Imprisonment for South Ethiopian people living with HIV presents a double health burden: lived experiences of prisoners

Abstract Background Optimal adherence is crucial for ensuring both therapeutic and preventative benefits of antiretroviral therapy (ART). Sub-optimal adherence is common in prisoners and little information is available about its predisposing circumstances in resource-limited settings. We explored lived experiences of inmates living with HIV (ILWH) and experiential accounts of service providers in South Ethiopia to identify barriers to and facilitators of HIV care use in the prison context. Methods We conducted qualitative in-depth interviewing with eleven ILWH and eleven service providers. Audio recorded interview data were transcribed verbatim in Amharic language, translated into English and coded based on emerging concepts. We employed a descriptive phenomenological approach to abstract meaning attributed to the prisoners’ lived experiences in relation to HIV care use and service providers’ experiential account regarding care provision as presented to our consciousness. Findings Several concepts emerged as barriers to HIV care use amongst ILWH in South Ethiopia including: limited access to standard care, insufficient health staff support, uncooperative security system, loss of patient privacy, a lack of status disclosure due to social stigma, and food supply insufficiency. In addition to a unique opportunity offered by an imprisonment for some ILWH to refrain from health damaging behaviours, the presence of social support in the prison system facilitated care use. Conclusions This study identified important structural and social contexts that can both hinder and enhance HIV care use amongst ILWH in South Ethiopia. Given the disproportionate burden of HIV in prisoners and the potential of transmission to others during and after incarceration, development of contextually-responsive strategies is required to address the barriers and to also strengthen the enablers

The association between malaria and malnutrition among under-five children in Shashogo District, Southern Ethiopia: a case-control study

Abstract Background Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition. Therefore, assessing the relationship between these two disastrous diseases in the most vulnerable groups, such as in children aged below 5\ua0years (under-five children), may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malaria-endemic areas. Therefore, this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission. Methods The study involved comparing malnourished children aged 6\u201359\ua0months and nourished children of the same age for their past exposure to malaria, in Shashogo District, Southern Ethiopia. A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data. The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software. Results A total of 356 (89 malnourished and 267 nourished) under-five children participated in the study. Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children ( P \u2009=\u20090.02 [ OR \u2009=\u20091.87, CI \u2009=\u20091.115\u20133.138]). Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children ( P \u2009=\u20090.001 [ OR \u2009=\u20090.422, CI \u2009=\u20090.181\u20130.978]). Conclusion This study found that exposure to Plasmodium has a significant impact on the nutritional status of children. In addition, socio-demographic factors, such as family income, may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas. Therefore, malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas

Magnitude of Malaria and Factors among Febrile Cases in Low Transmission Areas of Hadiya Zone, Ethiopia: A Facility Based Cross Sectional Study.

BACKGROUND:Despite a remarkable decline in morbidity and mortality since the era of malaria roll back strategy, it still poses a huge challenge in Ethiopia in general and in Hadiya Zone in particular. Although, there are data from routine health management information on few indicators, there is scarcity of data showing magnitude of malaria and associated factors including knowledge and practice in the study area. Therefore, the aim of this study was to assess magnitude and factors affecting malaria in low transmission areas among febrile cases attending public health facilities in Hadiya Zone, Ethiopia. METHODS:A facility based cross-sectional study was conducted in Hadiya Zone from May 15 to June 15, 2014. Simple random sampling was used to select the health facility while systematic random sampling technique was used to reach febrile patients attending public health facilities. Data were collected by a pre-tested structured questionnaire containing sections of socio demographic risk factors and knowledge and prevention practices of malaria. Data were entered to Epi-Info software version 3.5.4 and exported to SPSS version 16 for descriptive and logistic regression analysis. RESULTS:One hundred six (25.8%) of participating febrile patients attending at sampled health facilities were found to have malaria by microscopy. Of which, P.vivax, P.falciparum and mixed infection accounted for 76(71. 7%), 27 (25.5%) and 3 (2.8%), respectively. History of travel to malaria endemic area, [AOR: 2.59, 95% CI: (1.24, 5.38)], not using bed net, [AOR: 4.67, 95%CI:, (2.11, 10.37)], poor practice related to malaria prevention and control, [AOR: 2.28, (95%CI: (1.10, 4.74)], poor knowledge about malaria, [AOR: 5.09,95%CI: (2.26,11.50)] and estimated distance of stagnant water near to the residence, [AOR: 3.32, (95%CI: (1.13, 9.76)] were significantly associated factors of malaria positivity in the study. CONCLUSION:The present study revealed that malaria is still a major source of morbidity in the study area among febrile illnesses. Poor level of knowledge, poor prevention practices, not using bed net, travel history to endemic areas and residing near stagnant water were associated factors with malaria positivity in the study area. Therefore, implementers, policy makers and stakeholders should strengthen the services provided by the community health development army, health extension service and health facilities services focusing on increasing malaria intervention coverage and mobilization of information, education and communication to increase knowledge about malaria transmission, prevention and control practices

Factors of malaria among attendants of public health facilities of Hadiya Zone, Southern Ethiopia, 2014 (n = 411).

<p>Factors of malaria among attendants of public health facilities of Hadiya Zone, Southern Ethiopia, 2014 (n = 411).</p

Malaria and related factors among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).

<p>Malaria and related factors among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).</p

Level of practice on malaria prevention among attendants of health facilities in Hadiya zone, Southern Ethiopia, 2014 (n = 411).

<p>Legend: Blue color: expresses “they always practice the specified prevention items”. Red color or: expresses “they sometimes practice the specified prevention items”. Light green color: expresses “they never practice the specified prevention items”.</p

Knowledge about and reported practice on prevention, control, transmission and treatment seeking behaviors of malaria among febrile attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).

<p>Knowledge about and reported practice on prevention, control, transmission and treatment seeking behaviors of malaria among febrile attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).</p

Socio-demographic characteristics among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).

<p>Socio-demographic characteristics among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).</p

The distribution of source of information and treatment seeking for malaria among respondents in Hadiya zone, Southern Ethiopia, 2014 (n = 411).

<p>The distribution of source of information and treatment seeking for malaria among respondents in Hadiya zone, Southern Ethiopia, 2014 (n = 411).</p

Participants response about malaria related factors among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).

<p>Participants response about malaria related factors among attendants of public health facilities in Hadiya Zone, Southern Ethiopia, 2014 (n = 411).</p