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Background: About half of people infected with Human Immunodeficiency Virus (HIV) often present late for care, resulting in higher healthcare costs, undesired treatment outcomes, and ongoing HIV transmission. This study aimed to assess the prevalence and determinants of late HIV diagnosis and advanced HIV disease (AHD) in Tanzania. Methods: Data were obtained from the 2016– 17 Tanzania HIV impact survey. We included 677 newly diagnosed people living with HIV. Late HIV diagnosis and AHD were defined as having a CD4 cell count below 350 cells/μL or 200 cells/μL at diagnosis, respectively. Bivariate and multivariable logistic regression models were fitted to identify the determinants of late HIV diagnosis or AHD. Results: The mean age of the participants was 37.8 years (SD, 12.4). About two-thirds were women (62.6%). The prevalence of late HIV diagnosis was 42.4%, whereas the prevalence of AHD was 17.7%. Factors associated with late HIV diagnosis included age 31– 40 years (adjusted odds ratio [aOR] = 1.72, 95% confidence interval [CI]: 1.14– 2.60), age ≥ 41 years (aOR = 1.79, 95% CI: 1.16– 2.76), male sex (aOR = 1.88, 95% CI: 1.29– 2.73), and active syphilis infection (aOR=2.63, 95% CI: 1.20– 5.76). Factors associated with AHD were age 31– 40 years (aOR = 2.12, 95% CI: 1.18– 3.81), age ≥ 41 years (aOR = 2.42, 95% CI: 1.32– 4.41), male sex (aOR = 1.77, 95% CI: 1.09– 2.87), formal education (aOR = 0.49, 95% CI: 0.30– 0.81) and active syphilis infection (aOR = 2.49, 95% CI: 1.07– 5.77). Conclusion: Late HIV diagnosis and AHD are prevalent among newly diagnosed people living with HIV in Tanzania. Specific subgroups are more likely to present late for HIV care, including middle-aged and older adults, men, illiterate individuals, and those with active syphilis and HIV co-infection. Therefore, we recommend expanding HIV testing services and implementing targeted interventions to improve early access and enrollment in HIV care. [ABSTRACT FROM AUTHOR]

aim M Kosia,2 Josephine J Mkunda,2 Maja Weisser,1,3,5– 7 Sally Mtenga81Interventions and Clinical Trials, Ifakara Health Institute, Morogoro, Tanzania; 2The Nelson Mandela, African Institution of Science and Technology, Tengeru, Arusha, Tanzania; 3Chronic Diseases Clinic of Ifakara, St. Francis Referral Hospital, Morogoro, Tanzania; 4Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-es-Salaam, Tanzania; 5Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, 4031, Switzerland; 6University of Basel, Basel, 4002, Switzerland; 7Swiss Tropical and Public Health Institute, Allschwil, 4123, Switzerland; 8Health System Impact Evaluation and Policy, Ifakara Health Institute, Dar-es-Salaam, Tanzania Correspondence: Leila S Matoy, Ifakara Health Institute, P.O. Box 53, off Mlabani Passage, Ifakara, Morogoro, Tanzania, Tel +255 718 410 774, Email [email protected] Introduction: Healthcare workers (HCW) play an important role in managing women living with HIV (WLHIV) with gender-based violence (GBV) experience, but little is known about their experience in screening and managing GBV among WLHIV. This study explored the perceptions and experience of the HCWs on screening and managing GBV cases among WLHIV. Patients and Methods: We performed a descriptive phenomenological qualitative study to elicit the views and experience of HCW on GBV screening and management for WLHIV. The study was conducted in the semi-urban setting in Morogoro Region, Tanzania. Ten in-depth interviews (IDIs) were administered to HCW selected purposefully based on their roles at an HIV care and treatment center. Data were transcribed using patterns matching study aim and then merged into relevant themes for analysis and interpretation. NVIVO software version 12 was used for data coding and analysis. Results: We found that HCW experienced multiple challenges in GBV screening and management, including limited capacity for GBV screening and management; inadequate training on assessment and handling GBV cases, limited resources (time, GBV guidelines and screening tools), inadequate GBV referral and monitoring systems; referral forms for GBV survivors to social support centers and follow-up mechanisms to trace survivors, mental aspects; HCWs' fear of being stressed by listening to women's' GBV traumatic experiences, HCWs' fear of causing problems to the women's families and HCW biased notions on women disclosure of GBV; the believes that women will not report their GBV experiences. Conclusion: We identified context-specific challenges preventing HCW to deliver optimal services of GBV to WLHIV, stressing the necessity to strengthen HCW capacity and resources for GBV services and to integrate psychosocial services into HIV care. Policy and programs should be developed to support GBV screening and management for WLHIV. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis made the neonatal period the most perilous time for child survival, and it continued to cause preventable mortalities worldwide. These mortalities stem from the interaction of several factors that have not been sufficiently studied and, in some cases, remain overlooked. Thus, the study aims to investigate the predictors of mortality that arise from the interaction of these factors and quantitatively determine their etiologic fraction. Methods: A case–control study with hierarchical data input was conducted at Jimma Medical Center (JMC) in Oromia, Ethiopia, spanning from May 2022 to July 2023. It employed logistic regression to calculate adjusted odds ratios (AORs) and their corresponding 95% confidence intervals (CI) at a significance level of p ≤ 0.05. The model adjusted odds ratios (ORs) for variables within each level and farther levels and presented an etiologic fraction (EF), indicating the proportion of neonatal mortality attributable to specific factors. Results: The analysis of 67 cases and 268 controls unveiled significant predictors of mortality in sepsis that emerged from distal, intermediate, and proximal levels. In the final model, thus, rural residence [AOR 3.1; 95% CI (1.5, 6.3), p ≤ 0.01], prolonged labor [AOR 4.5; 95% CI (2.2, 9.3), p ≤ 0.01], prematurity [AOR 3.9; 95% CI (1.9, 7.9), P ≤ 0.0], gram-negative bacteremia [AOR 3.8; 95% CI (1.9, 7.6); P ≤ 0.01], convulsion [AOR 3.2; 95% CI (1.6, 6.4); P ≤ 0.03], low birth weight [AOR 2.7; 95% CI (1.3, 5.4); P≤ 0.01], and delayed breastfeeding [AOR 2.5; 95% CI (1.2, 4.9); P ≤ 0.01] attributed a variable percentage of mortality. Conclusion: Factors emerging and interacting at distal (residence), intermediate (prolonged labor), and proximal (prematurity, birth weight, convulsion, bacterial etiology, and feeding) levels influence neonatal mortality in sepsis at JMC. Therefore, concurrently improving rural family characteristics, managing labor duration, strengthening diagnostic stewardship, and promoting essential newborn care can actively prevent and reduce these mortalities. Plain Language Summary: The existing body of literature indicates that neonatal mortality in sepsis is influenced by a complex interplay of factors at different hierarchical levels. These factors encompass maternal characteristics, neonatal health status, healthcare system capacity, and socio-economic conditions. To accurately predict outcomes related to neonatal sepsis mortality, it is vital to have a comprehensive understanding of the intricate relationship among these factors. However, previous studies have not thoroughly explored the extent and role of these factors in relation to neonatal sepsis mortality. In a recent study, researchers conducted a comprehensive investigation into the implications of factors at three levels: distal, intermediate, and proximate. Employing a case–control design and hierarchical data input, the study aimed to explore the etiological fraction associated with each level. The findings of this study shed light on the presence, interaction, and contribution of predictors at each level, emphasizing the vital importance of addressing factors at all levels to effectively prevent and control neonatal mortality in sepsis. [ABSTRACT FROM AUTHOR]

Background: Uganda has one of the highest fertility rates in Sub-Saharan Africa (SSA). Improving contraceptive uptake in all genders, including males, may be critical to meeting family planning goals in such a setting. Yet, data on male contraception uptake and associated factors in SSA, including Uganda, are limited. We determined the uptake and associated factors of male contraception use in Lira City, Northern Uganda.Methods: We conducted a community-based cross-sectional study from November 12, 2022, to December 12, 2022, among men aged ≥ 18 years. We used multi-stage sampling to select participants from 12 cells of Lira City divisions of East and West. Data were collected using interviewer-administered structured questionnaires. We defined uptake in males who had used any contraceptive method, including periodic abstinence, withdrawal, condoms, and vasectomy in the previous four weeks. We performed modified Poisson regression to identify associated factors of male contraception uptake.Results: We recruited 401 participants with mean age of 30.4 (± 9.3) years. Male contraceptive uptake was 46.4%, 95% CI: 41.5– 51.3%. Ever heard about male contraception (adjusted prevalence ratio [aPR] =1.73, 95% CI: 1.172– 2.539, p=0.006), willingness to use novel methods (aPR=2.90, 95% CI: 1.337– 6.293, p=0.007), both partners being responsible for contraception (aPR: 1.53, 95% CI: 1.113– 2.119, p=0.009) were the factors associated with male contraception uptake.Conclusion: We found that nearly half of the men surveyed had used male contraceptive methods in Lira City. Factors associated with the uptake of male contraception included having heard about male contraception, joint couple decision regarding contraception, and the use of novel methods of male contraception. We recommend comprehensive education and awareness campaigns to promote male contraception, with a particular emphasis on encouraging shared decision-making within couples and introducing innovative contraceptive options. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) remains the leading cause of years of life lost among adolescent boys in eastern and southern Africa. Medical male circumcision (MMC) is a cost-effective one-time intervention that can reduce the risk of heterosexual HIV acquisition in men by approximately 60%. Despite its importance in HIV prevention, the uptake of MMC remains suboptimal among adolescent boys. This study aimed to identify factors associated with low MMC uptake among adolescent boys in Tanzania. Methods: This study was a secondary analysis of the 2016– 17 Tanzania HIV Impact Survey. Descriptive statistics were used to summarize the participants' characteristics. Unadjusted and adjusted multinomial logistic regression models were fitted to identify factors associated with low MMC uptake among adolescent boys. Results: A total of 2605 older adolescents (15– 19 years) and 1296 young adolescents (10– 14 years) were analyzed. The MMC uptake rates among older and young adolescents were 56.5% and 45.1%, respectively. Lower MMC uptake was found among respondents in rural areas (adjusted relative risk ratio [aRRR] = 0.40, 95% CI: 0.28– 0.57), in the traditionally non-circumcising zone (aRRR = 0.30, 95% CI: 0.23– 0.41), participants with no formal education (aRRR = 0.32, 95% CI: 0.23– 0.41), and those living in lower wealth quintile households (aRRR = 0.20, 95% CI: 0.11– 0.36). Respondents who were not covered by health insurance (aRRR = 0.67, 95% CI: 0.48– 0.94) and those who had no comprehensive HIV knowledge (aRRR = 0.55, 95% CI: 0.44– 0.70) were also found to have lower uptake of MMC. Conclusion: To achieve and maintain high MMC coverage, MMC interventions for HIV prevention should focus on uncircumcised adolescent boys who are rural residents, of lower socioeconomic status, and residing in traditionally non-circumcising communities. Furthermore, dissemination of HIV knowledge and increasing health insurance coverage may encourage more adolescent boys to undergo MMC. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy (DR) is the most prevalent microvascular consequence of diabetes mellitus, and it can result in blindness that is irreversible. Due to delayed diagnosis and limited access to diabetic care, the situation is even worse in developing countries. Scientific evidence on the prevalence of DR and its associated factors among diabetes patients in low-income countries, such as Ethiopia, is limited. This study aimed to determine the prevalence of DR and associated factors among adult diabetes patients in southeast Ethiopia. Methods: A hospital-based cross-sectional study was conducted among diabetes patients who visited Madda Walabu University Goba Referral Hospital. Fundus and slit-lamp examination were performed for screening of DR. Multivariate binary logistic regression was computed to identify factors associated with DR. Results: A total of 256 patients (144 men, 56.2%) aged 50.15± 15.71 years were included in the study. The prevalence of any DR was 19.9% (95% CI 15.4%– 25.3%), mild nonproliferative diabetic retinopathy (NPDR) 10.9% (95% CI 7.6%– 15.4%), moderate NPDR 5.9% (95% CI 3.5%– 9.5%), severe NPDR 0.9% (95% CI 0.2%– 3.9%), and proliferative DR 2.3% (95% CI 1.0%– 5.1%). Duration of diabetes ≥ 10 years (AOR 10.22, 95% CI 1.70– 61.44), central obesity (AOR 5.42, 95% CI 1.38– 21.19), overweight/obese (AOR 2.65, 95% CI 1.02– 6.92), lower high-density lipoprotein (HDL) cholesterol (AOR 5.82, 95% CI 1.86– 18.24), moderate triglyceride:HDL cholesterol ratio (AOR 4.13, 95% CI 1.13– 15.15), and urban dwelling (AOR 2.84, 95% CI 1.04– 7.78) were significantly associated with DR. Conclusion: One in every five DM patients had DR. Sociodemographic, anthropometric, and blood lipids were independently associated with DR. To reduce the burden of diabetes, strategies that focus on lifestyle modifications targeted at identified modifiable risk factors are essential. [ABSTRACT FROM AUTHOR]

Background: Diabetes, together with its complications, has a considerable negative influence on people's quality of life and healthcare delivery and raises diabetic mortality. However, there is limited information about the diabetes-associated chronic complications in the study setting. Therefore, this study aimed to determine the burden and factors related to the chronic complications among patients with type 2 diabetes (T2D) in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 879 patients with T2D at two public hospitals in Harar. The data were collected through interviews using a structured questionnaire. Data related to the diagnosis of chronic complications and biochemical tests were extracted from medical records. The outcome variable was the number of chronic complications that happened to the patients. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with chronic complications. An adjusted prevalence ratio with a 95% CI was reported to show an association using a p-value ≤ 0.05. Results: One or more chronic complications were presented in 43% of T2D (95% CI: 39.65, 46.19). Macrovascular and microvascular complications were found in 27.6% and 23.5% of patients, respectively. Urban residence (APR = 2.64; 95% CI: 1.54, 4.54), low wealth status (APR = 1.80; 95% CI: 1.17, 2.76), diabetes duration ≥ 5 years (APR = 1.46; 95% CI: 1.05, 2.01), hypertriglyceridemia (APR = 1.48; 95% CI: 1.07, 2.09) and poor self-care practices (APR = 1.62; 95% CI: 1.18, 2.23) were factors significantly associated with the chronic complications. Conclusion: The burden of chronic complications was high, with nearly half of T2D patients experiencing one or more chronic complications. Almost one in ten patients suffered from multiple chronic complications. The complications were mainly influenced by being urban resident, low wealth status, and poor self-care practices. Therefore, health care providers need to educate patients and promote self-care practices and healthy lifestyles to achieve treatment goals and lower the risk of chronic complications. [ABSTRACT FROM AUTHOR]

Purpose: Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia. Methods: A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value < 0.05. Results: The overall prevalence of food safety practices was 44.7% (95% CI: 40.5– 48.4%), of which 57.8% (95% CI: 53.0– 63.1%) were model and 31.6% (95% CI: 26.5– 36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98– 4.52), having a female household head (AOR=3.13; 95% CI: 2.13– 4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54– 3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43– 3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices. Conclusion: The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices. [ABSTRACT FROM AUTHOR]

Background: Globally, the human immunodeficiency virus (HIV) affects young people in their reproductive years. Most of the studies conducted in Ethiopia focus on the fertility desire of women of reproductive age and did not give due consideration to the men's fertility perspective. Thus, this study aimed to assess the fertility desire, knowledge of prevention of mother to child of HIV (PMTCT), and associated factors among HIV-positive men and women attending ART clinic at west Shewa zone, Oromia region, Ethiopia, 2020. Methods: Facility-based cross-sectional study design was applied to identify fertility desire, PMTCT knowledge, and associated factors among 590 HIV-positive reproductive age group men and women attending ART clinics at public health institutions of West Shewa zone. Data were collected by pre-tested structured questionnaires and analyzed using SPSS version 22. Binary logistic regression analysis was used to examine the association of predictors on fertility desire and knowledge about PMTCT. Odds ratio, 95% CI, and P value 0.05 were used to measure the statistical association. Results: The prevalence of fertility desire and knowledge of PMTCT in the study area were 58.8% and 30.7%, respectively. The odds of fertility desire were higher among the respondents aged > 25 years [AOR=4.64, 95% CI (2.75– 7.85)], housewives [AOR=3.14, 95% CI (1.90– 5.21)], merchants [AOR=5.31, 95% CI (2.55– 11.05)], ART use for ≤ 5 years [AOR=5.13, 95% CI (2.37– 11.12)] and among those voluntarily tested to know their HIV status [AOR=2.16, 95% CI (1.30– 3.58)]. Besides, the odds of fertility desire were low among husband who cannot read and write [AOR=0.07, 95% CI (0.02– 0.23)], primary education [AOR=0.22, 95% CI (0.09– 0.56)], and secondary education [AOR= 0.32, 95% CI (0.14– 0.73)] when compared with husband education of college and above. Likewise, the odds of PMTCT knowledge were higher among the respondents aged less than 25 years [AOR=2.53, 95% CI (1.32– 4.86)] who undergone voluntary testing during HIV diagnosis reasons [AOR=1.55, 95% CI (1.03– 2.35)], and ART use for more than five years [AOR=1.94, 95% CI (1.26– 2.98)]. Conclusion: Younger age, husband education, occupation, recent HIV test, and voluntary testing were significantly associated with fertility desire. Likewise, the younger age group, voluntary testing and counseling, and those on ART for more than five years had higher odds of PMTCT knowledge. Therefore, strengthening voluntary testing and counseling strong counseling on PMTCT throughout the follow-up care and involvement partners is of paramount importance should be insured to decrease MTCT. [ABSTRACT FROM AUTHOR]

Background: In most cases, people pay more attention to the microbial quality of drinking water than the quality of water they used to wash hands. This may lead to the occurrence of various foodborne illnesses through the introduction of pathogenic microbes during preparation and serving of food. Objective: To determine the effect of microbial quality of washing water on the hand hygiene status of food handlers in Jimma town. Methods: Laboratory-based cross-sectional study design was used. A total of 150 food handlers were selected randomly for hand hygiene examination, and 150 water samples were collected aseptically from water storage tanks, food handlers used to wash their hands. The samples were subjected for microbiological analysis using standardized protocol. Descriptive statistics and Pearson correlation coefficient were used to summarize the data and to determine the effect of microbial quality of water on hand hygiene of food handlers, respectively. Results: Among 150 food handlers included in the study, 104 (69.0%) of them were males and 64 (43.0%) of them aged between 35 and 50 years. On the other hand, 64 (42.7%) of the study participants had not attended formal education. About three-fourth of them used stored water to wash their hands, and almost similar proportion of them were waiters. The mean coliform bacteria of water and hand rinsate samples were 4.2 ± 0.8 and 4.1 ± 0.8 log CFU/mL, respectively. Conclusion: The study revealed that the microbial quality of water used to wash hands significantly affects the hand hygiene status of the food handlers. Hence, improving the microbial quality of washing water is important to improve the hand hygiene status of food handlers and consequently to prevent the occurrence of food-borne illness in the town. [ABSTRACT FROM AUTHOR]

Background: Incomplete vaccination can put children at greater risk of acquiring vaccine-preventable diseases. In Ethiopia, vaccination coverage against vaccine-preventable diseases is still a significant and persistent public health challenge. Thus, the aim of this study was to identify the determinants of incomplete childhood vaccination among children aged 12– 23 months in Gindhir District, Southeast Ethiopia. Methods: A community-based unmatched case–control design was employed among children aged 12– 23 months from 1 to 28 February 2020. A total of 254 cases and 508 controls were included using the stratified random sampling technique. Cases included children aged 12– 23 months who missed at least one dose of the routine vaccination, and controls were the children with complete vaccination with all required doses. Binary logistic regression analyses were used to identify the independent factors for children's incomplete vaccination status. Results: Of all assessed determinants, maternal knowledge about vaccination (AOR=0.50, 95% CI: 0.31, 0.80), educational status (AOR=2.61, 95% CI: 1.19, 5.67), average monthly income (AOR=0.33, 95% CI: 0.15, 0.77), model family (AOR = 2.50, 95% CI: 1.51, 4.14), taking TT vaccine (AOR= 0.45 95% CI: 0.29, 0.78), number of under five children (AOR= 4.90 95% CI: 1.72, 13.93) and birth order (AOR= 6.33, 95% CI: 1.89, 14.87) were found to have statistically significant association with childhood incomplete vaccination. Conclusion: In this study, the mother's education, model family, birth order, average monthly income, and knowledge were some of the independent determinants of incomplete childhood vaccination. Improving maternal knowledge, income, and educational status should be the expectable measure to reduce incomplete vaccination. [ABSTRACT FROM AUTHOR]

Purpose: Foodborne illness is a major public health problem worldwide. The supply of safe and healthy food is crucial to prevent foodborne illness. However, evidence regarding food safety knowledge and handling practice is limited in Ethiopia. Therefore, this study aimed to assess food safety knowledge, handling practice, and its associated factors among food handlers in Debre Markos Town, North West Ethiopia. Patients and Methods: An institutional-based cross-sectional study was conducted on 408 randomly selected food handlers at Debre-Markos town. A structured questionnaire and an observational checklist were used to collect relevant data. The main outcome of interest was food safety and handling practice. Multivariable logistic regression analysis was used to identify the factors significantly associated with food safety knowledge and food handling practice. Data were analyzed using SPSS version 25. Results: In this study, only 34.1% of food handlers had good food safety knowledge and nearly 54% of food handlers had good food handling practice. Level of education (AOR = 0.23 (0.14– 0.57)), training on food safety (AOR = 5.13 (3.57– 7.82)), and favorable attitudes towards food safety (AOR=2.54 (1.52– 4.25)) were the factors associated with knowledge of food safety. Similarly, training (AOR=2.05, 95% CI=1.31– 3.19), a good level of knowledge (AOR: 1.68, 95% CI: 1.40, 3.17), and work experience (AOR = 1.24, 95% CI: 1.10– 2.81) were positively associated with good food handling practice. Conclusion: In this study, the level of food safety knowledge and handling practices were relatively low. Therefore, the concerned bodies should work on the identified factors to improve food handlers' knowledge of food safety and practice level. Continuous training for food handlers should be given. [ABSTRACT FROM AUTHOR]

Background: With an increasing number of diabetes patients in developing countries, the burden of diabetes-related blindness is undoubtedly posing a massive challenge to the sustainable health care system due to the cost of care. Despite this fact, to date, most of the epidemiological research on diabetic retinopathy (DR) in eastern Africa, including Ethiopia, has been limited to survey studies. Thus, we determined the incidence of retinopathy and its predictors among diabetic patients in Jimma University Medical Center, Southwest Ethiopia. Methods: A retrospective follow-up study was conducted on 402 randomly selected diabetic patients of aged ≥ 15 years. A preliminary reviewed checklist was used to obtain information on the demographics, clinical and physiological attributes. Data were entered using EpiData version 4.6 and analyzed using Stata version 14. All variables at P-values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable accelerated failure time (AFT) regression analyses using Weibull distribution were used to examine the predictors of DR at a 5% level of significance. Results: Throughout a median follow-up period of 5.9 years, the cumulative incidence of DR was 20.15% (95%CI: 16.50– 24.37) and the incidence rate was 36.9 per 1000 person years (PY) (95%CI: 29.7– 45.9). Multivariable Weibull AFT regression analyses showed that type two diabetes mellitus (T2DM) (adjusted time ratio (ATR) 0.4095%CI: 0.20– 0.78), hypertension (HTN) (ATR 0.54; 95%CI: [0.35, 0.82]), low high density lipoprotein cholesterol (HDL-C) (ATR 0.51; 95%CI: 0.36– 0.73), and borderline high total cholesterol (TC) (ATR 0.63; 95%CI: 0.42– 0.94) were a predictor of time to DR. Conclusion: The overall incidence of DR among patients with diabetes mellitus was estimated to be 20.15% and is becoming a public health burden in Ethiopia. Our results indicate that T2DM, HTN, low HDL-C and borderline high TC independently predicts an increased incidence/decreased survival time of retinopathy among diabetes patients. The low HDL-C, HTN, and high TC are modifiable risk factors that should be managed along with diabetes. [ABSTRACT FROM AUTHOR]

Background: Ethiopia is one of the Sub-Saharan African countries with an increasingly risky sexual practice and mostly affected by the Human Immunodeficiency Virus (HIV) epidemic. Dual protection is an important preventive approach which can prevent both unwanted pregnancy and sexually transmitted infections including HIV/AIDS. Therefore, this study aimed to assess the dual contraceptive utilization and associated factors among reproductive-age women on Anti-Retroviral Therapy (ART) in central Ethiopia. Methods: An-institution based cross-sectional study was conducted among 311 women on ART at public hospitals of West Shewa Zone from June to September 2019. A systematic random sampling technique was used to select the study participants. A pretested structured interviewer-administered questionnaire was used for data collection. The data were entered into Epi data version 3.1 and exported to IBM SPSS statistical software version 25 for analysis. Bivariate and multivariable logistic regression analysis were computed. Odds ratio along with 95% confidence interval was computed to ascertain the association. Results: The prevalence of dual contraceptive utilization among women on ART was 21.4% (95% CI: 16.8– 25.9). Age of respondents between 15 and 24 years [AOR=8.35, (95% CI: 3.12– 17.78)], living in urban [AOR=2.59, 95% CI: 1.15– 4.22], separated women [AOR=2.28, 95% CI (1.26– 5.04)], had post-diagnosis counselling on family planning [AOR=5.33, 95% CI: 1.52– 18.68], disclosed HIV status [AOR=5.98, 95% CI: 1.63– 21.93], freely discuss with their husband [AOR=4.22, 95% CI, 1.84– 12.36], have no fertility desire [AOR=2.46, (95% CI: 1.34– 6.44)] were significantly associated with dual contraceptive utilization. Conclusion and Recommendation: The overall magnitude of dual contraceptive utilization among women on ART was found to be low. Factors like age, residence, marital status, post-diagnosis counselling, disclosure of HIV status, and free discussion with husband were significantly associated with dual contraceptive method utilization. Therefore, it is necessary to expand the range of strategies and tools available to married and single women's for protecting themselves from being infected with other strains and pregnancy. The concerned stakeholders also should emphatically consider those identified factors for intervention. [ABSTRACT FROM AUTHOR]

Introduction: Proper self-care in patients with chronic illnesses, such as heart failure is allied with the prevention or early detection of health problems and improved clinical outcomes. Even though self-care among patients with heart failure is commonly poor, a low-sodium diet, regular exercise, and weight monitoring are essential to control heart failure symptoms and exacerbation. Poor adherence to these self-care practices contributes to an increase in hospitalization, morbidity, and mortality. Objective: To assess adherence to self-care practices and associated factors among outpatient adult heart failure patients attending cardiac center in Ethiopia, Addis Ababa, 2020. Methods: Institution-based cross-sectional study design was used to incorporate 396 heart failure patients who attended the cardiac center in Ethiopia, Addis Ababa. The study was conducted from March to April 2020. Study participants were selected by using a systematic sampling technique. Data were collected through face-to-face interviews and from the patients' medical records. Epi-data version 3.1 and SPSS version 26 were used for data entry and analysis, respectively. Binary logistic regression analysis was performed to identify predictors of self-care practice. Those variables with p-value < 0.25 in the bivariable regression analysis were entered into the multivariable regression analysis and the result were presented using tables, chart, and mean. Results: Of 396 respondents, 111 (28%) of patients with heart failure had overall good self-care adherence. Comorbidity (AOR: 1.62; 95% CI: 1.07– 2.624), level of knowledge (AOR: 3.58; 95% CI: 2.23– 5.79) and depression (AOR: 2.45; 95% CI: 1.048– 5.726) were factors significantly associated with adherence to self-care practice. Conclusion: Comorbidity, inadequate knowledge, and depression were predictors of self-care practice. As a result, nursing intervention programs regarding knowledge on heart failure are recommended for enhancing self-care practices. Self-care strategies shall target patients with depression and comorbidity. [ABSTRACT FROM AUTHOR]

Introduction: Food hygiene is an essential matter of public health for protecting or preventing diseases caused by unsafe food due to lack of good quality from production to consumption. Objective: The current study aimed at assessing the food hygiene practice and determinant factors among food handlers working at the University of Gondar. Methods: Univariate and multivariable binary logistic regression analyses were used to test the association of covariates with the food safety practice. Variables with p-value < 0.2 were candidates for multivariable analysis. The adjusted odds ratio with 95% confidence interval and p-values less than 0.05 were used to report associations in the final model. Results: A total of 184(46.7%) of the study subjects had good self-reported food hygiene practice. Being male [Adjusted odds ratio (AOR): 2.37, 95% confidence interval (CI) (1.34, 4.19)], educational status (primary [AOR: 2.54, 95% CI (1.16, 5.58)] and secondary [AOR: 2.20, 95% CI (1.11, 4.37)]), workers with greater than 2 years work experience [AOR: 1.86, 95% CI (1.06, 3.25)], monthly income of 2044– 4867ETB/month [AOR: 2.05, 95% CI (1.01, 4.16)] were independent predictors of food safety practice of food handlers. Conclusion and Recommendations: Below half of the study subjects had good self-reported food hygiene practice. Sex, educational status, and income were factors associated with the food hygiene practice. There should be continuous supportive supervision to raise the skills of food handlers to comply to better food hygiene practice. Food hygiene training should be given especially to female food handlers. Frequent audits are also required to ensure the permanence of effective and continuous training. Regular medical check up and strict hygiene follow-up should be encouraged to prevent foodborne disease outbreaks at universities. [ABSTRACT FROM AUTHOR]

Background: "Fertility desire" is the intention of people to have more children despite being diagnosed with HIV, whereas intentions denote a commitment to implement that desire. Despite the overwhelming effects of HIV on a fetus, there is a desire for fertility among people positive for the virus/disease worldwide.  Therefore, this study aimed to assess fertility desires and factors associated with sexually active HIV positive reproductive-age women attending ART clinics at Amhara region referral hospitals, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted on reproductive-age women attending the clinics at the hospitals. A total of 427 eligible women were systematically included in the study. A semi-structured questionnaire was used to collect data via interviewer-administered techniques. EpiInfo7 and STATA 14 software was used for data entry and analysis, respectively. The logistic regression analysis method was used to identify factors associated with fertility desire. Factors that had p-values of ≤0.05 were considered statistically significant. Results: The findings indicated that 40.3% (95% CI; 35.7%, 45.0%) of the participants reported they had the desire to have children in the future. Variables such as women in the age group of 25–34 years (AOR= 2.80, 95% CI; 1.68, 4.68), participating with their sexual partner (AOR=3.52, 95% CI; 1.36, 9.13) and married women (AOR=2.32, 95% CI; 1.05, 5.10) had a positive association with the outcome variable, whereas having one or more live children (AOR=0.19, 95% CI; 0.09, 0.39) and having no formal education (AOR= 0.51, 95% CI; 0.29, 0.89) had a negative association with fertility desire. Conclusion: The proportion of sexually active HIV-positive women with desire for children was high among women visiting referral hospitals. Therefore, programmers and policymakers need to expand new PMTCT services throughout the region and consider the effects of these factors on HIV-positive women, as they develop interventions. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess fertility intentions (planning to have more children in the future) and associated factors among pregnant and postpartum HIV positive women in rural South Africa. Methods: In a longitudinal study, as part of a prevention of mother to child transmission (PMTCT) intervention trial, 699 HIV positive prenatal women, were systematically recruited and followed up at 6 months and 12 months postpartum (retention rate = 59.5%). Results: At baseline, 32.9% of the women indicated fertility intentions and at 12 months postnatal, 120 (28.0%) reported fertility intentions. In longitudinal analyses, which included timeinvariant baseline characteristics predicting fertility intention over time, not having children, having a partner with unknown/HIV-negative status, and having disclosed their HIV status to their partner, were associated with fertility intentions. In a model with time-varying covariates, decreased family planning knowledge, talking to a provider about a future pregnancy, and increased male involvement were associated with fertility intentions. Conclusion: Results support ongoing perinatal family planning and PMTCT education. [ABSTRACT FROM AUTHOR]