CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND TO THE STUDY

HIV (Human Immunodeficiency Virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and disease. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or medicine to prevent or treat HIV), or through sharing injection. Scientists believe that HIV originally came from a virus particularly to chimpanzees in West Africa during the 1930s, and originally transmitted to humans through hunting. Over the decades, the virus spread through Africa, and to other parts of the world. The following are some of the major events and the discoveries in HIV and AIDS since 1981 (Canadian Foundation for AIDS Research, 2017): During 1981, in the US, reporting of unusually high rate of rare forms of pneumonia and cancer in young gay men begins. The disease is initially called Gay-Related Immune Deficiency (GRID) because it is thought it only affects gay men. Cases are also reported in injection drug users by the end of the year. In 1982, the disease is renamed Acquired Immune Deficiency Syndrome (AIDS).It is realized that the infection can be sexually transmitted and cause by HIV. Cases are reported in blood transfusion recipients. In 1983 it is discovered that women can become infected   with2 AIDS through heterosexual sex. In 1986 it discovered that HIV can be passed from mother to child through breast-feeding in 1987 CANFAR is founded .The first anti retroviral drug is approved. Between 8-10 million people are estimated to be living with HIV worldwide (1990).In 1997 UNAIDS estimates there are 30 million people living with HIV and AIDS worldwide, with 16000 new infections daily. In the year 1999 world health organization announces that AIDS was the fourth biggest cause of death worldwide and the one killer in Africa. An estimated 33 million people were living with HIV, and 14 million people were recognized to die from AIDS since the start of the epidemic. In 2011 confirmation is published Timothy Brown is cured of HIV, four years after completing treatment. The first two AIDS cases in Nigeria was diagnosed in 1985 and reported in 1986 in Lagos one of which is a young female sex worker aged 13 years from one of the West African countries (Nasidi and Harry, 2006).Nigeria has the second largest HIV epidemic in world. Although HIV prevalence among adult is much less (2.8 %) then other sub Saharan African countries such as south Africa (18.8%) Zambia (11.5%) the size of Nigeria’s population means 3.1 million people were living with HIV in 2017(CDC, 2018). However, a recently  published Nigeria–HIV/AIDS indicator and Impact Survey(NAIIS), one of the largest population-based  HIV/AID house-hold survey ever conducted, found the prevalence to be just 1.4% .UNAIDS estimated that around two third of new HIV infections west and central Africa in 2017 in occurred  in Nigeria. Unprotected heterosexual sex accounts for 80% of new HIV infections in Nigeria, with the majority of remaining HIV infections occurring in key affected populations such as sex workers. Six states in Nigeria account for 41% of people living with HIV, including Kaduna, AkwaIbom, Benue, Lagos, Oyo and Kano.HIV prevalence is highest in Nigeria’s southern states (known as the south-south zone and stands at 5.5%. It is lowest in the south east (the south east zone) Where there is a prevalence of 1.8%  are higher rate of HIV in rural areas (4%) than In urban areas (3 %).Approximately 150000 people died from AIDS related illnesses  in Nigeria in 2017. Since 2005, the reduction in the number of annual AIDS related deaths has been minimal, indicative of facts only 33% of those with a positive diagnosis in Nigeria are accesses Anti Retroviral Treatment (ART). Despite being the largest oil producer in Africa and the 12th in the world, Nigeria rank 158 out of 177 on the United Nation Development (UNDP) human index. This poor economics position has meant that Nigeria faced with huge challenges in fighting it is HIV AIDS epidemic.

1.1 STATEMENT OF THE PROBLEM

Better health is central to human happiness and well being. It also makes an important contribution to economics progress, as health life longer, are more productive   more. However, Nigeria has about 3.8 million people living with (Center for disease control), the second largest globally .Many people living with HIV in Nigeria are unaware of their status. UNAIDS estimates that around two third of new HIV infections in west and central Africa in 2017 occurred in Nigeria. Approximately 150000 died from AIDS related illness in Nigeria.

Maintaining a healthy weight is important for health. In addition to lowering the risk of heart disease, stroke, diabetes, and high blood pressure, it can also lower the risk of many different cancers. However, being underweight can represents the following diseases osteoporosis, skin, hair or teeth problems, Anemia, irregular periods, immature birth, and feeling tired all the times. Being overweight or obesity can also cause problems to the individual’s health, as being underweight causes, including heart disease, certain cancer disease, high blood pressure, sleep apnea and kidney diseases. In response to this problem, our study proposes to;

·        Test if there is a significant relation between weight and the height of HIV positives patients.

·        Test whether or not gender has impact on the BMI of HIV positive patients.

·        Verify the relation between BMI and age of HIV positive patients.

·        To determine whether or not there is a statistically significance difference in the BMI of male and female patients.

·        To come up with a model that predicts the HIV positive patient height value when the BMI and weight are known.

 B  1.2 SIGNIFICANCE OF STUDY

The findings of this study would be of utmost importance to the HIV positive victims, medical practitioners, dieticians, and the society at large, in knowing the level of; nutrients, treatments, and care required by the HIV positive patients.

1.3 AIM AND OBJECTIVES

The aim of the study is to use non-parametric and parametric approaches to analyze the BMI and its influence on HIV positive patients.

Sequels to the aforementioned aim, the followings are the specific objectives of the study:

       I.            To determine if there is a significant relation between height and weight of HIV positive patients.

    II.            To test whether or not gender has impact on the BMI of HIV positive patients.

 III.            To verify the relation between BMI and age of HIV positive patients.

IV.            To determine whether or not there is a statistically significant difference in BMI of males and females HIV positive patients.

   V.            To come up with a model that predicts the height value when the BMI and weight are known.

          1.4 RESEARCH  HYPOTHESES

The formulation of an appropriate hypothesis goes hand in hand with the selection of a research problem. Hypothesis serves as an assumed answer to principal research questions of HIV positive patients. They Are guide for investigator in the entire process of research endeavor and they keep on the main line of his/her study. The followings are statistical hypotheses for the study, they shall be tested and confirmed or rejected in the subsequent chapter (i.e. chapter IV);

There is no significant relation between weight and height of HIV positive patients.

Gender has no significant impact on the BMI of HIV positive patients.

There is no significant relation between BMI and age of HIV positive patient.

There is no significance difference in the BMI between male and female patients.

1.5 SCOPE AND LIMITATION

This study only attempts to investigate the relation between height and weight of HIV positive patients, as such, the  scope of this study is only limited to HIV  positive patient  of Aminu Kano Teaching Hospital(AKTH).

1.6 DEFINATION OF BASIC TERMS

Height: the dimension of extension; distance from the base of something to the top (offline Advance English Dictionary).

Weight: how heavy somebody/something is which can be measured in, for example, kilograms or pounds (Oxford Language Dictionary).

Relation: is the mutual dealing or connection among persons or groups (offline Advance English Dictionary).

BMI (Body Mass Index): is a measure of someone’s weight in relation to height (offline Advance English Dictionary).

Positive (+ve): indicating existence or presence of a suspected condition or pathogens (offline Advance English Dictionary)