Determinants of antiretroviral treatment adherence among patients attending secondary health care facilities in north-east and south-west Nigeria: a comparative study.

BACKGROUND: Four decades after its discovery, HIV continues to be a major global public health issue, even with antiretroviral therapy (ART). Strict adherence to ART remains a challenge, with attendant implications for treatment success. This study aimed at comparing ART adherence between north-east and south-west Nigeria. METHODS: A comparative cross-sectional study was conducted in two regions in Nigeria among 400 HIV/AIDS patients on ART. Data were collected using a pre-tested, semi-structured interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of ART adherence in the regions. The level of significance was set at 0.05. RESULTS: The majority of respondents from both the north-east (87.5%) and south-west (92.5%) of Nigeria had good knowledge about ART. The self-reported adherence level was 90.0% in the north-east and 87.5% in the south-west. Predictors of ART adherence in the north-east were knowledge about ART (AOR 9.949; 95% CI 2.009-49.284) and transport costs to the clinic (AOR 0.177; 95% CI 0.047-0.661). In the south-west, education (AOR 0.198; 95% CI 0.047-0.832) and knowledge of ART (AOR 8.945; 95% CI 1.749-45.751) were identified as predictors of ART adherence. CONCLUSION: In both regions, knowledge about ART was appreciable, but adherence was sub-optimal. Strategies to support adherence should be tailored to specific predictors in each region.

Knowledge and utilisation of National Health Insurance Scheme among adult patients attending a tertiary health facility in Lagos State, South-Western Nigeria.

BACKGROUND: Despite the creation of the National Health Insurance Scheme (NHIS) by the Nigerian government, most Nigerians are not covered by the scheme. AIM: The aim of this study was to assess the knowledge and utilisation of NHIS among adult patients who attended a tertiary health facility in Lagos state, South-Western Nigeria. SETTING: Outpatient clinic, Lagos State University Teaching Hospital, Ikeja, Lagos. METHODS: A descriptive cross-sectional study of 487 respondents recruited using a multi- stage sampling method. Data were collected using pretested semi-structured self-administered questionnaires, and analysis was done using Microsoft Excel 2007 and EPI Info 7 statistical software. Level of significance was set at p 0.05. Ethical approval was obtained from the Health Research Ethics Committee Lagos State university teaching Hospital. RESULTS: A total of 487 of the 500 self-administered questionnaires were retrieved and analysed, giving a response rate of 97.4%. The study showed that 80.7% of the respondents had poor knowledge of NHIS, only12.3% of the respondents had registered with the NHIS, and 43.8% of respondents who had not registered with NHIS claimed they do not know where to register. There was a statistically significant association between age and utilisation (p = 0.0007), marital status and utilisation of NHIS (p = 0.016), employment status and utilisation of NHIS (p = 0.001).Most (96%) of those who have utilised NHIS were satisfied with NHIS services. CONCLUSION: Majority of the respondents had poor knowledge of NHIS and also majority of those who had registered were satisfied with the scheme. There should be increased awareness campaigns so that all Nigerians can benefit from the scheme.

Risk factors for chronic kidney disease among patients at Olabisi Onabanjo University Teaching Hospital in Sagamu, Nigeria: A retrospective cohort study.

BACKGROUND: Chronic kidney disease (CKD) is common and often goes undetected and undiagnosed until the disease is well advanced and kidney failure is imminent. It is estimated that approximately 36 million Nigerians suffer from different stages of CKD, as one in seven Nigerians has kidney disease. METHODS: This research was a retrospective cohort study of 150 cases and 300 controls. Selection of subjects was by a retrospective review of records of in-patients from 2010-2013 in a state teaching hospital. Data was analyzed using Chi-square at 5% level of significance. RESULTS: Majority of subjects were between ages 20 - 29 years. The mean (SD) age of the cases was 40.6 (14.4) and controls was 38.6 (15.8). Ninety (60%) of the cases and 212(70.7%) of the controls were males (p= 0.023). Almost 87% of the cases and 42% of the controls ingest herbal concoction. Use of bleaching substances was more among the cases 20(13.4%) compared with the controls 2(0.7%), ( p= 0.001). Eight (5.3%) of the cases had family history of CKD while only 1(0.3%) of the control had similar history (p= 0.001). There were more cases (10.7%) with diabetic mellitus compared with the controls (2.7%), (p= 0.001). The number of cases with high blood pressure was more than the number of controls, (p-value <0.001). Sixty-four percent of the cases had history of chronic use of analgesic compared with 10.3% of the controls (p < 0.001). CONCLUSIONS: CKD is mostly found among men in their productive age, who were either diabetic or hypertensive with history of ingestion of herbal concoction and chronic use of analgesic. Individual should engage in regular medical check, modify their life style while government and health care providers increase awareness and campaign on the causes and risk factors of CKD.