School of Nursing & Public Health

Permanent URI for this community

http://hdl.handle.net/11070/3321

Browse

Browsing School of Nursing & Public Health by Subject "AIDS (Disease)"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    The effect of HIV status disclosure and non-disclosure on the psychosocial wellbeing, adherence levels and treatment outcomes of adolescents on Highly Active Anti-Retroviral Therapy (HAART) at Katututra State Hospital, Namibia
    (University of Namibia, 2018) Tjituka, Francina
    Background: With the advent and wide availability of highly active antiretroviral therapy (HAART), HIV- infected children are currently living health lives and growing into adulthood. There has been mounting evidence on the benefits of appropriate HIV disclosure to adolescents. However, various researches reported contradicting results as disclosure having both negative and positive social and psychological impacts on children. This study aimed to determine the effect of HIV status disclosure on the psychosocial wellbeing, adherence to treatment and HIV treatment outcome of adolescents who are taking ART at Katutura State Hospital, pediatric HIV Clinic. The study also aimed to determine the risk of Psycho social “deviations” in HIV status disclosed adolescents as compared to undisclosed adolescent on HAART and to compare the adherence level, CD4 count, and viral load of disclosed and non-disclosed adolescent children also on HAART at the same clinic. The newly implemented Pediatric HIV disclosure program in Namibia prompted this study. The program is guided by the World Health Organization which reported mixed effects after HIV status disclosure on the adolescents and it was deemed necessary to assess whether HIV status disclosure results in a better psychosocial wellbeing, higher CD4 count and lower viral load among adolescent children put on HAART. Methods: A Cross-sectional Analytic research design was employed where the prevalence of being psychosocially unwell and the level of HIV treatment adherence, CD4 count and viral load was compared in two groups of HIV positive adolescents enrolled in HIV care and put on HAART at Katutura Hospital for at least 12 months. Results: Two-hundred HIV-infected adolescents took part in the study, data was analyzed, 99 (49.5%) were disclosed and 101(50.5%) were undisclosed. The mean age of the study participants was 12 years. The findings revealed no association between disclosure status and psychosocial well-being; as 97 (98%) and 98 (97%) of the participants from the disclosed and undisclosed groups were assessed to have been psychosocially well. It was also noted that both groups scored high on adherence to anti-retroviral therapy with an adherence level of above 98%. The results show no difference in viral load suppression between the disclosed and undisclosed group. In addition, the result did not show significant difference in CD4 count between the two groups of adolescents which concludes that disclosure of HIV status is not associated with decreased CD4 count for adolescent living with HIV. The results suggest that disclosure doesn’t affect the psychosocial wellbeing of adolescents, neither does it affect the treatment outcomes of HIV positive adolescents on HAART.
  • Thumbnail Image
    Item
    A health education programme to enhance knowledge and communication skills of health care workers serving people living with HIV/AIDS on haart in Namibia
    (University of Namibia, 2015) Chipare, Mwakanyadzeni A.
    Namibian health care workers (health care workers) are affected in providing quality health care services to people who are living with HIV/AIDS (PLWHA) if they do not have the necessary knowledge, as well as adequate interpersonal communication and counselling skills. In a health care facility set-up, all patients either come from the community or are referred from the wards or other departments by health care workers. The health care worker as a (sender) conveys information (messages) and a patient (receiver) is expected to comprehend these messages and to respond by giving feedback to the sender who, in turn, provides feedback until the communication process is completed. The process should take place in a conducive environment without any interference, such as noise, to allow the swift completion of the communication process. The messages that both parties convey should be clear, accurate, coherent, and concise. The purpose of the study was to develop a health education programme that would enhance the communication skills and knowledge of health care workers serving PLWHA on HAART in Namibia. The intention was to develop a health education programme (HEP) for strengthening these skills. The population comprised two groups, namely health care workers and HAART patients. A purposive sampling method was used for selecting 23 health care workers and 20 HAART patients. Data was collected through focus group discussions with health care workers and in-depth interviews with HAART patients. Tesch in De Vos, Krueger’s and Casey (2009) theories guided the data analysis process. The programme was developed based on themes of the study and implemented by training health care workers and describing recommendations. Trustworthiness validation utilised data credibility, transferability, dependability, and conformability. Ethical measures were observed throughout the study. The researcher conducted the study in four phases. Phase I presented a needs assessment of the health care workers’ experiences in interpersonal communication, counselling skills, HIV / AIDS management and health knowledge of PLWHA on HAART. Phase II represented the conceptual framework to illustrate the study results that were supported by the emerged themes and sub-themes discussed in Phase I of the research. Phase III comprised the development of a health education programme that enhanced knowledge and communication skills of health care workers who serve PLWHA on highly active antiretroviral therapy in Namibia. Phase IV presented the implementation of HEP that included a training workshop for health care workers and an evaluation exercise after the implementation of the programme. Three main themes emerged during data analysis. Theme one indicated that health care workers experienced a lack of sufficient communication skills that was necessary for addressing the health concerns of PLWHA on HAART. Health care workers responses indicated that they had insufficient knowledge and inadequate communication and counselling skills to deal with health needs of the PLWHA on HAART. From their responses, it also transpired that health care institutions experienced a severe shortage of information, education, and communication (IEC) materials and other resources for curbing HIV / AIDS From Theme two, it emerged that health care workers experienced a lack of exposure to knowledge about HIV / AIDS management. It transpired that health care workers were not getting any support from their health institutions in developing knowledge or in-service training on HIV / AIDS management. It was also surprising to note that there were no guidelines that clearly assisted them in engaging or communicating with PLWHA on HAART. There was no structured supervision or quality assurance strategies that guided their superiors in monitoring their performance on the execution of daily activities, specifically in relation to HIV / AIDS Management. Theme three exposed the insufficient availability of health information to PLWHA on HAART. It transpired that HAART patients did not have access to information on HIV / AIDS aspects; such as HIV prevention, adherence to treatment of HIV, blood results, sexual relationships, alcohol abuse, and nutrition. HAART patients also emphasised their need to be empowered in managing self-disclosure, stigmatisation, and discrimination. The health education programme that enhanced the knowledge, as well as the communication and counselling skills of health care workers for communicating successfully with PLWHA on HAART was finally evaluated in accordance with the guidelines of Schiavo and Quinn’s (2007) evaluation process.
  • Thumbnail Image
    Item
    Prevalence of cryptococcus among HIV infected patients attending the Intermediate hospital Oshakati, Namibia
    (University of Namibia, 2016) Nakale, Tayakula
    Cryptococcus is the most incriminated fungal pathogen that causes cryptococcal meningitis in HIV-infected patients and is known to constitute a major cause of mortality in AIDS patients. Previous studies, mostly from Africa have indicated that positive serum cryptococcus may precede the development of cryptococcal meningitis and cause early mortality among patients with advanced HIV infection. There is no published data on the burden of cryptococcal infections among HIV patients in Namibia; thus the magnitude of cryptococcal diseases associated with HIV is unknown. This study was done to determine the prevalence of cryptococcus among HIV-infected patients attending at Intermediate Hospital Oshakati and the level at which a patient’s CD4 count is significantly associated with cryptococcal antigenemia. A descriptive cross-sectional study was conducted at the Intermediate Hospital Oshakati. The study included 384 HIV-infected patients (231 females and 153 males) whose blood samples were examined for cryptococcus by using IMMY CrAg test kit at the NIP laboratory. Baseline clinical data and demographic information were retrieved from the patient medical records and laboratory information system. Among the 384 HIV-infected patients enrolled, 36 (9.38%) were positive for serum cryptococcal antigen. Among these 36 patients the CD4 count ranged from 2-301 cells/ul and median CD4 count was 72cells/ul. Of the 36 positive cryptococcus cases, 26 (72.22%) had CD4 counts below 100cells/ul. When stratified by CD4 count, 72.22% of patients with ≤100 cells/ul had a positive cryptococcal antigen test as compared to 25.00% with CD4 counts between 101-200 cells/ul and 2.78% with CD4 counts >200 cells/ul. This study demonstrates a high prevalence of cryptococcus among HIV-infected patients receiving their CD4 count measurements at the Communicable Disease Clinic, Intermediate Hospital Oshakati. Based on the study results, the cryptococcal antigen test and CD4 count levels Lower CD4 (≤100 cells/ul) were significantly associated with positivity for serum cryptococcal antigen. The prevalence of cryptococcus among HIV-infected patients was high and as such it calls for drastic public health interventions spearheaded by the Ministry of Health and Social Services (MoHSS). It is recommended that the MoHSS should take the leading role in implementing a routine screening of cryptococcus neoformans antigen among HIV patients with CD4 count ≤100cells/ul. This will improve the accurate early diagnosis and provide the surest way to reverse the deteriorating health status of the Namibian people.