International STD Research & Reviews

Distribution functions, their properties and interrelationships play a significant role in modeling naturally occurring phenomena. Numerous standard distributions have been extensively used over the past decades for modeling data in several fields, however, generalizing these standard distributions has produced several compound distributions that are more flexible compared to the baseline distributions. Acquired immune deficiency syndrome is a disease caused by human immunodeficiency virus (HIV) that leads to a continuous decay of the human body immune system. Over the past few years, the rate of mother-to-child transmission of HIV has been on a non-decreasing trend in Nigeria and hence becoming a threat to the health of the nation. The Weibull generalized family of distributions has been efficient in developing new continuous probability distributions with additional two shape parameters. In this paper, a Weibull-based model has been proposed and it is called “a Weibull-Exponential Inverse Exponential distribution”. The properties, estimation of parameters and application of the new distribution are presented and discussed in this paper. Adequate application and investigation of the new model was done using a dataset on the rate of mother-to-child transmission of HIV and the result was compared with that of other competing models.

Recently, researchers have shown much interest in developing new continuous probability distributions by adding one or two parameter(s) to the some existing baseline distributions. This act has been beneficial to the field of statistical theory especially in modeling of real life situations. Also, the exponentiated family as used in developing new distributions is an efficient method proposed and studied for defining more flexible continuous probability distributions for modeling real life data. In this study, the method of exponentiation has been used to develop a new distribution called “Exponentiated odd Lindley inverse exponential distribution”. Some properties of the proposed distribution and estimation of its unknown parameters has been done using the method of maximum likelihood estimation and its application to real life datasets. The new model has been applied to infant mortality rate and mother-to-child HIV transmission rate. The results of these two applications reveal that the proposed model is a better model compared to the other fitted existing models by some selection information criteria.

Introduction: Herpes simplex type 2 (HSV-2) is the main curse of Genital Herpes (GH) infection worldwide with developing countries having larger proportions. Little is known about its diagnosis using the synergy techniques of Immunoglobulin G (IgG) and Polymerase chain reaction (PCR) for its accurate diagnosis. This study focuses on carrying out the synergy (concurrent) between serology and PCR techniques for diagnosing GH caused by HSV-2.

Methods: A total of 388 pregnant women were sampled using a well-structured questionnaire, a self-collected vaginal swab for PCR shedding detection and 10 ml of blood collected for serological assay. Data were analyzed using statical packages for Social sciences. P value were kept at <0.05.

Results: A total 85 (21.9%) of the 388 sampled women were positive for Herpes simplex type 2 by PCR shedding techniques. Majority of the samples 345 (88.9%) were positive to serology assay. 57 (16.5%) of all 345 seropositive respondent are also shedders of the virus by PCR assays, p <0.05. Conversely, 28 (65.1%) of all 43 seronegative patients were shedders of HSV-2.

Conclusion: The synergistic technique of Serology and PCR should be considered incorporated as detection techniques for accurate diagnosis as this will assist in prompt management of genital herpes infection.

Aims: To explore the impact of enhanced adherence counseling (EAC) in achieving viral suppression among our patients unsuppressed viral load in a large Anti-retroviral therapy (ART) program in South West Nigeria.

Study Design: This study was a descriptive cross-sectional review of patients’ records.

Place and Duration of Study: The study was conducted in human immunodeficiency virus (HIV) Program located in Infectious Disease Institute, College of Medicine, University of Ibadan, Nigeria involving review of data of patients with unsuppressed viral loads between 1^st March 2017 – 30^th September 2018.

Methodology: We described the viral loads (VL) outcomes of patients with VLs >1 000 copies/ml after at least 6 months on ART and a comprehensive 3 monthly EAC support programme. We calculated adherence using pharmacy refill data. Patients with one VL measurement after the EAC sessions were eligible for analysis.

Results: Out of 400 patients with VL >1 000 copies/ml reviewed during the study period, only 204(51.0%) were virally suppressed at the end of the 3 EAC sessions. Those with initial VLs between 1000-5000cp/ml had the highest adherence rate (73.0%) and VL suppression rate (68%). The youngest age group (16-30 years) had the least adherence (55.2%) and the least viral suppression (44.8%) while the oldest age groups (61-80years) were the most adherent (69.0%) and the most virally suppressed (55.2%). The proportion of patients on second line regimen were significantly more virally suppressed than those on the first line regimen (P <0.002).

Conclusion: This study showed the role EAC in accomplishing VL suppression and the need to intensify adherence counseling at commencement of highly active anti-retroviral therapy (HAART) to strengthen adherence in people living with HIV (PLHIV) and consequently preventing raised VL at the next laboratory testing of viral load. We strongly advocate for better measurement of adherence to antiretroviral therapy that will be accessible and reliable as this was a limitation of this study.

This paper describes the WHO’s Model of Optimizing Volumes and Efficiencies (MOVE), adapted by the University Research Council (URC) - Department of Defense HIV/AIDS Prevention Program (DHAPP) to rapidly scale up Voluntary Medical Male Circumcision (VMMC) within Uganda’s military health facilities. First, we examine the MOVE model and then present the URC-DHAPP adapted intervention package comprising of: a) a Command-driven approach, b) Mobile theatres c) Quality assurance d) Data strengthening and reflection. To expand VMMC, URC-DHAPP worked with army commanders to create awareness, mobilize their troops and surgeons were assigned daily targets. The mobile theatre involved regular visits to hard-to-reach outposts and placing several mobile camps at health facilities close to deployment sites. All stakeholders were briefed on performance trends of previous medical camps and the program was monitored through VMMC camp reports. URC-DHAPP registered an exponential increase in VMMC coverage from 13% performance at Q2 to over 140% in Q4. The integrated approach led to circumcision of over 22,000 men (15-49 years) in a record four months. Our approach also contributed to health system strengthening and national HIV preventiontargets. We conclude that the MOVE is cost-effective and can be successfully scaled up in resource-limited settings with a high HIV burden when implemented with cognizance of contextual specificities.