Level of Antiretroviral Therapy Adherence and Associated Factors Among People Living with HIV in the Context of Early Antiretroviral Therapy Initiation in Wolaita Sodo Town, Ethiopia: Cross-Sectional Study

Early antiretroviral therapy (ART) initiation is WHO recommendation to fasten viral suppression and for prevention of further viral transmission sexually. There is no evidence showing the level of adherence to ART after initiation of the universal test and treat (UTT) strategy in Ethiopia, including study area. This study was aimed to determine the level of ART adherence and associated factors among HIV/AIDS patients in context of UTT strategy. A health facility-based study was conducted on 352 people living with HIV who started their ART follow-up after application of UTT strategy in Ethiopia from April 15 to June 5, 2020. Systematic random sampling method was used to select the study participants. Interviewer administered questionnaire was used to collect data and the collected data were entered directly in to SPSS version 21 and analyzed. Both bivariate and multivariate logistic regression analyses were carried out. Strength and direction of association was determined by using adjusted odds ratio (AOR) with 95% confidence interval. The total 352 participants included the study. The overall level of adherence was 290 (82.4%). Commonly used ART regimen was TDF +3TC+EFV, 201 (57.1%). In bivariate analysis, type of health institutions, crude odds ratio (COR) = 2.934 (1.388-6.200), age level of 18-27 years, COR = 0.357 (0.133-0.959), current viral load of 3log scale, COR = 0.357 (0.133-0.959), and change of ART medication, COR = 8.088 (1.973-33.165) were associated with medication adherence. Health institution type AOR = 2.615 (1.147-5.9600) and change of ART medication, AOR = 7.267 (1.683-31.384) were independent predictors of ART adherence. Low level of ART adherence was detected in this study. It was below the recommended good adherence standard and 90-90-90 target strategy. Therefore, patients should get adequate and comprehensive ART adherence counseling before initiation of ART treatment and during the follow-up time.

Isolation and Antibiotic Susceptibility Pattern of Bacterial Uropathogens and Associated Factors Among Adult People Living with HIV/AIDS Attending the HIV Center at Wolaita Sodo University Teaching Referral Hospital, South Ethiopia

Background

Urinary tract infection remains one of the major public health problems in developing countries, including Ethiopia. Its prevalence is fuelled by human immunodeficiency virus infection which represents a considerable health problem amongst these populations. This study aimed to assess the prevalence, antimicrobial susceptibility pattern and associated factors of bacterial urinary tract infections among adult PLHIV.

Methods

Cross-sectional study was conducted from May to December, 2018 among adult people living with HIV/AIDS in Wolaita Sodo University Teaching and Referral Hospital. The socio-demographic data and clinical data were collected using structured questionnaire. Mid-stream urine sample was collected for bacterial isolation and identification. Antimicrobial sensitivity testing was done by Kirby-Bauer disk diffusion technique. Logistic regression was conducted to check the association between UTI and associated factors.

Results

The overall prevalence of urinary tract infection was 29 (14.1%). The predominant bacteria isolated was E. coli 13 (44.8%) followed by S. aureus 5 (17.2%). Gender, CD4 count, history of catheterization, history of hospitalization, and DM status were independent factors for the occurrence of urinary tract infection. E. coli species were 100% and 84.6% susceptible to ciprofloxacin and norfloxacin, respectively; whereas, there was a complete resistance to amoxicillin-clavulanic acid and ampicillin. K. pneumoniae was pan resistant to gentamicin, amikacin and ampicillin, whereas 100% sensitive to nitrofurantoin. The rate of MDR was 23 (79.3%) with the majority, 16 (69.6%), gram negative and seven (30.4%) gram positive.

Conclusion

The burden of UTI among people living with HIV was considerably high. The findings of this study will help policy makers and other stakeholders as baseline information.

Magnitude of enteropathogens and associated factors among apparently healthy food handlers at Wolkite University Student's Cafeteria, Southern Ethiopia

Objective

The study aimed to assess enteropathogens carriage rate and risk factors among apparently healthy food handlers at Wolkite University cafeteria, Southern Ethiopia.

Results

Cross-sectional study was conducted among 170 food handlers to collect socio-demographic and related data by using structured questionnaires. Stool samples were collected and subjected to microscopic examination and cultured to determine intestinal parasites. Among the total study participants, 66% of them were found to be carriers of enteropathogens: bacteria (Salmonella typhi, Shigella species), and intestinal parasites (Ascaris lumbricoides,Taenia species, Giardia lamblia, Entameoba histolytica/dispar, Enterobius vermicularis, Hook worm and Trichuris trichiura). All Salmonella and Shigella isolates were sensitive to ceftriaxone, ciprofloxacin, and gentamicin. A significant association was found between hand washing practice before food preparation and isolated pathogens [p = 0.013]. A significant proportion of food handlers were found to be carriers of pathogens which require a periodic screening and antibiotic therapy monitoring.