Attitude of Health-Care Workers to HIV/AIDS

The current 5% prevalence rate of HIV in Nigeria represents a significant population of people living with HIV/AIDS (PLWHA). Discrimination against PLWHA has profound impact on the care and support required fro their optimal management particularly in resource-constrained settings. The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients\' HIV sero-status and review the factors that may contribute to such attitude. Self administered semi-structured questionnaires were administered to respondents who were selected by multi-stage sampling technique. The questionnaires explored the respondents\' knowledge about HIV and their attitude and practice regarding PLWHA. Three hundred and forty-five questionnaires were completed. Only 77.1% correctly identified breastfeeding as a source of HIV transmission; 5.2% and 26% respectively thought transmission was possible through mosquito bite and handshake. About 10% and 15% respectively among trained nurses and auxiliary nurses were unaware that HIV could be transmitted to the child during delivery. Some 13.9% and 12.7% of respondents respectively were unwilling to take vital signs and carry out physical examination on PLWHA. Compared to physicians, trained nurses and auxiliary nurses were more likely to deny services based on HIV ero-status. Negative attitude was more likely if the source of the HIV infection was from homosexual exposure or bisexual indiscretion. The health-care workers studied manifested certain attitudes that are potentially discriminatory of PLWHA well-coordinated continuing education of HIV/AIDS for all categories of health-care workers is recommended as a vital strategy in the crusade against the epidemic. African Journal of Reproductive Health Vol. 10 (1) 2006: pp. 39-4

A Review of Rhesus Iso-Immunization in a Nigerian Obstetric Population

Context: Haemolytic disease of the newborn, a problem that has not been sufficiently investigated in the Nigerian population, leads to significant perinatal morbidity and mortality. Objectives: To determine the incidence of Rhesus (Rh) isoimmunization and the utilisation rate of Rh-immunoprophylaxis in our population. Methods: A review of the clinical records of all Rh-negative pregnancies, booked at the Federal Medical Centre, Abeokuta between July, 1996 and June, 2000. The mothers' and infants' records were analysed for age, parity, ante-natal antibody status and some selected characteristics in the infant. Results: Seventy-seven Rh-negative pregnancies were managed, accounting for 2.6% of the total obstetric population. Those who received immuno-prophylaxis following previous abortions and deliveries were 15.4 % and 38.2% respectively. Initial testing, at booking, for sensitization was not done in 36.5% of the women, while 63.4% had no follow-up testing. The incidence of ante-natal sensitization was 1.3%. The time of onset of neonatal jaundice was 26.5 + 14.6 hours (mean + SD) in Rh-positive infants, compared to 44.4 + 17.8 hours in Rh-negative infants (p = 0.07). The haematocrit of both groups of infants were similar [42.8 + 5.8 versus 44.5 + 5.3; p = 0.6]. There was no perinatal death. The partners' Rh-status was determined in 59.7% and the infants' Rhesus group in 71.6%. Immunoprophylaxis rate was poor (44.8%). The majority of those who declined immunoprophylaxis did so for financial reasons. Conclusion: The risk of haemolytic disease of the newborn with its attendant perinatal morbidity and mortality is real in our community, yet the rate of Rh-immunoprophylaxis remains quite low in our obstetric population. (Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2):69-72

HIV in Pregnancy: Experience at Abeokuta, Nigeria

Background: The human immunodeficiency virus (HIV) pandemic remains a major threat to public health. Measures to minimize mother to child transfusion remain a major focus of research. Objectives: To determine the prevalence of HIV in pregnancy in our obstetric clinic population and evaluate the effects of HIV infection on the course and outcome of pregnancy. Materials & Methods: A case-control study of all HIV-positive pregnant women who delivered at the Federal Medical Centre, Abeokuta between January, 1997 and June, 2000. Selected characteristics including age, parity, gestational age at booking, weight gain in pregnancy, duration of pregnancy and the infants characteristics were compared between seropositive and negative women. Results: Sixteen women had HIV infection among a total of 2,442 women booked during the study period. The prevalence of HIV infection in pregnancy was 0.7%. Following diagnosis, eight of the HIV positive women defaulted from ante-natal care None opted for anti-retroviral therapy. There were no statistically significant differences in the haematocrit at booking (p=0.9), the weight gain in pregnancy (p=0.2), birth-weights between the two groups. All the women had vaginal deliveries. There were significant differences in the infants Apgar scores and perinatal mortality rates were higher in the HIV positive group. All the mothers chose to breastfeed their infants. Conclusion: HIV infection in this population is associated with birth asphyxia and a high perinatal mortality rate. The survivors are also at great risk of vertical transmission during breast-feeding. Key Words: HIV, Pregnancy, Vertical Transmission, Birth Asphyxia. [Trop J Obstet Gynaecol, 2002, 19: 21-24]