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Pan Afr Med J ; 33: 277, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692880


Introduction: Adherence is vital to effective antiretroviral therapy (ART) for reducing viral load and HIV/AIDS-related morbidity and mortality. This study was aimed at evaluating the adherence of HIV seropositive patients to ART in a tertiary institution in Nigeria. Methods: A cross sectional observational study was conducted among 400 HIV seropositive patients. The study was carried out between December 2016 and February 2017 at the HIV clinic of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Results: The mean age of the HIV patients was 42.2±9.5 years with a predominant female gender (Male:Female = 1:2.8). The median CD4 counts increased from 302.1±15.0cells/mm3 at diagnosis to 430.8±13.3cells/mm3 at the time of the study. Majority of participants were unaware of their spouses' HIV status (59.3%) while 32.5% of participants had a serodiscordant spouse. Poverty was a major challenge as 73.3% earned less than 140 dollars per month. Depressive symptoms, anxiety disorder and insomnia were also reported in 40.7%, 33.2% and 47.2% respectively. Poor adherence to ART was observed in almost 20% of the patients. Logistic regression indicated that predictors of poor adherence were depression, anxiety and low CD4 counts. Conclusion: Adherence to anti-retroviral therapy was good amongst the majority of HIV seropositive patients. Depression, anxiety disorder and low CD4 count were however associated with poor adherence. This emphasizes the role of the psychology units as integral part of the HIV clinic to assist patients' adherence to anti-retroviral regimens.

Fármacos Anti-HIV/administração & dosagem , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
Cureus ; 9(10): e1756, 2017 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-29226046


Introduction Chronic illnesses are slowly becoming more prevalent worldwide. The implications and ramifications of these illnesses vary and affect not only the patient but the entire household in many ways. This research focuses on the economic implications of this category of illnesses on the entire household. The aim is to determine the economic implications of chronic illnesses on households of patients in selected health facilities in Ile-Ife, Nigeria, and to elucidate the various coping strategies applied by households in low and middle income countries (LMICs) to keep up with these economic implications. Methods This study features a descriptive cross-sectional survey design with a total sample of 443. The target population consists of individuals with chronic diseases in selected health care facilities in Ile-Ife.  Results The mean household monthly incomes before and after illness episodes were found to be $335.84 and $318.01, respectively. The mean direct cost of chronic illness was $137.72 with about 79% (n=350) of the respondents spending more than 10% of the monthly household income on health. The indirect costs of illness were a loss of productivity of 18.9% and 5.1% for patients and caregivers, respectively. A large percentage of the respondents resorted to borrowing (44.7%; n=198), while another 5.0% (n=22) sold assets, and 8.6% (n=38) had access to health insurance in order to cope with the economic impacts of the illness. Conclusion The study showed that chronic illnesses imposed high and catastrophic cost burdens on patients and their households. The lack of effective coping strategies points at the need for policymakers to improve access to specialized care and increase coverage of formal health insurance so as to ameliorate the significant economic impacts that chronic illnesses have on entire households.

Toxicol Rep ; 3: 608-619, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28959584


Cyclophosphamide (CP) is a widely used cytotoxic alkylating agent with antitumor and immunosuppressant properties that is associated with various forms of reproductive toxicity. The significance of natural antioxidants of plant origin should be explored, especially in a world with increasing incidence of patients in need of chemotherapy. The neuro-endocrine effects of aqueous extract of Amaranthus viridis (Linn.) leaf (AEAVL) in Wistar rats with CP-induced reproductive toxicity was determined. Forty rats were used for this study such that graded doses of the extract were administered following CP-induced reproductive toxicity and comparisons were made against control, toxic and standard (vitamin E) groups at p < 0.05. The synthetic drugs (CP, 65 mg/kg i.p. for 5 days; Vitamin E, 100 mg/kg p.o. for 30 days) as well as the extract (100, 200 and 400 mg/kg p.o. for 30 days) were administered to the rats at 0.2 mL/100 g. CP induced reproductive toxicity as evidenced by significantly lowered levels of FSH, LH and testosterone, perturbation of sperm characterization, deleterious disruptions of the antioxidant system as evidenced by decreased levels of GSH as well as elevation of TBARS activity. Histopathological examination showed hemorrhagic lesions with scanty and hypertrophied parenchymal cells in the pituitary while the testis showed ballooned seminiferous tubules with loosed connective tissues and vacuolation of testicular interstitium. These conditions were significantly reversed (p < 0.05) following administration of the graded doses of the extract. It was, therefore, concluded that AEAVL could potentially be a therapeutic choice in patients with CP-induced neuro-endocrine dysfunction and reproductive toxicity.