HYGIENE FACTORS INFLUENCING OPPORTUNISTIC INFECTIONS AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS AND ACQUIRED IMMUNE DEFICIENCY SYNDROME IN ABUJA, NIGERIA

Abstract

Acquired Immune Deficiency Syndrome (AIDS) is one of the most devastating global health pandemics. The immune suppression of infected persons predisposes them to opportunistic infections resulting in high morbidity and mortality. Factors influencing HIV/AIDS in Nigeria are known; however, the influences of physical environmental factors on People Living with HIV and AIDS (PLWHAs) in Nigeria have not been fully explored. This study was therefore designed to investigate the association between these factors and the occurrence of Opportunistic Infections (OIs) among PLWHAs in Abuja. A case control study was conducted. PLWHAs in Abuja Municipal Area Council (AMAC) were randomly selected from the six area councils in FCT. Two health facilities were randomly selected by balloting from the nine that provides special services to PLWHAs in AMAC. Systematic random sampling was used to recruit 66 cases and 68 controls from the facilities. Cases were defined as HIV positive clients with OIs while controls were defined as confirmed HIV positive clients not manifesting OIs. Opportunistic Infections considered were Tuberculosis (TB), persistent diarrhea, oral thrush and herpes. The controls were matched by sex, age and residential area. Respondents’ demographic characteristics, level of knowledge and hygiene practices were assessed using a validated questionnaire. The level of knowledge of Environmental Influence on Health (EIH) was determined using 40 point scale. Observational checklist was used to assess the prevailing environmental conditions in households. Bacteriological examination of drinking water sources of 25.0% of cases and controls was conducted using standard methods as described by the American Public Health Association. Descriptive statistics, Chi-square and t-test were used for data analysis. Respondents’ mean age was 35.9 ± 6.7years for cases and 34.4 ± 7.0years for controls. About 48.6% and 51.4% of cases and controls respectively were females. The OIs manifested by cases were TB (56.6%), oral thrush (77.4%), persistent diarrhea (69.8%) and herpes (11.3%). The mean knowledge scores on EIH of cases and controls were 31.7 ± 8.9 and 29.0± 13.1 with no significant different. Majority of the cases (75.8%) and control (70.6%) washed their hands with soap after toilet use. Also 66.7% of cases and controls (68.7%) used water closets for excreta disposal. About twenty four percent of cases as against nine percent of controls obtained drinking water from contaminated sources (OR: 3.25; 95%CI: 1.09 – 10.14). Bacteriological analysis of client drinking water sources indicated that 76.0% of samples for cases and 64.3% for controls contained total coliform, while E.coli was detected in 21.4%, and 15.4% of samples for cases and controls respectively. The occurrence of water borne opportunistic infections among the cases may be attributable to contaminated drinking water sources. Provision of water especially potable water supply and continuing health education on hygiene practices are highly advocated.