Factors influencing the experience of sexual and reproductive healthcare for female adolescents with perinatally-acquired HIV: a qualitative case study

Background: Young people living with perinatally-acquired HIV require age-appropriate support regarding sex and relationships as they progress towards adulthood. HIV affects both genders but evidence suggests that young women are particularly vulnerable to sexual abuse and more prone to engaging in sexual behaviours to meet their daily survival needs. This can result in poor sexual and reproductive health (SRH) outcomes. HIV services in Malawi provide support for young women’s HIV-related clinical needs, but it is unclear whether there is sufficient provision for their SRH needs as they become adults. This paper explores the sex and relationship experiences of young women growing up with perinatally-acquired HIV in order to understand how to improve SRH care and associated outcomes. Methods: A qualitative case study approach was adopted in which each ‘case’ comprised a young woman (15–19 years) with perinatally acquired HIV, a nominated caregiver and service provider. Participants were purposively selected from three multidisciplinary centres providing specialised paediatric/adolescent HIV care in Malawi. Data was collected for 14 cases through in-depth interviews (i.e. a total of 42 participants) and analysed using within-case and cross-case approaches. The interviews with adolescents were based on an innovative visual method known as ‘my story book’ which encouraged open discussion on sensitive topics. Results: Young women reported becoming sexually active at an early age for different reasons. Some sought a sense of intimacy, love, acceptance and belonging in these relationships, noting that they lacked this at home and/or within their peer groups. For others, their sexual activity was more functional – related to meeting survival needs. Young women reported having little control over negotiating safer sex or contraception. Their priority was preventing unwanted pregnancies yet several of the sample already had babies, and transfer to antenatal services created major disruptions in their HIV care. In contrast, caregivers and nurses regarded sexual activity from a clinical perspective, fearing onward transmission of HIV and advocating abstinence or condoms where possible. In addition, a cultural silence rooted in dominant religious and traditional norms closed down possibilities for discussion about sexual matters and prevented young women from accessing contraception. Conclusion: The study has shown how young women, caregivers and service providers have contrasting perspectives and priorities around SRH care. Illumination of these differences highlights a need for service improvement. It is suggested that young women themselves are involved in future service improvement initiatives to encourage the development of culturally and socially acceptable pathways of care

The African intellectuals’ project

Soon after taking the position of editor of IJARS at the beginning of 2019, I was contacted by the dean of Unisa’s College of Graduate Studies (CGS), Prof. Lindiwe Zungu, who informed me that the university’s principal and vice-chancellor, Prof. Mandla Makhanya, had decided to revive his project, the African Intellectuals’ Project (AIP). I was asked to coordinate this project, through which Makhanya sought to invite scholars, academics, and intellectuals, both on and outside of the African continent, to deliver presentations reflecting on the ills afflicting Africa and, at the same time, to offer possible solutions. In pursuing the AIP, Prof. Makhanya was carrying on a perennial tradition

Pulmonary Lymphomatoid Granulomatosis: Report of A Case and Review of Literature

Lymphomatoid granulomatosis (LYG) is a rare angiocentric lymphoproliferative process predominantly affecting the lung. The diagnosis of this condition is often difficult as the physical signs, history, chest x-ray, and routine laboratory investigations are usually non-specific. Nevertheless, it is important to establish a tissue diagnosis, as this lymphoproliferative disorder can be refractory to treatment and even progress to overt lymphoma. We report a case of pulmonary LYG in a 52-year old Nigerian man of Ibo extraction treated in our centre in 2001 and followed up for a year. The difficulty in making diagnosis is highlighted and treatment modality discussed

Experience with 500 Consecutive Patients on Somatom AR. T Computerized Tomographic Scarner

Background: The technology of computerized tomography [CT] has brought about a giant leap in the ability to recognize and accurately elucidate pathologies located in various parts of the body. Undoubtedly, the availability of CT facility in our teaching hospital about five years ago is a welcome development. This report attempts to highlight the experience with the first 500 consecutive patients scanned in the hospital. Methods: The study included the first 500 consecutive patients scanned in our teaching institution between April 1997 and May 1999. All the CT examinations were performed on Siemens Somatom AR. T CT scanner using existing departmental scanning protocol. Results: About equal numbers of male [249] and female [251] patients were recorded in this study, their ages ranging between 1-month neonates to 86 years old. Most requests [73.4%] fall within the ages of 21 and 60years. Brain scans represented 52.8% of all the CT scan requests while CT pelvimetry accounted for 20.8%. Conclusion: CT scanning has potential to alter significantly clinical management decisions. Although a CT scan session appears expensive in this environment, its imaging superiority over the conventional radiography far outweighs other negative considerations. NQJHM Vol. 14 (1) 2004: pp. 35-3

Sperm count profile of men presenting for infertility evaluation in Nnewi Nigeria

Objectives: To determine the prevalence of sperm count abnormalities in men who presented at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi for infertility management. Materials: Patients' seminal fluid analysis records were accessed by permission from Microbiology Laboratory Department of NAUTH. Method: Retrospective review of the laboratory records on seminal fluid analysis. Records from October 2000 to March 2005 were reviewed. The number of samples that revealed normal sperm count, oligzoospermia and azoospermia were determined and their percentages calculated. Oligozoospemia was further subcategorized into mild, moderate and severe. The WHO criteria were applied, and the seminal fluid analysis was performed by manual method. Result: The result showed that out of the 1134 males tested for their semen quality, 561 patients (49.5%) had a normal sperm count. A total of (50.5%) has abnormal sperm count (sperm count below reference values or no sperm at all) 511 (45%) showed oligozoospermia while 62 (5.5%) showed azoospermia. Conclusion: This study revealed a high rate of abnormal sperm count parameters and by extension male infertility in the reviewed patients. Proper education of the populace as regards the role of male factor in infertility and its prevention is very essential. Assisted reproduction technology services will help in solving infertility for men who cannot produce functional quality sperm. Keywords: Sperm count, Male infertility. Tropical Journal of Medical Research Vol. 10(1) 2006: pp. 24-2