COMPLETE SCHOOL PROJECT TOPICS & MATERIALS :
CHAPTERS: Chapter 1-5
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ABSTRACT
The study was carried out to investigate how Nurses in Nigeria can increase the depth of knowledge and understanding of HIV/AIDS among Nigerians. The sample of the study was one hundred and three randomly selected nurses of General Hospital,Annua,Uyo,Akwa ibom state,Nigeria. An instrument tagged “Questionnaire on knowledge of HIV/ AIDS Pandemic (QKHP)” designed by the researcher was used to gather data. Three research questions and four research hypotheses were formulated to guide the study. Frequency counts and percentages were used for the analysis of the questions. Findings showed that the degree of the awareness level on HIV/AIDS among Nigerians was generally moderate. Further analysis, however,revealed that significant differences existed between male and female nurses when basic knowledge about HIVIAIDS, mode of transmission and prevention of HIV/AIDS were jointly and separately tested.The implications of these findings on counselling practice was discussed.
CHAPTER ONE
INTRODUCTION
BACKGROUND OF STUDY
Mankind has been contending with diverse health problems since the time of Adam. The greatest of this health problem manifested two decade ago and it was nick-named HIV/AIDS. Within the short pace of its discovery, Ojedokun (2004) remarks that it is among the top ten disease killers in the world wide and would soonest move to the top five at the rate at which it spreads across the nations. Ekoja (2006) describes the disease as the single most serious long term threat tosurvival, threatening to plunge the country into a multi-faceted development crisis.The disease, according to Factsheet on HIV/AIDS (2001), tops the list of the cause of death of people between the ages of 15 and 49 in some areas. Apart from these, the disease has no respect for the abilities and disabilities inherent in an individual.Tire (Jilid. Vol. 10 No I, March, 2008 fSSN. “19-636X 104 is an acronym for Human Immunodeficiency Virus. The onset of HIV in an individual commences when the HIV virus enters the body of an individual via sexual intercourse (vaginal, oral, and anal), blood transfusion, contaminated instruments like syringe. The infected person remains asymptomatic for diverse periods of time. Omoteso (2004) submits that HIV stays in the body for between eight and twenty years. This is possible because an infected person is naturally endowed with anti-bodies which are capable of defending the body against virus or micro-organisms infections. HIV, however, attacks the immune system to the point where the immune system would be incapable of defending the body against infections. Specifically, the virus destroys special cells of the body such as lymphocytes and monocycles. The continuous destruction of cells makes the infected person susceptible to other opportunistic diseases like chronic diarrhea, prolonged fever/malaria, tuberculosis, skin diseases etc. At this point the HIV virus has metamorphosed into full blown AIDS which is an acronym for Acquired Immune Deficiency Syndrome.The first AIDS care in Nigeria was officially reported in 1986. The victim was a 13 year old Ghanaian prostitute who paid visit to Nigeria from Cote Divoire. Since the discovery of this fact, quite a number of survey studies have been carried out to determine the prevalent level of HIV/AIDS pandemic in Nigeria. Findings from diverse studies indicate that:
- There is an exponential increase in the rate at which people get infected from 1.8% in 1992 to 3.8% in 1994 to 4.5% in 1996 to 5.49 in 1999 and 5.8% in 2001 (FMOH, 2001).
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There are established 5.5 million people with HIV/AIDS in Nigeria today.Benue and Cross River States are mostly affected with over 15% of adult aged 15-49 years infected. Lagos and Ebonyi States have 6.7% and 11.1 % respectively. (Otti, 2003).
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An estimated number of 3.47 million people infected with HIV with zeroprevalence rate of 5.8 percent (Folayan and Falobi, 2003).
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The prevalence level of HIV among the pregnant women in urban centres has decreased from 29.5% in 1992 to 11.25% in 2000 (Odumusu, 2000),The astronomical rate, at which Nigerians are infected with HIV/AIDS, as evident from above survey studies, has been attributed to a number of reasons, Ignorance and poor perception about HIV/AIDS have been penciled down by Odu (2003); Obioha, (2004); Busari and Danesy (2004); Ekoja, 2005). Consequently,quite a number of studies have been carried out on the HIV/AIDS related knowledge. Implications or counselling Practice and perception of people on HIV/AIDS. For instance, in a study which investigated the HIV/AIDS related opinions,knowledge and behaviour change of nurses among Nigerians. The revelation that perhaps up to four million Nigerians might have contracted (the) AIDS virus should spur the country into some form of coordinated action. Despite the havoc which HIV/AIDS has caused throughout the world, particularly Africa, Nigerians have, regrettably, continued to carry on as if nothing is happening. Many people still maintain multiple sex partners and engage in casual and unprotected sex. Our AIDS control strategy remains, at best, unstructured, without direction. If the report that some people have received blood infected with the virus is true, then there is danger on the horizon. It only goes to show that AIDS screening is not properly carried out in the country. Sadly, the problem has been compounded by the fact that the disease is still being treated with a less than honest approach by many Nigerians” (Daily Times 1997). This editorial by the leading government-owned newspaper conveys the lack of a proper reponse to one of the main threats to public health in Nigeria. The data is in line with earlier figures which calculated that 1,050,000 Nigerians were HIV positive by the end of 1994 and an extrapolation of over two million using the double-blind method
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(Orubuloye 1995; Sowunmi and Ikhemuemhe 1996). Three-quarters of commercial sex workers are HIV positive, so are 5 percent of blood donors and 4 percent of pregnant women (Sowunmi and Ikhemuemhe 1996). By implication, this means that babies from HIV/AIDS infected women are potential victims. The social width of the disease knows no bounds: the media reported the infection of schoolgirls in Akwa Ibom State and the AIDS-death of a community leader in Plateau State in the month of January 1997 alone (Post Express 1997; Punch 1997). The probability is that more Nigerians infected by HIV/AIDS is even higher than these startling figures suggest.
Compared to other African countries, Nigeria has been inordinately slow to wake up to the reality of HIV/AIDS. It has been even slower to embark on caring for HIV/AIDS patients. University College Hospital (UCH), Ibadan, is a Federal Teaching Hospital with a leading reputation for health care in the country. UCH operates an AIDS Screening Centre, the only one in Ibadan, a city of over 3 million inhabitants. In 1993, “the Oyo State Minister of Health declared wanted 43 blood donors whose blood showed traits of HIV” (AIDS 528 Gladys Effa-Heap Information Exchange Resource Centre 1993). Wanted for receiving the appropriate care, or wanted like criminals? In whatever case, the infrastructure is simply not in place, being not a priority among hospital managers and government ministries. For Nigerians with HIV/AIDS, health care is a misnomer. There is only health care neglect. On hearing a HIV/AIDS diagnosis of a patient, hospital authorities abandon all notions of caring. A notice of 23 March 1995 issued by the Chairman of the Medical Advisory Committee of UCH stated that:
(1) established cases of clinical HIV/AIDS should not be admitted.
(2) using their own discretion, doctors could admit in rare cases
HIV/AIDS patients for IV and blood transfusion, after which the patient must be discharged.
(3) known HIV/AIDS cases should be referred to the medical social services department for advice”.Many carriers of the causative virus are known to lead active lives. Allowing these people to remain in society without caution exposes the populace to avoidable danger. In the present setting, nothing bars HIV/AIDS carriers from donating blood or doing many other things
Which can impair the lives of other citizens. When asked in a recent magazine interview about the Federal Government’s policy towards HIV/AIDS under the title ‘Playing the ostrich’, Dr Lolade Olusola Ojo of the National AIDS and STD Control Programme in Nigeria responded: “We have a policy that is still undergoing the normal scrutiny of the government. This delay on the policy is because when AIDS was first discovered the government did not believe we had AIDS in the country”.The Nigerian Federal Ministry of Health has been very slow in waking up to the realities of HIV/AIDS and making combative plans to control its spread. Nothing has been done about equipping hospitals for proper management of HIV/AIDS cases. Another aspect of Dr Olusola’s revelations concerned the screening of blood: “There are 818 blood screening centres in Nigeria. A law is coming up to compel screening of all donated blood before transfusion. This is because for now, most of the medical laboratories write ‘screened blood’ on blood bags that are not screened. Sixteen percent of these so-called ‘screened blood’ [bags] are found to be contaminated”. Consultant haematologist Sumailman Akanmu also found a similar percentage of blood bags labelled screened and HIV negative, especially from private laboratories had, in fact been tainted with the HIV positive virus (Sowunmi and Ikhemuemhe 1996). It is in this negative sort of working environment that nurses’ attitudes towards educating and passing out knowledge about HIV/AIDS amongs Nigerians and in a particular HIV/AIDS patients is examined with particular reference to UCH, Ibadan (Effa-Heap 1997). Specific sub-problems to investigate include the level of knowledge of nurses on HIV/AIDS; their sources of information on HIV/AIDS; their attitude towards caring for HIV/AIDS patients; the relationships between the nurses’ age, exposure to infected patients, years of nursing experience, and the nurses’ The attitude of nurses to HIV/AIDS patients in Nigeria 529 attitude towards HIV/AIDS patients; and whether UCH is well equipped for the management of HIV/AIDS cases.