Search

Background. Tuberculosis (TB) is a preventable and treatable disease but it is the leading cause of death among people living with HIV (PLHIV). In addition, the emergence of the HIV pandemic has also had a major impact on TB incidence rates. There are studies in spatial patterns of TB and HIV separately in Ethiopia; there is, however, no information on spatial patterns of TB-HIV coinfection in the country at the districts level at least using yearly data. This paper, therefore, aimed at determining the spatial clustering of TB-HIV coinfection prevalence rates in the country at the districts level on an annual basis over a four-year period, 2015–2018. Methods. District-level aggregated data on the number of TB-HIV infections were obtained from the Ethiopian Federal Ministry of Health for 2015 to 2018. The univariate and bivariate global Moran's index, Getis-Ord G i ∗ local statistic, a chi-square test, and a modified t -test statistic for Spearman's correlation coefficient were used to evaluate the spatial clustering and spatial heterogeneity of TB among PLHIV and HIV among TB patients prevalence rates. Results. The district-level prevalence rate of HIV among TB patients was positively and significantly spatially autocorrelated with global Moran's I values range between 0.021 and 0.134 (p value < 0.001); however, the prevalence of TB among PLHIV was significant only for 2015 and 2017 (p value < 0.001). Spearman's correlation also shows there was a strong positive association between the two prevalence rates over the study period. The local indicators of spatial analysis using the Getis–Ord statistic revealed that hot-spots for TB among PLHIV and HIV among TB patients have appeared in districts of various regions and the two city administrations in the country over the study period; however, the geographical distribution of hotspots varies over the study period. Similar trends were also observed for the cold-spots except for 2017 and 2018 where there were no cold-spots for TB among PLHIV. Conclusions. The study presents detailed knowledge about the spatial clustering of TB-HIV coinfection in Ethiopia at the districts level, and the results could provide information for planning coordinated district-specific interventions to jointly control both diseases in Ethiopia. [ABSTRACT FROM AUTHOR]

Background. Stroke is a life-threatening condition that occurs due to impaired blood flow to brain tissues. Every year, about 15 million people worldwide suffer from a stroke, with five million of them suffering from some form of permanent physical disability. Globally, stroke is the second-leading cause of death following ischemic heart disease. It is a public health burden for both developed and developing nations, including Ethiopia. Objectives. This study is aimed at estimating the time to death among stroke patients at Jimma University Medical Center, Southwest Ethiopia. Methods. A facility-based retrospective cohort study was conducted among 432 patients. The data were collected from stroke patients under follow-up at Jimma University Medical Center from January 1, 2016, to January 30, 2019. A log-rank test was used to compare the survival experiences of different categories of patients. The Cox proportional hazard model and the accelerated failure time model were used to analyze the survival analysis of stroke patients using R software. An Akaike's information criterion was used to compare the fitted models. Results. Of the 432 stroke patients followed, 223 (51.6%) experienced the event of death. The median time to death among the patients was 15 days. According to the results of the Weibull accelerated failure time model, the age of patients, atrial fibrillation, alcohol consumption, types of stroke diagnosed, hypertension, and diabetes mellitus were found to be the significant prognostic factors that contribute to shorter survival times among stroke patients. Conclusion. The Weibull accelerated failure time model better described the time to death of the stroke patients' data set than other distributions used in this study. Patients' age, atrial fibrillation, alcohol consumption, being diagnosed with hemorrhagic types of stroke, having hypertension, and having diabetes mellitus were found to be factors shortening survival time to death for stroke patients. Hence, healthcare professionals need to thoroughly follow the patients who pass risk factors. Moreover, patients need to be educated about lifestyle modifications. [ABSTRACT FROM AUTHOR]