Effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy at public hospitals of Eastern Ethiopia: A retrospective cohort study.

BACKGROUND: In resource-limited countries such as Ethiopia, tuberculosis is the major cause of morbidity and mortality among people living with the human immunodeficiency virus. In the era of antiretroviral therapy, the effect of tuberculosis on the survival of patients who are living with human immunodeficiency virus has been poorly understood in Ethiopia. Therefore, this study aimed to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy in public hospitals in Eastern Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 566 participants from January 1, 2014, to June 30, 2018. The collected data were entered into EpiData version 3.1 before being exported to Stata version 14 for analysis. A Cox proportional hazard model was used to determine the effect of active tuberculosis on the survival of HIV-infected adult patients who initiated antiretroviral therapy, and a p-value less than 0.05 and a 95% confidence level were used to declare statistical significance. RESULT: Of the 566 patients included in the study, 76 died. The mortality rate was 11.04 per 100 person-years in tuberculosis co-infected patients, while it was 2.52 per 100 person-years in non-tuberculosis co-infected patients. The patients with tuberculosis co-infection had a 2.19 times higher hazard of death (AHR: 2.19; 95% CI: 1.17, 4.12) compared to those without tuberculosis. Advanced clinical stage, low CD4+ cell count, and previous episodes of an opportunistic infection other than tuberculosis were found to be independent predictors of mortality. CONCLUSION: Co-infection with tuberculosis at antiretroviral therapy initiation increases the hazard of death approximately two-fold. Hence, we recommend key organizations to enhance the region's collaborative interventional and preventative strategies for TB and HIV.

Determinants of uterovaginal prolapse in Western Ethiopia.

INTRODUCTION AND HYPOTHESIS: Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women's health and productivity. Thus, it is very important to identify determinant factors and take preventive actions. METHODS: A hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town from May 1 to July 30, 2019. Cases were women with grade II, III and IV uterovaginal prolapse while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered questionnaires, and measurements on height and weight were taken to calculate the women's body mass index. Data were entered using Epi Data version 3.1, and analysis was carried out by SPSS version 20. Descriptive, bivariate and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used, and statistical significance was declared at p < 0.05. RESULTS: This study revealed age ≥ 40 years (AOR = 10.49; 95% CI: 4.03, 27.35), duration of labor ≥ 24 h (AOR = 8.32; 95% CI: 3.58, 19.33), instrumental delivery (AOR = 7.40; 95% CI: 1.21, 45.28), non- utilization of family planning (AOR = 3.14; 95% CI: 1.32, 7.47) and underweight (BMI < 18.5 kg/m2) (AOR = 5.30; 95% CI: 1.83, 15.33) were determinants of uterovaginal prolapse. CONCLUSION: Age ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning service utilization and appropriate and timely obstetric care are advisable.