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Despite 15,000 people enter US jails yearly with undiagnosed HIV infection, routine HIV testing is not standard. Maximizing the yield and speed of HIV testing in short-term detention facilities could promote rapid entry or re-entry of people living with HIV (PLWH) into care. The goal of this study was to evaluate the impact of third generation, rapid point-of-care (rPOC) vs. fourth generation, laboratory-based antigen/antibody (LBAg/Ab) testing on the HIV care cascade in a large urban jail during a planned transition. We used aggregate historical data to compare rPOC testing and LBAg/Ab testing in the D.C. Department of Corrections. We examined two time periods, January to August 2019 when rPOC testing was performed, and October 2019 to January 2020 after LBAg/Ab testing began. We calculated monthly rates of HIV tests performed, HIV test results received, HIV test results received among those tested, antiretroviral therapy (ART) initiation, and proportion of PLWH receiving discharge planning prior to release. We then conducted an interrupted time series analysis to assess the differences between testing periods. There were 14,237 entrants during the first time period and 7,569 entrants during the second. Transitioning from rPOC to LBAg/Ab testing increased the rate of test uptake by 38.5% (95% CI: 14.0, 68.3), decreased the rate of test results received among those tested by 13.1% (95% CI: -14.0, -12.1), and increased the combined rate of HIV tests performed and results received by 20.4% (95% CI: 1.5, 42.8). Although the rate of HIV testing was greater under LBAg/Ab, PLWH received results immediately through rPOC testing, which is critically important in short-stay enviroments. Increasing rPOC uptake would increase its value and combined testing may maximize the detection of HIV and receipt of results among persons passing through jails.

Sisay Degno, 1 Daniel Atlaw, 2 Ashenafi Mekonnen, 3 Bikila Lencha, 1 Kebede Kumsa, 1 Yohannes Tekalegn, 1 Gashaw Walle, 2 Ashebir Niggussie, 4 Rameto Aman 1 1Department of Public Health, Madda Walabu University, Shashemene, Oromia, Ethiopia; 2Department of Human Anatomy, Madda Walabu University, Goba, Oromia, Ethiopia; 3Department of Midwifery, Madda Walabu University, Shashemene, Oromia, Ethiopia; 4Department of Anesthesia, Negelle Arsi General Hospital Medical College, Nagelle, Oromia, EthiopiaCorrespondence: Daniel Atlaw Email Danielatmwu@Gmail.ComBackground: Late presentation for HIV/AIDS care is defined as individuals newly presenting for HIV/AIDS care with a CD4 count below 350 cells/μl or presenting for care with WHO clinical staging of stage III or IV. Globally, around 21.7 million people living with HIV/AIDS were receiving ART in 2017, with an increase of 2.3 million since 2016. Despite this progress, most people start ART late in their disease progression.Objective: This study aims to identify predictors of late presentation for HIV/AIDS among people living with HIV and attending ART clinics in West Arsi Zone public health institutions, South Ethiopia, 2019.Methodology: A facility-based unmatched case–control study was conducted among people living with HIV attending ART clinics in West Arsi Zone public health institutions, with a total sample size of 500 (167 cases and 333 controls). The sample size was calculated using Epi info version 7 and participants were selected using the case-based control selection sampling technique. Descriptive statistics were carried out to summarize the data. Bi-variate binary logistic regression analysis was carried for selecting candidate variables for multivariate binary logistic regression. A p-value of < 0.05 was taken to declare the presence of a statistical association between outcomes and explanatory variables.Results: Rural residence (AOR=7.74 95% CI (3.4– 17.6)), being single (AOR=0.18 95% CI (0.06– 0.49)) symptom(s) at first HIV diagnosis (AOR=7.69 95% CI (4.09– 14.4)), no private house (AOR=5.09 95% CI (2.47– 10.45)), fear of losing job (AOR=4.12 95% CI (2.04– 8.31)), alcohol consumption (AOR=4.35 95% CI (2.18– 8.69), and having chronic medical illness (AOR=5.04 95% CI (2.48– 10.24)) were identified as having significant associations with late presentation of HIV/AIDS care.Conclusion: Rural residence, fear of losing a job, and chronic medical illness were potential risk factors for late presentation of HIV/AIDS care. Being single is the only protective factor for the late presentation of HIV/AIDS care.Keywords: late presentation, HIV/AIDS care, West Arsi Zone

Yohannes Tekalegn,1 Biniyam Sahiledengle,1 Kebebe Bekele,2 Abdi Tesemma,2 Tesfaye Aseffa,3 Zinash Teferu Engida,1 Alemu Girma,2 Alelign Tasew,1 Demisu Zenbaba,1 Rameto Aman,1 Kenbon Seyoum,4 Demelash Woldeyohannes,5 Birhan Legese6 1Department of Public Health, Madda Walabu University, Goba Referral Hospital, School of Health Sciences, Bale-Goba, Ethiopia; 2Department of Surgery, Madda Walabu University, Goba Referral Hospital, School of Medicine, Bale-Goba, Ethiopia; 3Department of Nursing, Madda Walabu University, Goba Referral Hospital, School of Health Sciences, Bale-Goba, Ethiopia; 4Department of Midwifery, Madda Walabu University, Goba Referral Hospital, School of Health Sciences, Bale-Goba, Ethiopia; 5Department of Public Health, Wachemo University, School of Medicine and Health Sciences, Hossana, Ethiopia; 6Department of Public Health, Ambo University, School of Medicine and Health Sciences, Ambo, EthiopiaCorrespondence: Yohannes TekalegnMadda Walabu University, Goba Referral Hospital, School of Health Sciences, Department of Public Health, Addis Ababa 22847 code 1000, EthiopiaTel +251 913578901Email yohannesefa@gmail.comPurpose: Coronavirus disease (COVID-19) mainly spreads through respiratory droplets and close contacts. Wearing a facemask and other personal protective equipment (PPE) is essential in preventing the spread of COVID-19. However, the use of PPE alone does not provide a sufficient level of protection, and correct use and disposal are required. Hence, this study aimed to assess health professionals’ practice regarding proper use of facemask in the perspectives of COVID-19 prevention.Methods: A web-based online survey was conducted from June 3, 2020, to August 11, 2020, to assess health professionals’ practice regarding correct use of facemask. The survey tool was prepared in Google form and distributed to the health professionals through their emails and social media pages. Data were analyzed using STATA version 14. A descriptive result was reported using frequency tables and bar charts. Factors associated with correct use of facemask were assessed using binary logistic regression model.Results: A total of 368 health professionals have participated in this study. All of the participants’ work involves direct contact with patients and 98 (26.6%) of them work in direct contact with COVID-19 patients daily. The level of overall correct use of facemask was 10.1% (95% CI: 7.4– 13.6). Two hundred fifty-five (69.3%) do not perform hand hygiene before wearing a facemask and 238 (64.7%) do not perform hand hygiene after removing the facemask. Three hundred twenty-three (87.8%) of the study participants reuse disposable facemasks. The odds of practicing correct use of facemask were more than two times higher among health professionals who received training related to personal protective equipment utilization (AOR= 2.2, 95% CI: 1.1– 4.5) compared to their counterparts.Conclusion: This study revealed that health professionals’ practice regarding the correct use of facemask in the context of COVID-19 prevention is very low. Receiving training related to proper utilization of personal protective equipment was found to favor the correct use of facemask. In this regard, health authorities should provide training to enable the rational and correct use of facemask among healthcare workers.Keywords: COVID-19, facemask, healthcare workers, infection, prevention, Ethiopia

Sewnet Girma,1 Tsion Teshome,1 Meseret Worku,1 Tinbit Solomon,1 Selam Kehulu,1 Reyana Aman,1 Mitiku Bonsa,2 Tesfaye Assefa,1 Habtamu Gezahegn3 1Madda Walabu University Goba Referral Hospital, School of Health Sciences, Department of Nursing, Goba, Bale, Ethiopia; 2Madda Walabu University Goba Referral Hospital, School of Health Sciences, Department of Public Health, Goba, Bale, Ethiopia; 3Madda Walabu University Goba Referral Hospital, School of Medicine, Medical Physiology Unit, Goba, Bale, EthiopiaCorrespondence: Habtamu GezahegnMadda Walabu University Goba Referral Hospital, School of Medicine, Medical Physiology Unit, P. O Box 302, Goba, Bale, EthiopiaTel +25112306248Email habgez47@gmail.comBackground: Globally, anemia is a public health problem, particularly in developing countries, including Ethiopia. Pregnant women are at a higher risk for anemia and anemic pregnant women often develop complications. Early diagnosis of pregnant women for anemia saves both the life of the newborn and hers. Therefore, the present study intended to assess anemia and its associated factors among pregnant women attending at Madda Walabu University Goba referral hospital.Methods: An institutional-based cross-sectional study was conducted from April 3 to May 3, 2019, among pregnant women attending Madda Walabu University Goba referral hospital. A total of 353 respondents were included in the study by using systematic random sampling techniques. Data were collected using both face-to-face interview and hemoglobin measurement. The collected data were entered into SPSS and analyzed using both bi-variable and multiple logistic regressions. Finally, statistical significance was declared at a p-value of less than 0.05 in the multiple logistic regressions.Results: In this study, the prevalence of anemia was 46.2% (95%CI: 40.9%, 51.5%). Factors significantly associated with anemia were positive stool examination for parasites (AOR=2.9, 95%CI 1.255– 6.856), lower consumption of fruits and vegetables (AOR=2.7, 95%CI 1.47– 4.86), no iron supplementation (AOR=2.2, 95%CI 1.07– 4.45), large family size (AOR=2.1, 95%CI 1.13– 3.77), and absence of abortion history (AOR=0.4, 95%CI 0.24– 0.77).Conclusions and Recommendation: Prevalence of anemia among pregnant women was high. Pregnant women with a previous history of abortion, positive stool for parasite, lower consumption of fruits and vegetables, no iron supplementation and large family size above five were risk factors for anemia. Therefore, encouraging pregnant women to take iron supplementation and to eat fruits and vegetables are important.Keywords: anemia, pregnant women, hemoglobin, Ethiopia

Yohannes Tekalegn,1 Demelash Woldeyohannes,1 Tesfaye Assefa,2 Rameto Aman,1 Biniyam Sahiledengle1 1Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia; 2Department of Nursing, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Bale Goba, EthiopiaCorrespondence: Yohannes Tekalegn Addis Ababa 22847 code 1000, EthiopiaTel +251 913578901Email yohannesefa@gmail.comPurpose: Multi-drug-resistant tuberculosis occurs when the tuberculosis bacteria develop resistance to at least the two most effective first-line anti-tuberculosis drugs, isoniazid and rifampicin. Sputum culture conversion is one of the indicators to monitor patients’ prognosis throughout the treatment. Hence, this study aimed to assess time to culture conversion and its determinants among drug-resistant tuberculosis patients.Patients and Methods: A total of 228 drug-resistant tuberculosis patients in selected hospitals in Oromia region, Ethiopia, were included in this study. Descriptive statistics like median time to sputum smear and culture conversion were computed. Bivariate and multivariate Cox proportional hazard models were used to identify the independent predictors of time to culture conversion. The adjusted hazard ratio (AHR) with 95% confidence interval (CI) was used to report the strength of association. Statistical significance was declared at p < 0.05.Results: The median age of the study participants was 28 years with inter-quartile range of (IQR) of 22– 32 years, and 60% of the patients were male. The median time to culture conversion was 61 days (IQR: 34– 92 days). The proportion of sputum culture conversion at 2nd, 4th, and 6th months of treatment initiation was 47%, 82.5%, and 89%, respectively. The final adjusted multivariate Cox proportional hazard model revealed that patients with massive effusion on chest radiographic finding had a 60%-decreased culture conversion time (AHR: 0.4, 95% CI: 0.1– 0.9). Patients with abnormalities without cavitations (AHR: 0.5, 95% CI: 0.2– 0.9) and those with uninterpreted findings (AHR: 0.3 95% CI: 0.1– 0.5) had delayed culture conversion time.Conclusion: Chest radiographic findings such as massive effusion, abnormalities without cavitations, and uninterpreted findings were found to be predictors of time to sputum culture conversion. Patients with such characteristics have prolonged culture conversion time. Hence, they may need special attention during the treatment.Keywords: multi-drug-resistant tuberculosis, tuberculosis, time to sputum culture conversion, predictors, survival analysis, treatment outcome, Oromia, Ethiopia

Rabia Aman,1 Stephanie B Engelhard,1 Asima Bajwa,1 James Patrie,2 Ashvini K Reddy1 1Department of Ophthalmology, 2Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA Purpose: To assess ocular hypertension (OHT) and hypotony as outcomes of uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of uveitis patients seen at the University of Virginia from 1984 to 2014. Results: A total of 442 patients (582 eyes) with uveitis were identified and included in the study. The patient population was 57.0% female. Overall, 61.9% were Caucasian and 26.6% were African American. Mean age was 46.8 years. Overall, 11.5% of the eyes had OHT at initial visit, and 7.9% had OHT at final visit (P=0.035). For each additional decade of life, the odds that an eye had OHT were elevated by a factor of 1.15 (95% confidence interval [CI]: [1.02, 1.30], P=0.027) at initial visit and by a factor of 1.15 (95% CI: [1.00, 1.32], P=0.055) at final visit. The odds that an anterior uveitis eye had OHT were greater by a factor of 2.50 (95% CI: [1.22, 5.14], P=0.013) than the odds for a nonanterior uveitis eye at initial visit and greater by a factor of 2.61 (95% CI: [1.24, 5.50], P=0.011) at final visit. For each additional 0.5 logarithm of the minimum angle of resolution increase in initial visual acuity, the odds that an affected eye had OHT were elevated by a factor of 1.18 (95% CI: [1.00, 1.39], P=0.047) at initial visit and 1.23 (95% CI: [0.99, 1.54], P=0.065) at final visit. Overall, 21 of 582 eyes (3.6%) were hypotonous initially, while 24 of 582 eyes (4.1%) were hypotonous at final follow-up (P=0.631). Conclusion: OHT was associated with increasing age, anterior uveitis, and poor presenting visual acuity. Ocular hypotony was more common in anterior uveitis than in nonanterior uveitis. Fluctuations in intraocular pressure are an important cause of visual impairment in patients with uveitis. Careful monitoring of all uveitis patients, and especially those most at risk for fluctuations in intraocular pressure, can preserve vision and improve patient outcomes. Keywords: uveitis, ocular hypertension, hypotony, intraocular pressure, uveitic glaucoma

The important human pathogen Streptococcus pyogenes (group A streptococcus GAS), requires several surface proteins to interact with its human host. Many of these are covalently linked by a sortase enzyme to the cell wall via a C-terminal LPXTG motif. This motif is followed by a hydrophobic region and charged C terminus, which are thought to retard the protein in the cell membrane to facilitate recognition by the membrane-localized sortase. Previously, we identified two sortase enzymes in GAS. SrtA is found in all GAS strains and anchors most proteins containing LPXTG, while SrtB is present only in some strains and anchors a subset of LPXTG-containing proteins. We now report the presence of a third sortase in most strains of GAS, SrtC. We show that SrtC mediates attachment of a protein with a QVPTGV motif preceding a hydrophobic region and charged tail. We also demonstrate that the QVPTGV sequence is a substrate for anchoring of this protein by SrtC. Furthermore, replacing this motif with LPSTGE, found in the SrtA-anchored M protein of GAS, leads to SrtA-dependent secretion of the protein but does not lead to its anchoring by SrtA. We conclude that srtC encodes a novel sortase that anchors a protein containing a QVPTGV motif to the surface of GAS.