Adherence to combined Antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria

Introduction: this study aims to assess the treatment adherence rate among People Living With HIV/AIDS (PLWHA) receiving treatment in a Nigerian tertiary Hospital. Methods: this was a cross-sectional study that assessed self-reported treatment adherence among adults aged 18 years and above who were accessing drugs for the treatment of HIV. Systematic random sampling method was used to select 550 participants and data were collected by structured interviewer administered questionnaire. Results: the mean age of respondents was 39.9±10 years. Adherence rate for HIV patients was 92.6%. Factors affecting adherence include lack of money for transportation to the hospital (75%), traveling (68.8%), forgetting (66.7%), avoiding side effects (66.7%), and avoiding being seen (63.6%). Conclusion: the adherence rate was less than optimal despite advancements in treatment programmes. Adherence monitoring plans such as home visit and care should be sustained

Seven year review of retention in HIV care and treatment in federal medical centre Ido-Ekiti

Introduction: Poor retention of patients in care is a major driver of poor performance and increased  morbidity and mortality in HIV/AIDS programme despite the expansion and advancement Anti-retroviral Therapy (ART). The objective of this study is to assess retention rates and possible determining factors in People Living with HIV (PLHIV) on ART. Methods: This is a descriptive, cross-sectional study conducted in Federal Medical Center, Ido-Ekiti, Nigeria. Medical records of clients who were enrolled in ART Care and support unit (HIV Clinic) of the health facility from 2005 to 2012 were reviewed and analyzed using SPSS version 16. A total of 621 client records were reviewed for basic demographic information, CD4 count, WHO stage, number of follow-up visit, client ART status and client retention status (defined as client attending at least one clinic visit in 2012. Results: A total of 347(63%) patients were retained in care and 208(37%) were not retained over the seven year review period. Retention was statistically significant with age (P-value 0.031), ART status (P-value 0.000) baseline CD4 (P-value 0.004), year of diagnosis and ART initiation (P-value= 0.027). Poor retention was associated decreasing age, pre-ART client, HIV stage 1&IV client and baseline CD4 above 400cell/mm3. Conclusion: Retention in care of PLHIV is a minimum necessary condition for maintaining or restoring health in the long run. The strategies to sustain and improve retention rate should be adopted to maximize ART benefits. A follow-up study on other factors affecting retention from diagnosis to long term retention ART programme is recommended.Key words: AIDS, antiretroviral, CD4, HIV, retentio

Human-centered innovations for improving the experience of informal caregivers of people living with neurocognitive disorders

Informal caregivers are an important part of the Canadian healthcare system. At any given time, about 28% of Canadians are caregivers and up to 50% will become at some point in their lifetime. As more people are being diagnosed with neurocognitive disorders (NCDs) such as dementia, there will be an increasing demand on and for informal caregivers. Caring for a person with a NCD is strenuous and carers experience a high level of burden compared to non-caregivers. Since the care, support, and companionship provided by caregivers are invaluable, there is a need to provide them relief, so they can continue to provide the much-needed assistance while having an appreciable quality of life. Research suggests that appropriate assistive technology reduces stress, and reduces caregiver demands. Technologies have greater impact and relevance if users are involved in the selection and design process of such solutions. A human-centered approach to design promotes the creation of solutions that are usable and acceptable to users. The overall goal of this research was to involve informal caregivers and people with NCDs to explore their needs, identify potential technological solutions, prioritize these and develop an initial prototype of a potential solution to meet their caregiving needs. To achieve this goal, five sequential studies were conducted including a mixed-methods study to determine the problematic care activities of informal caregivers of people with disabilities, a systematic review to identify the needs of informal caregivers, a meta-analysis to evaluate the efficacy of technology-based interventions for meeting the needs of carers, a survey to identify the most prioritized technological solutions, including services for informal caregivers and human-centered prototyping of the most prioritized technology. This study found that people with NCDs and their caregivers prefer to be involved directly in identifying their needs and the practical measures to address them satisfactorily. Participants pointed out their unmet needs and continued to be interested in the process to determine the best solutions to address them. Specifically, as participants wanted a more effective web-based service to assist them when they hire support workers, we worked with them to co-design a medium-fidelity prototype of this service.Medicine, Faculty ofGraduat

A reformulation and assessment of the Global AgeWatch Index: Inclusion of a gender-based domain

The Global AgeWatch Index (GAWI) is a measure that ranks countries according to the wellbeing of their older adults. The GAWI was constructed using four domains of wellbeing excluding a gender inequality domain. This research aimed to include the domain of gender equality in the GAWI and produce a reformulated index (rGAWI) so that the resulting ranking of countries based on the new indices can be compared with that observed for the original GAWI. This cross-sectional study utilized publicly available data on female labour force participation, total fertility rate and age at first marriage to create a new domain of gender inequality. The new domain was added to the original four GAWI domains to generate the rGAWI. The inclusion of the gender inequality domain into GAWI resulted in changes in the rankings of 87.5% of the countries and countries with lower gender inequality scores had poor reformulated indices of wellbeing

Cigarette smoking, alcohol intake and health status of older persons in England: The mediating effects of sociodemographic and economic factors

This study was conducted to determine whether there is an association between cigarette smoking, alcohol consumption and self-reported health status among older persons and how sociodemographic and socio-economic factors mediate the association between these lifestyle behaviours and health in old age. Data from wave 7 of the English Longitudinal Study of Ageing (ELSA) were analysed using bivariate and logistic regression method. Self-reported health status was assessed as a binary variable; cigarette smoking and alcohol consumption as independent variables; and age, sex, marital status, education, employment as well as financial status were assessed as covariates. Smoking had a significant inverse association with reported health status and the odds of reporting good health status versus bad health status was 59% and 38% times less for former and current smokers respectively compared with those that never smoked. However, mild alcohol consumption seemed to have a significant positive association with health status, while a negative association existed between heavy alcohol consumption and health. Sociodemographic and economic factors did not appear to mediate the effects of smoking and alcohol consumption on health status. This study provided evidence that it is important to consider interventions on smoking and heavy alcohol drinking behaviours on good health status of older adults

Self-medication among health workers in a tertiary institution in South-West Nigeria

Introduction: inappropriate self-medication results in wastage of resources, resistance to pathogen and generally entails serious health hazard. This study was undertaken to determine the knowledge, practice and reasons for practice of self-medication among health workers in a Nigerian tertiary institution. Methods: this was a cross-sectional descriptive study conducted among staff of Federal Medical Center Ido-Ekiti, Nigeria. Simple random sampling technique was used to select 305 respondents that were interviewed via a pretested semi-structured questionnaire. Analysis was done using SPSS version 15 and while chi-square test was used to test significance between variables, significant (p value set<0.05). Results: among the 305 respondents interviewed, the age range was 18-52yrs with greater proportion being males (51.8%). Majority of respondents were aware of self-medication (94.8%), but only 47.2% had good knowledge of it. Reasons for practicing self-medication were financial problem (10.8%), mild sickness (10.8%), lack of time (13.4%), knowledge of diagnosis (5.6%), convenience (2.3%) and non-availability of doctors (3.0%). The drugs used by respondents without prescription included analgesics (38.2%), antibiotics (19.0%) anti-malaria drugs (13.3%), and others (29.4%). Conditions for which respondents self-medicated were body pains (14.9%), catarrh (14.9%), headache (14.3%), sore throat (11.5%), diarrhea (11.2%), fever (9.0%) and toothache (5.6%). Conclusion: the study demonstrates that the prevalence of self-medication is relatively high. There is need for health education on the implication and danger of self-medication. There is also need for government to pass and enforce law to restrict free access to drugs.The Pan African Medical Journal 2016;2