Samuel Anu Olowookere

Living well with HIV in Nigeria? Stigma and survival challenges preventing optimum benefit from an ART clinic

Thirty years into the HIV pandemic, the interactions of stigma, social and economic survival, and clinical interventions continue to be key to understanding and managing HIV at both personal and societal levels. With antiretroviral therapy, HIV is increasingly a chronic condition requiring lifelong treatment, near-perfect adherence, and support from both social networks and formal services. This study asked: is stigma still a significant problem for people living with HIV (PLHIV) who have secured access to antiretrovirals (ARVs)? How do PLHIV accessing ARVs in Nigeria experience the social, economic and health service supports intended to address their needs? What are the concerns and challenges of PLHIV and health workers regarding these supports? What are the implications for approaches to stigma and discrimination? This qualitative study at the Antiretroviral (ART) Clinic of the Osogbo State Hospital, Osun State, Nigeria involved in-depth interviews with 15 PLHIV who have been attending the clinic for at least one year, and three health workers. The results reveal both the diversity among even a small number of patients, and persistent cross-cutting themes of stigma, discrimination, poverty, and the psychological impacts of insecure livelihoods and well-intentioned but ultimately stigmatizing supports such as selective food parcels. Both population-based interventions against stigma and poverty, as well as micro-level, contextualized attention to patients’, families’ and health workers’ fear of social exclusion and infection at a clinic and community level are needed if patients – and society – are to live well with HIV in Nigeria.

Reliability of Rapid Diagnostic Tests in the diagnosis of malaria amongst children in two communities in South West Nigeria

Background Prompt treatment of malaria following adequate diagnosis helps to reduce morbidity and mortality in children. Lack of resources and adequate manpower in developing countries make malaria microscopy difficult. The Rapid Diagnostic Test kit (RDT) remains unpopular despite its availability and ease of use because of lack of local research on its effectiveness leading to over-prescription of Artemisinin Combination Therapy (ACT).

A Population Based Study on the Prevalence of Cigarette Smoking and Smokers’ Characteristics at Osogbo, Nigeria

Background Cigarette smoking has been linked to several cancers worldwide. The characteristics of smokers have not been well documented among Nigerians. Objective This study assessed the prevalence and characteristics of cigarette smokers among the residents of Osogbo, in southwestern Nigeria. Method The study, a population based cross-sectional study of randomly selected consenting adult residents of Osogbo, was conducted in September of 2011. Data was collected using a semi-structured interviewer administered questionnaire on cigarette smoking. Results A total of 759 respondents were interviewed. Mean age was 42.1 ± 12.5 years. There were 364 (48%) males and 395 (52%) females. About 22% had ever smoked while 8.7% were current smokers, smoking an average of 22.9 ± 10.1 cigarettes per day. Males constituted the majority of current smokers. Most smokers (71%) were introduced to smoking by friends and ill health was the most often reported reason for quitting. Conclusion Cigarette smoking is commonly practiced among males in the studied population and awareness creation and advocacy should be conducted throughout the city in order to inform current smokers about the hazards and cumulative effects inherent in smoking.

Seroprevalence of transfusion transmissible viral markers in sickle cell disease patients and healthy controls in Ile-Ife, South-Western Nigeria: A case–control study

Background: The risk of acquiring transfusion transmissible viral infections is said to be higher in patients requiring regular blood transfusions such as those with sickle cell disease (SCD). Aim: We determined the seroprevalence of blood transfusion viral markers among our patients with SCD. Subjects and Methods: This a case–control analytical study consisting of 82 confirmed SCD patients on routine follow-up at our facility in steady state and 90 age-matched controls. Demographic and transfusion history were recorded while 5 ml of blood was drawn for hematocrit levels, and serum tested for transfusion transmissible viral markers for hepatitis B, (hepatitis B surface antigen [HBsAg], hepatitis B surface antibody [HBsAb], hepatitis B e antigen [HBeAg], hepatitis B e antibody [HBeAb], hepatitis B core antibody [HBcAb]), hepatitis C virus (HCV) and human immunodeficiency viruses (HIVs) using the rapid test kits. Ethical approval for the study was obtained from the Institutional Review Board and each participant gave informed consent. Data were analyzed using descriptive and inferential statistics. Results: The seroprevalence of HBsAg, HBsAb, and HBeAg in cases was 2 (2.4%), 7 (8.5%), and 0 (0.0%), respectively, whereas it was 7 (8.5%), 11 (13.4%), 6 (7.3%), and 2 (2.4%) for HBeAb, HBcAb, HCV, and HIV antibodies. Compared to the controls, cases had higher prevalence rate of HBeAb ( P = 0.005). No significant difference was observed in those with or without low hematocrit (≤18%) or those that received blood transfusion and those that did not ( P > 0.05). Conclusion: We conclude that blood transfusion did not significantly increase the seroprevalence of markers of transfusion transmissible viral infection in SCD patients.

An assessment of quality of care service provided to people living with HIV/AIDS by a secondary healthcare centre at Osogbo, Nigeria

Abstract Objective: The objective of this study was to assess the quality of service provided to people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) at a secondary healthcare centre at Osogbo, Nigeria. Design: Descriptive cross-sectional study design. Setting and subjects: People living with HIV/AIDS (PLWHA) at the State Hospital, Osogbo, Nigeria. Outcome measures: Quality of the services rendered to PLWHA. Results: A total of 304 PLWHA were interviewed. Their ages ranged from 16–60 years, with a mean age of 35.5 ± 8.8 years. There were 212 (69.7%) female and 92 (30.3%) male respondents, 248 (81.6%) were married and 108 (35.5%) had a tertiary education. Approximately half (148, 48.7%) rated the quality of the services rendered to them at the hospital as excellent, 132 (43.4%) rated it as good, and 24 (7.9%) as fair. None rated the services rendered as poor or very poor. Conclusion: The results of this study showed a good relationship between PLWHA and healthcare workers in general. Education, training and re-training of the health workers should be an ongoing exercise.

Epidemiology of an outbreak of cholera in a south-west state of Nigeria

On 19 August 2011, 11 suspected cholera cases were reported by three private hospitals to the Disease Surveillance Unit of Ede District in Osun State, Nigeria. Diagnoses were confirmed using the cholera rapid diagnostic test kit. A field investigation to provide descriptive epidemiology of the outbreak was conducted. There were 148 cases and eight deaths, giving a case fatality rate of 5%. Twelve of the 30 districts in the state were affected. Female cases constituted more than half (51%, n = 76). The distribution of cases by age category showed a higher incidence in the age group ≥ 15 years (61%, n = 90). The need to monitor the occurrence of cases closely and to provide continuous public enlightenment on household hygienic practices was emphasised.