Trends in prevalence of HIV infection: a 4-year review of the general population in Plateau State, Nigeria

Background: Plateau state is among the HIV hot zones with HIV prevalence above national average and the 6th state with the highest HIV burden in Nigeria. The study sought to determined the trend of HIV prevalence in the general population and the pattern by age and sex in Plateau state.Methodology: The study was a 4-year descriptive analysis of the trend in Prevalence of HIV in the general population of Plateau state, Nigeria based on the data generated between January 2012 and December 2015. The data on HIV services were managed through the electronic Nigerian National HIV/AIDS Response Information Management System (eNNRIMS) which was a web-based software. The data analyses were done using excel to obtain the proportions and trend of HIV prevalence in the general population and by year, age and sex.Results: Out of a total of 495,718 tested for HIV, 30,450 people tested positive, with the highest (13.1%) HIV prevalence recorded in 2012 and the lowest (3.2%) HIV prevalence recorded in 2015. The age groups 25 – 49 years and 50 years and above accounted for higher HIV prevalence, and the female population had higher HIV prevalence for most of the age groups.Conclusion: The HIV prevalence is on a downward trend with relatively less decline among the older female population in Plateau state.Keywords: HIV, Prevalence, Infection, Trends, Plateau Stat

Choice of place of antenatal care among women of reproductive age in a semiurban population in northcentral Nigeria

Background: Antenatal care has an important role in identifying high‑risk pregnancies and improving the chances of safe motherhood particularly in developing countries where obstetric indicators are still poor. The objective of this study was to determine the choices women of reproductive age in Vom, a semirural town at the outskirts of Jos the capital of Plateau State Nigeria made to have antenatal care.Materials and Methods: This was a cross‑sectional study carried out between January and March 2015 in Vom, a semirural area about 30 km from Jos the capital of Plateau State among 2,641 (Two thousand six hundred and forty one) women of reproductive age.Results: Fifty‑eight percent of the respondents opted for antenatal care in government‑owned hospitals while 29% chose faith‑based institution which was in their vicinity, 11% favored private hospitals for antenatal care, while 1% chose traditional birth attendants (TBAs) and prayer houses to receive antenatal care. The majority of the respondents (32%) were females between the ages of 40 and 44 years while 22% were aged between 25 and 29 years of age. They were predominantly farmers of the Berom ethnic group and 47% of them had completed primary level of education.Conclusion: Females in the reproductive age in this rural setting in northcentral Nigeria favored government‑owned hospitals as places to receive antenatal care. Their choices were not affected by their educational status varied according to the age ranges of the respondents.Keywords: Antenatal care; reproductive age women; semiurban populatio

Comparing neonatal outcomes in women with preeclampsia and those with normal pregnancy

Background: Preeclampsia has remained an important public health problem in the developing world where it is associated with a five-fold increase in perinatal morbidity and mortality. Objective: We set out to compare neonatal outcomes between women with preeclampsia and those with normal pregnancy. We also sought to evaluate factors associated with poor outcome in the neonates. Materials and Methods: This was a prospective cohort study that enrolled 90 women (45 with preeclampsia and 45 with normal pregnancy) after 20 weeks gestation. Maternal socio-demographic and clinical information was obtained at enrolment and delivery using questionnaire. Neonatalanthropometric and physiologic data was obtained at delivery and used for classifying the birth weight according to the WHO classification. APGAR score was used to evaluate the presence of birth asphyxia. We defined poor outcome as the presence of at least one of low birth weight,  prematurity, birth asphyxia and need for admission. SPSS version 25 was used in all analysis. Significance testing was set at p=0.05. Results: The women with preeclampsia were significantly heavier at booking (BMI 29.0±6.9 Kg/ m2 vs 25.0±5.2. p=0.005), have higher mean booking systolic blood pressure (122.±22.6 mmHg vs 111.5±12.7mmHg, p=0.003) and diastolic blood pressure ( 7 9 . 8 ± 1 4 . 3mm Hgvs 68.8±9.0mmHg, p<0.001). Neonates of women with preeclampsia were significantly more premature ( meangestational age = 36 . 8 ± 3 . 2 week svs 38.7±2.0weeks, p=0.001) and lighter (mean birth weight =2,529±817.5g vs 3,079.2±527.4g, p<0.001). Overall, 22 (49.4%) of the neonates of women with preeclampsiahad significantly poor outcome compared with 12(27.4%) of the neonates of women with normal pregnancy (p=0.01). Univariate logistic analysis showed only being a male neonate, maternal preeclampsia and admission in index pregnancy were significantly associated with poor outcome.  Multivariable logistic regression showed only being a male neonate to be 3 times more likely to have a poor outcome (Wald=5.34. OR=3.2, p=0.02) Conclusions: Intrauterine exposure to preeclampsia is associated with poor neonatal outcomes especially in males Key words: infant outcome, preeclampsia, Nigeri

Epidemiologic review of Zika virus disease

Zika virus disease has resonated great concern globally. The World Health Organization declared it “a public health emergency of International concern” on 1st February, 2016. The recent outbreaks have become a major challenge due to a drift from its earlier known benign exanthematous spectrum to a causal link to microcephaly. Historically, the name Zika virus comes from the Zika Forest of Uganda. It was first identified in 1947 among Rhesus Macaque sub-population. Two genetically distinct isolates have been well characterized; the Asian and African strains. This virus is spread by bites of day-time-active Aedes mosquitoes; the Aedes aegypti and Aedes albopictus. Zika Virus appears to spread along a narrow equatorial belt of Africa to Asia through the Pacific Ocean to French Polynesia, New Caledonia (southwest Pacific Ocean), the Cook Islands (south Pacific), and Easter Island (a Chilean territory in Polynesia), and most recently to Mexico, Central America, the Caribbean, and South America, where today has assumed a pandemic proportion.Up to eighty percent of infections are asymptomatic. Symptomatic infections are characterized by a self-limiting febrile illness and maculopapular rash, arthralgia, conjunctivitis, back pain and mild headaches. Maternal Zika viral load is thought to be a significant risk factor to fetal infection leading to invasion of either trophoblasts or placental cells or both through maternal decidua. Zika viral RNA proteins and associated extensive selective tissue injuries have been demonstrated in the brains and spinal cords of abortuses. Diagnosis of Zika virus is essentially based on viral RNA detection from clinical specimens. Currently, licensed preventive medicines or vaccines are unavailable. With the wide spate of recent outbreaks and consequent neurologic morbidity and mortality, there is need for deployment of point-of-care equipment for screening of pregnant women in our environment. This is an ambitious call for advocacy by all relevant health care providers.Keywords: Zika Virus, disease outbreaks, microcephaly, Aedes mosquitoe