An unsuspected yellow fever and lassa fever in a tertiary healthcare facility in Jos, North Central, Nigeria: a case report

Background: Yellow Fever and Lassa Fever are both zoonotic diseases (Mosquito borne flavirus and Rodent borne arenavirus, respectively) and classified as viral haemorrhagic fevers (VHF) because of their common clinical presentations – especially fevers and bleeding during the terminal stages of the diseases. After an incubation period of 3 – 6 days in Yellow fever, and 2 – 21 days in Lassa fever: they present with fevers, rigors, headache, myalgia, nausea, and vomiting. Jaundice is noticed in Yellow fever, while Lassa in addition to other symptoms also present with sore throat (with patchy tonsillar exudate), dysphagia, dry cough, chest pain, and cramping abdominal pain, diarrhoea or epigastric pains. Gradual deterioration is associated with oedema of the face and neck, respiratory distress, pleural and pericardial effusions, encephalopathy, and haemorrhage from various sites (including hypotension and shock, nonrelated to blood loss). The laboratory confirmation from a specialized virology laboratory was conducted for both disease conditions using reverse transcriptase polymerase chain reaction (PCR) testing, with containment facilities (biosafety level 4).The management of each of these conditions is mainly supportive, although Ribavirin has significantly reduced mortality associated with Lassa fever; with best results obtained when drug is started early in the course of the illness. Reports of Yellow fever and Lassa fever co-infection are particularly scarce. The objective of this study was to report a successfully managed Case report in an Adolescent Child.Case Report: A 10 – year old boy with a positive history of contact with and adult (grandmother) who died from a febrile illness, bleeding from body orifices and jaundice; presented with high grade fever, sore throat abdominal pain and passage of loose watery stool. All these symptoms were persistent for more than twelve days despite antibiotics and antimalarial medications. He was ill looking, febrile, anicteric and had right upper quadrant tenderness/hepatomegaly. A diagnosis of viral haemorrhagic fever was made, he was admitted and nursed in the isolation ward, infection prevention and control measures were observed, he had baseline investigations, supportive care and Ribavirin. PCR results was positive for Yellow fever and Lassa fever. He responded to treatment, was discharged home, and recuperated well during his follow up visits.Conclusion: This case clearly illustrates the importance of having high index of suspicion following the significant history of contact with a probable case of viral haemorrhagic fever (absence of laboratory confirmation at the time of her death) by the index case, especially when there was non-response to routine treatment for common causes of fever in the community.Keywords: Yellow Fever, Lassa Fever, Viral Haemorrhagic Fever, Polymerase Chain Reactio

Relationship between spiritual wellbeing and medication adherence among adults attending the antiretroviral therapy clinic of Bingham University Teaching Hospital, Jos

Introduction: HIV causes AIDS, which is a potentially life-threatening diagnosis, that can trigger deep spiritual questions about the meaning of illness, purpose of life, and relationship with God. When people living with HIV/AIDS take their medications, the virus is exposed to inadequate concentrations of antiretroviral medications. Spirituality assessment is increasingly becoming an important assessment for people with illnesses like HIV/AIDS, especially for evaluating the ART usage and for finding solutions to identified barriers influencing adherence to ARVs.Aim: The aim of the study was to determine the relationship between spiritual wellbeing and medication adherence of adults attending the ART Clinic of Bingham University Teaching Hospital, Jos.Methodology: The study was a cross-sectional analytic study carried out in the ART Clinic of Bingham University Teaching Hospital, Jos. A systematic random sampling method was used to select 372 consenting adults attending the ART clinic, who fulfilled the selection criteria. A semi-structured interviewer administered questionnaire was used to collect data, which was analyzed with the SPSS, version 22.Results: Majority of the study participants were between 18 and 49 years old. The prevalence of medication adherence in this study was 34.1%. More than half of the study participants had a high spiritual wellbeing score. Most of the clients were diagnosed with HIV for 1 - 10 years and had been on ART for about the same period. There was a significant relationship between spiritual wellbeing, educational status (p = 0.000) and high medication adherence of the study participants (p = 0.000).Conclusion: Non-adherence to antiretroviral drugs was common at Bingham University Teaching Hospital, Jos. The findings of this study illustrate the necessity for Researchers, Clinicians and Policy makers to understand the perspectives and relevance attributed to spirituality/religiosity by HIV/AIDS clients. Family Physicians should use every encounter with HIV/AIDS patient to screen for their medication adherence and spiritual wellbeing. Keywords: Spiritual wellbeing, Medication adherence, Antiretroviral therapy, Adults, Bingham University Teaching Hospital, Jo

Relationship between spiritual wellbeing and medication adherence among adults attending the antiretroviral therapy clinic of Bingham University Teaching Hospital, Jos

Introduction: HIV causes AIDS, which is a potentially life-threatening diagnosis, that can trigger deep spiritual questions about the meaning of illness, purpose of life, and relationship with God. When people living with HIV/AIDS take their medications, the virus is exposed to inadequate concentrations of antiretroviral medications. Spirituality assessment is increasingly becoming an important assessment for people with illnesses like HIV/AIDS, especially for evaluating the ART usage and for finding solutions to identified barriers influencing adherence to ARVs. Aim: The aim of the study was to determine the relationship between spiritual wellbeing and medication adherence of adults attending the ART Clinic of Bingham University Teaching Hospital, Jos. Methodology: The study was a cross-sectional analytic study carried out in the ART Clinic of Bingham University Teaching Hospital, Jos. A systematic random sampling method was used to select 372 consenting adults attending the ART clinic, who fulfilled the selection criteria. A semi-structured interviewer administered questionnaire was used to collect data, which was analyzed with the SPSS, version 22. Results: Majority of the study participants were between 18 and 49 years old. The prevalence of medication adherence in this study was 34.1%. More than half of the study participants had a high spiritual wellbeing score. Most of the clients were diagnosed with HIV for 1 - 10 years and had been on ART for about the same period. There was a significant relationship between spiritual wellbeing, educational status (p = 0.000) and high medication adherence of the study participants (p = 0.000). Conclusion: Non-adherence to antiretroviral drugs was common at Bingham University Teaching Hospital, Jos. The findings of this study illustrate the necessity for Researchers, Clinicians and Policy makers to understand the perspectives and relevance attributed to spirituality/religiosity by HIV/AIDS clients. Family Physicians should use every encounter with HIV/AIDS patient to screen for their medication adherence and spiritual wellbeing