Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in Sagamu, Southwestern Nigeria.

INTRODUCTION: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo University Teaching Hospital, (OOUTH) Sagamu. MATERIALS AND METHODS: A retrospective study of the clients accessing HCT services in OOUTH. Data was collected from clients using a client intake form. Pre-test counseling, HIV screening and post-test counseling were carried out. Informed consent and confidentiality were ensured. Data obtained were analyzed using SPSS 10.0. RESULTS: A total of 2607 clients accessed our HCT services between May 1 st 2008 and April 30 th 2010. The clients were between the ages of 1 year and 90 years. The mean age was 33.3 ± 15.26. The median age was found to be 32.0 years, with the modal age being 30.0 years. 73.7% (1828) were non-reactive (negative result), 25.9% (643) were reactive (positive result), while 0.3% (8) were indeterminate. Among the reactive results, 9.3% (242) were males while 15.1% (394) were females. CONCLUSION: A fair uptake of HCT services was noted. More females accessed services than males. More positive results were seen among females than males (P<0.05). RECOMMENDATIONS: Upscale of HCT services to involve Sexually transmitted infections clinics and free-standing, client-initiated testing centers is necessary. Continuous AIDS education and risk reduction should be promoted.

Seroprevalence of HIV among blood donors, antenatal women and other patients in a tertiary hospital in Nigeria

HIV/AIDS continues to remain a nightmare in the developing nations of the world especially in Nigeria, where about 2.9 million people are living with this problem. This study aimed at determining the sero-prevalence of HIV among both patients and blood donors at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Samples were collected between January 1st, 2005 and December, 31st 2006 and were screened using two rapid test kits, with two different principles (enzymatic and agglutination). Samples positive to the two methods were taken as truly sero-positive. The seropositive rate among blood donors, antenatal women, in- and out patients were, 3.2 percent, 6.9 percent and 17.5 percent respectively. There were five cases of positivity to both HIV I and II. Antenatal women between the ages of 26-35 were found responsible for 5.3 percent of the total positivity among antenatal women. Though, there is high prevalence rate among in- and out-patients, many of these were screened based on manifestation of clinical symptoms. However, more is to be done in the area of prevention of this disease, since no cure is yet found.

Seroprevalence of HIV among blood donors, antenatal women and other patients in a tertiary hospital in Nigeria.

HIV/AIDS continues to remain a nightmare in the developing nations of the world especially in Nigeria, where about 2.9 million people are living with this problem. This study aimed at determining the sero-prevalence of HIV among both patients and blood donors at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Samples were collected between January 1st, 2005 and December, 31st 2006 and were screened using two rapid test kits, with two different principles (enzymatic and agglutination). Samples positive to the two methods were taken as truly sero-positive. The seropositive rate among blood donors, antenatal women, in- and out patients were, 3.2%, 6.9% and 17.5% respectively. There were five cases of positivity to both HIV I and II. Antenatal women between the ages of 26-35 were found responsible for 5.3% of the total positivity among antenatal women. Though, there is high prevalence rate among in- and out-patients, many of these were screened based on manifestation of clinical symptoms. However, more is to be done in the area of prevention of this disease, since no cure is yet found.

Aetiology of catheter-associated bacteriuria in Lagos University Teaching Hospital.

A prospective study to determine the causative agents of catheter-related bacteriuria was carried out on 99 patients with median age of 55 years, on admission in the Oncology, Paediatric Surgery and Obstetric and Gynaecology wards of the Lagos University Teaching Hospital. There was significant bacteriuria in seventy-one (72%) of the 99 urine samples. All catheter urine samples were contaminated by day 5 Gram-negative bacilli were predominant (89.3%) of which Pseudomonas aeruginosa (26.2%) was the most common, while Escherichia coli and Enterobacter aerogenes accounted for 15.5% each, closely followed by Proteus mirabilis (14.3%) and Klebsiella pneumoniae (9.5%). The Gram positive isolates Enterococcus faecalis (8.3%) and Staphylococcus saprophyticus (2.4%) made up only 10.7% of isolates. Most of the isolates from catheterised patients were resistant to the common antibiotics such as ampicillin, cotrimoxazole, gentamicin and ceftriaxone with high susceptibility to ofloxacin and ceftazidime though the isolates of Enterococcus faecalis was also resistant to ofloxacin. However, isolates of S. saprophyticus were still susceptible to the penicillins and tetracycline.

Significant asymptomatic bacteriuria among Nigerian type 2 diabetics.

Significant asymptomatic bacteriuria is a risk factor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria among our type 2 diabetics with a view to documenting the prevalence, type of organisms responsible and the antibiotic susceptibility pattern. One hundred and twenty-four type 2 Nigerian diabetics (55 males and 69 females) submitted midstream urine specimens for culture. Thirty-three patients had significant bacteriuria (9 males and 24 females), showing the frequency of occurrence of asymptomatic bacteriuria to be 26.6%. The most common organism isolated was Klebsiella pneumonia at 42.4%. Gram-negative bacilli made up about 23 (69.7%) of the isolates. Isolates were poorly sensitive to the readily available antibiotics (ampicillin, tetracycline and cotrimoxazole), but a large number of the organisms isolated were sensitive to nitrofurantoin, gentamicin, ciprofloxacin and ofloxacin. Sensitivity to erythromycin, nalidixic acid and cefuroxime was moderate. Asymptomatic bacteriuria is, thus, more prevalent among the Nigerian diabetic population than in the non-diabetics. A changing pattern of disease is observed with Klebsiella sp. now accounting for the majority of asymptomatic bacteriuria among diabetics. The organisms are not sensitive to the commonly available antibacterial agents.

Bacteraemia--a Sagamu perception.

In this study laboratory records of all positive blood cultures at Olabisi Onabanjo University Teaching Hospital between January 1993 and December 1998 were reviewed and analyzed. A total of 2057 samples of blood cultures were received in the laboratory during the period of study. 495 (24.1%) samples yielded significant growth of microorganisms. 87 (17.6%) of the positive cultures were from the out patients. Most of the positive blood cultures (99.6%) were mono-microbial. A total of 497 isolates were obtained. The predominant organisms isolated were Klebsiella species (30.8%), Staphylococcus aureus (30.8%), atypical coliforms (11.9%) and Pseudomonas species (7.5%). There were more gram-negative organisms 309 (62.2%) than gram-positive organisms 188 (37.8%). Staphylococcus aureus (30.8%) and Staphylococcus epidermidis (5.0%) were the predominant gram-positive organisms isolated. A large number (>50%) of the organisms isolated were resistant to Ampicillin and Gentamicin but were sensitive to third generation cephalosporins and quinolones. In conclusion, this study demonstrates the need for all hospitals to monitor the microorganisms causing septicemia so that the clinicians can be alerted to a suitable strategy for blind therapy.