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Background: HIV patients have several habits that can produce oral lesions. However the association of oral habits and risk behaviors with oral and peri-oral lesions in HIV patients has not been studied in Ethiopia to date. Objective: To assess the relationship of oral and peri-oral lesions with oral habits risk behaviors socio-demographic factors and clinical stages of disease among HIV infected adult Ethiopians. Methodology A cross-sectional study was conducted on consecutive adult ART naive HIV patients at ART clinic of Tikur Anbessa Specialized University Hospital Addis Ababa Ethiopia during December 2005 to July 2006. The EC-clearing houses classification and diagnostic criteria for oral lesions in HIV infection was used. Written informed consent was obtained before enrollment to the study. Results A total of 384 patients 126 (33%) males and 258 (67%) females were evaluated. The mean + SD age of males was 39.9 +10.56 and females was 33.17 + 8.85 years. Fifty seven (15%) of the unit of analysis were smokers 178 (46%) alcohol consumers and 217(57.1%) khat chewers use tooth sticks for dental cleaning. Of which 132 (34.7%) clean their teeth at least once a day and 302 (79%) gave history of recent significant weight loss. Linear regression analysis showed association of oral and peri-oral lesions with less frequent cleaning (p=0.038 p=0.03 respectively) means of cleaning (p=0.004; p=0.001) broad-spectrum antibiotic use (p=0.019 p=0.008) advanced stage of HIV (p=0.016 p=0.001) and CD4 level below 200 Cells/mm3 (p=0.001 p=0.01). The oral lesions were seen more frequently among smokers (p=0.028) heavy alcohol consumers (p=0.041) those with age above 40 years (p=0.016) and recent weight loss (p=0.001). At the level of binary logistic regression analysis smoking (p=0.005) CD4 count less than 200 (p=0.039) and stage 3 (p=0.022) and stage 4 disease (p=0.046) were found to be independent risks while daily dental cleaning habit was found to be protective (p=0.021). Conclusion Oral and peri-oral diseases among HIV/AIDS patients and are significantly associated with correctable risk factors like smoking and poor oral cleaning habits. Lesions are also frequent with evidence of advanced HIV disease and low CD4 count. These findings demonstrate the need for oral health examination and education to improve on risk behaviors and oral care in HIV/AIDS patients.

Background : During the past decade, diabetes mellitus has emerged as an important clinical and public health problem through out the world. WHO estimated the number of cases of diabetics in Ethiopia to be about 800,000 in 2000, and projected that it would increase to about 1.8 million by the year 2030. Care for diabetic patients may require close and sustained support from a health care team, adequate financial resources, and advanced patient knowledge and motivation. In this respect, there is lack of information in the country. Objective : This study was conducted with the aim of assessing the characteristics of the health care system for diabetic patients, how diabetic patients are cared for including medical care and adequacy of facilities for the prevention of complications and outcomes at primary health care and secondary health care levels. Methods : An assessment of the characteristics of the health care system (structure) for diabetic patients was conducted in 21 health centres (primary health care level) and 5 regional hospitals (secondary health care level) in Addis Ababa. Furthermore, a total of 106 diabetic patients drawn from six out of the 21 health centres and another 123 diabetic patients drawn from three of the six hospitals were consecutively interviewed. Results : All the Regional hospitals and one of the health centres were running established diabetic referral clinics. Similarly, a lack of professionals was observed in all the health institutions in general and the health centres, in particular. Only 21% of patients had access for blood glucose monitoring at the same health institutions. The emphasis given for diabetic education (24%) was less than expected. Only 11 (5%) of diabetic patients were able to do self blood glucose monitoring at home. Fifty one percents of patients didn't have urine analysis, BUN, creatinine and lipid profile in the previous 1-2 years. None of diabetic patients had haemoglobin Alc (HbA1c) determination. Nearly 75% of the patients required admissions directly or indirectly due to uncontrolled diabetes. About 87% of the diabetics had regular follow ups at their respective health centres and hospitals. Hypertension (34%), diabetes related eye disease (33%) and renal disease (21%) were the major associated illnesses observed among the diabetics. Sixty-six patients (23%) had a total of about 131 admissions. Conclusion : Although there is a well-established health infrastructure for diabetics care in Addis Ababa, the diabetic care is below the acceptable standard. The finding of this study may, thus, help to clarify issues related to potential changes in the health care system dealing with diabetes and for strengthening the referral system for diabetes health care. Ethiopian Journal of Health Development Vol. 19(3) 2005: 203-210