Profiles of HIV-Affected Households in Ghana

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ABSTRACT

Background: To contribute to a fuller appreciation of Ghana’s HIV epidemic, this paper presents various profiles of the Ghanaian HIV-affected household. To comprehensively tackle the HIV epidemic in Ghana, the profiles would provide stakeholders with ready information for policy formulation. Methods: We used data from a nationally representative survey that measured livelihood activities, household asset wealth, household composition, health, and nutrition variables of 1745 HIV-affected households. From these emerged various profiles. Results: About 50% of the households are headed by females. Households headed by men have an average size of three members, compared to two for female-headed households. There are far more AIDS widows than widowers. The annual death rate among the surveyed households was about 1000 per 100,000-households. Relatively more deaths occurred in male-headed households. Two-thirds of the households were asset poor. Various coping strategies were instituted by the households in reaction to threat of food insecurity. The national prevalence of chronic energy deficiency is 16%. Conclusions: Our data show that age of household head, hosting of a chronically ill member, and average size of household differed by sex of household head. The annual death rate of 1000 per 100,000 households is very high.

Cite this paper

Laar, A. , Fiaveh, D. , Laar, M. , Boatemaa, S. , Abugri, J. , El-Adas, A. , Amenyah, R. , Atuahene, K. , Adjei, A. and Quakyi, I. (2014) Profiles of HIV-Affected Households in Ghana. Health, 6, 2004-2013. doi: 10.4236/health.2014.615235.

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http://dx.doi.org/10.1207/s15326888chc2501_3                                                                           eww141223lx
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Loneliness of the Marginalized

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Author(s)

ABSTRACT

This review article provides a bird’s eye view of several population groups that are marginalized, ostracized, and stigmatized. Those include the homeless, the physically disabled, and psychiatric patients, Lesbian, Gay, Bisexual and Transgender (LGBTs), and those afflicted with Human immunodeficiency Virus (HIV) or with Acquired Immunodeficiency Syndrom (AIDS). Their condition, how it leads to social isolation and loneliness, and its effects on them, their illness or condition, and their quality of life are described. Interestingly, while all experience loneliness, each group expresses and addresses it differently. Awareness of those unique expressions of loneliness could assist mental health workers in identifying, addressing, and helping the marginalized cope with loneliness.

Cite this paper

Rokach, A. (2014) Loneliness of the Marginalized. Open Journal of Depression, 3, 147-153. doi: 10.4236/ojd.2014.34018.

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http://dx.doi.org/10.1007/s10508-006-9081-z                                                                         eww141218lx

Vitamin D and Secondary Hyperparathyroidism in HIV Infected Patients Taking Antiretroviral Therapy

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ABSTRACT

Objective: Due to the lack of studies assessing hypovitaminosis D and secondary hyperparathyroidism in Brazilian HIV-infected population, especially in the northeastern population, this study aimed to determine the profile of these conditions in patients infected with HIV and its correlation with immuno-virological, sociodemographic data and associated comorbidities. Methods: Comparison studies were obtained from routine clinical samples of HIV infected patients submitted for 25-OH Vitamin D, PTH and alkaline phosphatase determination. Results: A total of 78 patients were included, 42 (53.8%) males, mean age 45.7 years. Antiretroviral regimens most used in this study were Zidovudine/Lamivudine/Efavirenz 17.9%, Tenofovir/Lamivudine/Efavirenz 17.9%,Tenofovir/Lamivudine/Atazanavir-r 15.4%. The mean value CD4 count was 592.1 ± 247.2 cells/mm3, CD8 cell count was 1026.5 ± 467.3 cells/mm3, mean detectable viral load was 2220 ± 15703 copies and CD4/CD8 ratio was 0.63 ± 0.33. A total of 34 vitamin D dosages were collected with 41.2% representing sufficient amount and 58.8% insufficient. Alkaline Phosphatase (ALP) dosage was elevated in 49.3% (N=35) of the patients. Parathormone (PTH) was elevated in 18% (N = 11). Among patients with elevated PTH levels, 81.9% had elevated levels of ALP (p = 0.01). In the group of patients with high levels of ALP, 45.7% had a CD4 count < 500 cels/mm3 (p = 0.02). There was no significant difference in vitamin D related to gender (p = 0.21), age (p = 0.23), CD4 count (p = 0.26), suppressed viral load (p = 0.44) or blood glucose (p = 0.45). Conclusions: This study evidenced a high prevalence of Vitamin D insufficiency in Northeast Brazil, which suggests HIV infection correlation. A high prevalence of Hyperparathyroidism was detected and related with inflammatory condition persistence and low CD4 count. We suggest improve vitamin D follow up and measurements in this population with better CD4 count control to avoid future osteoarticular complications of HIV treatment.

Cite this paper

Chaves, H. , Moreira, H. , Corrêa, H. , Machado, W. , Teles, R. , Nascimento, L. , Filho, J. , Queiroz, C. , Nóbrega, D. , Moreira, A. , Meneses, M. , Bezerra, F. and Medeiros, M. (2014) Vitamin D and Secondary Hyperparathyroidism in HIV Infected Patients Taking Antiretroviral Therapy. World Journal of AIDS, 4, 430-437. doi: 10.4236/wja.2014.44051.

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Aspects of Viral Involvement in Chronic Immune Thrombocytopenic Purpura

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52148#.VIZKymfHRK0

ABSTRACT

The immune chronic thrombocytopenic purpura is an illness characterized by peripheral thrombocytopenia occurred through a mechanism of early hyper destruction of blood platelets or by deficient platelet synthesis in the medulla. The chronic immune purpura can be primary, autoimmune in nature, thrombocytopenic idiopathic or secondary in the context of other associated pathologies. The idiopathic thrombocytopenic purpura (P.T.I.) is an immune-mediated acquired disorder. It is characterized by isolated thrombocytopenia, defined as platelet count assessment from peripheral blood smear of less than 100.000/mm3, in the absence of a different cause of thrombocytopenia. The secondary immune isolated thrombocytopenia occurs in the context of some associated pathologies. The aim of the study is to highlight the involvement of some infectious agents in the etiopathogenesis of the secondary immune thrombocytopenic purpura. The immune thrombocytopenia can be subordinated to some chronic infections such as infection with virus B or C, infection with virus HIV, infection with Cytomegalovirus (CMV) or the Helicobacter Phylori infection. The study was conducted on a group of 40 patients, distributed into two groups: the first group of patients is the asymptomatic patients who do their common tests while the other group of patients is with bleeding symptoms: Petequiae, bruising, epistaxis, gum bleedings. The studied group puts into evidence a thrombocytopenia with a mean platelet count of 60.20 ± 19.75 × 103/μL. 80% of patients had positive anti-platelet antibodies. Out of these, 20% carry infections with virus B and C while 30% carry Cytometalovirus infection (CMV). The study found one case of HIV infection. Thus we highlight the involvement of infectious agents in the etipathogenesis of secondary immune thrombocytopenic purpura as well as the way they affect the platelet function.

Cite this paper

Mocanu, M. , Bădescu, M. , Ciocoiu, M. and Bădulescu, O. (2014) Aspects of Viral Involvement in Chronic Immune Thrombocytopenic Purpura. Journal of Biomedical Science and Engineering, 7, 1067-1074. doi: 10.4236/jbise.2014.714104.

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https://www.synevo.ro/citomegalovirus-anticorpi-igg/                                                                    eww141209lx

Transfer out Patients Receiving Antiretroviral Therapy from Programme Clinic: A Potential “Leak” in the HIV Treatment Cascade

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51404#.VGlKPmfHRK0

ABSTRACT

Background: India has scaled up ART programme very rapidly. Though there are reports on retention of patients in the national programme, data on transfer out patients within the ART centers are scanty in India. Methods: This is a retrospective study of patients receiving antiretroviral treatment between January 2006 and July 2013. The patients who were transferred out from the ART center at National AIDS Research Institute in Pune were included in the study. The data on whether they reached the respective ART centers were collected either by making telephonic calls to the patients and/or to the respective ART centers. Results: Of the total 3015 patients ever started on treatment from the ART center, 158 (5.24%) were transferred out to other ART centers. Of these, 123 (77.8%) patients reached other centres and they were “transferred in”. However, 15 (9.5%) did not reach to respective ART centers and information could not be obtained for 20 (12.7%) transferred out patients. The analysis showed that those who were not living with their partners were 4.53 times more likely to not to reach the preferred ART centre after taking transfer [OR, 95% CI: (1.24 – 16.51), p = 0.022]. Conclusion: Our data suggest that significant number of transfer out patients is lost in HIV treatment cascade. Considering the total PLHIV on treatment in the country, this group adds significantly to the burden of lost to follow up patients. It is important to strengthen the system of tracking the transfer out patients in the programme which will help in patching an important leak in the cascade of HIV care.

Cite this paper

Ghate, M. , Zirpe, S. , Gurav, N. , Paranjape, R. , Rewari, B. and Gangakhedkar, R. (2014) Transfer out Patients Receiving Antiretroviral Therapy from Programme Clinic: A Potential “Leak” in the HIV Treatment Cascade. World Journal of AIDS, 4, 382-386. doi: 10.4236/wja.2014.44045.

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Human Immunodeficiency Virus Can Affect the Semiology of Osteoarticular Infections?

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51271#.VGFhYWfHRK0

ABSTRACT

Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticular infections recognized on the basis of radioclinical and epidemiological arguments were included in this study. The comparison that was based on the existence or was not of HIV infection focused on various clinical and biological components. Of these 15,800 rheumatic patients admitted in 18 years, 461 have suffered from Osteoarticular infection (2.9%). The 461 patient objects of this study were divided into 235 cases of infectious arthritis including 38 cases of co-infection with HIV and 225 cases of infectious spondylodiscitis including 21 cases of HIV co-infection. Results: There were 246 women (53.4%) and 215 men (46.4%) with a sex ratio of 1.1. The mean age was 37.7 ± 13.6 years. The data comparison of HIV-negative patients and HIV-positive patients had not shown statistically significant difference in the infectious spondylodiscitis group and in the group of infectious arthritis patients. Only fever was statistically significant in both groups and weight loss in the group of infectious arthritis (p < 0.001). Conclusion: HIV seems not to particularly influence the semiological profile of Osteoarticular infections in Lomé.

Cite this paper

Oniankitan, O. , Tagbor, K. , Kakpovi, K. , Fianyo, E. , Houzou, P. , Koffi-Tessio, V. and Mijiyawa, M. (2014) Human Immunodeficiency Virus Can Affect the Semiology of Osteoarticular Infections?. Open Journal of Rheumatology and Autoimmune Diseases, 4, 235-239. doi: 10.4236/ojra.2014.44032.

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Development, Dependency and HIV Risk in Kiribati

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47224#.VFwne2fHRK0

ABSTRACT

A study was undertaken in Kiribati, a small Pacific island nation, that has a low-level HIV epidemic but a high incidence of STIs among seafarers, their spouses (and children), and those involved in sex work. There are connections between development and dependency and HIV risk in Kiribati. Kiribati is a peripheral and dependent small island state underwritten by conditional aid and financial assistance and advice from donor countries, entwined in, and subject to, external globalising processes. We found two major factors related to Kiribati’s dependency engendered HIV risk. The first is Kiribati’s reliance on transnational seafaring. Long periods away from home, shipboard and port mateship cultures, and infrequent condom use in casual and paid sexual relations while in overseas ports, exacerbated by heavy alcohol use, have rendered i-Kiribati seafarers vulnerable to HIV. The second factor is related to the labour force participation of young women, which is extremely limited. In this context, some young i-Kiribati women choose to work on board, foreign fishing vessels selling sex. They stay with one client while on board a boat—for up to three months—and sex work is not only an economic transaction, but also emotional and affective labour. It is a pattern that makes consistent condom use problematic. Having multiple sequential seafarer partners may in fact generate considerable HIV vulnerability.

Cite this paper

McMillan, K. and Worth, H. (2014) Development, Dependency and HIV Risk in Kiribati. World Journal of AIDS, 4, 232-241. doi: 10.4236/wja.2014.42028.

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