Sampling procedures.

<p>The phenomena regarding the child nutrition were assumed to be homogenous among the districts of the study zone. Thus, four districts out of nine were selected using simple random sampling. The health facilities rendering OTP were stratified into health centers and health posts. One health center and three satellite health posts were included from each district. Using the Probability Proportional to Size (PPS), the n1, n2, n3, and n4 samples were drawn. Finally, the OTP record card of each child was selected using systematic random sampling. <i>HP: health post; HC: health center</i>.</p

Kaplan Meier survival curves and Log-rank test for recovery rates over grouped factors.

<p>The KM survival curves for each grouped factor were identified by color and pattern differences. They showed the recovery rates over the OTP intervention. The KM curves enable to compare the recovery rates between those with and without diarrhea, vomiting, loss of appetite with Plumpy'Nut, failure to gain weight and over children who took de-worming and amoxicillin drugs as compared to those who didn't take the drugs. The log-rank tests the significance of the observed differences in recovery rates on the KM survival curves between the grouped factors. <i>X²: Chi-squared test</i>.</p

Multivariate Cox-regression for prediction of recovery rate from SAM 2008–2012, Tigray, northern Ethiopia.

*<p><i>Significant at P<0.05,</i></p>**<p><i>significant at P<0.01,</i></p>***<p><i>significant at P<0.001.</i></p><p><i>N/A: Not applicable and N/A⁺ not applicable i.e. children less than one year ages are not eligible to take de-worming tabs).</i></p><p><i>HR = Hazard ratio.</i></p><p><i>All the predictors in the table were adjusted for one another to control for confounding effect.</i></p

Outpatient Therapeutic Feeding Program Outcomes and Determinants in Treatment of Severe Acute Malnutrition in Tigray, Northern Ethiopia: A Retrospective Cohort Study

<div><p>Background</p><p>Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate.</p><p>Methods</p><p>A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression.</p><p>Results</p><p>The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P<0.001). The adjusted hazard ratios to recovery of children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001), 4.49 (HR = 1.74, 95%-CI = 1.07, 2.83, P = 0.046) and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, P<0.001), respectively. Children who took amoxicillin and de-worming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more probability to recover from SAM as compared to those who didn't take them.</p><p>Conclusions</p><p>The OTP was partially successful. Management of children with comorbidities under the program and partial administration of routine drugs were major threats for the program effectiveness. The stakeholders should focus on creating the capacity of the OTP providers on proper management of SAM to achieve fully effective program.</p></div

The medical problems identified during the OTP treatment, 2008–2012, Tigray, northern Ethiopia.

<p>^{<>\raster(70%)="rg3"<>}<i>The medical problems were reported unclassified for their types, magnitude and severities.</i></p>▪<p><i>The proportion of each medical problems out of all (the denominator is the children the medical problems).</i></p>□<p><i>The proportion of children who had medical problems (the denominator is the total children in the study).</i></p

Routine medications intake among eligible children managed under OTP, 2008–2012, Tigray, northern Ethiopia

▪<p><i>The proportion of each medication administered out of all medications (the denominator is the total medication administered)</i>.</p>□<p><i>The proportion of children who took the each medication (the denominator is the total eligible children in the study).</i></p

Factors Associated with Low Levels of HIV Testing among Men Who Have Sex with Men (MSM) in Brazil

<div><p>The aim of this study was to assess risk factors associated with low levels of HIV testing among MSM recruited through respondent driven sampling (RDS) in Brazil. Of 3,617 participants, 48.4% had never tested previously for HIV. A logistic model indicated that younger age, lower socioeconomic class, education, poor HIV/AIDS knowledge, no history of cruising, and having been tested during the study were characteristics independently associated with low levels of previous HIV testing. The HIV testing rate among MSM in Brazil is still low in spite of the availability of a large number services providing universal and free access to HIV/AIDS diagnosis and treatment. To respond to low utilization, the authors propose a higher priority for testing for key populations such as MSM, expanded education, expanding testing sites and a welcoming and nonjudgmental environment in health services.</p></div

Multivariate analysis (final model) of never testing for HIV among MSM in Brazil, 2009.

<p>Multivariate analysis (final model) of never testing for HIV among MSM in Brazil, 2009.</p

Univariate analysis of never testing for HIV among MSM in Brazil, 2009.

<p>Univariate analysis of never testing for HIV among MSM in Brazil, 2009.</p

Natural environmental water sources in endemic regions of northeastern Brazil are potential reservoirs of viable Mycobacterium leprae

<div><p> BACKGROUND The detection of live Mycobacterium leprae in soil and animals other than humans suggests that the environment plays a role in the transmission of leprosy. OBJECTIVE The objective of this study was to investigate the presence of viable M. leprae in natural water sources used by the local population in five municipalities in the state of Ceará, northeastern Brazil. METHODS Samples were collected from 30 different sources. Viable bacilli were identified by reverse transcriptase polymerase chain reaction (PCR) of the M. leprae gyrA gene and sequencing of the PCR products. Physicochemical properties of each water source were also assessed. FINDINGS M. leprae gyrA mRNA was found in 23 (76.7%) of the water sources. No association was found between depth of the water and sample positivity, nor was there any association between the type of water used by the population and sample positivity. An association between viable M. leprae and temperature and pH was found. Georeferencing showed a relation between the residences of leprosy cases and water source containing the bacterium. MAIN CONCLUSIONS The finding of viable M. leprae in natural water sources associated with human contact suggests that the environment plays an important role in maintaining endemic leprosy in the study region.</p></div