ABSTRACT
Background: HIV infected children survive to adolescence because of anti retroviral therapy, however, only a small proportion know their diagnosis.Disclosure is critical to long-term disease management, yet little is known about if, how, and when disclosure takes place and the barriers associated with it, and its impact on children in resource limited settings. Objective: This study set out to determine the process of and barriers to HIV disclosure in children as well as the immediate impact of this on children and their caregivers. Methods: A cross-sectional study was done June-July 2016 using a structured questionnaire, convenience sampling and quantitative methods at the infectious disease clinics of National Hospital Abuja. A sample of 164 caregivers of HIV positive children aged 5 to 16 years receiving antiretroviral therapy for at least one year were enrolled. Results: Prevalence of full disclosure was 24.5%, partial 22.7% with overall prevalence of 47.2%. Main barrier to disclosure was child's age and fear of informing others. The impact of disclosure on caregivers was relief in 45.5% but emotional and difficult for others. Immediate reactions by children were sadness; tearfulness and worry in 28.6%, some showed no reaction while others even expressed relief. On a longer term, disclosure had several effects. Main predictors of disclosure on regression were the child's age and caregiver's opinion on disclosure. Conclusion: The prevalence of full disclosure is low and several barriers affect disclosure. Caregiver's and HCWs need empowerment and support with culturally appropriate skills and platforms to deal with the barriers, process and impact of disclosure
Subject(s)
Child , Communication Barriers , Disclosure , HIV Serosorting , Health Impact Assessment , NigeriaABSTRACT
Background: Neonatal malaria was said to be a rare entity. However there are increasing reports from many parts of the world about the occurrence of malaria in the newborn. Methods: A review of the literature on this subject was done with emphasis on developing countries. Literature search was done using Medline; as well as local and international journals. Results: The reasons for earlier reported rarity of neonatal malaria; and those for the recent rising incidence are discussed along with diagnostic and management issues. Conclusion: The physician must have a high index of suspicion to make a diagnosis of neonatal malaria; as the clinical features are non-specific and very similar to those of Neonatal sepsis. Neonatal malaria is a contributor to neonatal morbidity and mortality; which must be drastically reduced in order to achieve the fourth millennium development goal
Subject(s)
Malaria/congenital , Malaria/diagnosis , ReviewABSTRACT
BACKGROUND: If a HIV positive mother delivers in a health facility; interventions can be effected to reduce the risk of transmission of HIV to the baby. The study was done to evaluate the interventions offered to HIV positive women who delivered at Aminu Kano Teaching Hospital (AKTH) Kano. METHOD: Retrospective review of the case records of all HIV positive patients that delivered at AKTH over a 27 month period (October 2003 to December 2005) was used. RESULTS: There were 4922 deliveries out of which 125 were HIV positive; giving a prevalence rate of 2.54. Most (75.2) of the patients received Nevirapine alone in labour; 20.8 received a combination of antiretroviral drugs while 4 received none because their records were not available. Majority (88) of the patients had spontaneous vaginal delivery; 10.4 by elective CS and 1.6 by emergency CS. There was no maternal death but 3.2 of the babies were stillbirths. All the babies received a single dose of Nevirapine. Most (96) mothers chose exclusive breast milk substitute. CONCLUSION: HIV positive mothers need to deliver in health facilities to receive the full compliment of care they deserve. Highly Active Antiretroviral therapy (HAART) should be introduced; as it is more effective for PMTCT