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Introduction: Malaria is the major cause of mortality worldwide. Accurate diagnosis is key for effective management of the disease. Non-adherence to diagnosis guidelines by primary healthcare (PHC) workers affects quality healthcare provisions. Job aid posters help enhance adherence to guidelines for several diseases. Thus, this study determined PHC worker’s use of job aid posters and identified factors affecting its use as a guide for malaria diagnosis. Methods: The study was a hospital-based cross-sectional survey, a multistage sampling technique was used to select 384 PHC workers from seventy-eight PHC facilities in Ibadan Oyo State, Nigeria. A semi-structured, self-administered questionnaire was used to obtain participant’s socio-demographic characteristics, knowledge and adherence to malaria diagnosis guidelines, and factors affecting the use of job aid posters as a guide for malaria diagnosis. Data analysis was done using descriptive statistics, chi-square, and logistic regression with P-Value=0.05 declared as statistically significant. Results: Two hundred and forty-four (63.5%) PHC workers were knowledgeable about malaria diagnosis guidelines whereas only 58.1% of the total respondents adhere to the guidelines. Just less than half (45.3%) of participants uses job aid posters always. Knowledge of malaria diagnosis guidelines (AOR = 0.272, 95% C.I = 0.115-0.643), comprehensiveness of job aid poster (AOR = 0.345, 95% C.I = 0.148-0.807), physical integrity of job aid posters (AOR = 0.219, 95% C.I = 0.092-0.522), and positioning of job aid posters (AOR = 5.704, 95% C.I = 2.375-13.67) were significant predictors of use of job aid posters for malaria diagnosis. Conclusion: the healthcare worker’s adherence to guidelines for malaria diagnosis was inadequate. Provision of comprehensive job aid posters on malaria diagnosis, replacement of damaged ones, and strategic display of the job aid posters is recommended to enhance use and adherence.

The aim of this study was to assess the perception and utilization of HIV services in Lagos Nigeria. One focus group discussion (FGD) and three key informant interviews (KIIs) were conducted in eac...

Background World Health Organization recommends hepatitis B vaccine birth dose for all infants within 24 hours of birth as the most cost-effective measure to prevent perinatal hepatitis B virus infection (HBV). We assessed and identified the predictors of maternal knowledge and infants’ uptake of valid hepatitis B vaccine birth dose (HepB-BD). Methods We conducted a hospital-based cross-sectional survey among 366 mother-infant attendees of routine immunization clinics selected by multi-stage sampling technique in Enugu State, Nigeria. We collected data on socio-demographic characteristics, delivery history, maternal knowledge and infant’s receipt of valid HepB-BD with interviewer-administered questionnaire. Maternal knowledge was assessed using nine domain questions. Overall, good knowledge was defined as a score of ≥50%. Only infants who received first hepatitis B dose within 24 hours were considered to have received valid BD. We calculated frequencies, performed Chi square test and logistic regression. Results One hundred and two (29.7%) mothers knew HBV can be transmitted from mother to child; 119 (34.6%) and 156 (45.3%) knew their infant should receive valid HepB-BD and four doses for full immunization of HepB respectively. Overall, 114 (31.1%) mothers had good knowledge of HBV and 88 (26.9%) of 327 who delivered at the health facilities had valid HepB-BD. Predictors of maternal knowledge were attainment of tertiary education (adjusted Odds Ratio (aOR): 2.1, 95%CI: 1.3–3.5) and living in rural areas (aOR: 0.5, 95%CI: 0.3–0.9). Predictors of valid HepB-BD uptake were maternal knowledge (aOR: 2.4, 95%CI: 1.4–4.0) and delivery at facilities offering routine immunization services (aOR: 5.4, 95%CI: 2.5–11.9). Conclusion Knowledge and uptake of valid HepB-BD were low. Health education on benefits of valid HepB-BD was given to mothers after administration of questionnaires. We disseminated findings to the State Ministry of Health and recommended integration of child delivery and immunization services for birth dose vaccines especially valid HepB-BD.

Globally, there is an increasing incidence of Non-Communicable Diseases (NCDs). Major oral diseases such as caries and periodontal disease which are classified as NCDs, are not left out of this trend. Recent reports are suggestive of increasing prevalence and severity of oral diseases among adolescents, despite accessibility of dental services. Ascertaining the oral health status of adolescents making use of dental services and how they perceive their oral health could help develop preventive and therapeutic strategies. This study therefore aims to determine the self-perception of adolescents utilizing dental services about their oral health and factors affecting their oral hygiene status.This clinic-based cross-sectional study was carried out among adolescents attending the Dental Center, University College Hospital, Ibadan Nigeria. A total of 113 adolescents were recruited into this study using a systematic random sampling technique. A WHO Oral health questionnaire was administered to the participants. Questions were asked on socio-demographics, self-perception of oral health and oral hygiene practices. Descriptive statistics such as frequency, percentages, mean, standard deviation were used to present the data. Independent T test and One way ANOVA were used to analyze categorical exposure variables with normally distributed numerical outcomes. A p-value of0.05 was considered statistically significant.Majority of study participants had positive self-perception of health of their teeth (53.1%) and gingiva (62.8%) respectively, their mean OHI-S was 2.24 with 62.8% of adolescents having a fair oral hygiene. Mean DMFT was 0.96 with 75.2% of participants having a very low DMFT. OHI-S and DMFT were both significantly associated with age of adolescents, with late adolescents having significantly higher mean OHI-S and DMFT scores than early adolescents (p0.05). Adolescents who cleaned their teeth at least twice daily had significantly higher DMFT values than those who cleaned once daily (P0.05).This study found late adolescents had higher DMFT and OHI-S scores. There might be need to increase oral health awareness in senior secondary schools and tertiary institutions to help improve their oral health status. Its pertinent that adolescents are encouraged and taught good oral hygiene measures when they visit dental clinics, in school and at home. Adolescents utilizing dental services are likely to be more self-conscious about their oral health thus increasing the frequency of their teeth cleaning.

In some parts of Africa, the patients and those who survived COVID-19 are stigmatized and this has impeded the response activities put in place to control the pandemic. In spite of this, most efforts in preventing COVID-19 were geared towards the use of non-pharmacologic measures without corresponding measures to dissipate stigmatization in the community. Therefore, this study assessed the factors associated with perceived stigmatization of patients with COVID-19 among residents of Agege local government, Lagos State, Nigeria.We conducted a cross-sectional survey among 333 consenting residents recruited from Agege local government area (LGA) using a multi-stage sampling technique. A semistructure, interviewer-administered questionnaire adapted from the People Living with Human Immunodefiency Virus (PLHIV) Stigma Index was used to collect data on socio-demographic characteristics, knowledge of COVID-19 and perceived stigmatization. Bivariate analysis was done using Chi-square and binary logistic regression was used to identify the determinants of perceived stigmatization at 5% level of significance.The mean age of the respondents was 35.7 ± 13.6 years. Awareness about COVID-19 outbreak was 95.2%. Television (43.5%) and radio (36.9%) were the two major sources of information on COVID-19 infection and prevention. The proportions of the respondents who had poor knowledge and perceived stigmatization of COVID-19 patients were 50.0% and 47.7% respectively. A higher likelihood of perceived stigmatization was found among those aged 25 - 49 years (aOR= 3.1, 95% CI = 1.4 - 6.7),50 years (aOR= 2.1, 95% CI = 1.1 - 3.9) and married respondents (aOR= 1.8, 95% CI = 1.1 - 2.9).The study highlights the poor knowledge about COVID-19 and a high level of stigmatization. Hence, targeted health educational interventions are urgently needed for the residents of Agege, most especially among married respondents as well as the adults.Dans certaines parties de l’Afrique, les patients et ceux qui qui ont survécu au COVID-19 sont stigmatisés et cela a entravé les les activités de réponse mises en place pour contrôler la pandémie. Malgré cela, la plupart des efforts de prévention du COVID-19 ont été orientés vers l’utilisation de mesures non-pharmacologiques sans mesures correspondantes pour dissiper la stigmatisation au sein de la communauté. Par conséquent, cette étude a évalué les facteurs associé à la stigmatisation perçue des patients atteints de COVID-19 parmi les résidents du gouvernement local d’Agege, État de Lagos, Nigeria.Nous avons réalisé une enquête transversale auprès de 333 résidents consentants recrutés dans la zone de gouvernement locale (LGA) d’Agege en utilisant une technique d’échantillonnage à plusieurs degrés. Un questionnaire semi-structuré, administré par un intervieweur, adapté de l’indice de stigmatisation des personnes vivant avec le virus de l’immunodéficience humaine (PVVIH). L’index stigmate a été utilisé pour collecter des données sur les caractéristiques sociodémographiques, la connaissance de COVID-19 et la stigmatisation perçue. Une analyse bivariée a été réalisée à l’aide de l’outil Chi-square et une régression logistique binaire a été utilisée pour identifier lesdéterminants de la stigmatisation perçue au niveau de signification de 5%.L’âge moyen des répondants était de 35,7 ± 13,6 ans. La sensibilisation à l’épidémie de COVID-19 était de 95,2%. La television (43,5 %) et la radio (36,9 %) étaient les deux principales sources d’information sur l’infection et sa prévention. Les proportions des répondants qui avaient une mauvaise connaissance et stigmatisation perçue des patients atteints de COVID-19 étaient respectivement de 50,0% et de 47,7 % respectivement. Une probabilité plus élevée de perception de stigmatisation perçue a été constatée chez les personnes âgées de 25 à 49 ans (aOR=3,1, IC à 95% = 1,4 - 6,7),50 ans (aOR= 2,1, IC à 95% = 1,1 - 3,9)et les répondants mariés (aOR= 1,8, IC 95 % = 1,1 - 2,9).L’étude met en évidence le manque de connaissances sur le COVID-19 et un niveau élevé de stigmatisation. Par conséquent, Il est donc urgent de mettre en place des interventions éducatives pour les résidents d’Agege, en particulier parmi les répondants mariés ainsi que les adultes.Perception, stigmatisation, COVID-19, autodéclaration, Nigeria.

Background Female infertility is a public health problem, contributing to 65.9% of infertility in Tanzania. Lifestyle and oxidative stress (OS) have been suggested to affect female fertility; however, there are limited and controversial reports. This study aimed to determine the lifestyle and OS status of fertile and infertile women and relate lifestyle and OS to female infertility. The study was conducted among randomly selected 48 fertile and 48 infertile women aged 15–49 years attending a gynaecological clinic at Muhimbili National Hospital. Lifestyle information was collected using a proforma, and a sandwich ELISA method was used to analyse OS biomarkers (malondialdehyde and total antioxidant capacity). Chi-square, independent t test and correlation coefficient were used for data analysis at p < 0.05. Results Infertile women were significantly older (33.4 versus 30.3 years, p = 0.03), got married at later ages (25.0 versus 22.8 years, p = 0.02), were in employment (62.5% versus 29.2%, p = 0.001), had attained university degree (56.3% versus 27.1%, p = 0.004) and were more obese, more likely to consume alcoholic drinks (p = 0.02) and less likely to use supplements (p = 0.000) than fertile women. Infertile women had statistically significant higher malondialdehyde (p = 0.000) and lower total antioxidant capacity levels (p = 0.000) than fertile women. The total antioxidant capacity level had a statistically significant negative correlation with alcohol consumption (r = −0.27, p = 0.008) and obesity (r = −0.32, p = 0.002) and a positive correlation with supplement use (r = 0.24, p = 0.02). Also, malondialdehyde level had a statistically significant positive correlation with alcohol consumption (r = 0.31, p = 0.002) and obesity (r = 0.28, p = 0.007). Conclusions The differences in socio-demographic characteristics, lifestyle and oxidative stress between fertile and infertile women may account for difficulties in achieving pregnancy among infertile women in Tanzania. Lifestyle factors significantly affect oxidative stress. Health education on appropriate lifestyles that support female fertility and emphasis on supplement use during the preconception period may be beneficial in the management of female infertility.

Background: The National Health Insurance Scheme (NHIS) in Nigeria has succeeded in enrolling only a minute fraction of the population. Studies on the scheme among informal sector employees are required to plan a scale up of the programme in this group which represents the majority of the working population in the country. Objective: This study sought to assess the method of payment for health care, awareness of and the perception about the NHIS among auto-technicians in Abuja, Nigeria. Methods: A cross-sectional descriptive survey was conducted among auto-technicians in Abuja Municipal Area Council (AMAC), Nigeria. Data was collected using interviewer-administered questionnaire, and analyzed with SPSS version 17. Results: A total of 351 auto-technicians and allied workers participated in the study. Post-secondary education [(Odds Ratio (OR) = 7.78, 95% CI = 1.61 - 37.54, p = 0.01)] and having a spouse who is gainfully employed [(OR = 3.67, 95% CI = 1.04-12.93)] predicted awareness of the NHIS. Older people above forty years of age were significantly less likely to be aware of the NHIS, (OR = 0.27, 95% CI = 0.08 - 0.92, p = 0.036). Conclusion: Despite the glaring need and willingness of the participants to enroll in a prepayment scheme for health, workers in the informal sector of the economy may remain unreached by NHIS due to lack of awareness and skepticism. Strategic steps to remove ignorance and dispel doubts is imperative for scale up of the NHIS in the informal sector.

Background Hepatitis B vaccine (HepB) is an effective tool in prevention of hepatitis B virus (HBV) infection. When administered at birth, it prevents mother-to-child transmission of acute and chronic HBV infection. However, despite a decade and half of implementation of HepB birth dose (HepB-BD), uptake has remained persistently low in Enugu State, Nigeria. We assessed the uptake of valid HepB-BD and the reasons given by mothers of infants for not receiving the HepB-BD in Enugu State, South-east Nigeria. Methods An hospital-based cross-sectional survey was conducted among mother-infant pairs attending immunization clinics at randomly selected health facilities in Enugu State, Nigeria. Overall, 344 mothers and their infant children in this study were interviewed using structured questionnaire. Data on maternal reasons for non-receipt of valid HepB-BD by their infants and their recommendations on ways to improve valid HepB-BD uptake, were collected. We defined valid birth dose as the receipt of first dose of HepB within 24 h of birth. Results Overall, 254 (73.8%) infants did not receive valid HepB-BD. Major reasons for its non-receipt were vaccine not available at place of delivery (91.3%, n = 232), delivery did not take place on immunization day (75.6%, n = 192), lack of awareness on timing of valid HepB-BD (72.8%, n = 185), long distance from the health facility (5.1%, n = 13) and fee payment for immunization (6.3%, n = 16). Of the 384 maternal recommendations, 143 (37.2%) emphasized female literacy while 87 (22.7%) indicated pre-positioning the vaccines at labor rooms to improve valid HepB-BD uptake. Conclusion The low receipt of valid HepB-BD among infants attending routine immunization clinics, found in this study were attributed to lack of maternal awareness on timing of HepB-BD and poor integration of child delivery and immunization services. We recommend educating mothers on benefits of a timely HepB-BD and pre-positioning the vaccines at the labor rooms.

Background In Nigeria, Artemisinin-based Combination Therapy (ACT) is the recommended first line antimalarial medicine for uncomplicated malaria. However, health care providers still continue the use of less efficacious medicines such as Sulphadoxine-pyrimethamine and chloroquine. We therefore determined preference for ACT (PFA) and factors associated with PFA among healthcare providers (HCP) in Lokoja, North-Central Nigeria as well as assessed healthcare providers’ knowledge of malaria case management. Methods We conducted a cross-sectional study among physicians, nurses, pharmacists, community health officers (CHOs), community health extension workers (CHEWs) and, patent and proprietary medicine vendors (PPMVs). Interviewer-administered questionnaires were administered to collect data on respondents’ characteristics, previously received malaria case management training and knowledge of malaria treatment. Knowledge scores ≥3 were categorised as good, maximum obtainable being 5. Results Of the 404 respondents, 214 (53.0%) were males. Overall, 219 (54.2%) respondents who received malaria case management training included PPMVs: 79 (65.8%), CHEWs: 25 (64.1%), CHOs: 5 (55.6%), nurses: 72 (48.7%), physicians: 35 (47.3%) and pharmacists: 3 (23.1%). Overall, 202 (50.0%) providers including physicians: 69 (93.2%), CHO: 8 (88.9%), CHEWs: 33 (84.6%), pharmacists: 8 (61.5%), nurses: 64 (43.2%) and PPMVs: 20 (16.5%), had good knowledge of malaria treatment guidelines. Overall, preference for ACT among healthcare providers was 39.6%. Physicians: 50 (67.6%), pharmacists: 7 (59.3%) CHOs: 5 (55.6%), CHEWS: 16 (41.0%), nurses: 56 (37.8%) and PPMV: 24 (19.8%) had PFA. Receiving malaria case management training (adjusted odds ratio [aOR]) = 2.3; CI = 1.4 – 3.7) and having good knowledge of malaria treatment (aOR = 4.0; CI = 2.4 – 6.7) were associated with PFA. Conclusions Overall preference for ACT use was low among health care providers in this study. Preference for ACTs and proportion of health workers with good knowledge of malaria case management were even lower among PPMVs who had highest proportion of those who received malaria case management training. We recommend evaluation of current training quality, enhanced targeted training, follow-up supportive supervision of PPMVs and behavior change communication on ACT use.

HIV infection is still prevalent in Sub-Saharan Africa. The presence of a chronic illness in childhood, such as HIV infection, can affect the health-related quality of life (QoL) negatively.The study compared the QoL of HIV-infected and uninfected children in order to assess the impact of HIV infection and antiretroviral therapy on the QoLof children.It was a comparative cross-sectional study in which 150 primary caregivers of both HIV infected and HIV non-infected children were recruited. Data was collected on sociodemographic characteristics, negative life events and QoL domain scores on health perception, physical resilience, functional status, physical functioning, psychological functioning, social/role functioning and HIV-related symptoms from the primary caregiver and analysed.Mean age of HIV infected and non-infected children was 3.0 ± 0.9 years and 2.9±1.0 years respectively. HIV infected children had a greater proportion of their grandparents (15% versus 1%, p0.05) being their primary caregiver. HIV infected children were associated with significantly worse mean QoLscore compared with HIVnon-infected children (p0.05). Advanced HIV infection was associated with low QoL. Use of Antiretroviral Therapy (ART) among the HIV infected children was associated with a higher QoL in the general health rating, physical resilience, functional score, symptom, social and role functioning domains (p0.05) except for physical functioning and psychological functioning.HIV infection in children is associated with poor QoL. Advance HIV disease was associated with poor QoL and antiretroviral therapy was associated with improved QoL in HIV infected children.

Introduction:Brucellainfection, a neglected tropical zoonosis, poses public health threat to abattoir workers in developing countries including Nigeria. Oko-Oba abattoir is one of the largest abattoirs in the country that collects livestock from different parts of the country. This study determined the prevalence and factors associated with seropositivity of brucellosis among livestock slaughtered at Oko-Oba abattoir. Methods:a cross-sectional study was conducted from January to May 2018. A total of 473 serum samples were collected from livestock at the abattoir and tested for antibodies toBrucellaspecies using the Rose Bengal Plate Test (RBPT) and indirect Enzyme Linked Immunosorbent Assay (iELISA). Data were analyzed using descriptive statistics and chi square test (p < 0.05). Results:overall seroprevalence values were 15.3% (RBPT) and 16.3% (iELISA) among the livestock slaughtered at the Oko-Oba abattoir. Seroprevalence of 17.2% (RBPT) and 15.8% (iELISA) in cattle; 15.1% (RBPT) and 14.5% (iELISA) in goat; and 8.3% (RBPT) and 23.3% (iELISA) in sheep were obtained. Higher seroprevalence were recorded among females in cattle (18.8% iELISA) and sheep (23.1% iELISA) while male goats had average value higher (14.7% iELISA) than the female (p > 0.05). Conclusion:presence ofBrucellainfection among slaughtered livestock was confirmed at Oko-Oba abattoir, Lagos State, Nigeria and poses a threat to abattoir workers and public health. Control of the disease in livestock and use of personal protective gear is recommended.

Driving is recognized to be a visually intensive task and accordingly legal minimum standard of vision required for all motorists is stipulated. This study was carried out to find out how many commercial drivers in Ibadan North L.G.A met minimum legal requirement for driving in Nigeria. A cross sectional descriptive study was conducted among 340 commercial vehicle drivers selected by multistage sampling from eight transport stations (motor parks) in the city. Visual impairment was defined as vision acuity (VA) in both eyes which is below 3/18 but above 3/60 (VA

Objectives How soon an ever-married woman falls a victim of domestic violence after marriage is not documented in Africa. This study sought to assess the timing of first domestic violence (FDV) against women after marriage and determined the factors associated with the timings in Nigeria, Kenya, and Mozambique. Study design This is a cross-sectional study. Methods Data of 29,793 ever-married women of reproductive age consisting of 21,564, 4237 and 3992 from Demographic and Health Survey conducted in Nigeria (2013), Kenya (2014) and Mozambique (2011), respectively, were used. The timing of FDV was the time interval between marriage date and date of the FDV for those with reported violence but censored as the time interval between marriage date and the survey date for those without domestic violence. Survival analysis techniques were used to assess the timing and the factors influencing the timing at (P = 0.05). Results The lifetime prevalence of domestic violence among the ever-married women in Nigeria, Kenya and Mozambique was 15.4%, 39.0% and 31.0%, respectively. The overall median time to FDV was 3 years. The risk of FDV was twice higher in Kenya (adjusted hazard ratio (aHR) = 1.934; 95% confidence interval (CI): 1.729–2.132) and 15% higher in Mozambique (aHR = 1.156; 95% CI: 1.156–1.223) than in Nigeria. The hazard of domestic violence was significantly higher among separated/divorced women across the three countries (aHR = 1.326; 95% CI: 1.237–1.801). Other factors associated with the timing of FDV against women were respondents' education, age at first marriage, region and location of residence, religion, ethnicity, employment status, wealth quintile, spouse consuming alcohol and husbands' educational attainment. Conclusions Domestic violence against married women by their intimate partners is prevalent across Mozambique, Nigeria and Kenya, with earlier occurrences in Kenya and Mozambique. Age at first marriage, education factors, religion, ethnicity and region of residence in each country affected the timing of the first incidence of domestic violence.

Background. Unavailability of accurate, rapid, reliable, and cost-effective malaria diagnostic instruments constitutes major a challenge to malaria elimination. We validated alternative malaria diagnostic instruments and assessed their comparative cost-effectiveness. Method. Using a cross-sectional study design, 502 patients with malaria symptoms at selected health facilities in Ibadan between January and April 2014 were recruited consecutively. We examined malaria parasites using Cyscope®, QBC, and CareStart™ and results were compared to light microscopy (LM). Validity was determined by assessing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Costs per hour of use for instruments and turnaround time were determined. Result. Sensitivity of the instruments was 76.0% (CareStart), 95.0% (Cyscope), and 98.1% (QBC). Specificity was 96.0% (CareStart), 87.3% (Cyscope), and 85.5% (QBC). PPV were 65.2%, 67.5%, and 84.7%, while NPV were 93.6%, 98.6%, and 99.4% for CareStart, Cyscope, and QBC with Kappa values of 0.75 (CI = 0.68–0.82) for CareStart, 0.72 (CI = 0.65–0.78) for Cyscope, and 0.71 (CI = 0.64–0.77) for QBC. Average cost per hour of use was the lowest ($2.04) with the Cyscope. Turnaround time was the fastest with Cyscope (5 minutes). Conclusion. Cyscope fluorescent microscope had the shortest turnaround time and is the most cost-effective of all the malaria diagnostic instruments evaluated.

The availability of accurate, up-to-date, reliable and relevant health information on disease notification by medical laboratory practitioners is essential to detecting and responding to epidemic outbreaks. However, information on notification practices of private laboratory scientists are not well documented. This study was conducted to assess the level of awareness and knowledge of Integrated Diseases Surveillance and Response (IDSR), as well as its practice by private laboratory scientists in Lagos State, Nigeria. In a cross-sectional study, 190 respondents from 14 chapters of the Association of Medical Laboratory Scientists in Lagos state were interviewed using a pretested self-administered semistructured questionnaire to collect information on socio-demographic characteristics, awareness of IDSR and its policy, knowledge of notifiable diseases, practice of IDSR and constraints to reporting notifiable diseases. Data was analyzed using descriptive statistics, Chi-square test and logistic regression at P = 0.05. The mean age of the respondents was 34.0 years with a standard deviation (sd) of ±8.5 years and 65.3% were males. Half (50.0%) of them have ≤5 years of working experience with a mean of 7.5±5.8 years. About 8.9% had ever heard of IDSR. About 9.5% had ever seen a disease notification form and 51.1% had good knowledge of IDSR guidelines for the country. Most (86.3%) had never reported a notifiable disease. Lack of knowledge on how to report (56.8%) and inefficiency of the health department (44.7%) were the major reasons given for not reporting. A significant predictor of disease notification was awareness of IDSR (OR= 5.7, CI=1.9-16.7). Private medical laboratory practitioner’s awareness and practice of disease notification is poor. A range of interventions including awareness campaign, IDSR training, feedback and logistic support for reporting is recommended to improve reporting practices by private medical laboratory scientists.

Introduction: Although compliance with surveillance guidelines is crucial to epidemic diseases control, determinants of use of these guidelines in Nigeria are poorly documented. We assess health workers compliance and factors associated with the surveillance and response guidelines for epidemic-prone diseases in South-West Nigeria. Methods: In a cross-sectional study, 199 disease surveillance and notification officers in Oyo state were interviewed using a questionnaire on knowledge of disease surveillance and performance of surveillance activities. Data were analysed using descriptive statistics, chi-square and multiple logistic regression at P= 0.05. Results: Most surveillance units submitted disease outbreaks reports (81.48% at the health facility and 100% at the local government level). Timeliness and completeness of weekly reporting were 94% and 95% respectively. a quarter (25.9%) adhered to national case definitions guidelines. About 85.7% did laboratory case confirmation while 2.6% did facility level data analysis. Predictors for six months reporting activity include attending a training on surveillance and reporting (OR=7.92; CI=1.65–37.92), fund adequacy (OR=27.81; CI=7.68–100.60) and knowledge of surveillance dataflow (OR=4.80; CI=1.64–14.10). Conclusion: In addition to provision of adequate financial and laboratory resources, surveillance activities would benefit from continuous training on surveillance data flow. Keywords: Epidemic-prone diseases, case definitions guidelines, surveillance and response.

Investigating an outbreak of disease requires mastery of a set of skills and collaboration among different cadres of health workers. Although you want to focus on a specific disease, you need to keep your mind open to possibilities. This case study is based on investigation of an outbreak of rashes suspected to be measles but which proved to be otherwise. It reinforces the knowledge of the steps in outbreak investigation which should have been covered in classroom lecture or background reading. This case study is best suited for basic level of training in field epidemiology and can be completed within 2-3 hours.

Introduction : Despite efforts toward the prevention and management of diarrhoea, associated mortality among infants has remained high in Northern Nigeria. This study was designed to determine the prevalence and identify determinants of diarrhoea among infants in Kaduna North Local Government Area (KNLGA), Nigeria. Methods : In a cross-sectional survey 630 mothers of infants attending three primary health care centers were interviewed. Data was collected on socio-demo graphic characteristics, infant care practices, infant diarrhoea history and mothers knowledge of causes, symptoms and management of diarrhea. Data were analyzed using descriptive statistics, Chi-square, and logistic regression tests at 5% level of significance. Results : Mothers' mean age was 27±5.5 years and 46.1% had secondary education. Infants' mean age was 22.4± 12.8 weeks and 50% were females. Prevalence of diarrhoea in the two weeks preceding the study was 21.1%. Only 11.7% of mothers had poor knowledge of diarrhoea. About 76.3% of mothers always washed their hands with soap after cleaning infants' perineum. Majority of infants (84.6%) completed age appropriate immunization while 31.6% were exclusively breastfed. Infants whose mothers sometimes (OR=2.32; 95% CI: 1.4-3.87) or never washed (OR=2.64; 95% CI: 1.19-5.82) their hands with soap after cleaning the infants perineumand those with incomplete age appropriate immunization (OR=1.87, 95% CI: 1.2-2.896) were more likely to have diarrhoea. Conclusion : Promotion of hygiene and nutrition education for mothers particularly on proper infant feeding practices, hand washing practices and complete immunization of infants is needed to address the diarrhea determinants.

Unmarried status has been associated with low psychological and social wellbeing among young pregnant women, who are very likely to have unintended pregnancies. The current study investigated the psychological and social effects of pregnancy in unmarried young women aged 15 to 24 years in Bui, Northwest Cameroon. It was a cross-sectional facility-based survey and one hundred and eighty-four unmarried young women in six health facilities who met the inclusion criteria were recruited. Data were collected using an interviewer-administered, semi-structured questionnaire and analysed with the aid of SPSS 21.0. Univariate analysis was done for frequencies, means and standard deviations while hypotheses were tested using Chi square test and logistic regression. P value was set at p< 0.05. More than half (52.2%) of respondents were aged 20 to 24 years, 54.3% had never used a contraceptive and 82.1% reported their pregnancy was unplanned. Over half (57.1%) of the respondents reported high levels of anxiety and depression related to their pregnancy, 57.6% had a high perception of stigma and discrimination and 61.8% stopped schooling after discovering they were pregnant. Multivariate analysis revealed that compared to those who wanted their pregnancy, those who did not want their pregnancy had higher odds of experiencing high levels of anxiety and depression (AOR 6.38, 95% CI 2.93-13.88, p=0.00). It also showed that those who were not in relationship with their baby’s father had higher odds of perceiving high levels of stigma and discrimination (AOR 2.22, 95% CI 1.07-4.62, p=0.03). In conclusion, policy makers should intensify efforts to prevent unintended pregnancy among young unmarried women. They should not concentrate all efforts toward preventing unsafe abortion due to unwanted pregnancy, but focus attention also on how to help young women who choose to keep their pregnancy. Adequate and multidisciplinary supervision and support during pregnancy, labour and postpartum period will help promote psychosocial wellbeing among this group. The male partners of pregnant young women should also be empowered to take responsibility.

Sexual behaviour among the youth contributes largely to the burden of reproductive health problems in Nigeria. This may have been worsened by the introduction of electronic media like internet and television (TV). However, little is known about the effects of electronic media on sexual behaviour of youth in Nigeria. Therefore, exploring the influence of effect of electronic media on sexual behaviour of youth may help policy maker to provide interventions to these problems. Thus, this study was aimed at assessing the effect of electronic media on sexual behaviour of Undergraduates in the University of Ibadan.This was an analytical cross-sectional study, using a multistage sampling method and data were collected through self-administered semi-structured questionnaire. Variables measured are socio-demographic characteristics, exposure to electronic media and sexual practices of youths. Frequency tables were generated, and data analyzed by logistic regression.Four hundred and thirty three questionnaires were returned out of 456 distributed, giving a response rate of 95%. Mean age of respondents was 18.75 (SD = 2.5) years. About 58.4% of males use the internet and 58.6% watch TV while 41.6% of female use the Internet and 41.4% watch TV. Watching sexually explicit program on internet increases risk of having premarital sex (OR = 3.1; CI = 1.2-7.7) while watching non sexually explicit programmes on T.V protects from having premarital sex (OR = 0.4 CI = 0.2-0.8).These observed influence of exposure to sexually charged materials on the internet and electronic media indicates the need for efforts to be directed to controlling access, of youths to these sexually explicit programmes on the internet and television programmes.

Background: Despite changing sexual norms and mores generally perceived to be permissive of sexual expression, parents continue to serve as gateways to uptake of reproductive health services and commodities in our cultural settings. However, their support for adolescent uptake of human papilloma virus (HPV) vaccine are not well explored and documented. This study aims to assess parental knowledge and awareness of HPV infection and cervical cancer and their support for HPV vaccination for their adolescent children. Methods: In a descriptive cross sectional study 612 parents from in Ibadan North Local Government Area were interviewed using a pre-tested semi structured interviewer administered questionnaire to assess the awareness of HPV infection and cervical cancer as well as parental support for the vaccine. Results: Only a few of the respondents were aware of HPV infection (10.5%) and the HPV vaccine (6.5%), respectively. About 64.3% of those that were aware of HPV knew it can be transmitted through sexual intercourse. However, 78.4% supported the administration of the vaccine to their adolescent daughters. Reported reasons for not supporting HPV vaccination were high cost of the vaccine (32.2%) and lack of awareness of the vaccine (49.2%). Earning a monthly income above the minimum wage of 18,000 Naira increases the likelihood of parental support for HPV vaccination uptake for adolescents (p Conclusion: Ignorance and poverty remain as barriers to widespread coverage of the vaccine among adolescents. Health education and promotion on HPV infection and the HPV vaccine to the general public and subsidization of the vaccine to promote its uptake is advocated.

A descriptive cross-sectional study to assess adolescents' view of the practice and content of sex education within the family setting in a rural Nigerian community and explore whether there is any association between parental communication on sex and adolescents' sexual debut and habits. Simple random sampling was utilized, while a semi-structured questionnaire was used to collect data from 350 respondents. Data analysis was by the Statistical Package for Social Sciences (SPSS version 11). Majority of the respondents (48.8%) were late adolescents, 291 (85.1%) had had sex education, most (45.7%) of whom were exposed between ages 10 and 14 years. The main content of parental sex education was HIV/AIDS prevention (51.9%), avoidance of pregnancy (40.9%), abstinence (38.1%), and basic information about reproduction and biology (35.4%). Poor attitude to parental communication on sex was associated with a higher likelihood of pre-marital sex ( p = 0.001). Curiosity was the most common major reason for sexual debut. This emphasizes the importance of early sex education within the family setting and its possible impact in delaying sexual initiation. Promotion of parent-child communication about sexual issues is vital in order to improve the reproductive health of the adolescents in this environment. Community-based health education intervention programs for parents are recommended.

The study objective was to determine the nutritional status and its association with sociodemographic characteristics and health complaints of older persons presenting at the General Outpatients Department (GOPD) Clinic of University College Hospital (UCH), Ibadan, Nigeria. A cross-sectional descriptive design was used to select 500 consecutively presenting participants aged 60 years and older between September and December, 2009. The Mini-Nutritional Assessment (MNA) tool and body mass index were used to assess undernutrition and overweight, respectively. The prevalence of nutritional problems was 61.9% (undernutrition = 7.8% and overweight = 54.1%). Being unmarried (P 0.001), engagement in a job after the age of 60 years (P 0.001), constipation (P = 0.009), rectal bleeding (P = 0.008), and oral problems (mouth, teeth, and tongue) were significantly (P 0.001) associated with undernutrition. Younger age (P = 0.050) and female gender (P = 0.011) were significantly associated with being overweight. Logistic regression analysis showed being unmarried OR = 1.355 (95%CI 1.075-1.708) to be the most important factor for the development of undernutrition. The high prevalence of nutritional problems in this study underscores the need for intervention in this population. Correlation analysis (Pearson's) showed a positive association between BMI and MNA scores (r = 0.152, P = 0.001).

Context: Figures from several states indicate the prevalence of primary hyperthyroidism as 1.5%–5.4%. Goiters (including Graves' disease [GD]) and diabetes mellitus are the most common presentations at Nigerian endocrine clinics. Aim: This study aims to assess the efficacy of radioactive iodine-131 therapy (RAIT) of GD, evaluate factors affecting its outcome, and to find the impact of ophthalmic symptoms on response of GD to RAIT. Participants and Methods: A retrospective review of RAI-naϊve GD patients treated from 2006 to 2016 was performed. Results: Eighty-one treatments were made in this period to 75 patients; of these, 51 patients had had no prior RAI treatment. Overall, 41 patients (78.8%) were cured by mean time to cure 4.5 ± 2.36 months. Fourteen patients (26.9%) were cured by 3 months, an additional 19 (36.5%) by 6 months, an additional 5 (9.6%) by 9 months, and 1 more by 14 months, and 2 were cured later. Cure comprised euthyroidism in 14 patients (26.9%) and outright hypothyroidism in 27 (51.9%). Graves' ophthalmopathy (GO) is associated with less likelihood of cure (P = 0.025). Those with GO were ten times less likely to be cured than those without GO (odds ratio = 0.105, confidence interval = 0.11–0.979, P = 0.048). Conclusions: Findings suggest that GO is an adverse factor in RAIT for GD (as was found in an earlier study from this center) and also suggest that patients with GO will benefit from larger doses of RAI.

Although the mid upper arm circumference (MUAC) is used as a proxy to assess wasting in children, its validity abounds in controversies. This study therefore assessed the validity of MUAC as a measure of nutritional status among children aged 12-59 months in urban setting in western Nigeria. A cross sectional study of children aged 12-59 months in selected nursery schools in Moniya, Akinyele local government area, Oyo state was carried out between February to April 2010. The age, weight, length and MUAC, were obtained from the school children who were selected through total sampling. The sensitivity, specificity, positive predictive value, and negative predictive values of the MUAC were determined using weight for age as gold standard (underweight). Z-Scores for anthropometric indicators were calculated using EPI-NUT programme. Receivers operating curve was prepared to determine the optimal cut off of MUAC for the sensitivity and specificity. The overall prevalence of under nutrition among the respondents was 5.6%. The mean mid upper arm circumference was 15.47 ± 1.4 cm and appears to increase with age from 11.49 ± 3.0 at 12-23 months and peaks at age five with a value of 18.05 ± 3.5. At 13.5 cm cut off, the sensitivity of MUAC is 20%, and the specificity is 95.3%, with a Kappa of 16.7%. The receivers operating curve reveals an optimum cut off of 15.5 cm with optimal but improved MUAC sensitivity of 80% and specificity of 53.5%. Thus MUAC was a poorly sensitive indicator of under nutrition at a cut-off below 13.5 cm but highly sensitive at 15.5 cm. A higher cut off value is therefore for recommended for screening for acute malnutrition among under five children.

BACKGROUND: Antenatal care utilization is still low in Nigeria. This underutilization varies from region to region and from state to state. This study assesses the factors that determine the utilization of antenatal care service in Ibadan. METHODS: A cross-sectional study was carried out in two randomly selected local government council area in Ibadan. A pretested questionnaire was administered to 400 women. Information was obtained from the women on their attendance at antenatal clinic and the reasons for not attending the antenatal clinics RESULTS: Majority (76.8%) of the respondents attended ANC clinic. Women in urban areas were more than 2 times likely to attend antenatal clinic than women in urban areas [(OR=2.177, 95% CI, 1.081-4.382)]. Women who were Muslims or other religions were more than 2 times likely to attend ANC clinic than women who were Christians [(OR=2.398, 95% CI, 1.264-4.557)]. Also, Women who were 25 years and older were more than 2 times more likely to utilize antenatal than women who were 25 years or younger [(OR=2.236, 95% CI,1.106-4.107]. CONCLUSION: Efforts towards ensuring the utilization should be targeted towards rural areas, the importance of modern antenatal care should be emphasized even in the religious settings and younger women should be encouraged to utilize antenatal care services. Key words: maternal health services, antenatal care, utilization

Little efforts are geared towards prevention of CNS anomalies in the developing countries. A 1-year prospective cross-sectional analysis of the cases of CNS congenital anomalies seen in a Nigerian neurosurgical unit. This included both the children’s and parents’ sociodemographics, the profiles of the CNS anomalies, and the maternal obstetric health behaviors toward primary and/or secondary prevention of the anomalies. Statistical analysis was done with the Pearson’s chi-square (or Fishers’ exact) test. Level of significance set at P

Background The health-related quality of life (HRQOL) of hypertensives may be influenced by blood pressure, adverse effects of drugs used to treat hypertension, or other factors, such as the labelling effect, or beliefs and attitudes about illness and treatment. There is paucity of information on the determinants of HRQOL among black hypertensives especially in the developing countries such as Nigeria. This study describes the HRQOL and its determinants among black patients diagnosed and treated for Hypertension in Nigeria. Methods The study was a cross sectional in design that involved 265 hypertensive patients receiving treatment at the medical outpatient unit of the Federal Medical Centre Abeokuta, Nigeria. They were all consecutive patients that presented at the hospital during the period of the study who meet the inclusion criteria and consented to participate in the study. Demographic data, disease characteristics such as symptoms and signs and recent drug history were obtained from the patients and their hospital records as documented by the physician. The SF-36 questionnaire was administered once by interview to the participants to measure their HRQOL. Descriptive statistics was used in summarizing the demographic data and hypertension related histories of the participants. Multiple linear regression was used to model for the influence of socio demographic and clinical variables of the hypertensives on their HRQOL. Results Physical functioning domain mean score was far below average (33.53 ± 29.65). Role physical and role emotional domains were a little above average (54.7 ± 40.4, 51.1 ± 40.6 respectively). Role Physical (p = 0.043), Role Emotional (p = 0.003), Vitality (p = 0.014) and Mental Health (p = 0.034) domain mean scores for patients with controlled BP were significantly higher than patients with uncontrolled BP. The overall HRQOL was significantly better in the group of hypertensives with controlled blood pressure (p = 0.014). Increasing blood pressure (p = 0.005) and symptom count (p < 0.001), the presence of stroke (p = 0.008) and visual impairment (p = 0.015) were significant negative predictors of the overall HRQOL. Conclusion This study provides evidence for a model that links patients' status with regard to biology (blood pressure), symptoms, and functionality (HRQOL) and may prove useful in guiding follow-up of patients who receive treatment for hypertension. Identification of patient's symptoms, blood pressure, complication/comorbidity and changes in functioning may help clinicians increase their effectiveness in helping patients maintain adherent behaviour with drug and non drug interventions in chronic diseases such as hypertension.

UNLABELLED The purpose of this study was to describe the knowledge, attitude, and perception of teachers of their role in the sexuality education of secondary school students with a viewto suggesting strategies for improvement. METHODS The study was a descriptive cross-sectional survey. Information was collected from 305 secondary school teachers selected by multi-stage random sampling method from Osun state, Nigeria using a pre-tested semi-structured questionnaire. RESULTS Median age of respondents was 36 +/- 8.18 years. Male/female ratio was 1:1.2. Knowledge about key reproductive issues was poor and inadequate. Knowledge of more than one contraceptive method was low (39.0%), Condom was the most frequently mentioned (59.3%). The teachers exhibited poor perception of their role in sexuality education of their students. 52.8% placed the sole responsibility for sexuality education on parents and only 20.7% found that it should start before age 10 years. Mean menarcheal age was 13.1 +/- 1.7 y. A statistically significant association was found between respondents' gender and knowledge of menarcheal age (p = .03); and between class taught and knowledge of menarcheal age (p = .003). 86.90% had positive attitude towards inclusion of sexuality education in the school curriculum; however, 43.6% felt that contraceptive methods should not be part of the course content. CONCLUSION An urgent need exists for education and re-orientation of teachers through seminars and workshops, in-service training education program to equip them properly for the task. Policy makers need to formulate a definite, explicit, and workable sexuality education policy.

No Abstract. Nigerian Medical Practitioner Vol. 52 (1) 2007: pp. 16-18

Evidence suggests that infants feel pain, and painful experiences may lead to subsequent increased pain sensitivity. Owing to concerns regarding the potential adverse effects of pharmacological interventions in newborns, effective alternatives for pain control are being sought.The Neonatal Infant Pain Scale (NIPS) was used to determine the analgesic effect of breastfeeding during venepuncture.The study was of cross-over design where each neonate served as his/her own control. Median pain scores during venepuncture when neonates were being breastfed (BF) were compared with those when neonates were not being breastfed (NBF). The site of venepuncture and number of previous venepunctures were noted. Pain was assessed using NIPS.In all, 38 term neonates (25 male, 13 female) were recruited. Mean (SD) age and weight were 8.42 (8.74) days and 2.89 (0.67) kg, respectively. The median pain score (interquartile range) of the neonates when breastfed was 1.50 (1-2), and 4.00 (2-6) when not breastfed (p=0.0001). The Kruskal-Wallis H-test did not show statistically significant differences between the BF and NBF groups when the number of previous punctures (p=0.57, p=0.27) and site of venepuncture (p=0.71, p=0.77) were considered.Using NIPS, it has been demonstrated that breastfeeding is analgesic in neonates during venepuncture and previous venepuncture/s and site of venepuncture do not seem to affect pain scores. Breastfeeding should be the first-choice analgesic during painful procedures in neonates.

Anaemia in pregnancy is a serious condition contributing to maternal mortality, morbidity and fetal morbidity. Data however available on this condition in Nigeria is mainly hospital based and biased towards women with high-risk pregnancies. This study was carried out to determine the prevalence of anaemia and identify sociodemographic factors contributing to anaemia among low risk pregnant women attending primary care facilities. Five hundred and ninety seven pregnant women attending randomly selected primary care centres in urban and rural areas in Oyo State, Nigeria were enrolled and followed up till delivery of their babies. One hundred and ninety six (32.8%) of the mothers were anaemic. Prevalence of anaemia decreased with increasing maternal age in both urban and rural areas. Regression analysis showed that urban mothers (P = 0.003) and those who booked late in pregnancy (P = 0.048) were significantly more likely to be anaemic. Mothers with birth intervals 24 -35 months and women between the ages 20-29 years (P = 0.011) had a lower risk for anaemia. Prevalence of anaemia in pregnancy is still high in Nigeria. Effort should be made to ensure that mothers attend antenatal clinic early. Longer birth spacing should be encouraged through the use of effective contraception.

The human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) have constituted a major challenge and concern worldwide. This is especially true among health workers who have to take care of such patients. This paper is aimed at studying the attitude to HIV/AID burn patients of nurses working in a burn unit. The work was carried out at the burns unit of the National Orthopaedics Hospital in Enugu, Nigeria. In a cross-sectional descriptive study, 125 questionnaires were distributed among nurses working in the burn unit. All the 120 nurses who responded were aware of HIV/AIDS: 80.8% of them believed that the prevalence was high, 93.3% that they could be infected while taking care of the patients, 91.5% that all burn patients should be screened for HIV, and 41.4% that their knowledge of the patients’ HIV status would affect their professional duty to them; 31.1% would not want to dress the wounds of known HIV/AIDS burn patients. We conclude that there is a need to educate nurses and indeed all health care workers on adherence to universal precaution rather than routine screening for HIV of all burn patients as knowledge of the patients’ HIV status may lead to discrimination against them.

This study is part of a larger multi-centre survey on widowhood in Nigeria. Information was gathered using a structured self-administered questionnaire from 42 widows who are working at the University College Hospital and the College of Medicine, in Ibadan, capital of Oyo State in the southwest of Nigeria. The findings reveal that the majority of these widows are middle aged, between 35 and 55 years of age, with little or no prospect of remarriage. Almost half of them had only primary education and are of low professional status; 48% of them earn very low salary, and had a high parity, having 5 or more children. The problems identified by these widows in order of priority include financial/economic hardship (69%), absence of husband's will resulting in the loss of properties to husband's relations (55%), loneliness and depression (41%), poor relationship with in-laws (41%), difficulty in social interaction (21%), and poor housing (17%). Recommendation for alleviating the hardships of widows suggested include encouragement of female education, enhancement of women, economic empowerment, improving availability and effective utilization of family planning services and encouraging men to write their wills early in marriage. Also, through advocacy and public health awareness campaigns, to enlighten the masses about the plight of the widows, in order to eliminate the dehumanizing traditional practices to which Nigerian widows are often subjected.

We reviewed the nurse's involvement and role perception on informed consent in LAUTECH Teaching Hospital, Osogbo, Osun State, NigeriaThe study aimed at determining the nurses' knowledge, attitude and perception of role in informed consent and the level of participation in the procedure.A descriptive cross sectional study of the nurses in the medical and surgical units of LAUTECH Teaching Hospital was carried out using semi structured questionnaire.Sixty five nurses participated in the study. A high proportion - 60 (92.3%) had heard of informed consent but only 26(40%) had correct and adequate knowledge of informed consent. Forty (61.5%) had participated as witnesses to the procedure of seeking informed consent. Participation was only sometimes in 38 (58.5%) of respondents. Forty seven (86.2%) nurses wanted nurses to be involved in obtaining informed consent because it improves quality of patient care while 38(58.5%) nurses believed that involvement of nurses should be because it is the nurses' statutory responsibility.It would appear that the knowledge of informed consent among nurses was inadequate and nurses were not adequately carried along in the process. Training of nurses in this important procedure would greatly enhance the quality of patient care.