Predictors of Late HIV Diagnosis among Adult People Living with HIV/AIDS Who Undertake an Initial CD4 T Cell Evaluation, Northern Ethiopia: A Case-Control Study

Early HIV testing and timely initiation of ART is critical for the improved quality of life of PLWHIV. Having identified a higher rates of Late HIV diagnosis, this study was aimed to determine Determinants of late diagnosis of HIV among adult HIV patients in Bahir Dar, Northern Ethiopia.A case control study was conducted between January 2010 to December 2011 at Bahir Dar Felege Hiwot Referral Hospital. The study subjects consisted of 267 cases and 267 controls. Cases were adult people living with HIV/AIDS whose initial CD4 T cell count was < 200/μl of blood. Controls were those with a CD4 T cell count of greater than 200/ μl. Trained staff nurses were involved in data collection using a semi-structured questionnaire. Data was entered and analyzed using SPSS version 20. Descriptive statistics and Binary logistic regression were performed.Subjects who hold a certificate and above (AOR = 0.26; 95% CI = 0.13. 0.54), being initiated by friends, families and other socials to undertake HIV testing (AOR = 0.65; 95% CI = 0.29, 1.48), who reported a medium and high knowledge score about HIV/AIDS and who undertake HIV testing while visiting a clinic for ANC (AOR = 0.40; 95% CI = 0.19, 0.83) were less likely to be diagnosed late. Subjects who undertake HIV testing due to providers' initiation (AOR = 1.70; 95%CI = 1.08, 2.68), who reported a medium internalized stigma (AOR = 4.94; 95% CI = 3.13, 7.80) and who reported a high internalized stigma score towards HIV/AIDS (AOR = 16.64; 95% CI = 8.29, 33.4) had a high odds of being diagnosed late compared to their counterparts.Internalized stigma, low knowledge level about HIV/AIDS, not to have attended formal education and failure to undertake HIV testing by own initiation were significant determinant factors associated with Late HIV diagnosis. Education about HIV/AIDS, promotion of general education, and encouraging people to motivate their social mates to undertake HIV testing are highly recommended

Factors associated with delayed diagnosis of HIV among Adult PLHA who had undertaken initial CD4 count at Bahirdar FHRH from January 2010 to December 2011.

<p>Factors associated with delayed diagnosis of HIV among Adult PLHA who had undertaken initial CD4 count at Bahirdar FHRH from January 2010 to December 2011.</p

Immunological, clinical and behavioral characteristics of adult PLHA who undertake initial CD4 count at Bahirdar FHRH, Northern Ethiopia.

<p>PITCH: Provider initiated testing and counseling for HIV</p><p>Immunological, clinical and behavioral characteristics of adult PLHA who undertake initial CD4 count at Bahirdar FHRH, Northern Ethiopia.</p

Socio-demographic and economic characteristics of Adult PLHA who had undertaken initial CD4 count at Bahirdar FHRH, January 2010 to December 2011.

<p>Socio-demographic and economic characteristics of Adult PLHA who had undertaken initial CD4 count at Bahirdar FHRH, January 2010 to December 2011.</p

Efficacy of Chloroquine for the Treatment of <i>Vivax malaria</i> in Northwest Ethiopia

<div><p>Background</p><p>Resistance to anti-malarials is a major challenge for effective malaria control in sub-Saharan Africa. This triggered a need for routine monitoring of the efficacy of the antimalarial drugs every two years in all malaria endemic countries. Chloroquine remained the drug of choice for the treatment of vivax malaria in Ethiopia. Though, a strong scientific evidence of chloroquine resistance to <i>P</i>.<i>vivax</i> that could have brought change of treatment regimen is yet to be established in Ethiopia, continuous and regular monitoring of drug’s efficacy is critical for establishing rational anti-malarial drug policies. This study therefore, assessed the therapeutic efficacy of Chloroquine (CQ) for the treatment of <i>Plasmodium vivax</i> infections in Northwestern Ethiopia.</p><p>Methods</p><p>An observational, 28- day therapeutic clinical efficacy study was conducted from August to December, 2014, in Northwest Ethiopia. Patients confirmed to have monoinfection of vivax malaria, aged above 6 months were included. All subjects were treated with standard chloroquine dose of 25 mg/kg for three (3) days. Parasitological and clinical outcomes of treated patients were then evaluated on days 1, 2, 3, 7, 14, 21, and 28 during the entire 28-day follow-up period. A portable spectrophotometer (HemoCue Hb 301 System, Sweden) was used to estimate hemoglobin concentration.</p><p>Results</p><p>A total of 69 subjects had completed follow up. Some 57/69 (82.6%) had fever at enrolment and the rest 12 patients 48 hours before enrollment. Out of total, 65/69 (94.2%) and 66/69 (95.6%) of the study subjects were free of fever by day 1 and day 2 respectively but fever was cleared in all subjects by day 3. At base line the mean asexual parasitemia was 3540 parasites/μL of blood. Parasite carriage on day 3 was 3%. The overall cure rate (an adequate and clinical parasitological response) was very high (97%) [(95% CI = 93.1–99.4)]. The time to parasite, fever and gametocyte clearance as expressed in mean (SD) was 35 (3), 25 (4.6), 28 (3.2) hours respectively. Mean hemoglobin was significantly increased (P<0.001) from 12.2 (7–15) g/dl at day 0 to 13.3 (10–16) g/dl on day 28.</p><p>Conclusions</p><p>In view of our findings, CQ remains efficacious for the treatment of vivax malaria in the study area. However, there is a need to monitor CQR regularly using molecular and or biochemical tools for better evaluation of treatment outcomes.</p></div

Parasite and fever clearance rate and hemoglobin recovery in study participants Bullen Health center, Northwest Ethiopia.

<p>Parasite and fever clearance rate and hemoglobin recovery in study participants Bullen Health center, Northwest Ethiopia.</p

Baseline characteristics of the study participants, Bullen Health Center, August-December, 2014, Bullen, Ethiopia.

<p>Baseline characteristics of the study participants, Bullen Health Center, August-December, 2014, Bullen, Ethiopia.</p

Map of the study site.

<p>Metekel Zone, Bullen District.</p

Patient recruitment and follow-up for the trial of CQ efficacy against <i>P</i>. <i>vivax</i> malaria in Bullen Health Centre Northwest Ethiopia (17 August to 19 December, 2014).

<p>Patient recruitment and follow-up for the trial of CQ efficacy against <i>P</i>. <i>vivax</i> malaria in Bullen Health Centre Northwest Ethiopia (17 August to 19 December, 2014).</p

Pattern of parasite, gametocyte and fever clearance in <i>P</i>. <i>vivax</i> monoinfected patients treated with Chloroquine in Northwest Ethiopia.

<p>Pattern of parasite, gametocyte and fever clearance in <i>P</i>. <i>vivax</i> monoinfected patients treated with Chloroquine in Northwest Ethiopia.</p