Prevalence pattern and determinants of disclosure of HIV status in an anti retroviral therapy clinic in the Niger delta region of Nigeria

Background: In order to advance the extent of self-disclosure of HIV sero-status in Nigeria, we evaluated the prevalence, pattern and determinants of disclosure of HIV status amongst adult patients in a hospital in the Niger Delta. Materials and Methods: In a three month cross sectional study undertaken in March 2012, the demographic and clinical data as well as HIV sero-status disclosure frequency and pattern were obtained using a pre-tested questionnaire from consenting HIV infected adults attending the Anti-Retroviral Therapy Clinic in the Niger Delta. Independent determinants of HIV disclosure to current sexual partner were determined using an unconditional logistic model. P<0.05 was considered statistically significant. Results: A total of 260 patients were studied out of which 184(71%) were females. Disclosure to current sexual partner was found to be 62.0% and students had the least disclosure rate. Majority of study participants preferred to disclose to family members (57%) than past sexual partner (2.5%) or friend (4.9%). Although HIV disclosure was significantly associated with male sex, living with sexual partner, partner being HIV positive; the only independent determinants of HIV disclosure were partner being on ART (OR-12.7,95% CI 1.2-132.7)and being currently married (OR-8.8,95% CI 2.1-36.8). Conclusion: The results of our study suggest low rate of HIV status disclosure among HIV infected patients in the Niger Delta. We found that receiving ART and being currently married promoted disclosure. There is need for clinicians and policy makers to foster disclosure of HIV sero-status in Nigeria especially among HIV infected students and unmarried sexual partners

Cold chain facility status and the potency of animal rabies vaccine used in Nigeria

Rabies vaccine failures were reported in literature. Realising that rabies vaccine is sensitive to temperature change; there is need to assess the storage condition of rabies vaccine from distribution centres to veterinary clinics where they are used. This is to establish the sustained potency from source to use. Cold-Chain facilities were assessed and ampoules of rabies vaccine were collected from the distribution centres and veterinary clinics where they are used. The state of rabies vaccine before collection was noted and recorded. Laboratory assay for the potency of rabies vaccine collected was carried out using mice neutralisation test. Rabies vaccine collected from distribution centres had high virus titre ranging between log 10-2;4 and log10-2;5. The Cold-Chain facilities at these centres were adequate and functioning. However at the clinics; the storage condition deteriorated and the virus titres of vaccine tested ranged between log10-1;4 and log10-1;7. The Cold-Chain facilities were either non-functional or partially functional when they are present. Again there were no generator backups for power supply. The study showed that problem created by non-functional or partially functional Cold-Chain facilities resulted in the potency deterioration of rabies vaccine. It is therefore recommended that Cold-Chain facilities should be overhauled and backup generators be provided. Also recommended is the use of oral rabies vaccine that can stand the room temperature to vaccinate dogs