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A Cross-Sectional Study on the Impact of Operation Triple Zero (OTZ) Program on Viral Load Suppression amongst Members of the Adolescent Club in 68 Nigerian Army Reference Hospital Yaba Lagos, Nigeria

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World Journal of AIDS 2024年第2期14卷 35-44页

作者： nkechinyere harrison Ismail Lawal Yakubu Adamu Kehinde Aribisala Adegbenga Olarinoye Uzoamaka Agbaim Funmilayo Owolabi Dooshima Okonkwo Laura Chittenden Nathan Okeji Centre for Infectious Disease Clinic 68 Nigerian Army Reference Hospital Lagos Nigeria United States Army Medical Research Directorate-Africa Abuja Nigeria Henry Jackson Foundation Medical Research International LTD/GTE Abuja Nigeria Nigerian Ministry of Defence Health Implementation Program Abuja Nigeria

Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral l

关键词： Impact Operation Triple Zero Adolescent Viral Load Nigeria

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World Journal of AIDS（艾滋病） 2024年第2期 35页

作者： nkechinyere harrison Ismail Lawal Yakubu Adamu Kehinde Aribisala Adegbenga Olarinoye Uzoamaka Agbaim Funmilayo Owolabi Dooshima Okonkwo Laura Chittenden Nathan Okeji

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Prescription of intermittent preventive therapy (IPTp) among doctors practicing in an army hospital in Lagos, Nigeria

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Open Journal of Preventive Medicine 2013年第2期3卷 258-261页

作者： nkechinyere E. harrison Tolulope F. Olufunlayo Nkiru N. Odunukwe Clinical Divisions Nigerian Institute of Medical Research Yaba Lagos Lagos Nigeria Department of Community Health and Primary Care College of Medicine University of Lagos Idi-Araba Lagos Nigeria Department of Medicine 68 Nigerian Army Reference Hospital Yaba Lagos Lagos Nigeria

Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.

关键词： Prescription Intermittent Preventive Therapy for Malaria Army Hospital

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Utilization of the current national antimalarial treatment guidelines among doctors in army hospitals in Lagos, Nigeria

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Open Journal of Preventive Medicine 2012年第3期2卷 390-393页

作者： nkechinyere E. harrison Tolulope F. Olufunlayo Chimere O. Agomo Department of Community Health and Primary Care College of Medicine University of Lagos Idi-Araba Lagos Nigeria Department of Medicine 68 Nigerian Army Reference Hospital Yaba Lagos Nigeria Malaria Research Laboratory Department of Biochemistry Nigerian Institute of Medical Research Yaba Lagos Nigeria

Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria pro

关键词： National Antimalarial Treatment Guidelines Antimalarial Treatment Army Hospitals

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Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria

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World Journal of AIDS 2021年第1期11卷 25-40页

作者： nkechinyere Elizabeth harrison Kenneth Ejiofor Oruka Uzoamaka Concilia Agbaim Olutunde Ademola Adegbite Nathan Anelechi Elvis Okeji Centre for Infectious Disease Clinic 68 Nigerian Army Reference Hospital Yaba Lagos Nigeria Department of Medicine 68 Nigerian Army Reference Hospital Yaba Lagos Nigeria Ministry of Defence Health Implementation Programme Abuja Nigeria

Introduction: The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. Methods: This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. Results: Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. Conclusion: In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.

关键词： Prevention of Mother to Child Transmission of HIV HIV Positive Mothers Nigeria

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Evaluation of Adherence to Nevirapine for Prevention of Mother-to-Child Transmission amongst Infants of HIV Positive Mothers in the First 6 Weeks of Life in Lagos Nigeria

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World Journal of AIDS 2019年第2期9卷 70-84页

作者： Obiyo Nwaiwu Folasade A. Olatunde nkechinyere E. harrison Margaret O. Ilomuanya Oludaisi A. Oduniyi Department of Pharmacology Therapeutics and Toxicology College of Medicine University of Lagos Surulere Lagos Nigeria Department of Medicine 68 Nigerian Army Reference Hospital (68 NARH) Yaba Lagos Nigeria Department of Pharmaceutics and Pharmaceutical Technology Faculty of Pharmacy University of Lagos Surulere Lagos Nigeria

Background: Over 90% of infection in children is acquired through mother to child transmission (MTCT). Nevirapine’s efficacy, safety and affordable cost make it the most preferred non-nucleoside reverse transcriptase inhibitor (NNRTI) for paediatric prophylactic use in resource limited settings. There are very few studies on pediatric adherence to antiretroviral prophylaxis, especially in very young infants. The objective of the study was to evaluate the adherence to nevirapine for prevention of mother to child transmission (PMTCT) amongst infants of HIV positive mothers in the first 6 weeks of life. Methods: This was a questionnaire based prospective cross-sectional multicenter study initiated in July 2015 and concluded in December 2017. The study was carried out at the Aids Prevention in Nigeria (APIN/HIV) human immunodeficiency paediatric clinics of the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos State, 68 Nigerian Army Reference Hospital Yaba (68NARHY) Lagos, Nigeria and the Holy Family Catholic Hospital, Festac Town, Amuwo Odofin, Lagos State. Nevirapine adherence, in infants of 0 - 6 weeks was measured by maternal verbal reports. Results: Eighty-one (81) infants receiving nevirapine within the age of 0 - 6 weeks completed the study. Majority of the infants started treatment at birth (32%) and after 4 weeks (31%). 54% of the 81 respondents do not miss or skip their doses while 46% of respondents skip doses. Majority of the respondents 18 (49%) missed their doses for 24 - 48 hours while 25% missed their doses because they were away from home and 23% ran out of pills. 85.2% took ≥95% of the prescribed medications (good or high adherence ), 8.2% took 80% - 95% of doses (moderate adherence) while 6.2% took 0.05). Conclusions: The adherence rates found in this study are comparable to other studies in developing countries. But these rates are still low for good clinical outcomes. Different levels of adherence were documented with the majority having g

关键词： Adherence Infants Antiretroviral Prophylaxis Maternal/Caregiver Verbal Reports Nevirapine Six Weeks

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Prevention of Maternal-to-Child Transmission of HIV: Knowledge, Attitude and Factors Influencing Active Participation among HIV-Positive Men in a Military Health Facility in Lagos, South Western Nigeria

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Open Journal of Preventive Medicine 2020年第8期10卷 233-253页

作者： nkechinyere Elizabeth harrison Kenneth Ejiofor Oruka Uzoamaka Concilia Agbaim Olatunde Ademola Adegbite Obiyo Nwaiwu Nathan Anelechi Elvis Okeji Centre for Infectious Disease Clinic 68 Nigerian Army Reference Hospital Yaba Lagos Nigeria Department of Medicine 68 Nigerian Army Reference Hospital Yaba Lagos Nigeria Department of Pharmacology Therapeutics and Toxicology Faculty of Basic Medical Sciences College of Medicine University of Lagos Lagos Nigeria Ministry of Defence Health Implementation Programme Abuja Nigeria

Introduction: Traditionally, Prevention of Maternal-to-Child Transmission (PMTCT) of HIV involves women and excludes men despite their important roles. There is a need for more data on factors influencing male participation in PMTCT programs. Design: This was a cross-sectional, descriptive study of married HIV-positive men receiving care at the adult ART clinic, 68 Nigerian Army Reference Hospital Yaba. Data were collected from March 15 to April 30, 2018. Result: Out of the 366 respondents, 333 (91%) were aware that HIV can be transmitted from mother to child. However, only 43.2% correctly identified that it can be transmitted during pregnancy, while 30.2% stated during labour. Almost all of the respondents (96.4%) would also accept that their positive partners take antiretroviral treatment to protect her unborn baby, 86.9% would support non breastfeeding option after delivery, and 95.6% indicated readiness to buy formula milk for the baby. Similarly, majority believed that a pregnant woman can be tested for HIV without the permission of her partner (Mean = 1.47 ± 0.893), and that men should accompany their spouse to ANC/PMTCT clinics (Mean = 1.86 ± 0.921). Conclusion: This study revealed that despite low knowledge of PMTCT among men, there is a good level of attitude and involvement among them. We recommend further study to fully explore the impact of education on men’s participation.

关键词： Prevention Maternal to Child HIV Transmission Men Attitude Practice Nigeria

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Utilization of the current national antimalarial treatment guidelines among doctors in army hospitals in Lagos, Nigeria

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Open Journal of Preventive Medicine（预防医学期刊） 2012年第3期

作者： nkechinyere E. harrison Tolulope F. Olufunlayo Chimere O. Agomo

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Evaluating the Knowledge of HIV Transmission and Prevention of Mother to Child Transmission (PMTCT) of HIV among HIV-Positive Mothers Accessing Care in Military Hospital in Lagos, Nigeria

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World Journal of AIDS（艾滋病） 2021年第1期

作者： nkechinyere Elizabeth harrison Kenneth Ejiofor Oruka Uzoamaka Concilia Agbaim Olutunde Ademola Adegbite Nathan Anelechi Elvis Okeji

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