Zaidat A. Musa

Incidence of and socio-biologic risk factors for spontaneous preterm birth in HIV positive Nigerian women

BackgroundRecent studies have identified HIV as a leading contributor to preterm delivery and its associated morbidity and mortality. However little or no information exists in our sub-region on this subject. Identifying the factors associated with preterm delivery in HIV positive women in our country and sub-region will not only prevent mother to child transmission of HIV virus but will also reduce the morbidity and mortality associated with prematurity and low birth weight. This study was designed to determine the incidence and risk factors for preterm delivery in HIV positive Nigerians.MethodThe required data for this retrospective study was extracted from the data base of a cohort study of the outcome of prevention of mother to child transmission at the Nigerian Institute of Medical Research, Lagos. Only data of women that met the eligibility of spontaneous delivery after 20 weeks of gestation were included. Ethical approval was obtained from the Institution’s Ethical Review Board.Results181 women out of the 1626 eligible for inclusion into the study had spontaneous preterm delivery (11.1%). The mean birth weight was 3.1 ± 0.4 kg, with 10.3% having LBW. Spontaneous preterm delivery was found to be significantly associated with unmarried status (cOR: 1.7;1.52-2.57), baseline CD4 count <200 cells/mm3(cOR: 1.8; 1.16-2.99), presence of opportunistic infection at delivery (cOR: 2.2;1.23-3.57), multiple pregnancy (cOR 10.4; 4.24 – 26.17), use of PI based triple ARV therapy (eOR 10.2; 5.52 – 18.8) in the first trimester (cOR 2.5; 1.77 – 3.52) on univariate analysis. However after multivariate analysis controlling for potential confounding variables including low birth weight, only multiple pregnancy (aOR: 8.6; CI: 6.73 – 12.9), presence of opportunistic infection at delivery (aOR: 1.9; CI: 1.1 – 5.7), and 1st trimester exposure to PI based triple therapy (aOR: 5.4; CI: 3.4 – 7.8) retained their significant association with preterm delivery.ConclusionThe spontaneous preterm delivery rate among our cohort was 11.1%. HIV positive women with multiple pregnancies, symptomatic HIV infection at delivery and first trimester fetal exposure to PI based triple therapy were found to be at risk of spontaneous preterm delivery. Early booking and non-use of PI based triple therapy in the first trimester will significantly reduce the risk of preterm delivery.

Trends and risk factors for obesity among HIV positive Nigerians on antiretroviral therapy.

INTRODUCTION The increased access to antiretroviral therapy has changed the once deadly infection to a chronic medical condition, resulting in a dramatic change in causes of morbidity and mortality among HIV infected individuals. Obesity and its cardiovascular sequelae are increasingly reported in the literature. However, data on the burden, trends and risk factors for obesity are sparse in countries worst hit by the epidemic. OBJECTIVES To investigate the trend and risk factors for obesity among a cohort of HIV infected adults on antiretroviral therapy. METHODS We analysed prospectively collected data in an ongoing longitudinal observational study conducted at the HIV treatment centre, Nigerian Institute of Medical Research, Lagos, Nigeria. Patients who started treatment between June 2004 and December 2009, and completed a five year follow up were included in the analysis. Multivariate analysis was used to determine the risk factors for obesity among the cohort. RESULTS A total of 12 585 adults were enrolled in the treatment programme during the study period. Of which, 8819 (70.1%) met the inclusion criteria. At the start of treatment, 27.0% were either overweight (19.6%) or obese (7.4%) compared to 62.2% that were either overweight (35.7%) or obese (26.5%) at the end of 5 years. The observed differences were statistically significant (p<0.01). Female gender (aOR: 2.2; 95% CI: 1.81-2.67), low baseline BMI less than 20 (aOR: 1.9; 95% CI: 1.3-2.2) and baseline CD4 count less than 350/μl (aOR: 2.51; 95% CI: 2.13 - 3.09) were associated with the development of obesity at multivariate analysis. Type of antiretroviral drug, age, marital status, viral load and haemoglobin level were not associated with obesity after controlling for confounding variables. CONCLUSIONS Obesity is common among HIV infected Nigerians on antiretroviral therapy and is associated with.

Inappropriate infant feeding in the context of HIV infection and associated factors in southwestern Nigeria

Aim: Optimal adherence to infant feeding method of choice is not only context specific but requires deep understanding of facilitators and barriers to appropriate infant feeding. Limited data exists on these facilitators and barriers to effective adherence to appropriate infant feeding in the context of HIV infection. In this study, we determined the risk factors for in appropriate infant feeding in the context of HIV infection. Methods: Review of infant feeding practices of HIV positive mothers seen over a decade at a large HIV treatment centre in southwestern Nigeria. Data analysis was with SPSS version 20. Univariate and multivariate analysis were used to determine the risk factors for inappropriate infant feeding in the context of HIV infection. Results: The inappropriate infant feeding rate in the context of HIV infection was 2.8%. Low Agatha N. David1, Oliver C. Ezechi1, Endurance Aghahowa1, Titilola A. Gbajabiamila1, Lilian O. Ezechi2, Zaidat A. Musa1, Agatha E. Wapmuk1, Paschal M. Ezeobi1, Sabdat O. Ekama1, Olutosin Odubela1, Aigbe G. Ohihoin1 Affiliations: 1Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria; 2Department of Home Economics, Federal College of Education, Akoka Yaba, Lagos, Nigeria. Corresponding Author: Dr. Oliver C. Ezechi, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria; Email: oezechi@yahoo.co.uk Received: 05 February 2017 Accepted: 08 August 2017 Published: 19 September 2017 educational status (aOR: 3.6; CI:2.4–5.1), low socioeconomic status (aOR: 2.3; CI: 1.3–4.1), unemployed status (aOR: 3.9; CI: 2.5–5.5), not being on care before PMTCT enrolment (aOR: 1.9; CI: 1.5–2.7), non-disclosure of HIV status (aOR: 6.3; CI: 4.9–8.3) and delivery outside an orthodox health facility (aOR: 8.1; CI: 7.4–11.7) retained significant association with inappropriate infant feeding. Conclusion: Mothers with low educational and of low socioeconomic status, unemployed, not on care before PMTCT enrolment, yet to disclosed their HIV status and who delivered outside orthodox health facility are more likely to practice inappropriate infant feeding. Health programmes that promote safe infant feeding in context of HIV infection should target poor women and those not on care.

Trends and patterns of sexual assaults in Lagos south-western Nigeria

Introduction Sexual assault is a severely traumatic experience that disproportionally affects women and girls. Yet there is limited information on the subject in our environment. This study was conducted to determine the trend and pattern of sexual assault among Nigerians. Methods A retrospective study of sexual assault victims managed at a large clinic in south west Nigeria. Victims were identified from the programme data base and case files retrieved from medical records department. Relevant information was extracted and managed with SPSS for windows version 19. Results Steady increase in the proportion of reported cases of sexual violence over the years (P < 0.0001) was observed. Sexual assaults were recorded among the males (6.1%), although female victims were in the majority (93.9%). Sexual assault was found to be higher in person’s <20 years and the unmarried. Most sexual assault occurred during the day time. Assailants were mostly persons known to the victim (52.0%) and the assault occurred mostly in the assailants’ house or office (48.5%). Sexual assault through vaginal route only (87.2%) was the most common route of sexual assault. Threat of violence (31.1%) and physical force (29.6%) was the common methods for overcoming the victims. Follow up was completed by 75.0% of the victims. Conclusion Sexual assault is common in our environment, with increasing prevalence and change in pattern. Young persons aged less than 20 years constitutes the majority of victims and assailants were mostly persons known to them. The current public education on the evils of sexual violence should be intensified.