ABSTRACT
Background: In Sub-Saharan Africa, human immunodeficiency virus (HIV) remains a public health problem. There is need for evidence-based interventions to curb new infections. HIV status disclosure, especially to sexual partner(s) remains a critical step towards reducing viral transmission across sexual partners.Methods: A hospital-based cross-sectional study, conducted at HIV clinics of three selected hospitals. Systematic random sampling was employed to sample 384 people living with HIV/AIDS (PLWH). A pre-tested self-administered questionnaire was used to collect data.Results: Of the participants, 66% of the participants reported HIV positive status disclosure, with only 46% of these having disclosed to their sexual partner. Logistic regression analysis identified age (p value 0.035; AOR 0.94), being satisfied with counselling (p value 0.017; AOR 0.24), gender (p value 0.030; AOR 5.51) and education (p value 0.041; AOR 2.14) as factors associated with having disclosed HIV status. Being younger, satisfaction with counselling, being female and having attained at least secondary education were all associated with higher odds of HIV status disclosure.Conclusions: Based on the findings of the current study, it can be concluded that there is need to improve rates of HIV status disclosure among PLWH in Kigali, Rwanda. The current study findings have provided baseline information for the local health authorities, health care providers, policy makers and other scholars working in HIV epidemic control. The local health authorities can use this as a guide to develop a programme aimed to address the issue of non-disclosure of HIV status in Kigali City and hence help control the incessant spread of HIV infection.
ABSTRACT
Background: Body fluids are commonly used for diagnosis as sputum is not reliable in children. Hence it is essential to study efficacy of body fluids in comparison to GeneXpert which is a new diagnostic modality. Objectives of this study was to incidence of rifampicin resistance, HIV status and efficacy of fluid analysis among tuberculosis suspect pediatric cases.Methods: Present study was hospital based cross sectional study carried out over a period of two years at Department of Pediatrics, ACPM Medical College and Hospital from February 2016 to January 2018 among children with suspected tuberculosis. Rifampicin resistance was determined by using GeneXpert. Body fluids like CSF, pleural fluid, gastric aspirate etc were analyzed and compared with GeneXpert results.Results: Rifampicin resistance was present in 5 cases i.e. 3.3%. 15.15% Patients were HIV positive and in them 12 were GeneXpert positive with 1 Rif resistance. Different Fluid analysis showed maximum positivity with pleural fluid >TB Lymphadenitis >TBM. GeneXpert done on different body fluids showed extra case detection in different fluid analysis negative patients i.e. 28.6% extra case detection in CSF (2 cases), 87.9% in gastric aspirate (25 cases), 85.4% in induced sputum (35 cases), 14.3% in Lymph node aspirate (1 case), 50% in pleural fluid (2 case).Conclusions: : Rifampicin resistance found in present study is alarming. Among body fluids, FNAC, CSF and pleural fluids can be used reliably for diagnosis of tuberculosis where GeneXpert is not available.