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  1. Article: Predictors of Anemia Among HIV-Infected Children on Antiretroviral Therapy in Wolaita Zone, South Ethiopia: A Facility-Based Cross-Sectional Study.

    Geleta, Mesay Lema / Solomon, Fithamlak Bisetegn / Tufa, Efrata Girma / Sadamo, Fekadu Elias / Dake, Samson Kastro

    HIV/AIDS (Auckland, N.Z.)

    2021  Volume 13, Page(s) 13–19

    Abstract: Purpose: Anemia is a global public health problem, and the majority of human immunodeficiency virus (HIV)-positive people become anemic at some point in the course of the disease. We lack adequate evidence on the magnitude of anemia among children on ... ...

    Abstract Purpose: Anemia is a global public health problem, and the majority of human immunodeficiency virus (HIV)-positive people become anemic at some point in the course of the disease. We lack adequate evidence on the magnitude of anemia among children on highly active antiretroviral therapy in Ethiopia and particularly in South Ethiopia. Thus, this study aimed at determining the proportion and associated factors of anemia among children on highly active antiretroviral therapy in Wolaita zone, South Ethiopia.
    Patients and methods: A facility-based cross-sectional study was conducted from November to December 2018 on 256 children from 6 months to 14 years of age who were on antiretroviral therapy. Data were collected through an interview with caregivers and review of medical records. CD4+ cell count was analyzed using FACS Calibur, and hemoglobin level was measured with a Hem cue 301 analyzer. Stool samples were examined for the presence of intestinal parasites by direct wet mount technique. Data analyzed with Stata version 14.0 were conveyed in mean and standard deviation of the mean, median and inter-quartile range. Multivariate analysis was carried out to identify independent predictors of the outcome variable. Adjusted odds ratio with 95% confidence interval was reported.
    Results: The proportion of anemia was found to be 38.8%. Co-trimoxazole prophylaxis (AOR=0.45; 95% CI: 0.21, 0.95), caregivers not receiving nutritional counseling (AOR=0.90; 95% CI: 0.01, 0.98) and presence of intestinal parasites (AOR=3.10; 95% CI: 1.39, 6.88) were associated with anemia.
    Conclusion: The proportion of anemia found in this study is a moderate public health problem. Health education programs in antiretroviral therapy clinics should be targeted at appropriate dietary practice, and appropriate hand washing and other hygienic practices to prevent intestinal parasitic infections. Co-trimoxazole prophylaxis should be given to all eligible children based on the recommendation.
    Language English
    Publishing date 2021-01-08
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2520734-9
    ISSN 1179-1373
    ISSN 1179-1373
    DOI 10.2147/HIV.S282845
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Landscape analysis of nutrition services at Primary Health Care Units (PHCUs) in four districts of Ethiopia.

    Fenta, Esete Habtemariam / Endris, Bilal Shikur / Mengistu, Yalemwork Getenet / Sadamo, Fekadu Elias / Gelan, Endashaw Hailu / Beyene, Tsegaye Gebrezgher / Gebreyesus, Seifu Hagos

    PloS one

    2020  Volume 15, Issue 12, Page(s) e0243240

    Abstract: Background: Good nutrition and healthy growth during the first 1000days have lasting benefit throughout life. For this, equally important is the structural readiness of health facilities. However, structural readiness and nutrition services provision ... ...

    Abstract Background: Good nutrition and healthy growth during the first 1000days have lasting benefit throughout life. For this, equally important is the structural readiness of health facilities. However, structural readiness and nutrition services provision during the first 1000 days in Ethiopia is not well understood. The present study was part of a broader implementation research aimed at developing model nutrition districts by implementing evidence based, high impact and cost-effective package of nutrition interventions through the continuum of care. This study was aimed at assessing structural readiness of health facilities and the extent of nutrition service provision in the implementation districts.
    Methods: This assessment was conducted in four districts of Ethiopia. We used mixed method; a quantitative study followed by qualitative exploration. The quantitative part of the study addressed two-dimensions, structural readiness and process of nutrition service delivery. The first dimension assessed attributes of context in which care is delivered by observing availability of essential logistics. The second dimension assessed the service provision through direct observation of care at different units of health facilities. For these dimensions, we conducted a total of 380 observations in 23 health centers and 33 health posts. The observations were conducted at the Integrated Management of Neonatal and Childhood Illnesses unit, immunization unit, Antenatal care unit and Postnatal care unit. The qualitative part included a total of 60 key informant interviews with key stakeholders and service providers.
    Result: We assessed structural readiness of 56 health facilities. Both quantitative and qualitative findings revealed poor structural readiness and gap in nutrition services provision. Health facilities lack essential logistics which was found to be more prominent at health posts compared to health centers. The process evaluation showed a critical missed opportunity for anthropometric assessment and preventive nutrition counselling at different contact points. This was particularly prominent at immunization unit (where only 16.4% of children had their weight measured and only 16.2% of mothers with children under six month of age were counselled about exclusive breastfeeding). Although 90.4% of pregnant women who came for antenatal care were prescribed iron and folic acid supplementation, only 57.7% were counselled about the benefit and 42.4% were counselled about the side effect. The qualitative findings showed major service provision bottlenecks including non-functionality of the existing district nutrition coordination body and technical committees, training gaps, staff shortage, high staff turnover resulting in work related burden, fatigue and poor motivation among service providers.
    Conclusion: We found a considerable poor structural readiness and gaps in delivering integrated nutrition services with a significant missed opportunity in nutrition screening and counselling. Ensuring availability of logistics and improving access to training might improve delivery of nutrition services. In addition, ensuring adequate human resource might reduce missed opportunity and enable providers to provide a thorough preventive counselling service.
    MeSH term(s) Adult ; Counseling ; Ethiopia/epidemiology ; Female ; Health Facilities/trends ; Health Facility Environment/organization & administration ; Health Services Accessibility/organization & administration ; Humans ; Male ; Mothers ; Nutrition Policy/trends ; Nutritional Status/physiology ; Pregnancy ; Pregnant Women ; Prenatal Care/methods ; Preventive Health Services/methods ; Primary Health Care/organization & administration ; Quality of Health Care ; Social Determinants of Health
    Language English
    Publishing date 2020-12-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0243240
    Database MEDical Literature Analysis and Retrieval System OnLINE

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