Background Several factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia. Methods We performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We searched four electronic databases: PubMed/Medline, the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) for studies from December 1, 2017 to January 30, 2018. We also searched university repositories and conference abstracts for unpublished studies. We conducted a meta-analysis for the pooled effect of adherence using a random effects model in Stata version 14 and assessed publication bias using the Egger’s test for funnel plot asymmetry. Results Our search returned in 179 studies, of which seven (3.9%), were eligible and included in the final meta-analysis. The seven included studies were conducted from 2010 to 2015. Our analysis found that disclosure had a significant effect on the adherence to ART in adult patients living with HIV. Patients who disclosed were 1.64 times more likely to have good adherence to ART compared with those who did not (OR: 1.64, 95% CI: 1.11, 2.42). The small number of studies eligible for review and differences in study definitions of adherence and disclosure were the main limitations of this study. Conclusion This review found a statistically significant positive effect of disclosure status on the adherence to ART in adult patients living with HIV in Ethiopia. This suggests that Ethiopia’s national treatment and prevention programs should redouble efforts to encourage self-disclosure among people living with HIV/AIDS. Encouraging supportive social environments for disclosure, and promoting partner notification and partner disclosure support initiatives might be particularly helpful in this regard.
Background: The distribution of intestinal parasites among patients with tuberculosis in Ethiopia has not been well understood. Thus, this systematic review and meta-analysis was designed to determine the pooled national prevalence of intestinal parasites and its association with HIV among patients with tuberculosis in Ethiopia. Methods: Original articles were searched in PubMed, Google Scholar, EMBASE, and World Health Organization’s HINARI portal and supplemented by the hand searching of cross-references. Data were extracted using a standard data extraction checklist. Random-effects model was used to estimate the pooled prevalence of intestinal parasites and odds ratio of the association. The I2 statistic was utilized to quantify statistical heterogeneity across studies. Funnel plot asymmetry and Egger’s regression tests were used to check for publication bias. The analysis was done by STATA version 14 for Windows. Results: Of 725 identified studies, 12 articles were eligible for inclusion in the final analysis. The pooled national prevalence of intestinal parasites among patients with tuberculosis in Ethiopia was 36.1% (95% CI: 22.1 – 50.1, I2:98.7%). Subgroup analysis based on study design indicated that the prevalence of intestinal parasite among case-control studies was 41.69% (95% CI: 28.6 – 54.8, I2: 95.1%). The odds of intestinal parasites among patients with tuberculosis- HIV co-infection was not significantly different compared with patients with tuberculosis without HIV/AIDS (OR: 0.99, 95% CI: 0.7 - 4.7, p: 0.96). Conclusion: In Ethiopia, at least one out of three patients with tuberculosis have intestinal parasite. These findings suggest the need of more attention on increasing screening tuberculosis patients for intestinal parasites and deworming intervention.
BackgroundPneumonia is a leading cause of morbidity and mortality among children aged under 5 years in Ethiopia. Prolonged hospitalization of severe community-acquired pneumonia is a significant problem in resource-limited countries. This study seeks to provide insights that can help improve the management and outcomes of severe community-acquired pneumonia, which is particularly important in the context of the Benishangul-Gumuz Region, Ethiopia, where access to quality healthcare services is limited, and childhood pneumonia is a significant health challenge.ObjectiveThe aim of the study was to determine the predictors of prolonged hospitalization among children aged 2–59 months admitted with severe community-acquired pneumonia between 1 January 2016 and 30 December 2020 in the public hospitals in Benishangul-Gumuz Region, Ethiopia.MethodA retrospective follow-up study design was conducted among randomly selected samples of 526 children. Data were entered into EPI data version 4.6 and analyzed using STATA version 14.0. The Cox proportional hazard regression model was fitted to identify the independent predictors of prolonged hospitalization, and variables with a p-value <0.05 in the multivariable model were considered statistically significant.ResultsThe median hospital stay was 5 days (interquartile range 2–8 = 6). Approximately 149 (28.93%) children had prolonged hospitalization (>5 days) and the recovery rate from severe community-acquired pneumonia was 19.69 per 100 person-day observations. The significant predictors of prolonged hospitalization were as follows: having facility referral sources [0.79, 95% confidence interval (CI), 0.63–0.98]; a nutritional status of wasting (0.64, 95% CI, 0.44–0.94); anemia (0.65, 95% CI, 0.46–0.90); no identified hemoglobin level (0.53, 95% CI, 0.41–0.70); no identified blood film (0.65, 95% CI, 0.53–0.80); no chest x-ray investigation (0.81, 95% CI, 0.65–0.99); pulmonary effusion (0.31, 95% CI, 0.15–0.66); and late presenters to hospital (0.67, 95% CI, 0.53–0.84) at admission.ConclusionsThe median length of stay in hospital was delayed compared to other studies. Wasting, late presenting to hospital, pulmonary effusion, anemia, absence of investigations of hemoglobin level, chest x-ray, and blood film at admission time were factors that significantly prolonged the hospitalization time. Hence, attention should be given to the prevention of malnutrition and anemia in children, increasing early health-seeking behavior in the community. Attention should be given to complications such as pleural effusion, and investigations, such as chest x-ray, hemoglobin levels, and blood films, should be performed when the child is admitted.
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