Right ventricular function in treatment-naïve human immunodeficiency virus-infected patients.

BACKGROUND: Right ventricular dysfunction carries a poorer prognosis in human immunodeficiency virus (HIV)-positive patients. The objectives of this study were to ascertain the prevalence of right ventricular systolic and diastolic dysfunction, as well as its predictors, in antiretroviral therapy-naïve HIV-positive patients. METHODS: Participants in this cross-sectional, descriptive study comprised 60 HIV-positive patients and 60 HIV-negative controls. All participants had transthoracic echocardiography done to assess right ventricular systolic and diastolic function. The HIV-positive patients had their CD4 counts measured. RESULTS: The mean age of the study population was 34.63 ± 8.7 years versus that of the controls (34.45 ± 9.40 years) (p = 1.000). Right ventricular systolic dysfunction was found in 11.6% of the HIV-positive patients versus the controls (3.33%, p = 0.166) while right ventricular diastolic dysfunction was found in 15.0% of HIV-positive patients versus the controls (1.7%, p = 0.021). The CD4 count did not contribute to the frequency and degree of right ventricular systolic or diastolic dysfunction. CONCLUSION: Right ventricular systolic and diastolic dysfunction was common in treatment-naïve HIV-infected individuals but the frequency and degree were not associated with the CD4 count or other measured parameters.

Perception and practices towards Covid-19 amongst residents in Southern Nigeria.

BACKGROUND: Within a short duration, coronavirus disease 2019 (COVID-19) spread globally, affecting all facets of life and causing widespread panic. This study set out to assess the perception and practices towards COVID-19 of urban and rural residents in Akwa Ibom State, Nigeria. MATERIALS AND METHODS: A cross-sectional study design and multistaged sampling technique were used. Data were collected using an interviewer-administered questionnaire between October and December 2020. Scores assessing perception and practices were allocated and graded based on specific stratified demarcations. P < 0.05 was considered statistically significant. RESULTS: A total of 822 individuals from the selected households were interviewed (urban: 401, 48.8%; rural: 421, 51.2%). Majority of respondents urban (99.8%) and rural (97.9%) were aware of COVID-19. Most respondents had low risk-perception of COVID-19 (62.4%), with significantly more rural respondents having low-risk perception (70.6% rural vs. 54.0% urban). The general perception of COVID-19 amongst the respondents was good (79.2%) with no statistically significant difference between urban and rural residents. Most of the participants had good practices towards COVID-19, with significantly higher proportion of urban respondents having good practice (93.8%) compared to their rural counterparts (83.1%). Amongst rural residents, high-risk perception was associated with higher proportion of good practice (93.4%) compared to 84.5% of low-risk perception (P = 0.015). CONCLUSIONS: The participants had high level of awareness, low risk perception, good general perception and good practices toward COVID-19. However, urban respondents showed better practices towards COVID-19. More attention should be directed towards improving COVID-19 perception and practices particularly amongst rural residents.

Willingness to Pay for a Contributory Social Health Insurance Scheme: A Survey of Rural Residents in Akwa Ibom State, Nigeria.

Background: Health insurance is seen as a pathway to achieving Universal health coverage in low- and middle-income countries. The Nigeria Government has mandated states to set up social health insurance as a mechanism to offer financial protection to her citizens. However, the design of these schemes has been left to individual states. In preparation for the set-up of a contributory social health insurance scheme in Akwa Ibom State, Nigeria. This study assesses the willingness-to-pay for a social health insurance among rural residents in the state. Methods: The study was conducted in three local government areas in Akwa Ibom State, South south Nigeria. It was a cross-sectional study with multi-stage data collection using a demand questionnaire. Interviews were conducted with 286 household heads who were bread winners. Contingent valuation using iterative bidding with double bounded dichotomous technique was used to elicit the WTP for health insurance. Multiple regression using least square method was used to create a model for predicting WTP. Findings: About 82% of the household heads were willing to pay insurance premiums for their households. The median WTP for insurance premium was 11,142 Naira ($29), 95% CI: 9,599-12,684 Naira ($25-$33) per annum. The respondents were predominantly middle-aged (46.8%), Ibibio men (71.7%) with an average household size of five persons and bread winners who had secondary education (43.0%) and were mainly pentecostals (51.5%). The mean age of respondents was 46.4 ± 14.5 yrs. The two significant predictors of WTP for insurance premium amongst these rural residents were income of breadwinner (accounts for 79%) and size of household (2%). The regression coefficients for predicting WTP for insurance premium are intercept of 2,419, a slope of 0.1763 for Bread winner income and a slope of 741.5 household size, all values in Naira and kobo. Conclusion: Majority of rural residents in Akwa Ibom State were willing to pay for social health insurance. The amount they were willing to pay was significantly determined by the income of the breadwinner of the household and the size of the family. These findings are relevant to designing a contributory social health insurance scheme that is affordable and sustainable in order to ensure universal health coverage for the citizens.

Echocardiographic pattern of acquired heart diseases in Nigeria.

BACKGROUND: Acquired heart diseases (AHDs) are present from childhood to old age, and the frequency of pathology differs according to age and the geographical region of the patients. The aim of this study was to document the echocardiographic patterns of AHDs in our setting. MATERIALS AND METHODS: Retrospective analysis of echocardiographic diagnosis of AHD was done for age, sex, and echocardiographic pattern. RESULTS: There were 190 diagnoses in the 163 patients with 27 patients having a double diagnosis, consisting of 88 (54%) males and 75 (46%) females. The mean age was 50.4 years (age range 9-85 years). Ten types of acquired heart pathologies were identified and they included hypertensive heart disease in 49.47%, rheumatic heart disease in 26.32%, cardiomyopathy in 11.05%, endomyocardial fibrosis in 4.74%, and pericarditis in 3.68%. Others were cor pulmonale, pulmonary hypertension, intracardiac thrombi, left atrial myxoma and degenerative heart disease which accounted for the remaining 4.74%. CONCLUSION: This study identifies 10 types of AHDs among the study population. The huge impact of hypertensive heart disease and rheumatic heart disease is a big indicator pointing to the existence of a sub-optimal level of healthcare in the country.