Impact of Integrated Home-Based Care Programme on Antiretroviral Medication Adherence among Plwha: A Quasi-Experimental Study.

Background: Suboptimal Anti-Retroviral adherence is an advancing global issue.  Methodology: One-Group Pre- and Post-Test Integrated Home-Based Care intervention program with control was adopted. The validated questionnaire was used to gather information from 60 PLWHA following ethical approval and informed consent. Descriptive statistics and frequency distributions are employed in data analysis. One-tailed independent sample T-test was used to determine the impact of the intervention using percentage-change and Cohen’s Effect Size with a 5% level of significance. Validity and reliability of Instrument tested with Cronbach Alpha, 0.795. Results:  Respondents mean age was 35.38 ± 9.061, married (37.61%), females (66%) and self –employed (41.1%). Mumuye ethnic group (28.3%), Christians, 71.7% with lower educational attainments (56.6%). Control group reported predisposing factors in HIV treatment (137-point scale),  = 82.17(2.18) ±11.92 and  = 86.50(1.69) ±9.23; Reinforcing factors on 15-points scale, scored  = 9.00(0.65) ±3.65 and  = 8.87(0.69) ±3.78; Enabling factors on 15-points scale,  = 8.23(0.46) ±2.50 and  = 8.00 (0.51) ±2.77 and Self-Reported Adherence on 24-points scale,  = 16.23(0.82) ±4.49 and  = 17.87(0.91) ±4.99 at baseline and post intervention respectively for each group and adherence prevalence rate of 60.  Experimental group at baseline reported predisposing factors on 137-points scale,  = 80.90(2.77) ±15.15 and  = 97.13(8.12) ±1.48; Reinforcing factors on 15-points scale,  = 8.87(0.47) ±2.50 and  = 9.33(0.48) ±2.60; Enabling factors on 15-points scale,  = 7.23(0.41) ±2.24and  = 7.40(0.41) ±2.25 and Self-reported Adherence on 24-points scale,  = 15.98(0.57) ±4.39 and  = 23.13(0.43) ±2.37 at baseline and post intervention respectively for each group and adherence prevalence rate of 96%.  Conclusion: An integrated Home-Based Care intervention program will be more effective than the usual clinic-based program for HIV/ AIDS management. Recommendation:  An integrated Home-Based Care intervention program should be adopted for all HIV interventions

Evaluation of a school-based health education program on hepatitis B virus infection prevention practice in rural South-Western, Nigeria

Abstract Background Hepatitis B virus (HBV) infection prevention is most effective early in childhood with vaccination programme. However, where this is missed, primary prevention modes of intervention become an alternative recommendation to be considered before the occurrence of risk exposure to the virus. This study sought to evaluate outcomes of a theory-based HBV infection prevention educational intervention among students from four selected secondary schools in Ogun state, Nigeria. Methodology A quasi-experimental design enrolling 256 consenting secondary school students from four schools in Ogun state randomized into three intervention schools consisting teacher-instructed (E1), peer-directed (E2) and combination of the two (E3) respectively with a control group ( C) was implemented. The theory-based educational intervention was for six weeks with follow-up period of 8 weeks. A 66-item validated instrument was used to collect data at three reference points and response items for variables in the study were transformed into weighted-aggregate scores of mean and standard deviation of HBV infection prevention practice of participants. Statistical analysis of ANOVA, paired-sample t-test and Cohen’s D Effect Size (ES) was used to quantify the changes produced by the intervention on the outcome variable at 5% level of significance. Results At baseline, there was no significant difference (p > 0.05) in the mean HBV infection prevention practice scores between the four groups E1 (17.21 ± 3.03), E2 (15.57 ± 1.90), E3 (17.90 ± 3.10), and C (15.20 ± 2.44). However, at 14th week follow up, there was observed significant differences in mean scores of HBV infection prevention practices between all four groups E1 (23.09 ± 2.4), E2 (22.6 ± 3.6), E3 (23.82 ± 2.3), and C (15.25 ± 2.4). Paired-sample t-test conducted demonstrated significant differences between baseline and 14th week follow up for E1 (17.21 ± 3.07 and 23.18 ± 2.9; p = 0.001), E2(15.57 ± 1.90 and 23.53 ± 3.12; p = 0.001), E3(17.90 ± 3.10 and 25.1 ± 2.6; p < 0.001), but not for C (15.20 ± 2.44 and 15.25 ± 2.4; p = 0.92), with most significant impact (ES(95%CI) on HBV infection prevention practices observed for E2(3.106 95%CI: [2.66 to 3.55; p = 0.001]). Importantly, the participants in E2 showed more improvement in prevention practices than their counterparts from E1, E3, and control. Therefore, the intervention demonstrated proof-of-concept in facilitating behavior modification expected. Peer education can be utilized as a strategy to promote Hepatitis B infection prevention practices among adolescents

Positive and inverse correlation of blood lead level with erythrocyte acetylcholinesterase and intelligence quotient in children: implications for neurotoxicity

Blood lead level (BLL) is insufficiently sensitive for early detection of Lead-induced neurotoxicity (LIN). This study determined the possible role of the combination of BLL, intelligent quotient (IQ) and erythrocyte acetylcholinesterase (AChE) activity in the early detection of LIN in Children. Apparently healthy children (n=309) from eight public primary schools in Ibadan, Nigeria were recruited and classified into: children with Elevated BLL (EBLL) and children with Acceptable BLL (control) based on CDC cut-off for childhood lead exposure. Neurological indices (speech, memory, cranial nerves and cerebellar functions), IQ, BLL and erythrocyte AChE activity were assessed using standard methods, Standard Progressive Matrices, AAS and HPLC respectively. Statistical analysis involved Student’s t-test, Pearson’s correlation and multivariate regression. p<0.05 was considered significant. There were 169 (54.7%) children with EBLL while there were 140 (45.3%) control children. Both groups exhibited normal speech, memory, cranial nerves and cerebellar functions. However, IQ was lower in EBLL children (85.9±11.6) compared with control (91.5±14.0) while BLL and AChE activity were higher in EBLL children (0.4±0.1 µmol/l; 117.5±25.5 µkat/l) compared with control (0.2±0.0 µmol/l; 59.4±10.2 µkat/l). BLL showed inverse correlation with IQ (r=–0.134, p=0.019) but positive correlation with AChE (r=0.978, p≤0.001). 16.2% of the observed variation in BLL could be accounted for by AChE using the equation; [BLL=–0.007+0.003 AChE] p<0.05. Elevated blood lead level is prevalent among the school children and appears to have adverse effect on their IQ. Erythrocyte AChE could be a promising marker for early recognition of significant environmental lead exposure and lead-induced neurotoxicity in children