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Background: Uptake of HIV testing is vital for the early diagnosis of HIV infection and initiation of treatment, which are used to eliminate the disease's progression and reduce HIV-related mortality. Even if determining HIV testing is imperative to prevent HIV/AIDS among multiple sexual partners who are at higher risk of sexually transmitted infections, most of the countries in Sub Saharan Africa did not fulfil the global targets of UNAIDS. Moreover there is a paucity of literature on spatial variation and factors associated with HIV testing among high-risk groups in SSA. This study aimed to assess the pooled prevalence, spatial variation and determinants of HIV testing uptake among multiple sexual partners in Sub Saharan Africa. Methods: The Demographic and Health Surveys data conducted between 2011 and 2021 in 30 Sub-Saharan Africa countries was used to analyze total weighted sample of 56,210 multiple sexual partners. Exploratory spatial data analysis, with countries as the unit of analysis was conducted using ArcGIS V10.7.1 and Sat Scan V 10.1 soft wares. A multilevel binary logistic regression model was used to identify the factors associated with the HIV testing uptake. The Adjusted odds Ratio with a 95% confidence interval was reported to declare the strength of association and their statistical significance. Results: The spatial patterns of HIV testing uptake were found to be non-random. Primary clusters were identified around western and central sub- regions. Multiple sexual partners who were ever married, those attended primary level and above education, those from rich wealth status, aged above 24 years, having good HIV related knowledge, and exposed to media were positive association with HIV testing uptake. However, being male, having working status and living in rural area were negatively associated with HIV testing uptake. At the community-level, multiple sexual partners from communities in Eastern and southern sub regions, countries with upper middle income and countries with the survey year after 2014 were more likely to utilize HIV testing services compared with their counterparts. Conclusion: In this study, the pooled prevalence of the HIV testing uptake among multiple sexual partners was found to be lower than the universal target and showed differences in HIV testing uptake across Sub-Saharan Africa region. Both individual and community-level factors affected HIV testing uptake among multiple sexual partners. Stakeholders should implement interventions to help increase the uptake of HIV testing among those risky groups in this region. [ABSTRACT FROM AUTHOR]

Background: Early adjuvant chemotherapy improves the outcomes of breast cancer patients by increasing the benefit provided by the cytotoxic systemic therapies. Despite these, the recommended time to adjuvant chemotherapy and its predictors is very limited. Therefore, this study was determining the time to adjuvant chemotherapy and its predictors among women with breast cancer at the University of Gondar Comprehensive Specialized Hospital. Methods: An institution-based retrospective follow-up study was conducted at the University of Gondar Compressive Specialized Hospital from January 2015 to February 2019 among all women with breast cancer. Stata version 14 was used for data analysis. A stratified Cox regression model was fitted to identify the potential predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was reported to show the strength of the association. Cox–Snell residual test was used to check the goodness of fit. Results: In this study, the median time to adjuvant chemotherapy was 67 days with an interquartile range of 34– 102 days. More than three-fourth (79.9%) of patients received chemotherapy after 30 days. Of the total, 96.6% of patients with co-morbidity received adjuvant chemotherapy after 30 days. Regarding surgical complications, 97.0% of the patients with a surgical complications were received adjuvant chemotherapy after 30 days. Older patients (AHR= 0.34, 95% CI: 0.16,0.71), presence of co-morbidity (AHR= 0.43, 95% CI: 0.29, 0.62), positive surgical margin (AHR= 0.40, 95% CI: 0.25, 0.64), and presence of surgical complication (AHR= 0.55, 95% CI: 0.34, 0.88) were significantly associated with delayed time to adjuvant chemotherapy. Conclusion: In this study, time to adjuvant chemotherapy among women was longer. Age, co-morbidity, surgical complications, and margin status were significant predictors of time to adjuvant chemotherapy. Close follow-up is important for women with surgical complications, co-morbidities, elder patients, and patients with a positive margin. [ABSTRACT FROM AUTHOR]

Background: In response to critical gaps in medical oxygen access, 2 pressure swing adsorption (PSA) oxygen production centers were established using an ecosystem-strengthening strategy in Amhara, Ethiopia, in 2019. A qualitative study was conducted to assess enablers and bottlenecks to oxygen access at the hospital level after installation., Methods: A variety of hospital staff (clinicians, biomedical professionals, hospital administrators, and procurement teams) across 13 hospitals procuring oxygen from the plants participated in comprehensive, semistructured focus group discussions. A thematic framework analysis approach was used to identify key themes., Findings: A total of 101 individuals participated in 26 focus groups in 2021, 2 years after plants were installed. Primary themes were accessibility of supply, affordability, and hospital readiness. Respondents indicated a substantial increase in their hospital's ability to access lower-cost oxygen, with many attributing this to the locality of plants and reduced transportation barriers. However, other challenges persisted, and the emergence of COVID-19 1 year after plant installation and a civil conflict exacerbated supply shortages. Investments in equipment, supplies, and training optimized clinical utilization of oxygen and were highlighted as a need for ongoing investment., Conclusion: To achieve maximum impact, investments in large-scale oxygen systems must be accompanied by strategic plans to transport oxygen, reduce costs to hospitals, and provide support to clinical teams through equipment, supply procurement, and clinical training. These findings support comprehensive ecosystem approaches to strengthening oxygen access for sustainable impact., (© Smith et al.)