1

FEDERAL UNIVERSITY REQUIREMENT FOR

OF TECHNOLOGY, THE AWARD OF
OWERRI. BACHELOR OF SCIENCE
( B. SC ) DEGREE IN
P.M.B. 1526, OWERRI. BIOLOGY.

REPORT ON

STUDENT INDUSTRIAL APRIL, 2024.

WORK EXPERIENCE
SCHEME (SIWES).

DONE
AT

FEDERAL MEDICAL
CENTER UMUAHIA, ABIA
STATE.

WRITTEN BY:

UDEJIMBA
CHINONSO MIRACLE

REGISTRATION
NUMBER: 20201224415

SUBMITTED TO:

THE
DEPARTMENT OF
BIOLOGY,

SCHOOL OF
BIOLOGICAL SCIENCES.

IN PARTIAL
FULFILLMENT OF THE

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DEDICATION

This report is dedicated to

God Almighty, who
remains my help and
source. The one who has
been my anchor and
fortress in all ramifications.
The one whose grace,
goodness and mercy saw
me through the phase of
my industrial training.

I also dedicate this report

to my lovely siblings for
their support and immense
contributions throughout
the period of my industrial
training.

_____________________
_______ _____
UDEJIMBA CHINONSO
MIRACLE DATE

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bless you abundantly,

ACKNOWLEDGEMENT beyond measure. Amen.

I also want to sincerely

I want to express my thank the entire staff of the
heartfelt gratitude to God Biology-related units at
Almighty for granting me Federal Medical Center,
life and the strength of Umuahia, where I was
mind and body to assigned. Additionally, I
successfully complete my appreciate my friends and
training scheme. industrial training
colleagues who
I also appreciate my contributed to making this
siblings, who have been a period memorable and
source of inspiration and worthwhile. Thank you all,
motivation not only during and may God bless you
this program but abundantly.
throughout my life.

My sincere thanks go to
the Dean of the School of
Biological Sciences and
the Head of the
Department of Biology, Dr.
D.H. Ogbuagu, for their
dedication to advancing
Biology as a field of study
and for their commitment
to the success of Biology
students both within and
beyond our institution. I
am grateful to all my
outstanding lecturers in
the Department of Biology
for their insightful lectures,
as well as to my SIWES
coordinator, Dr. N.A.
Chiegboka, and my course
advisor, Dr. Ubah, for their
invaluable support during
my industrial training
orientation. To each one of
them, I say: may God

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TABLE OF
CONTENT

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LIST OF FIGURES

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CHAPTER ONE knowledge or working a rising concern and trend

experience before among
INTRODUCTION TO graduating from their industrialists that
STUDENT INDUSTRIAL various institutions. graduates from higher
WORK EXPERIENCE education institutions
SCHEME ( SWIES ). 1.2 HISTORY OF SIWES lacked appropriate
practical
1.1 BACKGROUND OF SIWES was founded in experience for
SIWES 1973 by ITF (Industrial employment. Students
Training Funds) to address who entered Nigerian
In the early stage of the problem of universities to study
science and technology tertiary institution science and
education in Nigeria, graduates’ lack of technology were not
students were graduating appropriate skills for previously trained in the
from their respective employment in Nigerian practical aspects of their
institutions without any industries. chosen fields. As a result
technical knowledge or The Students’ Industrial of their lack of work
working experience. Work Experience Scheme experience, they had
There was a growing (SIWES) was founded to difficulty finding work.
concern among be a skill training
industrialists that programme to help expose
graduates of institutions of and prepare students of
higher universities, Polytechnics
learning lacked adequate and colleges of
practical background education for the industrial
studies necessary for work situation to be met
employment in industries. after graduation.
Thus, the employers were This system facilitates the
of the opinion that the transfer from the
theoretical education going classroom to the
on in higher workplace and aids in the
institutions were not application of knowledge.
responsive to the needs of The program allows
the employers of labor. It students to become
was in this view that acquainted with and
students undergoing exposed to the experience
science and technology required in handling and
related courses were operating equipment and
mandated for training in machinery that
different institutions in view are typically not available
of widening their horizons at their schools.
so as to enable them have Prior to the establishment
technical of this scheme, there was

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scheme to ITF in 1.4 AIMS AND

As a result, employers November 1984. It was OBJECTIVES OF SIWES
believed that theoretical taken over by the
education in higher Industrial Training Fund 1. To provide an avenue
education was (ITF) in July 1985, with the for students in the Nigerian
unresponsive federal government universities to acquire
to the needs of labor bearing entire industrial
employers. Thousands of responsibility for funding. skills and experience
Nigerians faced this during their course of
difficulty till 1973. The 1.3 SIGNIFICANCE OF study.
fund’s main motivation for SIWES 2. To prepare students for
establishing and designing the work situation they are
the scheme in 1973/74 The scheme was designed likely to meet after
was launched to expose students to graduation.
against this context. industrial environment and 3. To expose the students
enable them to work methods and
The ITF (Industrial develop occupational techniques in handling
Training Fund) competencies so that they equipment and machinery
organization decided to aid can readily contribute their that may not be available
all interested Nigerian quota to national, in their universities.
students economic and
and created the SIWES technological development
program. The federal after graduation. The
government officially major benefit accruing to
approved and presented it students who participate
in 1974. During its early conscientiously in
years, the scheme was Students Industrial Work
entirely supported by the Experience Scheme
ITF, but as the (SIWES) are the skills and
financial commitment competencies they
became too much for the acquire. The relevant
fund, it withdrew in 1978. production skills remain a
The National part of the recipients of
Universities Commission industrial training as life-
(NUC) and the National long assets which cannot
Board for Technical be taken away from
Education (NBTE) them. This is because the
were given control of the knowledge and skills
scheme by the federal acquired through training
government in 1979. The are internalized and
federal government become relevant when
handed over supervision required to perform jobs or
and implementation of the functions.

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● To make it ● Supervise
4. To allow the transition mandatory for all students on
phase from school to the ministries, Industrial
world of working companies and attachment.
environment easier parastatals to offer ● Accept and
and facilitate students’ places to students process Master
contact for later job in accordance with and Placement lists
placements. the provisions of from institutions
5. To provide students with Decree No. 47 of and supervising
an opportunity to apply 1971 as amended agencies.
their theoretical knowledge in 1990. ● Vet and process
in real ● Formulate policies students’ logbooks
work situation thereby to guide the and ITF Form.
bridging the gap between running of the
theory and practice. scheme nationally.

1.5 ORGANIZATIONS 1.5.2 The Industrial

INVOLVED IN THE Training Fund (ITF).
MANAGEMENT OF
SIWES PROGRAM AND This agency is to:
THEIR ROLES
● Formulate policies
The Federal Government, and guidelines on
the Industrial Training SIWES for
Fund (ITF), the distribution to all
Supervising Agency, the SIWES
National Universities participating
Commission (NUC), bodies.
Employers of labor and ● Provide logistic
Institutions have specific material needed to
roles to play in the administer the
management of SIWES. scheme.
The roles are: ● Organize
orientation
1.5.1 The Federal programmers for
Government students prior to
attachment.
● To provide ● Provide
adequate funds to information on
the ITF through the companies for
Federal Ministry of attachment and
Industry for the assist in industrial
scheme. placement of
students.

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1.5.2 The Supervisory The institutions are to:

Agencies (NUC, ● Adequate office
NABTEB, etc) ● Establish SIWES space and well
Directorate with a furnished
The NUC is: separate account,
adequately staffed
● To ensure the and funded to
establishment and ensure effective
accreditation of operation of the
SIWES scheme.
unit/Directorate in
institutions under The unit must meet the
their jurisdiction. following minimum
● To vet and requirements.
approve Master
and Placement lists Minimum Personnel
of students from Requirements
participating
institutions and ● A full-time
forward the same Head/Director of
to ITF. SIWES, rank
● Fund SIWES should not be less
Directorate than that of a
adequately in Reader in a related
participating discipline.
institutions. ● An Administrative
● To direct for the Office (to assist the
appointment of full- Head)
time SIWES ● At least 4 full-time
Coordinator/Directo Industrial
r. Coordinators to
● Review operate the
programmers scheme at
qualified from Institutional level
SIWES regularly. ● A
● Participate in the Secretary/Typist/D
Biennial SIWES ata Entry Clerk
conferences and ● A Driver
seminars in ● A Clerk
conjunction with
ITF.

1.5.3 Institutions Minimum Material

Requirements

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● A personal programs with the ITF and Institutions’

computer employers-based based supervisors
● A photocopying supervisor on the to visit the students
machine National Training on attachment and
● A separate SIWES Guidelines for each Grade students in
account course. the assessment
● A functional car ● Submit completed Form and the ITF.
ITF Form 8 to the
ITF.
● Submit
The Institutions will also do comprehensive
the following: reports on the
scheme to the ITF
● Appoint SIWES after the
Coordinator in programme.
Schools.
● Prepare and The Employers/Industry
submit Master and
Placement lists to ● Accept students
the respective and assign them to
coordinating relevant on-the-job
agency and ITF. training.
● Place students on ● Provide tailor-made
attachment with training
employers. programmes for
● Organize the students.
orientation ● Attach experienced
programmers for staff to students for
students to prepare effective training
them for industrial and supervision on
training. a ratio of 1:10 (staff
● Supervise students : students).
on attachment and ● Control and
sign their logbooks. discipline students
A minimum of three like permanent
visits should be staff.
made to the ● Provide medical
Students by the care for students
institution’s within the limit of
supervisors during employer
the period of conditions of
attachment. service.
● Work out industrial ● Permit
tailor-made representatives of

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The Students Director and the

SIWES Directorate.
● To attend
institution’s SIWES
orientation program
before going on
industrial
attachment.
● Comply with the
employer rules and
regulations.
● Keep proper
records of training
activities and other
assignments in the
logbook.
● Arrange their own
accommodation
during the period of
attachment.
● Submit Log Books,
Reports and other
documents related
to SIWES as
required by their
institution at the
end of the training
period.
● Submit to ITF
through their
institution,
Evaluation Form
(ITF Form 8)
completed by the
students, the
employer and the
institution.
● Avoid changing the
place of
attachment except
in special
circumstances and
with the permission
of your Centre

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CHAPTER 2 ● NHIA(National
Health Insurance
2. INTRODUCTION TO Agency).
FEDERAL MEDICAL ● Intensive Care
CENTER, UMUAHIA Unit.
(FMCU)
And many more including
HISTORY/ Public Health services like
BACKGROUND OF Immunization, Family
FEDERAL MEDICAL planning, Tuberculosis and
CENTER, UMUAHIA HIV care treatment and
support and morgue
services.

Figure 1: Image of Federal

Medical Center, Umuahia.

The Federal Medical

Center located in Owerri,
Imo state Nigeria is
classified as a tertiary
institution providing care in
major clinical services
including Obstetrics and
Gynecology, Pediatrics
Care, a well robust
Surgical unit that offers
care including General
Surgery, Orthopedic
surgery, Ophthalmology,
Pediatrics surgery,
Neuron-surgery.

Also offer emergency care:

● Accident &
Emergency.
● Family Medicine.
● Community Health.
● Laboratory.

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In addition to these, the The Federal Medical skilled healthcare

organization offers training Centre, Umuahia, stands professionals, the center
for undergraduate and as a beacon of hope and offers a wide range of
post graduate interns. healing for residents of the medical services, including
region and beyond. primary care, specialized
Established to provide treatments, and
2.1 HISTORY AND quality healthcare emergency interventions.
BACKGROUND OF FMC, services, education, and
UMUAHIA research, this institution In addition to its clinical
has become a cornerstone services, the FMC,
The Federal Medical of the healthcare Umuahia, plays a vital role
Center Umuahia, is a landscape in southeastern in medical education and
tertiary health institution Nigeria. training. Affiliated with
structured mainly into two reputable medical schools
broad arms of clinical and It was renamed Ramat and training institutions,
non-clinical division, Its Specialist Hospital in the center serves as a
responsibility is primarily honor of the late slain teaching hospital,
the provision of advance Head of State, General providing hands-on
surgical and medical care Murtala Ramat learning experiences for
to patients, as well as part Mohammed. During the medical students, interns,
grade waste and first republic, under the and resident doctors.
internship training administration of the late
programmes. Chief Sam Mbakwe,
Governor of the old Imo
The Federal Medical State, it reverted to its
Centre, Umuahia was original name, Queen
established in 1945. The Elizabeth Hospital. It thus
hospital was formerly became the Federal
known as Queen Elizabeth Medical Centre (FMC),
Specialist Hospital, Umuahia, on its takeover
Umuahia, and was in November 1991. It is the
renamed to Federal first FMC to be so
Medical Centre, Umuahia recognized.
in November 1991. It
metamorphosed from the Since its inception, the
Queen Elizabeth Hospital Federal Medical Centre
which was commissioned (FMC), Umuahia, has
on March 24, 1956 by Sir been committed to
Clement Pleas delivering comprehensive
representing Queen and compassionate
Elizabeth the Second of healthcare to patients from
England. diverse backgrounds.
Equipped with modern
facilities and staffed by

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2.2 ORGANOGRAM/
ORGANIZATIONAL
FEDERAL MEDICAL
CENTER UMUAHIA

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CHAPTER 3 attentiveness, and the 3.2 NATIONAL

opportunities and activities PROGRAMME ON
3. MAJOR EXPERIENCE that would be made IMMUNIZATION ( NPI )
GAINED AT FEDERAL available to me as an UNIT
MEDICAL CENTER, intern in Community
UMUAHIA. Medicine. The National Programme
on Immunization was the
3.1 Realizing the stipulated first department of my
INTRODUCTION/ORIENT number of months for my posting according to my
ATION internship, he created a schedule, which was a
schedule for me to follow span of a month.
Upon arriving at the during my stay, ensuring
Federal Medical Center, that I could learn On my first day of
Umuahia, I was directed to extensively from all resumption as an intern at
my supervisor, Dr. Metu aspects of the core the Federal Medical
Kingsley, who serves as department in the Center, Umuahia, Dr. Metu
the IT Coordinator for specialist hospital. The Kingsley, my IT supervisor,
Community Medicine and departments I would be took me to the
holds the position of Head interning in include: department's director for a
of the Department of brief introduction and
Community Medicine. ● National handover. The director
Programme on overseeing the activities of
He welcomed me into his Immunization Unit the department, Nurse Uka
office, where introductions (NPI). Okali, took off from there.
ensued. I introduced ● Family Planning She gave me a brief
myself as the intern, and Unit. lecture on what the
he did the same as my IT ● Directly Observed department deals with.
supervisor. I presented a Therapy
copy of my IT letter and (D.O.T)/Kirk Ward
the approved letter of my Unit.
posting. ● Tuberculosis Unit. Figure 2: Image Of
● Heart to Heart National Programme On
From that point onward, (ART Clinic) Unit. Immunization (NPI) unit.
orientation commenced. Each department is
Dr. Kingsley provided headed by a director. As
briefings on what my part of my learning curve
internship would entail, and schedule, I was to
highlighting key intern around the
prerequisites and departments, spending a AIMS AND OBJECTIVES
modalities for my time at month in each department OF NATIONAL
the hospital. He and a maximum of two PROGRAMME ON
emphasized the weeks in each unit of each IMMUNIZATION
importance of promptness, department.
diligence, rapt

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1. To achieve and
maintain a high
immunization
coverage rate,
especially for
childhood
vaccines, across
the entire
population.
2. To reduce
morbidity, mortality,
and disability
caused by vaccine-
preventable
diseases through
the provision of
free, universal
immunization
services.
3. To ensure the
reliable and
effective
distribution,
storage, and
management of
vaccines supplied
through a strong
cold chain system.

COLD CHAIN SYSTEM

The cold chain system is a

system whereby the
vaccine is maintained at a
standard temperature from
the manufacturer to the
producer. It is essential for
preserving the potency
and effectiveness of the
vaccine. The required
temperature for the
storage of the vaccine is
+2°C to +8°C.

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Figure 3: (a & b ): Image of caregiver arrives at the

cold chain system used in immunization unit, they
preserving vaccines. present the child's
immunization card. The
staff then collects the card
and reviews the
information to determine
which vaccines are due
REGISTRATION AT based on the child's age.
IMMUNIZATION UNIT The appropriate vaccine is
then documented in the
The immunization unit at corresponding sections of
FMC primarily operates the card. It is crucial that
immunization services on the immunization card is
Tuesdays and present and that the
Wednesdays. This is the administered vaccines are
designated time when properly recorded in the
caregivers bring their card. This ensures a
children to the comprehensive and up-to-
immunization unit for date record of the child's
vaccination. During the immunization history.
child's birth, the caregiver
is issued an immunization
card. This card serves as
the child's vaccination
history. The card includes
details such as:

● The child's name

● Birth weight
● Date of birth
● Gender
● Mother's name
● Father's name
● Contact information
● Card identification
number, etc.

The card has columns to

document the various
vaccines administered to
the child from birth to 2
years of age. When the

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Figure 4: (a & b): Diagram

of Immunization Cards (a)
front and (b) back

VACCINES

Vaccines are prepared

antigens which stimulate
antibody production by a
person when introduced
into his or her body.

Figure 5: Image of
vaccines used

TYPES OF VACCINES
FREEZABLE VACCINES:
These vaccines requires
storage and transportation
at ultra-low temperature,
they can withstand being
frozen. They are stored in
freezer. Examples include;
Rota, Measles, BCG,
Yellow fever etc.

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motheres who gave birth

newly, and then every six
NON-FREEZABLE months till 5 years, the
VACCINES: They are child takes vitamin A. The
vaccines that are sensitive routo of administration
to freezing temperature includes;
and should never be
allowed to freeze. They
are stored in fridge.
Examples include; Penta,
Hepatitis B, Tetanus
diphtheria, pneumococcal
Conjugate vaccine (PCV)
etc.

MY EXPERIENCE
DURING THE
IMMUNIZATION OF
BABIES

Here, babies from 0-18

months are immunized
against childhood
preventable diseases. The
vaccines that are given are
BCG( Bacillus Calmette
Gueria) to prevent
hepatitis B, Pentavalent
which is a 5 - in -1 vaccine
to prevent Diphtheria,
Tetanus, Pertussis,
Hepatitis B, and
Hemophilus influenza B,
Measles 1and 2 vaccines
to prevent measles, Yellow
fever vaccine to prevent
yellow fever, Men A to
prevent Meningitis,
PCV( pneumococcal
Conjugate vaccine) to
prevent pneumonia.
Vitamin A is also given to

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Figure 6: The blue and red milk has three layers which
vitamin c ● If the baby's includes; the first layer
temperature is contains 75 - 85% of
normal, administer water, the second layer
paracetamol or contains the small
panda every 8 nutrients and the third
PRECAUTIONS hours for 2 days. layers contains the main
RECOMMENDED FOR ● If the fever persists nutrients.
MOTHER'S AFTER THE or increases, bring
ADMINISTRATION OF the baby back to She went further
VACCINES ON THEIR the immunization explaining that a nursing
BABIES unit for further mother should eat more of
evaluation. vegetables, fruits, Pap
After a bady receives a which is very good for
vaccine, it is commonly for Figure 7: Image of a baby lactation. Breast milk also
them to experience mild - receiving a vaccine contains antibodies and
side affects such as fever, immune factors that help
pain or irritability. It is protect the body against
important for the mother to MY EXPERIENCE infections and diseases,
closely monitor the baby DURING THE HEALTH reducing the risk of
and take the appropriate TALK ON respiratory infection, ear
steps to manage these BREASTFEEDING TO infections, allergies and
side effects and ensure THE NURSING gastrointestinal issues.
the baby's comfort. MOTHERS Breastfeeding is also
● Administer beneficial for the mother. It
paracetamol or At National Programme stimulates oxytocin, which
panda ( a type of On n Immunization (NPI), is a hormone that
analgesic for The chief matron, Nurse promotes bonding with the
babies) to reduce Uka Okali, Overseeing the baby and helps the uterus
pain and fever. activities of the unit, held a contract, reducing
● Give the first dose health talk on exclusive postpartum bleeding. It
immediately after breastfeeding to enlighten also aids in the production
the vaccine and widen their of the breast milk.
administration. knowledge.
● Repeat the dose
after 6 hours Breastfeeding is the
● If the baby's body natural and beneficial way
temperature is still to nourish and bond with
high after the your baby. It provides the
second dose, give combination of essential
another dose of nutrients, antibodies and
paracetamol or enzymes that support the
panda. body's growth and
development. The breast

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EXCLUSIVE ● It helps create a 3.3 FAMILY PLANNING

BREASTFEEDING strong bond UNIT
between the
Exclusive breastfeeding is mother and infant. Family planning refers to
the recommended way of ● It can help the the ability of individuals
feeding infants up to 6 mother's uterus and couples to anticipitate
months of age. It refers to return to its pre- and attains their desired
the practice of feeding pregnancy size and number of children and the
infant only breast milk, and may reduce the spacing and timing of their
no other liguids or solids, risk of postpartum birth by achieving that
with the exception of depression. through adhering to certain
vitamins, minerals, or rules and regulation as
medicines. control methods.
PROPER WAY OF
IMPORTANCE OF BREASTFEEDING A BENEFITS OF FAMILY
EXCLUSIVE BABY PLANNING
BREASTFEEDING:
● A nursing mother ● It makes the
● Exclusive should have a seat mother healthy.
breastfeeding is with a back seat to ● The children will
the recommended avoid pains while receive appropriate
way of feeding breastfeeding. care and training.
infants up to 6 ● The head of the ● Reduction of
months of age. baby will be at the overpopulation /
● It provides infants elbow joint, and the overcrowding.
with all the other hand will be ● It reduces ultra
nutrients they need at the bottom of the urethra deformity.
for healthy growth baby. ● It reduces maternal
and development. ● Then, while and infant death.
● Breast milk breastfeeding the
contains antibodies baby, make use of
that help protect the four fingers to
infants from hold the breast and Figure 9: Diagram of
common childhood the big thumb to different family planning
illnesses like push the nipple up, methods used in
diarrhea and while breastfeeding counseling client.
pneumonia. the baby.
● Exclusive METHODS OF FAMILY
breastfeeding has PLANNING
been shown to
reduce the risk of Figure 8: Image of a ● Hormonal
sudden infant mother breastfeeding the ● Mechanical
death syndrome baby.
(SIDS). HORMONAL METHODS

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They are known as

hormonal because they
tend to affect the
hormones of the individual
and prevent pregnancy.
And generally hormonal
will have to stay at least 7
days before an individual
will engage in sexual
intercourse under this
category we have;

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Figure 10: Images of contains only

Family planning methods Progestin.
used in counseling a client

ORAL
CONTRACEPTIVES: The INJECTABLES: These are
oral contraceptives are injected into the body and
short acting reversible administered
contraceptives. It is known subcutaneously and for
as "forget me not" which is some Intra-muscularly e.g.
taken once every day at a Sayana press (13 weeks)
stipulated time. They are administered
in two types, combined subcutaneously, Depo-
oral contraceptives and Provera (Imonth -
progestin only. 3months), Noristerat
(8weeks) intra-muscular.
● Combined oral
contraceptives
(coc): This is oral IMPLANTS: They are
contraceptives that known as long acting
contain oestrogen reversible contraceptives
and Progestin. It is e.g. Implanon (3years) one
not recommended rod contraceptive and
for breastfeeding jadelle (5 years) two rod
mothers due to the contraceptive. They are
oestrogen inserted at the left upper
component in the arm.
combined oral
contraceptives that
reduced the supply
of breast milk. Figure 11: images of
● Progestin only: implants used in family
This is another planning.
type of oral
contraceptives,
suitable for
breastfeeding
mothers but can
also be a viable
option for other
individuals,
including those
who are not
breastfeeding. It

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NON- HORMONAL I Exclusive

MECHANICAL breastfeeding can
METHODS be an effective
temporary method
Mechanical methods of of contraception,
family planning are known as the
physical barriers or Lactational
devices that are used to Amenorrhea
prevent pregnancy by Method
blocking or interfering with (LAM).However;
the fertilization process. exclusive
They are known as Intra- breastfeeding is
uterine contraceptive not a reliable
device (IUCD) and they method of family
are implanted at the planning for
vagina of a woman. everyone.
● Vasectomy:
CATEGORIES OF NON- permanent
HORMONAL/ contraception for
MECHANICAL male sterilization.

● CONDOMS: 99% OTHER ASPECTS OF

safe, safe from FAMILY PLANNING
STI,. Condoms
consist of the male ● Sex education
and female ● Infertility
condoms.The male management
condoms (Late ● Post conception
inserter, early counseling
remover), Female ● Pre-conception
condoms (Early counseling
inserter, late
remover).

Figure 12: (a&b): Images

of condoms (a) male
condom and (b) female
condom.

● Exclusive
breastfeeding:

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smoking pattern,
THE USE OF "GATHER" insert horizontally.
IN COUNSELING A NEW ● Observe position of
CLIENT the cut (Cooper
Tee) through the
Here in FMC Umuahia, a string.
new person coming into ● Observe the color
the family planning unit is of the discharge.
called a client and not a ● Check if the
patient due to the fact the discharge has bad
person is not sick at all. odor.
This is sa method used to ● If the patient
start a counseling process experiences pain
with a new client coming or not.
into the unit for the first ● If there is any sign
time, they are; or infection.

G- Greetings IMPLANON REMOVAL

A - Ask questions ● Put on gloves

● Clean up the
T- Tell her all you have surface with salvon
and disinfectant
H- Help her to find the with methylated
right choice spirit to clean of.
● Dilute 2ml of
E - Explain lidocaine with 2ml
of injection water.
R- Revisit

REVIEW OF COPPER
TEE (IUD)

This is also known as Cut

380 A.

● Obtain consent
from the patient.
● Disinfect the area
of the insertion.
● Using the cusco
vagina speculum in
a Cigarette

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● Infiltrate under the intake process for a client

rod, during coming in for an implanon
infiltration pull back implant removal, I checked
the nozzle of the and recorded the patient's
string, T any seen vital signs, with the
withdraw but if not patient's permission, I
seen infiltrate followed the nurse into the
completely. insertion room to observe
● Wait a little, and the implanon implant
then touch the area removal . In the room, the
in which vou nurse first located the
infltrate and ask existing implant, cleaned
the patient if there the area with salvon and
is any pain, if not methylated spirit and a
you discontinue. sterile tool ( mosquito
● Using your artery forceps) was used
mosquito artery to carefully extract it.
forceps, twist and Throughout the process,
slightly remove the the nurse communicated
implantation with clearly with the patient,
Savon. addressing any questions
● Clean the site for or concerns. I was able to
excess bleeding observe the nurse' skilled
that can cause and compassionate
blood. approach in performing
● Use your swab to this procedure. After the
clean for cross new Jadelle implant was
infection. successfully inserted, I
● Finally, use salvon helped apply a bandage
and plaster to close and provide the patient
to avoid cross with aftercare instruction.
infection.
● Then, the patient Figure 13: Images of a
will wait for 4 days client that is undergoing
for the removal of implanol remnoval
the plaster.

MY EXPERIENCE
DURING THE REMOVAL
OF IMPLANON

At the family planning unit,

I was fully involved by
assisting the nurse in the

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3.4 EXPERIENCE reason for this close provided with a

GAINED AT DIRECTLY monitoring of the patients treatment plan that
OBSERVED THERAPY is to identify and address includes specific
(D.O.T) KIRKWARD UNIT any challenges or barriers medications,
that patients may face dosages and
MY EXPERIENCE AT during the treatment duration of
DIRECTLY OBSERVED process. treatment.
THERAPY (D.O.T) Tuberculosis
At the Directly observed patients have a
It was the commencement therapy unit, I was taught stipulated time
and start of resumption at to know the reason for the which is one hour
my new department, unit. The reasons for every day before
directly observed therapy directly observed therapy having the meal.
Department, in a bid to unit included; ● Documentation:
expand the awareness of The date, time,
Tuberculosis, curtail its ● Rationale: Here, medication name,
spread and get infected we have patients and other relevant
persons into prompt that may struggle observations are
treatment, the Department to consistently take recorded to help
of Tuberculosis assigned their medication as track treatment
me to this very department prescribed, which progress and also
to have a vast knowledge can lead to identify any
of tuberculosis. Directly treatment failure, potential issues or
observed therapy unit by directly concerns.
work in hand with observing ● Proper Education/
Kirkward, the place TB medication intake, Counselling:
patients are taken care of. D.O.T aims to Enough health
overcome these education is given
THE MEANING OF issues and improve to the patients in
DIRECTLY OBSERVED the treatment order to take their
THERAPY (D.O.T) outcomes. treatment seriously,
● Diagnosis: This is to avoid or prevent
Directly observed therapy also the very place critical conditions.
is a method or drug they are fully ● Treatment
administration on which a diagnosed, which completion: Here,
healthcare professional involves a series of the patients
watches as a person takes examination, continue the
each dose of a medication medical history treatment regimen
and ensures that the review, physical provided by the
patients complete their full examination, and D.O.T unit till the
course of treatment, which chest x-ray and full course of their
is crucial for the effective sputum tests. treatment is
management of diseases ● Treatment plan: completed.
like tuberculosis. The The patient is

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Figure 14: A TB client

receiving medications. PULMONARY
TUBERCULOSIS: This is
In this unit, other cases the common form of
are reported and treated tuberculosis, which
too, they includes; dog primarily affecta the lungs.
bites, rape cases etc. The It occurs when the
reason is for medication Mycobacterium
adherence, complex tuberculosis bacteria infect
treatment regimens, high the lung tissues.
risk populations, intectious
diseases, mental health EXTRA-PULMONARY
conditions etc. TUBERCULOSIS: It refers
to the tuberculosis
MY EXPERIENCE AT infection that occurs
KIRKWARD outside the lungs and can
affect various organs like
Here in kirkward, this is spine, bone etc.
the place where patients
that are reported to be PREDISPOSING/RISK
critically ill are referred to, FACTORS OF
for proper medical TUBERCULOSIS
attention to be given to
them for Proper ● Malnutrition.
enhancement of their ● Chronic Steroid
standard health level. Intake.

OVERVIEW OF
TUBERCULOSIS

Tuberculosis (TB) is a
chronic infectious disease
characterized by air-borne
caused by the bacterium
Mycobacterium
tuberculosis.

SITE OF
TUBERCULOSIS

● Pulmonary
tuberculosis
● Extra- pulmonary
tuberculosis

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● HIV. administered which

● Diabetes. ADMINISTRATION OF are; Rifampicin,
● Overcrowding/Poor TREATMENT FOR Isoniazid,
Ventilation. TUBERCULOSIS pyrazinamide and
PATIENTS Ethambutol.
These factors are hence
characterized as a result The Pulmonary
of low immunity. tuberculosis patients take
their drugs for 6months,
SYMPTOMS OF while that of the extra
TUBERCULOSIS pulmonary tuberculosis
patients are placed on
● Persistent cough of treatment for duration of
about two weeks or one full year. The intake of
more. the drug administration
● Weight loss. given to any Tuberculosis
● Persistent low- patient starts from 6-7am,
grade fever. which is a one hour
● Profuse night interval before they can
sweat. have their meal. The
● Coughing out D.O.T ( Directly observed
blood. therapy) being associated
● Loss of appetite with the Kirkward carefully
watches how the patient
IMPORTANCE OF takes their drugs, to know
TUBERCULOSIS if they are taking it
consistently without
A single case of untreated skipping any, to improve
TB can affect 10-15 their health.
persons with TB in a
space of one year. The TREATMENT PHASES
importance of TB is to FOR TUBERCULOSIS
prevent the incessant
spread of the disease to ● INTENSIVE
the overall population by PHASE: This is the
applying primary first treatment
prevention against the given to a
spread of TB, and as well tuberculosis patient
reduce the predisposing and it lasts for a
factors which include: period of 2months.
health education, contact The intensive
tracing, TB Screening, etc. phase which is the
treatment phase;
four drugs are

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● CONTINUOUS one hour interval

PHASE: The every day.
continuous phase
being the final
stage. It lasts for
the period of
4months, which DIAGNOSIS BEFORE
involves the TREATMENT
administration of
two fixed drugs, ● Genexpert: This is
and they includes; used for the rapid
Rifampicin and and accurate
Isoniazid. When a diagnosis of
patient is resistant, infectious
it is usually diseases, such as
Rifampicin. tuberculosis.
● Chest x-rav: It is
used to assess the
Figure 15: Images of drugs conditions of the
given to TB client lungs, heart, blood
vessels and other
HEALTH EDUCATION structures within
GIVEN TO A NEW the chest.
PATIENT BEFORE THE ● Maenetic
ADMINISTRATION OF resonance imaging
THE DRUGS (MRI) : It is a non-
invasive medical
● Avoidance of imaging technigue
alcohol. that uses a
● Consistent intake powerful magnetic
of drugs. cross- sectional
● Avoidance of images of the
smoking. body, and it detects
● Eating enough Extra-pulmonary
fruits and tuberculosis.
vegetables.
● Report adverse
effect to the doctor.
● Having a stipulated
time for the intake
of drugs which is 6-
7am before
breakfast, and is a

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● Sputum test: It is units who gave me a warm

also known as welcome as an intern. The
sputum culture that units I visited include:
analyzes a sample
of sputum, which is ● The
the mucus Counseling/Adhere
coughed up from nce Unit
the respiratory ● The HIV Testing
tract. Services (HTS)
● The Strategic
Figure 16: A referral form Information Unit
for presumptive childhood ● The Vital Signs
adult TB cases. Check-up Unit
● The Viral Load
Testing Unit
● The Monitoring and
Evaluation Unit

3.5 HEART TO HEART

DEPARTMENT
(ART CLINIC)

INTRODUCTION/
ORIENTATION

It was the commencement

and start of resumnption at
my new department,
HIV/AIDS Departmnent.
The department comprises
of different units with
specific roles under the
department to meet the
vision and mission
statement of the
department. I was taken
round these units by the
director, and introduced to
the members of staff
working in the different

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HUMAN IMMUNO-
DEFICIENCY TRANSMISSION OF HIV
VIRUS/ACQUIRED INFECTION
IMMUNE DEFICIENCY
SYNDROME. HIV infection can be
transmitted by:
HIV means; Human
Immuno-deficiency Virus. ● Through blood
It is a virus that attacks the transfusion with
human immune system infected needles.
through the CD-4 cells ● Sexual contact with
which are the defense any infected
mechanism that person which
guarantees immunity in includes; anal, oral
the body. Here in Federal and vaginal sex.
medical center Umuahia, ● Through sharing of
HIV client are referred to unsterilized needle.
as RVD patients so as to ● Through contact
prevent stigma which is with infected blood
not widely recognized or materials.
established in relation to ● Through vertical
HIV. transmission (from
mother to child).
AIDS means; Acquired
Immune Deficiency
Syndrome. It is the NB: HIV infection cannot
complicated or advanced be transmitted through
condition of the HIV surface skin contact or
infection. inhalation.

RISK FACTORS OF HIV infection cannot be

HIV/AIDS transmitted through insect
bites.
High Risk Factors of HIV
Infection includes:
● Multiple sex
partners
● Prostitutes (Female
sex workers)
● Homosexuals
● Unprotected
transfusion of
blood and blood
products.

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STAGES OF HIV ● CD4 cell count is ● Do not squeeze or

INFECTION reduced to less run the injury.
than 200 cells pee ● Allow the blood of
● Acute Stage: The cubic millimeters. the patient flow
acute stage ● Advanced HIV freely.
involves people disease manifest. ● Wash the exposes
exposed d for the area with soap and
first time and running water. NB:
comes up with flu- WHO IS AN INDEX For exposure
like symptoms after CLIENT through splash.
10 days of rinse off the
exposure. Within An index client is a new exposed area.
this stage, the rate client that is tested HIV ● Report the
of transmission and positive for the first time. exposure to the
multiplication is Post test counseling is PEP officer.
very high. given to the person when ● Give PEP if
tested positive to come for eligible.
● Chronic stage: It is another confirmatory test
called result in the next three
asymptomatic months.
stage. In this stage,
all the flu-like MANIFESTATION OF HIV
symptoms INFECTION
disappear. During
this stage, the The infection starts to
immune system manifest when the viral
starts fighting the load in the body of the
virus and viral load infected person is high.
in the blood starts
coming down. INCUBATION PERIOD

● Aids stage: It is The incubation period of

called advanced the HIV varies, but the
stage of HIV, average period is 10 years
during this stage, or longer. This average
opportunistic period is shorter in infants
infections manifest. than in adults.

Adverse effects in Aids STEPS TAKEN WHEN

stage includes: THERE IS AN
EXPOSURE THROUGH
● Viral load is above NEEDLE PRICK
1000.

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 34

VIRAL LOAD antiretroviral

therapy. Their viral
Viral Load is the amnount load is very low but
of virus resident or present is not completely
in the blood of an HIV suppressed to
infected person. undetectable
levels. Their viral
Figure 17: A viral load load is from 50 etc.
chart
● Target not
detectable
FOUR TYPES OF HIV (TND):The TND
CLIENT client are known as
undetectable,
● Suppressed client: because their viral
They are those that load is very low, till
have a suppressed the extent of
viral load due to discovering any
their effective trace of f virus.
antiretroviral There is zero risk
therapy. They are of HIV transmission
consistent with during sex. Their
their medication, viral load is 0.
causing their viral
load to be low from DISCORDANT COUPLE
20, 30 etc.
Discordant couple: They
● Unsuppressed are referred as sexual
client: They are not partners in whom one has
consistent with a sexually transmitted
their antiretroviral infection and the other
therapy, causing does not. The couple is
their viral load to either tested positive of
be high from 1000- HIV and the other partner
above. is tested negative.

● Low level Viremia EXCRETION OF HIV

(LLV): It refers to INFECTION
the presence of
detectable but HIV infection is excreted
relatively low levels through body fluids such
of HIV in the blood as: blood, semen (sperm),
of the individuals breast milk and saliva.
who are on

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HIV IN PREGNANCY transmission. In ● They prevent

(PREVENTION FROM some cases, a transmission from
MOTHER TO CHILD cesarean section mother to child.
TRANSMISSION) delivery may be ● They provide
recommended to support to mother
This comprises of how HIV minimize the child's and child.
positive mothers are taken exposure during
care of when pregnant and birth. THE TWO TYPES OF
how to take care of their ● Breastfeeding: for BABIES INVOLVED IN
child from birth. certain infections, it PREVENTION FROM
may be advised to MOTHER TO CHILD
The main ways to prevent avoid TRANSMISSION
trannsmission from mother breastfeeding or to (PMTCT)
to child include: take specific
precautions, such 1. LOW-RISK
● Prenatal Care: as pasteurizing the BABIES
Ensuring the breast milk, to
mother receives prevent These are babies
regular prenatal transmission born to mothers
checkups and care through this route. who do not have
is crucial. ● Testing and any known
● Medication: Monitoring: infections that can
Depending on the Regular testing of be transmitted to
specific disease, the mother and the child.
the mother may be newborn, as well
prescribed as ongoing For these low-risk babies,
medications during monitoring can the focus is on:
pregnancy or help catch any
during delivery to infections early and ● Routine prenatal
reduce the risk of enable prompt screening and
transmission to the treatment to testing of the
child. For example, mitigate the risk of mother to identify
in the case of HIV, transmission. any infections
antiretroviral early.
therapy is
recommended for
pregnant women to THE PILLARS INVOLVED
lower the viral load IN PREVENTION FROM
and prevent MOTHER TO CHILD
transmnission.
● Delivery Method: ● They prevent
The mode of unintended
delivery can impact pregnancy.
the risk of

35
 36

● Ensuring the ● Considering

mother receives delivery methods For low-risk babies:
appropriate that may minimize
vaccinations (e.g.. the risk of ● The focus is on
influenza, transmission administering the
pertussis) to ● Carefully managing recommended
protect the baby. infant feeding to vaccinations and
● Administering prevent conducting routine
recommended transmission newborn screening
vaccinations and through tests.
prophylactic breastfeeding if
medications to the necessary. 2. 11 months after birth:
baby after birth. ● Closely monitoring This is the stage for the
● Closely monitoring and testing the mid test when the baby
the baby's health baby after birth to have stopped
and development ensure timely breastfeeding.
for any signs of intervention if
infection. needed. For high-risk babies:

2. HIGH-RISK THE MANAGEMENT ● Diagnosis testing is

BABIES AND TESTING OF repeated to confirm
THESE BABIES whether the baby
ase are babies INVOLVES THE has become
born to mothers FOLLOWING: infected or
who have been remained
diagnosed with an 1. Immediately after birth: uninfected.
infection that can At this stage, they are
be transmitted from given Nevirapine /
mother to child. Abacavir within 72hours of
birth; it acts as PEP (Post
for these high-risk babies, Exposure Prophylaxis) for
the prevention strategies the babies.
are more intensive and
focused on: For high-risk babies (born
to mothers with known
● Providing the infections):
mother with
appropriate ● The baby may
treatment and receive
management of the prophylactic
infection during medications or
pregnancy (e.g-, vaccinations to
antiretroviral provide immediate
therapy for HIV). protection.

36
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For low-risk babies: ● Dementia;

● High risk Mothers: Advanced level of
● Routine well-child They are mothers HIV
visits and that notice the virus ● Oesophagal
vaccinations during labor or one Candidaisis
continue, but no month to delivery. ● Herpes Zoster
specific disease- (Shingles)
related testing is ● Stable Mothers:
typically required at They are those that
this stage. their viral load is
low and CD4 cell is
high.
3. 18 months after birth:
This is the final stage for OTZ (OPERATION
the test and the use of TRIPLE Z)
Determine (HIV testing
stripe) is used on them, to ● Zero- Missed
know the final result. appointments

For high-risk babies: ● Zero - Missed

drugs
● A final round of
diagnostic testing ● Zero - Viral load
is conducted to
definitively
determine the SYMPTOMS OF HIV
baby's infection INFECTION
status.
Constitutional Symptoms:
For low-risk babies: This is also called Febrile
lliness. It often looks like
● Routine well-child malaria which is the early
care and signs of HIV infection, and
vaccinations it includes: fever,
remain the focus. headache, weakness and
with no additional fatigue.
disease-specie
testing needed at ● Lymph Atenopathy
this stage. (Enlargement of
the lymph nodes)
● Oral Thrush (Oral
TWO TYPES OF Candidaisis); which
MOTHERS INFECTED can be diagnosed
WITH HIV using spatula

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TOOLS USED IN HEART

● Kaposis Sarcoma TO HEART
DEPARTMENT (ART
AIMS OF ADHERENCE CLINIC)
UNIT
● HTS client intake
● Sustain viral form: This is used
suppression in counseling.
● Enhance immune
recovery ● HTS Register: This
● Improve the quality is used for full
of life and health documentations of
conditions. clients.

FACTORS THAT LEADS ● Request and result

TO POOR ADHERENCE form: This i is used
only for tested HIV
● Distance client.
● Staff attitude
● Lack of education ● Referral form: It is
● Stigmatization s : also another
● Lack of social type of form used
support to refer client that
are tested HIV
positive.

5 C's OF COUNSELLING
USED IN ADHERENCE /
COUNSELLING UNIT

● C- Confidentiality

● C- Consent

● C- Proper
counselling

● C- Correct result

● C- Connection to
care

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● Index testing or clients with their

service register: test result.
This is used to
collect information ● Cotton wool Figure 18: An image of a
from index client, to soaked in liquid client undergoing a a
assist them in spirit; Used for screening HIV test.
getting their partner cleaning the tip of
and children the finger to be
tested. pricked or
punctured.
HIV MONITORING
PARAMETERS ● Hand Glove; Used
by the test officer
● Viral load during the test
● CD4 cell count process.

MATERIALS USED FOR VALIDITY OF A TEST

HIV TEST USING BLOOD
AS SAMPLE ● A valid HIV test
result is when the
● EDTA Capillary; test kit shows a
Used for blood minimum of one
collection. line on the part of
the control line. An
● Lancet; Used for invalid result is a
pricking the result that does not
individual's finger, contain the control
usually the thumb line. A reactive test
or index finger. result is one that
shows double lines
● Buffer Solution; on both the control
Used on the blood and test part of the
collected to prevent kit. A non-reactive
quick clotting of the test result shows
blood and allow for no line at all on the
the movement of control and test
the blood on the part.
test strip.
● When the line on
● HIV Test Strip. the test part is very
faint, then the
● Intake Form; Used result is suspicious
for filling in the and should be
details of patients repeated.

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PREVENTION OF HIV reduction, persons who are

INFECTION adherence, etc. accidentally
exposure to
HIV infection can be ● Structural potential risk of
prevented through; Intervention: This acquiring HIV
has to do with within 72hrs
● Combination policies, rules and (3days) of
Prevention: It is regulations, exposure.
defined as the use cultures that help in
of HIV testing, the prevention of SIMILARITIES BETWEEN
condom use, HIV infection. PREP AND PEP
VMMC (Voluntary
Male Medication PREP AND PEP ● Both are used by
Circumcision), use PROPHYLAXIS HIV uninfected
of ARVs (Anti- persons.
retroviral drugs), ● PREP: This stands
PREP for Pre Exposure ● Both use ARVs to
(PreCunosure Prophylaxis. It is prevent HIV
Prophylaxis), PEP defined as the use acquisition.
(Post Exposure of anti-retroviral
Prophylaxis), ARTs drugs by HIV ● Both are effective
(Anti-retroviral uninfected persons when taken
Therapy), PMTCT to prevent the correctly and
(Prevention of acquisition of the consistently.
Mother-To-Child virus before
Treatment), STI exposure to HIV. ● Both are available
(Sexually by prescription by
Transmitted ● PEP: This stands clinical providers.
Infection) for Post Exposure
Treatment for the Prophylaxis. It is DIFFERENCES
prevention of HIV defined as the BETWEEN PREP AND
disease. short-term use of PEP
anti-retroviral
● Behavioral treatment to reduce PREP
Prevention: This the likelihood of
has to do with the HIV infection after ● PREP is started
behavior of the potential exposure, before potential
people in order to either exposure.
prevent the spread occupationally or
of HIV infection. through sexual
Examples include: assault.
education,
counseling, stigma ● PEP is given as
education, harm soon as possible to

40
 41

● it requires ongoing with flu-like

use as long as the symptoms).
individual is S
exposed to
potential risk of HIV
infection.

PEP LAB DIAGNOSIS OF HIV

● PEP is taken after ANTIBODY TEST:

exposure,
● This is the most
● It is taken for a common type of
period of 28 days HIV test.
(1 month), and it's
taken within 72hrs ● It looks for the
after exposure. presence of
antibodies against
NB: Window Period is the HIV virus in the
defined as the period blood.
when an HIV infected
person is being tested but ● Antibodies are
the result shows negative, proteins produced
yet the virus is present in by the body's
the body of the person. It immune system in
is usually not beyond response to an
3weeks. infection.

ELIGIBILITY FOR PREP ● Most people

develop HIV
● The person must antibodies within 2-
be HIV sero- 8 weeks after initial
negative. infection, though it
can take up to 3
● There should be no months in some
trace of Acute HIV cases.
Infection (It is
defined as the
early phase ot HiV
infection which is
characterized by
high vitamin, and
sometimes comes

41
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● Antibody tests are DIFFERENCES

generally very ● NAT tests can BETWEEN
accurate once identify HIV ANTIRETROVIRAL
enough time has infection much VACCINE (ARV) AND
passed for earlier than THERAPY (ART)
antibedies to antibody tests,
develop. often within 1-2 ● ARV is a drug used
weeks of initial to manage HIV
ANTIGEN/ANTIBODY infection. patients.
(COMBO) TEST:
● NAT is sometimes ● ART is used when
● This test looks for used to confirm a ARV is used to
both HIV positive antibody or gather a
antibodies and the antigen/antibody therapeutic
HIV p24 antigen. test result. outcome.

● Combo tests can

detect HIV infection
earlier than HIV VACCINE
antibody-only tests,
often within 2-4 They are Vaccines that
weeks of initial Induce an immune
infection. response that can control
HIV replication and
● They are disease progression in
considered more those already infected.
sensitive for acute They include;
HIV infection when
antibody levels ● Therapeutic
may not yet be Vaccine: It is
detectable. designed to
improve the
NUCLEIC ACID TEST immune system of
(NAT): the body, thereby
helping the body to
● This is the most suppress the virus.
sensitive type of
HIV test. ● Preventive
Vaccine: As the
● It directly detects name implies, they
the genetic are used to prevent
material (RNA or the virus.
DNA) of the HIV
virus itself.

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VIRAL PARTICLES Some viruses, such as foods and taking fruits

HIV, influenza, and frequently, amongst
A viral particle, also known herpes, have an additional others, scheduling of next
as a virion, is the lipid bilayer membrane appointments for
complete, extracellular
form of a virus that is called an envelope. follow-up visitation, as well
as initiation to treatment
capable of infecting a host The envelope is derived for newly HIV infected
cell. It consists of the from the host cell's patients. The
following key components: membrane during the viral
budding process. goal of the adherence unit
Genetic Material: here in the Federal
It contains viral Medical Center Umuahia,
This is the virus's genetic glycoproteins that help the is to ensure that the
information, which can be virus attach to and enter
in the form of DNA or host cells. individuals living with Hiv
RNA. are able to consistently
MY EXPERIENCE and correctly take their
It carries the instructions GAINED AT HEART TO prescribed
for the virus to replicate HEART DEPARTMENT
and produce new viral antiretroviral medications,
particles inside a ADHERENCE/ leading to optimal viral
COUNSELING UNIT suppression, improved
host cell. immune function,
My internship at the
Capsid: department kicked off at and overall better health
the counselling and outcomes.
The capsid is a protein adherence unit. At the unit,
shell that surrounds and 36
protects the viral genetic worked closely with the
material. doctor during clinic days
where I learnt medical
The capsid is made up of ethics in the
multiple copies of one or
more types of viral counseling of HIV infected
proteins. persons. Counseling was
done based on their
The specific shape and adherence to
structure of the capsid can
vary between different treatment, the side effects
types of viruses. they experience, their
nature of diet; in terms of
Envelope (optional): eating healthy

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44