Predictors of mortality among drug-resistant tuberculosis patients in Kaduna State, Nigeria.

Background: Specific death due to DR-TB has significantly contributed to tuberculosis (TB) mortality and overall global deaths. Aim: This study examines the predictors of mortality among DR-TB patients in Kaduna State, Nigeria. Subject and Method: This was a retrospective longitudinal study of DR-TB mortality carried out among 370 DR-TB patients from the 23 LGAs in Kaduna State. It involves a retrospective review of the MDR-TB records of the patients over a period of 10 years (2012-2021). Demographic and clinical data of all DR-TB patients enrolled in Kaduna State, Nigeria, between April 1, 2012, and March 31, 2021, were used. Survival analysis was performed with SPSS version 25, using Kaplan-Meier and Cox proportional hazard regression modeling, at 5% significance level. Results: The majority of the patients, 255 (68.9%), were below the age of 40 years, while 53 (14.3%) of the patients died within the study period. Most deaths 26 (49.1%) were associated with HIV co-infection and the disease severity. Results for the Cox proportional model show that there was a significantly lower risk of death when a patient had MDR-TB compared to pre-XDR-TB (adjusted hazard ratio, AHR = 0.34, 95% CI = 0.16-0.72, P = 0.04). Both models show that age, sex, residence, or year of treatment had no significant association with survival or death. Conclusion: HIV co-infection and DRTB with progression to more resistant and difficult-to-treat strains contributed to higher deaths. There is a need for concerted efforts from all DR-TB stakeholders to control the disease.

Predictors of pediatric HIV disclosure among caregivers of HIV positive children attending special treatment clinic in dalhatu araf specialist hospital, Lafia, Nigeria.

BACKGROUND: HIV-infected children now live longer due to the availability of HIV counseling, testing, and treatment with highly active antiretroviral treatment (HAART). Efforts to help these children to know about the HIV infection and their status are important steps toward long-term disease management. This study was conducted to determine the factors associated with pediatric HIV disclosure among caregivers of children attending Special Treatment Clinic at Dalhatu Araf Specialist Hospital, Lafia. METHODS: This was a descriptive cross-sectional study conducted among 160 caregivers of children attending the Special Treatment Clinic (STC) at DASH, Lafia, selected by systematic random sampling technique. Interviewer administered structured questionnaire was used to collect data, while bivariate and multivariate analyses were done with the Epi Info version 7. RESULTS: Pediatric HIV disclosure rate in this study was 33.8%. The mean age at pediatric HIV disclosure was 9.85 ± 1.86 years. The independent predictors for pediatric HIV disclosure following logistic regression were child's age, 10-14 years (AOR = 4.46; 95%CI 1.47-13.61), child knowledge of caregivers' HIV status (AOR = 51.18; 95%CI 13.40-195.66), and caregivers' age ≥40 years (AOR = 3.58; 95%CI 1.25-11.74). CONCLUSIONS: The pediatric HIV disclosure was low in this study due to the caregivers' and their wards' factors. Health care workers need to intensify health education on the benefit of pediatric HIV disclosure at the STC clinic.

An Epidemiological Study of Needlestick Injury among Healthcare Workers in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

BACKGROUND: Occupationally acquired infections are leading causes of morbidity and mortality among health care workers. The study aimed to determine knowledge, attitude and preventive practices of health care workers on needle stick injuries in Ahmadu Bello University Teaching Hospital, Zaria. METHODS: This was a cross sectional descriptive study in which stratified sampling technique was used to sample respondents. Data was collected using structured, close ended self-administered questionnaire. RESULTS: A total of 166 respondents completed the questionnaires out of 250 distributed questionnaires. Forty-three (25.9%) were males, 123 (74.1%) were females. The combined mean age was 40.9 ± 9.8 years. All the respondents were aware and knew of transmission of blood borne pathogens. Majority 116 (70.7%) had ever sustained injury while at work and 14 (8.8%) sustained injury in the last 3 months. The incidence of injury increases with work duration (c2= 17.88, p=0.001) and length of practice (c2=10.38, p=0.001). Eighty percent of respondents had received training on universal precautions. The commonest place of exposure was in the wards (65.6%) and circumstances of exposure were respectively sudden patient movements 21(19.3%) and recapping needle 20 (18.3%). Only 52 (43.3%) of respondents took appropriate measure (rinsing and disinfecting) the site after injury. CONCLUSION: This study revealed the high risk health care workers are exposed to at work. There is urgent need to improve the safety of health care workers through continuing education and strict adherence to universal precautions. There is need to establish a surveillance system to monitor such incidents and provision of post-exposure prophylaxis to those accidentally exposed.