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Differentiated service delivery models have been developed to accommodate the rising number of stable antiretroviral therapy clients and to maintain improvements in health outcomes and care retention. Ethiopia adopted the appointment spacing model and has had notable successes in implementing it. However, with the implementation of the six multi-month scripting/appointment spacing model in Ethiopia, little is known about the uptake and its associated factors. Therefore, this study aimed to assess the uptake and associated factors of the six multi-month scripting/appointment spacing differentiated service delivery model of care among stable clients on antiretroviral therapy in Southern Ethiopia. A hospital-based cross-sectional study was conducted among 419 stable clients on antiretroviral therapy in southern Ethiopia from June 22 to September 29, 2023. A systematic sampling technique was used to select the study participants. Using a structured questionnaire, socio-demographic, health service delivery, behavioral, and clinical-related data were collected. The collected data were entered into Epi Data version 3.1 and analyzed using Stata version 14. Variables with a P-value <0.05 in the multivariable logistic analysis were considered statistically significant. Multicollinearity and model fitness were checked using the variance inflation factor and the Hosmer and Lemeshow goodness of fit tests, respectively. The uptake of the six multi-month scripting/appointment spacing differentiated service delivery model of care was 63.25% (95% confidence interval (CI): 58.61%, 67.88%). Missed appointment (Adjusted Odds Ratio (AOR): 1.91 (95% CI: 1.13, 3.25)), distance to antiretroviral therapy facility (AOR: 2.90 (95% CI: 1.67, 5.04)), duration on antiretroviral therapy (AOR: 2.21 (95% CI: 1.34, 3.64)), and intermediate social support (AOR: 2.02 (95% CI: 1.29, 3.17)) and strong social support (AOR: 2.71 (95% CI: 1.23, 5.97)) were factors significantly associated with the uptake. The uptake of six multi-month scripting/appointment spacing differentiated service delivery models of care was six out of ten clients on antiretroviral therapy. To further improve the uptake, a precise intervention on the identified associated factor is required.

Human immunodeficiency virus (HIV) infected individuals are prone to opportunistic infections (OIs) due to HIV mediated immune suppression. When opportunistic infections occur in the form of relapse or reinfection, it is said to be reoccurrence. This study was aimed to assess Incidence and predictors of reoccurrence of opportunistic infections among adult people living with HIV (PLHIV) attending ART clinics in Arba Minch Town, Southern Ethiopia. This retrospective cohort study was conducted on 450 HIV/AIDS patients attending anti-retro viral therapy (ART) clinics in Arba Minch town, southern Ethiopia. Simple random sampling technique was used. Kaplan-Meier graph and log rank test were used for group wise comparison. Bivariate and multivariable Cox Proportional Hazard Regression model were used to identify independent predictors of reoccurrence of opportunistic infection. One hundred nineteen HIV/AIDS patient had reoccurrence of opportunistic infection. The incidence rate was 11.5 per 1000 person months. The mean time of reoccurrence was 56 months. One of the most reoccurred OIs was pulmonary tuberculosis (PTB). Predictors that were associated significantly were recent cell differentiation 4 (CD4) count, recent body mass index (BMI), recent functional status, and duration on anti-retroviral therapy (ART). Though the incidence rate of OIs decreased from previous findings, attention should be given to HIV patients with low CD4 count, low BMI and for those bedridden patients.

Human immunodeficiency virus (HIV) infected individuals are prone to opportunistic infections (OIs) due to HIV mediated immune suppression. When opportunistic infections occur in the form of relapse or reinfection, it is said to be reoccurrence. This study was aimed to assess Incidence and predictors of reoccurrence of opportunistic infections among adult people living with HIV (PLHIV) attending ART clinics in Arba Minch Town, Southern Ethiopia This retrospective cohort study was conducted on 450 HIV/AIDS patients attending anti-retro viral therapy (ART) clinics in Arba Minch town, southern Ethiopia. Simple random sampling technique was used. Kaplan-Meier graph and log rank test were used for group wise comparison. Bivariate and multivariable Cox Proportional Hazard Regression model were used to identify independent predictors of reoccurrence of opportunistic infection. One hundred nineteen HIV/AIDS patient had reoccurrence of opportunistic infection. The incidence rate was 11.5 per 1000 person months. The mean time of reoccurrence was 56 months. One of the most reoccurred OIs was pulmonary tuberculosis (PTB). Predictors that were associated significantly were recent cell differentiation 4 (CD4) count, recent body mass index (BMI), recent functional status, and duration on anti-retroviral therapy (ART). Though the incidence rate of OIs decreased from previous findings, attention should be given to HIV patients with low CD4 count, low BMI and for those bedridden patients.

Household food insecurity is a major public health problem in Ethiopia despite the presence of various interventions implemented by the government. However, there is a dearth of evidence regarding the prevalence and responsible factors in Ethiopia, specifically in the South Ari district. This study, therefore, aimed to assess household food insecurity and associated factors in South Ari district, Southern Ethiopia. A community-based cross-sectional study was employed from March 11 to April 11, 2021, at South Ari district, Southern Ethiopia. A two-stage sampling technique was used to draw a sample of 717 households. Data were checked and entered into Epi-Data V3.2., and exported to SPSS V25.0 for data exploration and analysis. Variables with a p-value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. Multivariable logistic regression analysis was fitted to determine factors associated with household food insecurity. Hosmer-Lemeshow goodness-of-fit statistic was used to check model fitness and was satisfied. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine the strength of association. P-value <0.05 was used to declare statistical significance. The prevalence of household food insecurity was 44.8% (95% CI: 41.1%, 48.5%). Larger family size (8 and above) (AOR = 1.91, 95% CI: 1.10, 3.30), high dependency ratio (AOR = 2.71, 95% CI: 1.67, 4.40), medium dependency ratio (AOR = 1.72, 95% CI: 1.13, 2.62), poor wealth index (AOR = 2.30, 95% CI: 1.53, 3.46), not using agricultural extension service (AOR = 2.25, 95% CI: 1.57, 3.23), and non-beneficiary of productive safety net program (AOR = 1.71, 95% CI: 1.01, 2.87) were factors significantly associated with household food insecurity. The findings of this study showed a significant proportion of households were food insecure in South Ari District. Larger family size, high and medium dependency ratio, poor wealth index, not using agricultural extension service, and non-beneficiary of productive safety net program were significant risk factors associated with household food insecurity. Therefore, rigorous work is highly needed to enhance income-generating activities, strengthen agricultural productivity, expand the productive safety net program, and limit population pressure through improved family planning use.

Background Iron-folate supplementation is a vital and economical approach to preventing iron deficiency anemia in pregnant women. The World Health Organization targets 70% compliance, while Ethiopia's 2030 National Nutrition Program-II aims for 50% of pregnant women receiving iron-folate for 90 days by 2023. Despite various initiatives, compliance in Ethiopia continues to be low. This study examined compliance with iron-folate supplementation and its influencing factors among pregnant women in Southern Ethiopia. Methods A multi-center cross-sectional study was conducted among 604 systematically selected pregnant women from April 1 to 30, 2022, using structured interviewer-administered questionnaires. Data were collected via the open data kit application and analyzed in the SPSS version 25 software. Bivariable and multivariable analyses were used to identify factors associated with compliance. An odds ratio with a 95% confidence interval was used to assess the direction and strength of the association. Results Iron-folate supplementation compliance was 47.7% [95% CI 43.71%, 51.68%]. Being an urban dweller [AOR: 2.8, 95% CI 1.70, 4.86], attending primary education [AOR: 2.0, 95% CI 1.13, 3.75], having secondary education or more [AOR: 5.3, 95% CI 2.83, 10.22], being multiparous [AOR: 1.9, 95% CI 1.05, 3.52], receiving home visits [AOR: 2.0, 95% CI 1.08, 3.83], receiving counseling on iron-folate [AOR: 2.5, 95% CI 1.30, 4.78], possessing good knowledge of iron-folate [AOR: 3.1, 95% CI 2.04, 4.72], and having a good understanding of anemia [AOR: 3.2, 95% CI 2.12, 4.88] were significantly associated with compliance. Conclusion Iron-folate supplementation compliance among pregnant women in Southern Ethiopia is progressing towards the 2030 national nutrition program target, although it remains below World Health Organization recommendations. Therefore, it is crucial to strengthen home visits and counseling to enhance knowledge of Iron-folate and anemia, as well as ensure consistent intake of iron-folate.

BackgroundAdequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making, risk-taking and poorer health and self-management. These factors increase the magnitude and severity of problems related to sexuality and reproduction, including unintended pregnancy, HIV/sexually transmitted infections, unsafe abortion and death. However, information regarding the status and affecting factors of literacy in the reproductive and sexual health of adolescents is scarce.ObjectiveTo assess reproductive and sexual health literacy status and associated factors among late-adolescent high school students.DesignA cross-sectional, institution-based study.SettingThe study included eight secondary schools in Arba Minch town (Gamo Zone) and three in Sawla town (Gofa Zone) in the South Ethiopia Region.MethodsThe study was done between 20 May and 20 June 2023, among late adolescent high school students. Using multistage sampling, 577 students were recruited. Reproductive health literacy was assessed using the Health Literacy Measure for Adolescents tool. Data were loaded into EpiData-V.3.1 and analysed using SPSS-V.25. Binary logistic regression analyses were used to identify associated factors. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A Hosmer-Lemeshow goodness-of-fit statistic was checked and satisfied. Statistical significance was indicated at a p value<0.05.ResultThe proportion of students with limited reproductive and sexual health literacy was 69.6% (CI 65.3% to 72.8%). The limited literacy status was significantly associated with school type (public school AOR 0.28 (0.17 to 0.46)), mother’s occupation (merchant AOR 0.42 (0.23 to 0.76)), family monthly income (income 10 000–20 000 birr AOR 0.45 (0.22 to 0.95)), having regular physical exercise >30 min (more than once per week, AOR 0.44 (0.23 to 0.84)), and knowledge about condoms (poor AOR 2.23 (1.38 to 3.64)).ConclusionA notable segment of adolescents exhibited limited reproductive and sexual health literacy. The result emphasises the necessity of all relevant parties to work diligently to guarantee that school adolescents can easily obtain, comprehend, evaluate and use reproductive and sexuality-related information.

Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum β-lactamase (ESβL) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation4 (CD4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load ≥ 150 were found statistically significant. The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum [beta]-lactamase (ES[beta]L) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation.sub.4 (CD.sub.4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load [greater than or equal to] 150 were found statistically significant. The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

Even though the co-occurrence of Human Immune-Deficiency Virus/Acquired Immune-Deficiency Syndrome (HIV/AIDS) and depression is the main cause of morbidity and mortality in youth living with HIV/AIDS, in Ethiopia, there is a scarcity of evidence on depression and associated factors. Hence, this study aimed at the assessment of depression and associated factors among HIV-positive youth attending antiretroviral therapy (ART) clinics at public hospitals in Gamo and Ari Zones, South Ethiopia. A facility-based cross-sectional study was conducted from March 1, 2024, to April 30, 2024, among HIV-positive youth attending ART clinics at public hospitals in Gamo and Ari Zones. A systematic random sampling technique was used to select 343 study participants. Descriptive statistics were used to describe variables. Binary logistic regression was used to identify factors associated with depression. Variables with p-value <0.25 on the bivariable logistic regression analysis were candidates for the multivariable logistic regression analysis. Adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was used to determine the strength of association. A p-value <0.05 was used to set a statistical significance. A total of 343 HIV-positive youths were included in the study, with a 96.4% response rate. The proportion of depression was 22.2% (95%CI: 18.1%, 26.9%). Poor psychosocial support (AOR = 2.87; 95%CI: 1.18, 6.98), death of parents (AOR = 3.28; 95%CI: 1.73, 6.20), substance use (AOR = 3.44; 95%CI: 1.60, 7.43), advanced WHO clinical staging (AOR = 4.35; 95% CI: 1.97, 9.61), and initiation on a non-Dolutegravir (DTG)-based regimen (AOR = 2.72; 95%CI: 1.15, 6.42) were associated with depression among HIV positive youths. Depression is found to be a significant public health problem in the study settings. Poor psychosocial support, death of parents, substance use, advanced WHO clinical staging, and initiation on a non-DTG-based regimen were significant predictors of depression. Special attention should be given to those with poor psychosocial support, substance use, orphaned, and poor baseline clinical characteristics. Moreover, early identification and treatment of youths with depression during routine HIV care is essential to avert depression.

Background Drug resistant tuberculosis (TB) has become a persistent health threat in Ethiopia. In this respect, baseline data are scarce in many parts of high TB burden regions including the different zones of Ethiopia. Methods A total of 111 culture positive M. tuberculosis isolates were recovered from TB patients and identified using region of difference (RD) 9 based polymerase chain reaction (PCR) and spoligotyping. Thereafter, their drug sensitivities to Rifampicin (RIF) and Isoniazid (INH) were evaluated using GenoType MTBDR plus assay . Results The result showed that 18.0% (20/111) of the isolates were resistant to either RIF or INH. Furthermore, 16.7 and 23.8% of the isolates from new and retreatment cases were resistant to any of the two anti-TB drugs, respectively. Multi-drug resistant (MDR) TB was detected on 1.8% (2/111) of all cases. Significantly higher frequencies of any drug resistance were observed among Euro-American (EA) major lineage (χ 2 : 9.67; p  = 0.046). Conclusion Considerably high proportion of drug resistant M. tuberculosis strains was detected which could suggest a need for an increased effort to strengthen TB control program in the study area.