Incidence and factors associated with treatment failure among HIV infected adolescent and adult patients on second-line antiretroviral therapy in public hospitals of Northern Ethiopia: Multicenter retrospective study.

BACKGROUND: This study aimed to determine the incidence and factors associated with treatment failure among HIV infected adolescent and adult patients on second-line antiretroviral therapy (ART) in public hospitals of Northern Ethiopia. METHODS: A retrospective study was conducted from September 1, 2007 to July 30, 2017 on 227 patients. The data were extracted using a retrieval checklist from the patient's charts. The incidence rate of treatment failure was calculated using Kaplan-Meier methods and Cox proportional hazard model was used to assess factors associated with treatment failure. RESULT: The study subjects were followed for a total observation of 788.58 person-years with a median follow-up period of 35 (IQR: 17-60) months after switching to second-line ART. About 57 (25.11%) patients developed treatment failure, out of which, 32 (56.14%) occurred during the first two years. The overall incidence of second-line treatment failure was 72.3 per 1000 person years (95%CI: 55.75-93.71) of observation. The Kaplan-Meier estimates of cumulative treatment failure after 1, 2, and around 10 years of follow-up were 12.31% (95%CI: 8.60-17.45%), 14.99% (95%CI: 10.82%-20.57%), and 48.67% (95%CI: 32.45-67.81%) respectively. Age >45 years AHR = 3.33, 95%CI = 1.33-8.31), WHO stage IV (AHR = 3.63, 95%CI = 1.72-7.67), CD4 count <100 cells/mm3 (AHR = 3.79, 95%CI = 1.61-8.91), TB co-morbidity (AHR = 3.39 95%CI = 1.91-6.01) and poor adherence level (AHR = 3.63, 95% CI = 1.89-6.96) at the start of second line ART were significantly associated with second-line ART failure. CONCLUSION: Incidence of second-line ART treatment failure in the first 2 years of follow-up was high. The rate of second-line ART failure was higher in patients who started second-line ART with poor drug adherence, CD4 count <100 cells/mm3, TB co-morbidity, age >45 years, and being in WHO stage IV. Therefore, intensive counseling and adherence support should be given along with strong TB screening. Moreover, the government of Ethiopia should consider endorsing third-line ART drugs after careful cost-benefit analysis.

Prevalence of Mental Distress and Associated Factors among Samara University Students, Northeast Ethiopia.

BACKGROUND: Empirical findings have indicated that higher institution students experience a higher prevalence of mental distress compared to the general population. Understanding the magnitude and associated factors of mental distress in university students would be helpful to practitioners and policymakers in Ethiopia. The aim of the present study was to examine the prevalence and associated factors of mental distress among Samara university students, Northeast Ethiopia. METHODS: Institution based cross-sectional study design was conducted in Samara university from December to June 2018. A simple random sampling technique was employed to select the study participants. Self-Reporting Questionnaire-20 (SRQ-20) was used to measure the mental distress of students. Multivariable logistic regression modeling was used to examine the association between sociodemographic and psychosocial factors with the mental distress of students. RESULTS: The proportion of students with mental distress were found to be 53.2% (95% confidence interval [CI]: 48.0%, 58.0%). Female students were more likely to be mentally distressed compared to male students (adjusted odds ratio [AOR]: 4.66; 95% CI: 2.81, 7.71). Ever khat use (AOR: 3.09; 95% CI: 1.74, 5.50) and poor sleep quality (AOR: 2.23; 95% CI: 1.12, 3.66) were significantly associated with mental distress of students. CONCLUSION: Our study indicates that the proportion of mental distress was found to be higher among Samara university students as compared to previously published studies in Ethiopia. Female students, ever khat users and those with poor sleep quality were associated with mental distress. There is a need for evidence-based interventional strategies such as self-help measures, sleep hygiene and peer support, as well as professional mental health services as part of student health services that would be helpful to reduce the burden of mental distress of students.

Characteristics and Treatment Outcomes of "Transfer Out" TB Patients after Crosschecking Registers at Four Hospitals of Tigray Regional State, Ethiopia: 2011-2015.

Globally, transferring TB patients to another health unit for treatment continuation is common trend while posing challenges for proper treatment outcomes monitoring. National guidelines indicated the importance of incorporating the treatment outcomes of those cases by the transferring unit when performing annual cohort analysis. However, in most instances, this is not taken into account. This study was conducted to determine the characteristics and treatment outcomes of 'transfer out' TB cases during the time period between 2011 and 2015 at four Hospitals of Tigray: Ethiopia. Initial data was extracted from TB treatment logbooks of transferring units using standardize checklist that were followed by a visit to each of the receiving units. The generated data were entered and analyzed using SPSS v. 22.0. Descriptive statistics were computed. P-value less than 0.05 were considered statistically significant. A total of 143 TB patients were transferred out during the specified time period whereas 73.4% (105/143) patients were traced and classified as "arrivals". From these, more than three-quarters, 87.6% (92/105), of patients had a successful treatment outcome (5.7% cured and 81.9% completed treatment) while 13/105 (12.3%) had an unsuccessful outcome (2.8% defaulted, 5.7% died, 1.9% failed, and 1.9% transferred out). However, none of the transferring unit received and traced status of the cases. Therefore, regular monitoring is needed to improve the existing communication gap.