Adherence determination using urine-tenofovir point-of-care testing and pharmacy refill records: A cross-sectional study.

Pharmacy refill records (PRR), are an accessible strategy for estimating adherence in low- and middle-income countries (LMICs). However, the low-cost urine-tenofovir point-of-care test opens up the possibility of an objective metric of adherence that is scalable to LMICs. This study compared adherence to tenofovir-based regimens using urine-tenofovir point-of-care (POC) test with pharmacy refill records in a Nigerian population of HIV-positive persons. This was a cross-sectional study among 94 HIV-positive adults, which was conducted from June to August 2021, in a large outpatient clinic in Lagos, Nigeria. Adherence to pharmacy appointments was automatically calculated using a computerized pharmacy appointment system (FileMaker Pro™). Urine drops on the urine-tenofovir POC test strip developed 2 lines for a negative test (tenofovir absent) and one line for a positive test. Fisher's exact test was used to examine the association between pharmacy refill record and urine-tenofovir point-of-care test. Logistic regression was performed to predict viral suppression (<1000 copies/mL, based on WHO recommendations) using both methods of adherence determination. A Receiver Operating Characteristic (ROC) curve of the association between specificity and sensitivity was generated to evaluate the predictive value of adherence determined using pharmacy-refill record and urine-tenofovir point-of-care test in forecasting viral suppression. The statistical significance level was set at 0.05. Fisher's exact test showed no statistically significant difference in adherence using urine-tenofovir point-of-care test or pharmacy refill record. The logistic regression model showed that an increase in pharmacy-refill record of ≥ 95% was associated with viral suppression (P = .019). From the ROC curve, the sensitivity was same at 95.5% for both methods, but the specificity of the urine-tenofovir point-of-care test was greater (96.6% vs 95.5%) than pharmacy refill record (P = .837). Urine-tenofovir point-of-care test provided equivalent adherence data to pharmacy refill data.

Factors influencing COVID-19 vaccine uptake among adults in Nigeria.

BACKGROUND: Emerging variants of Coronavirus disease 2019 (COVID-19) has claimed over 3000 lives in Nigeria and vaccination remains a means of reducing the death toll. Despite ongoing efforts by the government to ensure COVID-19 vaccination of most residents to attain herd immunity, myths and beliefs have adversely shaped the perception of most Nigerians, challenging the uptake of COVID-19 vaccine. This study aimed to assess the factors influencing the awareness, perception, and willingness to receive COVID-19 vaccine among Nigerian adults. METHODS: A cross-sectional online nationwide study was conducted from April to June 2021 among Nigerian adult population using the snowballing method. Descriptive analysis was used to summarise the data. Univariate and multivariate analysis was used to identify the predictors of COVID-19 uptake among the respondents. A p value <0.05 was considered significant. RESULTS: A total of 1058 completed forms were analysed and 63.9% were females. The mean age was 40.8 years±12.2 years. Most of the respondents (740; 69.5%) had satisfactory awareness of the vaccination exercise. The media was the main source of information. Health workers reported higher level of awareness (aOR = 1.822, 95% CI: 1.388-2.524, p<0.001). Respondents that are Christians and Muslims had better awareness compared to the unaffiliated (aOR = 6.398, 95% CI: 1.918-21.338, P = 0.003) and (aOR = 7.595, 95% CI: 2.280-25.301, p<0.001) respectively. There is average score for perception statements (566; 53.2%) towards COVID-19 vaccination. Close to half of the respondents (44.2%) found the short period of COVID-19 production worrisome. Majority of the respondents were willing to get the vaccine (856; 80.9%). Those without a prior diagnosis of COVID-19 had a lower willingness to get vaccinated (aOR = 0.210 (95% CI: 0.082-0.536) P = 0.001). CONCLUSION: The study revealed a high level of awareness, willingness to receive the vaccine and moderate perception towards the vaccination activities. Influencing factors that significantly affects awareness were religion, occupation, education and prior diagnosis of COVID-19; for perception and willingness-occupation, and prior diagnosis of the COVID-19 were influencing factors.

High Acceptability of Donating Hair and Other Biological Samples for Research Among People Living with HIV in an Outpatient Clinic in Lagos, Nigeria.

Willingness to donate hair samples is a rate-limiting step for assaying antiretroviral (ARV) concentrations in hair, an emerging technique for HIV prevention and treatment monitoring. We surveyed ethnically diverse Nigerians to determine their willingness to donate hair for biomedical research. A cross-sectional survey of people living with HIV on ARV therapy (ART) was conducted at the HIV clinic of Nigerian Institute of Medical Research, using systematic sampling. The researcher-administered questionnaire was designed to capture sociodemographic data, length of time on ART, and willingness to donate hair. Univariate analysis was performed on sociodemographic characteristics, and independent-samples t-test and chi-square tests were used for bivariate analysis. Multivariable logistic regression analysis was performed to assess factors associated with willingness to donate hair samples, with a significance level of 0.05. Of the 398 participants enrolled in the study, 258 (64.8%) were female, the average age was 40 years (±9.8), and the average time spent on ART was 7.3 years (±4.2). More than half (64.8%) of the respondents were willing to donate hair samples for biomedical research and they were 1.5 times more likely to donate hair than blood. For one-third of the participants, the anticipated benefit from the eventual research findings was the primary motivation to donate hair samples. Fear of use of hair for rituals was the most common stated reason for unwillingness to donate hair samples (21.2%). In an ethnically diverse, urban-based Nigerian study population, nearly two-thirds of the participants were willing to donate hair samples for biomedical research. These findings support the feasibility of hair sampling for future HIV clinical research conducted within Nigeria.

The relationship between patient-related factors and medication adherence among Nigerian patients taking highly active anti-retroviral therapy.

BACKGROUND: Through several initiatives, there are increasingly more people who have access to anti-retroviral therapy. Adherence to therapy is, however, necessary for successful management of disease. OBJECTIVES: The objectives of this study were to describe adherence rates and determine what patient-related factors are related to adherence to anti-retroviral therapy among adult patients in an HIV clinic located in Lagos, Nigeria. METHODS: Adherence was measured using the two-week self-recall method. Barriers, satisfaction with therapy, and socio-demographic and clinical variables served as independent variables. Data were collected via self-administered surveys. RESULTS: Most of the patients (79.5%) reported 100% adherence. The significant (p<0.05) barriers to adherence were forgetfulness, running out of medication, alcohol use, and medication side effects. For every unit increase in the number of barriers, patients were 60.8% less likely to be 100% adherent (p <0.05, odds ratio, OR = 0.392, 95% CI = 0.295-0.523). CONCLUSION: Interventions should target helping patients cope with forgetfulness, specifically employing strategies to overcome busyness in schedules, being away from home, and tiredness.