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Stallings Foley posted an update 6 months, 3 weeks ago
Introduction regular use of Antiretroviral Therapy (ART) in pregnancy and breastfeeding reduces the odds of Mother-to-Child HIV Transmission (MTCT). However, adherence to ART is critical for MTCT to be successful. The present study investigated factors that influence adherence to ART among HIV infected pregnant women in Zambia. Methods a cross-sectional study design was conducted involving 71 HIV infected pregnant women who were advised to join the Prevention of Mother-to-Child HIV Transmission (PMTCT) program during their routine Antenatal clinic (ANC) visit and were on ART for more than six months. We used the Medication Possession Ratio (MPR) to quantify adherence levels. We used logistic regression to establish factors that influence adherence to ART. Results a total of 71 HIV infected pregnant women with a median age of 27years (IQR, 25-30) were enrolled in the study. There was evidence of a difference in adherence levels between pregnant women above 30 years and ones between 15 years and 30 years (P less then 0.001). Median adherence levels in this group were found to be at 96%(IQR 89-97). The main predictor of adherence in this population was marital status (being on separation) and age. The women who were on separation were 0.14 times less likely to adhere to option B+ compared to married women. Conclusion adherence to option B+ among pregnant women is low. Adherence was significantly influenced by marital status (being on separation) and age. Efforts to improve adherence should be directed towards women on separation and young adults ( less then 30 years of age).Introduction asthma is a complex disease caused by the interaction of several genes. Some of them have a protective effect and some others contribute to disease onset. This study focuses on a region of the short arm of chromosome 6, where the genes encoding the major histocompatibility complex called HLA are located. This short arm plays an important role in the pathogenesis of asthma. Methods our study included 61 subjects, 30 non-asthmatic, non-allergic subjects and 31 patients with more than a 2-year history of allergic asthma. Atopic asthma was confirmed by skin tests and HLA-typing of class II which were performed following the principle of the serological technique of separation by FluoroBeads B. Results statistical analysis showed that HLA – DR11 and DQ2 genes were significantly more frequent in the asthmatic group compared to the control. The results were as follows HLA-DR11 with p=0.05 and HLA-DQ2 with p=0.002. Based on this results HLA markers could be associated with asthma. On the other hand HLA-DQ6 marker was substantially higher in the control group than in the asthmatic subjects with p=0.003. Conclusion HLA DR11 and DQ2 markers could be potential markers of susceptibility to asthma, while HLA-DQ6 may have a protective effect.Battered child syndrome (BCS) is a form of physical abuse that is characterised by multiple injuries and potentially fatal outcome. Despite the high prevalence of physical abuse in developing countries, BCS is rarely reported. Hence, this report highlighted a four-year-old Nigerian boy who suffered multiple injuries (scalp haematoma, bruises, right clavicular fracture, and burns) from the paternal uncle’s wife. This case report is discussed along the line of public health approach for curbing the social menace.Introduction annually, many people die due to being exposed to secondhand smoke (SHS) which they experience at a number of premises that include health institutions. Scientists agree that there is no safe exposure level to SHS, however, in the City of Bulawayo many people are exposed to SHS. There are great expectations from communities for health professionals to reduce SHS exposure-related morbidity and mortality. This study sought to establish exposure to SHS in health institutions and sources of knowledge on SHS. Methods a cross-sectional study, with participants randomly selected from residents visiting the 13 municipal revenue halls in the City of Bulawayo, was conducted. Data were collected through a structured questionnaire and were analyzed by performing descriptive and multivariate logistic regression. Results 26.3% (N = 419) of respondents who had been to health institutions in the previous 30 days had been exposed to SHS within those institutions. Almost all the respondents (85.4%) had never received a lesson on SHS from a health professional or had last received one three months before the survey. Furthermore, 74% of respondents had not seen posters on SHS or had last seen one more than three months before the survey. Conclusion health professional should collaborate with other professionals in the fight against exposure to SHS as evidenced by the high prevalence of exposure in the health institutions and low health education given on SHS exposure in the City of Bulawayo.Introduction heart failure (HF) is a major complication following ischemic heart disease (IHD) and it adversely affects the outcome. The objective of this study was to identify predictors of HF in patients with IHD. Methods this is a 24-month longitudinal retrospective study of all consecutive patients diagnosed with IHD. Endpoints were incident HF and time to incident HF. Patients with a previous history of HF were excluded. find more Results a total of 306 patients with IHD were included in the analysis. The 6-month, 12-month and 18-month cumulative risk of developing incident HF were 18.8%, 28.4%, and 53.5% respectively. Increasing age, female gender, diabetes mellitus (DM), lower hemoglobin, and dilated left atrium were strong predictors of incident HF. Predictors of shorter time to incident HF were coexisting DM and hypertension, and the presence of dilated left atrium in patients with left ventricular ejection fraction less then 40%. The strongest predictor of incident HF in patients with DM was a higher level of LDL cholesterol. Conclusion patients with IHD have a higher risk of incident HF. Strong predictors of incident HF in these patients were increasing age, female gender, DM, lower hemoglobin and dilated left atrium. Such patients need close follow-up and more intensive treatment.
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