Human immunodeficiency virus (HIV) infected children represent a very vulnerable population for anti-retroviral therapy (ART) drug resistance. As a global target, 90% of patients receiving ART should have HIV-RNA viral suppression. A threshold of > 1000 RNA copies/ml is used to define non-suppressed viral load. If it is confirmed in the laboratory, adherence should be addressed and should be followed by the switch to second-line ART. Therefore, the aim of this study was to assess the rate of viral load suppression among children tested at the Amhara Public Health Institute (APHI), Bahir Dar. Institutional based cross-sectional study design was conducted from July 01, 2017 to June 30, 2018, in children under the age of 15 years. Socio-demographic, clinical and HIV1RNA viral load data were collected from the excel database. The data were analyzed in SPSS 20.0 statistical software. A total of 1567 children, age ranged from one to 14 years, were tested for HIV viral load. Of which, about 54% were males. Children were treated using nevirapine-based (76.7%), efavirenz-based (21.8%) and protease inhibitor-based (1.5%) anti-retroviral drugs. Non-suppressed HIV viral load was found in 28.3% of the participants. High viral load (> 1000 cp/ml) were found in 24% of the children below the age of five years. Children on nevirapine-based treatment had about two times more non-suppressed viral load (Adjusted odds ratio [AOR]: 1.90; 95%CI: 1.41–2.56; P < 0.001) compared to those who had efavirenz-based treatment. However, adherence (P: 0.204) was not associated with non-suppressed viral load. There was a high rate of non-suppressed HIV viral load among children tested at APHI. Specifically, the odds of having a non-suppressed viral load was higher in NVP based treatment users. Hence, comprehensive management and follow up of children on ART, and testing for resistance as well as viral load could help to reduce the problem in advance.

Measles is an extremely contagious viral disease that can be prevented through vaccination. It is caused by the measles virus and presents with symptoms such as high fever, cough, runny nose, conjunctivitis, and a distinctive rash. Complications may include pneumonia, diarrhoea, and neurological issues. The disease spreads through respiratory droplets and continues to pose a significant public health challenge, especially in Africa, despite vaccination efforts. This systematic review and meta-analysis aim to estimate the pooled vaccine effectiveness of measles vaccines among African children, providing insights into immunization program success and informing policy decisions on vaccine distribution and resource allocation. Following PRISMA guidelines, search was conducted in databases including PubMed/Medline, Science Direct, HINARI, Cochrane/Wiley library, Europe PMC, and grey literatures like Google Scholar up to March 2024. Cross-sectional studies assessed measles vaccine effectiveness in African children aged nine months and above were included. Data was extracted using JBI extraction tool and entered into microsoft excel and analysed via STATA version 20.1 using random effect model. From 5295 identified articles, 18 met the inclusion criteria, encompassing 26,470 children from 13 African countries. The pooled measles vaccine effectiveness was 68.58%, with significant heterogeneity (I2 = 99.66%, p < 0.001). Subgroup analysis showed variability in vaccine effectiveness by study period, with higher effectiveness in studies conducted after the Global Vaccine Action Plan (GVAP) in 2012. Measles vaccine effectiveness varies in African regions, ranging from 98.4% in Nigeria to 36.5% in Mozambique, with an overall effectiveness of 68.58% and high heterogeneity among studies. Optimizing vaccine distribution, increasing coverage, and prompt administration are important for enhancing effectiveness. Continued support for GVAP strategies and further research is needed to understand factors affecting vaccine performance and improve immunization efforts in Africa.

Background: Globally, approximately 35 million people are infected with HIV infection. Sub-Saharan countries contributed 71% of global burden. Women are the most affected groups accounting for 51% of global infection and 90% of HIV infections in children (< 15 years) are a result of mother to child transmission. In the absence of any intervention, mother-to-child transmission has been estimated to 30– 40% that could occur at various periods like during pregnancy, delivery, and post-partum, via breastfeeding. For future generations to be born HIV-free, evidences on the level of viremia and contributing factors in pregnant mothers is important. Objective: The objective of this study is to determine the magnitude of viral non-suppression rate among pregnant women and identify the risk factors associated with viral non-suppression. Methods: A cross-sectional study was conducted from July 01, 2021 to June 30, 2022, in pregnant women who are on antiretroviral treatment and attending HIV viral load testing in Amhara region viral load testing sites, North West Ethiopia. Socio-demographic, clinical, and HIV-1 RNA viral load data were collected from the excel database. The data were analyzed in SPSS 23.0 statistical software. Results: Overall viral non-suppression rate was 9.1%. In other words, the viral suppression rate was 90.9%. Pregnant women being at AIDS stages III and IV and with fair treatment adherence and suspected testers were statistically associated with increased viral non-suppression rate. Conclusion: Relatively low viral non-suppression rate among pregnant mothers that had almost met the third 90 of UNAIDS target. But, still, some mothers received a non-suppressed viral replication specifically the odds of having a non-suppressed viral load was higher in pregnant women with poor treatment adherence and WHO Stage III and IV and suspected testers.

Measles is a highly contagious, vaccine-preventable viral disease that remains a major public health concern in low-income countries like Ethiopia, particularly in the Amhara Region. Despite ongoing vaccination efforts, periodic outbreaks continue to occur. In this regard, data on the recent epidemiological patterns, temporal trends, and spatial distribution of measles cases in the region are limited. Therefore, this study was conducted to assess the incidence, temporal trends, and spatial clustering of measles cases in Amhara region from 2019 - 2024 to inform targeted interventions and outbreak responses. A retrospective analysis of regional measles surveillance data from 2019-2024 was conducted in Amhara region, Ethiopia. Enzyme linked immunosorbent assay method employed for measles confirmation using anti-measles specific immunoglobulin M using EUROIMMUN test kit. Descriptive statistics and trend analysis was conducted using SPSS version 26. Spatial analysis to determine the spatial distribution, case distribution pattern (autocorrelation), and hot spot analysis was performed through ArcGIS tool. SaTScan statistics tool was used to identify the significant primary and secondary measles case clusters in the Amhara region. Out of a total of 18,468 reported measles suspected cases, 11354 (61%) were classified as clinically compatible, 3657 (20%) were epidemiologically linked, 1886 (10%) were discarded cases, and 1571 (9%) were laboratory-confirmed. The highest proportion of cases (36.5%) occurred among children aged 5–14 years, followed by adults aged ≥15 years (26%). Males accounted for the majority of cases (54%). Among all cases, 4.7% were ineligible for vaccination due to being under 9 months of age. Geographically, the highest number of cases were reported from Waghimra zone (16.6%), followed by Central Gondar (12.4%), Oromo Special zone (9.6%), and East Gojjam (9%). The crude incidence rate per 100,000 population increased from 0.53 to 2.13, peaking in 2023. Measles cases showed clear seasonal trends, with peaks occurring during the spring (March-May) and autumn (September-November) seasons. Spatial autocorrelation analysis indicated clustering of measles cases. Hotspots were identified at the woreda level in Waghimra, Oromo Special zone, South Gondar, and North Shoa zones. Significant primary clusters were also detected in the same zones. Measles transmission persists in Amhara Regional State, with increasing incidence and distinct spatial and temporal patterns. Immunity gaps in older children and geographically clustered outbreaks highlight the need for enhanced vaccination strategies. Strengthening measles surveillance, prioritizing catch-up vaccination for older children, and implementing targeted immunization campaigns in hotspot areas during peak transmission seasons are recommended. Not applicable.

There is growing evidence indicating that drug-resistant bacteria notably Extended spectrum β-lactamases producing Enterobacteria are greatly implicated in immunocompromised groups namely HIV-infected patients. Little is known about the burden of ESPL-E in places where HIV infection is rampant. Therefore, the study was aimed to assess the prevalence, antimicrobial resistance pattern of ESPL-E among HIV/AIDS patients. A cross-sectional study was conducted among HIV/AIDS patients seeking Antiretroviral Treatment (ART) service at the University of Gondar Hospital from February–May, 2017. The pretested and -structured questionnaire was used to collect data on sociodemographic and clinicalrelated factors. Clean catch midstream urine samples were collected and cultured in line with standard procedures. The drug susceptibility testing was performed by Kirby Bauer disc diffusion method. Extended-spectrum β-lactamase (ESBL) detection was performed using a doubledisc synergy test and combined disc methods. Data entry and analysis were performed using SPSS version 20. Among a total of 387 HIV/AIDS patients, 42 (10.9%) Enterobacteria uropathogens were identified. Among these isolates, nine (21.4%) were ESBL producers. The highest prevalence of ESBL production was Escherichia coli (44.4%) followed by Klebsiella pneumoniae (22.2%) and Enterobacter spp. (22.2%). Higher drug resistance rates were observed among ESBL-producing isolates compared to ESBL-nonproducing isolates. Amox-clavulanic (100%), ampicillin (95%), cotrimoxazole (74%), cefotaxime (88.9%), and ceftazidime (88.9%) had high resistance rates to Extended spectrum β-lactamases producing Enterobacteria. The overall prevalence of multidrug resistance of all isolates was 92.9%, and all the ESBL isolates were multidrug resistant. Therefore, antimicrobial stewardship programs needed to be promoted for the rational use of drugs especially in the management of HIV/AIDS patients.