The trend of HIV infection in Kano, Nigeria--a seven-year study of adult attendees of Aminu Kano Teaching Hospital.
ABSTRACT Human immunodeficiency virus (HIV) infection is a huge concern with increasing epidemic proportions The consequences are devastating in developing countries particularly in large areas of southeast Asia and sub Saharan Africa including decrease in life-expectancy, huge loss of manpower and a heavy economic and social burden. Sub-Saharan Africa has been hit harder by HIV/AIDS pandemic than any other region of the world At the end of 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that, globally 39.5 million people were living with HIV/AIDS, out of which 24.7 million were in sub-Saharan Africa. To determine the annual trend of HIV infection in Kano as well as the seroprevalence rates over the years.
This retrospective study includes all adults that are 15years and above, who are also AKTH attendees and. patients referred from other hospitals in Kano, who, based on clinical suspicion, were sent to the serology laboratory of the hospital for HIV screening and confirmation between January, 1997 and December, 2003. It however, excludes all pediatrics, antenatal care clinic attendees and all blood donors screened for HIV antibodies within the period. These have been collated under various risk groups elsewhere.
Of 9241 subjects tested, 3217 (34.8%) were confirmed seropositive for HIV antibodies consisting of 1908 (36.7%) and 1441 (35.7%) males and females respectively Analysis of results on yearly basis shows prevalence rates of 37.1% in 1997, 40% in 1998 and 47.9% in 1999. However, the HIV seroprevalence rates declined to 22.6% among these subjects in 2000 before rising to the peak (48.8%) in 2002 from 30% seroprevalence of the previous year, 2001. The prevalence rate for 2003 was 32.1%. effective control strategies aimed at curbing the spread of HIV infection.
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ABSTRACT: The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians. The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed. A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41-50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28-3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42-8.34; P = 0.001), and baseline CD4 count (2.71; 1.51-6.21; P = 0.02) remained significant predictors after adjustment for confounding. The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB.Journal of Epidemiology 02/2009; 19(2):81-7. DOI:10.2188/jea.JE20080026 · 2.86 Impact Factor
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ABSTRACT: Anecdotal evidence suggests that the HIV/AIDS prevalence rates in several African armed forces are high, with gender inequality rendering female military personnel more vulnerable to the disease. The objective of this study was to replicate a successful videotape-based HIV prevention intervention among Nigerian female military personnel in an effort to establish the cross-cultural stability, feasibility and cost-effectiveness of this approach in resource-limited countries. Enlisted women (N346) were recruited from two cantonments in Southwestern Nigeria and randomly assigned to either (a) a 5-session video-based, small group, cognitive-behavioral, HIV prevention intervention, or (b) a 5-session, video-based, contact-matched, HIV education control condition. Participants provided self-report of their HIV/AIDS-related knowledge and sexual behaviors at baseline, 3 and 6 months after completing the intervention. The results indicate that the motivational skills-building intervention did not improve participants' knowledge of HIV/AIDS any better than did the HIV education control condition at each assessment period, but it significantly increased condom use among women in this group by 53.6% at 3-month follow-up. HIV preventive behaviors among women in the motivational skills-building intervention group improved significantly, being 2 and 3 times more, compared to women in the HIV education control group at 3-month and 6-month follow-up assessments. The intervention also significantly improved behavioral intentions of participants as well as reduced alcohol use before sex by 25%, after 3 months; and number of sexual partners by 12% after 6 months. Women in the intervention group were five times more likely than women in HIV education control group to suggest that their new male partners use condom. These findings indicate that a videotape-based, HIV prevention intervention is a feasible and effective approach to HIV prevention among female military personnel from sub-Saharan Africa.Social Science [?] Medicine 01/2011; 72(1):63-71. DOI:10.1016/j.socscimed.2010.10.012 · 2.56 Impact Factor
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ABSTRACT: Background: In sub-Saharan Africa, women and children are vulnerable to HIV/AIDS with about 61% of the infections occurring in women and about 90% of the pediatrics infection through Mother-to-child transmission (MTCT). Antenatal attendees in Nigeria are offered routine HIV testing and counselling on the first visit with opt-out option irrespective of the gestational age at contact. This appears commendable but, considering the national HIV prevalence of 4.6%, our large population of >140 million, the long period of seroconversion of the virus and the fact that pregnant women continue to indulge in activities like: unprotected sexual intercourse with single or multiple partners or men with multiple sexual partners or legal polygamy, cross generational sex, intercourse with sero-discordant partners that put them at risk of new infections; a single screening test on contact may not be sufficient to detect all maternal infections. Aim and Objectives: This is to perform a second HIV testing in antenatal women late in pregnancy and determined the sero-prevalence of HIV amongst those who tested negative in the first half of pregnancy. Materials and Methods: This is a prospective cross sectional study conducted among previously HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi between November 2010 and February 2011. The rapid test kits: Determine, Stat Pak and Unigold were used for detection/diagnosis of HIV antibody. Semi structured questionnaire was used to collect socio-demographic data of the subjects. Descriptive analysis of the result was done using the SPSS version 16. Results: The HIV prevalence following repeat testing in late pregnancy was 3.91% (9/230). The mean HIV prevalence at antenatal booking during the study period was 20.64% (116/562). Conclusion: The study highlights the high prevalence of HIV among previously negative attendees in late pregnancy. It brings to the fore the enormity of "missed opportunity" associated with a single routine antibody rapid test for pregnant women on contact/early pregnancy. Therefore, routine repeat antenatal HIV testing and counselling in late pregnancy is strongly advocated.