Endalkachew Mekonnen Eticha* and Workineh Diriba Gemechu
Background: Cases of COVID-19 have been increasing in number and spread globally. Pharmacists are an important part of the health care system and their role is critical in completing the management cycles of Coronavirus outbreak surveillance.
Methods: A multi-centric cross-sectional study was conducted on 84 pharmacy professionals recruited from both community and hospital pharmacies in Jigjiga City to assess the knowledge, attitude and practice towards COVID-19. Self-administered questionnaires were developed and distributed to the participants. All extracted data were cleaned, coded and entered into the Statistical Package for the Social Science software version 20 and subsequently analyzed. Binary logistic regression analysis was used to identify determinants of knowledge, attitude and practice towards COVID-19.
Results: All of the respondents had already heard about COVID-19. More than 90% of the participants had adequate knowledge regarding typical symptoms, etiological causes, modes of transmission, measures to protect the infection, risky patients and primarily affected organ system by COVID-19. The majority of the respondents (71.4%) had adequate knowledge regarding COVID-19. The finding indicated that pharmacists had 8 times higher odds (AOR=8.34 95% CI (1.33-36.04)) of adequate knowledge than the pharmacy technicians. Greater than half of the study participants (53.6%) had a positive attitude towards COVID-19. More than 4 out of 5 participants were confident that Ethiopia can win the battle against the pandemic. Participants with less than five years of experience had 6 times greater odds (AOR=6.16; 95% CI (1.52-24.86)) of a positive attitude than their comparator. A low number of participants (16, 22.6%) exercised adequate practice to prevent and control the novel coronavirus spread.
Conclusion: The community and hospital pharmacists had good knowledge but had a poor attitude and practice towards the COVID-19. The majority of the participants perceived that they can play a great role in this pandemic.
Vian Namanya*, Dickens Owamaani and Edmund Byamukama
DOI: DOI: 10.37421/2155-6113.2022.13.891
HIV remains a global human threat with about 39 million people infected and it has claimed the lives of over 25 million over the last 25 years. Over 80% of these are in sub-Saharan Africa. As of 2019, Uganda had an estimated population of 41.5 million, of whom 1,915,533 live with HIV/AIDS with HIV incidence among susceptible individuals at 1.4%, the ultimate highest. About 53000 people were infected with HIV in 2018 whereas 23000 died of the illness in Uganda in 2018. In Uganda, 84% of the people living with HIV knew their status, 72% were on ART and 64% were virally suppressed. Among adults (15-64 years, the most sexually active), the prevalence is 6.2%. In western Uganda, the prevalence stands at 7.9% slightly below western Nile with the highest at 8%.
Vian Namanya* and Kalema Bashir Amza
DOI: DOI: 10.37421/2155-6113.2022.13.892
Introduction: Worldwide the efficacy and safety of Azithromycin and 4-Aminoquinoline regimen in the treatment of COVID-19 has remained uncertain in both pregnant and other mothers. Pregnancy complications studies are still lacking, although a high preterm birth rate due to the combination of this regimen has been reported which is mostly caused by iatrogenic preterm birth owing to the diagnosis of COVID-19 principally preterm cesarean deliveries and perinatal transmission may occur but seems rare. There is lack of evidence reporting an increase in the incidence of congenital abnormalities, an increase in stillbirth or neonatal death (miscarriages), Fetal Growth Restriction (FGR) among pregnant mothers with COVID-19.
Aim: This study aimed at systematically reviewing studies regarding the use of Azithromycin and 4-Aminoquinoline based regimens in COVID-19 positive pregnant mothers.
Methods: This was asystematic literature review. A systemic search of articles was done on PubMed, TRIP, EPPI COVID Living Map, Web of Science, and medRxiv databases until 2020 using the keywords “COVID-19”, “SARS-CoV-2”, “coronavirus”, “hydroxychloroquine”, and “mortality”. Relevant articles were chosen for further evaluation based on a review of their titles and abstracts. In vivo and in vitro studies were included assessing the safety and effectiveness of Azithromycin and 4-aminoquinline for treatment of COVID-19 pregnant mothers.
Results: A total of 438 articles were screened and 12 eligible clinical studies (seven peer-reviewed and published studies and five non-peer-reviewed studies from pre-print servers were included) selected. A number of studies have established very good virological and clinical outcomes with 4-Aminoquinoline in particular HCQ therapy alone or in combination with Azithromycin among COVID-19 pregnant mothers. However, some studies have shown negative results with combination of HCQ treatment and Azithromycin among COVID-19 pregnant mothers.
Conclusion: In this systematic review, we have found that the results of effectiveness and safety of Azithromycin and 4-aminoquinoline combination in COVID-19 pregnant mothers as obtained from 12 eligible clinical studies, is not satisfactory, although many of these studies had major methodological limitations. Stronger evidence from well-designed robust randomized clinical trials is required before conclusively determining the role of Azithromycin and 4-aminoquinoline combination regimen in the treatment of COVID-19. Clinical prudence is required to advocate of Azithromycin and 4-aminoquinoline combination regimen as an unmitigated therapeutic armamentarium in pregnant mothers with COVID-19. Also, the potential of HCQ as a chemo-prophylactic agent against COVID-19 needs to be explored.
Vian Namanya* and Ubaldo Sobimana
DOI: DOI: 10.37421/2155-6113.2022.13.872
Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality Worldwide. The risk of maternal death is much more common in developing countries than developed countries. Therefore it is necessary to recognize the signs and symptoms to predict the disease before it threatens the survival of both mother and fetus since it complicates about 3% of all pregnancies. Health workers like midwives, clinicians and doctors are the primary care givers in treating, understanding and explaining preeclampsia, its diagnosis, risk factors and complications as delay in diagnosis and prompt initiation of treatment could result in disastrous consequences for both the mother and the baby. The risk of maternal death is very high in lower health centers where there no enough trained doctors and other HWs. There is also inadequate supply of drugs used in management of preeclampsia. The study seeks to ascertain whether there are gaps in knowledge and practices by health workers in Bushenyi district contributing to the nationally high mortality rate in rural areas due to pre-eclampsia.36 health workers handling preeclampsia mothers in Bushenyi district were randomly selected and administered a questionnaire to assess their skills and knowledge. Study found that most health workers knew about preeclampsia, its risks but 46% knew less about HELLP syndrome. This study also finds that 52% of the health workers could not adequately prescribe magnesium sulphate and 46% could not signs of magnesium toxicity.
The researchers recommend more refresher course for health workers in Bushenyi and Uganda at large as well as emphasizing use of preeclampsia phone applications and strengthening hands on training for students in health training institutions.
Vian Namanya and Isaac Mugume*
DOI: 10.37421/2155-6113.2022.13.889
Gaspard Tekpa, Sylvain Honore Woromogo*, Eudes Gbangba Ngai, Valentin Fikouma, Larissa Eleonor Kpengougna, Prince Wilikoe and Boniface Koffi
DOI: DOI: 10.37421/2155-6113.2022.13.906
Background: Haematological manifestations during HIV infection in Bangui are common and poorly documented. The objective of our study was to evaluate the frequency of anaemia before and during antiretroviral treatment in people living with HIV (PLHIV) and to identify associated factors.
Methods: This was a retrospective analytical study covering the period from 1 January 2012 to 31 December 2016. PLHIV who were naive or had been treated with ARVs for more than six months and whose medical records included a blood count and a CD4 T-cell count were included. Sociodemographic and clinicobiological characteristics were collected using an anonymous questionnaire. The prevalence of anaemia was measured before and at the sixth month of antiretroviral treatment. Multiple logistic regressions were used to identify associated factors.
Results: We included 532 patients of whom 149 were men (28%). The average age was 37.5 ± 9.4 years. The patients were seen in stages 3 and 4 of the WHO classification of HIV infection in 70.81% of cases. The mean CD4 T cell count increased from 201 ± 175/mm3 before antiretroviral therapy (ART) to 361 ± 182/mm3 after six months of ART. Risk factors for anaemia in PLHIV before ART were CD4 200/mm3 (p=0.0391) and thrombocytosis (p=0.0083); on ART, anaemia was associated with cotrimoxazole use (p=0.0285) and thrombocytosis (p=0.0212).
Conclusion: Anemia in PLWH is common and has multiple risk factors, some of which are preventable, such as late treatment and tuberculosis. Better knowledge of risk factors, early detection and management could help reduce anaemia-related morbidity and mortality.
DOI: DOI: 10.37421/2155-6113.2022.13.907
Background: Knowledge about HIV and AIDS is important in promoting safer sexual behaviour. Given that there is no vaccine or cure for HIV and AIDS, knowledge about HIV and AIDS is an important enabler in the prevention efforts. The aim of the study is to investigate HIV and AIDS knowledge and predictors among students at Nelson Mandela University in South Africa.
Methods: The study was conducted using cross-sectional and quantitative research methodology among students at Nelson Mandela University. Stratified sampling was employed to select 884 undergraduate students. A self-administered questionnaire was used to collect data analysed using SPSS version 26. A bivariate and multivariable binary logistic regression model was employed to identify predictors of HIV and AIDS knowledge. The p-value <0.05 and odds ratio with 95% confidence interval were used to determine statistical significance of the findings.
Results: Findings show that 52.5% of the students had good knowledge about HIV and AIDS. Having a monthly stipend >2000 rand from parents/relatives (AOR=2.71 (1.35–5.49)), being in the third year level of study and higher up (AOR=5.35 (2.93–9.77)), and being in the health science faculty (AOR=16.29 (8.22–32.29)) were significant predictors of good level of HIV and AIDS knowledge.
Conclusion: Almost half of the students reported poor knowledge about HIV and AIDS. There were misconceptions about HIV transmission routes among students. Monthly income, level of the study, and faculty of study were reported to be significant predictors of HIV and AIDS knowledge. This study calls for the need to provide students with more HIV and AIDS education to address HIV and AIDS knowledge gaps and promote behavioural change.
DOI: 10.37421/2155-6113.2023.14.928
Background: The rate of prevalence of HIV among adults has been increasing in Sub-Saharan African countries over the last decade. The objective of this study was to identify the joint predictors of cART adherence and disclosure of HIV status among HIV infected adults at Felege Hiwot teaching and specialized hospital, North-West Ethiopia.
Methodology: A retrospective cohort of longitudinal data was conducted on 792 randomly selected patients in the study area. A joint model was used to identify predictor variables. The two response variables under the current investigation were cART adherence and disclosure of HIV status. Binary logistic regression was conducted for separate models.
Results: Among the predictors, the age of patients (AOR=1.020, 95% CI: (1.016,1.191); p-value=0.005), the number of follow-ups (AOR=1.014, 95% CI: (1.023, 1.030); p-value<0.0001). CD4 cell count (AOR=0.981; 95% CI: (0.765, 0.971), p-value<0.01), marital status (AOR=1.013; 95% CI: (1.002, 1.015), p-value=0.006), female patients (AOR=1.014; 95% CI; (1.001, 1.121), p-value<0.007), rural (AOR=0.982; 95% CI; (0.665, 0.998), p-value=0.004), non-educated adult patients (AOR=0.950, 95% CI; (0.92. 0.98). p-value=0.003), non-existence of social violence (AOR=1.012, 95% CI: (1.008, 1.234), p-value<0.01), an adult with non-opportunistic diseases (AOR=1.021, 95% CI; (1.002, 1.042). p-value=0.001) significantly affected the two response variables jointly.
Conclusion: Several variables that affected both disclosures of HIV status and adherence to cART had been identified in the current investigation. Due attention should be given to younger patients, rural residents, and non-educated patients to disclose the disease status and to have a long life with the virus.
Awoke Seyoum Tegegne* and Awoke Fetahi
DOI: 10.37421/2168-6113.2023.14.929
Background: Hepatitis B is the most common liver infection in the world which is caused by the Hepatitis B Virus (HBV). The virus can attack and injure the liver. The infection of hepatitis B virus leads to chronic viral hepatitis infections in hundreds of millions of people in worldwide. The objective of current study was to identify factors that affect the progression rate of hepatitis B virus in patients’ liver who were treated at Felege-Hiwot teaching and specialized hospital, during treatment period.
Methods: The data for this study was obtained from hepatitis B patients chart registered for treatment during January 2013 to December 2016 at chronic hepatitis B patients’ clinic at Felege-Hiwot teaching and specialized hospital, Bahir Dar, Ethiopia. A retrospective study design was conducted in current investigation. The estimation of the model parameters was done by Restricted Maximum Likelihood (REML) procedures.
Results: From the linear mixed effect model, main effects like visiting time (p-value<0.001), sex (p-value=0.0332), age (p-value<0.001), vaccination history (p-value=0.0141), marital status (p-value=0.0032), alanine aminotransferase (p-value=0.0057), genotype, A (p-value=0.0154), genotype, B (p-value=0.0183), genotype, C (p-value=0.0143) and albumin (p-value=0.0329) significantly affected the variable of interest. Similarly, interaction effects of time with marital status (p-value=0.0042) played statistically significance role on the progression rate of hepatitis B virus in the liver of patients.
Conclusion: A certain groups which are at maximum risk and needs intervention have been identified. Highly concrete evidences have been increased from time to time for certain population with chronic HBV infection being at great risk for progression of liver disease. Hepatitis B virus infected patients at the study area should have information about factors that can affect the progression rate of HBV. Ministry of health or health staff should aware the community to take vaccination that helps to protect individuals from hepatitis B virus.
Gebru Gebremeskel Gebrerufael* and Zeytu Gashaw Asfaw
DOI: 10.37421/2155-6113.2024.15.968
Background of the study: The Acquired Immune Deficiency Syndrome (AIDS), which has caused the world's worst heartbreak and danger, is caused by the Human Immunodeficiency Virus (HIV), which is a virus. The purpose of this inquiry was to pinpoint the key joint predictor factors and their relationships, two of which were the progression of CD4 cells and the time to death for HIV/AIDS patients starting ART at Mekelle General Hospital (MGH) in Northern Ethiopia.
Methods: A longitudinal retrospective cohort follow-up study involving 216 HIV positive individuals was used to look into the progression of CD4 cells and the time to mortality in these patients. The primary joint predictor variables and their association with time-to-mortality for HIV/AIDS patients who started ART were found using a joint model analysis approach. In the general hospital's records, 216 HIV positive patients were selected systematically at random. The JM package and R 3.6.1 version procedure were used to examine the secondary data.
Results: The findings showed that there was a statistically significant negative relationship between the two response variables, CD4 cell count progression and time to mortality (α=-9.4; and p<0.0001*). Being co-infected with (β=-0.125; and p<0.001*), as well as the follow-up visit duration (β=-0.005 and p<0.001*), had a statistically significant impact on the likelihood that the CD4 cells count would increase. Additionally, patients who were WHO stage-III or IV (AHR=1.7; and p<0.0384*), or co-infected with TB (AHR=3.63; and p<0.002*) had statistically been linked to a higher risk of mortality.
Conclusion: In order to simultaneously study the important effects of predictor factors on the change in CD4 cell count progression and the risk of patient mortality, the authors used that statistical joint model, which provides a flexible framework. The association parameter change of CD4 cell progression on the chances of mortality events was also evaluated by this combined model analysis.
Ibrahim S. Abd-Elazem, Kiattisak Lugsanangarm, Nadtanet Nunthaboot and Ru Chih C. Huang*
DOI: 10.37421/2155-6113.2024.15.1031
Background: Drug resistance associated with HIV-1 variants emerges due to undetected treatment failures. Therefore, it is urgent to search for an antiretroviral therapy to control HIV replication. We examined the synergistic inhibition of HIV-1 replication by a combination of potential inhibitors against clinical isolates and drug-resistant strains.
Methods: Nontoxic, natural product-derived inhibitors, the viral entry inhibitor (Gen-1 (tieghemelin, a triterpenoid saponin)), the integrase inhibitor (M522 (lithospermic acid)), and the transcription inhibitors (G4N (tetraglycylated NDGA) or M4N (tetra-O-methyl-NDGA, terameprocol)) were used to target viral entry, integration, and transcription steps. They have been tested against the replication of an AZT-resistant strain of HIV-1 and clinical isolates from HIV-infected patients, where they were examined alone and, in their combinations, to inhibit HIV replication in human H9 cells and PBMCs. The binding conformations and important interactions of all these inhibitors have been evaluated by molecular docking studies.
Results: The IC50 values for Gen-1, M522, and G4N were 20.0 μM, 2.2 μM, and 14.0 μM, respectively, when tested individually, while in combination, it was 1.2 μM when tested in HIV-1RTMF (AZT-resistant strain) infected PBMCs, whereas 65.0 μM, 18.0 μM, and 27.0 μM individually and in combination, it was 3.0 μM when tested against the clinical isolate. The effectiveness of the three inhibitors in combination was evaluated using the calculation of the combination index, where strong synergy was observed for the three inhibitors across all effect levels. Molecular docking calculations revealed that all inhibitors can bind and form chemical interactions via H-bond, π…π interaction, and hydrophobic interaction with the corresponding target.
Conclusion: We concluded that the targeted three-drug combination effectively blocked three steps of the life cycle of HIV-1 and prevented viral entry, integration, and transcription processes of the virus with high efficacy, which exhibited potent synergistic drug activities without any toxicity.
Jun Tao1*, Hannah Parent2, Harrison Martin2, Jhanavi Kapadia3, Amy Nunn4, Leandro Mena5, Brandon D. L. Marshall6, Henry Raymond7, Nancy Barnett3 and Philip A. Chan
HIV continues to be a significant health challenge in the United States, disproportionately affecting Black/African American (B/AA) and Hispanic/ Latino (H/L) Men who have Sex with Men (MSM). Pre-Exposure Prophylaxis (PrEP) is an effective HIV prevention pharmaceutical strategy, but its uptake among these populations has been suboptimal. Peer-Driven Interventions (PDIs) have demonstrated promise in increasing HIV prevention engagement, including PrEP services. This paper shares insights from a study aimed at promoting PrEP uptake among MSM using a PDI approach. The study recruited 39 peer educators through clinical outreach, LGBTQ+ community organizations and local nightlife venues, email outreach and collaboration with Community Health Workers (CHWs). Despite moderate success in peer educator recruitment, challenges arose in motivating peer educators to refer social network members for PrEP counseling sessions with our study team. Factors such as low referral incentives, time constraints, and lack of consistent engagement were identified as barriers. To address these challenges, future PDIs may benefit from integrating Artificial Intelligence (AI)-based tools to extend outreach and support both peer educators and their social networks. Additionally, hiring part-time peer educators and providing them with more in-depth training could improve recruitment and retention. The authors also emphasize the importance of a comprehensive approach to promoting PrEP uptake, combining peer support with professional services and care to improve PrEP outcomes, such as long-term adherence. These findings highlight the need for innovative solutions to optimize HIV prevention efforts in disproportionately affected populations.
Journal of AIDS & Clinical Research received 5264 citations as per Google Scholar report
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