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Hypertension in HIV-infected Patients at Boma Hospital in Democratic Republic of the Congo
Blaise Makoso Nimi,
Benjamin Longo Mbenza,
Carine Nkembi Nzuzi,
Roland Vangu Vangu,
Aliocha Nkodila,
Memoria Makoso Nimi,
Antoinette Ndele Nzita,
Michel Lutete Nkelani
Issue:
Volume 7, Issue 1, June 2021
Pages:
1-7
Received:
18 January 2021
Accepted:
30 January 2021
Published:
9 February 2021
Abstract: Background and aim: The prevalence of hypertension is steadily increasing both in the general population and in patients living with HIV. The contributing factors are from one part identical to all and other parts linked to the HIV infection and its management. Given the complications related to ART, we list the cardiovascular risk factors, determine the proportion of hypertensive in people living with HIV before treatment with ART. Methods: this was a cross-sectional study carried out from January to May 2019 at the Boma hospital located south of Kinshasa in DR Congo. It included any patient who tested positive for HIV and over 18 years of age. The parameters of interest were; demographic data, lifestyle, anthropometric and biological measurements. Results: The prevalence of hypertension was 34.5%. Of the 115 patients with hypertension, 50 (43. 5%) knew their status and 65 (56.5%) were diagnosed during the study). low CD4 count (p=0.002), Diabetes mellitus (p=0.001), advanced age (p=0.001) and central obesity (p=0.009) emerged as mainrisk factors associated with hypertension in patients with HIV. Conclusion: hypertension is one of the cardiovascular risk factors present in seropositive patients and whose prevalence should attract the attention of both political and health authorities.
Abstract: Background and aim: The prevalence of hypertension is steadily increasing both in the general population and in patients living with HIV. The contributing factors are from one part identical to all and other parts linked to the HIV infection and its management. Given the complications related to ART, we list the cardiovascular risk factors, determi...
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“I Feel Healthy Like Any Other Person” Reasons for Defaulting from ART Treatments Use Among Adults Living with HIV in Tunduru District: A Qualitative Inquiry
Emmy Metta,
William Yonathan,
Melkizedeck Leshabari
Issue:
Volume 7, Issue 1, June 2021
Pages:
8-14
Received:
1 March 2021
Accepted:
12 March 2021
Published:
22 March 2021
Abstract: Background: Continuing use of ART treatments is reported to improve health and health outcomes of people living with HIV. However, adherence to ART prescriptions is generally a challenge and many people default from HIV care and treatment. This study assessed reasons for ART treatment default among adults living with HIV in Tunduru district Tanzania. Methods: We conducted a qualitative cross-sectional study between January and February 2018. Ten key informants who had defaulted from HIV care and treatment for five or more months were engaged in in-depth interviews on reasons behind defaulting. Thematic analysis using NVivo was conducted to identify emerging themes. Results: Reasons for defaulting from ART treatments which emerged include being tired of using the ART medications for a long time, not experiencing HIV related symptoms, fear of stigma and shame of being known to use ART, inadequate food, fear of side effects and use of local herbs as alternative. Other reasons include long distance to the health facilities and long waiting time for the services at the facility. Conclusion: Reasons for defaulting from HIV treatment and care among adults are multifaceted in nature requiring multifaceted efforts to address them if the gains intended from the use of ART are to be achieved and sustained.
Abstract: Background: Continuing use of ART treatments is reported to improve health and health outcomes of people living with HIV. However, adherence to ART prescriptions is generally a challenge and many people default from HIV care and treatment. This study assessed reasons for ART treatment default among adults living with HIV in Tunduru district Tanzani...
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Implementation of Context Specific Diagnostics, Strategies and Resources for PMTCT Scale-up Programming in Conflict Affected Communities in Jos, Nigeria
Tinuade Abimbola Oyebode,
Zuwaira Hassan,
Tolulope Afolaranmi,
Musa Tanko Umar,
Francis Magaji,
Maria Pawa,
Patrick Akande,
Solomon Sagay,
Jerry Gwamna,
Prosper Okonkwo,
Phyllis Kanki
Issue:
Volume 7, Issue 1, June 2021
Pages:
15-26
Received:
28 April 2021
Accepted:
14 May 2021
Published:
26 May 2021
Abstract: The 2013 WHO HIV guidelines provided effective antiretroviral regimens to reduce perinatal transmission to below 2%. The option-B approach of providing antiretroviral drugs was adopted by Nigeria, which contributed 32% of global gaps in Preventing Mother to child transmission (PMTCT). In Plateau State, which had 7.7% HIV prevalence, incessant ethnoreligious conflict created challenges impacting on HIV service delivery and access to treatment centers. PMTCT diagnostics conducted by the lead HIV implementing Partner (IP), revealed that several communities in Jos, Plateau State, lacked HIV treatment centers, but were also unable to access existing centers because of conflict related partitioning of Jos, calling for specialized strategies and collaboration to scale-up to affected communities. To bridge existing challenges related to distrust amongst communities, the intervention strategy identified six community oriented resource persons (CORPs), of same ethnoreligious dispensation as people in affected communities, who also possessed HIV programing competencies, to lead the intervention. The project methodology included engagement of community gatekeepers and Plateau HIV stakeholders, who generated context specific strategies to enter these communities and scale-up HIV/PMTCT. The lead CORPs included a female public health/HIV physician, another clinician who owned a community hospital, a HIV laboratory personnel, a HIV trained Data officer, a religious cleric/youth leader and a female expert patient cum member of Federation of Muslim women association of Nigeria (FOMWAN). Collaborating with various stakeholders, they birthed a community faith based organization they called Muslim Health Initiative of Nigeria (MUHIN). This served as platform for community engagement to scale-up HIV/PMTCT services. The Lead HIV Partner supported, engaged and funded MUHIN to provide context specific scale-up to address existing gaps. MUHIN identified, assessed, upgraded and activated twenty-eight community clinics for HIV/PMTCT service deliver, building on existing Maternal, child and New-born health (MNCH) structures. They provided HIV trainings, MNCH materials, national data-capture tools and capacity building to the identified facilities, staff and CORPs. They stratified according to facility capacity, and linked them using the Hub-and-spoke model, to provide HIV testing, PMTCT and Antiretroviral therapy (ART) services. In order to bridge existing human resource for health gaps existing at the clinics, community health workers and HIV positive women who had successfully completed PMTCT programs were engaged and trained according to task shifting and task sharing (TSTS) guidelines, in preparation for HIV/PMTCT activation using HCT as entry. We conclude that detailed diagnostics, planning and utilization of context-specific strategies including TSTS are critical for successful project outcomes.
Abstract: The 2013 WHO HIV guidelines provided effective antiretroviral regimens to reduce perinatal transmission to below 2%. The option-B approach of providing antiretroviral drugs was adopted by Nigeria, which contributed 32% of global gaps in Preventing Mother to child transmission (PMTCT). In Plateau State, which had 7.7% HIV prevalence, incessant ethno...
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The Importance of Considering Religious and Spiritual Ontologies in the Care of HIV Patients in Zimbabwe - A Scoping Literature Review
Ursula Wuthrich Grossenbacher,
Julia Mutambara,
Nicholas Midzi,
Masceline Mutsaka
Issue:
Volume 7, Issue 1, June 2021
Pages:
27-47
Received:
29 April 2021
Accepted:
27 May 2021
Published:
4 June 2021
Abstract: Background: HIV continues to have a major impact on morbidity and mortality in Zimbabwe. Religion/Spirituality (R/S) including traditional beliefs and practices (TP) play an important role for most people living with HIV (PLWHIV) in Zimbabwe. PLWHIV conceive and practice healing holistically, embracing not only the physical conditions, but also the spiritual, psycho-emotional, social, and ecological dimensions. Objective: This scoping review aims to systematically map the research done around R/S and TP and HIV in Zimbabwe. It intends to describe what is known about the role and influence of R/S on the experience of living with HIV in Zimbabwe in general and especially, to illustrate the influence of R/S and TP on the physical and psychological wellbeing of PLWHIV, and the access to HIV care. Design: This scoping review followed the Joanna Briggs Institute’s guidelines. The online databases Medline & ATLA were used to identify articles published between 2010–2021 about R/S and TP and HIV in Zimbabwe. The review includes textual papers, qualitative, quantitative, and mixed studies. Results: 638 records were found and screened for inclusion. 46 records were considered relevant for the qualitative and quantitative synthesis. Most articles (27) addressed the influence of traditional beliefs and practices on health and HIV and 16 records examined the influence of religious beliefs and religious groups’ attitude on HIV. The qualitative synthesis illustrates the influence of R/S and TP on physical and psychological wellbeing and on access to HIV care of PLWHIV in Zimbabwe, thus portraying the medical relevance of R/S issues and TP. Further synthesis identified three areas of conflict with biomedical practice: The bio-psycho-socio-spiritual understanding of health and illness, the notion of patriarchy, and the perception of sexuality and procreation. Here religious/spiritual ontologies may lead to compromised biomedical therapy outcomes. Conclusion: This scoping review includes papers of authors from different backgrounds (theology, medicine, sociology). The synthesis of the content of the records revealed a coherent picture of themes addressed and problems identified. Thus, this review is a fair description of the experience of living with HIV in Zimbabwe and the medical relevance of R/S and TP. The findings show that religious/spiritual ontologies need to be considered and integrated into the design of new health programs. It must be the aim to avoid compromised therapy outcome and to further a holistic support of PLWHIV. This is only possible in collaboration with religious stakeholders and traditional practitioners.
Abstract: Background: HIV continues to have a major impact on morbidity and mortality in Zimbabwe. Religion/Spirituality (R/S) including traditional beliefs and practices (TP) play an important role for most people living with HIV (PLWHIV) in Zimbabwe. PLWHIV conceive and practice healing holistically, embracing not only the physical conditions, but also the...
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Halting the Scourge of HIV in Nigeria by Adopting World Health Organization Guidelines for Preventing New Infections (Policy Brief Paper)
Tinuade Abimbola Oyebode,
Martha Ochoga,
Yetunde Tagurum,
Solomon Atiene Sagay
Issue:
Volume 7, Issue 1, June 2021
Pages:
48-53
Received:
30 May 2021
Accepted:
15 June 2021
Published:
21 June 2021
Abstract: Nigeria bears 10% of global HIV burden and contributes 32% to global unmet-need for Prevention of Mother to Child transmission of HIV (PMTCT), which together with heterosexual transmission are the epidemic’s key drivers as PMTCT clinics show approximately 45% serodiscordance rates among couples. WHO recommends accelerated Anti-retroviral Therapy initiation for all persons living with HIV (PLHIV) for improved quality-of-life and preventing new vertical and horizontal infections, using same drug – Emtricitabine, Tenofovir and Efaverenz (once daily Atripla). The policy paper seeks to make a case that the National PMTCT task team and the Federal Ministry of health of Nigeria, should make a policy change, and shift from the current Option B PMTCT option. The option provides Antiretroviral drugs (ARVs) to pregnant HIV positive women who do for PMTCT, but discontinue them after cessation of breast-feeding, when the viral load is above 500cells/mm3. It proposes that the country should rather adopt the test and treat all policy for all HIV infected persons. The methodology entails the search and use of literature to demonstrate the multiple advantages of early commencement of treatment for all new of HIV infections, considering this has been shown to reduce morbidity and mortality. The results indicate that test and treat all for life, is now less complex as same drug regimen are used in PMTCT and other non PMTCT adult infections. Studies also show that virologic suppression (undetectable) leads to prevention of new HIV transmission (untransmitable), and this applies to different modes of HIV transmission. The brief concludes by proposing that the Federal Ministry of Health, the National AIDS Control agency, and all actors in Nigeria’s HIV terrains should adopt the WHO test and treat guidelines. This remains a critical step for the elimination of Paediatric HIV infections.
Abstract: Nigeria bears 10% of global HIV burden and contributes 32% to global unmet-need for Prevention of Mother to Child transmission of HIV (PMTCT), which together with heterosexual transmission are the epidemic’s key drivers as PMTCT clinics show approximately 45% serodiscordance rates among couples. WHO recommends accelerated Anti-retroviral Therapy in...
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