Knowledge, attitude & practice of non-dental health care providers in relation to the oral manifestations of HIV/AIDS in Butha-Buthe district, Lesotho

Abstract

BACKGROUND: The scourge of HIV and AIDS on the people of Lesotho is a huge public health problem faced by the country’s Ministry of Health and in 2005 the national adult HIV prevalence rate was 23% (WHO, 2009). It is estimated the one in every four adults in the country is HIV positive and in 2012, new HIV infection per year was estimated to be 18,000 (MoH Lesotho, 2014). The 2014 health reform by the Ministry of Health, Lesotho plans to capacitate village health workers (VHWs) to play an important role in addressing Lesotho's most urgent health crises which are: to reduce child mortality, to improve maternal health, to combat HIV/AIDS and other diseases. This is because VHWs and primary health care nurses (PHC nurses) are in vital positions to identify, manage or refer such patients for appropriate care. Studies have shown that between 74.4% - 90% of HIV infected people present with at least one oral lesions in the course of the disease. Health care workers need to have adequate knowledge of these conditions for effective management thereof. AIM: To determine the knowledge, attitudes and practices of nurses and VHW in Butha-Buthe district with respect to oral HIV/AIDS manifestations. METHODOLOGY: A descriptive cross-sectional survey was conducted on one hundred and forty-one Village health workers and nurses in Butha-Buthe district of Lesotho. A self– administered questionnaire was used to gather information on demographic characteristics of the participants and their knowledge, attitudes and practices regarding the management of oral lesions associated with HIV. Analysis was done using the SPSS statistical software package. Descriptive statistics such as frequency distributions and cross tabulations was generated and the results were summarized in tables and figures. RESULTS: The ages of the participants ranged between 21 and over 50 years. There majority were female (83.7%). And two thirds had a secondary school education. The healthcare providers that had ten years or less of service accounted for 59.6% of the respondents and 0.7% had more than 30 years of service. Most of the respondents (97.9%) had previous knowledge on oral lesions related to HIV/AIDS but only (8.2 %) reported having received knowledge through training institutions. The majority (79.3%) identified oral candidiasis (OC) as the most common lesion found in people living with HIV/AIDS while lesions of NOMA, aphthous ulceration, Kaposi’s sarcoma and herpes zoster were the least identified lesions by the respondents. The findings showed that 67.4% of the participants washed their hands routinely with water only whereas 66.7% routinely washed their hands with antiseptics. However, a majority of them (96.5%) said that they washed their hands with water and soap routinely. CONCLUSION: There are however gaps in the knowledge, attitude and practices of nurses and VHWs in Butha-Buthe district to oral HIV/AIDS manifestations. Improvement in the knowledge and ability of these cadres of health care providers to recognize and manage such lesions can be done through an introduction of such training in their school curriculum. It may also be necessary to continuously have seminars aimed at training and retraining these cadres of health workers on this topic. It is also worrisome that a high number of the participants indicated they didn’t strictly adhere to standard precautions as stipulated by WHO. It may be necessary to conduct studies to assess reasons for their infection control practices.