Factors associated with medication adherence among patients with schizophrenia in Mekelle, Northern Ethiopia.

Non-adherence to antipsychotic medication has a negative impact on the course of illness resulting in increased risk of relapse, rehospitalization and suicide, and increased costs to healthcare systems. The objective of this study was to investigate factors associated with medication adherence among patients with schizophrenia at Ayder Referral Hospital and Mekelle Hospital in Mekelle, Tigray region, Northern Ethiopia.The study was a cross-sectional survey in which sociodemographic characteristics, drug attitudes, insight and side effects were measured and explored in terms of their relationship with medication adherence. A structured questionnaire as a data collection tool was used. Data were analyzed with the help of SPSS Version 20.0.A total of 393 patients participated, 26.5% were non-adherent to their antipsychotic medication. The factors significantly associated with better adherence were positive treatment attitudes (AOR = 1.40, 95% CI: 1.26, 1.55), fewer side effects (AOR = 0.97, 95% CI: 0.94, 0.99), awareness of illness (AOR = 1.44, 95% CI: 1.12, 1.85) and the ability to relabel symptoms (AOR = 1.57, 95% CI: 1.19, 2.07). However, khat chewers (AOR = 0.24, 95% CI: 0.09, 0.68), being illiterate (AOR = 0.13, 95% CI: 0.03, 0.47) and older age group (AOR = 0.03, 95% CI: 0.01, 0.16) were associated with less medication adherence.A high prevalence of medication non-adherence was found among patients with schizophrenia. Intervention strategies focused on educating the patients to better understand the illness, medications and their potential side effects might be useful in improving adherence to antipsychotic medication treatment

CD4 cell count trends after commencement of antiretroviral therapy among HIV-infected patients in Tigray, Northern Ethiopia: a retrospective cross-sectional study.

The rate and extent of CD4 cell recovery varies widely among HIV-infected patients with different baseline CD4 cell count strata. The objective of the study was to assess trends in CD4 cell counts in HIV-infected patients after initiation of antiretroviral therapy in Tigray, Northern Ethiopia.A retrospective cross-sectional study was conducted by reviewing medical records of HIV patients who received antiretroviral treatment at twenty health centers in Tigray region during 2008-2012. Multi-stage cluster sampling technique was employed to collect data, and the data were analyzed using SPSS version 20.0 software.The median change from baseline to the most recent CD4 cell count was +292 cells/μl. By 5 years, the overall median (inter-quartile range, IQR) CD4 cell count was 444(263-557) cells/μl while the median (IQR) CD4 cell count was 342(246-580) cells/μl among patients with baseline CD4 cell counts ≤200 cells/μl, 500(241-557) cells/μl among those with baseline CD4 cell counts of 201-350 cells/μl, and 652(537-767) cells/μl among those with baseline CD4 cell counts >350 cells/μl. Higher baseline CD4 cell counts and being male were independently associated with the risk of immunological non-response at 12 months. Furthermore, it was also investigated that these factors were significant predictors of subsequent CD4 cell recovery.Patients with higher baseline CD4 cell stratum returned to normal CD4 Cell counts though they had an increased risk of immunological non-response at 12 months compared to those with the least baseline CD4 cell stratum. The findings suggest that consideration be given to initiation of HAART at a CD4 cell count >350 cells/μl to achieve better immune recovery, and to HIV-infected male patients to improve their health seeking behavior

Attitudes, medication side effects, satisfaction with medication, and insight.

<p>Higher score indicates a</p><p>¹more positive attitude towards treatment but negative value indicates negative attitude towards treatment,</p><p>²more severe side effect,</p><p>³more satisfaction with medication, and</p><p>⁴greater insight.</p><p>Attitudes, medication side effects, satisfaction with medication, and insight.</p

Socio-demographic characteristics of study participants.

<p>Exchange rate: 1 USD = 19.82 Ethiopian Birr (ETB).</p><p>Socio-demographic characteristics of study participants.</p

Results of multivariate logistic regression of independent variables and antipsychotic medication adherence.

<p>¹Adjusted for age, marital status, education status, residence, employment status, alcohol consumption, cigarette smoking, khat chewing, treatment attitudes, medication side effects, satisfaction with medication, relabel symptoms and awareness of illness.</p><p>Results of multivariate logistic regression of independent variables and antipsychotic medication adherence.</p

Association of sociodemographic factors with antipsychotic medication adherence among patients with schizophrenia.

<p>Association of sociodemographic factors with antipsychotic medication adherence among patients with schizophrenia.</p

Median CD4 cell count after initiation of ART.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122583#pone.0122583.g001" target="_blank">Fig. 1</a> indicates the six monthly changes in the median CD4 cell count after the commencement of ART and the number of patients who had recorded CD4 data.</p

Results of logistic regression analysis of baseline characteristics associated with the risk of immunological non-response (an increase of <50 cells/μl).

<p>Results of logistic regression analysis of baseline characteristics associated with the risk of immunological non-response (an increase of <50 cells/μl).</p

Multivariate analysis of baseline characteristics associated with changes in CD4 cell count.

<p><b>NOTE:</b> The initial model contained all covariates, and the final model contained only statistically significant covariates.</p><p>Multivariate analysis of baseline characteristics associated with changes in CD4 cell count.</p