Predictors of parent-child communication among a nationally representative sample in Nigeria.

This study explores what constructs are associated with parent-adolescent communication about AIDS/sexually transmitted infections (STIs) and sexual relationships in Nigeria. The analyses use data from the 2007 National HIV/AIDS and Reproductive Health Survey on 2593 men and women who had at least one child over the age of 12 years. The respondents were classified as low, medium, or high communicators. Low communicators were parents who did not talk to their child about either AIDS/STIs or sexual relationships. Medium communicators were parents who discussed only one topic with at least one child. High communicators were parents who discussed both topics with at least one child. Logistic regression was used to compare high communicators with low/medium communicators. There are commonalities and differences among men and women in the factors associated with parent-adolescent communication. Age, religion, and knowing where to obtain information about HIV/AIDS were associated with the extent of communication, regardless of the parent's gender. Perceived social support was an important correlate for fathers, while knowledge of female STI symptoms showed a significant association only for mothers. Programmatic and communication implications of the findings include addressing men and women differently, developing strategies to specifically reach younger parents and Muslims, and increasing general awareness of HIV/AIDS information resources. Further research is needed to understand the context, content, and timing of parent-adolescent conversations about AIDS/STIs and sexual relationships and how these factors affect the sexual behaviors of adolescents.

Feasibility of distributing rapid diagnostic tests for malaria in the retail sector: evidence from an implementation study in Uganda.

BACKGROUND: Despite the benefits of malaria diagnosis, most presumed malaria episodes are never tested. A primary reason is the absence of diagnostic tests in retail establishments, where many patients seek care. Malaria rapid diagnostic tests (RDTs) in drug shops hold promise for guiding appropriate treatment. However, retail providers generally lack awareness of RDTs and training to administer them. Further, unsubsidized RDTs may be unaffordable to patients and unattractive to retailers. This paper reports results from an intervention study testing the feasibility of RDT distribution in Ugandan drug shops. METHODS AND FINDINGS: 92 drug shops in 58 villages were offered subsidized RDTs for sale after completing training. Data on RDT purchases, storage, administration and disposal were collected, and samples were sent for quality testing. Household surveys were conducted to capture treatment outcomes. Estimated daily RDT sales varied substantially across shops, from zero to 8.46 RDTs per days. Overall compliance with storage, treatment and disposal guidelines was excellent. All RDTs (100%) collected from shops passed quality testing. The median price charged for RDTs was 1000USH ($0.40), corresponding to a 100% markup, and the same price as blood slides in local health clinics. RDTs affected treatment decisions. RDT-positive patients were 23 percentage points more likely to buy Artemisinin Combination Therapies (ACTs) (p = .005) and 33.1 percentage points more likely to buy other antimalarials (p<.001) than RDT-negative patients, and were 5.6 percentage points more likely to buy ACTs (p = .05) and 31.4 percentage points more likely to buy other antimalarials (p<.001) than those not tested at all. CONCLUSIONS: Despite some heterogeneity, shops demonstrated a desire to stock RDTs and use them to guide treatment recommendations. Most shops stored, administered and disposed of RDTs properly and charged mark-ups similar to those charged on common medicines. Results from this study suggest that distributing RDTs through the retail sector is feasible and can reduce inappropriate treatment for suspected malaria.