Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immunosuppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. This study was aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending at Gondar University Hospital.

The initiation of highly active antiretroviral therapy (HAART) plays a significant role in the clinical management of HIV infected people by preventing morbidity and mortality. This benefit becomes, the most terrible when treatment failure develops. Thus, this research aims to assess the prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia. Patients on ART with a minimum of 6 months and up to 12 years of treatment were being enrolled. The prevalence of treatment failure, immunological failure and virological failure among people living with HIV/AIDS attending University of Gondar referral hospital were 20.3, 13.2, and 14.7%, respectively. Patients who had no formal education (Adjusted odds ratio (AOR): 3.8; 95% CI, 1.05–13.77), primary level education (AOR: 4.2; 95% CI, 1.16–15.01) and duration on ART < 6 years (AOR: 2.1; 95%CI, 1.12–3.81) were a significant risk factor. However, initial adult regimen D4T + 3TC+ EFV (AOR: 0.025; 95% CI, 0.002–0.36), AZT +3TC + NVP (AOR: 0.07; 95% CI, 0.01–0.71), AZT + 3TC + EFV (AOR: 0.046; 95% CI, 0.004–0.57) andTDF+3TC + EFV (AOR: 0.04; 95% CI, 0.004–0.46) were significantly protective for treatment failure. Timely and early identification of associated factors and monitoring antiretroviral therapy treatment failure should be done to enhance the benefit and to prevent further complication of the patients. It is preferable to initiate ART using any one of the following ART regimens: AZT +3TC + NVP, AZT + 3TC + EFV and TDF + 3TC + EFV to prevent treatment failure. Since the prevalence of this treatment failure and its associated factor may be different from other ART centers and community in Ethiopia, further national representative institutional based cross-sectional researches are needed across all ART centers of Ethiopia in order to determine the prevalence of treatment failure and its associated factors.

Clinical decisions depend on timely laboratory result reporting. The timeliness is commonly expressed in turnaround time and serves as a quality improvement tool to assess the effectiveness and efficiency of the laboratory. According to the International Organization for Standardization (ISO) guidelines, each laboratory shall establish turnaround times for each of its examinations that reflect clinical needs, and shall periodically evaluate whether or not it is meeting the established turnaround times. Therefore, this study aimed to assess the TAT of laboratory results done in the reference laboratories of the Amhara Public Health Institute, Bahir Dar, Ethiopia. A retrospective cross sectional study was carried out from 01 January to 31 September 2018. Each patient sample was considered as a study unit. Nine months data were extracted from the sample tracking log and from the Laboratory Information System (LIS) database. Descriptive and summary statistics were calculated using SPSS version 20.0 statistical software. A total of 34,233 patients samples were tested during the study period. Monthly average TAT ranged from 38.6 to 51.3 days for tuberculosis (TB) culture, 5.3 to 42.4 days for exposed infant diagnosis (EID) for HIV, 8.4 to 26 days for HIV 1 viral load, and 1.9 to 3.5 days for TB genexpert tests. Compared with the standard, 76.5% of the viral load, 68.1% of the EID for HIV and 53.8% of the TB genexpert tests had delayed TAT. Repeated reagent stock out, high workload, activities overlapping, and staff turnover were major reasons for the result delays. There was a delayed turnaround time of laboratory results in APHI. HIV viral load, EID and TB genexpert results were the most affected tests. Workload reduction plan, proper stock management, specific work assignment and trained staff retention are important approaches to minimize the delayed TAT in the setting.

Background: Infant mortality remains a public health challenge in Ethiopia. Exploring infant mortality will aid in tracking the progress toward achieving sustainable development goals. Objective: The study aimed to explore the geographical variations and associated factors of infant mortality in Ethiopia. Method: A total of 11,023 infants from the 2016 Ethiopian Demographic and Health Survey (EDHS) data were extracted and included in the analysis. EDHS used a two-stage cluster sampling design with a census enumeration area as the primary sampling unit and households as the secondary sampling unit. Arc GIS software was used for spatial analysis using clusters for exploring geographical variations in infant mortality. A binary logistic regression was employed using R software to identify the significant determinants of infant mortality. Results: The study revealed that the spatial distribution of infant mortality was non-random in the country. Infants whose mothers not receiving ANC (AOR = 1.45; 95%CI: 1.17, 1.79), not breastfed status (AOR = 3.94; 95%CI: 3.19, 4.81), poor wealth index (AOR = 1.36; 95%CI: 1.04, 1.77), male infants (AOR = 1.59; 95%CI: 1.29, 1.95), birth order of six or above (AOR = 3.11; 95%CI: 2.08, 4.62), small birth size (AOR = 1.27; 95%CI: 1.26, 1.60), birth spacing [(≤ 24 months (AOR = 2.29; 95%CI: 1.79, 2.92), 25–36 months (AOR = 1.16; 95%CI: 1.12, 1.49)], multiple births (AOR = 6.82; 95%CI: 4.76, 10.81), rural residence (AOR = 1.63; 95%CI: 1.05, 2.77) and regions [Afar (AOR = 1.54; 95%CI: 1.01, 2.36), Harari (AOR = 1.56; 95%CI: 1.04, 2.56), and Somali (AOR = 1.52; 95%CI: 1.03, 2.39)] were the determinants of infant death in Ethiopia. Conclusions: There is a great geographical disparity in infant mortality rates across regions. Afar, Harari, and Somali regions were verified as hot spot areas. ANC usage, breastfed status, wealth index, sex of the infant, birth order, birth size, birth spacing, birth type, residence, and region were the determinants of infant death in Ethiopia. Therefore, appropriate interventions need to be implemented in the hot spots to alleviate the risk factors for infant mortality.

The aim of this study was to assess the magnitude, trend and reasons of rejection among referred specimens through referral network to the Amhara Public Health Institute (APHI) for laboratory testing. A total of 42,923 specimens were received at APHI reference laboratories. Of which, 221 (0.5%) specimens were rejected. CD4, HIV viral load, genexpert and EID specimens’ rejection rates were 0.7%, 0.6%, 0.3% and 0.2%, respectively. CD4 specimens were rejected due to wrong package (84.2%) and presence of clots (15.8%). Un-centrifuge (46.9%), hemolysis (19.8%) and use of wrong tube (17.7%) were the main rejection reasons for HIV viral load specimens. Although viral load specimen rejection was improved from 1.8 to 0% up to February/2018, the problem was reoccurred and continued to the end of May (1.3%) and June (0.3%) 2018. Moreover, CD4 specimen rejection (4.3%) was out of the established target in May, and exposed infant diagnosis (EID) specimen rejection became increased since March 2018. Hence, appropriate corrective and preventive actions and close follow up could reduce the problem of specimen referral network.

: Persistent trachoma is a growing concern to trachoma control programs globally and programs serving Ethiopia specifically. Persistent trachoma is defined as a district with two or more trachoma impact surveys (TISs) at which the prevalence of trachomatous inflammation-follicular (TF) among children ages 1–9 years is ≥5%, the elimination threshold. Because the global target for trachoma elimination as a public health problem is 2030, research is needed to better characterize persistent trachoma. This study described the epidemiology of ocular Chlamydia trachomatis infection, the causative bacteria of trachoma, in seven contiguous districts experiencing persistent trachoma. In 2019, multistage cluster random sampling TISs were conducted in the seven districts after 10 years of interventions. All individuals ages ≥1 year were examined for trachoma clinical signs by certified graders, and conjunctival swabs were collected from children ages 1–5 years to test for C. trachomatis infection. The district TF prevalence ranged from 11.8% (95% CI:7.6–16.0%) to 36.1% (95% CI:27.4–44.3%). The range of district-level C. trachomatis infection prevalence was between 2.7% and 34.4%. Statistically significant spatial clustering of high-infection communities was observed in the study districts, and children with infection were more likely than those without to be found in households with clinical signs of trachoma and those without latrines. These seven districts appear to constitute a persistent hotspot in Amhara, where an additional 3–5 years or more of interventions will be required. The global program will need to strengthen and enhance intervention strategies within persistent districts if elimination by 2030 is to be achieved.