Mobolanle Balogun

Trained Community Volunteers Improve Tuberculosis Knowledge and Attitudes Among Adults in a Periurban Community in Southwest Nigeria

Nigeria has the worlds 10th largest tuberculosis (TB) burden. Targeted community-based interventions can potentially help reduce TB incidence. We designed an intervention in a periurban community where 10 community volunteers were trained to provide community TB education and also detect and refer TB suspects to a nearby clinic. To determine the effect of the intervention on knowledge, attitude, and preventive practices of TB, we compared results from a pre-intervention survey with those of a post-intervention survey. Pre-intervention, respondents had a mean knowledge score of 10.6 ± 7.0 of a possible 34, a mean attitude score of 5.8 ± 3.3 of a possible 10, and a mean practice score of 5.3 ± 1.4 of a possible 7. The intervention significantly increased the mean knowledge score to 16 ± 5.4 (P < 0.001) and mean attitude score to 7.0 ± 1.8 (P < 0.001); however, there was no statistically significant difference in the mean practice score. Eight TB suspects were referred to the clinic, and one suspect was subsequently diagnosed with TB. The use of trained community volunteers to share information on TB improved the overall knowledge and attitudes of respondents. Continued empowerment of the community should be encouraged to promote TB prevention and care.

Prevalence of Tinea capitis infection among primary school children in a rural setting in south-west Nigeria

Dermatophyte infection is a common skin disorder. Tinea capitis, infection of the scalp and hair shaft, is the most common dermatophytosis in children aged between six months and pre-pubertal age. The aim of the study was to determine the prevalence, causative agents and to identify predisposing factors among primary school children in a rural community in Sagamu, Ogun state, Nigeria. This was a descriptive cross sectional study. Interviewer administered questionnaire was used. Following a physical examination, children with a clinical diagnosis of tinea capitis had scalp and hair scrapings for microscopy and culture. Tinea capitis was confirmed in 15.4%. Trichophyton mentagrophyte (51.7%) and Microsporum aoudouinii (20.7%) were the most prevalent organisms in this study. The most common predisposing factors were carrying of objects on the scalp; sharing of hair clippers, scissors, combs, towels and fomites. Low socioeconomic status coupled with overcrowding and poor hygiene was the major determinant of tinea capitis among the children. Tinea capitis remains a common infection among Nigerian school children. Health promotion and health education interventions are recommended to promote good hygiene, better living conditions, early identification and treatment.

Prevalence and pattern of urinary abnormalities among apparently healthy adult Nigerians

Background: Urinalysis is a simple and cheap method of screening for systemic diseases including kidney disease and may open a window of opportunity for prevention/early treatments especially in resource-constrained settings like Nigeria. We therefore studied the pattern of urinary abnormalities among an apparently healthy urban population. Methods: Mid-stream clean catch urine samples were collected from 1048 apparently healthy subjects and tested for urinary abnormalities using the dipstick method following a health promotional talk in Idi-araba, a Lagos slum. Results: A total of 1048 randomly selected subjects with a mean age of 38.7 ΁ 14.5 years (age range 18-85 years) were screened. This consisted of 597 (57%) females and 451 (43%) males. Protenuria, hematuria, leucocyturia, nitrituria, and glucosuria were present in 18.9%, 1.7%, 9.2%, 1.8% and 2% of the subjects respectively. Proteinuria and haematuria was more prevalent in subjects aged ≥40 years (P < 0.05). The prevalence of leucocyturia, nitrituria, and glucosuria were independent of age (P < 0.05). There were no gender differences in the prevalence of urinary abnormalities (P < 0.05). Four hundred and forty-four (42.3%) of the cohort had hypertension (HTN). Proteinuria and leucocyturia were more prevalent in hypertensive subjects (P < 0.05) while hematuria, nitrituria, and glucosuria was independent of hypertensive status of subjects (P < 0.05). Conclusion: Urinary abnormalities are common among apparently healthy adults in Lagos. It is therefore recommended that it should be routinely done as a cheap screening tool and further evaluation conducted where necessary. This may result in cheaper treatment and better outcomes.

Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease.

Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Results Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≤0.05). Conclusion Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources.

Psychosocial burden of caregivers of children attending Sickle Cell Clinic, Lagos, Nigeria, 2014

Introduction : sickle Cell Disease (SCD) is the most common genetic disorder amongst the black people and one of the major chronic non-communicable diseases affecting children. Nigeria accounts for more than 100,000 new births annually. The impact on the family is worse in developing countries because of inadequate social welfare and poor access to health care services. Our objectives were to determine the knowledge and attitude of caregivers of children with SCD towards the disease and the associated psychosocial burden.

Community Health Workers in Diabetes Prevention and Management in Developing Countries

BACKGROUND There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs. METHODS To identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Groups Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017. FINDINGS Ten studies were included (4 pre- and post-studies, 2 randomized controlled trials, 2 cohort studies, 1 cross-sectional study, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of social support through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes. CONCLUSIONS CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time.

Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

Abstract Background People living with HIV and AIDS (PLWHA) experience some form of stigma which could lead to poor medication adherence. Objectives This study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy. Method A cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD) with seven participants at the clinic using an interview guide with open-ended questions. Results Overall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs) in unlabelled pill boxes. Conclusion This study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.