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Bizunesh Dires Fenta,1 Alazar Berhe Aregawi,2 Teketel Tadesse Geremew,1 Berhanu Kelemework Fenta3 1Department of Pathology, Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia; 2Department of Surgery, Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia; 3Department of Internal Medicine, Yanet Internal Medicine Specialized Center, Hawassa, Sidama, EthiopiaCorrespondence: Alazar Berhe Aregawi, Tel +251911914624, Email alazarberhe@hu.edu.etAbstract: One kind of angioproliferative disorder is Kaposi’s sarcoma (KS). Growth of spindle-shaped cells, edema, inflammation, and neoangiogenesis are its defining features. Because it lacks the typical indicators of malignancy, it is classified as an intermediate neoplasm. People who are immunocompromised, receiving organ transplants, or receiving antiretroviral therapy are linked to KS. Although lymph node involvement by KS is extremely uncommon, when it does occur, it usually manifests as either the epidemic form in (Human Immuno-deficiency) HIV-positive patients or the endemic form in Africans. There are four primary clinical manifestations of KS that have been documented: endemic, epidemic, iatrogenic, and classic. The diagnosis of KS is made by history, physical examination, and tissue biopsy. When treating localized disease, highly active antiretroviral therapy (HAART) may be sufficient to either improve or completely eradicate the illness. Nonetheless, chemotherapy and HAART would be necessary in the case of widespread illness. Here, we present the case of a 28-year-old female patient who is HIV positive and has a viral load that is not detected. She presented with generalized lymphadenopathy of 8 months duration. She had no cutaneous manifestations. The lymphadenopathy involved the tonsils, axilla, inguinal, and an unusual site, intraparotid on both sides. After a pathologic examination of the lymph nodes, she was found to have epidemic-type KS and was treated with HAART and chemotherapy. In our nation, we are not aware of any published case reports pertaining to a case like this. The purpose of this case report is to raise physicians’ awareness of this uncommon ailment and to encourage them to suspect KS when HIV patients exhibit generalized lymphadenopathy. The early initiation of systemic treatment is lifesaving for these patients.Keywords: Kaposi’s sarcoma, KS, Human immune-deficiency Virus, HIV, human herpes virus-8, Acquired Immuno-deficiency Syndrome, AIDS, generalized lymphadenopathy

ObjectiveNumber of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach.MethodsThis is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019.ResultsResources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators.ConclusionObserved quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.

Objectives: This article describes the implementation of an automated medication dispensing system (AMDS) in Eswatini to increase medication access and presents the early lessons from this implementation.Methods: The AMDS was installed at four health facilities across two regions through collaborative stakeholder engagement. Healthcare workers were trained, and clients who met the inclusion criteria accessed their medications from the system. Each step of the implementation was documented and summarised in this article.Results: Early lessons suggest that implementation of the AMDS is acceptable and feasible to clients and healthcare workers and that phased introduction of medication classes, commencing with antiretroviral therapy (ART) and incorporating other medications in later phases is feasible. Additionally, improved client-centred messaging and communication, consistent power supply and internet network connectivity, and scheduling medication pickup with other services increase AMDS system utilisation.Conclusion: Eswatini has many clients living with HIV and non-communicable diseases (NCDs). Easy, convenient, quick, non-stigmatising and client-centred access to ART and medication for NCDs is critical in addressing retention in care and achieving optimal treatment outcomes.

Elimination of barriers to identification of new HIV infections, treatment adherence and retention in care of people living with HIV/AIDS is vital to the attainment of WHO's ambitious vision 2030 of 90:90:90 for HIV/AIDS. However, HIV-related stigma, especially among health workers, has been widely documented as a serious threat to this project. This study explored the factors associated with the stigmatization of people living with HIV among healthcare workers in Nigerian hospitals. Electronic literature search was conducted on eight databases using keywords and MeSH guidelines. Using the PRISMA protocol, studies published from 2003 to 2022 were retrieved and analyzed. Of the 1481 articles identified, 9 met the inclusion criteria. All the included studies were conducted across 10 of the 36 states in Nigeria, with every geo-political zone in Nigeria represented by at least two studies. The overarching themes identified were attitude and beliefs (n = 7), knowledge of HIV/AIDS (n = 3), quality of care (n = 4), education and in-service training (n = 4), and health facility policies and procedures (n = 3). Factors associated with HIV-related stigma among healthcare workers varied by gender, healthcare settings, specialties of health workers, and the presence of institutional stigma reinforcements. Healthcare workers without recent in-service training on HIV/AIDS and those who work in hospitals without anti-HIV/AIDS stigma policies exhibited more HIV-related stigmatizing attitudes. Continuous in-service training of healthcare workers and the development of comprehensive stigma reduction interventions that will be reinforced with anti-HIV stigma policies in clinical settings may facilitate the attainment of national HIV prevention goals. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate various variables between maternal overweight and/or obesity versus normal‐weight pregnant black South African women living with and without human immunodeficiency virus (HIV). Methods: A cross‐sectional study design was employed. A total of 200 pregnant women were enrolled in the study, categorized according to body mass index (BMI) (kg/m2) into two groups: (1) overweight/obese (≥25 kg/m2) (n = 97); and (2) nonoverweight/nonobese (<25 kg/m2) (n = 103), where 90 were HIV‐infected and 110 were HIV‐uninfected. The differences between the maternal BMI categories were assessed using Fisher's exact t‐test and the χ2 test. Simple and multiple logistic regression analyses were used to determine factors associated with maternal overweight and obesity. Results: Multiple logistic regression analysis showed that maternal age (odds ratio [OR]: 1.061; 95% confidence interval [CI] 1.008–1.117; p = 0.023) and gestational age (OR: 1.121; 95% CI 1.005–1.251; p = 0.041) were significantly associated with maternal overweight/obesity in both HIV‐infected and HIV‐uninfected. For maternal health outcomes, multiple logistic regression analysis showed that hypertensive disorders (OR: 0.273; 95% CI 0.124–0.601; p = 0.001) and anemia (OR: 2.420; 95% CI 1.283–4.563; p = 0.006) were significantly associated with maternal overweight/obesity in both HIV‐infected and HIV‐uninfected. The overweight/obese HIV‐infected participants (OR: 0.233; 95% CI 0.075–0.717; p = 0.011) had increased odds for developing hypertensive disorders compared to HIV‐uninfected overweight/obese participants (OR: 0.471; 95% CI 0.172–1.291; p = 0.143). Conclusions: Maternal overweight/obesity in both HIV‐infected and HIV‐uninfected pregnant black South African women was significantly associated with maternal age, gestational age, HPT disorders, and anemia. Maternal overweight/obesity decreased the odds for anemia, but increased the odds for the development of HPT disorders, especially in the HIV‐infected pregnant women. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) mother-to-child transmission (MTCT) can be prevented when HIV-positive pregnant women use effective prevention of mother-to-child transmission (PMTCT) of HIV services. Approximately 50% of HIV-positive pregnant women used free PMTCT services in Ethiopia. Aim: This study attempted to identify factors influencing women’s utilisation of PMTCT services. Addressing such factors could enable more Ethiopian women to use PMTCT services. The study investigated whether women’s utilisation of services was affected by socio-demographic issues, their partners’ known HIV status, disclosure of their HIV-positive status, stigma and discrimination, and satisfaction with services. Setting: Prenatal clinics in Addis Ababa, Ethiopia. Methods: A quantitative, cross-sectional study design was used and 384 questionnaires were completed by women who used PMTCT services in Addis Ababa. Results: No socio-demographic characteristic prevented women’s utilisation of PMTCT services, nor did stigma, discrimination or disclosure of their HIV-positive status. Most respondents’ partners with unknown HIV status did not know that the respondents used PMTCT services. Most women were satisfied with the PMTCT services. Conclusions: Prevention of mother-to-child transmission services should remain accessible to all HIV-positive women in Ethiopia. Concurrent HIV partner testing should be encouraged with appropriate counselling. HIV-positive pregnant women should be encouraged to disclose their status to their partners so that they need not use PMTCT services secretly. Patients’ high levels of satisfaction with PMTCT services are a good indicator for rolling out PMTCT initiatives at other facilities. Future research should focus on HIV-positive pregnant women who do not use PMTCT services.

Objectives: This article describes the implementation of an automated medication dispensing system (AMDS) in Eswatini to increase medication access and presents the early lessons from this implementation. Methods: The AMDS was installed at four health facilities across two regions through collaborative stakeholder engagement. Healthcare workers were trained, and clients who met the inclusion criteria accessed their medications from the system. Each step of the implementation was documented and summarised in this article. Results: Early lessons suggest that implementation of the AMDS is acceptable and feasible to clients and healthcare workers and that phased introduction of medication classes, commencing with antiretroviral therapy (ART) and incorporating other medications in later phases is feasible. Additionally, improved client-centred messaging and communication, consistent power supply and internet network connectivity, and scheduling medication pickup with other services increase AMDS system utilisation. Conclusion: Eswatini has many clients living with HIV and non-communicable diseases (NCDs). Easy, convenient, quick, non-stigmatising and client-centred access to ART and medication for NCDs is critical in addressing retention in care and achieving optimal treatment outcomes., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Williams, Haumba, Ngwenya-Ngcamphalala, Mafukidze, Musarapasi, Byarugaba, Chiripashi, Dlamini, Maseko, Dlamini, Nyapokoto, Kibwana, Bongomin, Mazibuko, Bhembe, Ojoo, Okello and Bazira.)

Objective: Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach., Methods: This is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019., Results: Resources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators., Conclusion: Observed quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV., Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma., Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression., Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women., (© 2020 Yousuf et al.)

Sphingomyelin- and cholesterol- enriched membrane domains, commonly referred to as “rafts” play a crucial role in a large number of intra- and intercellular processes. Recent experiments suggest that not only the volumetric inhomogeneity of lipid distribution in rafts, but also the arrangement of the 1D boundary between the raft and the surrounding membrane is important for the membrane-associated processes. The reason is that the boundary preferentially recruits different peptides, such as HIV (human immunodeficiency virus) fusion peptide. In the present work, we report a theoretical investigation of mechanisms of influence of the raft boundary arrangement upon virus-induced membrane fusion. We theoretically predict that the raft boundary can act as an attractor for viral fusion peptides, which preferentially distribute into the vicinity of the boundary, playing the role of ‘line active components’ of the membrane (‘linactants’). We have calculated the height of the fusion energy barrier and demonstrated that, in the case of fusion between HIV membrane and the target cell, presence of the raft boundary in the vicinity of the fusion site facilitates fusion. The results we obtained can be further generalized to be applicable to other enveloped viruses. [ABSTRACT FROM AUTHOR]