Factors Affecting Adherence to Pediatrics Antiretroviral Therapy in Mekelle Hospital, Tigray Ethiopia

The most important factor in the success of HIV treatment is adherence to antiretroviral therapy (ART).The challenge to adherence to ART is particularly serious in Sub-Saharan Africa as the high rates of HIV/AIDS lead to greater numbers of affected individuals. Although long-term good ART adherence has been observed in certain settings of public sectors the magnitude of this challenge in Sub-Saharan Africa remains large and there is evidence for high rates of patient\u27s poor adherence. Study aimed to assess the factors affecting adherence to pediatrics antiretroviral therapy (ART) among children in Mekelle hospital, Tigray, Ethiopia. A Hospital based cross-sectional study was conducted on 226 children on antiretroviral therapy from May 01 to 30/2014 at Mekelle hospital. Data was collected from care givers of children under 15 years old who are on ART. Of the 226 children under 15 years, 90.3 % reported complete adherence to antiretroviral therapy medications at the regular schedule over the past 7 days. Factors associated with adherence were having male care giver (AOR=2.10[1.01, 7.22]), age of the child (AOR=1.43[1.16, 3.98]) below 5 years and use of first line ART drugs (AOR=2.86[1.54, 3.67]). Over all the adherence of children on ART to their medication in this study is relatively higher as compared to others. However, complete adherence is expected in order to make the drugs effective. Different strategies have to be designed to improve the adherence level

Incidence and Predictors of Tuberculosis Among Adult PLWHA at Public Health Facilities of Hawassa City

Tuberculosis (TB) is the most frequently diagnosed opportunistic infection (OI) and disease in people living with HIV/AIDS (PLWHA), world-wide. This study aimed at determining the incidence and predictors of tuberculosis among people living with HIV.A Six year retrospective follow up study was conducted among adult PLHIV. The Cox proportional hazards model was used to identify predictors.A total of 554 patients were followed and produced 1830.3 person year of observation. One hundred sixty one new TB cases occurred during the follow up period. The overall incidence density of TB was 8.79 per 100 person-year (PY). It was high (148.71/100 PY) in the first year of enrolment. The cumulative proportion of TB free survival was 79% and 67% at the end of first and sixth years, respectively. Not having formal education(AHR=2.68, 95%CI: 1.41, 5.11 ), base line WHO clinical stage IV (AHR = 3.22, 95% CI=1.91-5.41), CD4 count <50 cell/ul (AHR=2.41, 95%CI=1.31, 4.42), Being bed redden (AHR= 2.89, 95%CI=1.72, 3.78), past TB history (AHR=1.65, 95% CI = 1.06,2.39), substance use (AHR=1.46, 95% CI=1.03,2.06) and being on pre ART (AHR=1.62, 95%CI:1.03-2.54 ) were independently predicted tuberculosis occurrence. Advanced WHO clinical stage, limited functional status, past TB history, addiction and low CD4 (<50cell/ul) count at enrollment were found to be the independent predictor of tuberculosis occurrence. Therefore early initiation of treatment and intensive follow up is important

Prevalence and Associated Factors of Hypertension Among Civil Servants Working in Arba Minch Town, South Ethiopia

Despite Hypertension is a global public health challenge and a leading modifiable risk factor for cardiovascular disease and death attention was not given in developing countries. Therefore measuring the prevalence and identifying predictors of Hypertension is very important. Institution based cross sectional study design was employed from March–April, 2016 by taking 319 randomly selected civil servants working in in Arba Minch town. Data was collected using structured questionnaire and standardized instruments for physical examination by 5 trained nurses. SPSS version 20 was used for data analysis. Bi-variable and Multivariate logistic regression was employed for analysis of risk factors. The mean SBP and DBP of study participants were 120.87 + 14.15 mmHg and 80.28 + 8.8 mmHg, respectively. The prevalence of hypertension was found to be 27.8% (95% CI = 22.9-32.7%). Civil servants of age 50 years and above [AOR = 13.3], age 40-49 years [AOR = 5], age 30-39 years [AOR = 3.5], abdominal obesity [AOR=12.2], general obesity [AOR = 4.2], stress status [AOR = 12.3], current alcohol drink [AOR = 3.3], ex-drinker [AOR = 8.9] and family history of hypertension [AOR = 5.6] were found to be significantly associated with hypertension. The prevalence indicates that it is hidden epidemic in this population; therefore for screening and risk reduction program are needed

Risky Sexual Behavior and Associated Factors Among High School Students in Gondar City, Northwest Ethiopia

According to World Health Organization (WHO), youth are young people within 15-24 years old. Studies reported that more than half of all new HIV infections occur among people between the ages of 15 and 24 years. Institution based quantitative cross-sectional study was conducted among high school students in Gondar city. Multistage sampling technique was employed to recruit study participants. Data were collected using pretested structured self-administered questionnaire. Data were entered in Epi Info version 7 and analyzed using SPSS version 21. Descriptive statistics were computed to describe important variables in relation to the outcome variable, Binary and multivariable logistic regressions were used to identify independent predictors of the outcome variable. The overall prevalence of risky sexual behavior was 12.8%. Two out of five sexually active respondents ever had unprotected sexual intercourse. Ever used alcohol ((AOR, 3.53 95% CI (1.73-7.19)), had no parental monitor (AOR, 12.21 95% CI (6.55-22.78), ever watched pornographic film (AOR, 2.24 95% CI (1.15-4.35), had no parental discussion on sexual and reproductive health issues (AOR, 2.57 95% CI (1.36-4.85) and peer pressure (AOR,2.50, 95%CI (1.20-5.21), were factors which significantly increases the odds of risky sexual behavior among youth. Risky sexual behavior among high school students in Gondar city administration was very high and worrisome; so that collaborated effort is needed from parents, schools, health facilities and health policy makers to bring healthy sexual behavior among school youth

Retrospective Assessment of Malnutrition Among Under-five Children in Ayder Referral Hospital, Tigray Ethiopia

Currently worldwide there are about 60 million children with moderate acute and 13 million with severe acute malnutrition. About 9% of sub-Saharan African and 15%of south Asian children have moderate acute malnutrition and about 2% of children in developing countries have severe acute malnutrition. The objective of aim the study was to assess the magnitude of malnutrition in under five children in Ayder referral hospital using a retrospective cross-sectional study design. This study showed that male children, 168(58.1%), were higher than female, 121(41.9%).. Majority, 133(46%), were in the age group b/n 12 to 24 months .More than half, 186(64.4%) were rural dwellers. The types of malnutrition identified were Marasmus, kwashiorkor, Marasmic kwash and underweight which account for 116(40.1%), 69(23.9%), 54(18.7%) and 50(17.5%) respectively. Marasmus was the predominant type of malnutrition in all age groups of under five malnourished children with prevalence of 40.1% where as underweight was the prevalent type of malnutrition (17.3%). More over the infant feeding practices such as exclusive breast feeding, timely initiation of complementary feeding, and having history of breast feeding once in their life during infancy were relatively higher among the children as compared with other studies

Prospecting environmental mycobacteria: combined molecular approaches reveal unprecedented diversity

Background: Environmental mycobacteria (EM) include species commonly found in various terrestrial and aquatic environments, encompassing animal and human pathogens in addition to saprophytes. Approximately 150 EM species can be separated into fast and slow growers based on sequence and copy number differences of their 16S rRNA genes. Cultivation methods are not appropriate for diversity studies; few studies have investigated EM diversity in soil despite their importance as potential reservoirs of pathogens and their hypothesized role in masking or blocking M. bovis BCG vaccine. Methods: We report here the development, optimization and validation of molecular assays targeting the 16S rRNA gene to assess diversity and prevalence of fast and slow growing EM in representative soils from semi tropical and temperate areas. New primer sets were designed also to target uniquely slow growing mycobacteria and used with PCR-DGGE, tag-encoded Titanium amplicon pyrosequencing and quantitative PCR. Results: PCR-DGGE and pyrosequencing provided a consensus of EM diversity; for example, a high abundance of pyrosequencing reads and DGGE bands corresponded to M. moriokaense, M. colombiense and M. riyadhense. As expected pyrosequencing provided more comprehensive information; additional prevalent species included M. chlorophenolicum, M. neglectum, M. gordonae, M. aemonae. Prevalence of the total Mycobacterium genus in the soil samples ranged from 2.3×107 to 2.7×108 gene targets g−1; slow growers prevalence from 2.9×105 to 1.2×107 cells g−1. Conclusions: This combined molecular approach enabled an unprecedented qualitative and quantitative assessment of EM across soil samples. Good concordance was found between methods and the bioinformatics analysis was validated by random resampling. Sequences from most pathogenic groups associated with slow growth were identified in extenso in all soils tested with a specific assay, allowing to unmask them from the Mycobacterium whole genus, in which, as minority members, they would have remained undetected

Global Transcriptional Analysis of Spontaneous Sakacin P-Resistant Mutant Strains of Listeria monocytogenes during Growth on Different Sugars

Subclass IIa bacteriocins have strong antilisterial activity and can control the growth of Listeria monocytogenes in food. However, L. monocytogenes may develop resistance towards such bacteriocins. In this follow-up study, the transcriptomes of a high level (L502-1) and a low level (L502-6) spontaneous sakacin P-resistant mutant strain of L. monocytogenes were compared to the wild-type (L502). The growth of the resistant strains was reduced on mannose but not affected on cellobiose and the transcriptomics was performed during growth on these sugars. The mannose phosphotransferase system (PTS) encoded by the mptACD operon (mpt) is known for transporting mannose and also act as a receptor to class IIa bacteriocins. The mpt was repressed in L502-1 and this is in accordance with abolition of the bacteriocin receptor with resistance to class IIa bacteriocins. In contrast, the mpt was induced in L502-6. Despite the induction of the mpt, L502-6 showed 1,000 times more resistance phenotype and reduced growth on mannose suggesting the mannose-PTS may not be functional in L502-6. The microarray data suggests the presence of other transcriptional responses that may be linked to the sakacin P resistance phenotype particularly in L502-6. Most of commonly regulated genes encode proteins involved in transport and energy metabolism. The resistant strains displayed shift in general carbon catabolite control possibly mediated by the mpt. Our data suggest that the resistant strains may have a reduced virulence potential. Growth sugar- and mutant-specific responses were also revealed. The two resistant strains also displayed difference in stability of the sakacin P resistance phenotype, growth in the presence of both the lytic bacteriophage P100 and activated charcoal. Taken together, the present study showed that a single time exposure to the class IIa bacteriocin sakacin P may elicit contrasting phenotypic and transcriptome responses in L. monocytogenes possibly through regulation of the mpt