The increasing number of people living with HIV/AIDS is causing concern among surgeons over risk of occupationally acquired HIV infection. This may influence their attitude to such patients. The purpose of this study was to develop a cross-sectional survey of orthopaedic surgeons to assess their concerns, attitudes, and practices towards management of HIV-positive patients in Nigeria. All respondents were males, 55 (73.3%) of them indicated concern over the risk of occupational acquisition of HIV infection and 37 (49.3%) had examined or operated on at least one HIV/AIDS patient. Sixty (79.9%) were willing to be tested for HIV and 51 (67.9%) were previously tested. Fifty-seven (75.9%) would order preoperative HIV screening of high risk patients, and 67 (89.3%) would operate on HIV-positive patients. Most orthopaedic surgeons in Nigeria would operate on HIV-positive patients.Résumé L'augmentation du nombre de patients vivant avec le virus HIV peut influencer l'attitude des chirurgiens vis à vis de ces patients. L'objectif de cette étude est d'évaluer l'attitude des chirurgiens orthopédistes au contact de patients présentant une séro contamination HIV positive au Nigéria. un questionnaire a été réalisé et distribué aux chirurgiens orthopédistes du Nigéria afin de mettre en évidence leur attitude et leurs pratiques envers ces patients. toutes les réponses ont concerné des hommes: 55 (73,3%) et 37 (67,9%) ont examiné ou opéré un patient porteur du virus du sida. 60 (79,9%) ont voulu ou avaient l'habitude d'être testés et 51 (67,9%) ont été testés de façon préventive. 57 (75,9%) ont demandé à ce que le dépistage du virus HIV soit fait en pré-opératoire chez les patients à haut risque et 67 (89,3%) ont opéré ce type de patients. la plupart des chirurgiens orthopédistes au Nigéria traitent des patients HIV positifs.
IntroductionTrauma accounts for a significant proportion of death and disability globally, and the impact is particularly enormous in developing lowand middle-income countries. Apart from cost-effective preventive strategies to reduce the risk of trauma, the determinants of favourable outcomes following trauma include the immediate onsite emergency care, the expertise of manpower, availability of infrastructure and appropriate facilities for care and access to specialised care. In many developing countries challenged by multiple communicable and non-communicable disorders, compounded by ailing and rudimentary health systems and inadequate manpower (in terms of absolute numbers and depth of experience and training), there is a disparate unacceptably higher mortality and morbidity from trauma compared to developed countries. The aim of this review was to discuss the challenges in trauma management in developing countries. ConclusionChallenges to trauma care include inadequate pre-hospital trauma care protocol, staff with limited training in trauma management, nonavailability and poor distribution of resources, communication deficiencies, transportation and general infrastructure deficits, lack of a holistic approach to trauma management, ignorance of the populace on basic life support measures, cultural and health-seeking behaviours preferring alternative unconventional care and absent or limited institutional and governmental action to address trauma care. Strategies targeting these challenges, and employing/ adapting mechanisms proven to be effective in developed countries will reduce the burden of disease attributable to trauma in developing countries.
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