Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria

People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive studycarried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25–44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apartfrom spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reportedfrom the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society

Effect of Safety Education on Knowledge of and Compliance with Road Sefety Signs Among Commercial Motorcyclists in Uyo, Southern Nigeria

Objective: Compliance with road safety signs is important in the reduction of motorcycle accidents. The aim of this study was to implement health education intervention and assess its impact on the knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria. Method: This was an intervention study among motorcyclists in Uyo, Southern Nigeria, with a control group from a similar town. The instrument of data collection was a semi-structured interviewer administered questionnaire. Subjects were selected through multistage sampling method. Baseline data on compliance to road safety signs was collected from both groups. Motorcyclists in the intervention group were given education on the importance of compliance to road safety signs. Data was subsequently collected from both groups 3 months post intervention and analysed using the Statistical Package for the Social Sciences version 11. Result: A total of 200 respondents participated in the study, 100 from each group. Following intervention, respondents with good knowledge score increased from 21% at baseline to 82% at 3 months post intervention in the intervention group (p<0.05) and from 19% to 21% in the control group. Compliance score in the intervention group increased from 15% to 70% (p<0.05) and from 12% to 18% in the control group. Conclusion: A significant increase in compliance to road safety signs was recorded among motorcyclists in the intervention group after safety education. All motorcyclists should therefore be given education on road safety signs as this will improve compliance and lead to safer road use among them. Keywords: knowledge score; compliance score; road safety signs, motorcycle accidents, safety educationGhana Medical Journal, September 2011 Volume 45, Number

Drug availability and health facility usage in a Bamako Initiative and a non-Bamako Initiative Local Government Areas of Akwa Ibom State, South -South Nigeria

Background: The availability of drugs on a continuous basis is paramount to the success of any health care system. The Bamako Initiative (BI) had provision of essential drugs as one of its key thrusts in order to improve the utilization of health facilities. This study compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of Akwa Ibom State in south-south Nigeria.Methodology: This was a cross sectional comparative descriptive study that used an interviewer administered semi-structured questionnaire as an instrument for data collection. Data collected was analyzed using SPSS software version 11.Results: A total of 154 respondents in each LGA were interviewed. Up to 135 (88.8%) opined that drugs were always available in the BI LGA as against 103 (66.9%) in the non-BI LGA (p <0.001). Similarly, 133 (86.3%) said drugs were usually available in the required formulation for BI LGA compared to 115 (74.7%) in the non-BI LGA (p <0.05). More respondents in the BI facilities, 45 (45%) reported using the facilities often compared to 39 (35.8%) in the non-BI facilities (p = 0.03). A total of 116 (75.3%) respondents in the BI LGA felt drugs were not costly compared to 50 (32.7%) in the non-BI LGA (p <0.001). Up to 11 (7.2%) respondents in the non-BI LGA were not satisfied with the drug services in the health centers, compared to 1(0.6%) in the BI LGA (p = 0.01).Conclusion: Availability of essential drugs therefore seemed to contribute to patients' usage of health facilities.Keywords: Bamako Initiative, Essential Drugs, Availability, Patronage, Health Facilities, Utilizatio

Quality of life and sex-differences in a South-Eastern Nigerian stroke sample

BackgroundQuality of Life (QOL) studies in stroke among Africans are rather few and mainly from South-Western Nigeria. Hardly is there any from the other regions of this vast nation. Reports on gender influences on stroke survivors’ QOL have also been contradictory.ObjectivesThis study set out to provide preliminary data on the QOL of stroke survivors in South-Eastern Nigeria and also investigate sex-differences in the QOL.MethodsOne hundred and three volunteering stroke survivors (53 males, 50 females) were recruited from various settings. The Stroke-Specific Quality of Life (SS-QOL) scale was used to assess participants’ QOL. Participants mean QOL score in the overall and individual domains were presented as percentages of Maximum Possible Scores (MPS) while sex-differences across domains were investigated with Mann-Whitney U test statistics at 0.05 alpha level.ResultsParticipants mean scores in the vision (12.44 ± 3.56), thinking (11.50 ± 3.71), mood (18.55 ± 4.81) and language (19.04 ± 6.81) domains were above 70 percent of MPS while mean score in the social role (11.82 ± 4.75) was below 50% of MPS. Overall QOL score was slightly below 70% of the MPS. No significant sex-difference was found in all the SS-QOL domains (p<0.05).ConclusionsQOL seems to be affected, albeit not too severely, among stroke survivors from South-Eastern Nigeria. The effect is however similar for survivors of both gender. Social and family roles and physical functioning seem to be areas requiring keener clinicians’ attention.Key words: Stroke, Quality of life, Sex-differences, South-Eastern Nigeria

Self-reported physical activity versus physical function capacity: alternatives for energy expenditure estimation

Introduction: The extent to which self-report activity measured by the International Physical Activity Questionnaire (IPAQ) can substitute performance-based functional capacity measured by the Six-Minute Walk Test (6MWT) remains inconclusive. This study assessed Physical Activity (PA) and Functional Exercise Capacity (FEC); and also determined the relationship between PA and FEC in apparently healthy young adults. Materials and methods: A total of 342 (145 males and 197 females) undergraduates of Obafemi Awolowo University, Ile-Ile, Nigeria participated in the study. The IPAQ was used to assess PA, while FEC was assessed using the 6MWT, and expressed in terms of the Six-Minute Walk Distance (6MWD), Six-Minute Walk Work (6MWW), Maximum Oxygen Uptake (VO2max) and Metabolic Equivalent (METS). Anthropometric and cardiovascular parameters were measured following standardized procedures. Data was analyzed using descriptive and inferential statistics. The alpha level was set at 0.05. Results: The mean age of the participants was 22.0±2.87 years. The mean IPAQ score of all participants was 1471.4±1086.93. The percentage for low, moderate and high PA was 19% (65), 41.2% (141) and 39.8% (136), respectively. The mean 6MWD, 6MWW, VO2max and METS were 639.47 ±66.6 m, 41805.0 ±8520.6 kg, 28.9 ±1.92 mlO2k-1min-1, 4.05 ±0.32 mL/kg, respectively. There were signifi cant positive correlations between PA and each of the 6MWD (r=0.268; p=0.001), 6MWW (r=0.219; p=0.001), VO2max (r=0.268; p=0.001), METS (r=0.268; p=0.001). Measures of exercise capacity were not signifi cantly correlated with the anthropometric variables (p>0.05). Conclusion: Self-report of physical activity in healthy young adults does not adequately substitute the results of the Six-Minute Walk Test

Interpreting ciliopathy-associated missense variants of uncertain significance (VUS) in Caenorhabditis elegans

Better methods are required to interpret the pathogenicity of disease-associated variants of uncertain significance (VUS), which cannot be actioned clinically. In this study, we explore the use of an animal model (Caenorhabditis elegans) for in vivo interpretation of missense VUS alleles of TMEM67, a cilia gene associated with ciliopathies. CRISPR/Cas9 gene editing was used to generate homozygous knock-in C. elegans worm strains carrying TMEM67 patient variants engineered into the orthologous gene (mks-3). Quantitative phenotypic assays of sensory cilia structure and function (neuronal dye filling, roaming and chemotaxis assays) measured how the variants impacted mks-3 gene function. Effects of the variants on mks-3 function were further investigated by looking at MKS-3::GFP localization and cilia ultrastructure. The quantitative assays in C. elegans accurately distinguished between known benign (Asp359Glu, Thr360Ala) and known pathogenic (Glu361Ter, Gln376Pro) variants. Analysis of eight missense VUS generated evidence that three are benign (Cys173Arg, Thr176Ile and Gly979Arg) and five are pathogenic (Cys170Tyr, His782Arg, Gly786Glu, His790Arg and Ser961Tyr). Results from worms were validated by a genetic complementation assay in a human TMEM67 knock-out hTERT-RPE1 cell line that tests a TMEM67 signalling function. We conclude that efficient genome editing and quantitative functional assays in C. elegans make it a tractable in vivo animal model for rapid, cost-effective interpretation of ciliopathy-associated missense VUS alleles

Comparison of start back screening tool and simmonds physical performance based tests battery in prediction of disability risks among patients with chronic low-back pain

Objectives: This study identified disability sub-groups of patients with chronic low back pain (LBP) using the Subgroup for Targeted Treatment (or STarT) Back Screening Tool (SBST) and Simmonds Physical Performance Tests Battery (SPPTB). In addition, the study investigated the divergent validity of SBST, and compared the predictive validity of SBST and SPPTB among the patients with the aim to enhance quick and accurate prediction of disability risks among patients with chronic LBP. Methods: This exploratory cross-sectional study involved 70 (52.0% female and 47.1% male) consenting patients with chronic non-specific LBP attending out-patient physiotherapy and Orthopedic Clinics at the Obafemi Awolowo University Teaching Hospitals, Ile-Ife and Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Disability risk subgrouping and prediction was carried out using the SBST and SPPTB (comprising six functional tasks of repeated trunk flexion, sit-to-stand, 360-degree rollover, Sorenson fatigue test, unloaded reach test, and 50 foot walk test). Pain intensity was assessed using the Quadruple Visual Analogue Scale. Data on age, sex, height, weight and BMI were also collected. Descriptive and inferential statistics were used to analyze data at p<0.05 Alpha level. Results: The mean age, weight, height and body mass index of the participants were 51.4±8.78 years, 1.61±0.76 m and 26.6±3.18 kg/m2 respectively. The mean pain intensity and duration were 5.37±1.37 and 21.2±6.68 respectively. The divergent validity of SBST with percentage overall pain intensity was r = 0.732; p = 0.001. Under SBST sub-grouping the majority of participants were rated as having medium disability risk (76%), whilst SPPTB sub-grouped the majority as having high disability risk (71.4%). There was a significant difference in disability risk subgrouping between SBST and SPPTB (χ²=12.334; p=0.015). SBST had no floor and ceiling effects, as less than 15% of the participants reached the lowest (2.9%) or highest (1.4%) possible score. Conversely, SPPBT showed both floor and ceiling effects, as it was unable to detect ‘1’ and ‘9’, the lowest and highest obtainable scores. The ‘Area Under Curve’ for sensitivity (0.83) and specificity (0.23) of the SBST to predict ‘high-disability risk’ was 0.51. The estimated prevalence for ‘high-disability risk’ prediction of SBST was 0.76. The estimate for true positive, false positive, true negative and false negative for prediction of ‘high-disability risk’ for SBST were 0.77, 0.23, 0.31, and 0.69 respectively

Pleosporales

One hundred and five generic types of Pleosporales are described and illustrated. A brief introduction and detailed history with short notes on morphology, molecular phylogeny as well as a general conclusion of each genus are provided. For those genera where the type or a representative specimen is unavailable, a brief note is given. Altogether 174 genera of Pleosporales are treated. Phaeotrichaceae as well as Kriegeriella, Zeuctomorpha and Muroia are excluded from Pleosporales. Based on the multigene phylogenetic analysis, the suborder Massarineae is emended to accommodate five families, viz. Lentitheciaceae, Massarinaceae, Montagnulaceae, Morosphaeriaceae and Trematosphaeriaceae

Development and preliminary testing of a culturally-friendly pain assessment tool for children (crying faces pain scale)

Background and aims: Having a universal tool for assessing pain in children is hamstrung by cultural sensitivity. This study aimed to develop and validate a culturally-friendly pain assessment tool (i.e. Crying Faces Pain Scale (CFPS)) among Nigerian Children. Material and methods: This study employed criterion-standard design. The study was in three phases, namely: (1) development of CFPS, (2) cross-validity and (3) validation of the CFPS. 70 children (39 (55.7%) males and 31 (44.3%) females) within the age range of 4-13 years who had post-surgical pain, orthopaedic pain, stomach pain or headache were involved in the validation phase. Psychometric properties and preferences for the CFPS compared with the Wong-Baker FACES Pain Rating Scale (FACES) were examined. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p<0.05. Results: The median score of the CFPS was 4.60 compared to FACES median score of 4.49. There was weak correlation between FACES and CFPS (r=0.325; p=0.006). Preference score as a culturally friendly tool for CFPS and FACES was 6.07±1.23 and 3.67 ±1.09 respectively, based on a modified 0-10 numerical pain scale. Conclusions: The crying faces pain scale has fair psychometric properties for assessing pain in children. However, CFPS was preferred to FACES as a culturally friendly tool for assessing pain among Nigerian children. Implications: The CFPS is more culturally friendly and so might be better suited as a pain scale in Africa. However, due to its fair psychometric properties, further studies may be needed to improve upon this scale

Cultural adaptation and psychometric evaluation of the Yoruba version of the Health Literacy Questionnaire

Background. Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire. Methods. A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach’s alpha, intra class correlation) and association with sociodemographic variables. Results. A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was ‘Actively managing my health’ and hardest was ‘Ability to find good health information’ and ‘Navigating the healthcare system’. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach’s α of ≥0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76. Conclusion. The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare