Human immuno-deficiency virus antibody seroprevalence among pregnant women at booking at a university teaching hospital in South-Eastern Nigeria
In Africa, human immuno-deficiency virus (HIV) infection continues to be progressively feminized. This has led to an increase in the number of paediatric HIV infections reported due to increased risk of mother-to-child transmission (MTCT) of HIV during pregnancy, labour and breastfeeding.
The objective of the study was to determine the HIV positive sero-prevalence at booking among pregnant women at the Imo State University Teaching Hospital, Orlu.
A retrospective analysis of the case records of women who booked and were screened for Human Immune-deficiency Virus at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st March 2008 to 28th February 2010 was done. Data on age, parity, educational status, gestational age at booking, and retroviral status were collected and analysed using spss version 13.
Nine hundred and twenty one pregnant women were screened for the presence of HIV 1 & 2 antibodies in their serum. One hundred and six of them were positive, giving a sero-prevalence rate at booking of 11.5%. The highest sero prevalence rate of 45.2% occurred in the age group of 26-30 years. Petty traders contributed 97 (91.5%) of the HIV positive women, while multiparous (para 2-4) women contributed 50% of the positive pregnant women. Only 32 (30.2%) of the HIV positive women booked within the first trimester for antenatal care. Majority 53 (59.4%) of the HIV positive women had secondary education, while those that had no formal education contributed only 6 (5.7%) of the HIV positive women.
There was a high HIV seroprevalence at booking among pregnant women at IMSUTH, Orlu. A lot more needs to be done in order to reduce vertical transmission of HIV in our environment.
Available from: Carole P Mcarthur
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Tobacco smoking is highly prevalent among the HIV-1-infected population. In addition to diminished immune response, smoking has been shown to increase HIV-1 replication and decrease response to antiretroviral therapy, perhaps through drug-drug interaction. However, the mechanism by which tobacco/nicotine increases HIV-1 replication and mediates drug-drug interaction is poorly understood.
In this review, the authors discuss the effects of smoking on HIV-1 pathogenesis. Since they propose a role for the cytochrome P450 (CYP) pathway in smoking-mediated HIV-1 pathogenesis, the authors briefly converse the role of CYP enzymes in tobacco-mediated oxidative stress and toxicity. Finally, the authors focus on the role of CYP enzymes, especially CYP2A6, in tobacco/nicotine metabolism and oxidative stress in HIV-1 model systems monocytes/macrophages, lymphocytes, astrocytes and neurons, which may be responsible for HIV-1 pathogenesis.
Recent findings suggest that CYP-mediated oxidative stress is a novel pathway that may be involved in smoking-mediated HIV-1 pathogenesis, including HIV-1 replication and drug-drug interaction. Thus, CYP and CYP-associated oxidative stress pathways may be potential targets to develop novel pharmaceuticals for HIV-1-infected smokers. Since HIV-1/TB co-infections are common, future study involving interactions between antiretroviral and antituberculosis drugs that involve CYP pathways would also help treat HIV-1/TB co-infected smokers effectively.
Available from: Nathanael Sirili
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ABSTRACT: Background: A major emphasis in the ongoing health sector reforms in Tanzania is to increase the
number of graduates in medical field in all aspects. Tanzania development vision 2025 set quality
livelihood for all as one of its principle objectives. For this to be realized not only Human resource
for Health (HRH) in all Medical fields are required but a highly trained calibre HRH is of
paramount. Whether it has worked or not is a subject of speculation. This paper sets out to examine
to what extent number of produced medical doctors (MDs) has turned positively the number of
surgeons for the past one decade in Tanzania.
Methods: Retrospective analysis of reports from five health Universities in Tanzania with a
focus on graduated Medical Doctors and those trained to become surgeons for the period 2001
Results: Between 2001 and 2010 five institutions trained these graduate Human Resource for
Health (HRH). Combined local training institutions produced a total of 2,022 Medical Doctors.
These Institutions included a public institution Muhimbili University of Health and Allied
Sciences (MUHAS), Private faith based (Kilimanjaro Christian Medical Centre (KCMC) and
Bugando University College of Health Sciences (BUCHS) and private for profit (International
Medical and Technology (IMTU) and Hurbert Kairuki Memorial University (HKMU).
MUHAS alone trained 1,285 MDs or 64% of these graduates. Faith based produced 287 and
the rest (450) were produced by the private for profit institutions. Out of 1285 MDs trained at
MUHAS in the mentioned period, only 25(1.9%) became surgeons, and out of all 2022 Medical
Doctors locally trained in that period only 51(2.5%) trained to become general surgeons. This
is a major challenge for the profession.
Conclusion: If only 2.5% (51 out of 2,022) of all locally trained Medical Doctors trained to
become Surgeons in a period of ten years realization of vision 2025 health sector goals is
questionable. The major question which remain unanswered is why this trend? It is the
authors’ view that Marshall Plan need to be adapted to redress the situation.
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