BackgroundHuman immunodeficiency virus (HIV) testing is critical for early linkage to treatment and care services. However, there is a substantial gap in HIV testing, particularly in resource limited settings due to low accessibility of HIV testing sites, inconvenient testing hours, and concerns about loss of confidentiality. Thus, adopting new strategies such as HIV self-testing (HIVST) could overcome these barriers and increases HIV testing uptake.ObjectiveThe aim of this study was to evaluate the diagnostic performance of non-invasive HIVST kit using oral fluid for HIV diagnosis. This study also aimed to assess the ability of clients in interpretation of OraQuick HIVST results.MethodBetween December 2017 and February 2018, a total of 400 study participants were enrolled into the study to assess a diagnostic accuracy of Oral fluid-based HIVST kit (OraQuick) in 15 public health facilities in Addis Ababa, Ethiopia. Participants were provided with instructions and visual aids on how to perform HIVST and interpret results. They also underwent a blood-based rapid HIV antibody test as per the current national algorithm. The results of HIVST were interpreted independently by the participants and respective health care workers (HCWs). The sensitivity, specificity, positive predictive value (PPV), Negative predictive value (NPV) and inter-rater agreement of the test were computed.ResultsOut of 200 participants who tested positive on the national algorithm testing, oral fluid-based self-testing was positive in 199 (99.5%), false negative in 1 (0.5%). Of 200 participants who tested negative on the national algorithm testing, self-testing was negative in 200 (100%). There were no false positive and invalid tests. The sensitivity and specificity of the OraQuick HIVST were 99.5% (95%CI: 97.26–99.99) and 100% (95%CI: 98.18–100.0), respectively. The overall agreement between the two tests was high (κ value = 0.995). The PPV and NPV of OraQuick test were 100% and 99.5% (95%CI: 96.59–99.93) respectively.ConclusionThis study showed a high diagnostic performance of OraQuick HIV self-test and suggests that OraQuick HIVST kit has a potential to be used for HIV testing in Ethiopia along with the national algorithm.

Background: Complicated severe acute malnutrition is the common reason for pediatric hospital admission in many poor countries, which pauses additional burden on limited resources. In hospitals, it remains poorly managed which led to mortality rate of under-five children became higher than the acceptable level as different studies revealed. However, survival status and its associated factors for complicated severe acute malnutrition were yet not get attention to halt its sequels.

Background: Though the unprecedented global effort at scaling up universal access to antiretroviral therapy (ART) has decreased the progression of HIV, treatment failure (TF) among pediatric patients receiving ART against human immunodeficiency virus (HIV) is becoming a global public health concern which may impact on treatment outcome. Thus, the aim of this study was to determine the rate and predictors of treatment failure (TF) among HIV-infected pediatric patients taking ART in Ethiopia. Methods: A prospective and retrospective follow-up study was conducted from March 2016 to 2017. Retrospective clinical and laboratory data were captured from patients medical record. Socio-demographics and explanatory variables of participants were collected using pre-tested structured questionnaire and study participants were followed for three to six month after baseline viral load has been done to classify virologic failure (VF). TF was ascertained from population who virally failed with the denominator of population taking ART. Chi-square test and multiple logistic regressions were conducted to assess predictors TF. Statistical significance was set at P-value less than 0.05. Results: A total of 554 pediatrics patients taking ART from 40 selected health facilities were included in the study. Viral load suppression (VLS) (VL<1000 copies/ml) among pediatric population taking ART in Ethiopia were found to be 344 (62.1%). From those who was not virally suppressed at baseline of the study 210 (37.9%), 99 (51.6%) were re-suppressed after three to six month of enhanced adherence and counseling, leading the overall virologic failure (VF) among pediatric population taking ART in Ethiopia to be 93 (17.3%). The mean CD4 count was improved from 490 cells/ml at ART initiation to 921 cells/ml after 80 months of ART exposure. Moreover, the clinical outcome was improved from 42% to 89% at ART initiation and after 80 month of ART experience. CD4 count, clinical stage, Hemoglobin and weight were found to be predictors of VF. Moreover; family HIV and disclosure status, duration on ART, age, being orphan, stigma and medication adherence have significant association with VF. Conclusions: The low level of VLS (62.1%) and the high level of VF (18.3%) could explain the challenge on the national ART program among pediatric population. The significant improvement on immunologic and clinical outcome could indicate the success of ART on treatment outcome among pediatric population. CD4 count, clinical stage, Hemoglobin and weight could be good predictors of TF among pediatric population. Improving disclosure status, stigma and medication adherence could improve the treatment outcome of pediatric population taking ART in Ethiopia.

Background: Nearly, 350 million people in the world are currently living with depression. Depression happening in PLHIV leads to alteration of economic productivity, decrease of working abilities, social isolation, physical decline and difficulties in solving problems. This study investigates the burden of depression and associated factors on HIV/AIDS patients attending an ART clinic. Methods: An institution-based cross-sectional study was implemented from April 1 to May 30, 2019 on a total of 417 HIV-positive patients. Systematic random sampling technique was used to access the study participants. Interviewer-administered structured questionnaire was used for data collection. Data were entered in to EpiData 3.1 and then were exported into Statistical Package for the Social Sciences (SPSS window version 20) for analysis. Results: Four hundred ten (410) respondents participated in the study with a response rate of 98.3%. The burden of depression was 50.5% in this study. Male (AOR=1.53; 95%CI: 1.016-2.311), people living in urban (AOR=2.20; 95%CI: 1.29-3.75), patients who had opportunistic infection (AOR=1.98; 95%CI: 1.27-3.11), poor medication adherence (AOR=1.79; 95%CI: 1.13-2.85) and high HIV-related perceived stigma (AOR=1.66; 95%CI: 1.04-2.67) were more likely depressed compared to their counterparts. Conclusion: In this study, male sex, those patients living in urban areas, having opportunistic infections, poor medication adherence, and high HIV-related perceived stigma were significantly associated with depression. Hence, organizations working on HIV programs should address these factors to prevent and manage depression among HIVpositive patients.