Quality of life of people living with HIV and AIDS attending Irrua Specialist Teaching Hospital, Edo State, Nigeria

Background: With the use of highly active antiretroviral therapy (HAART), life expectancy of HIV-infected persons had increased and the disease is now managed as a chronic one, but the quality of life (QOL) of the patients is now a concern. Social support enhances QOL of patients with chronic illnesses. However, no study has been done to determine the QOL of people living with HIV and AIDS (PLWHA) in our environment. This study therefore assessed the QOL of PLWHA attending antiretroviral therapy (ART) clinic of Irrua Specialist Teaching Hospital (ISTH), Edo State of Nigeria Methodology: A descriptive cross-sectional study design was used. Two hundred and thirty PLWHA attending the ART clinic of ISTH, Irrua, Edo State, Nigeria, were systematically selected for the study. A structured questionnaire was interviewer-administered to collect data on sociodemographic and clinical profiles of selected participants, and the WHOQOL-HIV BREF questionnaire was used to collect data the QOL of each participant. Data were analyzed with IBM SPSS version 20.0. Results: The overall mean QOL score for the participants was 89.13±1.18 (95% CI=87.95-90.31). The scores in three of the six life domains in the WHOQOL-HIV BREF instrument were similar and high; spirituality/ religion/personal beliefs (16.33±0.36), physical health (15.83±0.28) and psychological health (15.07±0.24). Lower mean QOL scores were observed in the social relationships (13.49±0.28) and environment (13.45±0.20) domains. Clinical HIV stage, marital status, educational status and gender were significantly associated with mean QOL scores in bivariate analysis while only HIV stage 1 and 2 were significantly associated with good QOL in multivariate logistic regression analysis. Conclusion: It is pertinent that PLWHA are kept in early stages of HIV disease through combination of efforts such as prompt enrolment, commencement and monitoring compliance of HAART, and treatment of opportunistic infections, as well as public health measures including education, de-stigmatization, early diagnosis by extensive accessible screening/testing of at-risk population, social supports and economic empowerment, psychotherapy and social integration of affected individuals especially in a functional home.

Lassa Fever: another infectious menace

Nigeria is presently suffering from another Lassa fever epidemic. This was confirmed in the statement of the Minister of Health of the Federation in which he said; ""There has been an upsurge in the reported cases of Lassa fever since the beginning of this year; especially in the Federal Capital Territory and its environs. Within two weeks; 12 cases with five deaths due to the disease were recorded. 25 contacts are confirmed by laboratory investigations to have been infected; including 4 health staff working in the National Hospital; Abuja.""1 Lassa fever is an acute viral haemorrhagic fever first described in 1969 in the town of Lassa in Borno state; Nigeria.2 It is endemic in West African countries; and causes 300;000 cases annually with 5000 deaths.3 Lassa fever epidemics occur in Nigeria; Liberia; Sierra Leone; Guinea and the Central African Republic.4 Lassa virus; the agent of the disease is a member of the Arenaviridae family. The virus is pleomorphic with single-stranded and bisegmented RNA genome.3 Its primary host is Natal Multimammate Mouse (Mastomys natalensis). Transmission to man occurs via exposure to the rat excrement through respiratory or gastrointestinal tracts5; exposure of broken skin or mucus membrane to infected material; direct contact; sexually and transplacentally. The prevalence of antibodies to the virus is 8-229 in Sierra Leone; 4-55in Guinea;12 and 21in Nigeria.13 The disease is mild or asymptomatic in 80of infected people; but 20have a severe multisystemic disease. Clinical features are difficult to differentiate from that of other viral haemorrhagic fevers and common febrile illness such as Malaria; Typhoid fever and so on. Definitive diagnosis is by viral isolation; Antigen and Antibody detection and Reverse Transcriptase PCR. Treatment is with Ribavirin; an antiviral agent. No vaccine is currently available. Prevention is by keeping rats away from homes