Family APGAR and treatment outcomes among HIV patients at two ART Centers in Kumasi, Ghana

objectives: This study aimed to examine the association between Family Adaptability, Partnership, Growth, Affection and Resolve (Family APGAR) and HIV treatment outcomes. Design: A cross-sectional study using the Family APGAR questionnaire Setting: The study was conducted in Kumasi, Ghana, at the Komfo Anokye Teaching Hospital and the Kwame Nkrumah University of Science and Technology Hospital Participants: Consenting HIV-positive patients who had been on treatment for at least 12 months were recruited. Main outcome measures: The Family APGAR questionnaire was administered, and relevant data were extracted from hospital records and analysed using STATA® software. The relationship between Family APGAR and treatment outcomes was determined using Chi-squared tests or Fisher's exact test. Results: Approximately 70.1% of 304 participants were females with a mean age of 41.8 years (±9.9). At treatment initiation, 47.4% of the patients presented at World Health Organisation (WHO) clinical stages I and II and had a CD4 count ≥ 200 cells/mm3 . Females were less likely (Odds Ratio= 0.52; 95% CI=0.31 ­ 0.90, p = 0.018) to report late for treatment compared with the males. After 12 months of treatment, approximately 70% recorded undetectable viral load. Patients with functional families constituted 70.4%, which had a statistically significant relationship with viral load (p = 0.041). Conclusion: HIV care providers should incorporate family functionality evaluation into clinical practice and provide early essential support to enhance treatment outcomes

Predictors of family functionality amongst human immunodeficiency virus-serodiscordant couples in two major hospitals in Kumasi, Ghana

Background: Family instability and partner conflicts are reportedly common in serodiscordant relationships. To date, the family adaptability, partnership, growth, affection and resolve (Family APGAR), a standardised tool for assessing family function, has not been used in any published literature involving this peculiar group. Aim: The aim of this study was to determine the predictors of family functionality and its association with human immunodeficiency virus (HIV) serodiscordance. Setting: The study was undertaken at the Kwame Nkrumah University of Science and Technology Hospital and Komfo Anokye Teaching Hospital in Kumasi, Ghana. Method: This was a cross-sectional study. A systematic sampling method was used to select HIV-positive clients whose partners were seropositive (concordant) or seronegative (discordant). A standardised format was used to extract relevant data. All data were analysed using STATA® (version 14). Results were reported as odds ratios with 95% confidence intervals for study and outcome variables. Results: The study recruited 374 respondents, of which 52% (195) were in HIV-discordant relationships. Approximately 68% (254) of the respondents rated their families as functional, 15% (57) rated as moderately dysfunctional and 17% (63) rated as severely dysfunctional. A statistically significant relationship was found between family functionality and gender, as well as between family functionality and HIV status disclosure to the partner. No association was found between the Family APGAR and HIV serodiscordance. Conclusion: Amongst HIV couples, the strongest predictors of family functionality are gender and status disclosure. Healthcare providers should invest efforts into addressing gender-based challenges, utilise the Family APGAR and support disclosure of HIV status, especially amongst discordant couples

Hypoglycaemic Effect of Lycopene in Streptozotocin-Induced Diabetic Wistar Rats.

Aim: The study was designed to investigate the hypoglycaemic potential of lycopene in streptozotocin (STZ)-induced diabetic Wistar rats. Methodology: To achieve this, a total of thirty (30) adult Wistar rats of both sexes were used. The animals were made diabetic by single intraperitoneal injection of freshly prepared (60 mg/kg body weight) of STZ. Diabetes was confirmed by the presence of high blood glucose ≥ 200 after 72 hr. Diabetic animals were divided into six (6) groups (1, 2, 3, 4, 5 and 6) comprising five animals each. Animals in Group 1 (Diabetic control) and Group 2 (Normal control) received 0.5 ml of olive oil, while those in groups 2, 3, 4, 5 and 6 were administered 10, 20, 40 and 2 mg/kg b w of lycopene and glibenclamide respectively orally once daily for a period of four weeks. After the last day of treatments, all animals were sacrificed and blood samples collected and the serum separated for determination of serum insulin concentration. The liver tissue was excised and homogenized in equivalent volumes of phosphate buffer for the determination of hepatic glucokinase enzyme activity. Results: The results obtained showed that lycopene at all doses significantly (P < 0.05) decreased the blood glucose concentration steadily from (431.4±48.84 mg/dL) to (171.1±7.65, 118.4±1.97 and 100.8±6.89 mg/dL) after four weeks of treatment. The Serum insulin level was increased from (3.02±0.24 μIU/mL) to (4.02±0.70, 3.96±1.41 and 5.06±0.96 μIU/mL), but was not significant (P>0.05), when compared with diabetic control animals. The activity of hepatic glucokinase was significantly (P<0.05) increased from (8.78±1.11 ng/mL) to (11.96±0.54, 14.23±0.88 and 15.78±0.27 ng/mL), when compared with diabetic control group. Conclusion: It is therefore, suggested that antidiabetic-activity may be linked to enhanced glucokinase enzyme activity and not due to increased serum insulin level as the elevation was not statistically significant (P > 0.05) when compared with the diabetic control group. It is recommended that, lycopene may be used as a dietary component in controlling sustained hyperglycaemia in diabetes.