Introduction: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 million persons are living with the infection, with an annual death rate of 180,000. Psy...Introduction: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 million persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompanies chronic illnesses and may be associated with substance abuse, poor health seeking behaviour and adherence to treatment program;it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geopolitical zone of Nigeria, the study would help to identify high risk groups and prevent the progression and spread of the infection. Objectives: To identify HIV-infected persons with psychological morbidity, accessing HIV-clinic at Shika Hospital, Zaria, Kaduna State;and analyze their socio-demographic profile. Methodology: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires;the General Health Questionnaire (GHQ-12) measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalence rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7 percent were mildly distressed. The females were more likely to be distressed than men (65 percent vs. 35 percent of those with psychological morbidity, OR = 3.5 CI 95 percent). It was (57 percent) for patients whose HIV-infection was of relatively shorter duration (less than 4years) than (43 percent) those of longer duration (5 years and above;OR = 1.7, CI 95 percent = 1.1 - 3.5). The age group (18 - 40 years) was more likely to screen positive for psychological morbidity (58.3 percent vs. 41.7 percent, OR = 2.4, CI 95 percent), than the age group (41 - 75 years). On the other hand, Christians were more likely than Muslims (55 percent vs. 45 percent, OR = 1.5, CI 95 percent = 1.1 - 3) to be distressed. For married patients with partners it was 20 percent and for singles 30 percent;for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 38 percent for all the other minority tribes put together. Conclusion and recommendations: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.展开更多
Background: Noma, mostly identified in malnourished young children in the world’s low-income countries, causes severe orofacial disfigurement and significant mortality and morbidity. The majority of noma patients sur...Background: Noma, mostly identified in malnourished young children in the world’s low-income countries, causes severe orofacial disfigurement and significant mortality and morbidity. The majority of noma patients surviving with aesthetical effects are exposed to stigmatization and social rejection. Studies focusing on the socio-psychological impact of noma survivors have rarely been done. Our study aimed to identify the differences in social acceptance/rejection and the influencing factors associated with social acceptance in noma patients. Methods: A cross-sectional study was conducted at the NGO-Sentinelles (Niger) reception center on patients with noma from Zinder, Maradi, and Tahoua regions between 9<sup>th</sup> May 2017 and 2<sup>nd</sup> June 2017. The survey was conducted through a face-to-face interview on patients admitted to the center and those discharged from the centre after the treatment. The interview questionnaire comprised 45 questions (Cronbach’s alpha coefficient = 0.812) with pathological information, sociodemographic characteristics, and socio-psychological qualitative information. Findings: We recorded 50 noma patients (43 from Zinder and 7 from Maradi and Tahoua). The younger patients (1 - 5 years old), noma patients who stayed in school during follow-up treatment, patients who were referred by a health structure, patients enrolled into the centre in a short time (<30 days), and patients in the acute phase of noma had a significantly high social acceptance rate with 60.0%, 82.9%, 60.0%, 57.1% and 94.3% respectively;whereas single adults and cheek lesion site had the highest social rejection rate when compared to their corresponding factors with 60.0% and 86.7% respectively. There were significant differences in victims’ perception of noma [χ<sup>2</sup> = 45.536, (P < 0.001)] and acceptance of their new faces [P = 0.023], between the social acceptance and social rejection rate, therefore all patients who accepted their new faces felt social acceptance. Social acceptance was significantly highly correlated with pathological history (admission method, phase of noma, care, and treatment received at center) with r<sub>s</sub> ranging from 0.609 to 0.810, moderately correlated with patient’s sociodemographic characteristics (age, marital status, and region) with r<sub>s</sub> ranging from 0.381 to 0.474. Lowly correlated with clinical evolution after treatment (r<sub>s</sub> = 0.293). Logistic regression results showed that the likelihood of social acceptance increased when the patient’s age was young (≤15 years), their marital status was minor, they were enrolled at the school before noma appearance, they were referred to the centre after diagnosis, the admission time to the centre was short (≤30 days), acute phase of noma, and care received at the centre was non-surgery. The location of the lesion on the cheek was a risk factor for social acceptance, indicating cheek lesions from noma increased the likelihood of social rejection in our study. Conclusion: The sociodemographic characteristics, pathological history, and psychological aspects of noma patients were correlated and were found to be important factors influencing their social acceptance/rejection rate.展开更多
文摘Introduction: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 million persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompanies chronic illnesses and may be associated with substance abuse, poor health seeking behaviour and adherence to treatment program;it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geopolitical zone of Nigeria, the study would help to identify high risk groups and prevent the progression and spread of the infection. Objectives: To identify HIV-infected persons with psychological morbidity, accessing HIV-clinic at Shika Hospital, Zaria, Kaduna State;and analyze their socio-demographic profile. Methodology: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires;the General Health Questionnaire (GHQ-12) measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalence rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7 percent were mildly distressed. The females were more likely to be distressed than men (65 percent vs. 35 percent of those with psychological morbidity, OR = 3.5 CI 95 percent). It was (57 percent) for patients whose HIV-infection was of relatively shorter duration (less than 4years) than (43 percent) those of longer duration (5 years and above;OR = 1.7, CI 95 percent = 1.1 - 3.5). The age group (18 - 40 years) was more likely to screen positive for psychological morbidity (58.3 percent vs. 41.7 percent, OR = 2.4, CI 95 percent), than the age group (41 - 75 years). On the other hand, Christians were more likely than Muslims (55 percent vs. 45 percent, OR = 1.5, CI 95 percent = 1.1 - 3) to be distressed. For married patients with partners it was 20 percent and for singles 30 percent;for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 38 percent for all the other minority tribes put together. Conclusion and recommendations: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.
文摘Background: Noma, mostly identified in malnourished young children in the world’s low-income countries, causes severe orofacial disfigurement and significant mortality and morbidity. The majority of noma patients surviving with aesthetical effects are exposed to stigmatization and social rejection. Studies focusing on the socio-psychological impact of noma survivors have rarely been done. Our study aimed to identify the differences in social acceptance/rejection and the influencing factors associated with social acceptance in noma patients. Methods: A cross-sectional study was conducted at the NGO-Sentinelles (Niger) reception center on patients with noma from Zinder, Maradi, and Tahoua regions between 9<sup>th</sup> May 2017 and 2<sup>nd</sup> June 2017. The survey was conducted through a face-to-face interview on patients admitted to the center and those discharged from the centre after the treatment. The interview questionnaire comprised 45 questions (Cronbach’s alpha coefficient = 0.812) with pathological information, sociodemographic characteristics, and socio-psychological qualitative information. Findings: We recorded 50 noma patients (43 from Zinder and 7 from Maradi and Tahoua). The younger patients (1 - 5 years old), noma patients who stayed in school during follow-up treatment, patients who were referred by a health structure, patients enrolled into the centre in a short time (<30 days), and patients in the acute phase of noma had a significantly high social acceptance rate with 60.0%, 82.9%, 60.0%, 57.1% and 94.3% respectively;whereas single adults and cheek lesion site had the highest social rejection rate when compared to their corresponding factors with 60.0% and 86.7% respectively. There were significant differences in victims’ perception of noma [χ<sup>2</sup> = 45.536, (P < 0.001)] and acceptance of their new faces [P = 0.023], between the social acceptance and social rejection rate, therefore all patients who accepted their new faces felt social acceptance. Social acceptance was significantly highly correlated with pathological history (admission method, phase of noma, care, and treatment received at center) with r<sub>s</sub> ranging from 0.609 to 0.810, moderately correlated with patient’s sociodemographic characteristics (age, marital status, and region) with r<sub>s</sub> ranging from 0.381 to 0.474. Lowly correlated with clinical evolution after treatment (r<sub>s</sub> = 0.293). Logistic regression results showed that the likelihood of social acceptance increased when the patient’s age was young (≤15 years), their marital status was minor, they were enrolled at the school before noma appearance, they were referred to the centre after diagnosis, the admission time to the centre was short (≤30 days), acute phase of noma, and care received at the centre was non-surgery. The location of the lesion on the cheek was a risk factor for social acceptance, indicating cheek lesions from noma increased the likelihood of social rejection in our study. Conclusion: The sociodemographic characteristics, pathological history, and psychological aspects of noma patients were correlated and were found to be important factors influencing their social acceptance/rejection rate.
