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Saarcj hiv article Saarcj hiv article Document Transcript

  • SAARC J. TUBER. LUNG DIS.HIV/AIDS 2008 V(II)1-6 Socio-demographic Profile and Outcomes of the Admitted AIDS Patients in BPKIHSMehta R. S.1, Singh B21Asst. ProfessorMedical-Surgical Nursing Department2Nursing OfficerB. P. Koirala Institute of Health Sciences, NepalAbstract: In world More than 40 million people are living with HIV/AIDS, 2.3 million are under 15yrs , 14000 new infections each day , 1.7 million human infected with HIV/AIDS, 3.1 million deathsfrom AIDS , Million new HIV cases (13425) per day. In south East Asia 6.3 million PLWHA in 2005(Source: WHO, UNAIDS).It was retrospective descriptive study design conducted at B. P. Koirala Institute of Health Sciences(BPKIHS) among the admitted AIDS cases using their case notes during the period of 1-9-2003 to30- 8-2006 using developed Performa. It was found that Majority of the subjects (83.4%) were ofage group 20-40 years, Male (89.6%), and from Sunsari district (47.9%). Half of the subjects wereimproved after treatment and then discharged.As the number of AIDS cases are increasing rapidly in eastern Nepal and BPKIHS is a centre fortreatment of AIDS cases, it is essential to conduct awareness activates regarding prevention ofdisease and advocacy about available facilities of BPKIHS.Key words: AIDS, Socio-demographic profile, BPKIHSCorrespondence to:Dr. Ram Sharan MehtaAsst. ProfessorMedical-Surgical Nursing DepartmentB. P. Koirala Institute of Health Sciences, NepalEmail: ramsharanmehta@yahoo.comIntroduction in South Asia and poses a threat to development and poverty alleviation efforts inIn Nepal the estimated number of PLWHA at the region. HIV infection is fueled by riskend 2005 is 61,000, HIV prevalence in 2005 behavior, extensive commercial sex, lowwas 0.5, estimated number of AIDS cases condom use and access, injecting drug use,are 7,800, number of child (0-18) orphaned population movements (cross-border/rural-by HIV/AIDS is 18000, receiving Ant urban migration), and trafficking.1Retroviral Treatment (ART) till December2005 was 210. HIV infection has taken rootSAARC Journal of Tuberculosis Lung Diseases & HIV/AIDS 1
  • Social and economic vulnerabilities, including Study conducted by Asrath10, among migrantpoverty and illiteracy, highlight the need to workers in eastern Nepal found that, majorityact effectively and aggressively to reduce it’s of migrant workers (94.9%) had heard ofspread. South Asia has about 4.2 million of HIV/AIDS, but only few know the symptomsthe world’s 36 million people living with of HIDS. Most of them aware that use ofHIV/AIDS. While overall prevalence rates condom prevent spread of HIV/AIDS butremain relatively low, the region’s large 25% of them do not use, while havingpopulations mean that a rise of a mere pre/extra marital sex. About 11.9 % workers0.1percent in the prevalence rate in India, for were going to sex workers at a regularexample, would increase the national total of intervals and no one using condoms.adults living with HIV by about half a millionpersons.2 HIV/AIDS is emerging as a major threat in the socio-economic and health sectors ofThe current situation of HIV in Nepal is Nepal. Their multiple effects have so fardifferent from when the first case was been minimal in the country, but theirdiagnosed in 1988. There are gaps and potential impact is immense.challenges to be addressed in the fightagainst HIV and AIDS. Nepal is lowprevalence country for HIV and AIDS. ObjectivesHowever, some of the groups show evidenceof a concentrated HIV epidemic e.g. sex To find out the socio-demographic profile andworkers (19.5%), migrant population (4-10 outcomes of the admitted AIDS patients in B.%), and intravenous drug users (IVDUs) P. Koirala Institute of Health Sciences.both in rural and urban areas (68 %). Since1988 when the first case was diagnosed MethodsMoHP/DoHS and different stakeholderscame forward to address HIV and AIDS It was retrospective descriptive study design,issues.1 conducted at BPKIHS among the admitted AIDS clients. The available Case-sheets ofA significant percentage (60%), of HIV the diagnosed AIDS cases admitted betweenpositive patients belongs to lower socio- 1st September 2003 to 30th August 20006economic class and many of them were constituted the population of the study. Allmobile workers and contracted their illness the case notes of diagnosed dischargedwhile working in Indian metropolis in the past AIDS cases are samples and total 48reported by Aich5 in their study. available case notes were included in the study. Using total enumerative samplingStudy conducted by Agrwal6 reported that technique all the case notes were collectedthere was a significant difference in the from the medical record section using codeddomain concerning social relationship numbers (B 24, ICD–10) of files after takingbetween the HIV positive individuals with the written permission from the hospital director.controls. The files not available and incomplete were excluded. Using standard semi structuredStudy conducted by Parakh7 at BPKIHS Performa the data was collected.among the health professionals showed thathealth professionals had a hesitation in A list of diagnosed AIDS cases weretreating patients with HIV/AIDS, tempered by prepared using coded index (ICD-10, Code-Bconcerns regarding provision of such care.SAARC Journal of Tuberculosis Lung Diseases & HIV/AIDS 2
  • 24) files and than case notes were collected Table I Socio-Demographic Profile andfrom record section and information were Outcomes of the Admitted AIDS Patientscollected in the prepared format. All the case in BPKIHS (N= 48)notes from September 1, 2003 to August 30,2006 i.e. Bhadra 15, 2060 to Bhadra 14, S Item/Particular Percentage2063 were studded. Anonymity of the N (%) 1 Age group of the subjects:subjects was maintained. The information < 20 years 8.3obtained was kept confidential and used only 20-30 years 48.0for this study. The collected data was 30-40 years 35.4entered in SPSS-10.5 software package and >40 years 8.3analyzed. The findings are presented in Mean 29.26tables and graphs. Using Percentage, Mean SD 9.4and SD the demographic findings and Range 2-50 Years 2 Gender:outcomes were described. Male 89.6 Female 10.4Results 3 Caste of the subjects: Brahmin/ Chetri 29.2The number of AIDS cases admitted in Mangolian 50.0 Newar 2.1BPKIHS is increasing day by day i.e. 10, 12 Teri Origin 18.8& 16 in the years 2061, 2062, and 2063 4 District Wise distributionrespectively as per the record but actual of the subjects:number is much more because the files are Sunsari 47.9coded on the basis of written diagnosis on Morang 18.8the admission discharge sheet, which was Jhapa 14.6usually accurately filled and only the Sirha 4.2 Others: ( Mahotari,admitted diagnosis is mentioned. Now, Dhankuta, Dhanusa, Ilam,BPKIHS is a centre for treatment of AIDS Taplagunj, Udapur) 10cases of Eastern Nepal, where the facilities 5 Duration ofof HIV testing, ART, PMTCT, VCT, and hospitalization:regular OPD services are available. Among < 5 days 41.7all the 48 subjects, majority of them (83.3%) 5-10 days 29.1 10-15 days 20.9were of age group 20-40 years Male > 15 days 8.3(89.6%), Mangolian (50%), from Sunsari Mean 7.98district (47.9%) and among those 50% were SD 5.32improved and discharged from the hospital. Range 1-28 days 6 Department wiseThe details of the findings are depicted in distribution of the subjects:Table-I. Medicine 89.6 Pediatric 6.3 Surgical 4.2 7 Outcome of the clients: Improved & discharged 50.0 Unchanged & discharged 22.9 Expired 14.6 LAMA 8.3 Discharge on Request 2.0 Absconded 2.0SAARC Journal of Tuberculosis Lung Diseases & HIV/AIDS 3
  • Discussion Outcomes of the clientsThe report on the pattern of demographic Half of the clients were improved with theand clinical profiles of HIV positive persons in symptoms and discharged, where as 22.9%Nepal are scarce.5 HIV/AIDS is rapidly were unchanged. The disease is not curablespreading in countries of Asia including but treatable; hence life long treatment isNepal. It could cause major socio-economic required along with management ofimpact in the country. It obviously has many opportunistic infections if occurred. Thehealth implications.9 HIV/AIDS is a growing symptoms persist and client will die if thepublic health problem with complex social disease is not diagnosed in early stage andand behavioral issues related to protection, treatment (ART) started on time.prevention of transmission and care fornursing and midwifery personnel caring for Conclusionspeople living with HIV/AIDS.8 HIV/AIDS is no longer only a health issue; itDemographic Profile of the subjects is also a development issue. Tackling the epidemic will require not only prevention andMajority of the clients were of age group of control of HIV infection among vulnerable20-40 years i.e. 83.4%, which is similar and risk groups, but a multi-sectoralpattern with national as well as international approach addressing the lack of access bytrends. Majority of clients were male (89.6%) risk groups to health care and education andthough the disease has equal prevalence. recognition of the populations at risk. PeopleThis low reporting may be due to social living with HIV and AIDS should be broughtstigma and ignorance of diseases among to the forefront in the fight against HIV/AIDS.female. Majority of the clients were Family members, local communities, civilMangolian (50%), as the hospital is situated society organizations, donors, andin Dharan, where IVDUs are endemic, major government all have their own important roleoccupation of these groups of people are to play. Increasing trend of the diseaselahure, and majority of people residing in certainly has given pressure to focus on theDharan are Mangolian. Similar demographic use of comprehensive targeted interventiondata were reported by Agrwal.6 programs in risk groups sub-populations.Most of the clients were from Sunsari AIDS is a treatable disease, which is(47.9%), Morang (18.8%), and Jhapa common among age groups of 20-40 years(14.6%), as BPKIHS is situated in Dharan of their productive life. If proper treatmentwhich is easily arrival by the population of and care is provided the life of the clients canthese three districts and there are three be prolonged with comfort. Keeping themunicipalities are in Sunsari, one is Morang, emerging trends in mind it’s mandatory toand two in Jhapa. Most of the clients are provide pubic awareness regarding theadmitted under medicine department (89.6%) nature of disease, prevention of furtheras the disease is cared by doctors of spread and advocacy about availability ofmedicine departments being adult patients. services and their utilization among the public like: HIV testing, screening OPD, VCT, PMTCT, ART, Management of opportunistic infection, CD-4 count services and other services of HIV/AIDS available atSAARC Journal of Tuberculosis Lung Diseases & HIV/AIDS 4
  • BPKIHS along with elimination of social 6. Agrwal H, Mourya R, Shrestha RK, Agrwalstigma so that clients can approach easily at S, Singh GK. Assessment of quality of life ofhospital and will be benefited with available HIV positive individuals at Dharanfacilities. Municipality, 13th annual celebrations scientific programme abstract book, 2006, Dharn, Nepal.References 7. Parakh P, Gupta G, Rizal S. HIV/AIDS related knowkedge, attitudes and risk1. AIDS News letter: Quarterly (2061; Asoj). perception amongst health professionals in Women, Girls, HIV & AIDS, 53:13-17. BPKIHS. 13th annual celebrations scientific2. Bhardwaj, A., Biswas, R., & Shetty, K.J. programme abstract book, 2006, Dharn, (2001) HIV in Nepal: Is it rarer or the tip of Nepal. an iceberg? Trop Doct, 31: 211-213. 8. Impact of HIV/AIDS on Nursing /Mideifery3. WHO, SERO (1992). Carrying out HIV personnel. ICN Positin( www.ich.ch). Sentinel Surveillance. 9. Acharya RP, Bhattari MD. HIV/AIDS4. Vithayachockitikhum, N. (2006) Family prevention and control. J. Nep. Med. Asso. caregiving of persons living with HIV/AIDS in 1999: 38: 106-108. Thailand. Caregiver burden, an outcome 10. Asrath U, Sah S, Jha N etal. Awareness and measure. International Journal of Nursing high risk behaviours among migrant workers Practice; 12(3): 12 in relation to HIV/AIDS- a study from eastern5. Aich TK, Dhungana M, Kumar A, Pawha VK. Nepal. SAARC Journals of tuberculosis, lung Demographic and clinical Profiles of HIV diseases and HIV/AIDS. 2006; III(1): 5-12. positive cases: A Two-year study report from 11. Joshi AB, Banjara MR, Karki YB, Subedi BK, a tertiary teaching Hospital. JNMA, 2004, Sharmam M. Status and trends of HIV/AIDS 43(153). epidemic in Nepal. JNMA 2004; 43(152).SAARC Journal of Tuberculosis Lung Diseases & HIV/AIDS 5