Reproductive health and lifestyle factors associated with health-related quality of life among perinatally HIV-infected adolescents in Uganda

Background With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL. Methods In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10–19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression. Results The mean age was 16.2 ± 2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health (AOR = 2.07, 95 % CI: 1.24–3.46) and four times more likely to present with better mental health (AOR = 3.9, 95 % CI: 2.22–6.92) than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health (AOR = 5.3, 95 % CI: 1.86–15.41) compared those who had attained primary or no education. Participants who desired to have a child in future more likely (AOR 1.7, 95 % CI: 1.05–3.00) to present with a better mental health. Lack of communication with guardians on sexuality (AOR = 0.6, 95 % CI: 0.40–0.89), or dissatisfaction with SRH services (AOR 0.34, 95 % CI: 0.18–0.62) were associated with poorer mental health. Conclusion Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health

Perceptions of community members on tuberculosis and its effect on health-seeking behavior in Nigeria☆

Background: Tuberculosis (TB) remains a major health challenge in the sub-Saharan African countries; Nigeria being one of the most affected countries. A number of interventions have been employed to reduce the scourge of the disease; however, the burden of the disease remains of public health dimensions. This study seeks to provide insight into the factors that may be affecting access to TB services by exploring the perception of the TB disease among the general population and how this affects health-seeking behavior. The specific perceptions addressed in this study are the causes of TB and whether there is a cure for TB. Methods: Qualitative methodology using in-depth interviews and focus group discussions (FGDs) were employed. This was done as part of a knowledge, attitude and practice survey. The survey was conducted in six States, namely: Akwa Ibom, Ebonyi, Gombe, Katsina, Benue and Ondo States. Results: Community key informants and FGD participants identified financial capability, knowledge about orthodox medicine, fear of stigmatization and the influence of religious leaders as factors that determine the choice of treatment. Across the six States, the general thought is that people first consult the chemist, then traditional healers/faith-based healers before visiting the hospital because it is cheaper. It was found that persons who believe that the disease is caused by germs usually seek health care in the formal health settings, while those who believe that TB is caused by supernatural forces, such as ancestral curses and witchcraft, usually seek help at the herbalists/traditional/unorthodox health settings. Also, people who believe that TB can be cured are more likely to seek medical care. Conclusion: Specific information on TB, such as the fact that TB is curable and caused by a germ, if well disseminated at the population level to the point where the information is understood and accepted to be true, is able to change the health-seeking behavior of the population such that the population seek care for TB at the formal health clinics

Seasonality in TB notification in Nigera: Reality or myth?

Background: Seasonal fluctuations in tuberculosis (TB) notifications have been identified and reported in a number of countries. Nigeria remains one of the 22TB high-burden countries (HBCs) in the world, and the notification of TB cases in the country over the years has shown a definite pattern that suggests seasonal variation. Previous studies conducted in India, Japan, Mongolia, the Netherlands, Russia, Spain, the United Kingdom and the United States have evaluated the seasonality of TB notification. However, in Nigeria, there has been no systematic study to establish that this pattern is not just a myth. This study seeks to establish the seasonal variations suggested by the trend pattern of TB case notification (all forms of TB) in Nigeria over the past ten years. Method: The yearly TB notification data in Nigeria from 2004 to 2013 was examined for seasonal fluctuations by plotting the quarterly notification figures for the years under review. A rapid trend analysis was done based on the amplitude of the fluctuating curves. Standardization was done by zones. Results: The trend analysis showed a spike in the first quarter of the year for the ten-year period studied (with the exception of 2005 and 2011). This quarter is generally characterized by the dusty, dry harmattan wind in most parts of the country, particularly the northern region. The curves generally plummeted in the third quarter and remained in that neighborhood for the rest of the year. The differences in case notification between the first and last quarter for the ten-year period ranged from 347 to 4230 cases notified. The result of this trend analysis when standardized by zones for the six zones of the country was similar to the overall result for the country. Conclusion: According to the results of this study, there is evidence to suggest that there are seasonal variations in notification of TB cases across the four quarters of the year. This has significant implications for TB control strategies. Further investigation of the reasons for seasonal variations may help to identify risk factors. Also, planning and forecast of TB commodities to order cannot be based on experience from the preceding quarters, but must rather be based on reports from the same quarter in the previous year. Allocation of resources may also have to be intensified during the peak periods in order to adequately control the disease at these periods. Footnotes: Further investigation is required to unmask the reasons for the seasonal variations in TB notification in Nigeria

Nematicidal Activity of Mint Aqueous Extracts against the Root-Knot Nematode Meloidogyne incognita

The nematicidal activity and chemical characterization of aqueous extracts and essential oils of three mint species, namely, Mentha × piperita, Mentha spicata, and Mentha pulegium, were investigated. The phytochemical analysis of the essential oils was performed by means of GC-MS, whereas the aqueous extracts were analyzed by LC-MS. The most abundant terpenes were isomenthone, menthone, menthol, pulegone, and carvone, and the water extracts yielded mainly chlorogenic acid, salvianolic acid B, luteolin-7-O-rutinoside, and rosmarinic acid. The water extracts exhibited significant nematicidal activity against Meloidogyne incognita, and the EC50/72h values were calculated at 1005, 745, and 300 mg/L for M. × piperita, M. pulegium, and M. spicata, respectively. Only the essential oil from M. spicata showed a nematicidal activity with an EC50/72h of 358 mg/L. Interestingly, menthofuran and carvone showed EC50/48h values of 127 and 730 mg/L, respectively. On the other hand, salicylic acid, isolated in the aqueous extracts, exhibited EC50 values at 24 and 48 h of 298 ± 92 and 288 ± 79 mg/L, respectively