Introduction. ART has improved the survival of HIV-infected patients. However, patients in resource-poor countries have higher mortality rates, particularly the first months after initiating ART. In this study we tried to determine the survival factors in HIV-infected patients treated with HAART in Zewditu Memorial Hospital. Methods. A retrospective cohort study was conducted from 2008 to 2012. All HIV-infected patients above the age of 14 took first line ART. Data were collected, entered, and analyzed using Epi Info 7 and SPSS Version 20. Life table was used to estimate mortality after initiation of ART, and Kaplan-Meier was used to compare survival curves. Cox proportional hazards model was used to assess the predictors of mortality. Results. The incidence of mortality was 3.8/100 person-years. Independent predictors of mortality were WHO clinical stages 3-4 (HR=2.39 at 95% CI (1.26, 5.31)), anemia (hemoglobin level < 10 gm/dL (HR=5.54 at 95% CI (2.58, 11.86)). Conclusion. Incidence of mortality was found relatively low, majority of deaths occurring within 3 months of starting ART. WHO stages 3-4, anemia (hemoglobin count < 10 gm/dL), and past TB coinfection were the main predictors of mortality. The underlying causes for early death in patients presenting at late stages should be investigated.

Introduction. Antiretroviral Therapy has transformed HIV infection into a chronic manageable disease; it requires near perfect adherence rates (as high as 95%). In this study, we assessed antiretroviral treatment adherence rate and associated factors among people living with HIV in Dubti Hospital. Methods. A retrospective cross-sectional study design was conducted within February 1–30, 2014. All HIV-infected patients above the age of 18 years who took first line Antiretroviral Therapy were eligible for inclusion of the study. Adherence Scale was used for labeling patients as adherent or nonadherent. All HIV-infected patients record data were collected from the medical records, entered, and analyzed using Epi Info 7 and SPSS Version 20. Multivariable analysis was used to identify the relative effect of explanatory variables on low adherence rate. Results. A total of 370 patients aged 18 years and above, who started ART, were included in this study. The self-reported adherence rate of the patient on ART was 81.1%. Independent predictors of adherence were treatment duration. Conclusion. Adherence rate was associated with time to ART. That is, the longer they were on ART, the lesser they adhered.

Background: Despite the availability of effective vaccines, pertussis remains endemic with high fatality rates in low and middle-income countries (LMIC). This study aims to describe an outbreak of pertussis in a health district of Ethiopia. The study highlights the challenges faced by the health system in identifying pertussis cases and appropriately responding to the outbreak at the district level.Methods: A descriptive cross-sectional study was conducted using data sourced from the District Public Health Emergency and Management (PHEM) surveillance service and outbreak management field reports. Stratified attack rates and fatality rates for pertussis are described. Systemic problems leading to the outbreak are explored and narrated. A modified CDC pertussis case definition was employed with a polymerase chain reaction used to confirm cases.Results: From September 2018 to January 2019, 1840 suspected, probable, and confirmed pertussis cases and six deaths were identified. Pertussis cases ranged from 1 month to 51 years in age. An outbreak occurred in 14 out of the 24 villages of Dara Malo district. The overall attack rate was 1708 per 100,000 population with a fatality rate of 3.3 per 1000 pertussis cases. The highest attack rate of 12,689/100,000 was seen in infants. Among confirmed, probable and suspected pertussis cases, only 41.1% had completed the three-dose pertussis vaccine’s primary schedule. The household survey revealed a population coverage of 73.4 and 40.8% for Pentavalent vaccine dose one and three respectively. Investigations suggested the existence of a poor cold chain management system in the study area.Conclusions: There is an urgent need to build capacity to strengthen routine vaccination services and improve the maintenance of the vaccine cold chain. Other LMICs are urged to take lessons learned from this outbreak to strengthen their own vaccination programs and capacitate health workers to manage local outbreaks.

The surgical repair of fistula can address the physical symptoms, but may not end the psychological challenges that women with fistula face. There are a few studies that focus on women with this condition in Ethiopia. Hence, the aim of this study was to determine the effects of surgical repair of obstetric fistula on the severity of depression and anxiety in women with obstetric fistula in Ethiopia. The study employed a longitudinal study design to investigate the changes in 219 women with obstetric fistula admitted to six fistula management hospitals in Ethiopia. The data were collected on admission of the patients for obstetric fistula surgical repair and at the end of six-month post repair. A structured questionnaire was used to obtain socio-demographic information and medical history of the respondents. Depression and anxiety symptoms were measured using the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scales. The data was entered using Epi-Data software and then exported to SPSS for further analysis. The Mann-Whitney-U test, the Kruskal-Wallis test and Paired t-test were performed to measure the change in psychological symptoms after surgical repair. Though 219 respondents were interviewed pre-obstetric fistula surgical repair, only 200 completed their follow up. On admission, the prevalence of depression and anxiety symptoms were 91 and 79% respectively. After surgical repair, the prevalence rate was 27 and 26%. The differences in the prevalence of screen-positive women were statistically significant (P < 0.001). The study concluded that the severity of depression and anxiety symptoms decrease post-obstetric fistula surgical repair. However, a woman with continued leaking after surgery seems to have higher psychological distress than those who are fully cured. Clinicians should manage women with obstetric fistula through targeted and integrated mental health interventions to address their mental health needs.

Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. Timely analysis of measles surveillance data is crucial for epidemic control and can show disease control program status. Therefore, this study aimed to show vaccination status and delay in seeking health care using surveillance data. A retrospective study was carried out in Southern Nations Nationalities and People’s Region (SNNPR), Ethiopia. We reviewed 2132 records from measles surveillance line list data from July 2013 to January 2014. Descriptive statistics were performed using SPSS 20 for Windows. From a total of 2132 confirmed and suspected measles cases, 1319 (61.9%), had at least one dose of measles containing vaccine; the rest 398 (18.7%) and 415 (19.5%) were unvaccinated and had unknown status respectively. About two fifth, 846 (39.7%), cases visited health facilities within 48 h of onset of clinical signs/symptoms with a median of 2.0 days, IQR (1.0, 3.0). Majority of the measles cases were vaccinated with at least one dose of measles containing vaccine and vaccination data or vaccine potency at lower level was unclear. Delay in seeking healthcare was noted as only about two fifth of cases visited health facilities within 48 h of clinical manifestation. Vaccination and surveillance data quality and factors associated with delay in seeking health care should be investigated.

Background: Maternity waiting home (MWH) within primary health care facilities is an ideal platform to reach women with family planning education and counseling. MWH users interact with health care providers on a regular basis throughout their waiting period and can prepare to initiate family planning method of their choice immediately after childbirth. However, to date, there has been no clear evidence about the use of MWHs to increase uptakes of immediate postpartum family planning (IPPFP). Therefore, the aim of this study is to assess the contribution of MWHs to increase IPPFP uptake among women who deliver in health facilities in Ethiopia.Methods: A comparative cross-sectional study design was conducted to collect quantitative data from women who gave birth in the past 12 months. Multi-stage random sampling procedures were employed to select 884 women. Descriptive summary and logistic regression with 95% confidence intervals were conducted in Stata 14 to analyze the data.Result: The prevalence of IPPFP use among women who used MWHs was 44% and 36% among those who did not use MWHs. The use of MWHs significantly contributed to increase immediate postpartum family planning uptake (OR = 1.48, 95% CI = 1.08- 2.04, p=.016).Conclusions: This study showed that, MWHs significantly contributed for improving IPPFP uptake by an average of 8%-point difference for beneficiaries within 48 hours after delivery. Developing a comprehensive package of service for maternal care has the potential to improve family planning uptake of postpartum women. Women’s who have used maternity waiting home more likely utilized postpartum family planning than women who have not used maternity waiting home. Providing a comprehensive package of services, including family planning information and counseling, in maternity waiting homes can have a positive impact on improving postpartum family planning use.