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Background: The lofty objectives of the National Youth Service Corp (NYSC) are not only predicated on healthy graduates of tertiary institutions but also graduates who are confident in making informed health-related decisions. Therefore, Corp members' awareness, knowledge, and perception of the National Health Insurance Scheme (NHIS) and its programs become imperative. Materials and Methods: This was a cross-sectional study involving 203 participants selected by convenience sampling technique from NYSC members during Orientation Camp in June 2019. A self-administered questionnaire was used to collect data regarding their sociodemographics, awareness, knowledge, and perception about the NHIS. Results: The mean age of respondents was 25.8 ± 2.3 years; they were predominantly males (136 [67.0%]) with university degrees 131 (64.5%); 200 (98.5%) were aware of the NHIS and its programs. Although 161 (80.5%) respondents had at least average knowledge of the NHIS, only 97 (48.5%) had adequate knowledge. One hundred and fifty-eight (79.0%) respondents benefited from the Tertiary Institutions Social Health Insurance Programme (TISHIP) as students; 114 (57.0%) viewed TISHIP as a good program; however, 194 (97.0%) felt that the NHIS services should be extended to NYSC members, while 188 (94.0%) were willing to participate in the scheme if its services were extended them. Conclusion: Although awareness level was high, adequate knowledge of the NHIS was low and their perception about TISHIP is unimpressive; most were willing to participate in the NHIS. Current mass NHIS-programs education campaigns and services offered by NHIS-accredited health-care facilities need improvement; fast-tracking of processes necessary for the extension of NHIS services to NYSC members is required.

Background: Insufficient physical activity (PA) is a recognized risk factor for noncommunicable diseases. Evaluating health-care workers' PA is crucial because PA impacts their health, and they are important health promotion agents. Hence, this study assessed the PA profile of medical practitioners in Kano, Nigeria. Materials and Methods: This was a cross-sectional study involving 178 medical practitioners selected from attendees of a 1-day continuing-medical-education lecture, using a modified physical activity assessment tool. It assessed the moderate- and vigorous-intensity PAs performed, PAs' sufficiency, their plan and confidence of increasing PA, and factors associated with performing sufficient PA. Chi-square test and logistic regression analysis were employed in determining the association between variables and sufficient PA and predictors of sufficient PA, respectively. Results: Respondents' mean age was 37.5 ± 9.5 years; they were predominantly males (133, 74.7%). They spent a median (interquartile range [IQR]) of 65.0 (22.5–165.0) minutes per week on moderate-intensity activities and median metabolic equivalent-minutes/week (IQR) of 400.0 (120.0–1140.0). Most respondents (119, 66.8%) had engaged in PA in the past 5–6 months or intended to become more physically active in the next six months. Most (155, 87.1%) had some level of confidence in increasing their PA levels. The association between respondents' sociodemographic variables and sufficient PA was statistically insignificant. However, engagement in moderate-intensity housework (odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.15–4.96, P = 0.02) and aerobic exercises (OR = 11.57, 95% CI = 1.29–103.63, P = 0.03) increased the odds of attaining sufficient PA. Conclusion: Sufficient PA prevalence among respondents was low. Engagement in moderate-intensity housework and aerobic exercises were predictors of sufficient PA. Most respondents were motivated to become physically active in the future. Appropriate interventions are required to improve their PA levels.

Objective: To assess the proportion of caregivers of children and patients who received malaria prevention counseling from their healthcare provider at the time of outpatient malaria treatment. Methods: This was a descriptive cross-sectional study involving 353 randomly selected adult patients and caregivers of children attending the general and paediatric outpatient clinics of a Nigerian hospital. An interviewer-administered questionnaire was used to collect data on participants’ sociodemographics and last malaria-episode characteristics. Chi square test and logistic regression analysis were used to determine factors associated with and predictors of receiving malaria-prevention counseling, respectively. Results: The mean age of the respondents was (33.6±9.6) years; they were predominantly females (257, 72.8%). Most had at least secondary-level education (304, 86.1%); the family size was mostly 1-6 persons in 202 (57.2%) respondents. They were treated mostly by doctors 256 (72.5%), but only 132 (37.4%) received malaria prevention counseling. Educational-level (χ2 =5.42, P=0.02), family size (Fisher’s exact, P=0.01), place of treatment (Fisher’s exact, P=0.0002), pretreatment malaria test (χ2 =9.48, P=0.002), who prescribed treatment (Fisher’s exact P=0.001), consultation time (χ2 =22.09, P

Objective: To assess emergency department utilization at a semi-urban (resource-limited) Nigerian hospital. Methods: A systematic random sampling technique was adopted. A proforma was used to obtain general information such as age, gender, mode of transfer, time of presentation, symptom duration, diagnoses, treatment duration, treatment outcome (transfer to the ward, referral to another hospital, discharge or death) and date and time of discharge. Chi-square test and logistic regression analysis were used to determine the association of variables with mortality and predictors, respectively. Results: Patients were predominantly male (62.2%) with a mean age of (36.0±19.0) years. Most visits occurred in September (49.1%). The median symptom duration was 24 h (interquartile range: 4.0, 72.0 ). More incidences were caused by non-surgical (61.9%) than surgical reasons. Infectious diseases (predominantly malaria, 34.5%) and injuries from road traffic accidents (mostly head injuries, 9.4%) were the commonest non-surgical and surgical cause, respectively. The mortality rate was 9.2%. Typhoid-intestinal-perforation and sepsis contributed 45.2% of overall mortality. Age (χ2=16.44, P

Background: Snakebite envenoming is a neglected tropical disease that accounts for preventable morbidity and mortality, especially in resource-limited settings. This review aimed at examining the snake and human behaviors that facilitate snake-human encounters and highlighting the primary preventive measures for snakebite and the resultant envenoming. Materials and Methods: Google Scholar, Medline (via PubMed), and African Journal Online were searched from January 1959 to April 2019 for peer-reviewed studies addressing primary prevention of snakebite. We extended our search to grey literature from conference proceedings, documents from organizations, book chapters, and thesis. Results: We found few studies in medical literature on community knowledge of the intrinsic characteristics of snakes (e.g., its unique venom apparatus for nutrition, defense and competition, and its habitat and activities); however, there is appreciable amount of studies on human activities associated with snakebite envenoming. Deservedly, more studies appear to focus on snakebite management (secondary and tertiary prevention) with inadequate emphasis on primary prevention of snakebite (which may be the only intervention in some resource-limited settings). Conclusion: Synergy of efforts toward improving community knowledge of human behaviors associated with snakebite and snake behaviors may generate appropriate environmental and behavioral responses to curtail human-snake encounters. Hence, intensive promotion of primary prevention may be a useful approach toward reducing snakebite burden in resource-limited settings.

Introduction: Typhoid ileal perforation is a very serious complication of typhoid fever and remains a significant surgical problem in developing countries like Nigeria, where it is associated with higher mortality and morbidity, due to lack of adequate clean drinking water, poor sanitation and lack of access to health facilities in remote areas and delays in hospital presentation.Materials and methods: This was a retrospective study; all patients treated for typhoid ileal perforation at the centre in the period from January to December 2016 were included.Results: There were 22 (59.5%) males and 15 (40.5%) females, with a male to female ratio of 1.5: 1. The ages ranged from 5 to 49 years with mean of 16.5± 9.2 years. The month of October recorded the highest cases of typhoid ileal perforation. Abdominal pain, anorexia, fever and abdominal swelling were the most common symptoms reported by the subjects. The number of ileal perforations was from 1 to 7 with mean of 2.0 ± 1.3; however, the majority had a single perforation. In addition, excision and simple closure was the most common surgery performed in these cases. Operation site infection was the most common complication in this study. Furthermore, the majority of cases were successfully discharged while eight deaths were recorded.Conclusion: Typhoid ileal perforation was most common among males; abdominal pain, swelling and fever were common findings; single site perforation was the most common intra-operative findings and excision and simple closure was the most common operative procedure. Therefore early presentation, adequate resuscitation and lower number of ileal perforations are associated with better prognosis.Keywords: clinical presentations, complications, surgical procedure, typhoid ileal perforation

Background: The National Health Insurance Scheme (NHIS) of Nigeria was designed to eliminate known cultural, physical, and resource-related barriers to quality health-care access. Although choice of primary health-care facility (PHF) remains in the domain of the scheme enrollees, little is known about factors influencing their choice. Hence, the study of the perception of factors influencing PHF choice among NHIS enrollees of a northwest Nigerian hospital becomes imperative. Methods: This was a cross-sectional study of 284 principal enrollees randomly selected from patients attending the NHIS clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, using a designed, pretested, investigator-administered questionnaire. Their sociodemographics and factors influencing their choice of the clinic were assessed. Results: Respondents’ mean age was 40.9 ± 9.0 years and they were predominantly males (83.1%) with tertiary education. Median distance between their homes and PHF was 7.6 ± 12.5 km. Most respondents were aware of other accredited PHFs in the city and believed it was their right to choose a PHF. Among the various factors influencing their choice of index PHF were better functioning equipment (83.5% of respondents), more specialists/trained health workers (78.5%), ease in receiving specialist care (69.4%), and better overall quality of care (78.9%). Conclusion: There are multiple factors associated with enrollee choice of PHF in this study. The NHIS enrollees value the presence of functioning equipment/facilities, ease in receiving specialist care, and overall high quality of care in their choice of PHF. Improving enrollee enrollment at accredited PHF may require addressing these factors.

Background Snakebite envenoming causes considerable morbidity and mortality in northern Nigeria. The clinician's knowledge of snakebite impacts outcome. We assessed clinicians' knowledge of snakebite envenoming to highlight knowledge and practice gaps for possible intervention to improve snakebite outcomes. Methods This was a cross-sectional multicentre study of 374 doctors selected from the accident and emergency, internal medicine, family medicine/general outpatient, paediatrics and surgery departments of nine tertiary hospitals in northern Nigeria using a multistage sampling technique. A self-administered questionnaire was used to assess their sociodemographics, knowledge of common venomous snakes, snakebite first aid, snake antivenom treatment and prevention. Results The respondents' mean age was 35.6±5.8 y. They were predominantly males (70.6%) from urban hospitals (71.9%), from the northwest region (35.3%), in family medicine/general outpatient departments (33.4%), of

Background: Nigeria is not insulated from the global threat of Zika virus disease (ZVD) because of international travel and the presence of Zika-virus-carrying mosquitoes in the country. A paucity of studies exists concerning knowledge of ZVD among at-risk populations. Thus, the necessity for assessment of knowledge of ZVD among reproductive-age women in general outpatient setting.Materials and methods: A cross-sectional study was conducted on 377 reproductive-age women attending a Nigerian tertiary hospital’s general outpatient clinic. Their knowledge of ZVD was assessed using a structured questionnaire. A chi-square test was used to assess the relationship between participants’ sociodemographics and ZVD knowledge.Results: The participants’ median age was 27.0 ± 7.19 years. Though 68.97% of participants were aware of ZVD, only 23.85% of those had good knowledge of ZVD. Their median knowledge score was 57.14%. Participants’ age (< 27 years) (p = 0.00399), tribe (Hausa) (p = 0.0174) and monogamous family t...

Introduction: Existing evidence suggests that barotitis media (BM) is common among air travellers, and it has the potential to cause severe discomfort and sometimes permanent hearing and balance deficits. It has not been studied in Nigeria. Objective: This study aimed to assess the pre-air travel health-seeking behaviour, prevalence of BM, knowledge of BM and its associated factors among a cohort of outpatients with a history of recent air travel in Kano, Nigeria. Materials and Methods: This questionnaire-based survey involved 97 participants systematically and proportionately selected from adult patients or caregivers of children with recent air travel history attending two outpatients clinics over 7 weeks. Information on biodata, pre-air travel advice-seeking behaviours, air travel experience and BM knowledge were obtained. Data were analysed using the descriptive statistical methods, Chi-square or Fisher's exact tests and odds ratio (OR). Results: Most participants were male (54.6%) with tertiary education (87.6%); the prevalence of BM was 44.3% (43/97). Only 2.1% (2/97) had ever sought pre-air travel advice from a doctor; 83.5% (81/97) had heard of BM before; 42% had adequate knowledge of BM. Employment status (Fisher's exact, P = 0.001), clinic at recruitment (Fisher's exact, P = 0.00008), duration of last flight (Fisher's exact, P = 0.0001) and persistent ear-pain after landing (Fisher's exact, P = 0.001) were significantly associated with participants' knowledge of BM. Persistent ear-pain after landing was the predictor of BM knowledge (OR = 0.04, 95% confidence interval [0.002–0.67], P = 0.025). Conclusion: The BM knowledge level of this cohort suggests the need for further studies to ascertain the complete picture and justify improved pretravel education of air travellers in our setting.

INTRODUCTION: Microalbuminuria has been studied in some acute and chronic illnesses such as urinary tract infection (UTI), heart failure, and diabetes mellitus, but nothing much has been said about children with malaria and pneumonia which are most common in the tropics. Therefore, this study seeks to establish how common microalbuminuria is among acute febrile children. MATERIALS AND METHODS: This was a prospective longitudinal study. One hundred and eighty-nine febrile children admitted for febrile illnesses who met the inclusion criteria were recruited consecutively between November 2017 and January 2018. Five milliliters of urine was tested for proteinuria using ComboStik 10 strips (DFI Co. Ltd., Gyung-Nam, Korea); positive cases were excluded from the study. Another 5 ml of urine was tested for the presence of microalbumin using ComboStik 2AC strips (DFI Co. Ltd., Gyung-Nam, Korea). RESULTS: The age ranged from 1 year to 14 years, whereas the mean age was 5.54 ± 3.37 years. There were 138 (73%) males and 51 (27%) females, with a male-to-female ratio of 2.7:1. Most patients with malaria (57.8%), bacterial sepsis (62.5%), bronchopneumonia (42.8%), meningitis (100%), and UTI (72.0%) had high abnormal ratio; however, among the various subgroups, this was observed mostly among those with meningitis, UTI, and bacterial sepsis. The mean values and standard deviations of the age, urine creatinine, microalbumin, and the ratio of microalbumin/creatinine for the various illnesses showed higher values for UTI (age, microalbumin, and microalbumin/creatinine ratio) and bacterial sepsis (creatinine). CONCLUSION: Microalbuminuria is common in children with febrile illnesses such as malaria, bronchopneumonia, and meningitis; therefore, usage as a screening tool for microalbuminuria should be in afebrile children.

The National Health Insurance Scheme (NHIS) aims at universal health coverage through access to high-quality health-care to all enrolees. To achieve this goal, it is necessary to incorporate feedbacks from periodic patient-surveys into service improvement plans. This study therefore, assessed satisfaction and utilization of health-care services by enrolees of a Nigerian tertiary hospital. This was a crosssectional study of 399 respondents randomly selected from enrolees attending the NHIS-clinic of Aminu Kano Teaching Hospital, Kano. Using an intervieweradministered questionnaire, it assessed their sociodemographics, medical history, number of and reason for clinic visits, satisfaction with- access to care, patient-provider relationships and hospital facilities/environment. Respondents’ mean age was 38.3 ± 9.2 years and females accounted for 55.9% of respondents. Most respondents (60.4%, 69.8%, 96.0%) were satisfied with the ease of accessing care, waiting-time and hospital facilities/environment respectively. Most respondents (94.8%, 81.1%, 73.3%, 74.5%, 83.1%, 91.1%) were satisfied with their relationship with physicians, nurses, laboratory staff, pharmacists, record officers and other hospital-staff respectively. Overall, 80.5% of respondents were satisfied with the hospital’s services. All respondents had visited the clinic at least once in the preceding 12-weeks. Although 49.1% visited for non-communicable diseases, more respondents who were for antenatal-care (followed by non-communicable and communicable diseases) had had ≥ 2 clinic visits (c2 =15.5%, df=2, P=0.0001). This study observed a high utilization of and overallsatisfaction with the hospital’s services; however, there is a need for service improvement plans to address the challenges of patient access to care and waitingtime.

Background: The health status of workers and their families affects workplace productivity. The National Health Insurance Scheme (NHIS) objective of improving healthcare accessibility to Nigerians has increased service utilisation but may pose new challenges to existing facilities. This study was undertaken to describe the pattern of clinic utilisation, disease entities of subjects, use of the excused-duty certificate and identify points of delay.Methods: A prospective cross-sectional study of 352 subjects randomly selected over 6 weeks among patients attending the Aminu Kano Teaching Hospital Staff clinic.Results: Most subjects (307, 87.2%) had insurance and were predominantly (227, 64.5%) dependants. Most subjects (190, 55%) had used the clinic once to three times in the preceding 12 weeks and were predominantly (85, 24.2%) hospital attendants. Infectious disease (204, 58%) was the commonest reason for the clinical encounter. Their mean waiting and consultation times were 77.3 (SD ± 43) and 9.6 (SD ± 4....

Introduction: Undergraduate medical education requires the studying of a wide range of medical specialties to produce the future workforce of the healthcare system. Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the population. However, many Nigerian medical schools (Bayero University inclusive) are yet to include FM in their undergraduate curriculum. Methods: This was a descriptive cross-sectional study of 178 respondents randomly and proportionately selected from 400-, 500- and 600-level medical students of Bayero University Kano. Using a structured questionnaire, their awareness of FM discipline, specialty preferences, factors influencing specialty preferences and their views on the relevance of FM in improving health systems were assessed. Results: A majority of the respondents (60.7%) were males and most (93.8%) had heard of FM. However, only 19.7% of respondents were aware that FM was taught in the undergraduate programme of medical schools; 86% were aware of a postgraduate FM programme. FM (22.5%) was the second most preferred specialty following surgery (23.6%). Personal interest in the specialty was the main (76.5%) reason for preference. Only 2.9% believed the postgraduate training for FM had a longer duration. All respondents believed FM was relevant as a specialty. Conclusion: The knowledge and perception of the FM discipline among clinical medical students of Bayero University was good. They expressed that FM was relevant in the healthcare system as shown in their preference for the specialty, which ranked second among other specialties. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1313487

Background: Prepayment health-care financing mechanisms are recommended for achieving universal health coverage (UHC) as it prevents catastrophic health-care expenditure and poverty. This preference is due to the inadequacies of the out-of-pocket model in many low- and middle-income countries such as Nigeria. However, it took Nigeria several decades to operationalize the national health insurance scheme in 2005. This review aimed at highlighting various health-care financing options and their suitability for providing health care to all (including the poor and vulnerable groups). Materials and Methods: Data for this review were obtained from searching Google Scholar, MEDLINE (via PubMed), and African Journal Online, using relevant terms (in English language) that addressed health-care financing options and their suitability for UHC (including the poor and vulnerable groups) and were published between January 2007 and May 2019. Studies published in other languages were excluded for lack of resources to translate them. Results: Out-of-pocket, general taxation, private, community-based, and social health insurance, and innovative financing were found to have differing attributes. The social health insurance adopted by low- and middle-income countries such as Nigeria appears promising but not without challenges. Conclusion: A mixed model of social health insurance and general taxation is a prospect in extending health coverage to all citizens including the poor and vulnerable groups. Information on health financing options offers stakeholders the opportunity to understand the attributes of these options, an essential in the choice of a suitable mechanism that can deliver UHC.

Background: Older reports estimate that malaria accounts for 60% of outpatient clinic encounters in Nigeria. However, current estimates suggest that malaria control programs have considerably reduced malaria-related morbidity and mortality on a global scale. The extent to which these programs impacted malaria prevalence in endemic countries such as Nigeria after the Millennium-Development Goals era may not have been fully appreciated. This study, therefore, assessed how common malaria was among febrile patients attending a semi-rural medical center in Nigeria. Materials and Methods: This was a cross-sectional study involving 290 randomly selected general and pediatric outpatients (who fulfilled inclusion criteria) attending the Federal Medical Centre, Birnin Kudu in August 2016. It assessed participants' clinical features, insecticide-treated net usage and presence of malaria parasitemia (confirmed by microscopy). Results: Participants' overall mean age was 18.4 ± 16.3 years (ranging from 0.25–62.0 years); 146 (50.3%) were females; 73.4% used insecticide-treated-net the previous night. Their mean overall temperature was 37.7°C ± 1.1°C. Overall malaria prevalence was 65.5%; however, the incidence was highest in ≥15 years age-group (30.3%) followed by ≤4 years age group (20.7%). Clinical features predicting malaria parasitemia were pallor (odds ratio [OR] = 5.03, 95% confidence interval [CI] = 1.96–14.42) and history of convulsion (OR = 4.06, 95% CI = 1.53–10.78). Their median parasite density was 1 ± 1.3. Clinical features poorly predicted malaria parasite density among participants. Conclusion: The malaria prevalence in this study was worryingly high. There is a need to review or modify current malaria control programs using more comprehensive strategies if reduction in the malaria-related morbidity and mortality in this and similar settings is desired.

INTRODUCTION: Among common determinants of survival include the ability to effectively execute the basic life support drill during resuscitation. Therefore, this study seeks to determine the knowledge of cardiopulmonary resuscitation (CPR) among medical trainees who are in their clinical years in our tertiary hospital with the aim of identifying knowledge gaps if any. MATERIALS AND METHODS: The study was cross-sectional and was conducted over 12 weeks from April to June 2017. A pretested self-administered questionnaire which was developed in English language was distributed to the subjects. RESULTS: There were 118 male (67.4%) and 57 female (32.6%). Furthermore, 95.4% of the respondents were unaware of circulation, airway and breathing sequence (CAB) in adult resuscitation; and 82.3% were aware of ABC steps in pediatric resuscitation; 52% of the respondents were wrong in adult chest compression to ventilation ratio; similarly, 46.3% were incorrect on pediatric chest compression: ventilation ratio. One hundred and forty-six (83.4%) of the respondents had seen a defibrillator; however, only 3 (2.1%) had ever used it. The knowledge score of the respondents ranged from 0.0 to 55.0; while the mean was 19.4 ± 11.8. One hundred and seventy (97.1%) of the respondents scored CONCLUSION: There was poor knowledge of CPR among respondents despite reporting been trained.

Background: In spite of over a decade of operations, the National Health Insurance Scheme (NHIS) of Nigeria has continuously been criticized for its quality of services. Healthcare consumer satisfaction surveys (an important measure of service quality worldwide) in this domain have presented differing accounts of satisfaction with the services of the NHIS from their vantage perspectives. This narrative review aimed at studying the preliminary trends in the utilization of and patient satisfaction with the NHIS services. The correlates of patient satisfaction were also studied. Materials and Methods: We searched local literature whose full texts were accessible using predominantly Google Scholar. Results: We found progressive improvement in scheme enrolment, service utilization, and above-average overall satisfaction scores (i.e., >50% of respondents were satisfied) from most studies. Overall satisfaction scores/ratings were associated patients’ level of education, knowledge of the scheme, years of enrolment, facility cleanliness, consultation time, pharmaceutical services, ease in accessing medical records and laboratory results, health worker availability, health worker friendliness, and responsiveness to patients’ requests. Conclusion: The observed trajectory in service utilization, satisfaction scores, and their correlates may be useful for strategic planning to improve NHIS services in the country toward universal health coverage.

Introduction: Elevated blood pressure (BP)/hypertension contributes significantly to global morbidity and mortality. It is a silent killer; therefore, earlier diagnosis is imperative. A simple instrument called sphygmomanometer measures BP. Getting an accurate and precise reading is essential for making the diagnosis. Our study sorts to determine if there is any significant change in BP readings when the bladder cuff is inverted during BP measurement. Materials and Methods: This was a cross-sectional study involving 540 individuals who were consecutively recruited from the outpatient clinics over a year period. BP was measured with a mercury sphygmomanometer in three postures of sitting, standing, and supine comparing the standard protocol (control) and our designed protocol of inverted cuff (test). Results: The mean systolic and diastolic BP for all the postures for both sexes were significantly corresponding for both test positions in majority of the age groups; all observed differences in means were

Background: Globally, cervical cancer affects approximately 528,000 women each year, with about 80% of them occurring in developing countries. Developed countries have successfully reduced the incidence of cervical cancer by 70% through organized cervical screening programs. Objective: The aim of the study is to assess the level of Pap smear awareness and utilization among adult females attending the general outpatient clinic of Aminu Kano Teaching Hospital, Northwestern Nigeria, in order to encourage early detection of premalignant cervical cancer. Methods: This was a descriptive cross-sectional study that assessed Pap smear awareness, utilization, and pattern of cervical intraepithelial neoplasia among 422 adult females in Kano, Northwestern Nigeria, using an interviewer-administered questionnaire. SPSS version 20 was used to analyze the data. The sociodemographic characteristics of participants, risk factors of cervical cancer, and awareness and utilization of Pap smears by participants were expressed in means and proportions. The Chi-square test was used to explore associations between categorical variables. Logistic regression was performed to identify the predictors of Pap smear awareness and its utilization among the study participants. P < 0.05 was considered statistically significant. Results: Of the 422 women who participated in the study, the majority (292, 69.2%) had never heard of Pap smear screening while 130 (30.8%) were aware of Pap smear. Similarly, 342 (81.0%) women who participated in the study had never undergone a Pap smear. Three hundred and eight (74%) had normal cytology results, 107 (25%) had inflammatory changes, 4 (0.8%) had low-grade squamous intraepithelial lesion, and 1 (0.2%) had high-grade squamous intraepithelial lesion. Having higher education and being employed were associated with Pap smear awareness while increasing age and educational level were associated with Pap smear utilization. Conclusion: This study revealed a low awareness and utilization of Pap smear screening in Northwestern Nigeria.

Introduction: Menstruation is a normal physiologic phenomenon which is indicative that a woman is ready for her reproductive roles. Adolescents are often uninformed and inexperienced on most health‑related issues including menstruation. This study therefore hopes to determine the common menstrual hygiene practices among adolescent females. Materials and Methods: This was a cross‑sectional study involving women aged 14–18 years. A pretested questionnaire was administered by trained female clinical assistants to those who cannot read and write; however, literate respondents self‑administered the questionnaires. Results: Three hundred and ninety‑six (95.4%) of the respondents were aware of menstruation before their first period. Four hundred and two (96.9%) respondents believed menstruation was caused by the age of maturity, while 13 (3.1%) reported failure of fertilization of the ovum resulted in menstruation. Close relations were common source of information on menstruation; however, the age of menarche ranged from 9 to 18 years, with a mean age of 13.4 ± 1.5 years. Sixty‑one (14.7%) respondents used clean cloth for menses, 271 (65.3%) used sanitary pad, while 83 (20.0%) used tampon. However, 55 (13.3%) reused their sanitary wares. Most respondents changed their sanitary wares twice in a day; they mostly bath twice in a day even during their periods. Conclusion: Most respondents were aware of menstruation before their menarche and their close relatives were their common source of information on menstruation, 13 years was the mean age of menarche; most respondents used sanitary pads; however, 20% of them still used tampons. Keywords: Female adolescents; menstrual hygiene; menstruation; sanitary wares

Snakebite envenoming causes considerable morbidity and mortality in rural, agrarian, and poor-resourced communities of Sub-Saharan Africa and Asia. Echis ocellatus (carpet viper) is responsible for most injuries and deaths in Northern Nigeria. Tissue necrosis and hemorrhage are the key features of this snake species. While bleeding can occur into virtually any tissue of the body following snakebite envenoming, sublingual hematoma (SLH) has been scarcely reported. The index patient was an adult female farmer with delayed presentation of SLH following venomous snakebite in a rural Nigerian community. Diagnostic and management challenges were encountered.

Venomous snakebite is a medical emergency encountered worldwide, especially in resource-limited communities. It usually leaves victims at the mercy of traditional care, whose effectiveness have come under scrutiny over time. Several of these traditional/ first aid practices have also been reported over time. Controversies over their efficacy often result in confusion among snakebite victims, their caregivers, and sometimes, among health-care providers. This narrative review describes reported prehospital interventions for venomous snakebites highlighting their usefulness, dangers, and/or limitations associated with their use and the currently widely recommended prehospital activities for venomous snakebite.

Background: Patient satisfaction plays a key role in health-care reforms and service delivery. It is determined by patient's perception of the structural, interpersonal, and technical components of care. With current efforts toward universal coverage, government-owned National Health Insurance Scheme (NHIS)-accredited health facilities may need to improve the structural and interpersonal aspects of patients' care to survive in the emerging competitive health-care industry in Nigeria. Materials and Methods: A cross-sectional study of 220 NHIS enrollees randomly selected from patients attending the Staff Clinic of Aminu Kano Teaching Hospital Kano assessed patients' satisfaction with the structural (service-window-locations, cleanliness, adequacy of seats and toilets, and staff sufficiency) and interpersonal (staff friendliness, communication, respectfulness, response-to-requests, and efficiency) components of care as well as overall clinic satisfaction using a modified general practice assessment questionnaire. Results: Most of the respondents (65.9%) were satisfied with the clinic services. Respondents' satisfaction with the clinic's cleanliness, ease in locating medical records' unit and retrieving laboratory results, adequacy of doctors, friendly/respectful and responsive cashiers and clinical assistants (CAs), receiving satisfactory explanation on how to use prescribed drugs and unavailable drugs were all associated with the overall clinic satisfaction. However, cashiers' efficiency (odds ratio [OR] = 6.5, P = 0.006) and CAs' responsiveness (OR = 5.0, P = 0.03) were the predictors of overall satisfaction. Conclusion: Improvements in patients' overall satisfaction with the clinic services may require increasing the proportion of patients satisfied with the cashiers' efficiency and CAs' responsiveness (or those with similar roles) in service delivery.

Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross-sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents' perceived waiting time, level of satisfaction at the clinic's service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors' consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers.

Background: Despite global control efforts, malaria still accounts for preventable morbidity and mortality in Africa. Reported knowledge of its preventive measures appears high, but disparity exists between knowledge and uptake of preventive practices in Nigeria. It becomes necessary to evaluate adherence to use of insecticide-treated nets (ITN) and other malaria preventive measures at peak periods of malaria transmission as the Millennium Development Goal era terminates. Materials and Methods: A cross-sectional study was conducted at the general and pediatric out-patient clinics of Aminu Kano Teaching Hospital, among 413 adult patients and caregivers of children selected by systematic sampling technique and using a validated interviewer-administered questionnaire. Their knowledge of malaria and utilization of and adherence to preventive measure utilization were assessed. Results: The respondents’ mean age was 33.6 ± 8.9 years. Majority (90.6%) had adequate knowledge of malaria. Their mean malaria knowledge score was 78.7%. Among those who used ITNs, only 54.1% adhered to daily use. For other preventive measures, 65.3, 52.3, 46.5, and 25.2% adhered to environmental sanitation, insecticide spraying, wearing protective clothing, and mosquito repellent use, respectively. Hot weather was the main barrier to ITNs and wearing protective clothing adherence, whereas cost, lack of time, fear of side effects was the barrier to adherence to insecticide spraying, environmental sanitation, and mosquito repellent, respectively. Tertiary education was associated with adequate knowledge of malaria (χ2 = 8.36, P = 0.004). There was also association between adequate knowledge of malaria and monthly environmental sanitation participation (χ2 = 9.06, P = 0.003). Conclusion: Knowledge of malaria was high but adherence to practice was low. Nonadherence with preventive measures is an obstacle to achieving malaria control and could be overcome by effective mass education and addressing adherence barriers.