviews using a short Amharic version of World Health Organization QoL instrument for HIV clients. Multiple linear regressions were used to assess the predictors of health-related QoL. There was an improvement in all of the domains of QoL at the sixth month follow-up compared with the baseline for both groups of patients (P < 0.001). Lack of social support and income were associated with the low improvement in QoL in most of the domains in both groups. Compared with patients having severe acute malnutrition, patients having moderate acute malnutrition and normal nutritional status were better in most of the QoL domains in both groups of patients. Both antiretroviral and anti-VL treatments showed improvement in all dimensions of QoL. Income, social support, and nutritional status were the predictors for most of the QoL domains.

Health-related quality of life of HIV infected adults with and without Visceral Leishmaniasis in Northwest Ethiopia.

BACKGROUND: Health-related quality of life (HRQoL) is an important outcome measure among HIV infected patients receiving antiretroviral therapy (ART). When HIV infected patients coinfected with Visceral Leishmaniasis (VL) the problem become severe because VL accelerates HIV replication and disease progression. The impact of VL on the quality of life of HIV infected patients has not been studied. In this study in Ethiopia, we compared the quality of life of HIV infected patients with and without VL. METHODS: A cross-sectional study was conducted from October 2015 to September 2016 in selected health centers and hospitals, in Northwest Ethiopia. Data on quality of life was collected by trained nurses. The instrument used to collect the data was the short Amharic version of the World Health Organization Quality of Life for HIV clients (WHOQoL-HIV). Depression was assessed using the validated version of Kessler scale. Data was entered and analyzed using SPSS version 20. Descriptive statistics, bivariate and multivariate linear regression model was used to summarize the results. RESULTS: A total of 590 study participants were included in the study with response rate of 95%. Of the 590 patients included in our study 125 (21%) were HIV-VL coinfection. HIV-VL coinfected patients had a lower quality of life in all the domains as compared to HIV patients without VL. Depression was consistently and strongly associated with all the quality of life domains of both groups. Also, in HIV infected patients a longer duration in ART was associated with higher HRQoL domains except for the spiritual and level of independence domains. With regard to HIV-VL coinfected patients, a longer duration in ART was associated with psychological, spiritual and level of independence domains of HRQoL. Demographics, clinical, and treatment characteristics resulted few significant associations with HRQoL domains of both groups. CONCLUSION: HIV-VL coinfected patients had a poor quality of life in all the domains of the WHOQoL-HIV instrument. Depression, duration of ART and education were strongly associated with the quality of life. Depression should be targeted for intervention to improve the quality of life.

Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

BACKGROUND: Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. METHODS: Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. RESULTS: Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. CONCLUSION: Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

Household flood preparedness and associated factors in the flood-prone community of Dembia district, Amhara National Regional State, northwest Ethiopia.

BACKGROUND: Flood preparedness empowers the community to respond effectively to related hazards. However, there was no research done in the country concerning household flood preparedness. Therefore, the aim of this study was to assess household flood preparedness and associated factors in the flood-prone community of Dembia district, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from March to April 2014 in the Dembia district. A two-stage sampling technique was used. The study was conducted using 806 flood-prone participants. An interviewer-administered questionnaire was used to collect data. The collected data were entered using Epi info version 3.5.1 and transported into SPSS version 16 for further analysis. Descriptive and analytic statistics were computed. Variables having association with the outcome variable were reported using odds ratio with 95% confidence interval (CI). Model fitness was checked by Hosmer and Lemeshew chi-square test. RESULTS: Household flood preparedness was found to be 24.4%. The age group of ≥ 46 years (adjusted odds ratio [AOR]=2.62; 95% CI: 1.12, 6.00) above, monthly household income >893 Ethiopian Birr, (AOR=6.72; 95% CI: 2.2 7, 19.88) attending primary level education (AOR=22.08; 95% CI: 8.16, 59.74), warning system in household (AOR=5.41; 95% CI: 2.38, 12.32), knowledge of flood prevention, (AOR=2.52; 95% CI: 1.43, 5.57) were positively associated with household flood preparedness. CONCLUSION AND RECOMMENDATION: This study has demonstrated that household flood preparedness was found to be low in the study area. Household flood preparedness was significantly associated with the older age group, attending primary level education, having a higher monthly income, receive household level warning messages, having knowledge on preparedness, prior exposure to a flood, and length of flood >6 days. Strengthening household flood preparedness in advance is important in order to prevent flood and its related consequences.

Prevalence of Human Immunodeficiency Virus and associated factors among Visceral Leishmaniasis infected patients in Northwest Ethiopia: a facility based cross-sectional study.

BACKGROUND: Visceral Leishmaniasis coinfection with HIV/AIDS has emerged as a series of disease pattern. It most often results in unfavorable responses to treatment, frequent relapses, and deaths. Scarce data is available regarding the prevalence of HIV and associated factors among Visceral Leishmaniasis coinfected patients. This study sought to determine the prevalence of HIV and associated factors among Visceral Leishmaniasis infected patients. METHODS: Facility based cross-sectional study was conducted from October, 2015 to August, 2016 in Northwest Ethiopia. Cluster sampling technique was used to select 462 Visceral Leishmaniasis infected patients. Serologic and parasitological test results have been used to diagnose Visceral Leishmaniasis. The HIV diagnosis was based on the national algorithm with two serial positive rapid test results. In case of discrepancy between the two tests, Uni-Gold TM was used as a tie breaker. Structured questionnaire was used to collect independent variables. Data was entered by using Excel and analyzed by using SPSS version 20. Descriptive statistics and logistic regression model was used to analyze the data. RESULTS: A total of 462 study participants were included in the study with a response rate of 92.4%. HIV and Visceral Leishmaniasis coinfection was found to be 17.75% with 95% CI; 14.30-21.40. Age ≥ 30 years (AOR = 22.58, 95% CI 11.34, 45.01), urban residents (AOR = 2.02, 95% CI 1.16, 4.17) and daily laborer workers (AOR = 4.99, 95% CI 2.33, 10.68) were significantly associated with HIV and Visceral Leishmaniasis coinfection. CONCLUSION: HIV and Visceral Leishmaniasis coinfection in the Northwest Ethiopia was found to be low. Age, residence and employment were independently associated with HIV-VL coinfection in the Northwest Ethiopia. It is better to design interventions to prevent and control HIV-VL coinfection for productive age groups (age ≥ 30) and daily laborers.

Perceived quality of life among Visceral Leishmaniasis and HIV coinfected migrant male-workers in Northwest Ethiopia: a qualitative study.

BACKGROUND: There is paucity of data on quality of life as a dimension of treatment outcome among Visceral Leishmaniasis and HIV coinfected patients. This study sought to explore perceived quality of life among Visceral Leishmaniasis and HIV coinfected male migrant workers in Northwest Ethiopia. METHODS: Twenty Visceral Leishmaniasis and HIV coinfected study participants took part in the in-depth interviews at Visceral Leishmaniasis and HIV treatment centers. Ten participants were on antiretroviral treatment (ART) and the remaining 10 have not yet started ART. All interviews were recorded, transcribed and translated for analysis. Data were analyzed by qualitative content analysis using Open Code software version 3.4. RESULT: Participants reported on four aspects of quality of life: liveability of the environment, utility of life, life ability of a person and appreciation of life. Respondents living environment, therapeutic side effects of Visceral Leishmaniasis drugs, poverty and stigma negatively affected their quality of life. On the contrary, good treatment response and financial security were reported to positively affect their quality of life. CONCLUSION: Challenges related to the living environment, financial limitations and sub-optimal response of Visceral Leishmaniasis drug and relapse of Visceral Leishmaniasis disease are factors most negatively affecting the quality of life of Visceral Leishmaniasis and HIV coinfected patients. Micro-financing and other socio-economical support programs should be launched to assist the unemployed males migrating to Visceral Leishmaniasis endemic and relatively higher HIV prevalent areas to work as daily laborers. HIV prevention programs in HIV positive-living counseling programs should target such high risk migrant workers in the endemic areas.

Predictors of treatment failure on second-line antiretroviral therapy among adults in northwest Ethiopia: a multicentre retrospective follow-up study.

BACKGROUND: The number of patients using second-line antiretroviral therapy (ART) has increased over time. In Ethiopia, 1.5% of HIV infected patients on ART are using a second-line regimen and little is known about its effect in this setting. OBJECTIVE: To estimate the rate and predictors of treatment failure on second-line ART among adults living with HIV in northwest Ethiopia. SETTING: An institution-based retrospective follow-up study was conducted at three tertiary hospitals in northwest Ethiopia from March to May 2015. PARTICIPANTS: 356 adult patients participated and 198 (55.6%) were males. Individuals who were on second-line ART for at least 6 months of treatment were included and the data were collected by reviewing their records. PRIMARY OUTCOME MEASURE: The primary outcome was treatment failure defined as immunological failure, clinical failure, death, or lost to follow-up. To assess our outcome, we used the definitions of the WHO 2010 guideline. RESULT: The mean±SD age of participants at switch was 36±8.9 years. The incidence rate of failure was 61.7/1000 person years. The probability of failure at the end of 12 and 24 months were 5.6% and 13.6%, respectively. Out of 67 total failures, 42 (62.7%) occurred in the first 2 years. The significant predictors of failure were found to be: WHO clinical stage IV at switch (adjusted HR (AHR) 2.1, 95% CI 1.1 to 4.1); CD4 count <100 cells/mm3 at switch (AHR 2.0, 95% CI 1.2 to 3.5); and weight change (AHR 0.92, 95% CI 0.88 to 0.95). CONCLUSIONS: The rate of treatment failure was highest during the first 2 years of treatment. WHO clinical stage, CD4 count at switch, and change in weight were found to be predictors of treatment failure.

Iodine deficiency and associated factors among school children: a cross-sectional study in Ethiopia.

BACKGROUND: Iodine deficiency remains a public health problem in the world. It is the leading cause of preventable mental retardation and brain damage worldwide. Though 12 million school age children are at risk of developing iodine deficiency, there is a scarcity of literature showing the magnitude of iodine deficiency in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of iodine deficiency among school children in Robe District, southeast Ethiopia. METHODS: A school based cross-sectional study was conducted from February to June, 2015. A structured interviewer-administered questionnaire was used to collect data. A systematic random sampling technique was employed to select 422 children. A multivariate logistic regression analysis was carried out to identify factors associated with iodine deficiency. In the multivariate analysis, variables with a P-value of <0.05 were considered statistically significant. RESULTS: A total of 393 school children participated in the study. The median urinary iodine level was 78 µg/l. About 57 and 43.5 % of the children were found with low urinary iodine level and goiter, respectively. Only 29 % of the households utilized adequately iodized salt. The result of the multivariate analysis revealed that the odds of iodine deficiency were higher among female [AOR = 2.23; 95 % CI: 1.54, 3.55] and older (10-12 years) [AOR = 2.21; 95 % CI: 1.44, 3.42] children. CONCLUSION: In this community, the prevalence of goiter and low urine iodine level is high. Thus, iodine deficiency exists as severe public health problem. In addition, there is a low utilization of iodized salt in the setting. Therefore, it is crucial to intensify efforts in the implementation of iodized salt. Moreover, attention should be given to school children to address ID.

Undernutrition and associated factors among children aged 6-59 months in East Belesa District, northwest Ethiopia: a community based cross-sectional study.

BACKGROUND: Undernutrition remains the major public health concern in Ethiopia and continues as the underlying cause of child mortality. However, there is a scarcity of information on the magnitude and determinant factors of undernutrition. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors among children aged 6-59 months in East Belesa District, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from April to May, 2014. A multistage stratified sampling technique was used to select 633 study participants. A structured interviewer-administered questionnaire was used to collect data. In order to identify factors associated with undernutrition (stunting and wasting) a multivariate logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the strength of the association. In the multivariate analysis, variables with a p-value of <0.05 were considered as statistically significant. RESULTS: In this study, about 57.7 and 16 % of the children were stunted and wasted, respectively. The odds of stunting were higher in children born to mothers who gave their first birth before 15 years of age (AOR = 2.4; 95 % CI: 1.19, 5.09) and gave prelacteal feeding to their child (AOR = 1.83; 95 % CI: 1.28, 2.61). However, lower odds of stunting were observed among children aged 36-47 months (AOR = 0.41; 95 % CI: 0.22, 0.78) and had higher family monthly income, Et. Br. 750-1000, (AOR = 0.61; 95 % CI: 0.39, 0.92). Moreover, the odds of wasting were higher among children who received butter as prelacteal food (AOR = 2.32; 95 % CI:1.82, 5.31). CONCLUSION: Child undernutrition is a critical public health problem in the study area. Advanced age of children (36-47 months) and higher family monthly income were inversely associated with stunting. However, higher odds of stunting were observed among children whose mothers delivered their first child before 15 years of age, and gave their children prelacteal feeding. Thus, delaying the first pregnancy and reducing prelacteal feeding is of a paramount significance in reducing the burden of undernutrition.

Magnitude of visceral leishmaniasis and poor treatment outcome among HIV patients: meta-analysis and systematic review.

BACKGROUND: Visceral leishmaniasis (VL) coinfection with HIV/AIDS most often results in unfavorable responses to treatment, frequent relapses, and premature deaths. Scarce data are available, regarding the magnitude and poor treatment outcomes of VL-HIV coinfection. OBJECTIVE: The main objective of this systematic review was to describe the pooled prevalence of VL and poor treatment outcome among HIV patients. REVIEW METHODS: Electronic databases mainly PubMed were searched. Databases, such as Google and Google scholar, were searched for gray literature. Articles were selected based on their inclusion criterion, whether they included HIV-positive individuals with VL diagnosis. STATA 11 software was used to conduct a meta-analysis of pooled prevalence of VL-HIV coinfection. RESULTS: Fifteen of the 150 articles fulfilled the inclusion criteria. A majority of the study participants were males between 25 years and 41 years of age. The pooled prevalence of VL-HIV coinfection is 5.2% with 95% confidence interval of (2.45-10.99). Two studies demonstrated the impact of antiretroviral treatment on reduction in relapse rate compared with patients who did not start antiretroviral treatment. One study showed that the higher the baseline CD4+ cell count (>100 cells/mL) the lower the relapse rate. Former VL episodes were identified as risk factors for relapse in two articles. In one of the articles, an earlier bout of VL remains significant in the model adjusted to other variables. CONCLUSION: The pooled prevalence of VL in HIV-infected patients is low and an earlier bout of VL and CD4+ count <100 cells/mL at the time of primary VL diagnosis are factors that predict poor treatment outcome.

Menstrual problems and associated factors among students of Bahir Dar University, Amhara National Regional State, Ethiopia: A cross-sectional survey.

INTRODUCTION: Menstrual problems are the most common gynecologic complaints. The prevalence is highest in the 20 to 24-year-old age group and decreases progressively thereafter. They affect not only the woman, but also family, social and national economics as well. However, Population studies on Menstrual problems and associated factors were very little for university students in Ethiopia. METHODS: Institutional based quantitative cross-sectional study was employed at Bahir Dar University from October 14 to 20, 2010, Ethiopia. Stratified sampling technique was used and 491 study subjects were randomly selected from faculties. Only 470 respondents had given complete response for the self-administered questionnaire and were included in the final analysis. Data was entered and analyzed with SPSS version 16.0 windows. The main statistical method applied was logistic regression (unconditional) and both the classical bivariate and the multivariate analyses were considered. RESULTS: The prevalence of dysmenorrhea and premenstrual syndrome were 85.1% and 72.8%, respectively. The most contributing factors remained to be statistically significant and independently associated with dysmenorrhea were having menstrual cycle length of 21-35 days (AOR=0.16, 95%CI: 0.04, 0.71), family history of dysmenorrhea (AOR=3.80, 95%CI: 2.13, 6.78) and circumcision (AOR=1.84, 95%CI: 1.001, 3.386) while with premenstrual syndrome were educational status of mothers being certified in certificate and beyond (AOR=0.45, 95%CI: 0.25, 0.83), living in Peda campus (AOR=2.11, 95%: 1.30, 3.45), having irregular menstruation (AOR=1.87, 95%CI: 1.17, 2.99) and family history of premenstrual syndrome (AOR=4.19, 95%CI: 2.60, 6.74). CONCLUSION: The prevalence of menstrual problems among students of Bahir Dar University was very high. Menstrual cycle length, family history of dysmenorrhea and circumcision were the most contributing factors associated with dysmenorrhea while educational status of mothers, regularity of menstruation, and family history of premenstrual syndrome were for premenstrual syndrome. Health education, appropriate medical treatment and counseling, should be accessible and persistently provided to the affected students by Bahir Dar University. Maximum effort is needed to eliminate circumcision by all levels and further steps that would enable females to join their college education should be applied.

Perception and predictors of quality of life among HIV patients attending art clinics in northwest Ethiopia: a prospective longitudinal study.

BACKGROUND: In treating HIV as a chronic disease, monitoring changes of quality of life of patient's overtime is important for clinicians and policy makers. However, to our knowledge little research attention has been directed towards examining the longitudinal change of quality of life overtime in sub-Saharan Africa. OBJECTIVE: To examine longitudinal changes in quality of life among patients initiated ART METHOD: A prospective longitudinal follow-up study was conducted from December 2009 to August 2011 to evaluate the changes in quality of life and how this relates with baseline socio-demographic and clinical characteristics among consecutive adult ART naïve patients attending ART clinic. Quality of life was measured by WHOQOL-HIV BREF. RESULT: All quality of life domain scores improved significantly during 12 month follow-up in the ART program. At each follow-up visit, scores were significantly higher than baseline scores (p < 0.001). Predictors of improved quality of life were male gender, disclosure of HIV status, starting ART at higher CD4, > 200 cells/µL, and good baseline overall quality of life, whereas predictors of poor quality of life were starting ART with advanced disease stage and tuberculosis co-infection. CONCLUSION: This study demonstrated that the quality of life improved overtime for HIV-infected individuals receiving ART which is consistent with previous studies. It also provided information regarding the predictive effects of baseline socio-demographic and clinical factors on the changes in quality of life at the 12-month follow-up time. The finding of the study has implications of starting ART at a higher CD4 and early stage of the disease for better quality of life outcomes.

Death and seeking alternative therapy largely accounted for lost to follow-up of patients on ART in northwest Ethiopia: a community tracking survey.

BACKGROUND: Antiretroviral treatment programs in sub-Saharan African countries are highly affected by LTF. Tracking patients lost to follow-up and understanding their status is essential to maintain program quality and to develop targeted interventions to prevent LTF. We aimed to determine the outcome and factors associated with LTF. METHOD: A lost to follow-up community tracking survey was conducted to determine the reasons, outcomes and factors associated with LTF at the University of Gondar Hospital, northwest Ethiopia. All patients were tracked at home to ascertain outcome status for lost to follow-up (death and non-death losses). RESULT: Out of the 551 patients LTF, 486 (88.20%) were successfully tracked. Death was the most common reason accounted for 233 (47.94%) of the lost to follow-up. Reasons for non-deaths losses include: stopped antiretroviral treatment due to different reasons, 135(53.36%), and relocation to another antiretroviral treatment program by self-transfer, 118(46.64%). The rate of mortality in the first six months was 72.12 per 100 person-years (95% CI: 61.80-84.24) but this sharply decreased after 12 months to 7.92 per 100 person-years (95% CI: 4.44-14.41). Baseline clinical characteristics were strongly associated with mortality. CONCLUSION: Death accounts for about half of the loss to follow up. Most deaths occur in the first six months of loss. Seeking alternative therapy is another major reason for loss to follow up. Early tracking mechanisms are necessary to prevent death.

Predictors of HIV status disclosure to sexual partners among people living with HIV/AIDS in Ethiopia.

INTRODUCTION: Disclosure of HIV positive sero-status to sexual partners, friends or relatives is useful for prevention and care. Identifying factors associated with disclosure is a research priority as a high proportion of people living with HIV/AIDS never disclose in Ethiopia. This study was carried out to assess the magnitude and factors associated of HIV seropositive status disclosure to sexual partners among peoples living with HIV/AIDS. METHODS: A hospital based cross-sectional study was conducted April-June, 2010, among systematically selected 334 HIV patients attending at Woldia hospital, Ethiopia. Data were collected through pre-tested questionnaire, using exit interview. Bivariate and multivariable logistic regression models were fitted to identify associated factors for disclosing their HIV seropostive status to sexual partner. RESULTS: One hundred nineteen nine (59.6%) was females, 218(65%) was from urban area, 297(85.8%) are on antiretroviral therapy. The study found a significant association between higher educational status of the respondents (AOR:0.4; 95%CI (0.17-0.92)) and sexual partners (AOR: 9.0; 95% CI(2.8-29.3)), knowing HIV status of sexual partner (AOR:8.1; 95%CI(3.4 -19.2)), being on antiretroviral therapy (AOR:7.9; 95%CI(3.42-18.5)), having follow up counseling (AOR:5.26; 95%CI(2.2-12.5)), and being tested for HIV in ante natal care clinic (AOR:0.21; 95%CI(1.14- 6.46)) with disclosure of HIV status to sexual partner. CONCLUSION: The study concluded the need for giving more emphasis for the patients who are not on antiretroviral therapy and the need for giving emphasis on techniques how to disclose status to sexual partner.

High loss to followup and early mortality create substantial reduction in patient retention at antiretroviral treatment program in north-west ethiopia.

Background. There has been a rapid scale up of antiretroviral therapy (ART) in Ethiopia since 2005. We aimed to evaluate mortality, loss to followup, and retention in care at HIV Clinic, University of Gondar Hospital, north-west Ethiopia. Method. A retrospective patient chart record analysis was performed on adult AIDS patients enrolled in the treatment program starting from 1 March 2005. We performed survival analysis to determine, mortality, loss to followup and retention in care. Results. A total of 3012 AIDS patients were enrolled in the ART Program between March 2005 and August 2010. At the end of the 66 months of the program initiation, 61.4% of the patients were retained on treatment, 10.4% died, and 31.4% were lost to followup. Fifty-six percent of the deaths and 46% of those lost to followup occurred in the first year of treatment. Male gender (adjusted hazard ratio (AHR) was 3.26; 95% CI: 2.19-4.88); CD4 count ≤200 cells/ µ L (AHR 5.02; 95% CI: 2.03-12.39), tuberculosis (AHR 2.91; 95% CI: 2.11-4.02); bed-ridden functional status (AHR 12.88; 95% CI: 8.19-20.26) were predictors of mortality, whereas only CD4 count <200 cells/ µ L (HR = 1.33; 95% CI: (0.95, 1.88) and ambulatory functional status (HR = 1.65; 95% CI: (1.22, 2.23) were significantly associated with LTF. Conclusion. Loss to followup and mortality in the first year following enrollment remain a challenge for retention of patients in care. Strengthening patient monitoring can improve patient retention AIDS care.

Predictors of HIV Status Disclosure to Sexual Partners among People Living with HIV/AIDS in Ethiopia

Introduction: Disclosure of HIV positive sero-status to sexual partners; friends or relatives is useful for prevention and care. Identifying factors associated with disclosure is a research priority as a high proportion of people living with HIV/AIDS never disclose in Ethiopia. This study was carried out to assess the magnitude and factors associated of HIV seropositive status disclosure to sexual partners among peoples living with HIV/AIDS. Methods: A hospital based cross-sectional study was conducted April -June; 2010; among systematically selected 334 HIV patients attending at Woldia hospital; Ethiopia. Data were collected through pre-tested questionnaire; using exit interview. Bivariate and multivariable logistic regression models were fitted to identify associated factors for disclosing their HIV seropostive status to sexual partner. Results: One hundred nineteen nine (59.6) was females; 218(65) was from urban area; 297(85.8) are on antiretroviral therapy. The study found a significant association between higher educational status of the respondents (AOR:0.4; 95CI (0.17-0.92)) and sexual partners (AOR: 9.0; 95 CI(2.8-29.3)); knowing HIV status of sexual partner (AOR:8.1; 95CI(3.4 -19.2)); being on antiretroviral therapy (AOR:7.9; 95 CI(3.42-18.5)); having follow up counseling (AOR:5.26; 95CI(2.2-12.5)); and being tested for HIV in ante natal care clinic (AOR:0.21; 95CI(1.14- 6.46)) with disclosure of HIV status to sexual partner. Conclusion: The study concluded the need for giving more emphasis for the patients who are not on antiretroviral therapy and the need for giving emphasis on techniques how to disclose status to sexual partner

Epidemiology of non-penetrative sex among university students in the context of HIV/AIDS prevention in Northwestern Ethiopia.

OBJECTIVES: This study was conducted to explore the knowledge, attitude and practices related to non-penetrative sexual behavior in the context of HIV/AIDS prevention among Bahir Dar University students in Northwestern Ethiopia. METHODS: We conducted a cross-sectional study among a representative sample of 624 regular students attending their education in academic year 2007 in Bahir Dar University in Ethiopia selected by stratified sampling technique. Association between practices and the explanatory variables was assessed in bivariate analysis using Chi-square tests and the associations were further expanded using multivariate logistic regression analysis. RESULTS: The overall knowledge assessments of the respondents showed that 65.2% of the respondents were having reasonable and good knowledge. Around 46.7% were currently practicing one or more of the non penetrative sexual practices. Among those who were practicing one or more of the non penetrative sexual behaviors (n = 286) were for the reasons as make sexual pleasure (56.8%), prevent HIV and STI (49.8%), keeping virginity (17.1%) and prevention of pregnancy (16.7%)respectively. Around 60.7% had unfavorable attitude towards non penetrative sexual behavior. Having good knowledge, being male gender, and having favorable attitudes towards NPS were associated with non penetrative sexual practice. CONCLUSIONS: Most of the students have relatively good knowledge and a considerable proportion of them were already engaged in one of the NPS practices withstanding the unfavorable attitude they have towards NPS. This remained that it is advisable to further consider NPS as one option and additional menu for avoiding unwanted penetrative sex in order to maximize young people's options to prevent HIV/AIDS and STIs along with broader IEC/BCC interventions.