Temporal distribution of baseline characteristics and association with early mortality among HIV-positive patients at University College Hospital, Ibadan, Nigeria

The first six months of HIV care and treatment are very important for long-term outcome. Early mortality (within 6 months of care initiation) undermines care and treatment goals. This study assessed the temporal distribution in baseline characteristics and early mortality among HIV patients at the University College Hospital; Ibadan; Nigeria from 2006-2013. Factors associated with early mortality were also investigated. This was a retrospective analysis of data from 14 857 patients enrolled for care and treatment at the adult antiretroviral clinic of the University College Hospital; Ibadan; Nigeria. Effects of factors associated with early mortality were summarised using a hazard ratio with a 95% confidence interval obtained from Cox proportional hazard regression models. The mean age of the subjects was 36.4 (SD=10.2) years with females being in the majority (68.1%). While patients' demographic characteristics remained virtually the same over time; there was significant decline in the prevalence of baseline opportunistic infections (2006-2007=55.2%; 2011-2013=38.0%). Overall; 460 (3.1%) patients were known to have died within 6 months of enrollment in care/treatment. There was no significant trend in incidence of early mortality. Factors associated with early mortality include: male sex; HIV encephalopathy; low CD4 count ( 50 cells); and anaemia. To reduce early mortality; community education should be promoted; timely access to care and treatment should be facilitated and the health system further strengthened to care for high risk patients

Quality of life of People living with HIV and AIDS attending the Antiretroviral Clinic, University College Hospital, Nigeria

Background: Quality of life (QOL) is an important component in the evaluation of the well-being of people living with HIV and AIDS (PLWHA), especially with the appreciable rise in longevity of PLWHA. Moreover, limited studies have been conducted in Nigeria on how PLWHA perceive their life with the World Health Organisation Quality of Life Brief Scale (WHOQOL-Bref) instrument. Objective: This study assessed the QOL of PLWHA attending the antiretroviral(ARV) clinics, UCH Ibadan, Nigeria. Method: A cross-sectional study was conducted from June to September 2008 that involved 150 randomly selected HIV-positive patients who were regular attendees at the antiretroviral clinic, UCH Ibadan. An interviewer administered questionnaire was used to collect information on sociodemographic data, satisfaction with perceived social support, medical records, and QOL was assessed with WHOQOL-Bref. Results: The mean age of the respondents was 38.1 ± 9.0 years and the male:female ratio was 1:2. The mean CD4 count was higher in female patients than in male patients, 407 cells/mm3: 329 cells/mm3(p=0.005). The mean QOL scores on the scale of (0­100) in three domains were similar: psychological health,71.60 ± 18.40; physical health, 71.60 ± 13.90; and the environmental domain, 70.10 ± 12.00; with the lowest score in the social domain, 68.89 ± 16.70. Asymptomatic HIV-positive patients had significantly better mean QOL scores than symptomatic patients in the physical (74.04 ± 16.85 versus 64.47 ± 20.94, p=0.005) and psychological domains (76.09 ± 12.93 versus 69.74 ± 15.79, p=0.015). There was no significant difference in the mean QOL scores of men compared to those of women, in all domains assessed. Conclusion: High QOL scores in the physical, psychological and environmental domains may be reflective of the effectiveness of some of the interventions PLWHA are exposed to at the ARV clinic, UCH Ibadan (on-going psychotherapy, free antiretroviral drugs). Relatively low social domain scores may suggest ineffective social support networks, because PLWHA are still exposed to stigmatisation and discrimination. An improvement in social support for PLWHA, therefore, will improve their quality of life further