Journal of AIDS and HIV research (Online)最新文献

{"title":"Evaluating an enhanced adherence intervention among HIV positive adolescents failing atazanavir/ritonavir-based second line antiretroviral treatment at a public health clinic.","authors":"Tariro Dianah Chawana, David Katzenstein, Kusum Nathoo, Bernard Ngara, Charles Fungai Brian Nhachi","doi":"10.5897/JAHR2016.0406","DOIUrl":"10.5897/JAHR2016.0406","url":null,"abstract":"<p><p>Sustaining virological suppression among HIV-infected adolescents is challenging. We evaluated a home-based adherence intervention and characterized self-reported adherence, virological response and drug resistance among adolescents failing atazanavir/ritonavir (ATV/r)-based 2^nd line treatment.</p><p><strong>Methods: </strong>HIV-positive adolescents (10-18 years) on ATV/r-based 2^nd line treatment with virological failure (viral load (VL) ≥1 000 copies/ml) were randomized to either standard care (SC) or SC with addition of modified directly administered antiretroviral therapy (mDAART) for 90 days. VL was measured and questionnaires were administered at study entry and at 3 months. Genotyping was done for participants with continued failure. Primary outcome was suppression to VL < 1 000 copies/ml.</p><p><strong>Results: </strong>Fifty adolescents aged 10-18 years on 2^nd line treatment for >180 days were enrolled, 23(46%) were randomized to mDAART and 27(54%) to SC. Fifty-four percent were female; mean age was 15.8 years; mean baseline VL was 4.8(log₁₀) copies/ml; 40% reported adherence <80% in previous 1 month at baseline; 40% suppressed (VL <1 000 copies/ml) after follow-up. mDAART resulted in significantly increased self-reported adherence (RR= 0.1; 95% CI=0.02-0.8, p=0.023); closely following dosing schedule (RR= 4.8; 95% CI=1.6-13.8, p=0.004); VL decrease (p=0.031) and modest increase in virological suppression to <1 000 copies/ml (p=0.105). Genotyping in 28/30 participants with continued virological failure demonstrated high level atazanavir resistance (I50L, N88S and I84V) in 6(21%); 3(11%) of whom also had high level resistance to lopinavir and darunavir (V32I, I50L, I54V, 147V and V82A).</p><p><strong>Discussion: </strong>The mDAART intervention modestly improved virological suppression among adolescents with ATV/r-based 2^nd line treatment failure, significantly increased self-reported adherence and decreased viral load. High level ATV/r resistance was demonstrated.</p><p><strong>Conclusion: </strong>Targeting mDAART to adolescents who are virologically failing PI-based 2^nd line treatment decreases viral load and increases self-reported adherence. Early drug-resistance testing could reduce morbidity and mortality.</p>","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"9 1","pages":"17-30"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass incarceration, residential segregation and racial disparities in HIV","authors":"Loren Henderson","doi":"10.5897/JAHR2016.0387","DOIUrl":"https://doi.org/10.5897/JAHR2016.0387","url":null,"abstract":"Using a “mass incarceration” framework and county-level national data, this paper examines the relationship between incarceration, ex-offender reentry locations, and HIV rates in counties with different racial compositions. A series of “race-of-county” stratified regression models estimate HIV prevalence rates with incarceration and ex-offender reentry locations when taking into consideration residential segregation (that is, Black isolation and White isolation), region, high school graduation rates, sex ratios, unemployment rates, median income, healthcare professional shortages, percentage of residents without insurance, population density, and income inequality. As predicted, HIV rates are higher in counties with high incarceration rates or with ex-offender reentry facilities. A race-of-county stratified analysis, however, reveals nuanced patterns: In White counties and the highest-percentage Black counties, HIV rates increase as incarceration rates increase. In integrated counties, they do not. In the highest-percentage Black counties, the presence of reentry locations is associated with higher rates of HIV, but this is not true in White and integrated counties. In integrated counties, higher levels of Black isolation are associated with high HIV rates. In counties of all racial compositions, higher levels of White isolation are associated with lower rates of HIV. Implications of these results are discussed. \u0000 \u0000 Key words: HIV, mass incarceration, residential segregation, racial disparities in HIV.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"150-162"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71135322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare providers (HCPs) attitude towards older adults with HIV and AIDS in Botswana","authors":"N. Ama, S. Shaibu, D. Burnette","doi":"10.5897/JAHR2016.0389","DOIUrl":"https://doi.org/10.5897/JAHR2016.0389","url":null,"abstract":"This study obtained the views of a random sample of 164 healthcare practitioners on their attitudes to older adults with HIV and AIDS. It shows that although the knowledge of protective measures to avoid HIV infection, mode of transmission and stigmatization are high among the healthcare providers (HCPs), yet the majority of them (76.2% of medical officers, 80.4% of nurses and 93.3% of others) are aware of discrimination against people living with HIV (PLHIV). Attitudes of HCPs to older adults with HIV with respect to quality of life, tolerance, education and training, support and treatment of PLHIV are positive, but they significantly differ on issues of blame and sexual attitude of the PLHIV. There is very little engagement between the HCPs and the older adults on their sexual characteristics which can be attributed to the low literacy of the PLHIV. The study recommends appropriate education and counselling, more awareness creation of HIV, its mode of infection, prevention and treatment among HCPs, to eliminate the fears associated with HIV and AIDS. Health facility policies and stringent laws against discrimination need to be put in place. \u0000 \u0000 Key words: People living with HIV (PLHIV), healthcare providers, attitude, older adults, HIV, AIDS","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"136-149"},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71135337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus retinitis in HIV patients attending Eye/Uveitis clinic in Korle-Bu Teaching Hospital, Accra -Ghana","authors":"J. Ibrahim, A. Innocent, V. Orish, A. Stephene, F. Gladys, S. Makafiu, K. A. Kwashie, C. SagoeK.W., K. Amegan-Aho, K. T. Adiku","doi":"10.5897/JAHR2016.0382","DOIUrl":"https://doi.org/10.5897/JAHR2016.0382","url":null,"abstract":"Cytomegalovirus (CMV) retinitis is an ocular manifestation of human immunodeficiency virus (HIV) infection especially in individual with low CD4 cells count. In Ghana, a country where CMV infection is hyperendemic, there is no data of CMV retinitis among HIV positive persons. This work was conducted to evaluate the prevalence of CMV retinitis among HIV positive persons attending eye clinic in Korle-Bu Teaching Hospital. Eye swab and vitreous samples were collected from HIV positive patients with retinal inflammation. The samples were assayed for DNA of Herpes Simplex Virus, Varicella Zoster, Cytomegalovirus and Epstein - Barr virus by using qualitative polymerase chain reaction (PCR) (multiplex PCR) to detect the presence or absence of herpes viruses. Sixty-two patients had retinal inflammation from ophthalmoscopy out of the total 404 that came into the clinic during the study period from July, 2010 to April, 2011. Forty six of these were HIV positive. Only 3 (6.5%) HIV positive patients had their swab or vitreous humour samples yielding DNA of CMV virus. These patients had their CD4 cell counts above 25 cells/µl. This is the first study to show the prevalence of CMV retinitis among HIV patients in Korle-Bu Teaching Hospital, Ghana. It is necessary for more comprehensive longitudinal study to evaluate incidence and cumulative risk of CMV retinitis among HIV positive individual. \u0000 \u0000 Key words: Cytomegalovirus, human immunodeficiency virus, Ghana, Korle-Bu, retinitis, CD4, ophthalmoscopy.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"129-135"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the rebirth to seven wonders powder supplement for nutritional management in HIV-infected subjects on antiretroviral therapy","authors":"L. A. Atchibri, Ahou efa Nina-Laurette, D. J. Jacques, Serge Kouyo","doi":"10.5897/JAHR2016.0336","DOIUrl":"https://doi.org/10.5897/JAHR2016.0336","url":null,"abstract":"The rebirth to seven wonders (R7M) powder supplement was used for nutritional management of HIV-infected patients. The powder is a multipurpose powder used as a food supplement in human foods because of its nutritional qualities. It has many uses such as in the fight against malnutrition in Cote d’Ivoire because of its nutritional qualities. The purpose of this study was to evaluate the effect of supplementation of the “R7M” powder consumption on the clinical evolution and the laboratory findings in people living with HIV/AIDS and on antiretroviral treatment. The present work is focused on biochemical analysis and monitoring of some anthropometric and laboratory parameters. The biochemical analysis of the powder showed that 100 g of powder contains 54.02 g of carbohydrate, 7.6 g of fat and 31.25 g of proteins. The same amount of powder contains minerals such as magnesium (149.25 mg), calcium (77.5 mg), zinc (3.25 mg) and iron (47.5 mg). After six months of using the “R7M” powder among both groups, anthropometric parameter (weigh) and biological parameters (creatine, hemoglobin and CD4 count) were measured. Nutritional recovery with the “R7M” powder showed an improvement in the main follow-up criteria, that is, weight, hemoglobin, creatine and CD4 count in both groups. This improvement was significantly increased in HIV group with antiretroviral (ARV) treatment. This study confirms the nutritional properties of the “R7M” powder which can be used as food supplement in the fight against protein-energy malnutrition and micronutrient deficiencies. \u0000 \u0000 Key words: Powder, rebirth to seven wonders, nutrition, HIV, food supplement.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71135026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of HIV post-exposure prophylaxis (PEP) in a tertiary health institution in south-eastern Nigeria","authors":"A. Isah, N. Igboeli, Maxwell Ugochukwu Adibe, C. Ukwe","doi":"10.5897/JAHR2016.0380","DOIUrl":"https://doi.org/10.5897/JAHR2016.0380","url":null,"abstract":"This study aimed to evaluate the implementation of HIV post-exposure prophylaxis (PEP) guidelines and determine its clinical outcome in a PEPFAR (APIN-CDC) Clinic in south-eastern Nigeria from 2008 to 2012. It was a retrospective review of data of patients who accessed HIV PEP services from the clinic. Data on demographic and clinical characteristics of patients were retrieved from the database of the clinic and analyzed. Descriptive statistics and Chi-square test were applied to analyzed data at significance level of p<0.05. The result showed that thirty three (33) individuals were enrolled into PEP during the period. Thirty-one (31; 93.94%) were due to occupational exposure, while two (2; 6.06%) were due to non-occupational exposure. AZT+3TC 23 (69.70%), AZT+3TC+LPV/r 9 (27.27%) and AZT+3TC+ATV/r+RTV 1 (3.03%) were the ARVs used. The nature of exposure did not significantly determine the choice of the ARV. The study concludes that APIN/CDC Clinic, UNTH Enugu substantially followed recommendations of standard guidelines in HIV PEP management, but the absence of followup test results for majority of the enrollees was an impediment to any general statement on its clinical outcome.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of prevention of mother-to-child transmission (PMTCT) of HIV in a tertiary health institution in south-eastern Nigeria","authors":"A. Isah, N. Igboeli, M. Adibe, C. Ukwe","doi":"10.5897/JAHR2016.0375","DOIUrl":"https://doi.org/10.5897/JAHR2016.0375","url":null,"abstract":"Mother-to-child transmission is the highest mode of acquisition of HIV infection in children, with a 1545% risk of an infant acquiring HIV from an infected mother without any medical intervention. The objectives of this study were to evaluate the implementation of prevention of mother-to-child transmission (PMTCT) guidelines and determine its clinical outcome in a PEPFAR Clinic in Nigeria from 2008 to 2012. A retrospective review of data of patients who accessed PMTCT from the Clinic in the University of Nigeria Teaching Hospital (UNTH), Enugu was conducted. Data were retrieved from the clinic’s database and analyzed. The result showed that three hundred and seventy-three (373) pregnant women (aged 30.22±4.88) and three hundred and sixty-seven (367) children from the pregnancies were enrolled into PMTCT. Ten (10) regimens were used for the mothers: AZT/3TC/NVP, TDF/3TC+NVP and AZT/3TC+EFV accounting for 80.00, 11.00 and 2.65%, respectively. AZT (15.80%) and NVP (84.20%) were used for the infants, 8 (2.18%) of whom tested positive for HIV. The study concluded that PEPFAR Clinic, UNTH Enugu substantially followed the guidelines in its PMTCT programme which was found to drastically reduce the transmission of HIV from mother to child.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"114-120"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disclosure of HIV diagnosis to infected children receiving care in University of Uyo Teaching Hospital, Uyo, Nigeria","authors":"Emmanuel Ikpeme Enobong, Tony Dixon Umo Ofonime","doi":"10.5897/JAHR2016.0374","DOIUrl":"https://doi.org/10.5897/JAHR2016.0374","url":null,"abstract":"Disclosure of human immunodeficiency virus (HIV) diagnosis to infected children is still a challenge despite proven evidences that it has numerous social and medical benefits for the child and family.  The aim of this study was to document the disclosure rate of HIV diagnosis to children in Uyo, Nigeria and determine the factors influencing disclosure or non-disclosure to these children. This was a descriptive cross-sectional study. A pre-tested and validated semi-structured questionnaire was administered to consenting parents/caregivers of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) infected children aged 6 to 17 years in care at the Paediatric Infectious Diseases Unit of the University of Uyo Teaching Hospital, Uyo (UUTH) from January to June, 2015.  One hundred and twenty-two caregivers (26 males and 96 females), giving a male to female ratio of 1:3.7, aged 20 to 60 years, were interviewed. Sixty-eight (55.8%) of them had post secondary education. Twenty (16.4%) of the children aged 9 to 17 years (13.3±2.4 years) had been disclosed to. Age of the children, gender, orphan status, their level of schooling and their socio-economic class positively affected disclosure. Also, caregivers between ages 30 and 49 years who were more educated were more likely to disclose the HIV status of their children. Commonest reason for non-disclosure was child being sad (29.5%).  Others were blaming the parents (18.0%), not understanding the import of the diagnosis (9.8%) and 6.6% feared child disclosing to others.  Forty-four (37.7%) did not give reasons for non-disclosure. Sixty-seven (54.9%) of the caregivers who did not disclose said they would do so after 10 years of age. A national protocol for paediatric HIV disclosure is desirable.     \u0000 \u0000   \u0000 \u0000 Key words: Disclosure, diagnosis, children, human immunodeficiency virus (HIV), Nigeria.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"93-99"},"PeriodicalIF":0.0,"publicationDate":"2016-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2016.0374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of infants born to HIV-positive women through the aspects of prevention of mother to child transmission in Lom (Togo, West Africa) from 2008 to 2010","authors":"A. B. Adama-Hondegla, A. Djeha, K. Lawson-Evi, D. Y. Atakouma","doi":"10.5897/JAHR2015.0350","DOIUrl":"https://doi.org/10.5897/JAHR2015.0350","url":null,"abstract":"Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) infection in children under 15 years is mostly due to mother to child transmission. The purpose of this study was to assess the outcome of infants born to HIV-positive women through the prevention of mother to child transmission (PMTCT) aspects at Sylvanus Olympio’s Teaching Hospital of Lome. This retrospective study of 24 months (from September 1, 2008 to September 1, 2010) was performed in 232 recorded files of infants delivered in the centre and monitored in the pediatrics department. From 230 women who had given birth to 232 infants, 224 (97.4%) knew their positive HIV status before delivery and 6 (2.6%) tested positive after child birth. Low birth weight was observed in 21.5% of newborns and 12.3% were born preterm. Two hundred seven (55.0%) infants were exclusively breastfed, with abrupt weaning at 4 months in 40.2% (39). Polymerase chain reaction (PCR) test was performed at 17 and 19 weeks in the 232 infants and 13 positive cases were found (5.6% transmission rate). An assessment of the centre in 2010 identified a mother-child transmission rate of HIV that was still high. There was need to strengthen screening strategies, counselling during antenatal care, and access to ART for all pregnant women. \u0000 \u0000   \u0000 \u0000 Key words: Prevention of mother to child transmission (PMTCT), human immunodeficiency virus (HIV) pregnant women, antiretroviral treatment, Togo, West Africa.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2016-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2015.0350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the practice of exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa: A scoping review of counselling, socioeconomic and cultural factors","authors":"M. Al-Mujtaba, N. Sam-Agudu, R. Khatri","doi":"10.5897/JAHR2015.0353","DOIUrl":"https://doi.org/10.5897/JAHR2015.0353","url":null,"abstract":"The World Health Organization (WHO) recommends exclusive breast-feeding (EBF) for HIV exposed infants for six months; this is considered best practice for reducing mother-to-child transmission of HIV in the postpartum period. This is a scoping review of the barriers affecting women's decision-making and choice to sustain the practice of EBF in sub-Saharan Africa (SSA). An online literature search via PubMed, Science Direct, Google Scholar, WHO and Joint United Nations programme on HIV and AIDS (UNAIDS) websites identified research studies and reports that explored socio-economic, cultural and infant feeding counselling-related barriers to EBF among HIV-positive mothers in SSA. A total of 341 relevant articles were identified only 35 (23 qualitative, 3 quantitative and 9 mixed methods) met the inclusion criteria. Findings reveal that key barriers to choice and sustained practice of EBF are healthcare workers’ personal biases, inadequate counselling skills and guideline knowledge, a culture of mixed feeding norms, and maternal lack of decision-making power and fear of vertical transmission. Transmission of HIV programs in countries where major challenges persist should evaluate and address the identified healthcare worker and community-level factors impeding EBF.","PeriodicalId":73590,"journal":{"name":"Journal of AIDS and HIV research (Online)","volume":"8 1","pages":"70-79"},"PeriodicalIF":0.0,"publicationDate":"2016-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5897/JAHR2015.0353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71134431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}