Adherence to Medication among Patients with Chronic Hepatitis B Infection Attending a Tertiary Hospital in South Western Nigeria.

INTRODUCTION: Chronic hepatitis B (CHB) is an international public health problem. Treatment reduces its morbidity, mortality and infectivity. The aim of this study was to determine adherence among CHB infected patients on Tenofovir and the reasons for non-adherence. METHODOLOGY: It was a cross-sectional study of patients on tenofovir for at least 6 months. Information was obtained on bio- data, adherence to tenofovir, duration and reasons for nonadherence using an interviewer administered questionnaire. Non- adherence was defined as patient reporting missing medication at all. Chi square or Fisher exact test and Student's t-test were used to determine associations. P value less than 0.05 was considered significant. RESULTS: A total of 150 participants comprising of 76 (50.7%) females and 74 (49.3%) males with mean age of 39.2 ± 11.4 years, participated in the study. Non adherence rate was 65%. There was no significant association between non-adherence and tribe (p=0.7), level of education (p=0.8), religion (p=0.2), sex (p=0.9), clinical state (p=0.8), treatment experience (p=0.8) and months on Tenofovir (0.1) while a significant association existed with age (0.01), the presence of comorbidity (p=0.02) and taking another medication apart from tenfovir (0.00). The reasons for non-adherence included out of station 22 (14.7%), financial constraint 19(12.5%), unavailability of the drug 19 (12.5%), forgetfulness 15 (10%), perceived side effects 12 (8%), undetectable serum DNA quantification 11 (7.3%), ignorance of continuous use of Tenofovir 10 (6.7%), and pregnancy 9 (6%) among others. CONCLUSION: Adherence to Tenofovir is poor among CHB patients attending University College Hospital, Ibadan.

INTRODUCTION: L'hépatite B chronique (HCB) est un problème de santé publique international. Le traitement réduit sa morbidité, sa mortalité et son infectiosité. Le but de cette étude était de déterminer l'adhésion chez les patients infectés par CHB sur Tenofovir et les raisons de la non-adhésion. MÉTHODOLOGIE: Il s'agissait d'une étude transversale de patients sous ténofovir depuis au moins 6 mois. Des informations ont été obtenues sur les données biologiques, l'adhésion au ténofovir, la durée et les raisons de la nonadhésion à l'aide d'un questionnaire administré par un intervieweur. La non-observance a été définie comme un patient déclarant qu'il n'y avait aucun médicament manquant. Le test du chi carré ou exact de Fisher et le test t de Student ont été utilisés pour déterminer les associations. Une valeur p inférieure à 0,05 a été considérée comme significative. RÉSULTATS: Un total de 150 participants comprenant 76 (50,7%) femmes et 74 (49,3%) hommes avec un âge moyen de 39,2 ± 11,4 ans, ont participé à l'étude. Le taux de non-adhésion était de 65 %. Il n'y avait pas d'association significative entre la non-adhésion et la tribu (p = 0,7), le niveau d'éducation (p = 0,8), la religion (p = 0,2), le sexe (p = 0,9), l'état clinique (p = 0,8), l'expérience du traitement (p=0,8) et des mois sous Ténofovir (0,1) alors qu'il existait une association significative avec l'âge (0,01), la présence de comorbidité (p=0,02) et la prise d'un autre médicament en dehors du tenfovir (0,00). Les motifs de non-observance inclus hors station 22 (14,7%), contrainte financière 19 (12,5%), indisponibilité du médicament 19 (12,5%), oubli 15 (10%), effets secondaires perçus 12 (8%), quantification de l'ADN sérique indétectable 11 (7,3 %), méconnaissance de l'utilisation continue du ténofovir 10 (6,7%) et grossesse 9 (6 %) entre autres. CONCLUSION: L'adhésion au ténofovir est faible chez les patients infectés par CHB fréquentant l'University College Hospital d'Ibadan. MOTS-CLÉS: Infection chronique par l'hépatite B, ténofovir, observance, Nigéria.

Human Papilloma Virus Vaccine Awareness and Vaccination History in Patients Attending STI Clinics in Lagos and Ibadan, Nigeria.

HPV is one of the most common causes of sexually transmitted disease in both men and women worldwide. It is transmitted through vaginal, anal, and oral sex. This study provided information on the Human Papilloma Virus (HPV) vaccine awareness and vaccination history in relation to the level of antibodies to (HPV) in the population at risk in Nigeria. Patients attending STI clinics at Lagos and Ibadan were recruited and informed consent was obtained from all the participants. Using semi structured questionnaire, vaccination history, demography and past experiences of the patients were obtained. Whole blood samples were obtained and the sera screened for specific antibodies to HPV using ELISA test kits for determination of IgG to HPV by DIA PRO Diagnostic Bioprobes Milano-Italy according to the manufacturer's instruction. Of the170 samples analysed 50 (29.4%) samples were positive for HPV. Thirty (17.6%) were from females and 20 (11.7%) of them were males. Thirty-five (35%) of the 100 women participants were aware of HPV vaccine. 15(15%) women did not take the vaccine because they did not know where to get it while 20 (20%) of them could not afford it. It was also noted that there is higher prevalence among the middle-aged women. A high prevalence of HPV antibodies was observed in the study yet none of the participants had received the HPV vaccine thus the antibodies may be from infection. Implication is that the 30 women who tested positive for the HPV antibodies may be at risk of cervical cancer.

Prevalence and Genotypes of Parvovirus B19 Among HIV Positive Children in Ibadan, Oyo State, Nigeria.

Human Parvovirus B19 (B19V) is a global infection with over 50% of infected children residing in sub-Saharan Africa. It causes persistent anaemia under immuno-compromised states such as HIV infection, thereby complicating the course of HIV infection. This study was therefore designed to determine the prevalence and genotypes of B19V among HIV positive children. Blood specimens were collected from HIV positive children and genomic DNA extracted and assayed for the presence of Parvovirus B19 DNA using polymerase chain reaction and the product detected by gel electrophoresis. Amplicons for positive PCR were purified and sequenced for genotype analysis. For the purpose of comparison (differences in the sequences of the NS1/VP1u region), nine HIV negative children were enrolled in this study. Two (1.3%) of the 158 HIV infected children were positive for Parvovirus B19 DNA. Analysis of the results showed a low prevalence of Parvovirus B19 among HIV positive children but a significant relationship was established between Parvovirus B19 infection and the severity of anaemia (p=0.015). Phylogenetic analysis of the sequence data showed that all the B19 virus isolates detected in this study were genotype 1. This study therefore has been able to give an insight to the prevalence and circulating genotypes of Parvovirus B19 among HIV infected children and also establishing a relationship between anaemia and parvovirus B19 infection.