Knowledge of, and attitudes to, acquired immune deficiency syndrome (AIDS) among traditional birth attendants (TBAs) in rural communities in Cross River State, Nigeria.

AIM: To survey knowledge of, and attitudes to, HIV/AIDS held by traditional birth attendants (TBAs) in rural communities in Cross River State, Nigeria. BACKGROUND: As the HIV/AIDS epidemic continues to spread, undermining development, reversing health gains and exacerbating poverty, TBAs in rural communities in Cross River State, Nigeria are still less informed about this dreadful disease. METHODS: A survey consisting of structured questionnaires was used with 140 randomly selected TBAs to assess their knowledge of HIV/AIDS, source of information on HIV and protective practices. FINDINGS: Results revealed that 62 (44.3%) of the TBAs had no formal education. Forty-four (31.4%) had primary education, while 19 (13.6%) had secondary education. On knowledge of HIV and sources of information, 49 (35.0%) of respondents reported knowing what HIV means. While 26.4% indicated that they received information about HIV from the government health centres, 23.6% had no information about the disease. There was a great disparity between male (73.7%) and female (28.9%) respondents on knowledge about HIV. On the use of protective safety procedures during delivery, 61 (43.6%) used sterilized blades, while 10.7% admitted wearing protective clothes and gloves. Only three (2.1%) of the respondents said that they were aware of the HIV status of their clients prior to delivery. CONCLUSIONS: This survey has demonstrated that few TBAs in the communities studied in Cross River State are informed about HIV/AIDS, and this has revealed the urgency of starting a programme specifically designed for TBAs in rural communities towards a massive educational campaign on HIV/AIDS.

Human immunodeficiency virus type-1 (HIV-1) and the associated clinical features among sero-positive Nigerian subjects.

Enzyme Linked Immunosorbent Assay (ELISA) and Westernblot were employed to analyze sera collected from one thousand and fifty (1050) patients who tested HIV positive type-1. Out of this, 95 (9.1%) of the patients were less than 2 years old, 102 (10.0%) were aged between 2-15 years old while 813 (77.4%) were aged above 15 years. For any age group, the ratio of male to female was 1:1 except that there was excess of males below 5 years. There were four (4) most frequent signs and symptoms observed. These were loss of weight or malnutrition, generalized lymphadenopathy, chronic watery diarrhoea and chronic chest infections. Loss of weight was recorded in 65.0% of the seropositive patients in all age groups. Generalized lymphadenopathy was seen in 35.0% of all the age groups but was most frequent in 36.1% of those less than 2 years. Chronic watery diarrhoea (42.8%) was frequent in patients less than 2 years and less frequent in 18.0% of older children between 1-15 years. Chronic chest infections were least frequent in 25.0% of adults above 15 years old and highest frequency was observed in 53.0%, children less than 2 years. Forty patients had incomplete documentations and children of pediatric ages had acutely overt clinical manifestation of HIV (1&11) attributable to undeveloped immune competence.

The problems of indeterminate HIV results in blood transfusion services in Nigeria.

Five hundred sera samples were collected from individuals whose age range was 16-40 years, analysed using Murex 1 and 2 and Capillus HIV kit (Cambridge Biotechnology, Cambridge, UK), and confirmed with Western Blot technique (Biorad). Of these, 186 (37.2%) were repeatedly reactive, 90 (48.4%) were confirmed positive, 55 (29.6%) indeterminate (20 [10.7%] from blood donors) and 44 (22.0%) were negative. The data reveal a significant correlation between indeterminate results and confirmed positive sera (P < 0.05). This demonstrates the high incidence of indeterminate HIV results encountered in blood transfusion services.

The evaluation of non-specific cellular immunological parameters amongst children with Schistosoma haematobium infection in Nigeria.

This study used the leucocyte migration index to assess cellular immune function in children with urinary schistosomiasis. Migration inhibitory factor was produced (with other lymphokines) by sensitizing mitogens. The production of antigen-induced migration inhibitory factor in vitro correlated with the in vivo state of cellular hypersensitivity of the lymphocyte donor. The percentage positive leucocyte migration rate using three mitogens was least with inactivated measles haemagglutinin virus (IMV) and highest with Bacillus Calmette-Guerin (BCG) in the control group, while highest with tuberculin purified protein derivative (PPD) and least with IMV in the test group. The measurement of the migration index of leucocytes comparing the control with lightly- and heavily-infected children on activation using three mitogens was significantly reduced, except in the case of the control versus lightly-infected children using IMV. Using IMV, the leucocyte migration index for control versus lightly-infected children and heavily-infected children was significant (p > 0.002 and p < 0.001, respectively). Using BCG the difference between controls and lightly- and heavily-infected children were significant (p < 0.02). PPD showed no significant difference in leucocyte migration between control and the lightly- or heavily-infected children. In all leucocyte migration index decreased with intensity of infection except in the case of PPD (p < 0.002 for BCG; p < 0.001 for the IMV). There was a significant correlation between egg count and leucocyte migration index; for BCG (r = -0.20, p < 0.005); for IMV (r = -0.3, p < 0.001); for PPD (r = -0.38,p < 0.001). Patients with schistosomiasis infection can express normal and effective cellular immune responses to non-schistosomal antigens and also have equal immunological ability to combat pathogens as S. haematobium-free controls.

Hepatitis B surface antigen (HbsAg) in the sera of medical, nursing and microbiology students in Ibadan, Nigeria.

A total of 331 serum samples collected from medical students, student nurses, microbiology students, and patients presenting with Pyrexia of Unknown Origin (PUO) were tested for the presence of Hepatitis B surface Antigen (HbsAg). While only seven (14.0%) of 50 microbiology students (mean age 24.0 years) tested positive for HbsAg, six (6.7%) of 89 student nurses (mean age 21.6 years) and 13 (13.5%) of 95 medical students (mean age 24.3 years) in the clinical phase of their study were found to have HbsAg in their sera. Also, 10 (10.3%) of 97 patients with PUO (mean age 25.4 years), a group of patients from whom medical personnel are most likely to often collect blood for laboratory studies, were found to have HbsAg in their sera. No significant difference was found in the prevalence of HbsAg among the different groups examined in this study (P>0.05). The result of the study thus shows that medical and nursing students, unlike what is known for practising nurses, physicians and surgeons are not at a higher risk of HBV transmission than students of botany and microbiology. Likewise, patients with PUO do not constitute a group that is more likely to transmit HBV to medical personnel than other groups of patients. Vaccination against hepatitis B virus during the early period of medical and nursing training may therefore go a long way to reduce the high prevalence of hepatitis B virus infection previously reported among practising health personnel in Nigeria.