Home > The Prevalence and Factors Associated With Nonadherence With Arv Treatment and Cotrimoxazole Preventive Therapy Among Hiv Infected Adolescents Attending Out-Patient Hiv Clinics in Kenya
The Prevalence and Factors Associated With Nonadherence With Arv Treatment and Cotrimoxazole Preventive Therapy Among Hiv Infected Adolescents Attending Out-Patient Hiv Clinics in Kenya
Background: There is an increase in the burden of HIV infected adolescents, both those perinatally infected as well as those acquiring HIV during adolescence. Female adolescents continue to be at the highest risk for acquiring HIV; in many Southern African countries, they have a three fold risk of acquiring HIV compared to their male counterparts. Adherence to treatment among adolescents has been shown to range between 30-70%, which is unacceptably low for antiretroviral therapy (ART). Psychosocial wellbeing and social support have been shown to be possible contributing factors to adherence to ART. This relationship has not been previously evaluated among Kenyan adolescents. Objectives: The overall objective of this study was to determine prevalence of non-adherence to medication among HIV infected adolescents aged 13-18 years attending selected outpatient HIV clinics in Kisumu, Kenya. The secondary objectives included determining the effect of psychosocial well being on adherence, and determining factors, including peer group support and their effect on adherence to medication. Methods We conducted a multi-center retrospective cohort study at seven outpatient HIV clinics in Kisumu, Kenya; enrolling 285 adolescents aged 13-18 years. Adherence data was obtained from pharmacy refill data and for each subject and a percentage adherence computed as the proportion of completed scheduled pharmacy visits. The main v predictor variable, psychosocial well being data was collected using a validated tool and a psychosocial score calculated using the corresponding score sheet and categorized as good (score was >22), moderate (15-22) and poor (<15). The maximum possible score was 30. Demographic data on potential determinants of adherence were collected in a face-to-face interview using a structured questionnaire. Characteristics of study participants were summarized using means and standard deviations for continuous variables; counts and proportions for categorical variables. The associations between adherence, psychosocial well-being and other factors were assessed using univariate and multivariate logistic regression. Results: The mean age of the participants was 15 years (mode 13, median15), 59% of whom were female. The majority (67%) had been enrolled into care when less than 12 years old and therefore considered to have been infected perinatally; 52% were on ART. The overall average adherence was 86%. Adolescents were categorized as adherent (adherence >95%) or non-adherent (adherence <95%) and 65% of them were adherent. Poor psychosocial well being was associated with increased likelihood of poor adherence (OR 3.37 CI 1.17 to 9.69; p=.017). Mental health showed a tendency to affect adherence negatively (p=.09). Other
فصل اول: قوانین ِحدودوقصاص کے نفاذ میں معاون اساسی اقدامات اسلام محض چند عبادات کا مجموعہ نہیں کہ جن کی بجا آوری پر اخروی کامیابی کا دارومدار ہے ،بلکہ اسلام اپنے ہمہ گیر قوانین حیات اور احکام زندگی کی رو سے ایک مکمل دین ہے۔ یہ ایک ایسا کامل دین ہے جس میں انسان کی سماجی، تمدنی، تاریخی،معاشی، فکری، اخلاقی ،تعلیمی،دفاعی اور قانونی زندگی کی تمام جہات کو مضبوط بنیادوں پر استوار کرنے کے اصول پائے جاتے ہیں۔ تمام شعبہ ہائے حیات میں ان مختلف اصولوں کو نافذ کرنے اور ان کو بہتر انداز سے عمل میں لانے کے لیے ایک ریاست کا وجود ناگزیر ہے۔ اسلامی ریاست کے قیام کے بعد ہی زندگی کے اجتماعی گوشوں میں ان اصولوں کو آزمایا جا سکتا ہے اور ان سے بہترین نتائج اخذ کیے جاسکتے ہیں۔اسلام اور ریاست لازم و ملزوم ہیں۔ یہ ایک دوسرے سے اس طرح وابستہ ہیں کہ اگر ریاست اور حکومت اسلام سے علیحدہ ہوجائے تو وہ ظلم و زیادتی اور ناانصافی کا ذریعہ بن جاتی ہے اور نتیجتاً چنگزیت رونماہوتی ہے ۔ اگر اسلام اقتدار کے بغیر ہو تو اس کے ایک حصہ پر عمل ممکن نہیں رہتا اور اسلام محض عقائد و عبادات کامجموعہ رہ جاتا ہے ۔ رسول اللہ ﷺنےاسلامی ریاست اور اس کے حاکم (سربراہ )کے حوالے سے ارشاد فرمایا "اَلْاِسْلَامُ وَالسُّلْطَانُ اَخَوَانِ تَوْأَمَانِ لَا یَصْلُحُ وَاحِدٌ مِّنْھُمَا اِلَّا بِصَاحِبِہ فَالْاِسْلَامُ اُسٌّ وَالسُّلْطَانُ حَارِسٌ وَّمَا لَا اُسَّ لَہُ یھَدِمٌ وَّمَا لَا حَارِسَ لَہ ضَائِعٌ " 315 " اسلام اور اقتدار دو جڑواں بھائی ہیں دونوں میں سے کوئی ایک دوسرے کے بغیر درست نہیں ہو سکتا ۔ پس اسلام کی مثال ایک عمارت کی سی ہے اور حکومت گویا اس کی نگہبان ہے جس عمارت کی بنیاد نہ ہو وہ گرجاتی ہے اور جس کا نگہبان نہ ہو وہ لوٹ...
Right to Information (RTI) has become one of the major laws to strengthen the democracy of a country. Therefore, this study aims to analyze the awareness and accessibility of RTI for minorities in Pakistan and India. In this regard, a survey questionnaire was distributed to the total of 50 Pakistani Hindus and 50 Indian Muslims under snowball sampling method. The findings were analyzed with the help of independent-samples t-test on SPSS. Findings indicate Pakistani Hindus have only 12% awareness and right to access information as compare to Indian Muslims. For the future studies, there is a need to develop awareness of Right to Information specially in Pakistan in order to improve accountability and transparency in the structure of government.
The industrial wastewater is the leading source of water pollution due to diverse nature of pollutants present in the effluents. The goal of this work was to establish methods for the treatment of petroleum refinery, soap & detergent and pulp & paper effluents as well as simulated solution of nonylphenol ethoxylates (NPEOs) using gamma and UV radiation in the presence of H 2 O 2 and TiO 2 . The degradation of pollutants was monitored through UV/Vis, FTIR, GC-MS and HPLC techniques. The efficiency of advanced oxidation processes (AOPs) was evaluated on the basis of extant of degradation, water quality parameters and detoxification. The toxicities were determined through various bioassays such as allium cepa, haemolytic, shrimp and Ames tests. The independent variables such as radiation dose, catalysts concentration, exposure time, pH, temperature etc. were optimized using response surface methodology for maximum degradation of pollutant. Through advanced characterization techniques, it was found that the AOPs were able to oxidize recalcitrant, toxic and non-biodegradable compounds to various intermediates and eventually to inert end products by generating intermediacy hydroxyl radicals. The gamma ray/H 2 O 2 treatment degrade the toxic residues, improve water quality and reduce the toxicity significantly, however, UV/TiO 2 /H 2 O 2 furnished better response. From the results, it is concluded that the AOPs (UV/TiO 2 /H 2 O 2 and gamma ray/H 2 O 2 ) could be successfully used for the treatment of petroleum refinery, soap & detergent and pulp & paper effluents as well as NPEOs since the water quality fall within the permissible limits recommended by the environmental agencies.