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Abstract
This study was undertaken to
determine the case fatality of AIDS at University of Port Harcourt
Teaching Hospital from 2003-2008. To achieve the
purpose of the study, eight research questions were formulated and four
hypotheses were postulated, to guide the study. The study adopted the
descriptive method utilizing the expost-facto design. The sample for the study
consisted of 289 AIDS fatality cases at University of Port Harcourt
Teaching Hospital from 2003 -2008. The data were
collected using the researcher-designed AIDS fatality inventory proforma, which
was used to gather hospital information concerning AIDS fatality cases. The
Data collected were analyzed using percentages for the purpose of answering the research questions, while
chi-square () statistics was used to test the hypotheses at .05 level of
significance. The results of the study revealed that: a total of 289 AIDS
fatality cases were recorded from 2003-2008; the overall case fatality rate
was 8 deaths per 100 AIDS cases; there
was an increased trend in AIDS fatality from 2004-2005, which then declined
from 2006-2008; tuberculosis was the leading opportunistic infection that
caused AIDS fatality. The result further revealed that there was no difference
in the case fatality of AIDS according to gender and location respectively,
while there was difference in the case fatality of AIDS according to age and
level of education, respectively. The results were exhaustively discussed and
recommendations were made among which were that health educators should educate
HIV and AIDS patients on the issue of treatment and management of HIV and AIDS.
Much of such education can be done in schools, hospitals, communities and work
places. Also, there should be constant testing of AIDS patients for
tuberculosis, to ensure early detection and treatment of tuberculosis among
AIDS patients.
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CHAPTER ONE
Introduction
Background of the Study
Acquired Immune Deficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV) has become a significant cause of morbidity and mortality in the world. It is increasingly becoming a predominant cause of childhood and adulthood morbidity and mortality. World Health Organization (WHO, 2003) reported that HIV and AIDS are major global health emergency, affecting all regions of the world, causing death and suffering to millions of people. According to WHO’s report, AIDS is the leading cause of adult death in the world and has a case fatality rate (death rate) that approaches that of the bubonic plague. It is the world’s most devastating infectious disease. Weiss (1997) opined that AIDS is one of the “Pandemic diseases” of the late 20th century. United Sates Agency for International Development (USAID, 2001) reported that Africa carries 70 per cent of the burden. WHO (2003) reported that about forty million people living in Africa in 2002 were infected with the virus. Bollinger; Stover and Nwaorgu (1999) stated that AIDS has the potential to create severe economic impacts in many African countries. They further stated that AIDS is different from most other diseases because it strikes people in the most productive age groups and is essentially 100 per cent fatal.
The disease, AIDS is not of Nigerian origin, but it is now living with us. According to the Federal Ministry of Health (FMOH, 2003) report on AIDS, the first case of AIDS was identified in Nigeria in 1986. Available data indicate that the infection rate is increasing irrespective of the fact that many Nigerians do not report cases of HIV and AIDS to the appropriate quarters. Besides, there is substantive evidence that AIDS is increasing (Ugwuegbulam, 2004). FMOH (2003) reported that adult HIV prevalence increased from 1.8 per cent in 1991 to 5.8 per cent 2001 and slightly reduced to 5 per cent in 2003. It is estimated that 3.2 to 3.8 million Nigerian adults and children were living with HIV and AIDS by the end of 2003. Projections show an increase in the number of people living with HIV and AIDS to be between 3.4 million and 4 million in 2005. As a result of the epidemic, the crude death rate in Nigeria was about 20 per cent higher in 2000 than in 1990. In 2001 alone, 170 thousand adults and children died of AIDS. By 2008 cumulative deaths from AIDS would be between 3.6 million to 4.2 million people (FMOH, 2003). As a result of the figure, the FMOH lamented that there is a dire and urgent need to effectively control AIDS fatality in Nigeria in the interest of human development, reduction of orphans and vulnerable children, social justice and poverty alleviation. The Millennium Development Goals (MDG) aim at combating and halting AIDS by 2015 and also begin to reverse the spread and impact of HIV and AIDS (MDG, 2004). According to FMOH (2003), AIDS fatality reduction has been included as one of the aims of the National AIDS Policy launched on 4th August 2003.
AIDS is the severe symptomatic phase of HIV infection. It is a name given to a group of illnesses, which occur in HIV positive people as a result of a weakened immune system. Onwuekwe (2005) described AIDS as a disease caused by HIV. He further explained that AIDS is the manifestation of HIV infection in an infected individual. AIDS is the last stage in the progression of HIV infection. AIDS was first discovered in the United States of America in 1981 among homo-sexuals (Centre for Disease Control, 1990). Today, AIDS has become a challenge to the world in general and the developing world in particular. The world is being seriously threatened by this deadly disease, and no vaccine has been discovered to prevent it. In 2002 AIDS was reported in every continent and in every country (WHO, 2003). Kingston (1994) described AIDS as a democratic disease. It affects all ages, sexes, cultures and ethnic groups. It equally affects both rich and poor. Oreh and Nzewi (1996) viewed AIDS as a difficult disease to discuss because it hinges on two extreme sensitive issues, sex and death. WHO (2003) stated that AIDS is a disease, whose impact is much greater, where there is poverty and social inequality, including gender inequality. According to MDG (2004) report in Nigeria, the issue of poverty and low status of women is one of the great predicaments to fighting the disease.
