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Background: Antiretroviral therapy (ART) has shown promising effects on the reduction of new HIV infection as well as HIV-related morbidity and mortality. In order to boost the effect of ART on ending HIV epidemics by 2030, the World Health Organization (WHO) indeed introduced a universal test and treat strategy in 2015 that recommends rapid (within seven days) initiation of ART for all HIV-positive patients. However, in low-income countries, a substantial number of HIV-positive patients were not enrolled in time, and information on delayed ART initiation status in Ethiopia is limited. Method: A multicenter cross-sectional study was conducted on 400 HIV-positive adults receiving ART at public health institutions in Bahir Dar city, Northwest Ethiopia. A structured checklist was used to extract data from the patient's medical record. Data was entered into Epi-data version 4.6 and exported to SPSS version 26 for further analysis. Both simple and multivariable binary logistic regressions were executed, and variables with a p-value < 0.05 in the final model were considered significant predictors of delayed ART initiation. Results: The magnitude of delayed ART initiation was 39% (95% CI: 34%–44%). Being male [Adjusted odds ratio(AOR) = 1.99, 95%CI:1.3–3.2], having opportunistic infections (OIs) [AOR = 2.50, 95%CI:1.4–4.6], having other chronic diseases [AOR = 3.70,95%CI:1.7–8.3], substance abuse [AOR = 3.79, 95%CI: 1.9–7.4], having ambulatory functional status [AOR = 5.38, 95%CI: 1.4–9.6] and didn't have other HIV-positive family member [AOR = 1.85, 95%CI: 1.2–2.9] increases the odds of delayed ART initiation. Conclusion and recommendation: The burden of delayed ART initiation is found to be high. The presence of OIs and other chronic problems, substance abuse, ambulatory functional status, being male, and not having other HIV-positive family members were identified as significant predictors of delayed ART initiation. Special emphasis needs to be considered for those individuals with the identified risk factors. [ABSTRACT FROM AUTHOR]

Background: The inconsistent use of antiretroviral therapy can lead to the risk of cross-resistance between drugs. This reduces subsequent antiretroviral drug options. The burden of initial antiretroviral therapy ranges from 11.3% in South Africa to 71.8% in Malaysia. There is evidence that it is important to maintain children's initial antiretroviral therapy regimens. However, the incidence and predictive factors of initial antiretroviral therapy regimen changes in the research context are still unknown in the study setting. So, the study was aimed to assess incidence and predictors of initial antiretroviral therapy regimen changes among children in public health facilities of Bahir Dar city.Methods: A retrospective follow-up study was conducted in 485 children who received antiretroviral therapy between January 1, 2011 and December 30, 2020. These children were selected using simple random sampling techniques. The data were entered by Epi data 3.1 and the analysis was completed by STATA 14.0. The missing data was treated with multiple imputation method. The data were also summarized by median or mean, interquartile range or standard deviation, proportion and frequency. The survival time was determined using the Kaplan Meier curve. The Cox Proportional Hazard model was fitted to identify predictors of initial antiretroviral therapy regimen change. The global and Shoenfeld graphical proportional hazard tests were checked. Any statistical test was considered significant at P-value < 0.05. Finally, the data were presented in the form of tables, graphics and text.Result: Among the 459 study participants, 315 of them underwent initial regimen changes during the study accumulation period. The shortest and longest follow up time of the study were 1 month and 118 months, respectively. The overall incidence rate of initial regimen change was 1.85, 95% CI (1.66-2.07) per 100 person-month observation and the median follow up time of 49 (IQR 45, 53) months. The independent predictors of initial regimen changes were poor adherence (AHR = 1.49, 95%CI [1.16, 1.92]), NVP based regimen (AHR = 1.45, 95%CI [1.15, 1.84]) comparing to EFV based regimen, LPVr based regimen (AHR = 0.22, 95%CI: (0.07, 0.70)) comparing to EFV based regimen, history of tuberculosis (AHR = 1.59, 95%CI [1.14, 2.23]) and being male (AHR = 1.28, 95%CI [1.02, 1.60]).Conclusions and Recommendations: In this study, the incidence of initial regimen change was high. The risk of initial regimen change would be increased by being male, poor adherence, having history of tuberculosis and NVP based initial regimen. Therefore, strengthening the health care providers' adherence counseling capability, strengthening tuberculosis screening and prevention strategies and care of initial regimen type choice needs attention in the HIV/AIDS care and treatment programs. [ABSTRACT FROM AUTHOR]

The 14th author's last name is incomplete. The correct name is: Ahmed Nuru Muhamed.By Berihun Bantie; Gebrie Kassaw Yirga; Moges Wubneh Abate; Abreham Tsedalu Amare; Adane Birhanu Nigat; Agmasie Tigabu; Gashaw Kerebeh; Tigabu Desie Emiru; Nigusie Selomon Tibebu; Chalie Marew Tiruneh; Natnael Moges Misganaw; Dessie Temesgen; Molla Azmeraw Bizuayehu; Ahmed Nuru Muhamed; Endalk Getasew Hiruy and Amare KassawReported by Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

Background: Anemia is one of the common hematological problems among HIV-infected children. It impairs physical functioning, affects the quality of life, increases HIV progression, and decreases survival of HIV-infected children. In Ethiopia, limited studies were conducted on the incidence and predictors of anemia among HIV-infected children on antiretroviral therapy (ART). Therefore, this study aims to assess the incidence of anemia and predictors among HIV- infected children on ART at public health facilities of Bahir Dar City, Northwest Ethiopia.Methods: An institution-based retrospective follow-up study was conducted among 403 HIV- infected children who have followed at ART clinics in public health facilities of Bahir Dar City from 2010 to 2020. A simple random sampling technique was employed to select the study units. Data was entered using Epi-data version 4.6 and analyzed using STATA 14.0. Cox proportional hazard model assumption was checked graphically and by scaled Schoenfeld residual test. Bivariable Cox-proportional hazards regression model was employed for each explanatory variable to check the association with the outcome variable. Variables with a p-value of < 0.2 in the bivariable analysis were candidates to the multivariable proportional hazard model. Cox proportional hazards model was used at a 5% level of significance to identify predictors of anemia.Results: The overall follow up time was 1587 person-years. The overall incidence density of anemia was 6.87 with 95% confidence interval (CI) = (5.60, 8.16) per 100 person-years. The independent predictors show an association were child age from 0.25 to 5 years adjusted hazard ratio (AHR) = (1.83; 95% CI = 1.22, 2.77), World health organization clinical stage III and IV (AHR = 1.80; 95% CI = 1.22, 2.67), being underweight (AHR = 1.5; 95% CI = 1.01, 2.26), having fair/poor adherence to anti-retroviral therapy (AHR = 1.75; 95% CI = 1.08, 2.85) and zidovidine based anti -retroviral therapy regimen (AHR = 1.72; 95% CI = 1.12, 2.64).Conclusion: The overall incidence rate of anemia was high compared to other country reports. Age, clinical, and ART-related variables provoked the incidence of anemia. Therefore, a need to emphasize the younger age group, prevent and manage opportunistic infections of WHO clinical stage III and IV, and select and monitor appropriate ART regimen types. [ABSTRACT FROM AUTHOR]