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Factors Associated with Delay in Presentation of Symptomatic Cancers among HIV Infected Persons in Plateau State, Nigeria

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World Journal of AIDS 2017年第3期7卷 157-165页

作者： Mercy Wakili isichei Ayedima Michea Misauno Femi Alexander Ale isichei christia. ogoegbunem Aisha Abubakar Kabiru Sabitu Patrick Nguku Prince Anyawu Jos University Teaching Hospital Jos Nigeria Faith Alive Foundation Jos Nigeria Ahmadu Bello University Zaria Nigeria Nigeria Field Epidemiology and Laboratory Training Program Abuja Nigeria Excellence Community Education Welfare Scheme Abuja Nigeria

There is increased incidence of cancer worldwide but much of the burden of morbidity and mortality will occur in the developing world because of cancer associated infectious diseases of which HIV infection carries a large proportion. Site-based studies show that proportion of late stage cancer presentation range between 60% - 92% in the last 10 years. There is paucity of information on reasons for the late presentation. This study is aimed to find out the factors associated with delay in presentation of symptomatic cancers among HIV infected persons in Plateau State, Nigeria. A mixed method study consists of quantitative and qualitative component. Participants were sampled from HIV infected persons diagnosed with cancer and referred to the Oncology unit. Variables on Patient and health service factors associated with late presentation of cancers were collected. Quantitative data was analyzed using Epi info version 3.5.3 and Microsoft Excel while thematic analysis was done for qualitative data. There were 503 respondents and the mean age was 48.7 ± 13.5 years. Male sex OR 2.5, (P = 0.002);Farming occupation OR 1.7, (P = 0.0005) and Primary education OR 2.0, (P = 0.0005) were associated with delay. Majority of respondents 349(69%) presented more than six months after onset of symptom. Common symptoms were pain 462(45.70%), swelling 237(23.44%) and skin discoloration 210(20.77). Their Initial reaction was mainly the use of alternative remedies 234(46.5) CI 42.1 - 51.0. Up to 274(54.47%) of participants obtained diagnosis 3 months after presenting to a health facility. Laboratory related issues 199(39.56%) and long booking time 163(32.40%) were the most common reasons for delay. Delay was found to be both patient and services related. The study also suggests that cancer symptom awareness is poor among the participants. There is no tangible cancer prevention program in the HIV/AIDs treatment program. A more in-depth knowledge of cancer is required for both the sufferer a

关键词： Delay Cancer Presentation HIV/AIDS Factors

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Baseline Laboratory Profile of HIV Positive Patients on Antiretroviral Therapy in Jos North Central Nigeria: Implications for Pre-vention, Treatment, Care and Support

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World Journal of AIDS 2015年第4期5卷 328-334页

作者： christia. ogoegbunem isichei Mercy Wakili isichei Jean Emile Njab Johnson Ibidun Rotimi Tinuade Abimbola Oyebode Charles Ujunwa Anyaka Kenneth Emeka Enwerem Ayuba Ishiaku Affi Lucius Chidiebere Imoh Alexander Ogielu Abu Solomon Abiola Asorose Noel Omuya Amadu Propser Ihenacho Okonkwo Ngozi Ijeoma Okoro Department of Chemical Pathology Faculty of Medical Sciences University of Jos Jos University Teaching Hospital Jos Nigeria Faith Alive Foundation Jos Nigeria Department of Surgery Faculty of Medical Sciences University of Jos Jos University Teaching Hospital Jos Nigeria Department of Chemical Pathology Bingham University Jos Campus Jos Nigeria Department of Obstetrics and Gynaecology Faculty of Medical Sciences University of Jos Jos Nigeria AIDS Prevention Initiative in Nigeria (APIN) Abuja Nigeria

Background: We characterized baseline laboratory data of patients to identify priority treatment areas, most affected populations, anticipated clinical complications and assessed the potential burden of retention in care in Jos, Plateau State—North Central Nigeria. Methods: This study was a cross-sectional design from January 2004 to December 2005 at Faith Alive Foundation (FAF). All participants were HIV-positive and underwent pre-antiretroviral therapy counseling based on the national antiretroviral therapy (ART) guidelines and baseline laboratory testing. Data were captured on Microsoft Excel, validated on Epi Info and analyzed on SPSS version 21 at P < .05 level of significance. Results: Total of 1499 (463 men and 1036 women) participants were evaluated in this study. The age and sex related distribution of participants showed that majority (80.3% for males and 92.5% for females) were 16 - 45 years old. Amylase and creatinine were significantly higher in males than females (P = .02). Anaemia was the most common baseline abnormality (63% for females and 58% for males), while baseline CD4 count was significantly lower in males than females (P < .02) and at one-third had elevated liver enzymes (AST and ALT). Conclusion: The baseline laboratory profile of most HIV positive patients in Jos and environs of North Central–Nigeria was characterized by anaemia, elevated creatinine, and abnormal liver transaminase levels (AST and ALT). This pre-ART laboratory result suggests that HIV-positive individuals have multiple clinical abnormalities which may require more extensive care than just treating the HIV disease.

关键词： Baseline Laboratory Profile HIV-Positive Patients PEPFAR HTC Nigeria

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