Prevention of Mother-to-child HIV Transmission in Nigeria: Six Years' Experience from a Tertiary Institution.

BACKGROUND: In line with global standards and progress made in Prevention of Motherto- Child Transmission (PMTCT), an assessment of the outcome of Early Infant Diagnosis in northern Nigeria is necessary to evaluate progress towards zero Human immunodeficiency Virus (HIV) infection among children. OBJECTIVES: This study assessed the infection rate and risk factors for mother-to-child HIV transmission among HIV-exposed children in Kano, northwest Nigeria. METHODS: Using a retrospective cohort design, pregnant HIV-positive women and their exposed infants were recruited over a period of six years (2010 to 2016). Participants were enrolled during pregnancy or at delivery in the PMTCT clinic of a tertiary health facility in Kano, Nigeria. The main outcomes for the study were Early infant diagnosis positivity for HIV at 6 weeks and risk factors for positivity. RESULTS: Of the 1,514 infants studied, early infant diagnosis was positive for HIV among 13 infants (0.86%). Infants whose mothers did not have antiretroviral therapy (adjusted Prevalence Ratio aPR = 2.58, 95%CI (1.85- 3.57)), who had mixed feeding (aPR = 12.06, 95%CI (9.86- 14.70)), and those not on antiretroviral prophylaxis (aPR = 20.39, 95%CI (16.04- 25.71)) were more likely to be infected with HIV. HIV-exposed infants on nevirapine and zidovudine prophylaxis were 95% and 74%, respectively, less likely to be infected with HIV. CONCLUSION: HIV infection rate remains high among HIV-exposed infants whose mothers did not receive PMTCT services. Scaling up proven interventions of early commencement of antiretroviral treatment for mothers, adherence to antiretroviral prophylaxis, and avoidance of mixed feeding among HIV-exposed infants would protect future generations from HIV infection.

Quality of Life Following Hemiarthroplasty in the Elderly.

Background: Fracture neck of femur in the elderly population, are common and often a devastating condition leading to morbidity and sometimes even mortality if not treated or appropriately addressed. The optimal treatment has been a subject of debate. Arthroplasty or surgical fixation gives good outcome among others. Health related quality of life is a useful tool in assessing the outcome of hemiarthroplasty. This study compared the quality of life of elderly patient before and after hemiarthroplasty using EQ-5D and EQ-VAS health questionnaire as a tool. Methodology: This was a prospective descriptive study done over 18 months on elderly people with fracture neck of femur who had hemiarthroplasty at the national orthopedic hospital, Dala, Kano, Nigeria. This study was designed to measure the outcome of hemiarthroplasty using health related quality of life with EQ-5D and EQ-VAS health questionnaire as a tool. Result: There was a significant change in the quality-of-life indices observed during the pre-operative period and six months after surgery (P<0.05). This significant change was seen using both the EQ-5D descriptive system and the EQ-VAS. Conclusion: Hemiarthroplasty improves the health-related quality of life among elderly patients with fracture neck of femur. The EQ-5D and EQ-VAS health questionnaire are a valuable tool in assessing the health related Qol following hemiarthroplasty.