Ai Zoakah

Malaria among antenatal clients attending primary health care facilities in Kano state, Nigeria

BACKGROUND Malaria in pregnancy remains a major public health problem especially in sub-Saharan Africa. However, the prevalence of clinical and asymptomatic infection among antenatal client (ANC) attendees is largely unknown, especially at primary health care (PHC) level in northern Nigeria. This study assessed the prevalence of fever, malarial parasitemia and anemia among pregnant women attending PHC facilities in Kano, northern Nigeria. METHODS A cross-sectional descriptive study was conducted among 360 ANCs attending PHC facilities in two Local Government Areas (LGAs) in Kano state. Data were collected using a pre-tested semi-structured interviewer administered questionnaire. Blood samples were also obtained for thin blood smear for malaria parasite using Giemsa staining technique. Hemoglobin was estimated from the Packed Cell Volume (PCV) determined using hematocrit. RESULTS Age of the subjects ranged from 15 to 42 years with a mean +/- SD of 24.0 +/- 6.0. Up to 39.2% (n = 141) (95% Confidence Interval = 34.1-44.4%) of the subjects were found to have malarial parasitemia. Exactly 36.2% (n = 51) of those with parasitemia had fever (temperature >or= 37.5 degrees C) while 63.8% (n = 90) of them were asymptomatic. Anemia, (hemoglobin of <or=11 g/dl) was found in 48.1% (n = 173) of the respondents. A higher proportion of primigravid and secondigravid clients (61% vs. 39%) and younger pregnant women (54.6% vs. 45.4%) had malarial parasitemia compared to multigravid and older women, respectively. Similarly, a significantly higher proportion (67.6%) of anemic ANC clients had malarial parasitemia. (chi2 = 113.25, df = 1, P < 0.05). CONCLUSION Malarial infection is common among the ANC clients attending PHC facilities in Kano state and the infection is commonly associated with anemia. Intermittent Preventive Treatment (IPT) should be provided especially among primigravid, secondigravid and younger mothers at PHC centres.

Supportive supervision: An effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria

BACKGROUND Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. MATERIALS AND METHODS This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. RESULTS The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. CONCLUSIONS This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.

Risk factors associated with dental fluorosis in Central Plateau State, Nigeria

OBJECTIVES Dental fluorosis is known to occur in some parts of Plateau State, but the factors responsible for its occurrence are unknown. The purpose of this study, therefore, was to determine the factors associated with the occurrence of dental fluorosis in Central Plateau. METHODS The study was cross-sectional and comparative in design. Subjects were selected using the multi-stage sampling technique. One Local Government Area each was randomly selected from the high and low altitude parts of the district, and from each selected Local Government Area two health districts were randomly selected with probability proportional to size. From each of the selected health districts two major settlements were selected again with probability proportional to size. Twelve- to fifteen-year-old lifelong residents of the selected settlements were then selected for study. Each respondent completed an interviewer-administered questionnaire after which he/she was clinically examined to ascertain his/her fluorosis status. Samples of water were collected from water sources consumed by the respondents in each settlement. RESULTS One thousand one hundred children aged 12-15 years were studied, 554 (50.4%) of which lived in the high altitude part of the district and 546 (49.6%) in the low altitude part of the district. Fluorosis prevalence was significantly associated with altitude and the fluoride level of water. The prevalence of fluorosis was significantly associated with altitude (chi(2) = 85.735, d.f. = 1, P < 0.0001) and the fluoride level of water (chi(2) for trend = 8.009, d.f. = 1, P < 0.05) in the low altitude parts of the district. None of the respondents had used fluoride-containing toothpaste before 4 years of age and none used fluoride supplements. CONCLUSION The occurrence of dental fluorosis in Central Plateau could be because of the high altitude of the area and the fluoride concentration of the waters consumed in the district.

Pattern of obesity among chief executives of public and private organizations in Jos, Plateau state, Nigeria

Background: Obesity and overweight are known to be associated with other non-communicable diseases (NCD). In recent times, there has been an increase in the prevalence of this health-related condition, not only in the developed but also in developing countries. This study set out to assess the prevalence and factors associated with this health condition among chief executives of private and public organizations in Jos metropolis. Materials and Methods: A total of 250 chief executives of public and private institutions in Jos north local government area (LGA) of Plateau State were selected using a multi-stage sampling technique and data was collected from them using interviewer-administered, structured questionnaires. The data were analyzed using Epi Info statistical software (version 3.5.3). Results: The ages of the respondents ranged between 27 and 68 years with a mean of 44 + 2 years. Majority of the respondents (68%) were males. The prevalence of obesity was found to be 38% while 48.8% of subjects were overweight. BMI of subjects had a statistically significant relationship with sex and income of respondents but not with exercise. There was a fair knowledge of obesity, its contributory factors, and complications among the respondents (63.6%). Conclusion: The prevalence of obesity and overweight were found to be high among the studied executives, despite their fair knowledge of the disease and its complications. The increasing prevalence of obesity among chief executives of organizations needs to be addressed by increased health education. Managements of organizations should insist on periodic medical check-ups for their executives.

Effect of health education on the uptake of HIV counseling and testing among long distance drivers in Jos North Local Government Areas of Plateau State

Background: The impact of HIV/AIDS has been felt in virtually all aspects of life. Long distance drivers are of particular concern to HIV prevention and care programs because they constitute a high risk group. HIV Counseling and Testing (HCT) is an intervention which gives the client an opportunity to confidentially discuss his or her HIV risks and be assisted to learn his/her HIV status for purposes of prevention treatment care and support. The objective of this study was to determine the effect of health education on the uptake of HCT among Long Distance Drivers (LDDs) in Plateau State. Methodology: This was a quasi-experimental study with a pre and post intervention phase carried out among 161 LDDs in Jos North Local Government Areas. Health education intervention was provided using a structured health education guide in the form of lecture and discussion. Epi-infoTM statistical software version 3.5.4 developed by Centre for Disease and Control and Prevention (CDC) 1600 Clifton Rd. Atlanta GA 30333 usa was used for data analysis and 95% confidence interval was used for the study and P = 0.05 was considered as statistically significant. Results: The mean age of the respondent in this study was 41.0 ± 7.9 years with majority (92.5%) of the LDDs married and 91.3% resident within the state. Knowledge and uptake of HCT among LDDs improved significantly from 4.17 ± 1.43 to 6.70 ± 1.55 and 18.6-57.2% following the intervention (P < 0.001) respectively. Conclusion: This study has shown that health education is an effective tool in improving the uptake of HCT among long distance drivers. Therefore it should be used to improve HCT uptake among high risk groups.

Presentation and survival in patients with hematologic malignancies in Jos, Nigeria: A retrospective cohort analysis

Background: Hematologic malignancies cause significant morbidity and mortality and are not uncommon in resource-limited low-income countries. However, the types, pattern of presentation, and treatment outcomes vary across regions. We assessed the presentation and overall survival (OS) over an 11-year period in adult patients with hematologic cancers in Jos, North Central Nigeria. Materials: and Methods This retrospective outcome study evaluated patients who presented with hematologic malignancies between 2005 and 2015 at the Jos University Teaching Hospital, Jos. Variables of interest were abstracted through chart reviews. Descriptive statistics were used to evaluate baseline and follow-up parameters. OS was assessed by using Kaplan–Meier method. Results: Sixty patients, contributing 25,994 person-days of follow-up were evaluated. The mean age was 43 ± 17 years and 61.7% were males. Thirty-one patients (51.7%) presented with leukemia, 45.0% with lymphoma, and 3.3% with multiple myeloma. Forty-two (70.0%) presented with advanced disease, 5 (5.2%) were human immunodeficiency virus positive and 4 (6.7%) had died at the end of follow-up. OS was 84.3% (95% confidence interval: 58.1–94.7). Survival differed by disease group (P = 0.01) and having fever at presentation (P = 0.02). Conclusion: We found long-term OS to be impacted by disease type and status of fever at presentation. Disease-specific strategies to improve early diagnosis and therapies are needed to ensure optimal outcomes in Nigerian patients.

Determinants and outcome of teenage pregnancy in a rural community in Jos, Plateau State, Nigeria

Background: In Nigeria, the rate of teenage mothers was reported in 2008 to be 22.9% and the poor socio-demographic status of the pregnant teens play a major role in the poor maternal and child health indices and contribute to the slow pace of attainment of the related Millennium Development Goals (MDGs). This study was designed to determine the proportion of teenagers who have been pregnant, the outcome of the pregnancy and the socio-demographic determinants of the affected teens in the community. Materials and Methods: It was a community-based cross-sectional study in which an interviewer administered questionnaires was administered to 192 respondents aged 13-19 years. Results: the proportion of those who have ever been married was 25.5%, with significant association found between the age of the teenagers and being pregnant (P < 0.001). Most of the teenagers were single (75.6%) and a significant association was found between TP and teenage marriage (P < 0.001). Although 72.9% were still in school, TP was significantly associated with teenagers that were out of school (P = 0.001). TP was observed to be higher among teens with lower level of parental education though not statistically significant. (Father- none-33% and primary-36.4%; Mother: Primary-30.4%). TP was also found to be higher among teens of unskilled parent (30.4%), from polygamous family setting (42.3%) and teens in tertiary level of education (40.7%), though no statistical significant association was observed. Conclusion: Teenage pregnancy still remains a major issue in our environment and the socio-demographic characteristics of both the parents and the teenagers were found to be determinants of teenage pregnancy.

Use of community volunteers to improve knowledge and uptake of tuberculosis and human immunodeficiency virus screening services among community members in Qu'an Pan Local Government Area, Plateau State

Background: The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV) / AIDS is one of the major public health challenges of our time. Ignorance fear stigma and poverty have promoted the course of TB and HIV infections particularly among people residing in the rural areas despite the availability of free diagnostic and treatment services. Community volunteers (CV) have been used successfully to promote and sustain knowledge and utilization of health services in various parts of the world. This study sought to determine the impact of the use of CV on knowledge and uptake of TB / HIV screening services in the study population. Methodology: The study design was a community-based quasi-experimental study. A multistage sampling technique was used to select the study participants. The Primary Health Care (PHC centres offering TB and HIV screening services were the primary sampling units while the communities close to the PHCs were the secondary sampling units. The intervention involved a CV in each community providing education and services on TB and HIV / AIDS infections to the community members. Knowledge and uptake of TB and HIV screening services among the community members were assessed before and after the intervention. Results: A total of 1305 people were recruited into the study and five communities each were selected per PHC. Postintervention there was an increase in the knowledge of the cause mode of transmission symptoms and treatment of TB among community members from a mean score of 2.23 +or- 2.31 to 5.37 +or- 2.64 (P < 0.0001). There was also an increase in the knowledge of the modes of transmission symptoms and prevention of HIV / AIDS among community members from a mean score of 6.66 +or- 2.92 to 8.36 +or- 3.35 (P < 0.0001). Uptake of TB screening rose from 59.4% to 75.0% (P = 0.0161) among community members with a history of chronic cough and uptake of HIV counselling and testing (HCT) also rose from 53.8% to 64.1% (P = 0.0215) among the community members. Conclusion: Community Volunteers were found to improve the people’s knowledge of TB and HIV / AIDS infections as well as uptake of HCT and TB screening services. Their use will help improve TB and HIV collaborative activities and also contribute to the reduction of morbidity and mortality associated with TB and HIV infections.

Training: A vital tool for improving the knowledge and practice of food safety and hygiene among food handlers in boarding secondary schools in Plateau State

Background: Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food handlers have been found to play prominent roles in the transmission of food borne diseases, therefore training of food handlers on food safety and hygiene is crucial to the prevention of food borne diseases. Methodology: A quasi-experimental study carried out among food handlers in boarding secondary schools in Jos North Local Government Area to determine the effect of training on the knowledge and practice of food safety and hygiene. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≤ 0.05 considered statistically significant. Result: The mean age of the food handlers in the study was 42.07 ± 8.71 years with the mean years of work experience as 11.59 ± 8.05 years. The level of knowledge of food safety and hygiene improved significantly after the training ( P χ 2 = 76.6; P < 0.001). Conclusion: This study has demonstrated the effectiveness of training in improving the knowledge and practice of food safety and hygiene among food handlers.