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Predictors of Change in CD4 Count among Adult HIV/AIDS Patients on Anti-Retroviral Treatment in West Hararghe Zone, Ethiopia; Retrospective Longitudinal Study
Adisu Birhanu Weldesenbet,
Biruk Shalmeno Tusa,
Sewnet Adem Kebede,
Getachew Asfaw Dagne
Issue:
Volume 6, Issue 2, December 2020
Pages:
32-37
Received:
3 June 2020
Accepted:
17 June 2020
Published:
4 July 2020
Abstract: Background: As one of the countries in the Sub-Saharan African Region, Ethiopia also happens to bear a higher burden of HIV infection. For HIV-infected patients, the level of CD4 count remains an important test with regard to diagnostic decision-making. There is limited information on predictors of longitudinal change in CD4 count over time that examine immunologic response of patients during the course of treatment in Ethiopia. Therefore, this study aimed to examine predictors of change in CD4 count among adult HIV infected patients on antiretroviral treatment in west Hararghe zone, Ethiopia. Methods: An institutional based retrospective cohort study was conducted among 405 adult HIV/AIDS patients on Anti-Retro Viral Therapy (ART) from September 2013 to January 2019. Data was entered into Epi info 7 and analyzed in R software. Generalized mixed effect model was applied to identify predictors of longitudinal change in CD4 count. Results: In multivariable analysis time since start of ART (beta=0.306, 95%CI, 0.286: 0.326), primary level educational status (beta=0.048, 95%CI, 0.004: 0.092), tertiary educational status (beta=0.094, 95%CI, 0.007: 0.182), WHO RVI stage II (beta=-0.108, 95%CI, -0.156:-0.061), bedridden functional status (beta=-0.175, 95%CI,-0.309:-0.039), poor baseline adherence (beta=-0.145, 95%CI, -0.214: -0.076) and baseline weight (beta=-0.004, 95%CI, -0.006, -0.002) were significant predictors of longitudinal CD4 change. Conclusion: In this study time since start of ART, primary and tertiary educational status contributed positively to the change in CD4 count whereas bedridden functional status, poor adherence, WHO RVI stage II and baseline weight are negatively associated with longitudinal change in CD4 count. Close monitoring for bedridden patients and patients with poor baseline adherence is needed especially during the initiation of ART for immunological response.
Abstract: Background: As one of the countries in the Sub-Saharan African Region, Ethiopia also happens to bear a higher burden of HIV infection. For HIV-infected patients, the level of CD4 count remains an important test with regard to diagnostic decision-making. There is limited information on predictors of longitudinal change in CD4 count over time that ex...
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Economic Burden of Accessing Antiretrovirals Among People Living with HIV; Findings from a Cross-Sectional Survey in Lagos State, Nigeria
Ogunnaike Adewale Adeyemi,
Adewole David,
Temowo Oluseyi Sunday,
Fisher Oladipupo,
Essien Michael,
Dada Julianah
Issue:
Volume 6, Issue 2, December 2020
Pages:
38-43
Received:
23 June 2020
Accepted:
15 July 2020
Published:
13 August 2020
Abstract: Background: HIV/AIDS is one of the major diseases with multifaceted burdens; health, emotional and financial. After the introduction of the Antiretroviral Therapy (ART), HIV/AIDS became a chronic disease that requires long-term management thus competing with other day-to-day economic obligations of People Living with HIV/AIDS (PLWH). There have been limited studies assessing economic burden of accessing ART treatment vis-a-vis catastrophic health expenditure (CHE) in this environment. Therefore, this survey explores the CHE resulting from accessing ART treatment and identifying some of the predictors for CHE among PLWH in Lagos State, Nigeria. Materials and methods: This study was a descriptive cross-sectional, quantitative survey that was carried out among 217 consenting PLWH recruited from 15 Support groups in Lagos State, Nigeria. The data was collected using 29-items self-administered questionnaire (research assistants aided PLWH who cannot read or write) developed from the review of relevant literatures. The data were analyzed using SPSS version 20. Chi-square at p-value of < 0.05 was used to determine significance of factors associated with CHE. Results: Age of the respondents was 42.81±8.517 years. Female respondents were more than 70% (171) and about half of the respondents, 109 (50.2%) were married. Above half, 129 (59%), of the respondents attend drug pick-up sites for their ARVs monthly. Less than 60% of the respondents (mean annual income 1111.203±821.371 dollars) earn below $1000 annually with 41.2%, 39.0% and 19.8% of the respondents in low, middle and high income groups respectively. Only 5% of the PLWH expend $200 annually for refill of ARVs. Considering the global definition of CHE (health expenditure>10% of household consumption,) 40% of the surveyed respondents experienced CHE. Using chi-square to determine factors associated with CHE among respondents; occupation, income group and ARVs refill frequency were significant at P<0.05. However, the binary logistic regression identified formal occupation (aOR=0.025, 95% C.I=0.02-0.35, p-value=0.006), being in middle income group (aOR=0.007, 95% C.I=0.001-0.05, p-value=0.0001) and high income group (aOR=0.035, 95% C.I=0.10-0.12, p-value=0.0001) and visiting health care facility for ARVs refill bi-monthly (aOR=17.555, 95% C.I=4.64-66.40, p-value=0.0001) as predictors of CHE among respondents. Conclusions: The results of this survey revealed that having formal employment, belonging to middle and high income groups protects respondents from CHE while bi-monthly ARVs refill predisposes PLWH in this survey to CHE.
Abstract: Background: HIV/AIDS is one of the major diseases with multifaceted burdens; health, emotional and financial. After the introduction of the Antiretroviral Therapy (ART), HIV/AIDS became a chronic disease that requires long-term management thus competing with other day-to-day economic obligations of People Living with HIV/AIDS (PLWH). There have bee...
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Patient Satisfaction with Healthcare Service Delivery in an ART Treatment Centre in Nigeria
Osho Patrick Olanrewaju,
Adepoju Omoseni Oyindamola,
Joseph Oluyemi,
Gbenga-Fabusiwa Funmilayo Joy,
Oni Oluwatosin Idowu,
Ojo Oladotun Ayotunde
Issue:
Volume 6, Issue 2, December 2020
Pages:
44-52
Received:
24 May 2020
Accepted:
13 July 2020
Published:
16 September 2020
Abstract: Optimal Service delivery is imperative for a favorable patients’ care outcome. PLWHV have social and welfare needs asides their health need. Healthcare service delivery is key to meeting these needs. This study assessed the level of satisfaction of PLWHV with the Healthcare service they are being provided with at a tertiary hospital in Nigeria. The cross-sectional study involved the use of structured questionnaire containing closed and open ended questions as an instrument for data collection, having employed the non-probability convenience sampling method to select respondents for the study. A total of 143 respondents participated in the study out of the 150 questionnaires that was distributed representing 95.3% response rate. Primary data were analyzed using Frequency, means score rating and Regression analysis after a Cronbach Alpha greater than 0.70. The study showed that services provided have significant effect on the level of patients satisfaction at (R=0.574, R2=0.305 and sig=0.00; P<0.05). The study concludes that the four types of services provided to HIV/ AIDS patients have more effect on their level of satisfaction than other types of services. It recommends that services provided to HIV/ AIDS patients should exhibits the following twelve (12) characteristics; qualitative, prompt, unambiguous, focused, friendly, non- judgmental, elaborate, preventive, meticulous, futuristic, healthy and of good memory.
Abstract: Optimal Service delivery is imperative for a favorable patients’ care outcome. PLWHV have social and welfare needs asides their health need. Healthcare service delivery is key to meeting these needs. This study assessed the level of satisfaction of PLWHV with the Healthcare service they are being provided with at a tertiary hospital in Nigeria. The...
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HIV Infection Testing and Service Delivery of One Accredited Treatment Center in Cameroon
Serge Bruno Ebong,
Calixte Ida Penda,
Juste Patient Mbébi Enoné,
Patricia Epee Eboumbou,
Madeleine Mbangue,
Samuel Honore Mandengue,
Carole Else Eboumbou Moukoko
Issue:
Volume 6, Issue 2, December 2020
Pages:
53-61
Received:
2 September 2020
Accepted:
6 October 2020
Published:
13 October 2020
Abstract: Effectiveness of Anonymous and free Voluntary Counseling and Testing (AVCT) Centers in the HIV prevention and care can be threatened by a low use of its service delivery, especially in developing countries. This study was designed to obtain reliable data on the current state of the quality of the services and, evaluate the factors that are associated with use of one Accredited HIV/AIDS Treatment Center (AHTC). A cross-sectional and prospective study was conducted among adults attending the AHTC of the Douala Laquintinie Hospital (DLH), Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling. Descriptive and logistic regression analyses were performed using StataSE11 software (version 11 SE) in data analysis. Overall 80 (64%) of 125 adult volunteers for HIV testing reported that the reception at AHTC was excellent and 69.6% (80/115) of those who underwent the pre-test and among them, 49.6% were satisfied with the pre-test. Less than half of the participants were explained the merits of HIV testing. The interview was conducted in a confidential framework in 60% of those who underwent the pre-test and, 41.7% explained the merits of HIV testing. Among the 10 evaluated minimal items that the provider should have addressed, less than 6 items were done in 66.9% of the participants and between 9 and 10 items for 11.3%. Informed consent agreement was obtained in 89.60% of volunteers. Knowledge of HIV status was more reported among men than women who reported more requesting the HIV testing for prevention strategies for an exclusive sexual relation (p=0.038). The prevalence of HIV infection was 25.6% and, primary education remained significantly associated with higher risk of HIV infection in multivariate analysis (OR=0.11; IC95%=0.015-0.72; p=0.022). These results highlight the important of the appropriate sensibilization for the responsible implementation of the pretest counseling steps by health care providers in the AHTC of the DLH.
Abstract: Effectiveness of Anonymous and free Voluntary Counseling and Testing (AVCT) Centers in the HIV prevention and care can be threatened by a low use of its service delivery, especially in developing countries. This study was designed to obtain reliable data on the current state of the quality of the services and, evaluate the factors that are associat...
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Prevalence of HIV in North-East Nigeria: A Case of Comprehensive HIV Service Delivery in 3 Internally Displaced Persons Camps in Borno State, Northeast, Nigeria
Nsikan Affiah,
Sunkanmi Fadoju,
Paul Yunana,
Jummai Adamu,
Ndifreke James,
Peter Dickson,
Joseph Jasini,
Emmanuel Opada,
Henry Udenenwu,
Jonah John
Issue:
Volume 6, Issue 2, December 2020
Pages:
62-66
Received:
30 October 2020
Accepted:
11 November 2020
Published:
19 November 2020
Abstract: The humanitarian crisis in North-East Nigeria has had its greatest impact in Borno, Adamawa and Yobe states who now depend largely on humanitarian assistance for their survival. According to the 2017 UNDP estimates, 8.5 million people are caught in the middle of the humanitarian crises in Northeast Nigeria, resulting in widespread displacement, insecurity, destroyed infrastructure and collapsed basic services. This setting presents context of fragility, vulnerability and uncertainties, which encourages and exacerbates HIV transmission. The relationship between HIV, humanitarian emergencies and prolonged conflict is multifaceted and complex. The recent 2019 NAIIS reported HIV prevalence in Borno state to be 1.3%, however in the IDP camps, the risk of transmission appears to increase due to inadequate access to HIV and other basic health services. This study is aimed to determine the prevalence of HIV infection and uptake of comprehensive HIV services in 3 IDP camps; Ngala, Banki and Dikwa Local Government Areas of Borno state. The study adopted a case study approach with sample size of 26,712 individuals who were counseled and tested for HIV. The collected data was analyzed using STATA14. The result of study revealed the prevalence of HIV in the 3 IDP camps to be 0.98%. In Ngala Camp, Ngala LGA of Borno state, there was a high prevalence rate of 1.98%, which is higher than the Borno state’s and the National indices. The HIV testing Uptake was estimated to be 56.31% across the 3 camps. Improved awareness to HIV infection and sustained service provision will enhance good health seeking behavior and reduce incidence of HIV infection and stigmatization of affected persons in the IDP camp.
Abstract: The humanitarian crisis in North-East Nigeria has had its greatest impact in Borno, Adamawa and Yobe states who now depend largely on humanitarian assistance for their survival. According to the 2017 UNDP estimates, 8.5 million people are caught in the middle of the humanitarian crises in Northeast Nigeria, resulting in widespread displacement, ins...
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Prevalence and Correlates of HIV Infection Among Men Who Have Sex with Men in Congo, 2017
Gilbert Ndziessi,
Axel Julius Aloumba,
Raphael Bioko,
Benjamin Atipo,
Joseph Axel Ngatsie,
Michel Bitemo,
Gontran Ondzotto
Issue:
Volume 6, Issue 2, December 2020
Pages:
67-72
Received:
16 November 2020
Accepted:
30 November 2020
Published:
8 December 2020
Abstract: Background: The risk of contracting HIV is very high in Men who have sex with men (MSM) compared to the general population. This study aimed to estimates HIV prevalence among MSM in 2018 in Congo and identified associated factors. Methods: Cross-sectional study using the respondent-driven sampling method was conducted. Blood samples were collected and tested for HIV. Chi-square or Fischer test was used for proportion comparisons and logistic regression was carried out to assess predictors of HIV infection in MSM using the Statistical Package for the Social Sciences (SPSS) software. Results: HIV prevalence among 182 MSM was 41,2%. Average age was 25±5 years. Current age between 25-29 years (ORa=18.9 [1.9 – 25.0]; p=0.01), current age between 30-34 years (ORa=47 [40.0 – 59.0]; p=0.003), not use condoms for passive penetration (ORa=5.2 [1.1 – 24.1]; p=0.03), and non-use of the condom due to faithfulness to one's partner (ORa=6.9 [1.9 - 25.1]; p=0.003) were found associated with HIV infection among MSM. Conversely, being more than 20 years old at first anal sex was found to be associated with reduced risk of acquiring HIV (ORa=0.2; IC=1.1 – 11,4; p=0.03). Conclusion: Among MSM in Congo, HIV prevalence is high as a result of high-risk sexual behavior. Programs aimed at reducing risk should be enhanced in MSM including, as a priority, preventive advice, condom supplies, HIV and STI testing and communication.
Abstract: Background: The risk of contracting HIV is very high in Men who have sex with men (MSM) compared to the general population. This study aimed to estimates HIV prevalence among MSM in 2018 in Congo and identified associated factors. Methods: Cross-sectional study using the respondent-driven sampling method was conducted. Blood samples were collected ...
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