Usage of cervical cancer screening services among HIV-positive women in Southern Ethiopia: a multicentre cross-sectional study

Objectives To assess the usage of cervical cancer screening services and associated factors among HIV-positive women on antiretroviral treatment in Southern Ethiopia in 2020.Design A multicentre cross-sectional study.Setting The study was conducted in Wolaita Sodo University Teaching Referral Hospital and Sodo Health Centre, Southern Ethiopia, from 1 July 2020 to 30 September 2020.Participants Four hundred and seventeen HIV-positive women on antiretroviral treatment attending public health facilities were approached during the study period. A multivariable binary logistic regression model was carried out to identify independent factors associated with the usage of cervical cancer screening services, and a p value<0.05 was used to declare statistical significance.Results The uptake of cervical cancer screening services among HIV-positive women was 27.8% with a 95% CI of 24.2% to 33.1%. Married women and women reporting a high level of perceived barriers were 75% and 66% less likely to receive cervical cancer screening services, adjusted OR (AOR)=0.25; 95% CI: 0.07 to 0.93, and AOR=0.34; 95% CI: 0.12 to 0.98, respectively. Whereas, being a government employee, AOR=3.85; 95% CI: 1.31 to 11.3, sexual debut before the age of 20, AOR=2.39; 95% CI: 1.09 to 5.26, using modern contraceptives, AOR=2.43; 95% CI: 1.05 to 5.65, having a high perceived self-efficacy, AOR=4.42; 95% CI: 1.79 to 10.89 and having a high perceived benefit of cervical cancer screening services, AOR=12.23; 95% CI: 2.22 to 67.35 were significantly associated with the usage of cervical cancer screening services.Conclusions The usage of cervical cancer screening services among HIV-positive women remains low in this setting. Married HIV-positive women and those with a high perceived barrier were associated with low uptake of cervical cancer screening services. Being a government employee, having an early sexual experience, using modern contraceptives, having a high perceived self-efficacy and having a high perceived benefit were identified as factors associated with increased uptake of cervical cancer screening services

Comparison of the air change per hour measured over four seasons in the residential buildings of the urban, rural, and industrial areas of South Korea: K-IOP Study

Air infiltration, calcuated by air changes per hour (ACH) is a key factor in assessing the potential amount of air borne pollutants moving from outdoor into indoor spaces. We measured the natural ACH through fall, winter, spring, and summer (2 weeks/season), in 81 nonsmoking elderly houses located in urban (n = 29), industrial (n = 26) and rural (n = 26) areas from 2021 to 2022 consecutively. Indoor CO2 data measured at dawn (01:00 to 05:00 a.m.) over four season was used to estimate the ACH. Moreover, morning ACHs were also calculated from the CO2 level monitored in the morning, when the levels were dropped significantly with opening a window during fall, winter, and spring. The ACH at dawn over the four seasons ranged from 0.02 to 0.03,while that in the morning with opening a window was 0.2 to 0.3. Our multivariate regression models demonstrated that the difference in CO2 concentration during dawn was positively associated with the ACH change after adjusting for seasonality. In addition, after controlling for the study area, ACH was approximately 50 % higher during summer than during the other seasons (p < 0.05). This study elucidates the seasonal and regional distributions of ACH; a determination of these patterns may further contribute to future simulation or prediction studies assessing the associations among indoor air quality, activity patterns and ventilation practices among Korean elderly population

Sepsis : emerging pathogens and antimicrobial resistance in Ethiopian referral hospitals

Background Sepsis due to multidrug resistant (MDR) bacteria is a growing public health problem mainly in low-income countries. Methods A multicenter study was conducted between October 2019 and September 2020 at four hospitals located in central (Tikur Anbessa and Yekatit 12), southern (Hawassa) and northern (Dessie) parts of Ethiopia. A total of 1416 patients clinically investigated for sepsis were enrolled. The number of patients from Tikur Anbessa, Yekatit 12, Dessie and Hawassa hospital was 501, 298, 301 and 316, respectively. At each study site, blood culture was performed from all patients and positive cultures were characterized by their colony characteristics, gram stain and conventional biochemical tests. Each bacterial species was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI TOF). Antimicrobial resistance pattern of bacteria was determined by disc diffusion. Logistic regression analysis was used to assess associations of dependent and independent variables. A p-value &lt; 0.05 was considered as statistically significant. The data was analyzed using SPSS version 25. Results Among 1416 blood cultures performed, 40.6% yielded growth. Among these, 27.2%, 0.3% and 13.1%, were positive for pathogenic bacteria, yeast cells and possible contaminants respectively. Klebsiella pneumoniae (26.1%), Klebsiella variicola (18.1%) and E. coli (12.4%) were the most frequent. Most K. variicola were detected at Dessie (61%) and Hawassa (36.4%). Almost all Pantoea dispersa (95.2%) were isolated at Dessie. Rare isolates (0.5% or 0.2% each) included Leclercia adecarboxylata, Raoultella ornithinolytica, Stenotrophomonas maltophilia, Achromobacter xylosoxidans, Burkholderia cepacia, Kosakonia cowanii and Lelliottia amnigena. Enterobacteriaceae most often showed resistance to ampicillin (96.2%), ceftriaxone (78.3%), cefotaxime (78%), cefuroxime (78%) and ceftazidime (76.4%). MDR frequency of Enterobacteriaceae at Hawassa, Tikur Anbessa, Yekatit 12 and Dessie hospital was 95.1%, 93.2%, 87.3% and 67.7%, respectively. Carbapenem resistance was detected in 17.1% of K. pneumoniae (n = 111), 27.7% of E. cloacae (n = 22) and 58.8% of Acinetobacter baumannii (n = 34). Conclusion Diverse and emerging gram-negative bacterial etiologies of sepsis were identified. High multidrug resistance frequency was detected. Both on sepsis etiology types and MDR frequencies, substantial variation between hospitals was determined. Strategies to control MDR should be adapted to specific hospitals. Standard bacteriological services capable of monitoring emerging drug-resistant sepsis etiologies are essential for effective antimicrobial stewardship