HIV- and hypertension-related knowledge and medication adherence in HIV seropositive persons with hypertension.

BACKGROUND: There is increasing prevalence of diseases associated with ageing such as hypertension, among people living with HIV (PLWHV). This study sought to assess: (1) knowledge related to HIV infection and hypertension, (2) adherence to prescribed medications and (3) clinical outcomes among HIV-positive persons with hypertension at a Nigerian hospital. METHODS: The Patient's HIV Knowledge Questionnaire (PHKQ), Hypertension Knowledge-Level Scale (HK-LS) and Adherence to Refills and Medication Scale (ARMS) were administered to 220 eligible patients through the HIV clinic. Demographic and clinical data were also obtained. RESULTS: Participants were predominantly females (57.3%), with a median (IQR) age of 46 (38-58) years; majority were married (67.8%) and employed (60.8%). Participants reported a higher hypertension-related knowledge compared with HIV-related knowledge (63.6% versus 33.3%, Z = -10.263, P < 0.001), but better adherence to antiretroviral medications compared to antihypertensives (100.0% versus 89.3%, Z = -9.118, P < 0.001). Of the 98 participants with documented viral load, 55 (56.1%) had undetectable (<40 copies/ml) values; however, only four (2.0%) of the entire sample had controlled (<140/90 mmHg) blood pressure. CONCLUSIONS: Despite having a higher hypertension-related knowledge, adherence to antihypertensive medications and blood pressure control were poor. There is a need for increased attention to HIV education and comorbidities in PLWHV.

Assessing the reliability of microscopy and rapid diagnostic tests in malaria diagnosis in areas with varying parasite density among older children and adult patients in Nigeria.

BACKGROUND: Current malaria control strategies are based on early diagnosis and appropriate treatment of malaria cases. The study aimed at comparing the performance of blood film microscopy and rapid diagnostic test (RDT) in Plasmodium falciparum detection in patients ≥6 years of age. MATERIALS AND METHODS: A total of 154 consecutive pyretic patients aged 6-62 years were enrolled, sampled, and tested for malaria using RDT (first response) and microscopy by Giemsa staining. Genomic DNA was extracted after saponin hemolysis and nested polymerase chain reaction (PCR) was used to detect Plasmodium falciparum. The endpoints were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: Of the 154 patients, 80 (51.9%) had fever of ≥37.5°C. 106 (68.8%) were positive by First response® , 132 (85.7%) by microscopy, and 121 (78.6%) by PCR. The sensitivity, specificity, PPV, and NPV of first response compared to microscopic method were 82.2%, 100.0%, 100.0%, and 34.3%, respectively, while it was 75.4%, 75.0%, 95.3%, and 31.2%, respectively, when compared to PCR. The sensitivity, specificity, PPV, and NPV of the microscopic method compared to PCR were 92.3%, 50.0%, 90.91%, and 54.5%, respectively. There was a significant difference in the performance of RDT and film microscopy methods (P ≤ 0.05). CONCLUSION: Microscopy performed better and is more reliable than first response (RDT) in areas with low parasite density among patients ≥6 years of age. Rapid diagnostic tests could be useful in aareas with high parasite density as an alternative to smear microscopy.

Development of a patient satisfaction questionnaire for HIV/AIDS patients in Nigeria.

OBJECTIVE: The aim of this study was to develop and validate a questionnaire for assessing HIV-infected patients' satisfaction with pharmaceutical care received in Nigerian HIV clinics. METHOD: Questionnaire's items were selected based on similar published studies and designed on a 5- point Likert response scale. Face and content validity, feasibility, factorial validity, reliability, and construct validity were evaluated. The instrument's feasibility was assessed in a secondary health care facility (St. Charles Borromeo Hospital Onitsha) and validated in a tertiary health care facility (University of Nigeria Teaching Hospital Enugu). Factor analysis used principal components and varimax rotation. Reliability was established using internal consistency with Cronbach's alpha. Convergent and discriminant validity were determined using Spearman's rho correlation. RESULTS: A self-administered 16-item questionnaire in 5-point Likert response scale format was developed. Questionnaire evaluated cumulative experience of patients with comprehensive pharmaceutical care practice in pharmacies of HIV clinics. Eighty questionnaires were collected for pilot test while four hundred questionnaires were retrieved for the validity test. Factor analysis resulted in four factors: 'Interpersonal/Professional relationship with pharmacist', 'patient counseling', 'drug information' and 'managing therapy', with a cumulative variance of 56.7%. Cronbach's alpha for the whole questionnaire was 0.85, and 0.81, 0.66, 0.67 and 0.72 for the four factors, respectively. Four items used for convergent and discriminant validity showed convergence between the related items and variance between the unrelated items. CONCLUSION: The questionnaire developed is a reliable and valid instrument for assessing patient satisfaction with pharmaceutical care in HIV clinics in Nigeria. Further research is needed to expand the instruments' robustness.

Antiulcer activity of roots of zapoteca portoricensis (fam. Fabiaceae).

BACKGROUND: The roots of Zapoteca portricensis is a common remedy in the treatment gastrointestinal disorders used by tradomedical practitioners in Eastern Nigeria. AIM: This study was aimed at evaluating the possible antiulcer activity of the root of this plant in experimental rats. METHODS: A methanolic root extract was prepared by cold maceration. Antiulcer activity was tested using absolute ethanol and indomethacin induced ulcer models. Sucralfate (100 mg/kg oral) was used as the reference drug. Different groups of albino rats of male sex were given three doses (50, 100, 200 mg/kg) of the extract. Phytochemical analysis of the freshly dried roots was also done. RESULTS: Phytochemical results revealed presence of alkaloids, terpenoids, glycosides and flavonoids. The ethanol model produced an average ulceration in rats with reduction of ulcer (50%, 75% and 90%) seen in all the extract treatment. A dose dependent inhibition of ulcer was seen in all doses of the extract with doses 100 and 200 mg/kg produced a significant reduction compared with control. In the indomethacin model, an absolute ulceration was produced in all the animals. Inhibition of ulcer (57.1%, 65.7% and 80.0%) was seen in the treatments with the extracts in a dose dependent manner. All the three doses of the extracts produced significant ulcer protection compared with control. CONCLUSION: This study has shown that roots of this plant (Zapoteca portoricensis) possess potent antiulcer activity.