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Abraham A, Kawuki J, Aragie T, Elias C, Birahanu Z, Dawit D, Israel E. Nearly half of HIV-positive children attending public health facilities are suffering from chronic under-nutrition in conflict-affected zones of Southern Ethiopia. Front Nutr 2024; 11:1356931. [PMID: 38694221 PMCID: PMC11061431 DOI: 10.3389/fnut.2024.1356931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/29/2024] [Indexed: 05/04/2024] Open
Abstract
Background In combination with HIV infection, malnutrition is a complicated medical condition with high morbidity and mortality rates in affected children due to a variety of socioeconomic and medical etiological variables. To combat this, information from a range of contexts is required, but there is little evidence, particularly about the nutritional status of under 15 living with HIV in impoverished communities such as conflict affected areas. Therefore, in this study the magnitude and related factors of stunting among under 15 children antiretroviral therapy at public health facilities was assessed. Methods An institution-based cross-sectional study was conducted among under 15 children living with HIV in conflict-affected zones of Southern Ethiopia. After providing written informed consent to study participants, data were collected using an interviewer-administered questionnaire and anthropometric measurements. Bivariable and multivariable logistic regression models were used to identify factors associated with nutritional status, using SPSS Version 25. Results Of the 401 participants, 197 (49.1%, 95% CI: 0.44, 0.54) had height-for-age z-score ≤ -2. In the multivariable analysis, larger household size (AOR = 1.58, 95% CI: 1.04-2.40), dietary diversity (AOR = 1.78; 95% CI: 1.07-2.96) and having a history of recurrent diarrhea (AOR = 1.96; 95% CI: 1.07-3.59) were significantly associated with chronic under nutrition. Conclusions The prevalence found in this study was high when compared with the stunting target set in SDG, which states to end all forms of malnutrition In order to mitigate the negative health effects of diarrhea during HIV therapy, extra attention needs to be paid to facilitate timely detection and on-going monitoring. Nutrition programs in conflict-affected areas need to consider households with larger family sizes and/or routinely having fewer food groups.
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Affiliation(s)
- Awoke Abraham
- Division of Nutrition, Maternal and Child Health Unit, Wolaita Zone Health Department, Sodo, Ethiopia
| | - Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Tesfaye Aragie
- Department of Public Health, Private Sector Support Officer, Marie Stopes International Ethiopia Reproductive Choices, Hawassa, Ethiopia
| | - Cherinet Elias
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Zewudu Birahanu
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Desalegn Dawit
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
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Joseph F, Jean Simon D, Kondo Tokpovi VC, Kiragu A, Toudeka MRAS, Nazaire R. Trends and factors associated with recent HIV testing among women in Haiti: a cross-sectional study using data from nationally representative surveys. BMC Infect Dis 2024; 24:74. [PMID: 38212702 PMCID: PMC10782569 DOI: 10.1186/s12879-023-08936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION In the Latin America and Caribbean region, Haiti is one of the countries with the highest rates of HIV. Therefore, this study examined the factors associated with HIV testing among women in Haiti and trends in HIV testing in 2006, 2012, and 2016/17. METHODS Data from the last three Haitian Demographic and Health Surveys (2006, 2012, and 2016/17) were used. The analysis was restricted to women aged of 15-49 years who made their sexual debut. STATA/SE 16.0 was employed to analyze the data by computing descriptive statistics, Chi‑square, and multilevel regression model to describe the trends and identify factors associated with HIV testing in Haiti. P-value less than 0.05 was taken as a significant association. RESULTS HIV testing prevalence increased more than twofold from 2006 (8.8%) to 2017 (21.3%); however, it decreased by 11.6% between 2012 and 2016/17. Additionally, the results indicated that age, place of residence, region, education level, wealth index, mass media exposure, marital status, health insurance, age at first sex and number of sexual partners were significantly associated with HIV testing. CONCLUSIONS To significantly increase HIV testing prevalence among women, the Haitian government must invest much more in their health education while targeting vulnerable groups (youth, women in union, and women with low economic status).
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Affiliation(s)
- Fanor Joseph
- Doctoral School of Social and Human Sciences, University of Antananarivo, Antananarivo, Madagascar
- Bureau d'Etudes Et de Recherche en Statistiques Appliquées, Suivi Et Evaluation (BERSA-SE), Port-au-Prince, Haiti
| | - David Jean Simon
- Bureau d'Etudes Et de Recherche en Statistiques Appliquées, Suivi Et Evaluation (BERSA-SE), Port-au-Prince, Haiti.
| | | | - Ann Kiragu
- Department of Law and Political and Social Sciences, University of Sorbonne Paris Nord, Paris, France
| | | | - Roodjmie Nazaire
- Faculté de Médecine et de Pharmacie (FMP), Université d'Etat d'Haïti (UEH), Port-Au-Prince, Haiti
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Malli IA, Hamdan D, Aljahdali A, Almutairi A, Jar R, Alzahrani R, Khan MA. Medical Interns' Knowledge, Attitude, and Practice Toward People Living with HIV: Multicenter Experience from Saudi Arabia. HIV AIDS (Auckl) 2023; 15:571-582. [PMID: 37744212 PMCID: PMC10516208 DOI: 10.2147/hiv.s418948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
Background Discrimination by some healthcare providers toward people living with HIV/AIDS has been documented. Differences in cultural backgrounds make it harder for future doctors, who need a lot of knowledge and a positive attitude to treat patients. In conservative countries like Saudi Arabia, not enough is known about how much medical interns know about HIV and how they feel about people living with HIV/AIDS. Methods From April to September 2021, this cross-sectional study use non-probability random sampling and utilized a self-administered questionnaire to collected the data from 346 medical interns who had graduated from five different medical schools. Results Most of the subjects correctly identified the main transmission routes, such as unprotected sex (94.57%), blood and body fluid exchange (94.19%), and sharing needles or syringes (91.47%). But they did not know what the most common co-infections were for HIV patients or how to protect themselves after exposure. This paper showed that medical interns have some stigmatizing behaviors toward patients living with HIV, as 31.1% and 22.9% agreed, respectively, that they would feel more sympathetic toward people who get AIDS from blood transfusions compared to IV drug users (IDU). Conclusion Medical interns also showed some positive attitudes, as more than half of the sample (56.2%) would not isolate beds for people living with HIV/AIDS. The study's conclusion is that HIV education and training programs should be added for medical interns, which might have a significant positive impact on their attitude.
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Affiliation(s)
- Israa Abdullah Malli
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Jeddah, 22384, Saudi Arabia
| | - Dalia Hamdan
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
| | - Alhanoof Aljahdali
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
| | - Amal Almutairi
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
| | - Raghad Jar
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
| | - Reham Alzahrani
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
| | - Muhammad Anwar Khan
- Department of Basic Medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 21423, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, 22384, Saudi Arabia
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Masuke R, Kihaga Y, Mashala M, Ndalio S, Sukari O, Panga O. Twelve months antiretroviral therapy retention among clients newly enrolled to care and treatment services in Geita Regin, Tanzania: does universal test and treat matter? Pan Afr Med J 2023; 46:20. [PMID: 38035160 PMCID: PMC10683168 DOI: 10.11604/pamj.2023.46.20.40772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/03/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction sustaining high rates of retention is critical for management of HIV clients, newly initiated antiretroviral therapy (ART). In low resource settings including Tanzania, retention among clients on ART was challenging due to inaccessible infrastructure, gender-based violence, inadequate skilled staff and socio-economic disparities. Low retention leads to increased morbidity and mortality. Tanzania adopted universal test and treat (UTT) strategy in mid of 2016 as recommended by Joint United Nations Program on HIV/AIDS (UNAID) that set goals for HIV epidemic control globally. Studies demonstrated controversial findings on whether UTT strategy improves retention, until now there is limited information on the effect of UTT on retaining HIV patients in our settings. Methods a retrospective cohort study was conducted between July 2014 to June 2015 and July 2017 to June 2018 to determine 12 months ART retention among clients newly initiated ART prior and during universal test and treat (UTT) strategy in Geita Region, Tanzania. A total of 13,649 newly clients-initiated ART were extracted from the National AIDS control care and treatment database (CTC2 database). Among these clients 4,624 initiated ART prior the UTT strategy and clients 9,025 start ART after the rollout of UTT strategy. Chi-square test was deployed to determine the significant difference of proportion within categories for each UTT group. Kaplan-Meier curve and long rank test were used to determine significant differences of retention rate prior and during UTT program. Cox regression models were used to estimate the association between exposure variables and ART retention with 95% confidence intervals and p-value of p<0.05. Results the overall mean age at ART initiation was 38 years (SD=11.6) with observed significant mean difference between two cohorts (prior UTT, mean=41, SD=11.7 Vs during UTT, mean=37, SD=11.3). The cumulative retention was 83.1% among newly initiated ART clients in both cohorts with significant difference observed between two cohorts (69.7% for prior UTT and 89.9% during UTT, p-value<0.001). The overall person year of follow up was 127,209.3 with an incidence rate of ART retention of 86 per 1000 person-year. It was significantly higher among clients enrolled during UTT strategy than clients enrolled prior UTT strategy (95.1 per 1000 PY Vs 69.6 per 1000 PY, p-value<0.001). The log rank test and Kaplan-Meier survival curve demonstrated clients enrolled in the UTT program had greater probability of retention than clients enrolled prior UTT treatment program (log rank X2 test = 599.2, p value < 0.001). Newly HIV clients who initiated ART after the rollout of UTT strategy had 27% higher likelihood to be retained in care and treatment as compared to clients who were enrolled prior UTT strategy, (HR=1.27; 95% CI [1.21 -1.33], p value < 0.001). Sex, District councils, World health Organisation (WHO) stage and client's visit type were significant factors associated with retention among clients newly initiated to care for both arms. Conclusion this results, showed that probability of ART retention increased after the rollout of UTT strategy. There is a need to promote universal test and treat strategy in line with other intervention to control HIV epidemic in Geita, Tanzania.
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Affiliation(s)
- Rachel Masuke
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
| | - Yohane Kihaga
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
| | - Michael Mashala
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
| | - Saimon Ndalio
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
| | - Omari Sukari
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
| | - Onna Panga
- Health, Nutrition and Social Welfare Section, Geita Regional Secretariat, Geita Region, Tanzania
- Management and Development for Health (MDH), Dar-es-Salaam, Tanzania
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