Incidence of common opportunistic infections among HIV-infected children on ART at Debre Markos referral hospital, Northwest Ethiopia: a retrospective cohort study.

BACKGROUND:Opportunistic infections (OIs) are the leading cause of morbidity and mortality among children living with human immunodeficiency virus (HIV). For better treatments and interventions, current and up-to-date information concerning occurrence of opportunistic infections in HIV-infected children is crucial. However, studies regarding the incidence of common opportunistic infections in HIV-infected children in Ethiopia are very limited. Hence, this study aimed to determine the incidence of opportunistic infections among HIV-infected children on antiretroviral therapy (ART) at Debre Markos Referral Hospital. METHODS:A facility-based retrospective cohort study was undertaken at Debre Markos Referral Hospital for the period of January 1, 2005 to March 31, 2019. A total of 408 HIV-infected children receiving ART were included. Data from HIV-infected children charts were extracted using a data extraction form adapted from ART entry and follow-up forms. Data were entered using Epi-data™ Version 3.1 and analyzed using Stata™ Version 14. The Kaplan Meier survival curve was used to estimate the opportunistic infections free survival time. Both bi-variable and multivariable Cox proportional hazard models were fitted to identify the predictors of opportunistic infections. RESULTS:This study included the records of 408 HIV-infected children-initiated ART between the periods of January 1, 2005 to March 31, 2019. The overall incidence rate of opportunistic infections during the follow-up time was 9.7 (95% CI: 8.13, 11.48) per 100 child-years of observation. Tuberculosis at 29.8% was the most commonly encountered OI at follow-up. Children presenting with advanced disease stage (III and IV) (AHR: 1.8, 95% CI: 1.2, 2.7), having "fair" or "poor" ART adherence (AHR: 2.6, 95% CI: 1.8, 3.8), not taking OI prophylaxis (AHR:1.6, 95% CI: 1.1, 2.4), and CD4 count or % below the threshold (AHR:1.7, 95% CI: 1.1, 2.6) were at a higher risk of developing opportunistic infections. CONCLUSIONS:In this study, the incidence rate of opportunistic infections among HIV-infected children remained high. Concerning predictors, such as advanced disease stage (III and IV), CD4 count or % below the threshold, "fair" or "poor" ART adherence, and not taking past OI prophylaxis were found to be significantly associated with OIs

The effect of hourly nursing rounds on patient satisfaction at Debre Markos Referral Hospital, Northwest Ethiopia: A non-randomized controlled clinical trial

Background: Today, implementation of hourly bedside nursing rounds is an important component of evaluating the excellence of hospitals and it is one of the strategies to increase the quality of care. Nevertheless, there has been little emphasis on the implementation of hourly nursing rounds and limited evidence is available on its effect on patient satisfaction with nursing care in Ethiopia. Hence, the objective of this study was to determine the effect of hourly nursing rounds on patient satisfaction with nursing care. Methods: A quasi-experimental nonequivalent groups study design was used to determine the effect of hourly nursing rounds on patient satisfaction with nursing care at Debre Markos Referral Hospital. A convenience sample of 104 hospitalized patients participated in this study (52 in control and 52 intervention group). The control group received the usual care in the selected units compared with the intervention group who received care with hourly nursing rounds. Patient satisfaction with nursing care scores was taken on the second and fifth days of hospitalization in both groups. Independent t-test was used to compare the statistical difference between the mean satisfaction scores of the two groups. A P-value of less than 0.05 was considered significant. Results: The result of the t-test demonstrated that patients in the intervention group had a higher satisfaction score than patients in the control group on the second day of hospitalization although it was not statistically significant (P = 0.215). However, there was a significant difference in the mean satisfaction scores on the fifth day of hospitalization (from 71.02 ± 14.37 in the control group to 79.69 ± 12.21 in the intervention group, P = 0.001). Conclusion: This study revealed that patients in the intervention group have higher satisfaction scores than the control group, providing evidence that hourly nursing rounds improve patient satisfaction with nursing care and quality of care. Therefore, policymakers (FMoH) need to consider the implementation of consistent hourly nursing rounds in our hospitals to improve patient satisfaction and overall quality of care at large. Trial registration ID: PACTR201907735468929