Alhaji A. Aliyu

Prevalence of Psychoactive Substance Use Among Commercial Motorcyclists and Its Health and Social Consequences in Zaria, Nigeria

BACKGROUND In recent years commercial motorcyclists (Okada riders) have come to bridge the huge public transport gap in most cities across the country. However, this is not without the dangers they pose to themselves, passengers and to other road users. It is claimed that some of these Okada riders operate under the influence of drugs and other substances. But there are few community-based studies that have investigated the problem in this part of Nigeria. Therefore, this study was conducted to determine the prevalence, health and social consequences of psychoactive substance use among commercial motorcyclists (Okada) in Zaria, northern Nigeria. METHOD Multi-stage sampling technique was used to sample commercial motorcyclists registered with commercial motorcyclists union in Zaria city, Kaduna state, Nigeria. Structured, closed ended and interviewer administered questionnaires were used to collect information on socio-demographic characteristics, factors influencing psychoactive substance use, impact on health status, motor cycle riding experience and work performance. RESULTS Two hundred commercial motor cyclists were intervi ewed, majority of them were in the age group 21-25 years (55.5%) with a mean age of 25.4 +/- 3.9 years. All the motorcyclists were male, (60.5%), had no formal education, (79.5%) are of Hausa extraction and (69%) worked for more than 10 hours per day. A high prevalence of 59.5% of road traffic accident that was associated with the use of psychoactive drugs was found among the motorcyclists. Commonly identified psychoactive substance/drugs used were: marijuana [Indian hemp] 25.8%, solution 24.5%, caffeine (Kola) 15.8%, and coffee 4.8%. Keeping awake, suppression of fatigue, and peer group effect were the identified factors influencing psychoactive substance use. The commonest types of injuries sustained were bruises and lacerations (62.5%) and fractures of upper and lower limbs (10.5%). CONCLUSION Road traffic accidents among commercial motorcyclists are a frequent occurrence in this part of the country. There is need for public awareness campaigns on road safety education and health consequences of psychoactive substance use among commercial motorcyclists. It is further recommended that law enforcement agencies (NAFDAC, NDLEA and FRSC) need to work in tandem so as to curb the problem of substance abuse in our society and reduce the rate of accidents on Nigerian roads.

Knowledge, Sources of information, and Risk Factors for Sexually Transmitted Infections among Secondary School Youth in Zaria, Northern Nigeria

Background: Sexually transmitted infections (STIs) are responsible for a variety of health problems especially among the youth who engage in risky sexual behavior. There are few studies that describe STIs among the youths in Northern Nigeria. The objective of the study was to assess knowledge of STIs and risk factors among secondary school youth. Materials and Methods: This was a cross-sectional study in which structured, self-administered questionnaire was used to collect data on socio-demographics, knowledge on STIs, and risk factors. Three senior secondary schools were purposively selected for the study. Results: A total of 1765 youths aged 10-30 years with mean age of 16.9 ± 2.0 years participated in the study. 1371 (77.7%) and 394 (22.3%) were respectively Muslim and Christian. Mean age at first sexual intercourse was 16.7 ± 2.0 years. A majority (67.6%) of them heard about STIs; sources of information of STIs were school lessons 23.6%, mass media 23.3%, and health magazines 19.2%, respectively. Generally, knowledge on STIs was good as 75.4% of respondents knew how the disease is transmitted. This knowledge was significantly associated with class of student, place of treatment, and religious teaching (χ2 = 9.6, P = 0.047, χ2 = 22.1, P = 0.035 and 42.6, P = 0.001, respectively). Mean knowledge score was 0.698 ± 0.01. A majority of respondents were engaged in risky sexual behavior as only 16.2% use condom as a preventive measure. Eleven percent reported ever having an STI in the past and majority (52.8%) go to government hospital for treatment of acquired STI. 56% of the youth had two or more boy/girl friends and 30% had sexual relationships. Conclusion: It was concluded that secondary school youth had good knowledge about STIs; however, the opposite is true when it comes to preventive practice (use of condom). Interventions such as periodic publicity awareness and school seminars focusing on STI preventions are needed to control the disease among the youth.

Management of disasters and complex emergencies in Africa: The challenges and constraints

Natural and man-made catastrophes have caused significant destruction and loss of lives throughout human history. Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. African continent has not been spared of these events. A new phenomenon in the continent is terrorism that is fuelled by globalization of arms trade and has contributed significantly to escalation of conflicts in sub-Saharan Africa (SSA) resulting in complex emergencies and destruction of socioeconomic structures. The aim of this paper is to review relevant papers on management of disasters and complex emergencies in Africa and the challenges and constraints against the background of a weakened health system. Systematic search of published literature was conducted between 1990 and 2013. Grey literature (technical reports, government documents), published peer review journals, abstracts, relevant books and internet articles were reviewed. The review revealed that the frequency of both natural and man-made disasters in Africa is escalating. Complex emergencies are also on the increase since the Rwandan crisis in 1994. The impact of these events has overstretched and overwhelmed the health care system that is least prepared to handle and cope with the surge capacity and also render normal services. In conclusion, there is an urgent need for national emergency agencies/departments across Africa to develop a robust emergency preparedness and response plan. Every hospital most have a disaster management committee with flexible disaster management plan to respond to these catastrophes. There is a need for curriculum review in tertiary institutions across SSA to introduce and or expand training in disaster management.

Urbanization, cities, and health: The challenges to Nigeria – A review

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living.

Predictors of delayed Antenatal Care (ANC) visits in Nigeria: secondary analysis of 2013 Nigeria Demographic and Health Survey (NDHS)

Introduction Antenatal Care (ANC) is an important component of maternal health and covers a wide range of activities with huge potential benefits for positive pregnancy out comes. However, large proportions of women do initiate ANC early resulting in adverse consequences. Methods The study utilized the nationally-representative sample of women of reproductive age interviewed during the 2013 Nigeria DHS. Analysis was restricted to 20, 467 women aged 15-49 years who had a live birth in the five-year period prior to the survey. Multinomial logistic regression was performed using Stata v13 to determine significant factors related to timing of initiation of ANC. Relative risk ratio (RRR) was used to assess the strength of association between independent and dependent variables. Results Overall, 27%, 62% and 12% of women initiated ANC in the first, second and third trimesters respectively. In both the two model, the findings reveal that maternal education, level of media exposure, region and place of residence are the uniform predictors of initiation of ANC; having health insurance is a significant predictor of third trimester ANC initiation relative to first to first trimester only. Within the categories of household wealth, levels of participation in household decision-making and region some categories are significant predictors while others are not. Conclusion Maternal education, level of media exposure, region and place of residence are the uniform and consistent predictors of delay in ANC initiation. This suggests that girl-child education, universal health coverage and universal health insurance could be the interventions required to improve service utilization and maternal health.

Social characteristics and risk factors for diseases among internally displaced persons: A study of stefano's foundation camp in Jos, Nigeria

Background: Nigeria like the rest of the world is exposed to a wide range of natural and human-induced disasters such as flood, plane crash, communal clashes, and postelection violence and recently, insurgency from Boko Haram. Most of these disasters have led to population displacement and its consequences. This study assessed the social characteristics and risk factors for diseases among the internally displaced persons (IDPs) at Stefanos foundation camp in Jos, Nigeria. Methodology: The study was a cross-sectional descriptive in nature carried out on March 1–30, 2015. The data were collected using 312 interviewer-administered questionnaire, key informant interview, and participants observation and analysis was performed using SPSS version 20.0. Results: Majority (85%) of the respondents were within the age bracket of 18–49 years, 61% of females, 39% had no formal education, 53% of farmers by profession among others, 96% and 4% of them were displaced as a result of the insurgency in Borno and Adamawa States, respectively and had stayed in the camp for 3 months (43.8%). There was report of several morbidities and one case of mortality from malaria, diarrhea, and cholera due to inadequate water supply, poor refuse, and fecal disposal and the presence of disease vectors in the camp and a case of death of a 6-year-old child from malaria. Majority (83%) of the IDPs obtained medical treatment at the ill-equipped camp clinic. Conclusion: This study showed that the IDPs were faced with so many challenges and the nongovernmental organization has been rendering assistance. There is a need for all relevant stakeholders to key in to make life meaningful to this vulnerable group.

Sources of health care financing among patients at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Introduction: Health care financing is the mobilization of funds for health care services. This study determined the various sources of health care financing among the patients on admission at the Ahmadu Bello University Teaching Hospital (ABUTH), Shika-Zaria in 2011 and the effects of the medical bills on the patients and their family members. Methodology: A multi-staged sampling technique was used to select 100 clients for the study. The clients were stratified into the four major wards of the ABUTH; the medical, surgical, obstetrical and gynecological and the pediatric wards. A total of 25 clients were equally allocated to each ward and these were then selected by balloting. Information was sought on their socio-demographic characteristics, sources of the health care financing and the adverse effects of the medical bills on the patients and their family members. Results: Majority of the clients were married, Hausa Muslim housewives who earned Conclusions: The main source of health care financing in this tertiary center was through out of pocket expenditure by patients and their relatives. Recommendation: There is a need for the urgent implementation of the community health insurance scheme in Nigeria for the benefit of the less privileged.