Browsing by Author "Okonkwo, P."

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HIV infection among newly Daignosed TB patients in southwestern Nigeria: A multi-DOTS center study
(Scientific Research, 2013) Odaibo, G. N.; Okonkwo, P.; Lawal, O. M.; Olaleye, D. O.
Backgroud: The burden of TB and HIV infection is estimated to be about 512/100,000 and 3,000,000 people respectively. However, accurate data on TB/HIV co-morbidity in different parts of Nigeria were not available due to limited access to HIV Counseling and Testing (HCT) by individuals with TB infection. This study was designed to determine the true rate of HIV infection among newly diagnosed TB patients by providing comprehensive HCT services in 43 DOTS centers in Oyo State, Southwestern Nigeria. Methods: All patients meeting the case definition for TB suspects who presented at each of the 43 DOTS Centres were counselled and those who consented tested for presence of HIV antibodies using HIV 1/2 Determine, Unigold and Stat-Pak rapid test kits in a serial algorithm. Results: A total of 13,109 TB positive patients were enrolled for the study, out of which 1605 (12.3%) tested positive for HIV antibodies. HIV infection was higher among female (15.5%) than male (9.5%) TB patients (p < 0.05). The rates also varied among the age groups, ranging from 4.3% in the 10 - 19 years to 18.0% in the 40 - 49 years age group. A relatively high rate (10.5%) of HIV infection was found among children less than ten years of age. Conclusion: The results of this work show the true burden of TB/HIV in any region in Nigeria for the first time. Higher rate of TB/HIV co-infection among female patients and children are significant and important factors that should be considered in the planning of intervention measures in Nigeria and other TB and HIV endemic countries in Africa.
Pattern of HIV-1 drug resistance among adults on ART in Nigeria
(2013) Odaibo, G. N.; Okonkwo, P.; Adewole, I. F.; Olaleye, D. O.
Background: The development of anitiretroviral drug resistance may limit the benefit of antiretroviral therapy. Therefore the need to closely monitor these mutations, especially the use of ART is increasing. This study was therefore designed to determine the ARV drug resistance pattern among ART na?ve and expose individuals attending a PEPFAR supported by antiretroviral clinic in Nigeria. Methodology: The study participants included patients attending the PEPFAR supported by University College Hospital (UCH), Ibadan ART clinic who have been on HIV treatment for at least one year with consecutive viral load of over 2000 copies/ml as well some ART Na?ve individuals with high (>50,000 copies/ml) baseline viral level attending the hospital for pre-ART assessment. Blood sample was collected from each individual for CD4 enumeration, viral load level determination and DNA sequencing for genotypic typing. Antiretroviral drug resistance mutations (DRM) were determined by using the Viroseq software and drug mutations generated by using a combination of Viroseq and Stanford algorithm. DRM were classified as major or minor mutations based on the June 2013 Stanford DR database. Results: The most common major NRTI, NNRTI and PI mutation were D67N (33.3%), Y181C (16.7%) and M46L/I (55.6%) respectively. Lamivudine (3TC) and emtricitabine (FTC); nevirapine (NVP) and nelfinavir (NFV) were the most common NRTI, NNRTI, and PI drugs to which the virus in the infected individuals developed resistance. Isolates from 4 patients were resistant to triple drug class, including at least one NRTI, NNRTI and a PI. Only one (4.8%) of the isolates from drug Na?ve individuals had major DRM that conferred resistance to any drug. Conclusion: Demonstration of high rates of antiretroviral DRM among patients on 1st and 2nd line ART and the presence of DRM in drug Na?ve individuals in this study show the importance of surveillance for resistance to ARV in line with the magnitude of scaling up of treatment program in the country.
Sleep disturbance and associated factors among Nigerian adults living with HIV in the dolutegravir era
(Frontiers Media S.A., 2022) Osiyemi, A. O.; Owoaje, E.; Mundt, J. M.; Oladeji, B.; Awolude, O.; Ogunniyi, A.; Okonkwo, P.; Berzins, B.; Taiwo, B. O.
Sleep disturbance is common among persons living with HIV (PLWH) causing significant health impacts. Nigeria recently switched from efavirenz to dolutegravir (DTG) for first-line antiretroviral therapy (ART). This study aimed to assess the prevalence of sleep disturbance and to determine factors associated with sleep disturbance among treatment-experienced PLWH. Using a cross-sectional study design and systematic random sampling, 300 participants were recruited from the Infectious Diseases Institute, Ibadan, Nigeria (IDI). Interviewer administered questionnaire was used to collect data regarding sociodemographic, sleep disturbance (Pittsburgh Sleep Quality Index; PSQI), depression (Patient Health Questionnaire; PHQ-9), anxiety (Generalized Anxiety Disorder-7; GAD-7), and psychoactive substance use. HIV-specific data were retrieved from IDI’s medical records. The relationship between the PSQI score and the scores on the PHQ-9 and GAD-7 were explored with the Pearson correlation coeffcient. Chi-square global tests of independence were used to assess factors associated with sleep disturbance and a multivariable binary logistic model was used to determine independent predictors of sleep disturbance. The mean age of the sample was 44.5 ± 11.4 (years), the average duration of HIV diagnosis was 8.13 ± 5.33 (years) and the majority were on DTG-based regimens (95%). Depression and anxiety were present in 14 and 17.3%, respectively. Prevalence of sleep disturbance (PSQI score of 6 ormore) was 21.7%. Higher PSQI scores were associated with higher PHQ-9 scores (r = 0.526; p < 0.001) and higher GAD-7 scores (r = 0.529; p < 0.001). Sleep disturbance was associated with age ($ 2 = 4.483, p = 0.038), marital status ($ 2 = 7.187, p < 0.01), depression ($ 2 = 46.589, p < 0.001), and anxiety ($ 2 = 38.379, p < 0.001). There was no significant association between sleep disturbance and HIV clinical stage at diagnosis, virological suppression status, and ART regimen type (p > 0.05), whereas tea intake was associated with an absence of sleep disturbance ($ 2 = 6.334, p < 0.014). Age (>45 years), depression and anxiety were associated with higher odds of sleep disturbance among PLWH. Sleep disturbance remains common among PLWH in the DTG era. Depression and anxiety are significant factors associated with sleep disturbance. Assessing these factors in future studies may improve the sleep health of PLWH.