Measuring HIV Stigma for PLHAs and Nurses Over Time in Five African Countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho; Malawi; South Africa; Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection; their adherence to medication; and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69); and 67.1(N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63); and 88.6(N=784) were females. Eighty-four per cent PLHAs reported one or more HIV-stigma events at baseline. This declined; but was still significant 1 year later; when 64.9reported experiencing at least one HIV-stigma event. At baseline; 80.3of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.71 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions; particularly focused at healthcare providers who experience HIV stigma by association

A study of the association between improved sanitation facilities and children's height in Lesotho.

The impact of improved sanitation on the anthropometric status of children under 5 years in Lesotho was investigated using children recruited into a case-control study of diarrhoea morbidity. The children's height-for-age Z-scores were used as an indicator of chronic undernutrition. Classifying children as 'stunted' or 'adequately nourished' revealed some evidence of an association between latrine ownership and attained height. After allowing for confounding variables, the odds of stunting were 18 per cent lower among children in households with latrines (95 per cent confidence interval, 36 per cent lower to 3 per cent higher). More powerful analyses, using height-for-age as a continuous outcome variable, revealed that the mean height-for-age Z-score of children from households with a latrine was 0.27 standard deviations higher than that of children from households without a latrine (95 per cent c.i. = 0.12 to 0.42). These results suggest that the anthropometric status of children may be as responsive to improvements in sanitation facilities as diarrhoea morbidity in some settings.

A case-control study of the impact of improved sanitation on diarrhoea morbidity in Lesotho.

A health impact evaluation of the Rural Sanitation Pilot Project in Mohale's Hoek district, Lesotho, was conducted from October 1987 to September 1988. A clinic-based case-control design was used to investigate the impact of improved sanitation on diarrhoea morbidity in young children. The results indicate that under-5-year-olds from households with a latrine may experience 24% fewer episodes of diarrhoea than such children from households without a latrine (odds ratio = 0.76; 95% confidence interval, 0.58-1.01). The impact of latrines on diarrhoea was greater in those households that used more water, practised better personal hygiene, and where the mothers had a higher level of education or worked outside the home. In common with studies conducted in Malawi, Philippines, and Sri Lanka, little evidence was found that the relationship between latrine ownership and diarrhoea was confounded by socioeconomic status or environmental variables. For a sample of cases and controls, data on exposure status (presence or absence of a latrine) that were collected by interview at the clinics agreed closely with those obtained by observation during a home visit.

A case-control study on the impact of improved sanitation on diarrhoea morbidity in Lesotho

A health impact evaluation of the Rural Sanitation Pilot Project in Mohale's Hoek district, Lesotho, was conducted from October 1987 to September 1988. A clinic-based case--control design was used to investigate the impact of improved sanitation on diarrhoea morbidity in young children. The results indicate that under 5-year-olds from households with a latrine may experience 24 percent fewer episodes of diarrhoea than such children from households without a latrine (odds ratio = 0.76; 95 percent confidence interval, 0.58-1.01). The impact of latrines on diarrhoea was greater in those households that used more water, practised better personal hygiene, and where the mothers had a higher level of education or worked outside the home. In common with studies conducted in Malawi, Phillippines and Sri Lank, little evidence was found that the relationship between latrine ownership and diarrhoea was confounded by socioeconomic status or environmental variables. For a samble of cases and controls, data on exposure status (presence or absence of a latrine) that were collected by interview at the clinics agreed closely with those obtained by observation during a home visit

A case-control study of the impact of improved sanitation on diarrhoea morbidity in Lesotho

A health impact evaluation of the Rural Sanitation Pilot Project in Mohale's Hoek district; Lesotho; was conducted from October 1987 to September 1988. A clinic-based case-control design was used to investigate the impact of improved sanitation on diarrhoea morbidity in young children. The results indicate that under-5-year-olds from households with a latrine may experience 24 percent fewer episodes of diarrhoea than such children from households without a latrine (odds ratio = 0.76; 95 percent confidence interval; 0.58-1.01). The impact of latrines on diarrhoea was greater in those households that used more water; practised better personal hygiene; and where the mothers had a higher level of education or worked outside the home. In common with studies conducted in Malawi; Philippines; and Sri Lanka; little evidence was found that the relationship between latrine ownership and diarrhoea was confounded by socioeconomic status or environmental variables. For a sample of cases and controls; data on exposure status (presence or absence of a latrine) that were collected by interview at the clinics agreed closely with those obtained by observation during a home visit