Background Access to antiretroviral therapy (ART) in Ethiopia has been scaled up since the introduction of the service in 2003. Free ART was launched in 2005, resulting in fewer new human immunodeficiency virus (HIV) infections and deaths from acquired immunodeficiency syndrome (AIDS). However, immunological and clinical failures for first-line ART due to poor adherence and other factors have received less attention. Thus, this study aims to determine the magnitude and associated factors of clinical and immunological failure among HIV-positive adults after six months of first-line ART in Dire Dawa, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted using secondary data of patients on ART in all health facilities providing ART services in Dire Dawa. A total of 949 samples were collected. The data were entered into Epidata version 3.02, and the analysis was performed using SPSS version 16.0. Univariate and multivariate analyses were performed to determine the magnitude of clinical and immunological failure and identify factors significantly associated with the outcome variable. Results The magnitude of clinical and immunological failure was 22.7% ( n = 215). Of these, 33 (15%) patients were switched to second-line ART. CD4 count ≤100 cells/mm3 (AOR: 1.78, 95% CI: 1.18–2.69), poor adherence (AOR: 2.5, 95% CI: 1.19–5.25), restarting after interruption of ART (AOR: 1.93, 95% CI: 1.23–3.07), regimen change (AOR: 1.50, 95% CI: 1.05–2.15), ambulatory/bedridden functional status at the last visit on ART (AOR: 2.41, 95% CI: 1.22–4.75) and patients who died (AOR: 3.94, 95% CI: 1.64–9.45) had higher odds of failure. Conclusion The magnitude of clinical and immunological failure was high. To curb this problem, initiation of ART before the occurrence of severe immune suppression, early detection and management of failure and improved adherence support mechanisms are recommended. Restarting treatment after interruption and regimen changes-should-be-made-cautiously.
4 Business Development Officer with caRe ethiopia and cuso international, Monitoring and evaluation advisor, harar, ethiopia Background: Satisfaction with intrapartum care is crucial for the well-being of the mother and newborn. It also serves as a proxy indicator for future utilization and recommendation of the facility. Conversely, little is known about women's level of satisfaction during the intrapartum period in the Ethiopian context of a high maternal mortality ratio. As such, the aim of this study was to assess women's satisfaction with intrapartum care and its predictors at hospitals in Harar, Eastern Ethiopia. Materials and methods: A hospital-based, analytical, cross-sectional study was conducted in Harar hospitals, Eastern Ethiopia from February 1 to 28, 2017. The data were collected using an interviewer-administered questioner from 398 women who delivered in the selected hospitals during the data collection period. The collected data were entered into EpiData version 3.1 and analyzed using SPSS version 22.0. Bivariate and multivariable logistic regression was applied to identify the effect of each predictor on the outcome variable (satisfaction). A P-value of <0.05 was considered to be statistically significant. Results: The proportion of women who were satisfied with intrapartum care in this study was 84.7% (95% CI: 81.1, 88.2). Factors including a minimal waiting time to be seen by the healthcare provider, ample availability of emergency drugs within the hospital, not having antenatal care follow-up, having a previous experience of home delivery, planning to deliver in the hospital, and experiencing a short hospital stay after delivery were statistically and positively associated with women's satisfaction. Conclusion: Overall, ~85% of the women were satisfied with the service provided in the facilities. Decreasing waiting time to be seen by the healthcare providers, ensuring emergency drugs in the hospitals, advising mothers to have antenatal care follow-up, and delivering in the health facilities are crucial to improve the quality of intrapartum care.
A cross sectional study was conducted from November, 2011 to April, 2012 in Adigrat, Ethiopia, with the objective of assessing the prevalence of bovine mastitis, the risk factors associated with the disease and identifying the bacteria responsible for the disease. A total of 322 cows were selected from 10 small holder dairy farms using simple random sampling method. California Mastitis Test (CMT), clinical examination of udder and teats and bacteriological examination were employed. The overall prevalence of mastitis at a cow level was 64.3% (207/322), from which 15 (31/322) and 85% (176/322) were clinical and subclinical, respectively. The quarter level prevalence of the disease was also 54% (696/1288) from which 20.5 (264/1288) and 33.5% (432/1288) were clinical and subclinical form, respectively. As compared to the others, the right hind quarters were affected with the highest infection rate (63.9%). The left hind quarters were the second with an infection rate of 59.3% followed by right front quarters (52.5%) and left front quarters (40.4%). Among the bacterial causes of bovine mastitis in the study area, Staphylococcus aureus, Echerichia coli and Streptococcus agalactiae were the major isolates with percentages of 51.7, 20.9 and 20.3, respectively. All the potential risk factors considered in this study namely, parity, age, stage of lactation and breed showed significant effects on prevalence of mastitis in the present study. The present study concludes that mastitis was a major health problem of dairy cows in the area. Hence, strategic control measures against the disease and regular surveillance measures are recommended.
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