BackgroundResults: There were 47,066 households approached in 294 villages: 97% of households allowed entry. Of the 138,026 individuals captured, 101,167 individuals were eligible for testing: 89% of adults and 58% of children consented to HIV testing. The prevalence of HIV in these communities was 3.0%: 2.7% in adults and 3.7% among children. Prevalence was highest in the 36-45 year age group and was almost always higher among women and girls. All persons testing HIV-positive were referred to Academic Model Providing Access to Healthcare (AMPATH) for further assessment and care; all consenting persons were counselled on HIV risk-lowering behaviours. Conclusion: Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa. More research is needed to describe the cost-effectiveness and clinical impact of this approach.
Background Timely vaccination is key to prevent unnecessary childhood mortality from vaccine-preventable diseases. Despite the substantial efforts to improve vaccination completeness, the effort towards timeliness of vaccination is limited with non-attendance and delays to vaccination appointments remaining a big challenge in developing countries. There is also a limited evidence on timeliness of vaccination. Therefore, this study aimed to determine the magnitude and associated factors for timely completion of vaccination among children in Gondar town administration, north-west, Ethiopia.Methods This study employed a community-based cross sectional study design. A sample size of 821 children aged 12-23 months were considered. Two stages random sampling technique was applied. To account the effect of clustering, both bivariable and multivariable multilevel logistic regression analysis were applied. The measures of association estimates were expressed as adjusted odds ratio (AOR) with their 95% confidence intervals.Results Of the 774 children included for the analysis, 498 (64.3%) were fully vaccinated while 247 (31.9%) were fully vaccinated on-time. Caregivers of greater than 35 years old (AOR= 0.469; 95% CI: 0.253-0.869], who had secondary education and above (AOR = 2.391; 95% CI: 1.317- 4.343), from richest households (AOR = 2.381; 95% CI: 1.502-3.773), children whose mothers attended four and more ante natal care visits (AOR = 2.844; 95% CI: 1.310-6.174) and who had two or more post natal care visits (AOR =2.054; 95%CI:1.377-3.063) were positively associated with on-time full vaccination. In contrary, being vaccinated at health post (AOR=0.144; 95%CI: 0.048-0.428) and caregivers who travelled more than 30 minutes (AOR= 0.158; 95%CI: 0.033-0.739) were negatively associated with on-time full vaccination. The random effects indicated that 26% of the variability in on-time full vaccination was attributable to differences between communities.Conclusion In this study, untimely vaccination was found to be high. Different individual and contextual factors were found to be associated with on-time full vaccination. Therefore, tailored strategies have to be designed and implemented to address people and the communities where they live. Moreover, timeliness of vaccination should be considered as another important indicator of the immunization program performance in Ethiopia.
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