scholarly journals Adrenal Insufficiency: A Forgotten Diagnosis in HIV/AIDS Patients in Developing Countries

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
David D. Nassoro ◽  
Mkhoi L. Mkhoi ◽  
Issa Sabi ◽  
Alfred J. Meremo ◽  
Paul S. Lawala ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Low Income ◽  
Advanced Disease ◽  
Developed Countries ◽  
Low Income Countries ◽  
Adrenal Crisis ◽  
High Morbidity ◽  
Hiv Patients ◽  
Aids Patients ◽  
Hiv Aids

Adrenal insufficiency (AI) is one of the most common endocrine disease in patients with HIV/AIDS, leading to high morbidity and mortality in HIV patients who become critically ill. Various etiologies are associated with the condition, including cytomegalovirus (CMV), Mycobacterium tuberculosis, lymphoma, Kaposi’s sarcoma, and drugs such as rifampin, among others. HIV patients with advanced disease develop relative cortisol deficiency largely due to the reduction of cortisol reserve, which predisposes patients to adrenal crisis in periods of stress or critical illness. The prevalence of AI in HIV/AIDS patients during HAART era is higher in developing than developed countries, probably due to limited access to both diagnosis and adequate treatments which increases the risk of opportunistic infections. The clinical features of functional adrenal insufficiency in HIV/AIDS patients can be masked by various infectious, noninfectious, and iatrogenic causes, which reduce clinical recognition of the condition. Development of simple screening algorithms may help clinicians reach the diagnosis when approaching these patients. In many low-income countries, most HIV patients are diagnosed with advanced disease; thus, further research is necessary to elucidate the prevalence of adrenal insufficiency in HIV/AIDS patients and the condition’s impact on mortality in this population.

scholarly journals Psychiatric morbidity amongst adolescents in a Nigerian juvenile correctional facility

2021 ◽  
Vol 27 ◽  
Author(s):  
Amudalat T. Kuranga ◽  
Abdullahi D. Yussuf
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Low Income ◽  
Juvenile Justice System ◽  
Psychiatric Morbidity ◽  
Developed Countries ◽  
Low Income Countries ◽  
Disruptive Behaviour ◽  
High Morbidity ◽  
Disruptive Behaviour Disorders

Background: The high occurrence of psychiatric disorders amongst adolescents within the Juvenile Justice System (JJS) has been confirmed. Most of the available data are from developed countries and some of them focus on just a single psychiatric disorder which may not be representative of the situation in low-income countries, hence the need for more studies in developing countries, including Nigeria.Aim: The study aimed to determine the prevalence of psychiatric disorders amongst adolescent residents of a correctional facility.Setting: The study was carried out at a Borstal Institution in North-Central Nigeria.Methods: A descriptive cross-sectional study design was used. One hundred and twenty adolescents were assessed using the socio-demographic pro forma questionnaire designed by the researcher and the Kiddies Schedule for Affective Disorders and Schizophrenia (KSADS-PL). Data were analysed using EPI-INFO 4.06 d version 6.04 software.Results: A total of 62.5% of the male respondents were older than 15 years. The percentage of respondents with a psychiatric disorder was 82.5%. The rate of psychiatric disorders was high with disruptive behaviour disorders being the most common at 40.8%, others were substance use disorders (15.8%), anxiety disorders (14.2%), psychosis (6.7%) and mood disorders (5%).Conclusion: This study has established a high prevalence rate of psychiatric disorders amongst incarcerated adolescents. This is in line with the findings of numerous studies worldwide. This study has identified the need to increase awareness and knowledge about the high morbidity of mental disorders in growing juvenile detainee populations. This will allow early identification of adolescents at risk of psychiatric disorders and ensure efficient resource distribution of both JJS service and mental healthcare. Effective and appropriate interventions have shown to improve overall health, quality of life and reduce the rate of recidivism amongst incarcerated juveniles.

scholarly journals Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

2018 ◽  
Vol 12 (02) ◽  
pp. 89-96
Author(s):  
Héctor M Prado-Calleros ◽  
Bertha B Castillo-Ventura ◽  
Irma Jiménez-Escobar ◽  
Juan P Ramírez-Hinojosa ◽  
Antonio López-Gómez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Hiv Infection ◽  
Developed Countries ◽  
Cochrane Library ◽  
High Morbidity ◽  
Aids Patients ◽  
Keywords Hiv ◽  
Severity Of The Disease ◽  
Hiv Aids

Introduction: Noma is an opportunistic polymicrobial infection that cause necrosis of the mouth and face, with high morbidity and mortality, predominantly affecting malnourished children and persons with debilitating diseases. Cases of noma-like disease in adults, although rare, have been increasingly reported in HIV/AIDS patients particularly in developing countries but also in more developed countries. Methodology: A systematic review of the literature to assess the occurrence and clinical impact of noma and noma-like disease in HIV/AIDS patients was performed on PubMed, Virtual Health Library, Cochrane Library and Google Scholar using the keywords "HIV"[ All Fields] AND "Noma"[All Fields] in December 2016 (years includead for the search: 1985 to 2016). Results: Twenty-four published studies were identified that document the occurrence of noma or noma-like disease in a total of 133 HIV/AIDS children and adult patients in the last 22 years. Although HIV infection is not the principal risk factor for noma, in some regions may play a substantial role in its pathogenesis. The mortality rate for noma-like disease in HIV/AIDS patients was 54.3%, compared to the 15% mortality rate of treated noma patients without HIV/AIDS. Most of the cases have never been on antiretroviral therapy, and their HIV infection was discovered because of the noma-like disease. Conclusions: The syndemic interaction between HIV/AIDS and noma-like disease adversely impacts the severity of the disease and the mortality rate. Noma-like disease, although not yet considered a specific or frequent disease associated with HIV infection, should be considered as an opportunistic infection for AIDS.

Socioeconomic and Demographic Statuses as Determinants of Adherence to Antiretroviral Treatment in HIV Infected Patients: A Systematic Review of the Literature

2019 ◽  
Vol 17 (3) ◽  
pp. 161-172 ◽  
Author(s):  
Nuredin Nassir Azmach ◽  
Temam Abrar Hamza ◽  
Awel Abdella Husen
Keyword(s):  
Systematic Review ◽  
Occupational Status ◽  
Original Research ◽  
Positive Trend ◽  
Hiv Patients ◽  
Aids Patients ◽  
Pubmed Database ◽  
Education And Employment ◽  
Socio Economic Factors ◽  
Hiv Aids

Background: Socioeconomic and demographic statuses are associated with adherence to the treatment of patients with several chronic diseases. However, there is a controversy regarding their impact on adherence among HIV/AIDS patients. Thus, we performed a systematic review of the evidence regarding the association of socioeconomic and demographic statuses with adherence to antiretroviral therapy (ART) among HIV/AIDS patients. Methods: The PubMed database was used to search and identify studies concerning about socioeconomic and demographic statuses and HIV/AIDS patients. Data were collected on the association between adherence to ART and varies determinants factors of socioeconomic (income, education, and employment/occupation) and socio-demographic (sex and age). Findings: From 393 potentially-relevant articles initially identified, 35 original studies were reviewed in detail, which contained data that were helpful in evaluating the association between socioeconomic/ demographic statuses and adherence to ART among HIV patients. Two original research study has specifically focused on the possible association between socioeconomic status and adherence to ART. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 7 studies (36.8%), 7 studies (28.0%), and 4 studies (23.5%) respectively out of 19, 25, and 17 studies reviewed. Sex (being male), and age (per year increasing) were significantly and positively associated with the level of adherence in 5 studies (14.3%), and 9 studies (25.7%) respectively out of 35 studies reviewed. However, the determinant of socioeconomic and demographic statuses was not found to be significantly associated with adherence in studies related to income 9(47.4%), education 17(68.0%), employment/ occupational 10(58.8%), sex 27(77.1%), and age 25(71.4%). Conclusion: The majority of the reviewed studies reported that there is no association between socio- demographic and economic variables and adherence to therapy. Whereas, some studies show that age of HIV patients (per year increasing) and sex (being male) were positively associated with adherence to ART. Among socio-economic factors, the available evidence does not provide conclusive support for the existence of a clear association with adherence to ART among HIV patients. There seems to be a positive trend between socioeconomic factors and adherence to ART in some of the reviewed studies.

scholarly journals A study on knowledge attitude and practices regarding HIV/AIDS among general population in a community of Kottarakkara, Kerala

2021 ◽  
Vol 8 (2) ◽  
pp. 613
Author(s):  
Nimmy N. John ◽  
Athira Krishnan Krishnan ◽  
H. Doddayya
Keyword(s):  
Sexual Intercourse ◽  
Sexual Practices ◽  
High Morbidity ◽  
Hiv Patients ◽  
Knowledge And Attitudes ◽  
Aids Epidemic ◽  
High Knowledge ◽  
History Of ◽  
General Populations ◽  
Hiv Aids

Background: HIV/AIDS epidemic has emerged as one of the most serious and enormous health problems associated with high morbidity and mortality rate. A prospective questionnaire based observational study was carried out in Kottathala community of Mylom Gramapanchayat, Kottarakkara to analyse the peoples knowledge on HIV/AIDS, as well as attitudes towards HIV patients and actual sex practices for the control or prevention of HIV.Methods: A total of 150 participants were interviewed by using a predesigned questionnaire and responses were reviewed and analysed by using descriptive statistics namely total numbers and percentage.Results: Out of 150 participants females were more (84%) and most of them were under the age group of 18-30 years. Majority of the participants had higher degree of education (51.33%) as they are still youth. The overall participants had a higher degree of knowledge regarding HIV and most of them had a positive attitude towards the HIV patients. Around 84% of participants had history of sexual intercourse but majority of them (46%) never used condoms during sexual intercourse in which, 11.33% only using condom regularly. Most of them were following unsafe sexual practices.Conclusions: This study concludes that the surveyed general populations had high knowledge and attitudes regarding HIV/AIDS and had risky sexual practices. 

scholarly journals Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy at Selected Hospitals in Sidama Zone, Southern Ethiopia: A facility-based cross-sectional study

2019 ◽  
Author(s):  
Demelash Wachamo ◽  
Fisseha Bonja
Keyword(s):  
Associated Factors ◽  
Opportunistic Infections ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Sectional Study ◽  
Aids Patients ◽  
Cross Sectional ◽  
Hiv Aids

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

A Systems Approach for Sustainably Reducing Childhood Diarrheal Deaths in Developing Countries

2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Systems Approach ◽  
Developed Countries ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Crisis ◽  
Industrialized Nations ◽  
Sub Saharan

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.

Comparing the Effects of Unsustainable Production and Consumption of Food on Health and Policy Across Developed and Less Developed Countries

2021 ◽  
pp. 1011-1035
Author(s):  
Josue Mbonigaba
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Food Consumption ◽  
Low Income ◽  
Developed Countries ◽  
High Income ◽  
Low Income Countries ◽  
Less Developed Countries ◽  
Review Of The Literature ◽  
Production And Consumption

The unsustainable food consumption across high-income countries (HICs) and low-income countries (LICs) is expected to differ in nature and extent, although no formal evidence in this respect has been documented. Documenting this evidence is the aim of this chapter. Specifically, the chapter seeks to answer the following questions: 1) Do the contexts in less developed countries (LDCs) and developed countries (DCs) make the nature and extent of unsustainability in food consumption different? 2) Do the mechanisms of the linkage between unsustainability of food consumption and health outcomes independent of countries' contexts? 3) Are current policies against unsustainable food consumption equally effective in DCs and LDCs? These questions are answered by means of a systematic review of the literature for the period 2000-2017. The findings are that the nature and extent of unsustainability is quite different across contexts of LICs and HICs.

The House of Love and the Mental Hospital

2021 ◽  
Author(s):  
Murphy Halliburton
Keyword(s):  
Family Support ◽  
Family Involvement ◽  
Low Income ◽  
Global Mental Health ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Low Income Countries ◽  
Rehabilitation Centre

The Movement for Global Mental Health has defined the person suffering psychopathology in low-income countries as an abused and suffering subject in need of saving by biomedical psychiatry. Based on fieldwork in Kerala, South India, carried out at psychiatric clinics and a psychosocial rehabilitation centre, this paper examines patients’ experiences of illness, the degree and quality of family support, and attributions made to the role of ‘sneham’, or love, in recovery. The role of love and family involvement may help explain the provocative finding by WHO epidemiological studies that ‘developing’ countries – and India in particular – showed better rates of recovery from severe mental illness when compared to developed countries.

scholarly journals To screen or not to screen women for Group B Streptococcus (Streptococcus agalactiae) to prevent early onset sepsis in newborns: recent advances in the unresolved debate

2020 ◽  
Vol 7 ◽  
pp. 204993612094242
Author(s):  
Guduru Gopal Rao ◽  
Priya Khanna
Keyword(s):  
Risk Factor ◽  
Antimicrobial Resistance ◽  
Low Income ◽  
Streptococcus Agalactiae ◽  
Early Onset ◽  
Group B Streptococcus ◽  
Developed Countries ◽  
Low Income Countries ◽  
Early Onset Sepsis ◽  
Group B

Streptococcus agalactiae, also known as Group B streptococcus (GBS) is the commonest cause of early onset sepsis in newborns in developed high-income countries. Intrapartum antimicrobial (antibiotic) prophylaxis (IAP) is recognized to be highly effective in preventing early onset Group B sepsis (EOGBS) in newborns. The key controversy is about the strategy that should be used to identify mothers who should receive IAP. There are two strategies that are followed in developed countries: screening-based or risk-factor-based identification of women requiring IAP. The debate regarding which of the two approaches is better has intensified in the recent years with concerns about antimicrobial resistance, effect on newborn’s microbiome and other adverse effects. In this review, we have discussed some of the key research papers published in the period 2015–2019 that have addressed the relative merits and disadvantages of screening versus risk-factor-based identification of women requiring IAP. Although screening-based IAP appears to be more efficacious than risk-based IAP, IAP-based prevention has several limitations including ineffectiveness in prevention of late-onset GBS infection in babies, premature and still births, impact of IAP on neonatal microbiota, emergence of antimicrobial resistance and difficulties in implementing IAP-based strategies in middle and low income countries. Alternative strategies, principally maternal immunization against GBS would circumvent use of IAP. However, no licensed vaccines are currently available for use.

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