G. Odaibo, O. Babalola, O. Akpa, Fasola Fa, A. Odetunde, B. Brown, Nanfisat A. Alamukii, C. Babalola, A. Falusi
Aim: This study was designed to determine the prevalence of HBV, HCV and HIV infections among individuals with Sickle Cell Disease (SCD) in Ibadan, southwestern Nigeria. Methodology: In this case-control study, 1017 patients with SCD and 1017 age and gender matched controls were enrolled from 6 health facilities and some communities in Ibadan, southwestern Nigeria. Blood samples were tested for the presence of HIV, HBV and HCV infections. Structured questionnaire was used to capture participants’ information and data analyzed using descriptive statistics, McNemar Chi-square/Fishers exact test. Results: Blood transfusion was significantly more common among SCD cases [566 (55.7%)] than controls [54 (5.3%)], while history of vaccination was higher in the control group (p = 0.001). The overall prevalence of HIV [2 (0.2%) vs 11 (1.1%)], HBV [58 (5.7) vs 66 (6.5%)] and HCV [10 (1.0) vs 22 (2.2%)] was lower among SCD cases than controls, respectively, although significantly different only in HCV infection (p = 0.048). All three infections were significantly higher in adults than in children. Co-infection was found only in four of the participants, all of whom were SCD patients. Conclusion: The prevalence of HIV, HBV and HCV infection among SCD patients indicates an improvement in the transfusion safety measures in the region. The prevalence of HBV and HCV found in this study is still relatively high when compared with reports from some other regions. There is a need for continued surveillance and subsidized cost of drugs for treatment of these infections, especially for SCD patients who already have a compromised immunity.
目的：本研究旨在确定尼日利亚西南部伊巴丹镰状细胞病（SCD）患者中HBV、HCV和HIV感染的流行率。方法：在这项病例对照研究中，1017名SCD患者和1017名年龄和性别匹配的对照者来自尼日利亚西南部伊巴丹的6个卫生机构和一些社区。血液样本检测是否存在HIV、HBV和HCV感染。结构化问卷用于获取参与者的信息和数据，并使用描述性统计、McNemar Chi square/Fishers精确检验进行分析。结果：SCD患者中输血的发生率[566（55.7%）]明显高于对照组[54（5.3%）]，而对照组的疫苗接种史更高（p=0.001）。SCD患者的HIV总患病率[2（0.2%）vs 11（1.1%）]、HBV总患病率[58（5.7）vs 66（6.5%）]和HCV总患病率[10（1.0）vs 22（2.2%）]分别低于对照组，尽管仅在HCV感染中有显著差异（p=0.048）。所有三种感染在成人中均显著高于儿童。只有四名参与者同时感染，他们都是SCD患者。结论：SCD患者中HIV、HBV和HCV的感染率表明该地区输血安全措施有所改善。与其他地区的报告相比，本研究中发现的HBV和HCV的患病率仍然相对较高。需要继续监测和补贴治疗这些感染的药物费用，特别是对于已经免疫力受损的SCD患者。
{"title":"Prevalence of HIV, HBV and HCV Infections among Sickle Cell Disease Patients in Southwestern Nigeria: A Case-Control Study","authors":"G. Odaibo, O. Babalola, O. Akpa, Fasola Fa, A. Odetunde, B. Brown, Nanfisat A. Alamukii, C. Babalola, A. Falusi","doi":"10.4236/wja.2021.113009","DOIUrl":"https://doi.org/10.4236/wja.2021.113009","url":null,"abstract":"Aim: This study was designed to determine the prevalence of HBV, HCV and HIV infections among individuals with Sickle Cell Disease (SCD) in Ibadan, southwestern Nigeria. Methodology: In this case-control study, 1017 patients with SCD and 1017 age and gender matched controls were enrolled from 6 health facilities and some communities in Ibadan, southwestern Nigeria. Blood samples were tested for the presence of HIV, HBV and HCV infections. Structured questionnaire was used to capture participants’ information and data analyzed using descriptive statistics, McNemar Chi-square/Fishers exact test. Results: Blood transfusion was significantly more common among SCD cases [566 (55.7%)] than controls [54 (5.3%)], while history of vaccination was higher in the control group (p = 0.001). The overall prevalence of HIV [2 (0.2%) vs 11 (1.1%)], HBV [58 (5.7) vs 66 (6.5%)] and HCV [10 (1.0) vs 22 (2.2%)] was lower among SCD cases than controls, respectively, although significantly different only in HCV infection (p = 0.048). All three infections were significantly higher in adults than in children. Co-infection was found only in four of the participants, all of whom were SCD patients. Conclusion: The prevalence of HIV, HBV and HCV infection among SCD patients indicates an improvement in the transfusion safety measures in the region. The prevalence of HBV and HCV found in this study is still relatively high when compared with reports from some other regions. There is a need for continued surveillance and subsidized cost of drugs for treatment of these infections, especially for SCD patients who already have a compromised immunity.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45224611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Kamangu, B. Bulanda, Idriss M. Mwanaut, Simplice K. Makoka, G. Mesia
Background: The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the efficacy, safety and accessibility of antiretroviral drugs (ARVs), it is recommended that they should be prescribed according to national guidelines; which are evolving with the various recommendations of the World Health Organization (WHO) and the arrival of newer, more effective and safer molecules. Objective: The objective of this study was to assess the rational use of Antiretrovirals in patients treated in Kinshasa before the use of Dolutegravir within the national program in order to assess the correct use of these molecules. Methods: This work is a descriptive cross-sectional study to assess the rational use of first-line ARVs among People Living with HIV (PLHIV) in different Centers of Treatment (ATCs) in Kinshasa before the introduction of Dolutegravir. The records of patients on ARVs were randomly and rationally selected in 12 different ATCs for HIV in Kinshasa according to three centers per district in the period from June to September 2018. Information on use and consumption of ARVs, compliance with guidelines, change of therapeutic combination as well as their reasons were consulted for the present study. Results: 507 files of PLHIV were collected in the various ATCs. 274 (54.1%) were from female patients. The most represented age group was 26 to 35 years with 192 patients (37.9%). The mean duration of first-line treatment for all patients included was 16.30 ± 5.85 months. The most widely used combination of ARVs overall was TDF + 3TC + EFV at 45.4%. 305 (60.2%) PLHIV kept the same first-line treatment molecule throughout the treatment period with an average treatment duration of 12.9 ± 2.77 months. The most common combination found in this population was TDF + 3TC + EFV (69.2%). 202 (39.8%) PLHIV changed treatment molecule yet respecting the first-line combinations. The average duration of treatment for those who changed molecules was 21.43 ± 7.25 months. Before the change, 112 (55.5%) of these patients were using the ZDV + 3TC + EFV combination. After switching, 105 (52%) of the patients used the TDF + 3TC + NVP combination. The first reason for changing molecules was its unavailability (53.3%) in the ATCs. Conclusion: Although some banned molecules are still available in some treatment centers, the guidelines on first-line treatments are respected in different centers in Kinshasa.
{"title":"Evaluation of Rational Use of Antiretrovirals before the Dolutegravir Transition in Kinshasa, Democratic Republic of Congo","authors":"E. Kamangu, B. Bulanda, Idriss M. Mwanaut, Simplice K. Makoka, G. Mesia","doi":"10.4236/WJA.2021.112004","DOIUrl":"https://doi.org/10.4236/WJA.2021.112004","url":null,"abstract":"Background: The ultimate goal of AntiRetroViral Treatments (ART) is to achieve complete immune restoration and lasting viral suppression in the infected patient. In order to ensure the efficacy, safety and accessibility of antiretroviral drugs (ARVs), it is recommended that they should be prescribed according to national guidelines; which are evolving with the various recommendations of the World Health Organization (WHO) and the arrival of newer, more effective and safer molecules. Objective: The objective of this study was to assess the rational use of Antiretrovirals in patients treated in Kinshasa before the use of Dolutegravir within the national program in order to assess the correct use of these molecules. Methods: This work is a descriptive cross-sectional study to assess the rational use of first-line ARVs among People Living with HIV (PLHIV) in different Centers of Treatment (ATCs) in Kinshasa before the introduction of Dolutegravir. The records of patients on ARVs were randomly and rationally selected in 12 different ATCs for HIV in Kinshasa according to three centers per district in the period from June to September 2018. Information on use and consumption of ARVs, compliance with guidelines, change of therapeutic combination as well as their reasons were consulted for the present study. Results: 507 files of PLHIV were collected in the various ATCs. 274 (54.1%) were from female patients. The most represented age group was 26 to 35 years with 192 patients (37.9%). The mean duration of first-line treatment for all patients included was 16.30 ± 5.85 months. The most widely used combination of ARVs overall was TDF + 3TC + EFV at 45.4%. 305 (60.2%) PLHIV kept the same first-line treatment molecule throughout the treatment period with an average treatment duration of 12.9 ± 2.77 months. The most common combination found in this population was TDF + 3TC + EFV (69.2%). 202 (39.8%) PLHIV changed treatment molecule yet respecting the first-line combinations. The average duration of treatment for those who changed molecules was 21.43 ± 7.25 months. Before the change, 112 (55.5%) of these patients were using the ZDV + 3TC + EFV combination. After switching, 105 (52%) of the patients used the TDF + 3TC + NVP combination. The first reason for changing molecules was its unavailability (53.3%) in the ATCs. Conclusion: Although some banned molecules are still available in some treatment centers, the guidelines on first-line treatments are respected in different centers in Kinshasa.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41747857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To describe the implementation and outcomes of using telehealth in combination with a differentiated ART delivery model to improve HIV antiretroviral therapy pick up at a large treatment facility in Trinidad and Tobago during COVID-19. Design and Methods: Beginning in April 2020, a list of patients was generated daily prior to their scheduled ART appointments. Nurses, doctors and social workers conducted telephone consultations to first screen patients for COVID-19 symptoms, conducted brief medical and behavioural health screenings, and helped patients to identify barriers to ART retention. Patients were recommended for 1) fast track ART refill collection at facility, 2) community ART refills, and 3) ART pick-up through patient peers. The uptake and outcomes of telehealth and ART pick up were compared with the corresponding period in 2019. Data was analyzed using SPSS 21.0. Results: During the period April-June 2020, 1361 patients were identified for telephone consultations, 1084 (80%) were successfully contacted and 984 patients (88%) participated in phone session. The independent t test showed a significant increase in ART pick-up when compared to the corresponding period in 2019. 59% of patients collected via fast-track ART refill, 30% had community refills, and 11% pick-up medications through patient peers. Conclusion: Telehealth is an integral component of DSD as part of the COVID-19 response at the MRF. Understanding the medium and longer-term outcomes of Telehealth can provide additional insights on the scale up of telehealth as a component of DSD to improve ART outcomes for patients in the context of the developing countries of the Caribbean.
{"title":"Telehealth Combined with Differentiated ART Delivery Improves ART Pick Up during COVID 19 at a Large HIV Treatment Facility in Trinidad and Tobago","authors":"Nyla Lyons, W. Francis, J. Edwards, O. Lavia","doi":"10.4236/WJA.2021.112005","DOIUrl":"https://doi.org/10.4236/WJA.2021.112005","url":null,"abstract":"Objective: To describe the implementation and outcomes of using telehealth in combination with a differentiated ART delivery model to improve HIV antiretroviral therapy pick up at a large treatment facility in Trinidad and Tobago during COVID-19. Design and Methods: Beginning in April 2020, a list of patients was generated daily prior to their scheduled ART appointments. Nurses, doctors and social workers conducted telephone consultations to first screen patients for COVID-19 symptoms, conducted brief medical and behavioural health screenings, and helped patients to identify barriers to ART retention. Patients were recommended for 1) fast track ART refill collection at facility, 2) community ART refills, and 3) ART pick-up through patient peers. The uptake and outcomes of telehealth and ART pick up were compared with the corresponding period in 2019. Data was analyzed using SPSS 21.0. Results: During the period April-June 2020, 1361 patients were identified for telephone consultations, 1084 (80%) were successfully contacted and 984 patients (88%) participated in phone session. The independent t test showed a significant increase in ART pick-up when compared to the corresponding period in 2019. 59% of patients collected via fast-track ART refill, 30% had community refills, and 11% pick-up medications through patient peers. Conclusion: Telehealth is an integral component of DSD as part of the COVID-19 response at the MRF. Understanding the medium and longer-term outcomes of Telehealth can provide additional insights on the scale up of telehealth as a component of DSD to improve ART outcomes for patients in the context of the developing countries of the Caribbean.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47859553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Jahun, M. Mukhtar, A. Yakubu, M. Zakirai, Bamidele Moyosola, A. Aliyu, A. Habib, Gambo Aliyu
Introduction: With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. Methods: Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. Results: Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). Conclusion/recommendation: Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.
{"title":"Assessment of the Affordability of Out-of-Pocket Payments among Some Selected People Living with HIV in Kano, Nigeria","authors":"I. Jahun, M. Mukhtar, A. Yakubu, M. Zakirai, Bamidele Moyosola, A. Aliyu, A. Habib, Gambo Aliyu","doi":"10.4236/wja.2021.112007","DOIUrl":"https://doi.org/10.4236/wja.2021.112007","url":null,"abstract":"Introduction: With an estimated 1.8 million People Living with HIV (PLHIV), Nigeria’s HIV response is still heavily donor dependent. However, with anticipated decline in donor funding for HIV/AIDS program as the country takes ownership of the program, understanding financing options for PLHIV is important. One of such financing options is affordability of out-of-pocket payments (OOP) for anti-retroviral drugs (ARV) by PLHIV. We assessed affordability of OOP payments for ARVs in Kano State, North-Western Nigeria. Methods: Four Hundred and sixty-nine PLHIV receiving donor-supported-free ARV in Kano, North Western Nigeria were systematically selected and interviewed during routine clinic visits. Affordability for ARV was assessed by a combination of variables including willingness and financial means to incur extra expense for full dose of ARV based on landing and distribution cost of 8.3 USD (about 3,000 NGN) per month dose. Results: Four hundred and sixty-nine respondents were interviewed. Of those, 72 (15.4%, 95% CI: [13.2 - 19.7]) can afford ARV OOP on monthly base. The proportion of males able to pay 3,000 NGN (8.3 USD) or more OOP for ARVs was not different from that of women (15.5% versus 15.2%). Attending school, education level, employment, monthly income and wealth have all been found to be associated with willingness and ability to pay for monthly dose of ARV OOP (p < 0.0001). Conclusion/recommendation: Majority of PLHIV in Kano State may not afford ARV OOP in the event of withdrawal of supports by international donors. Innovative sustainable financing mechanisms from domestic resources are needed for HIV program sustainability.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43401540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Fomundam, A. Tesfay, S. Mushipe, H. T. Nyambi, A. Wutoh
Background: Patients medical records are used to document care processes for communication amongst healthcare workers for continued patient management. Incomplete or inaccurate documentation can adversely affect the quality of patients’ care, leading to medication and treatment errors, increased morbidity, and mortality. Quality documentation in medical records is therefore an essential component of optimal healthcare and facilitates an individual’s continuity of care. This study aimed to assess the quality of documentation of clinical data through the review of the accuracy and completeness of clinical records among newly diagnosed HIV-positive persons. The study is a sub analysis of a prospective longitudinal study that followed a cohort of 12,413 persons who were newly diagnosed with HIV infection. Severe limitations in retrieving reliable information and data became an obstacle to our research and led the study team to conduct medical records documentation and data audit to verify the accuracy and completeness of the data for newly diagnosed HIV positive persons. Methods: A cross-sectional study was conducted using routine data generated from 75 randomly selected newly diagnosed HIV positive persons aged 12-years-old and above between June 1, 2014 and March 31, 2015 in 36 purposively selected primary health care (PHC) clinics in South Africa. The facilities were selected from three high HIV-burden districts of South Africa (Gert Sibande, uThukela and City of Johannesburg). Results: Significant differences in the accuracy and completeness of clinical records were observed between data generated through the self-assessment by the facility managers and data primarily collected through review of the patients’ clinical stationery and facility registers. 80% of the newly diagnosed HIV positive persons were not documented as screened for tuberculosis (TB) on the clinical chart and 69% of newly diagnosed clients were not clinically staged (WHO staging). Furthermore, 80% of newly diagnosed HIV positive persons’ follow up visit dates were not documented in the patient’s clinical chart. Completeness of the data elements on the case record forms ranged from as low as 26% to a maximum of 66%. It was noteworthy that all the clients’ information documented in HIV counselling and testing registers, continuum of care registers and clinical charts were only partially completed. Conclusion: Each of the health care facilities under study had some significant gaps in medical records documentation of clinical data on newly diagnosed HIV positive persons. Data and information accuracy and completeness were a serious challenge in most facilities during the period under investigation. Of interest was the inconsistency of data recorded in the HCT registers, continuum of care and clinical charts of individual patients. This is a major impediment to HIV/AIDS comprehensive care.
{"title":"Medical Records Documentation of HIV/AIDS Clinical Services at Primary Health Care (PHC) Facilities and Its Implications on Continuum of Care and Operational Research in South Africa","authors":"H. Fomundam, A. Tesfay, S. Mushipe, H. T. Nyambi, A. Wutoh","doi":"10.4236/wja.2021.112006","DOIUrl":"https://doi.org/10.4236/wja.2021.112006","url":null,"abstract":"Background: Patients medical records are used to document care processes for communication amongst healthcare workers for continued patient management. Incomplete or inaccurate documentation can adversely affect the quality of patients’ care, leading to medication and treatment errors, increased morbidity, and mortality. Quality documentation in medical records is therefore an essential component of optimal healthcare and facilitates an individual’s continuity of care. This study aimed to assess the quality of documentation of clinical data through the review of the accuracy and completeness of clinical records among newly diagnosed HIV-positive persons. The study is a sub analysis of a prospective longitudinal study that followed a cohort of 12,413 persons who were newly diagnosed with HIV infection. Severe limitations in retrieving reliable information and data became an obstacle to our research and led the study team to conduct medical records documentation and data audit to verify the accuracy and completeness of the data for newly diagnosed HIV positive persons. Methods: A cross-sectional study was conducted using routine data generated from 75 randomly selected newly diagnosed HIV positive persons aged 12-years-old and above between June 1, 2014 and March 31, 2015 in 36 purposively selected primary health care (PHC) clinics in South Africa. The facilities were selected from three high HIV-burden districts of South Africa (Gert Sibande, uThukela and City of Johannesburg). Results: Significant differences in the accuracy and completeness of clinical records were observed between data generated through the self-assessment by the facility managers and data primarily collected through review of the patients’ clinical stationery and facility registers. 80% of the newly diagnosed HIV positive persons were not documented as screened for tuberculosis (TB) on the clinical chart and 69% of newly diagnosed clients were not clinically staged (WHO staging). Furthermore, 80% of newly diagnosed HIV positive persons’ follow up visit dates were not documented in the patient’s clinical chart. Completeness of the data elements on the case record forms ranged from as low as 26% to a maximum of 66%. It was noteworthy that all the clients’ information documented in HIV counselling and testing registers, continuum of care registers and clinical charts were only partially completed. Conclusion: Each of the health care facilities under study had some significant gaps in medical records documentation of clinical data on newly diagnosed HIV positive persons. Data and information accuracy and completeness were a serious challenge in most facilities during the period under investigation. Of interest was the inconsistency of data recorded in the HCT registers, continuum of care and clinical charts of individual patients. This is a major impediment to HIV/AIDS comprehensive care.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45920227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Harrison, K. Oruka, U. C. Agbaim, O. A. Adegbite, N. Okeji
Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.
{"title":"Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria","authors":"N. Harrison, K. Oruka, U. C. Agbaim, O. A. Adegbite, N. Okeji","doi":"10.4236/WJA.2021.111003","DOIUrl":"https://doi.org/10.4236/WJA.2021.111003","url":null,"abstract":"Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"11 1","pages":"25-40"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49278436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jamie Yoon, David S. Chung, Michelle Kim, Kunmin Kim, Sang Heon Lee, Tae Youn Kim, Hark Joon Lee, S. Moon, Jooheon Park, P. Chung, T. Nyirenda
Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with HIV in 2016, with 24,000 HIV-related deaths. The Option B+ program, first implemented in Malawi, aimed to initiate ART for all pregnant women, regardless of their CD4 cell count or disease stage. This study serves to analyze and assess the effectiveness of Option B+ retention, in relation to the facilitation of how various social and cultural barriers were handled. A literature review of 29 publications was conducted. Careful evaluation of various studies indicates that although there is a myriad of reasons explaining low levels of retention, the women who were at the highest risk for low retention were young pregnant women who were treated on the same day of HIV-diagnosis. Solutions focused around women and their partners or communities showed promising evidence of success in increasing adherence, as these strategies likely provided women reliable social and emotional support to address major barriers to retention such as a lack of support from male partners, ineffective education from healthcare workers, or stigma towards their HIV disclosure statue.
{"title":"An Assessment of the Social, Cultural, and Economical Barriers to Option B+ Retention and Their Solutions in Malawi: A Review","authors":"Jamie Yoon, David S. Chung, Michelle Kim, Kunmin Kim, Sang Heon Lee, Tae Youn Kim, Hark Joon Lee, S. Moon, Jooheon Park, P. Chung, T. Nyirenda","doi":"10.4236/WJA.2021.111002","DOIUrl":"https://doi.org/10.4236/WJA.2021.111002","url":null,"abstract":"Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with HIV in 2016, with 24,000 HIV-related deaths. The Option B+ program, first implemented in Malawi, aimed to initiate ART for all pregnant women, regardless of their CD4 cell count or disease stage. This study serves to analyze and assess the effectiveness of Option B+ retention, in relation to the facilitation of how various social and cultural barriers were handled. A literature review of 29 publications was conducted. Careful evaluation of various studies indicates that although there is a myriad of reasons explaining low levels of retention, the women who were at the highest risk for low retention were young pregnant women who were treated on the same day of HIV-diagnosis. Solutions focused around women and their partners or communities showed promising evidence of success in increasing adherence, as these strategies likely provided women reliable social and emotional support to address major barriers to retention such as a lack of support from male partners, ineffective education from healthcare workers, or stigma towards their HIV disclosure statue.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"11 1","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44539096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Isaac, A. Ajani, A. J. Difa, J. Aremu, Oyeniyi Christianah Oluwaseun, Muhammad Hassan
Background: The adult ART (antiretroviral therapy) programme started in Nigeria in 2002. After many years of ART in the country, the National implementation plan for the scale up of viral load testing was launched in 2016. Viral load estimation is the most important indicator of ART response. Aim: To describe viral suppression in adults on the HIV ART programme Material & methods: Viral load blood samples of 9450 adults on highly active antiretroviral therapy living with HIV from 4 states within Nigeria were analyzed for HIV RNA in Polymerase Chain Reaction laboratory of the Federal Teaching Hospital, Gombe between December 2017 and December 2019. Results: Males were 2577/9450 (27.3%) and 6873 (72.7%) females. Adults aged 26 - 45 years constituted 69.5% (6572). Viral load test was primarily routine in 96.3% (9098). ART was AZT/3TC/NVP in 52.5% (4962); TDF/3TC/EFV in 46.3% (4375). 48.3% (4568/9450) adults had received HAART for 1 - 5 years; 7.4% (699) for 6 months but 10 years. The most recent CD4 count before viral load request was ≥1000/μL in 6.5% (612) of adults; 500 - 999/μL in 38.6% (3651); 350 - 499 μL in 23.2% (2195) and 1000 c/ml in 22.8% (587/2577) males and 23.0% (1580/6873) females. Of adults aged 19 - 25 years, 28.4% (211/743) had viral load >1000 c/ml; 23.5% (1544/6572); 20.0% (294/1473); 17.8% (93/523) and 18.0% (25/139) aged 26 - 45 years, 46 - 55 years; 56 - 65 years and >65 years also had viral load >1000 c/ml (p value 1000 c/ml in 26.0% (182/699) of adults on HAART for 6 months - 1 year and 21.3% (975/4568) after receiving HAART for 1 - 5 years. 24.9% (885/3551) and 19.8% (125/632) adults had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively. (p value < 0.001) Conclusion: Over all viral suppression of 77% in our study is high but fell below the WHO threshold of 90%. ART programme in Nigeria requires strengthening.
{"title":"Viral Suppression in Adult Nigerians in a Regional Antiretroviral Therapy Programme: A Cross Sectional Descriptive Study","authors":"E. Isaac, A. Ajani, A. J. Difa, J. Aremu, Oyeniyi Christianah Oluwaseun, Muhammad Hassan","doi":"10.4236/WJA.2021.111001","DOIUrl":"https://doi.org/10.4236/WJA.2021.111001","url":null,"abstract":"Background: The adult ART (antiretroviral therapy) programme started in Nigeria in 2002. After many years of ART in the country, the National implementation plan for the scale up of viral load testing was launched in 2016. Viral load estimation is the most important indicator of ART response. Aim: To describe viral suppression in adults on the HIV ART programme Material & methods: Viral load blood samples of 9450 adults on highly active antiretroviral therapy living with HIV from 4 states within Nigeria were analyzed for HIV RNA in Polymerase Chain Reaction laboratory of the Federal Teaching Hospital, Gombe between December 2017 and December 2019. Results: Males were 2577/9450 (27.3%) and 6873 (72.7%) females. Adults aged 26 - 45 years constituted 69.5% (6572). Viral load test was primarily routine in 96.3% (9098). ART was AZT/3TC/NVP in 52.5% (4962); TDF/3TC/EFV in 46.3% (4375). 48.3% (4568/9450) adults had received HAART for 1 - 5 years; 7.4% (699) for 6 months but 10 years. The most recent CD4 count before viral load request was ≥1000/μL in 6.5% (612) of adults; 500 - 999/μL in 38.6% (3651); 350 - 499 μL in 23.2% (2195) and 1000 c/ml in 22.8% (587/2577) males and 23.0% (1580/6873) females. Of adults aged 19 - 25 years, 28.4% (211/743) had viral load >1000 c/ml; 23.5% (1544/6572); 20.0% (294/1473); 17.8% (93/523) and 18.0% (25/139) aged 26 - 45 years, 46 - 55 years; 56 - 65 years and >65 years also had viral load >1000 c/ml (p value 1000 c/ml in 26.0% (182/699) of adults on HAART for 6 months - 1 year and 21.3% (975/4568) after receiving HAART for 1 - 5 years. 24.9% (885/3551) and 19.8% (125/632) adults had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively. (p value < 0.001) Conclusion: Over all viral suppression of 77% in our study is high but fell below the WHO threshold of 90%. ART programme in Nigeria requires strengthening.","PeriodicalId":58633,"journal":{"name":"艾滋病(英文)","volume":"11 1","pages":"720-726"},"PeriodicalIF":0.0,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45143646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：