Review Article
Viral Load Suppression After Adherence Counselling and Its Predictors Among HIV Patients on Art At Selected Public Health Centers in Addis Ababa
Wakgari Dhinsa Hora,
Tefera Tezera*,
Gurmessa Bayecha Eticha,
Getu Kusa,
Zelalem Negash
Issue:
Volume 6, Issue 1, March 2025
Pages:
1-15
Received:
5 September 2024
Accepted:
16 January 2025
Published:
31 March 2025
Abstract: Background: For unsuppressed viral load count, World Health Organization (WHO) currently encourages enhanced adherence counseling (EAC) for human immunodeficiency virus (HIV) seropositive people on antiretroviral therapy (ART) before switching the treatment to the second-line regimen. This study aimed to assess viral load suppression after EAC and its predictors among clients on ART. Methods: Institutional-based retrospective cohort study design was used to assess viral load suppression after EAC and its predictors among 175 high viral load and 175 virally suppressed HIV seropositive clients in selected public health centers at Lideta sub-city from November 2019 to December 2022. The magnitude of viral load suppression was determined by proportion. For comparing the probability of viral load suppression Kaplan–Meier curve was used. Cox-regression was used to identify predictors of viral resuppression after EAC. Result: The overall viral load suppression after EAC was 76.2% while viral load suppression among exposed and unexposed group were 72.6% and 80% respectively. The median time to complete the EAC of exposed group was 3 months. In this study, participants who were on ART for more than 12 months had more probability of viral load suppression (13-35 months AHR=6.586, 95% CI: 3.307-13.117, 36-59 months AHR=6.826, 95% CI: 4.316-10.796, ≥60 months AHR=6.596, 95% CI: 4.485-9.700) when compared with ART experience ≤ 12 months. Participants who had not disclosed their serostatus, had history of ART drug discontinuation, were free of opportunistic infection and daily laborer had more viral load suppression, too. Conclusion: This study showed that viral suppression after enhanced adherence counseling was greater than the WHO’s finding (70%) but still below United Nations’ 90-90-90 target. The study findings showed gaps in dalliance of completing recommended time of EAC with repeat viral load testing and needs another assessment with issue of groups’ comparison.
Abstract: Background: For unsuppressed viral load count, World Health Organization (WHO) currently encourages enhanced adherence counseling (EAC) for human immunodeficiency virus (HIV) seropositive people on antiretroviral therapy (ART) before switching the treatment to the second-line regimen. This study aimed to assess viral load suppression after EAC and ...
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Research Article
Virulent and Multidrug-Resistant STEC Non-O157:H7 in Raw Milk in Khyber Pakhtunkhwa Pakistan: The Need for Proper Quality Surveillance and Assurance Plans
Safir Ullah*
,
Sana Ullah,
Muhammad Jamil Khan
Issue:
Volume 6, Issue 1, March 2025
Pages:
16-18
Received:
27 March 2025
Accepted:
16 April 2025
Published:
9 May 2025
DOI:
10.11648/j.ajnhs.20250601.12
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Abstract: Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due to its susceptibility to contamination at various stages of production, handling, and distribution. These strains of E. coli are highly virulent, and their ability to produce Shiga toxins makes them particularly unsafe. Infections caused by STEC can result in severe foodborne illnesses, such as hemolytic uremic syndrome (HUS), which primarily affects young children and the elderly. A key concern adjoining STEC is their increasing resistance to multiple antibiotics. Multidrug resistance complicates the treatment process, and increasing the possibility of complications. Moreover, these pathogens often go undetected due to inadequate testing facilities and limited public awareness, especially in rural and semi-urban areas. Given these risks, there is an urgent need to implement effective quality surveillance and assurance strategies in the dairy sector. Regular monitoring and microbial testing of milk at both the farm and market levels are essential to detect contamination early. In addition, promoting better hygiene practices among dairy workers and ensuring the cleanliness of equipment can significantly reduce the risk of contamination. Pasteurization of milk should be strongly encouraged to reduce pathogenic microorganisms before consumption. In addition, antibiotic stewardship must be emphasized in dairy farming to prevent the misuse of antibiotics, which contributes to the rise of resistant bacterial strains. By adopting these preventative measures and strengthening regulatory oversight, the health risks associated with STEC in raw milk can be significantly reduced, ultimately safeguarding public health in the region.
Abstract: Shiga toxin-producing Escherichia coli (STEC), particularly the non-O157:H7 strains, present a major and growing public health threat in Khyber Pakhtunkhwa, Pakistan. This region, like many others in the country, has a high rate of raw milk consumption, which is often unpasteurized. Raw milk serves as a potential vehicle for STEC transmission due t...
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