Sexual maturation of HIV-infected and uninfected male children in Abakaliki, South-East, Nigeria: a cross-sectional study.

Introduction: HIV infection, through various mechanisms causes a derangement in sexual maturation. This study compared the Marshal and Tanner staging of HIV-infected and uninfected males. The aim of the study was to determine the sexual maturation in male children infected with HIV on HAART in Abakaliki. Methods: this was a cross-sectional and comparative study involving 80 HIV-infected boys aged 8-17 years and 80 uninfected counterparts matched for age and socio-economic class. Stages of sexual maturation (testicular size and pubic hair) were determined according to the method proposed by Marshall and Tanner. The testicular size was measured using an orchidometer. Data analysis was done with SPSS version 20. Structured questionnaire was used to collect information on socio-demographics. Results: assessment of pubic hair development, showed that 45 (56.2%) of the subjects were in the pre-pubertal stage compared to 27 (33.8%) among the controls, this relationship was statistically significant (p=0.005, OR = 2.5, C.I=1.3-4.8). The mean testicular volume among subjects was found to be 8.29 ± 8.26mls compared to 11.57 ± 8.26mls found in controls. This relationship was also statistically significant. There were significant statistical relationships between duration on HAART and clinical stages of disease with both pubic hair development and testicular volume of subjects and controls. Conclusion: HIV-infected males had significantly delayed onset and progression of sexual maturation. Routine assessment of the sexual maturation of HIV-infected children as well as addressing the modifiable variables influencing sexual maturity is recommended.

Impact of socioeconomic status on patient experience on quality of care for ambulatory healthcare services in tertiary hospitals in Southeast Nigeria.

BACKGROUND: To determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria. METHODS: The study is of a cross-sectional design and exit poll was used to collect its data. A pre-tested structured questionnaire was administered to clients accessing care in the outpatient departments of three tertiary hospitals in Nigeria. The assessment of patient experiences for quality of care was based on five (5) domains of care: waiting time; environment of the outpatient department; quality of doctor's care; quality of care by nurses/other health workers; and responsiveness of care. In addition, the overall quality of care was assessed. RESULTS: The mean rating of patient experience for quality of care for ambulatory healthcare services (outpatients' care) was 74.31 ± 0.32%. Moderate differences were observed between the hospitals assessed for various levels of patients' care, especially for waiting time, quality of doctors' care and overall quality of care. Employment status was a statistically significant (p ≤ 0.05) determinant of overall patient experience rating for quality of care, while the level of patient's education was an influence on the perception of waiting by the patients and their rating of care from nurses/other healthcare providers (apart from medical doctors). CONCLUSION: The study showed that educational and employment status (measures of socioeconomic status) of patients determined how patients receiving ambulatory (outpatient) healthcare services perceived the quality of care in the hospitals. Hence, in order to ensure equity, there is need to institutionalize patient-centered care, while full consideration is given to the patients' socioeconomic status.