Bassey Ikpeme

Factors associated with appropriate home management of uncomplicated malaria in children in Kassena-Nankana district of Ghana and implications for community case management of childhood illness: a cross-sectional study

BackgroundHome management of uncomplicated malaria (HMM) is now integrated into the community case management of childhood illness (CCM), an approach that requires parasitological diagnosis before treatment. The success of CCM in resource-constrained settings without access to parasitological testing significantly depends on the caregiver’s ability to recognise malaria in children under five years (U5), assess its severity, and initiate early treatment with the use of effective antimalarial drugs in the appropriate regimen at home. Little is known about factors that influence effective presumptive treatment of malaria in U5 by caregivers in resource-constrained malaria endemic areas. This study examined the factors associated with appropriate HMM in U5 by caregivers in rural Kassena-Nankana district, northern Ghana.MethodsA cross-sectional household survey was conducted among 811 caregivers recruited through multistage sampling. A caregiver was reported to have practiced appropriate HMM if an antimalarial drug was administered to a febrile child in the recommended regimen (correct dose and duration for the child’s age). Binary logistic regression was used to determine factors associated with appropriate HMM.ResultsOf the 811 caregivers, 87% recognised the symptoms of uncomplicated malaria in U5, and 49% (n = 395) used antimalarial drugs for the HMM. Fifty percent (n = 197) of caregivers who administered antimalarial drugs used the appropriate regimen. In the multivariate logistic regression, caregivers with secondary (OR = 1.71, 95% CI: 1.03, 2.83) and tertiary (OR = 3.58, 95% CI: 1.08, 11.87) education had increased odds of practicing appropriate HMM compared with those with no formal education. Those who sought treatment in the hospital for previous febrile illness in U5 had increased odds of practicing appropriate HMM (OR = 2.24, 95% CI: 1.12, 4.60) compared with those who visited the health centres.ConclusionsHalf of caregivers who used antimalarial drugs practiced appropriate HMM. Educational status and utilisation of hospitals in previous illness were associated with appropriate HMM. Health education programmes that promote the use of the current first line antimalarial drugs in the appropriate regimen should be targeted at caregivers with no education in order to improve HMM in communities where parasitological diagnosis of malaria may not be feasible.

Influenza A H1NI (Pandemic 2009): How prepared are healthcare providers in Calabar, Nigeria?

In April 2009, an outbreak of influenza was reported in Mexico and California and within months, it spread to all continents of the world. An influenza pandemic has always posed a threat to global public health. The objective of this study was to assess the knowledge, attitude, reported practice and preparedness of health care providers in Calabar, Nigeria, regarding the H1N1 pandemic. This was a prospective study. A semi-structured questionnaire was administered on health care providers in Calabar, Nigeria. One hundred and forty-five (41.6%) respondents reported that the infection was transmitted from pigs to humans whereas 53 (15.1%) reported that it was transmitted from humans to humans. Two hundred and thirty-one (66.0%) respondents were not willing to work in a hospital unit where patients with Influenza A H1N1 are treated. One hundred and thirty-eight (39.4%) respondents were willing to receive vaccination against Influenza A H1N1 while majority, 212 (60.6%) were not willing. There are gaps in knowledge of respondents regarding H1N1 infection and their level of preparedness is low. Capacity building in emergency preparedness for infectious disease epidemic is recommended. Key words: Influenza, H1N1, pandemic, infections, Calabar, Nigeria. INTRODUCTION The Black Death of the 14

Social determinants of alcohol use among drivers in Calabar

Objective: Hazardous use of alcohol is a public health problem which accounts for 4.0% of global disease burden. Although the prevalence of alcohol use among drivers of commercial vehicles in Nigeria has been documented, not much is known about its social determinants. This study was, therefore, aimed at assessing the social determinants of alcohol use among drivers of commercial vehicles in Calabar. Materials and Methods: A cross-sectional descriptive study was conducted among 360 male commercial drivers. A semistructured questionnaire, which included the World Health Organization Alcohol Use Disorders Identification Test, was administered at interview. Binary and multinomial logistic regression analyses were used to identify social determinants of any and hazardous alcohol use. Results: Determinants of any alcohol use (binary logistic) were history of use by parents (adjusted odds ratios (AOR)=2.7; 95% CI=1.1–6.3), friends (AOR=3.2; 95% CI=1.3–7.8) and ready availability (AOR=4.1; 95% CI=1.9–8.8) while determinants of hazardous use (multinomial logistic) were history of use by parents (AOR=5.8; 95% CI=2.0–16.9), siblings (AOR=7.0; 95% CI=2.6–16.9), friends (AOR=6.6; 95% CI=1.8–24.4), hostile upbringing environment (AOR=3.8; 95% CI=1.3–11.1), use of other drugs (AOR=55.6, 95% CI=14.5–200), and respondents who had fathers with a maximum of primary or no formal education (AOR=4.6; 95% CI=1.8–11.8). Conclusion: Alcohol use was associated with family use, friends’ use, and use of other drugs. Multiple health education interventions are needed to tackle these challenges.

Dose-response relationship between alcohol use and blood pressure among drivers of commercial vehicles in Calabar, Southern Nigeria

Alcohol is a sedative/hypnotic with effects similar to those of barbiturates.1 The type of alcoholic beverages consumed depends on the social context and financial capability. Alcoholic beverages may be in form of beer, wine, dry gin. Drinking alcohol is an activity that many people enjoy; taking a few drinks occasionally is generally harmless. Most people do not have problems as a result of drinking alcohol in this manner, although this may predispose to heavy use. Heavy alcohol consumption has been shown in observational studies to have a strong positive association with elevated blood pressure.2-4 Further evidence have been shown by clinical trials5,6 that have demonstrated that reduction in alcohol intake among individuals who drink heavily (i.e. three or more drinks per day) can lower blood pressure in normotensive and hypertensive men. Some studies have recorded a linear dose-response relationship sometimes starting with a consumption threshold of three drinks per day (30 g of ethanol).7-13 In others, the relationship has been non-linear especially in women, and some authors have speculated that ingestion of small quantities may reduce blood pressure.14-22 These discrepancies may reflect differences in investigational design, methods and populations.23 Many studies have been done in this area in developed countries like the United States, United Kingdom and Australia. This is however, not a commonly researched area in this part of the world. The aim of this study was to assess the relationship between alcohol consumption and blood pressure of drivers of commercial vehicles.

Prevalence of stress, stressors and coping strategies among medical students in a Nigerian medical school

Introduction: Several international studies suggest that medical school training is associated with high levels of stress. Although stress is peculiar to the medical profession, it is rarely given the desired attention, especially in resource-constrained settings. This study was therefore conducted to determine the prevalence of stress stressors, coping strategies of medical students in the University of Calabar, Nigeria. Materials and Methods: A cross-sectional descriptive survey of 451 medical students was conducted on available classes during the study period. A semi-structured self-administered questionnaire was used to elicit information from respondents. Data were summarized using proportions, and Chi-square test was used to explore associations between categorical variables. Level of significance was set at P < 0.05. Results: Majority (94.2%), of undergraduate medical trainees perceived the training as stressful. The major stressors identified were excessive academic work load (82.3%), inadequate holidays (76.4%), and insufficient time for recreation (76.2%). Feeling depressed, sleeping problems and anxiety were the most common effects of stress reported by the respondents. The coping strategies adopted by the students were mainly positive. Perceived stress was significantly associated with being in the clinical level of study, residing on campus and a higher monthly allowance (P < 0.05). Conclusion: Majority of the students interviewed perceived their training as stressful. There is, therefore, an urgent need for medical educators to introduce of stress management courses or programs into the curriculum.

Intra-family transmission of Vibrio cholerae during a cholera epidemic in rural south-southern Nigeria

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