Ej Peters

Diverse blood exposures associated with incident HIV infection in Calabar, Nigeria

Few types of blood exposures have been assessed in relation to incident HIV infection in sub-Saharan Africa, despite evidence that penile–vaginal sex cannot account for the epidemic in the region. To investigate correlates of incident HIV infection in Calabar, Nigeria, we surveyed clients at voluntary HIV counselling and testing centres. Participating clients who tested multiple times were generally similar to those testing only once in terms of demographic characteristics, sexual and blood exposures and HIV prevalence. Blood exposures were common. Serial testers had a 10% annual incidence of HIV infection. Seroconverters and seronegative serial testers were similar on most demographic characteristics and sexual exposures. However, seroconverters were more likely than seronegatives to report blood exposures during the test interval, both for most specific exposures as well as summary measures of blood exposures. In particular, seroconverters were substantially more likely to report one of a set of blood exposures that cannot be explained as a consequence of unprotected vaginal sex or of health care for symptoms of HIV infection (adjusted odds ratio = 6.6, 95% confidence interval = 1.2–38). The study design we used is an inexpensive approach for describing the local epidemiology of HIV transmission and can also serve as the foundation for more definitive investigations that employ contact tracing and sequencing of HIV DNA.

Socio-cultural Factors Influencing Insecticide Treated Bed Net Utilization in a Malaria Endemic City in north-central Nigeria

Objective: To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets (ITNs) in a malaria endemic city of Makurdi, north central Nigeria. Methods: The study was cross-sectional in nature using systematic sampling method to identify households. Both quantitative and qualitative data was generated from adult women using structured and semi structured questionnaires, and focused group discussions (FGDs) to obtain information on rate and patterns of utilization of ITNs. Information such as age, educational level, marital status, awareness or otherwise of the existence of malaria, and factors influencing rate of ownership and utilization of ITNs were obtained. FGDs were used to obtain qualitative information on rate of utilization of ITNs not raptured in the questionnaires. Data obtained was analysed using Epi Info 6 statistical software. Results: Among the respondents interviewed, 97.0% (2013/2075) were aware of existence of malaria and 87.0% of these (1751/2013) would associate it with mosquitoes. The rate of ownership of any bed net, ITNs and untreated bed nets (UTNs) was 25.1%. 17.0% and 8.3%, respectively. Utilization of ITNs among children was 30.0% (112/373) and UTNs 12.9% (48/373). Positive contributors to ITNs utilization were literacy, enhanced economy, experience of marriage, and being gainfully employed (P＜0.05); while negative contributors were ignorance, poverty and some cultural beliefs and values. Conclusions: A mole synchronized advocacy should be carried out on the potential benefits of ITNs utilization and sustained. Also ITNs should be made available to the people of the community at minimal or no cost.

The relationship between lung function and indoor air pollution among rural women in the Niger Delta region of Nigeria

Background: Burning of biomass is widely used by the rural poor for energy generation. Long term exposure to biomass smoke is believed to affect lung function and cause respiratory symptoms. Materials and Methods: Women with long term occupational exposure to burning firewood were recruited from a rural fishing community in Nigeria. A questionnaire was used to obtain information on symptoms of chronic bronchitis and spirometery was performed to measure lung function. Data obtained from the subjects was compared with that from healthy controls. Results: Six hundred and eighty six women were recruited for this study made up of 342 subjects and 346 controls. Sixty eight (19.9%) of the subjects had chronic bronchitis compared with eight (2.3%) of the controls (χ2 = 54.0, P < 0.001). The subjects had lower values for the lung function as well as the percentage predicted values (P < 0.05). Fish smoking and chronic bronchitis were significantly associated with predicted lung volumes. Conclusion: Chronic exposure to biomass smoke is associated with chronic bronchitis and reduced lung functions in women engaged in fish smoking.