Opportunistic Infections among People Living with HIV (PLHIV) with Diabetes Mellitus (DM) Attending a Tertiary Care Hospital in Coastal City of South India.

BACKGROUND: HIV/AIDS and Diabetes Mellitus are the diseases' known to supress cell mediated immunity and predispose patients for opportunistic infections. Hence, we conducted a study to compare the common opportunistic infections (OIs) between People Living with HIV with DM (PLHIV-DM) and PLHIV without DM (PLHIV). METHODOLOGY: PLHIV with DM and without DM (1:1) were prospectively included in the study from January 2011 to January 2012 at a tertiary care hospital in Mangalore city. Patients were classified as Diabetic if their fasting plasma glucose was ≥ 7.0 mmol/l (126 mg/dl) or 2-h plasma glucose was ≥11.1 mmol/l (200 mg/dl). Standard procedures and techniques were followed for diagnosis of OIs as per WHO guidelines. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. FINDINGS: The study included 37 PLHIV with DM and 37 PLHIV without DM and both groups were treated with Anti-Retroviral Therapy (ART). The median age was 47 years (IQR: 41-55 years) for PLHIV-DM as compared to 40 years (IQR: 35-45.5 years) for PLHIV (p<0.0001). PLHIV-DM had median CD4 counts of 245 (IQR: 148-348) cells/µl compared to 150(IQR: 70-278) cells/µl for PLHIV (p = 0.02). Common OIs included oral candidiasis (49% of PLHIV-DM and 35% of PLHIV); Cryptococcal meningitis (19% of PLHIV-DM and 16% of PLHIV); Pneumocystis jiroveci pneumonia (5% of PLHIV-DM and 18% of PLHIV); extra pulmonary tuberculosis (22% of PLHIV-DM and 34.5% of PLHIV); and Cerebral toxoplasmosis (11% of PLHIV-DM and 13.5% of PLHIV). Microbiological testing of samples from PLHIV-DM, C krusei was the most common Candida species isolated from 9 out of 18 samples. Out of six pulmonary TB samples cultured, four grew Non-tuberculosis mycobacteria (NTM) and two Mycobacterium tuberculosis complexes. CONCLUSIONS: Study did not identify any significant difference in profile of opportunistic infections (OIs) between PLHIV with and without Diabetes.

Gender preferences among antenatal women: a cross-sectional study from coastal South India.

BACKGROUND: A balanced sex ratio is essential for a stable society. OBJECTIVE: The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition. METHOD: In this cross-sectional study 132 antenatal women were interviewed in their preferred language using a predesigned semi-structured questionnaire. The collected information was analyzed using SPSS version 11.5. RESULTS: The mean age of the study participants was 27.2 ± 4.1 years. The majority of the antenatal women (60.6%, n=80) did not have any gender preferences. Among those who had a gender preference (39.4%, n=52), male and female preference was reported by 55.7% (n=29) and 44.3% (n=23) of the participants respectively. The overall son preference index was observed to be 1.3. No consistent relationship could be established between the socio-demographic factors and the preference for gender. The mean preferred family size in our study was 1.85±0.531 and more than half of the participants had a balanced gender preference. The majority of the participants were aware that the adverse sex ratio can lead to fall in the number of brides and that it would bring about a social imbalance. CONCLUSION: As a developed society we need to ensure that both the genders get equal respect and are free from any sort of preferences and prejudices. To achieve this, more and more people need to be made aware of the consequences of gender imbalance and adverse sex ratio in a society.

Evaluation of Integrated Counselling and Testing Centres (ICTC) for HIV in a District of India

ICTCs provide a critical entry point for prevention, care and support for both people affected by HIV/AIDS and general population. The study was conducted with the objective of evaluating ICTCs in terms of infrastructure and staffing, services provided, level of utilization and quality of counselling. The structure and process evaluation of 13 ICTCs under National AIDS control programme III (NACP III) was carried out in a Coastal District of South India. The evaluation was carried out using UNAIDS Tools between July and September of 2010. Twelve out of 13 ICTCs (92%) had adequate infrastructure and staff. Most of the general clients (75%) attending ICTCs were provider initiated and 84.5% of antenatal women in the district attended pre-test counselling and also underwent HIV testing. Twenty six pre-test counselling sessions and 12 post test sero-positive counselling sessions were observed. Pre-test counselling content assessment revealed that only 57.4% of sessions address all the issues whereas, 79% of post-test sessions addressed most of the issues during counselling. Counsellors’ skills assessment information gathering and information giving were found to be poorly done. It was found that post test counselling sessions were not conducted for clients with HIV negative report. The aspects of ICTCs such as services provided at the centers, utilization of services by the clients, infrastructure and staffing pattern were found to be adequate. Counselling forms the vital component of the ICTC needed improvement and post test counselling should be mandatory to all the clients.