Molecular Epidemiology of Escherichia Coli in HIV-Positive Individuals in South west Nigeria

IntroductionEscherichia coli infection is a major health concern for human immunodeficiency virus (HIV)/AIDS patients because it is a substantial cause of diarrhoea-associated morbidity and mortality. Materials and MethodsStool and blood samples were collected from 879 HIV/AIDS patients in a tertiary hospital in southwest Nigeria. The blood samples were screened for HIV IgM using competitive ELISA, and the concentration of the IgM was determined. The stool samples were cultured on eosin methylene blue agar. The isolates were characterised based on the production of green metallic sheen on EMB agar..DNA was extracted from all the isolates, and the extracted DNA was analysed by PCR with primers specifically targeting the virulence genes of enterohemorrhagic E. coli (EHEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), and enteroinvasive E. coli (EIEC). Statistical analysis was conducted using the openepi online epidemiological package. ResultsAll the blood samples tested positive for HIV IgM antibodies, and 80% had high concentration. All the stool samples were positive for E. coli, based on cell culture and DNA extraction. Of all the DNA tested by PCR using gene-specific primers targeting the 4 strains of E. coli, 222 samples were positive for EHEC shiga toxin 1 (stx1) gene, 212 samples were positive for EPEC intimin (eaeA) gene, 289 were positive for EHEC serotype O157:H7 using the stx2a&b gene, 125 were positive for EIEC haemolysin (hlyA) gene, and 31 were positive for ETEC uid gene.DiscussionThe high prevalence of E. coli O157:H7 is an indication that this strain, which has been previously linked with diarrhoea-related mortality in infants, may be responsible for most of the cases seen in HIV/AIDS patients. Though this strain is not common in adults, its involvement in HIV/AIDS is indicative of suppressed immunity in this group of people. Other strains are also present in significant proportions, indicating that these strains also constitute a public health concern, because they may be transmitted to infants or other immunocompromised individuals

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

Background: Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Methods: Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants\u27 experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Results: Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants\u27 experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members\u27 diagnosis were less likely to report experiencing HIV stigma and more likely to report not feeling less than a man and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Conclusions: Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their care seeking behaviors. These findings have implications for HIV programs geared towards African heterosexual men in general and HIV positive men in particular

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

<p>Abstract</p> <p>Background</p> <p>Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems.</p> <p>Purpose</p> <p>The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors.</p> <p>Methodology</p> <p>We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included.</p> <p>Results</p> <p>The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts.</p> <p>Conclusion</p> <p>Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.</p

Effects of Photo-Voice Approach on Recall Accuracy in 24-Hour Dietary Assessment Procedure among University of Ibadan Undergraduate Students

Background: Misreporting in 24-hour dietary recall procedure limits establishing diet-diseaserelationship, thus, innovations to improve recall accuracy is desirable.Objective: This study was designed to assess the effects of photo-voice approach on 24-hour dietary recall accuracy among undergraduate students.Method: This cross-sectional study involved 200 undergraduate students selected using a simple random sampling from a pool of consenting students using WhatsApp-enabled smartphones. Socio-demographic characteristics and dietary intake data were obtained using semi-structured questionnaire. Respondents were prompted to capture and submit daily foods and drinks consumption and randomly sampled for assessment over a 30-day period. Dietary intake was assessed using 24-hour multi-pass recall and photovoice-aided 24-hour multi-pass recall same day. Energy and nutrients intake and percentage difference in the two approaches were calculated and compared using descriptive statistics and Chisquare test (p≤0.05).Results: Age was 21.0±1.8 years and 57.5% were males. Estimated intakes of energy (1701.2±795.3; 1684.4±774.4)kcal, Protein (50.6±29.1; 50.1±28.1)g, Vitamin A (2712.5±1903.4; 2149.5±1747.4)RE and other nutrients were largely higher with photovoice-aided than conventional 24-hour recall approach, respectively. Large underreporting of phosphorus (-76.7%); thiamin (-72.7%),vitamin A (-26.2%), and vitamin C (-10.1%); and overreporting of vitamins B6 (+33.3%); B2 (+11.1%), and B12 (+17.6%) were observed. Recall accuracy for energy (+15.2%; -8.2%); thiamin (+21.4%; - 58.5%); riboflavin (+27.3%; -24.2%), vitamin B6 (+9.1%; -18.6%), folate (+27.8%; -12.2%), calcium (+11.3%; -17.9%), zinc (+10.9%;-2.6%) and iron (+14.1%; -8.2%) differed significantly in female and male respondents, respectively.Conclusion: Application of photo-voice methodology improves recall accuracy in 24-hour dietary recall procedure and reflects gender difference in recall accuracy

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

Abstract Background Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Methods Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants’ experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Results Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants’ experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members’ diagnosis were less likely to report experiencing HIV stigma and more likely to report “not feeling less than a man” and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Conclusions Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their care seeking behaviors. These findings have implications for HIV programs geared towards African heterosexual men in general and HIV positive men in particular