Open Access Original Research Article

Modelling Human Immunodeficiency Virus cum Tuberculosis Co-infection Dynamics in Kwande-Nigeria: An Econometrics Time Series Approach

David Adugh Kuhe, James Serumun Ivande

International STD Research & Reviews, Page 1-9
DOI: 10.9734/ISRR/2017/33099

Aims: To model the dynamics of Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) co-infection in Kwande region of Benue state in Nigeria using econometrics time series techniques.

Place and Duration of Study: The study is conducted in Kwande-Nigeria and utilizes monthly data of serologically confirmed cases of HIV and Tuberculosis infections from patients attending General hospital Adikpo in Kwande region from January 2007 to December 2016.

Methodology: The study employs Phillips-Perron (PP) unit root test, simple correlation and regression analysis, Engle-Granger cointegration test, error correction model (ECM) as well as pairwise Granger causality test as methods of analysis.

Results: Results showed that the series are integrated of order one, HIV and TB are found to be strongly and significantly positively correlated. HIV is found to have long lasting, positive and significant impact on TB and every HIV patient in the study area is found to have equal chance of developing TB. The study found a long-run stable relationship between HIV and TB. HIV is also found to Granger caused TB in the study area.

Conclusion: The study recommends policies that would improve health promotion and education of the people, health awareness campaign of the public on HIV and TB be implemented in the study area and beyond, also the importance of HIV and TB screening prior to marriage contracts should be emphasized.

 

Open Access Original Research Article

Poor Adherence Predictors and Factors Associated with Antiretroviral Treatment Failure among HIV Seropositive Patients in Western Nigeria

Saheed Opeyemi Usman, Gbemiga Peter Olubayo, Oluwole Tosin Oluwaniyi, Abayomi Joseph Afe, Ganiyu Babatunde Agboola, Olufunmi Abodunde, Timothy Akinmurele, Olatoun Adeola, Maduakolam Onyema

International STD Research & Reviews, Page 1-8
DOI: 10.9734/ISRR/2017/38469

Background: The efficiency and success of antiretroviral therapy (ART) depends on a good level of patient’s adherence to a life-long regimen of antiretroviral (ARV) which is beneficial in reducing the risk of emergence of HIV resistant strains. This adherence is however influenced by several factors related mainly to patient and medication. This study is therefore carried out to determine the adherence rate of adult patients infected with HIV and identify the factors associated with antiretroviral therapy (ART) interruption or poor adherence.

Methods: This cross sectional study was carried out in Ondo & Ekiti States, South Western Nigeria. The target population was adult patients living with HIV and already initiated on ART. Data was collected by trained volunteers and supervised by appointed supervisors, by a face-to-face interview. All data were statistically analysed, using statistical package for the social sciences (SPSS) and statistical test of significance was performed with Chi-Square test.

Results: A total of 412 consenting respondents participated in the study with a mean age ± SD is 37.93 ± 9.30 years. 116 (40.8%) of them are males while 244 (59.2%) are females. ART adherence level was 79.6%. The main factor associated with ART adherence was educational status (χ² = 16.18, df = 3, P = 0.001). Drug reminder strategy have lower association with missing ART drug (OR: 0.51, 95% CI: 0.28 – 0.92) while patients experiencing ART drug side effect have higher association with missing ART drug (OR: 1.82, 95% CI: 1.01 – 3.28).

Conclusion: ART adherence is sub-optimal, with barriers largely patient-dependent thus it is imperative to intensify medication adherence counselling in an holistic behavioural educational improvement strategy aimed at improving the ability to fit therapy into own lifestyle, avoid drug exhaustion, achieve optimal adherence and remarkable patient outcome.

 

Open Access Original Research Article

Knowledge and Practices Regarding Prevention of Mother-to-child Transmission of HIV among Health Workers in Primary Healthcare Centers in Sokoto, Nigeria

S. A. Arisegi, K. J. Awosan, H. Abdulsamad, A. H. Adamu, M. B. Isah, S. Mora

International STD Research & Reviews, Page 1-9
DOI: 10.9734/ISRR/2017/38680

Introduction: Evidence from studies has shown that transmission of HIV from mother-to-child during pregnancy, labor, delivery or breastfeeding can be reduced from 15 – 45% in the absence of any intervention to below 5% with effective interventions during these periods. This study aimed to assess the knowledge and practices regarding prevention of mother-to-child transmission of HIV among health workers in Primary Healthcare Centers in Sokoto, Nigeria.

Methods: A cross-sectional descriptive study was conducted among 241 Primary Health Care (PHC) workers selected by universal sampling. Data were collected with a set of standardized, semi-structured, self-administered questionnaire, and analyzed using the IBM SPSS Version 20 statistical computer software package.

Results: All the 241 respondents were aware of mother-to-child transmission (MTCT) of HIV infection. About two-thirds (62.6%) of respondents have attended a training workshop on prevention of mother-to-child transmission (PMTCT) of HIV infection. Only about two-thirds (63.5%) of respondents had good knowledge of MTCT of HIV and its prevention; and it was significantly associated with cadre. The most commonly known methods of MTCT of HIV were through the placenta (71.4%), during vaginal delivery (70.5%) and through breast feeding (62.7%). Only about half to two-thirds of respondents knew the methods of preventing mother-to-child transmission of HIV infection. The methods most commonly known to the respondents were delivery by cesarean section (66.8%), avoiding procedures that increase risk of MTCT of HIV (66.4%), and HIV testing and counseling of pregnant women (63.5%). Barely two-thirds of respondents (58.9%) routinely provide HIV testing and counseling for all the pregnant women seen by them at their respective health facilities, and less than half of respondents (44.4%) routinely administer ARV prophylaxis to mother and child or refer them to where such services are available.

Conclusion: Although, awareness of PMTCT of HIV was high among the respondents in this study, on the job training, knowledge and practices were poor. These findings suggest the need to ensure universal coverage in training and access to information on PMTCT of HIV among healthcare workers. In addition, governments and other stakeholders involved in HIV/AIDS prevention and control should give PMTCT of HIV top priority.

 

Open Access Original Research Article

Impact of Highly Active Antiretroviral Therapy on Hepatic Enzyme Elevation among HIV Seropositive Individuals: A Case Control Study in Ghana

Louis Boafo Kwantwi, Christian Obirikorang, Margaret Agyei Frempong

International STD Research & Reviews, Page 1-7
DOI: 10.9734/ISRR/2017/39117

Background: Increasing access to highly active antiretroviral therapy (HAART) in our population in recent times has necessitated the assessment of the impact of these therapies on hepatic enzymes. We therefore aimed to assess the impact of highly active antiretroviral therapy on hepatic enzymes and to ascertain the trend of hepatic enzyme elevation in HIV disease progression.

Method: 192 confirmed HIV individuals consisting of 104 HAART experienced and 88 HAART naïve patients were recruited into the study. Venous blood was taken for the assay of Alkaline Phosphatase (ALP), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Gammaglutamyltransferase (GGT).

Results: There was a significant increase (p<0.0.5) in the median AST, GGT, ALT and ALP in the HAART naïve patients than the HAART experienced patients. There was a significant increase (p<0.0001) in the prevalence of AST, ALT, ALP and GGT elevation in the HAART naïve patients (35.2%, 28.4%, 28.4% and 48.9% respectively) than the HAART experienced patients (5.8%, 1.9%, 5.8% and 10.6% respectively).

Conclusion: It is clear from this study that HAART may have a minimal effect on hepatic enzyme elevation and longer duration of treatment does not result in liver enzyme elevation. Close monitoring of patients receiving HAART is still relevant.

 

Open Access Original Research Article

Nephroprotective Effect of Highly Active Antiretroviral Therapy among HIV Seropositive Individuals: A Case-Control Study in Ghana

Louis Boafo Kwantwi, Christian Obirikorang, Margaret Agyei Frempong

International STD Research & Reviews, Page 1-8
DOI: 10.9734/ISRR/2017/39118

Background: Despite the widespread use of highly active antiretroviral therapy (HAART), renal insufficiency still exists among HIV infected individuals. This study aimed to use creatinine-based equations to determine the role of highly active antiretroviral therapy on renal function.

Methods: One hundred and ninety-two (192) HIV individuals consisting of one hundred and four (104) HIV patients on HAART and eighty-eight (88) HIV HAART naïve patients were recruited into the study. Serum creatinine, urea, CD4 count and weight were determined. Glomerular filtration rates were estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Kidney Disease (MDRD) equations.

Result: The calculated renal insufficiency (eGFR<60 ml/min /1.73 m2) among the studied population was (7.8% for CKD-EPI and 10.9% for MDRD).The prevalence of renal insufficiency in HAART individuals was lower (1.9% for CKD-EPI and 2.9% for MDRD) than HAART naïve individuals (14.7% for CKD-EPI and 20.4% for MDRD).

Conclusion: The results of this study provide evidence of a significant improvement in renal function and a reduced prevalence of renal insufficiency among HIV individuals on HAART showing the importance and the effectiveness of HAART in improving renal function. Our result confirms the safety of tenofovir regimens given the fact that none of the patients on tenofovir-based regimen had renal insufficiency.