Perceived Family Support and Medication Adherence amongst Hypertensive Outpatients in a Tertiary Hospital, Ibadan, Nigeria

BACKGROUND

Adherence to medications is a primary determinant of treatment effectiveness and studies have shown that the level of adherence is positively correlated with treatment outcomes in patients with chronic diseases. Besides, an association has been reported to exist between family support and good health outcome. Determining the relationship between medication adherence and family support will assist physicians in offering holistic care to patients with hypertension.

OBJECTIVE

To determine the relationship between family support and adherence to drug treatment amongst hypertensive outpatients in a family practice in Ibadan.

METHOD

This was a prospective cross-sectional study. Atotal of 390 outpatients aged 18years and above with hypertension at the Family Medicine Clinic, University College Hospital, Ibadan (UCH) were recruited randomly for 3months. Participants' data were obtained through a semi-structured interviewer-administered questionnaire. The data was analyzed using bivariate analysis and significant variables were analyzed using logistic regression.

RESULT

The medication adherence rate was 42.6%. Participants with perceived strong family support (97%), older age (55.6%), and with the diagnosis of disease of more than 10years (54.4%) adhered better to medication in this study.

CONCLUSION

The medication adherence amongst patients with hypertension still remain low and Family support is an important positive factor, hence, involvement of family members in treatment is sacrosanct. Furthermore, the physician should use every encounter to counsel younger patients with hypertension and with lesser years of diagnosis on the benefits of medication adherence.

Discordant rapid HIV tests: lessons from a low-resource community

OBJECTIVES

HIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community.

METHODS

A cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine™ HIV 1/2 and Uni-Gold™ HIV assays, plus plasma HIV-1 antigen testing with the COBAS^® Ampliprep/COBAS^® Taqman^® HIV-1 assay, followed by western blot in those with detected HIV-1 antigen.

RESULTS

Of 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60).

CONCLUSIONS

When the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations.

Optimization of process conditions for removal of cadmium using bioactive constituents of Moringa oleifera seeds

Pollutants, especially heavy metals like cadmium, Chromium, lead and mercury, play a significant role in causing various water-borne diseases to humans. This study evaluates the sorption properties of bioactive constituents of Moringa oleifera seeds for decontamination of cadmium at laboratory scale. The performance of the bioactive constituent extracted by salt extraction method was enhanced by process optimization with various concentration of bioactive dosages, agitation speed, contact time, pH and heavy metal concentrations. Statistical optimization was carried out for evaluating the polynomial regression model through effect of linear, quadratic and interaction of the factors. The maximum removal of cadmium was 72% by using 0.2 g/l of bioactive dosage.

Performance of an extended aeration-microfiltration (EAM) reactor in treating high strength industrial wastewater

A laboratory study was conducted on an Extended Aeration-Microfiltration (EAM) reactor in treating a food industry wastewater. The reactor contained horizontally laid hollow fibre microfiltration (MF) units that were fully submerged. The MF units were connected to a peristaltic pump that was used to extract permeate continuously under suction pressure. Continuous aeration from beneath the modules provided the crossflow effect to the MF units. Active activated sludge was used in the start-up where the sludge was mixed together with the feed water at a Food/Microorganisms (F/M) value of about 0.1. Primary effluent with Chemical Oxygen Demand (COD) values ranged between 1,500 and 3,000 mg/l was used as feed water. The EAM reactor was operated for nearly three months without initiating cleaning of the MF units. A suction pressure of 0.9 bar and Mixed Liquor Suspended Solids (MLSS) of over 5,500 mg/l were reached when nearing the end of the three month operation period. Permeate COD and turbidity reduction of over 97% and 99% respectively, were achieved. Prior to this, the MF module arrangements were studied; where vertically arranged modules were found to perform poorly as compared to the horizontally laid modules, in terms of clean water permeate flux.