Masters Degrees (CHNS)

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Browsing Masters Degrees (CHNS) by Subject "AIDS (Disease)"

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    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.
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    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.