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Item Prevalence and risk factors of hypertension in HIV-positive adults on antiretroviral therapy in Ondo State, Nigeria(Polish AIDS Research Society, 2020) Ilesanmi, O. S; Akpa, O. MAbstract Introduction: The occurrence of hypertension in people living with human immunodeficiency virus/ acquired immunodeficiency syndrome (PLWHA) on antiretroviral therapy (ART) is increasing. In Nigeria, where the national human immunodeficiency virus (HIV) prevalence is 1.4%, an estimated 700,000 PLWHA are on ART. We investigated the prevalence of hypertension and associated factors among adults on ART in Owo, Ondo State Material and methods: A retrospective study with 300 PLWHA on ART in Federal Medical Centre, Owo, was conducted. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg and/or diastolic blood pressure (DBP) ≥ 90 mm Hg. Descriptive statistics were performed. Chi-square tests were used to identify associations between sociodemographic/clinical parameters and hypertension. Odds ratio and adjusted odds ratio were used to examine risk factors associated with hypertension. Results: The mean age of PLWHA was 38.3 years (SD, 10.4) and 33.7% were males. Median duration on ART was 6 years (range, 0.5-15). The prevalence of hypertension was 20.3%, with 25.7% in males and 17.5% among females. The prevalence of hypertension before commencing ART was 14.7% and 20.3% after ART was commenced (p = 0.043). Mean SBP was 110 ± 16 mm Hg before ART use and 118 ± 18 after utilization of ART (p < 0.001). Hypertension before commencing ART was associated with age of 38 years and above (OR: 2.7; 95% CI: 1.3-6.8). Amongst PLWHA, hypertension after com mencing treatment was associated with being previously hypertensive (AOR: 9.2; 95% CI: 4.5-18.6). Conclusions: HIV treatment programs should include screening and management of hypertension. Screening and assessment of risk factors were directed at PLWHA diagnosed with hypertension before commencing ART, while routine check of blood pressure was evaluated at subsequent visits. HIV AIDS Rev 2020; 19, 3: 199-205 DOI: https://doi.org/10.5114/hivar.2020.99681 Key words: HIV, anti-retroviral therapy, PLWHA, hypertension among PLWHA.Item Mitigating environmental sustainability challenges and enhancing health in urban communities: The multi-functionality of green infrastructure(Alanya University, Faculty of Engineering and Natural Sciences, 2020) Dipeolu A. A.; Akpa O. M.; Fadamiro J. A.Green Infrastructure (GI) facilities have capacity to enhance health and mitigate Environmental Sustainability Challenges (ESC). However, the extent of the mitigation and health benefits is unclear in developing countries. This study examined the impact of GI on ESC and Perceived Health (PH) of urban residents in Lagos Metropolis, Nigeria. Multi-stage sampling technique was used to select 1858 residents of Lagos Metropolis who completed semi-structured questionnaires. Descriptive statistics and chi-square test were used to explore data distributions and assess association of the availability of GI with resident’s PH and ESC. Odds ratio with 95% confidence interval (OR;95%CI) were estimated for good health and ESC mitigation. Participants were mostly men (58.9%) and younger than 50 years old (86.3%). Good health (20.5%) and high mitigation of ESC (collection and disposal of waste-52.7% and official development assistance 63.9%) were reported where GI is mostly available. Participants were more likely to report good health (OR:1.40; 95%CI:1.02-1.92) and high mitigation of ESC [water quality (OR:1.42; 95%CI:1.12-1.81) passenger transport mode (OR:1.41; 95%CI:1.06-1.89)] where GI are mostly available. Availability of Green infrastructure is supporting health and mitigating environmental sustainability challenges in the study area. Green infrastructure should be provided in urban areas where environmental sustainability is under threatItem Factors Associated with Vulnerability to HIV and Sexually Transmitted Infections among Street Children in Selected Towns of Ethiopia, 2016(Scientific Research Publishing, 2017) Chimdessa A.; Olayemi O.; Akpa O. M.Background: The problem of street children is becoming a world crosscut ting issue since these children exist in every part of the world and become a worldwide problem. Objective: To assess factors associated with vulnerability to STIs and HIV/AIDS among street children in selected towns of Ethiopia. Methodology: Community-based cross-sectional descriptive study de sign was used on the three selected towns of Ethiopia from June-September, 2016. A total of 360 street children were selected, using snow ball sampling technique. Data were collected using pre-tested interviewer-administered questionnaire. Logistic regression was used to analyze the data. Results: A total of 360 (97.8%) respondents were included in this study. Among them, 167 (46.4%) of them had practiced sexual intercourse and out of these, 137 (82%) had started having sex at the age of 16 years old. Out of these, 61 (36.53%) of them started to get daily basic needs whereas 54 (32.3%) of them were forcefully raped on the street. Only 53 (59.6%) had used condom consistently and 83 (49.7%) had conducted survival sex within the last 12 months. Children on the street or chewing khat or consumption of alcohol had more vulnerability to STIs and HIV about 2.532 (1.57 - 4.08), 2.32 (1.11 - 4.80), 4.18 (2.31 - 7.55) times respectively. But those enrolled in school were about 0.40 (0.25, 0.64) less likely vulnerable than their counterparts. Conclusion: Street children are at a higher likelihood of vulnerability to STIs and HIV. Intervention targeted multilevel approach such as re-integration with their family, life skills training, sexuality education, creating income-generating activities and information education about STIs.Item Is there any relationship between hearing threshold levels and CD4 cell count of human immunodeficiency virus infected adults?(College of Medicine, University of Ibadan, 2016) Fasunla A. I.; Ijitola J. O.; Akpa O. J.; Nwaorgu O. G. B.; Taiwo B.; Olaleye D. O.; Murphy R. L.; Adewole I. F.Background: The role of viral load level and/or CD4 (Cluster of differentiation 4) cell count in the aetiopathogenesis of hearing loss in HIV infection is unclear. Therefore, we investigated the relation hip between CD4 cell counts, viral load and hearing threshold of HIV (Human immunodeficiency virus) infected adults. Methods: This cohort audiometric study involved consecutive HIV-infected and HIV-uninfected adults as controls. Clinical data relating to hearing loss, HIV status, and highly active antiretroviral therapy (HAART) were obtained. Audiometric evaluation was performed. The most recent CD4 cell counts and RNA viral load of HIV-infected participants were obtained from clinic records. Results: There were 299(66.7%) HIV-infected adults and 149(33.3%) controls with mean age of 39.64± 12.45 years and 39.60±12.45 years respectively (p=0.98). In both groups, there were more participants with Ieft hearing loss. Mild to profound hearing loss was found in 65.9% H IV infected participants and 53.7% controls. Majority (86.3%) of the HIV-infected participants were on HAART. The mean CD4 cell count was 654.58±289.15 in 41 HIV-infected participant not on HAART and 523.95±300.17 in 258 participants on HAART (p=O.O I). Majority, 197 (62%) HIV infected participants with hearing loss had CD4 cell count S200 cells/mm'. Higher viral load significantly correlated with low CD4 cell counts (p<0.01; r= 0.18) and low CD4 cell count significantly correlated with high hearing threshold (p<0.01; r= 0.17) Conclusion: There was a trend towards more hearing loss among the HIV-infected adults. The higher hearing threshold in those with low CD4 cell counts of <200 cells/mm3 suggests possible relationship between hearing status and severity of HIV disease.Item Psychiatric disorders and adherence to antiretroviral therapy among a population of HIV-infected adults in Nigeria(Sage publications, 2016) Adejumo, O.; Oladeji, B.; Akpa, O.; Malee, K.; Baiyewu, O.; Ogunniyi, A.; Evans, S.; Berzins, B.; Taiwo, B.Psychiatric disorders are common among HIV patients in Nigeria. Adherence is necessary to optimize the outcome of antiretroviral therapy. In this study, we aimed to identify associations between antiretroviral adherence measured by 1-week and 1-month self-reported missed doses, and psychiatric illness in a cohort previously assessed for psychiatric disorders using the Composite International Diagnostic instrument (CIDI). The study participants comprised 151 adults with major depression, anxiety or suicidal symptoms, and 302 matched-control participants. Two controls were randomly selected for each case within the same gender and education stratum. We compared participants with psychiatric disorders (WPDs) and without psychiatric disorders (NPDs) on selected demographic and clinical variables, in addition to adherence. Participants with 1 or more missed doses in the preceding month had twice the odds of having a major depressive episode as those with no missed doses during this period (OR 2.22, 95% CI 1.03, 4.79). This association remained significant after adjusting for selected risk factors. There was no statistically significant difference between WPD and NPD groups on either 1-week or 1-month adherence, or on age, marital status, occupational class, HIV viral load at enrollment or current CD4. Among Nigerian adults with HIV, suboptimal antiretroviral adherence is associated with, and could be a Corresponding author: Olurotimi Adejumo, Department of Psychiatry, University College Hospital, PMB 5116, Ibadan, Nigeria, Phone: +2348033778540, +13122167417, radejumo@yahoo.com. HHS Public Access Author manuscript Int J STD AIDS. Author manuscript; available in PMC 2016 October 01. Published in final edited form as: Int J STD AIDS. 2016 October ; 27(11): 938–949. doi:10.1177/0956462415600582. Author Manuscript Author Manuscript Author Manuscript Author Manuscript pointer to depression. Routine self-report adherence assessments may have potential utility for identifying individuals at risk among this population.