HIV, Hepatitis B and C viruses’ coinfection among patients in a Nigerian tertiary hospital

Introduction: Hepatitis co-infection with HIV is associated with increased morbidity and mortality. Methods: This cross sectional study was carried out among HIV positive patients and HIV negative blood donors, HIV infected patients were recruited from the antiretroviral therapy clinicsof the Lagos State University Teaching Hospital, in Nigeria. The diagnosis of HIV infection among patients and predonation screening of controlblood donors was carried out using Determine1/2 screening rapid kits. (Inverness Medical, Japan). Reactive patients’ sera were confirmed withEnzyme Linked Immunosorbant Assay (Elisa) based immuuocomb1&11 comb firm kits (Orgenics, Israel). Hepatitis B surface antigen (HBsAg) andantibodies to hepatitis C virus (anti-HCV) were assayed using 4th generation Dialab Elisa kits for patients and control sera. Results: Dual presence of HBsAg and anti-HCV was observed in 4(3.9%) of HIV infected patients, while 29(28.4%) and 15(14.7%) were repeatedly reactive for HBsAg and anti-HCV respectively. HIV negative blood donor controls have HBsAg and anti-HCV prevalence of (22) 6.0% and (3) 0.8% respectively. The prevalence of hepatitis co infection is higher among the male study patients 16(50%) than the female32 (45.7%).p>0.001.Data analysis was done with statistical Package for social sciences (SPSS,9) and Chi square tests. Conclusion: This study reveals a higher risk and prevalence of HBV andHCV co infections among HIV infected patients compared to HIV negative blood donors p<0.001

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Knowledge, standard precaution practices and attitudes of healthcare providers to people living with Human Immunodeficiency Virus

No Abstrac

HIV seroprevalence among children outpatients in a Lagos Hospital, Nigeria

No Abstract

Condom use among antiretroviral therapy naive people living with HIV at a tertiary health care hospital in Lagos, Nigeria: Implication for prevention of new infections

Background: The consistent use of male latex condom significantly reduces the risk of HIV infection among men and women.Objective: This study was designed to assess the prevalence and pattern of male and female condom use among antiretroviral therapy naïve people living with HIV (PLHIV) in Lagos, Nigeria.Methods: This was a cross -sectional descriptive study. Interviewer administered questionnaires were used to collect demographic data of age, gender, marital status, rate, pattern of and reasons for not using condoms among PLHIV.Results: Four hundred and forty three respondents were interviewed with age range from 14 to 75 years and a mean of 35±9 years. There were 175 (39.5%) males and 268 (60.5%) females in the study. Overall, 71 (16.0%) of respondents used condom consistently. Only 55 (12.4%) of the respondents were aware of female condom while 9 (2%) used it.Conclusion: This study reveals that there is a low consistent use of male condoms and a very low awareness and use of female condoms among studied PLHIV.Key words: condom use, people, HIV, prevention,Nigeri

Alcohol use and HIV risk sexual behaviours among counseling and testing clients in Nigeria

Background: Alcohol use is an important factor for high risk sexual behaviours thereby enhancing HIV transmission and acquisition.Objectives: This study sought to find out the pattern of alcohol use and risky sexual behaviours among HIV counseling and testing clients.Methods: This was a cross-sectional descriptive study. A structured interviewer administered questionnaire was used to collect information from consenting consecutive HIV counseling and testing (HCT) clients.Results: A total of 358 HCT clients comprising 301 (84.1%) males and 57 (15.9%) females were interviewed. HIV prevalence among the respondents was 19 %( n=68). Overall, most of the respondents 83.2% (n=298) used alcohol. Majority of the respondents 148(90.2%) who had multiple sex partners used alcohol p=0.00. Alcohol use was prevalent 157(76.6%) among the respondents who didn't use condom for sexual acts p=0.00.Conclusion: Alcohol use was prevalent and significantly associated with HIV risk sexual behaviours among studied HCT clients.Keywords: HIV infection, alcohol consumption, prevention, Nigeri