Best Ordinioha

The human health implications of crude oil spills in the Niger delta, Nigeria: An interpretation of published studies

Background: The health hazards created by oil exploration and exploitation are covert and slow in action. They are not given the deserved attention in official documents in Nigeria, even as they can be major contributors to the disease burden in oil-bearing communities. This study is an interpretation of the data reported in several published studies on crude oil spills in the Niger delta region, Nigeria. Materials and Methods: A manual and Internet search was conducted to extract quantitative data on the quantity of crude oil spilled; the concentrations of the pollutants in surface water, ground water, ambient air and plant and animal tissue; and the direct impact on human health and household food security. Results: An average of 240,000 barrels of crude oil are spilled in the Niger delta every year, mainly due to unknown causes (31.85%), third party activity (20.74%), and mechanical failure (17.04%). The spills contaminated the surface water, ground water, ambient air, and crops with hydrocarbons, including known carcinogens like polycyclic aromatic hydrocarbon and benxo (a) pyrene, naturally occurring radioactive materials, and trace metals that were further bioaccumulated in some food crops. The oil spills could lead to a 60% reduction in household food security and were capable of reducing the ascorbic acid content of vegetables by as much as 36% and the crude protein content of cassava by 40%. These could result in a 24% increase in the prevalence of childhood malnutrition. Animal studies indicate that contact with Nigerian crude oil could be hemotoxic and hepatotoxic, and could cause infertility and cancer. Conclusions: The oil spills in the Niger delta region have acute and long-term effects on human health. Material relief and immediate and long-term medical care are recommended, irrespective of the cause of the spill, to ensure that the potential health effects of exposures to the spills are properly addressed.

Intersection Between Alcohol Abuse and Intimate Partner’s Violence in a Rural Ijaw Community in Bayelsa State, South-South Nigeria:

According to the 2008 National Demographic and Health Survey, the south-south zone of Nigeria had the highest prevalence of domestic violence. This study is to find out if this is related to the widespread consumption of alcohol in the region. The study was carried out in Okoloba, a rural Ijaw community in Bayelsa State, where alcohol is produced and consumed in large quantities; using a cross-sectional study design. The data was collected from married or cohabitating adults aged between 16 and 65 years, with a structured interviewer-administered questionnaire. A total of 346 subjects, comprising 187 males, and 159 females were studied. They had an average age of 41.4 ± 2.5 years, were mostly Christians (91.9%), farmers/fisher folk (52.3%), and had at most primary school education (64.2%). More than 90% of the subjects took alcohol in the preceding year, while 36% can be classified as alcohol abusers according to their AUDIT score. More than half (55.8%) were perpetrators of intimate partner violence during the preceding 12 months, with a male-to-female prevalence of 83.4%, and female-to-male prevalence of 23.3%. Out of these, 77.2% were under the influence of alcohol during the act. The violence was more likely to be perpetrated by male alcohol abusers (p-value < 0.001), but there were no significant differences in the educational levels and religion of the perpetrators (p-value > 0.05). The study therefore concludes that there is a link between intimate partner abuse and alcohol abuse in the study community.

Community participation and childhood immunization coverage: A comparative study of rural and urban communities of Bayelsa State, south-south Nigeria

Background: Immunization coverage rates in Nigeria have remained very poor, in spite of numerous programs and strategies, specifically designed to improve coverage. This study was to assess the possible effects of greater community participation on immunization coverage, by comparing the immunization coverage in a rural community with a functional community health committee, with an urban community, with no distinct community structure. Materials and Methods: The study was carried out in Ondewari, a rural, riverine community, in Bayelsa State; and Yenagoa, the capital of Bayelsa State, south-south Nigeria; using a cross-sectional, comparative study design. The data were collected using a structured interviewer-administered questionnaire, administered on female head of households in both communities, with under-five children; and used to collect information on the socio-demographic characteristics of the respondents, the immunization status of children in the household below the age of 2 years, and reasons for none and incomplete immunization. Results: A total of 288 respondents were studied in the rural community, while 270 respondents were studied in the urban center. The respondents in the urban center were significantly younger (P<0.01), better educated (P<0.001), and had fewer number of children (P<0.01). The immunization status of children in the rural community was significantly better than those in the urban community (P<0.000). Only 11.46% of the children in the rural community were not immunized, compared to 47.04% in the urban community. However, the dropout rate in the rural community was much higher; with a DPT dropout rate of 77.34%, compared to 12.39% in the urban community. Most of the reasons given in the urban community for the incomplete immunization were linked lack of motivation, and include relocation (11.34%) and the adverse rumor about childhood immunization (17.23%), while the reasons in the rural community were mostly health facility related, and included the absence of the vaccinator (20.46%) and nonavailability of vaccines (26.64%). Conclusion: The immunization coverage in the rural community was surprisingly better than that of the urban community, which can be attributed to better mobilization and participation in the delivery of immunization services.

The prevalence of hypertension and its modifiable risk factors among lecturers of a medical school in Port Harcourt, south-south Nigeria: Implications for control effort

BACKGROUND Hypertension and other noncommunicable diseases are currently responsible for at least 20% of all deaths in Nigeria, and constitute up to 60% of the patients admitted into the medical wards of most tertiary hospitals in Nigeria. Yet, the treatment outcomes for the diseases have remained very poor, prompting calls for better patient education. It has however been established that the effectiveness of patient education is linked to the healthy habits of the doctor. This study was conducted to find out the prevalence of hypertension and its modifiable risk factors among the lecturers of the University of Port Harcourt Medical School. MATERIALS AND METHODS A descriptive cross-sectional study design was used, with the data collected using a modified form of the WHO STEPS instrument that consists of a questionnaire component and the measurement of body mass index (BMI) and blood pressure. The questionnaire was used to collect information on the sociodemographic characteristics of the respondents, the use of tobacco, the consumption of alcohol, the type of diet, and the amount and types of physical activities undertaken. RESULTS A total of 75 lecturers participated fully in the study, out of an eligible total of 109. They were mostly males (65.33%), married (88.33%), and had an average age of 46.06 ± 9.62 years. The prevalence of hypertension was 21.33%; out of which 12 (75.00%) were already aware of their status, and were on appropriate therapy. Only 13 (17.33%) of the lecturers were of normal weight, 45 (60.00%) were overweight, while 17 (22.67%) were obese. Only 2 (2.67%) currently smoke, while most (94.67%) drank less than three standard units of alcohol in a day, mainly in social occasions. CONCLUSION The prevalence of hypertension among the lecturers in the medical school was lower than that in the general population, mainly due to their better health-seeking behavior and healthy lifestyle.

Experience with the use of community health extension workers in primary care, in a private rural health care institution in south-south Nigeria

BACKGROUND The difficulty in recruiting and retaining doctors in rural areas has encouraged the use of substitute health workers in the provision of primary care for undiagnosed patients with undifferentiated health problems. This study was performed to report the experience of the use of Community Health Extension Workers (CHEWs) in the provision of primary care in a private rural health care facility in a community in Nigeria. METHODS The study was carried out over a 6-month period in a private health facility in a semiurban community. The CHEWs were recruited through the recommendation of their schools and were retrained and deployed incognito, but with a clear job description. Their performances were monitored using the level of patient satisfaction, the type of cases seen, the number of telephone consultations made with the doctors of the NGO, the length of prescriptions and the number of adverse events that followed the consultations. RESULTS A total of 1,028 patients were seen in the health facility during the 6-month study period, of which 294 (28.6%) telephone consultations were made with the doctors of the NGO, 215 (20.9%) of the patients were admitted in the hospital, while 81 (7.9%) were referred to other health facilities. Most of the cases were malaria (54.2%), typhoid (6.9%) and minor injuries (12%). The average length of the prescriptions given to the patients per encounter was 6.3, and most of the patients (86.5%) were satisfied with the quality of care provided by the CHEW. A total of 7.6% of the patients seen by the CHEWs were readmitted as emergencies, mainly with severe anemia (47.4%) and the deterioration of previously treated ailment (24.4%). CONCLUSIONS CHEWs, working under the direct supervision of doctors can provide safe and good quality care, to the satisfaction of most of their patients, when required to provide primary care. It cannot however be assumed that similar results would be obtained if the health workers are used in different settings or with more complicated patients.

The use and misuse of mass distributed free insecticide-treated bed nets in a semi-urban community in Rivers State, Nigeria

BACKGROUND Insecticide-treated bed net (ITN) is currently distributed free of charge to vulnerable groups in Nigeria, for malaria control. Consistent use of the nets is required for maximum effectiveness; but studies indicate that the nets are often jettisoned in periods of low mosquito activity and high night time temperature. The objective of this study has been to assess the use of mass distributed nets in a semi-urban community in Rivers State, south-south Nigeria, during the late dry season, when mosquito activity is at the lowest in the community. MATERIALS AND METHODS The study was carried out in Ishiodu - Emohua, using a cross-sectional study design. The data was collected using a structured, interviewer-administered questionnaire, administered to female head of households in the community, with under-five children. RESULTS A total of 170 respondents were studied; they had an average age of 34.3 ± 7.6 years, most were married (86.5%), and had secondary school education (68.2%). All the households owned at least one ITN, and an average of 1.7 nets, with 75.3% of the households owning two or more ITNs. Almost all the nets (99.4%) were obtained free of charge. Of the 170 households that received the nets, 71.8% had hanged the nets as at the time of the survey; 83.6% of these hanged the nets over a bed, while 10.7% used the nets as window curtain. Of the 102 ITNs that were properly deployed, only 27.5% were occupied the night before the survey, by an average of 2.5 persons, mainly under-five children (37.7%). CONCLUSION The distribution of free ITNs has resulted in universal household ownership, but the use of the nets is still very poor. Proper health education is required to encourage the consistent use of the nets, even in hot night, with low mosquito activity.

Socio-demographic characteristics of alcohol abusers in a rural Ijaw community in Bayelsa State, South-South Nigeria

BACKGROUND Causal relationship has been established between alcohol and more than 60 types of disease and injury. Despite this, alcohol is still widely consumed in several communities in Nigeria, and sometimes considered a health tonic. This study described the pattern, prevalence, and factors associated with alcohol abuse in a typical Ijaw community, where alcohol is produced and consumed in large quantities. MATERIALS AND METHODS The study was carried out in Okoloba, a rural community in Bayelsa State, South-South Nigeria using an analytical cross-sectional study design. The data were collected from members of the community aged 16 to 65 years, using the Alcohol Use Disorders Identification Test questionnaire and clinical examination for hepatomegaly, tongue tremor, and hand tremor. RESULTS A total of 322 subjects, comprising 166 men and 156 women were studied. They had an average age of 41.4 ± 2.5 years, were mostly farmers (43.17%), married (66.15%), and had at most primary school education (62.42%). More than 90% of the subjects took alcohol in the preceding year, with more of them (43%) preferring the locally produced drinks. About 33% of the subjects had harmful drinking, while 12.73% had alcohol dependence problem. There is no significant age difference between the alcohol abusers and abstainers/social drinkers (P > 0.05), but alcohol abusers were significantly more likely to be males (P < 0.001), in polygamous marriages (P < 0.00001), had lower educational status (P < 0.0001), likely to be practitioners of the traditional religion (P < 0.0001), and more likely to be engaged in palm wine tapping. CONCLUSION Alcohol is widely consumed in the community, but the prevalence of abuse was moderate, mainly due to cultural restrictions. Sales restrictions might be needed as the drinking habits of members of the community change with urbanization.

Knowledge, attitude, and infection control practices of two tertiary hospitals in Port-Harcourt, Nigeria.

BACKGROUND Surgical site infections (SSIs) are a significant cause of morbidity, emotional stress and financial cost to the affected patients and health care institutions, and infection control policy has been shown to reduce the burden of SSI in several health care institutions. This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, Nigeria. MATERIALS AND METHODS A cross-sectional, comparative study design was used for the study, with data collected using a structured questionnaire and guided observation of doctors and nurses involved in the management of patients that had caesarean sections in two comparable tertiary hospitals in Port Harcourt-the University of Port Harcourt Teaching Hospital (UPTH) and the Braithwaite Memorial Specialist Hospital (BMSH). RESULTS There were no statistically significant differences in the designations and length of practice of the respondents in both hospitals (P = 0.77). However, 63.64% of the respondents in UPTH were aware of the infection control committee, compared with none in BMSH. The appropriate timing for the administration of prophylactic antibiotics, and for the removal of the hair at the incision site were observed by 57.58% and 69.69% respectively of the respondents in UPTH, compared with 22.86% (P = 0.00) and 0.00% (P = 0.02) in BMSH. The reasons given by the respondents in UPTH for nonadherence to the infection control policy include poor supervision (39.39%) and lack of in-service training (21.21%), while the respondents in BMSH gave reasons that include inadequate supply of consumables (34.29%) and absence of a hospitals policy on infection control (22.88%). CONCLUSION The implementation of the infection control policy resulted in some improvements in certain infection control practices.

Prevalence of hypertension and its modifiable risk factors amongst traditional chiefs of an oil-bearing community in south-south Nigeria

Background: The epidemiological transition has firmly berthed in Nigerias oil-bearing communities, but the pace is often different in subsets of the community, depending on how readily the western lifestyle is being adopted. This study determined the prevalence of hypertension and its modifiable risk factors amongst the traditional chiefs of an oil-bearing community in Rivers State, Nigeria. Materials and Methods: A descriptive cross-sectional study design was used, with the data collected using a modified form of the WHO STEPS instrument that consists of a questionnaire component and measurement of body mass index (BMI) and blood pressure. The questionnaire was used to collect information on the socio-demographic characteristics of the respondents, the use of tobacco, and consumption of alcohol. Results: A total of 106 traditional chiefs were studied. They were all males, mostly married (95.28%), with a mean age of 56.5 ± 4.10 years. The study population had a mean systolic blood pressure of 149 ± 17 mmHg, a mean diastolic blood pressure of 98.7 ± 14.8 mmHg, and prevalence of hypertension was 68.9%. Most (63.01%) of the hypertensive chiefs were aware of their status and were on anti-hypertensive drugs (50.68%). None of the chiefs were underweight, and most were either overweight (51.89%) or obese (26.42%). Nearly all (92.45%) the chiefs regularly took alcoholic beverage, while 24.53% currently smoke cigarettes. Conclusion: The prevalence of hypertension amongst the traditional chiefs was higher than in the general population. This can be attributed to their older age and acculturation.

Alcohol consumption among pregnant women attending the ante.natal clinic of a tertiary hospital in South.South Nigeria

BACKGROUND As efforts to reduce maternal and childhood mortality rates continue to yield results in Nigeria, it is time to put more emphases on the health of children. Alcohol consumption is one of the few modifiable risk factors for poor pregnancy outcome. This study assessed the consumption of alcohol among pregnant women attending the antenatal clinic of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. MATERIALS AND METHODS This study was carried out using a descriptive cross-sectional study design, with data collected using an interviewer-administered questionnaire. The questionnaire was used to collect information on the knowledge of the harmful effects of alcohol on the fetus, attitudes toward alcohol use by pregnant women, and alcohol use by the respondents. RESULTS A total of 221 subjects were studied. The respondents had an average age of 29.5 ± 4.6 years, were mostly married (96.83%), Christians (94.57%), and had tertiary education (73.76%). Only, 51.58% of the respondents knew of the harmful effects of alcohol on the fetus; of whom, 62.29% were told by a health professional. More than half (59.28%) of the respondents had taken alcohol during the index pregnancy, about a third (39.40%) of whom drank alcohol on a regular basis, whereas 25.79% were binge drinkers. There were no statistically significant differences in the marital (P = 0.16) and educational status (P = 0.15) of the respondents who abstained from alcohol in the index pregnancy, compared with those who drank alcohol; although, statistically significant differences were observed in the age (P < 0.001), parity (P = 0.02) and religion (P < 0.001) of the respondents. CONCLUSION The level of alcohol consumption among the pregnant women is high. Health education is, therefore, required to change the attitude of the public and the knowledge and behavior of the pregnant women.