BackgroundUse of combination antiretroviral therapy (cART) has led to significant reductions in morbidity and mortality. However, there is a growing concern about metabolic syndromes (MS), among patients receiving cART. Despite this fact, there is limited evidence for the prevalence of the MS among HIV-infected persons receiving cART in developing countries, particularly Ethiopia.ObjectiveTo determine the prevalence and predictors of MS among people living with HIV/AIDS in Jimma health centre, Jimma Zone south west Ethiopia.MethodsA cross-sectional study was conducted on people living with HIV/AIDS (PLWHA) in Jimma health centre that fulfilled the inclusion criteria. Data on demographic and anthropometric characteristics were collected using World health organization (WHO) stepwise approach. Fasting blood glucose and lipid profile was measured. The Third Report of National Cholesterol Education Program-adult treatment panel III (NCEP-ATP III)-2001, the International Diabetes Federation (IDF)-2005 and the Joint interim statement-2009 (JIS) criteria were used to define MS. Data were analyzed using statistical software package (SPSS) version 20.0. Logistic regression analysis was done to identify predictors of MS and predictors with p value < 0.05 were used to declare statistical significance.ResultsOf 268 HIV-infected participants included in the analysis, 211 (78.7%) were women. The mean age of the participants was 39.32 ± 10.626 years. Using the NCEP-ATP III criteria, the prevalence of MS was found to be 23.5% (63 patients). While it was 20.5% (55 patients) and 27.6% (74 patients) with IDF and JIS criteria respectively. Enrollment in formal education resulted in 75% increment in the odds of MS (AOR = 0.25, 95% CI [0.072–0.879]). The odds of MS in patients with body mass index > 25 kg/m2 was elevated to 13.4 times (AOR = 13.39, 95% CI [3.943–45.525]) and exposure to D-drugs was attributed to 59% increment in the odds of MS (AOR = 1.59, 95% CI [0.58–4.56]), although the finding lacks statistical significance.ConclusionsMetabolic syndromes was relatively common to the study population. Hence, promoting health education and monitoring patient’s clinical and laboratory parameters at every visit and taking appropriate measure is ideal.

BackgroundEvaluation of client’s perception and satisfaction with pharmacy services is important to identify specific areas of the service that need improvement in achieving high-quality pharmacy services. It also helps to detect the gaps in the current pharmaceutical services provision.ObjectiveTo assess clients’ perception and satisfaction toward service provided by pharmacy professionals at Mizan-Tepi University Teaching Hospital.MethodsA cross-sectional study design was employed from March 8 to 24, 2016. A semistructured questionnaire was used to assess clients’ perception and satisfaction toward service provided by pharmacy professionals. The data collected were entered into Epi data 3.1, cleaned, and transported into and analyzed using SPSS version 20. Logistic regression was employed to determine associated factors, and statistical significance was considered at p-value <0.05.ResultsAmong 384 respondents, 53.1% were male. Of the total participants, 63.8% had good perception and 36.2% had poor perception toward pharmacy services. With regard to satisfaction, 52.6% of the respondents were satisfied and 47.4% were unsatisfied by the pharmaceutical services. Sociodemographic variables such as educational level (p=0.000), occupation (p=0.031), payment for service (p=0.002), and reasons the respondents seek service (p=0.001) showed statistically significant association with the level of perception. Clients’ satisfaction was found to be significantly associated with educational level (p=0.002) and reason for seeking service (p=0.016).Conclusion and recommendationThis study showed that the overall mean perception and satisfaction of clients in Mizan-Tepi University Teaching Hospital was low, even though it was above the mean level of perception and satisfaction. Action has to be taken to improve the perception and satisfaction of clients with the services provided in the pharmacy section.

Background Although tenofovir (TDF)/emtricitabine (FTC)/efavirenz (EFV) and zidovudine (ZDV)/lamivudine (3TC)/efavirenz (EFV) are used as preferred first line regimen, their head-to-head comparison in terms of their efficacy and tolerability was limited. This review aimed to synthesize the best available evidence on the comparative efficacy and tolerability of the two regimens. Methods Seven sites and databases in addition to Google search until August 20, 2016, were searched. Only randomized clinical trials conducted on adult population were included in this study. Our primary outcome was viral load suppression while secondary outcomes were death and tolerability. Undetectable viral load is defined as <50 Human Immunodeficiency Virus (HIV) ribonucleic acid (RNA) copies/ml. Joanna Briggs institute meta-analysis of statistics assessment and review instrument (JBI-MAStARI) and critical appraisal and data extraction tool were applied for critical assessment and data extraction, respectively. We performed a random effect meta-analysis to pool the relative risk (RR) for viral load suppression (<50 HIV RNA copies/ml and <400 HIV RNA copies/ml), tolerability, and death. Result Data was extracted from four articles, which included a total of 2381 participants. We found superior viral load suppression among tenofovir (TDF) arm compared to zidovudine (ZDV) arm. Tenofovir arm achieves viral load <50 HIV RNA copies/ml (RR = 1.12, 95% confidence interval (CI) [1.04, 1.21], I2 = 0%) higher than zidovudine arm. Similarly TDF arm is superior in viral load suppression to <400 HIV RNA copies/ml (RR = 1.19, 95% CI [1.11, 1.27], I2 = 0%). Moreover, TDF based regimens were more likely to be tolerated than ZDV based regimens (4 trials, 2381 participants (RR = 1.06, 95% CI [1.02, 1.10], I2 = 51%)). However, forest plot of death shows that it was not significant (RR = 0.91, 95% CI [0.51, 1.62]). Conclusion The use of TDF/FTC/EFV as first line regimen for naïve HIV-1 infected adult patient showed superior viral load suppression and tolerability as compared to ZDV/3TC/EFV. In order to compare the death outcome of both ZDV/3TC/EFV and TDF/FTC/EFV further research is needed.

Background: The introduction of Combined Antiretroviral Therapy (cART) shifted the perception of HIV/AIDS from a fatal to a potentially manageable chronic disease. As a result, patient-perceived health-related quality of life (HRQoL) is becoming an important outcome measure among HIV infected patients. We assessed the quality of life of admitted HIV/AIDS patients and the association of socio-demographic, clinical, and psychosocial characteristics of patients with health-related quality of life. Methods: Health facility-based cross-sectional study was conducted from April 1 to May 31, 2018 in selected tertiary care hospitals of Ethiopia. HRQoL was measured at discharge using the interviewer-administered World Health Organization’s Quality of Life HIV short-form instrument (WHOQoL-HIV BREF). Data were entered into EpiData 3.2 and exported to SPSS version 21.0 for cleaning and analysis. Descriptive analytical results were reported in text and table. Logistic regression was conducted to identify predictors of poor quality of life. Variables with p-value ≤ 0.25 in bivariate regression were considered as a candidate for multivariable regression. Multivariable logistic regression was performed to identify independent predictors. Regression coefficients and their 95% confidence intervals together with p-value < 0.05 were used to identify independent predictor of poor QoL. Results: Majority, 56 (58.9%) of the study participants, had poor general health-related quality of life. Being unemployed (AOR: 4.1, 95% CI; (1.23, 13.64); p=0.02), lack of support from family (AOR: 3.6, 95% CI: (1.05-12.6); p=0.04), and having co-morbidity (AOR: 4.2, 95% CI: (1.08, 16.65); p=0.039) were found to be independent predictors of poor quality of life. Conclusions: The study showed that the majority of the participants had poor health-related quality of life which was affected by unemployment, co-morbidity, and social support from family.

Background:About 20 million people worldwide are believed to be using khat. Although some studies reported that khat chewing might result in cardiovascular disorders, conclusive evidence is limited.Method:The objective of this review was to synthesize the best available evidence for the effect of khat on the cardiovascular system. Databases searched were PubMed, Cochrane database of systematic reviews, CINAHL, poplin, LILACS, MedNar and Scopus. All papers included in the review were subjected to rigorous appraisal using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. Review Manager Software (Revman 5.3) was used for meta-analysis and effect size and the 95% confidence interval (CI) was calculated.Result:Data was extracted from 10 articles. Our meta-analysis included 9,207 subjects, (2123 chewers and 7084 non-chewers, respectively) to elucidate the effect of khat on heart rate, diastolic and systolic blood pressure. The mean diastolic and systolic blood pressure of khat chewers was higher than the non-chewers with a mean difference of 5.1 mmHg, 95%CI [2.7,7.5] and 7.9 mmHg, 95%CI [2.65, 13.18], respectively. Similarly, the heart rate of the chewers remained consistently higher, making the mean difference of 6.9 beats/min, 95%CI [0.5, 13.3]. In addition, khat was found to have either a causative or worsening effect on stroke, myocardial infarction and heart failure.Conclusion:We showed that khat chewing could significantly affect the cardiovascular system through its effect on heart rate and blood pressure. Therefore, health promotion should be aimed to encourage quitting khat chewing.