Introduction: The most common and severe cause of morbidity and mortalityamong HIV- positive children is opportunistic infections (OIs). All HIV-infectedchildren are at risk of developing a variety of OIs. Healthcare workers,programmers, and other stakeholders are in doubt about using the onset andpredictors of OIs among schoolchildren on antiretroviral therapy (ART) due tothe presence of conflicting results found in the primary studies. Hence, thisstudy was conducted to provide a single figure of onset and specificpredictors of OIs by overcoming the existing heterogeneity in Ethiopia.Methods: The included studies were searched from different national andinternational databases systematically. The included studies were cohort indesign and published in English between 2015 and 2022. The data wereextracted using a validated Microsoft Excel tool after the quality of theincluded studies was assured. The extracted data were exported to StataVersion 17.0 for further management and analysis. The presence ofheterogeneity across studies was checked using the Chi-square test andquantified using the I2 test. Various methods, including forest plots,publication bias assessment, sensitivity tests, subgroup analysis, andmeta-regression, were employed to determine the source of heterogeneity,but none were successful. The overall onset of OIs was estimated by poolingthe incidence of primary studies using a random-effects meta-analysis model.The predictors were identified using meta-regression and the presence ofsignificant association was declared using a p-value of 0.05 with 95% CI. Thestrength of association was reported using an adjusted hazard ratio with 95% CI.Results: Eleven studies were included in this systematic review andmeta-analysis. The onset of OIs among schoolchildren on ART in Ethiopia was5.58 (95% CI: 4.50, 6.67) per 100 children-years of OI-free observations.Those children who had no parents had a 1.41 (95% CI: 1.10, 1.80) timeshigher chance of getting OIs when compared with those children having oneor both parents. Children who had poor ART adherence had a 2.96 (95% CI:1.66, 5.29) times higher chance of experiencing OIs than children who hadgood ART adherence. Finally, the chance of experiencing OIs amongrural children was 2.15 (95% CI: 1.63, 2.83) times higher than theircounterparts in Ethiopia.
Conclusions: Three in every 33 schoolchildren on ART developed OIs in Ethiopia.Predictors of OIs included schoolchildren without parents, those with pooradherence to ART, and rural residents. This suggests that social support,medication adherence, and access to healthcare services may play importantroles in preventing and controlling OIs among schoolchildren living with HIV inrural areas.KEYWORDS: schoolchildren, opportunistic infections, onset and predictors, children on ART, Ethiopia

BackgroundAdverse drug reaction is one of the emerging challenges in antiretroviral treatment. Deter-mining the incidence rate and predictors among children on antiretroviral treatment (ART) isessential to improve treatment outcomes and minimize harm. And also, evidence regardingthe time to major adverse drug reactions and its predictors among children on antiretroviraltreatment is limited in Ethiopia.ObjectiveThis study aimed to assess the time to major adverse drug reaction and its predictorsamong children on antiretroviral treatment at selected public hospitals in Northwest Amhara,Ethiopia, 2023.MethodA retrospective cohort study was conducted among 380 children on antiretroviral treatmentwho enrolled from June 27, 2017, to May 31, 2022. Data was collected using a structureddata extraction checklist. Data were entered into Epidata 4.6 and analyzed using STATA14. The incidence rate of major adverse drug reactions was determined per person/months.The Cox proportional hazards regression model was used to identify predictors of majoradverse drug responses. A p-value less than 0.05 with a 95% CI was used to declare statisti-cal significance.
ResultThe minimum and maximum follow-up time was 6 and 59 months, respectively. The studyparticipants were followed for a total of 9916 person-months. The incidence rate of majoradverse drug reactions was 3.5 /1000 person–months. Advanced clinical stages of HIV/AIDS (III and IV) [adjusted hazard ratio = 7.3, 95% CI: 2.74–19.60)], poor treatment adher-ence [adjusted hazard ratio = 0.33, 95% CI: 0.21–0.42], taking antiretroviral treatment twiceand more [adjusted hazard ratio = 3.43, 955 CI: (1.26–9.33)] and not taking opportunisticinfection prophylaxis [adjusted hazard ratio = 0.35, 95% CI: 0.23–0.52)] were predictors ofmajor adverse drug reactions.ConclusionThe incidence rate of major adverse drug reactions among children on antiretroviral treat-ment was congruent with studies in Ethiopia. Advanced clinical stages of HIV/AIDS, poortreatment adherence, taking antiretroviral treatment medications twice or more, and not tak-ing opportunistic infection prophylaxis were predictors of major adverse drug reactions.

Background Inadequate glycemic management in type 2 diabetes Mellitus patients is a serious public healthissue and a key risk factor for progression as well as diabetes-related complications. The main therapeutic goal ofpreventing organ damage and other problems caused by diabetes is glycemic control. Knowing when to modifyglycemic control in type 2 diabetes Mellitus is crucial for avoiding complications and early drug intensifications.Methods An institutional based retrospective follow-up study was undertaken among 514 eligible adult diabetespatients in Amhara region Comprehensive Specialized Hospitals, Northwest Ethiopia, from January 2017 to January2022. Simple random sampling technique was used to select study participants. The Kaplan Meier curve was usedto assess the survival status of categorical variables, and the log-rank test was used to compare them. The coxproportional hazard model was fitted to identify the predictors of time to first optimal glycemic control. Variables witha p-value < 0.05 were considered to be statistically significance at 95% confidence interval.Results A total of 514 patient records (227 males and 287 females) were reviewed in this study. The median time tofirst optimal glycemic control among the study population was 8.4 months IQR (7.6–9.7). The predictors that affect thetime to first optimal glycemic control were age group ((AHR = 0.63, 95% CI = 0.463, 0.859 for 50–59 years), (AHR = 0.638,95% CI = 0.471, 0.865 for 60–69 years), and (AHR = 0.480, 95% CI = 0.298, 0.774 for > = 70 years)), diabetes neuropathy(AHR = 0.629, 95% CI = 0.441,0.900), hypertension (AHR = 0.667, 95% CI = 0.524, 0.848), dyslipidemia (AHR = 0.561, 95%CI = 0.410, 0.768), and cardiovascular disease (AHR = 0.681, 95% CI = 0.494, 0.938).Conclusion The median time to initial optimal glycemic control in type 2 diabetes Mellitus patients in this study wasshort. Age between 50 and 59 years and 60–69, diabetes neuropathy, hypertension, dyslipidemia, and cardiovascular
disease were predictor’s of time to first glycemic control. Therefore, health care providers should pay extra attentionfor patients who are aged and who have complications or co-morbidities.Keywords: Adults, First optimal glycemic control, Type 2 diabetes mellitus, Ethiopia