Prevalence Pattern and Determinants of Disclosure of HIV Status in an Anti Retroviral Therapy Clinic in the Niger Delta Region of Nigeria.

BACKGROUND: In order to advance the extent of self-disclosure of HIV sero-status in Nigeria, we evaluated the prevalence, pattern and determinants of disclosure of HIV status amongst adult patients in a hospital in the Niger Delta. MATERIALS AND METHODS: In a three month cross sectional study undertaken in March 2012, the demographic and clinical data as well as HIV sero-status disclosure frequency and pattern were obtained using a pre-tested questionnaire from consenting HIV infected adults attending the Anti-Retroviral Therapy Clinic in the Niger Delta. Independent determinants of HIV disclosure to current sexual partner were determined using an unconditional logistic model. P<0.05 was considered statistically significant. RESULTS: A total of 260 patients were studied out of which 184(71%) were females. Disclosure to current sexual partner was found to be 62.0% and students had the least disclosure rate. Majority of study participants preferred to disclose to family members (57%) than past sexual partner (2.5%) or friend (4.9%). Although HIV disclosure was significantly associated with male sex, living with sexual partner, partner being HIV positive; the only independent determinants of HIV disclosure were partner being on ART (OR-12.7, 95% CI 1.2-132.7) and being currently married (OR-8.8, 95% CI 2.1-36.8). CONCLUSION: The results of our study suggest low rate of HIV status disclosure among HIV infected patients in the Niger Delta. We found that receiving ART and being currently married promoted disclosure. There is need for clinicians and policy makers to foster disclosure of HIV sero-status in Nigeria especially among HIV infected students and unmarried sexual partners.

The Asthma Control Test and its Relationship with Lung Function Parameters

The Asthma Control Test (ACT) is a validated, simple,and inexpensive instrument to assess control among patients with bronchial asthma. However, its relationship with lung function parameters is yet to be demonstrated among Nigerian asthma patients. Our study aimed at assessing asthma control using ACT scores and determining its relationship with lung function parameters among persons with asthma in a university respiratory clinic.The cross-sectional study included 65 patients with bronchial asthma who underwent routine check-ups in respiratory clinics at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria between October 2009 and January 2011. The ACT was administered to assess for asthma control. Lung function testing was done using the guidelines of the American Thoracic Society (ATS).The mean pre-bronchodilator FEV1 (forced expiratory volume in 1 second) was 1.97±0.87L and mean ACT score was 18.2+4.28; 24 (37%) of the study subjects had well-controlled asthma. The ACT scores were weakly correlated with percentage of predicted,FEV1(r=0.220, p=<0.078) and PEF (peak expiratoryflow), (r=0.168,p=0.18).In this study, most of the patients had poor asthma control and lung function parameters correlated poorly with ACT scores. It is important that the ACT complements other physiological measures of assessing asthma control in our environment

Prevalence pattern and determinants of disclosure of HIV status in an anti retroviral therapy clinic in the Niger delta region of Nigeria

Background: In order to advance the extent of self-disclosure of HIV sero-status in Nigeria, we evaluated the prevalence, pattern and determinants of disclosure of HIV status amongst adult patients in a hospital in the Niger Delta. Materials and Methods: In a three month cross sectional study undertaken in March 2012, the demographic and clinical data as well as HIV sero-status disclosure frequency and pattern were obtained using a pre-tested questionnaire from consenting HIV infected adults attending the Anti-Retroviral Therapy Clinic in the Niger Delta. Independent determinants of HIV disclosure to current sexual partner were determined using an unconditional logistic model. P<0.05 was considered statistically significant. Results: A total of 260 patients were studied out of which 184(71%) were females. Disclosure to current sexual partner was found to be 62.0% and students had the least disclosure rate. Majority of study participants preferred to disclose to family members (57%) than past sexual partner (2.5%) or friend (4.9%). Although HIV disclosure was significantly associated with male sex, living with sexual partner, partner being HIV positive; the only independent determinants of HIV disclosure were partner being on ART (OR-12.7,95% CI 1.2-132.7)and being currently married (OR-8.8,95% CI 2.1-36.8). Conclusion: The results of our study suggest low rate of HIV status disclosure among HIV infected patients in the Niger Delta. We found that receiving ART and being currently married promoted disclosure. There is need for clinicians and policy makers to foster disclosure of HIV sero-status in Nigeria especially among HIV infected students and unmarried sexual partners

Impact of scarcity of automobile fuel on attendance at a referral centre for tuberculosis in Nigeria.

BACKGROUND: Tuberculosis in its pulmonary and extra-pulmonary form is still a common finding in the developing world. This study was to investigate the impact of a period of scarcity of automobile fuel in the Niger-Delta area of Nigeria on attendance at a Tuberculosis Referral Centre in Igbogene, Yenagoa, Bayelsa State. METHODS: Data was collected on attendance before, during and after the scarcity. This Tuberculosis and Leprosy Control Centre is run by a German non-governmental organization. (NGO), and the State's Ministry of Health. No user fee is charged. RESULTS: During the period of scarcity of automobile fuel, the total 12-months attendance of males decreased to 25.1% of that before the advent of scarcity. Attendance rose in the post-scarcity period, but reached only 78.5% of the pre-scarcity level. For females, the 12 months attendance during the scarcity period reduced to 75.3% of the pre-scarcity level. The 12-months attendance by females rose in the post-scarcity period to 109.2% above the pre-scarcity level. There was no evidence of an increase in attendance over the course of the period of automobile fuel scarcity among either males or females. CONCLUSION: The scarcity of automobile fuel which usually translated to an increase in cost of transportation probably increased the number of untreated tuberculosis patients in the population with potential serious long term health implications. The provision of vehicles as well as facility for storage of automobile fuel to this referral Centre by either the NGO or the Ministry of Health is suggested. This would allow the Centre carry out domiciliary service to these patients.