Comparative Analysis of Patient Satisfaction Levels in HIV/AIDS Care in Secondary and Tertiary Health Care Facilities in Nigeria

Background: Continuous quality improvement is linked to the use of timely and useful feedback from clients in HIV care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction of Antiretroviral Drugs (ARTs) services in Nigeria has significantly impacted positively on the overall well being of people living with HIV/AIDS (PLWHAs). However, there is little understanding of their satisfaction and perception of quality of care provided. Objective: This study comparatively assessed patients' satisfaction with ambulatory HIV/AIDS care in secondary and tertiary health facilities in Anambra State. Methods: This was a descriptive comparative crosssectional study of 300 PLWHAs conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi (150) and at St. Charles Borromeo Catholic Hospital (SCBH), Onitsha (150). Sample selection was by systematic sampling technique whereby every 3rd patient registered to see the doctor each day was recruited. Data was collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. Results: Patients in Nnewi were more likely to spend more 2 money on transport (÷ = 33.36, p=0.0001), while those in Onitsha were more likely to incur more expenses on non-HIV 2 tests (÷ = 5.73, p=0.017). Patients visiting the tertiary health facility were significantly more satisfied with access to care than those visiting the secondary health care facility were, (

The Role of Oxidative Stress in Diabetes Mellitus: A 24-year Review

Background: Diabetes mellitus is a widespread and devastating disease. Diabetes is associated with several mechanisms of tissue damage, one of which is oxidative stress. Oxidative stress and oxidative damage to tissues are common end points to chronic diseases such as atherosclerosis, diabetes and cardiovascular diseases. Oxidative stress plays an important role in the pathogenesis of and the complications of diabetes. Hyperglycaemia results in overproduction of oxygen free radicals which contributes to the progression of diabetes.Objective: This review aims at determining the role of oxidative stress in diabetes and diabetic complications.Method: Relevant literatures were reviewed from medical journals, library search, Pub Med search, Google search and other internet search engines (Google Scholar, Hinarii, Ask.com) from 1987 to 2011.Results: Several studies demonstrated that oxidative stress plays a role in the progression of diabetes and also in the development and progression of diabetic complications.Conclusion: Increasing evidence has implicated a role for oxidative stress in progression of diabetes and diabetes associated complications. Antioxidant therapy has been effective in management of diabetes and diabetic complications. In addition, physical exercise and insulin therapy can also improve diabetes through the reduction of oxidative stress.Keywords: Oxidative stress, free radicals, antioxidants, diabetes, diabetic complications

Adolescent Sexual Behaviour and Practices in Nigeria: A Twelve Year Review

Background: Adolescence is a time of opportunity and risk. During this time, attitudes, values and behaviours that forms a young person's future begin to develop and take shape. The World Health Organization (WHO) estimates that 70% of premature deaths among adults are largely due to behaviours initiated during adolescence. Age of sexual debut is generally low, yet there is dearth of knowledge on sexuality.Objective: The article reviewed the sexual practices and behaviours of Nigerian adolescents in the last twelve years.Methods: Available publications in local and international journals on adolescent sexual behaviour and practices covering a twelve-year period from January 2000 to December 2011 were retrieved from the Library (NAUTH Medical Library). Additional search for published articles was done on the internet from Pubmed/Medline and other search engines.Results: Adolescents engage in unhealthy sexual behaviours, characterized by early age at sexual initiation, unsafe sex and multiple sex partners. Reasons given for this include curiosity, peer influence, pleasure and financial benefit, amongst others.Conclusion: The strategies given in this review have the potential to increase sexual awareness in adolescents, encourage contraceptive use and improve adolescent reproductive and sexual health in the country.Keywords: Adolescent sexual behaviour, Adolescent health and development, secondary school students, adolescent pregnancy

Infant Feeding Choices and Practices as Risk Factors of Mother-to-Child-Transmission of HIV among Exposed Infants in Nnamdi Azikiwe University Teaching Hospital Nnewi

Background: Mother to child transmission of HIV infection (vertical transmission) is of major concern, because of the attendant consequences of morbidity and mortality on the child. The success of a prevention of mother to child transmission (PMTCT) programme in reducing sero-conversion among exposed newborn infants is determined by many factors, including the administration of Anti Retroviral drugs to both HIVpositive mothers and their newborns; infant feeding practices; access to and use of well-baby care; and the health system's ability to provide care, including counseling and support to both the HIV-positive mother and her exposed newborn. Aim: This study is aimed at examining the various infant feeding choices and practices as risk factors of mother to child transmission of HIV among exposed infants in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. Method: The study design is descriptive cross-sectional. A total of 288 consenting HIV positive mothers of recruited children were selected using the systematic sampling technique. Data were collected using a pre-tested structured interviewer-administered questionnaire, and analyzed by means of the Statistical Package of Social Sciences (SPSS) software. Result: The mean age of the respondents was 30.46+4.86 years. Majority of the patients were married, and most of them were traders. Inadequate receipt of replacement feed, breastfeeding of an HIV exposed infant, duration of breast feeding among others constitute significant determinants of current health status of baby (

Prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory of Nigeria

Background: In developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food‑borne diseases often transmitted through food, water, nails, and fingers contaminated with faeces. Accordingly, food‑handlers with poor personal hygiene could be potential sources of infections by these micro‑organisms. Objective: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. Materials and Methods: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects’ stool, urine, and fingernail analyses were carried out and the result scientifically scrutinized. Results: Fingernail bacteria isolates include: E. Coli (1.8%), coagulase‑negative staphylococcus (17.9%), Staphylococcus aureus(7.1%), Klebsiella species (2.4%), Serratia species (1.2%), Citrobacter species (1.2%), and Enterococcus species (1.8%). The subjects’ stool samples tested positive: For A. lumbricoides (14.9%), T. trichuria(1.8%), S. starcolaris (3.0%), E. histolytica (10.7%), G. lambilia (1.8%), S. mansoni (1.2%), and Taenia species (4.8%). Furthermore, 42.3% and 15.5% of the stool specimen tested positive for Salmonella and Shigella species, respectively. Conclusion: Food establishments should screen and treat staff with active illness, and regularly train them on good personal and workplace hygiene practices.Keywords: Bacteria, federal capital territory, food handlers, intestinal parasitesNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 201

Determinants of subjective health status of HIV positive mothers in NAUTH Nnewi

BACKGROUND: Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support groups and stigma-free HIV services by providers may have good impact on the quality of life of HIV-positive mothers.  This study was aimed at assessing the determinants of subjective health status of HIV-positive mothers accessing prevention-of-mother-to-child-transmission (PMTCT) of HIV services in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi.METHODS: This is a descriptive study in which 288 consenting HIV positive mothers were selected using the systematic sampling technique. Data on demographics, life style, social support, contraceptive use and subjective feeling about current health status were collected from the subjects using a pre-tested, structured, interviewer-administered questionnaire. RESULTS: The mean age of the respondents was 30.46+4.86 years. Majority (89.2%) of them were married while 55.2% were traders. A significantly higher proportion of the mothers on highly active anti retroviral therapy (HAART) (70.8%) than non users (29.2%) described their current health status as 'excellent' (p<0.001). Also a significantly higher proportion of condom users (99%) than pill users (1%) described their health status as 'excellent' (p<0.02). The same significantly higher proportions of 'excellent' response were given by subjects who engage in social support activities (p<0.001), who practice good feeding (p<0.01) and personal hygiene (p<0.01).CONCLUSION: Access to family planning services and HAART, participation in support group activities and positive lifestyle practices tend to improve subjective health status and should be comprehensively encouraged among the HIV positive mothers.   KEY WORDS: Determinants, health status, HIV positive mothers