Olorunfemi Akinbode Ogundele

Relationship between Depression and Quality of Life in Persons with Hiv Infection in Nigeria

Objective: Despite the fact that two-thirds of all the people with HIV live in sub-Saharan Africa, little is known about the emotional state and quality of life (QOL) of subjects with HIV in this region. The objective of this study was to evaluate the association between clinical depression and quality of life in a group of HIV sero-positive subjects in Nigeria. Methods: Subjects with HIV infection (n=87) completed a questionnaire detailing sociodemographic and HIV related variables. The subjects were assessed for the diagnosis of depression using the Mini International Neuropsychiatric Interview (MINI) and their subjective health related quality of life (QOL) was assessed using the short version of the WHO quality of life scale (WHOQOL-BREF). Results: There were 25 (28.7%) subjects with diagnosis of depression. Lower educational level correlated with poorer QOL in all the domains of WHOQOL-BREF except the “social relationship” domain. Also, poor social support correlated with poorer QOL scores on domains of “physical health” and “social relationship” and presence of medical problems was significantly associated with poorer scores on domains of “physical health” and “psychological health.” Diagnosis of depression was significantly correlated with poorer QOL in all domains except the “social relationship” domain. Conclusion: Poorer health related QOL in Nigerian subjects with HIV was associated with depression, lower educational and socioeconomic levels, and poor social support. Early identification and referral of patients with depression needs to be incorporated into intervention programs designed for HIV infected individuals in this region.

The Effect of Psychological Distress on Medication Adherence in Persons With HIV Infection in Nigeria

BACKGROUND A high level of adherence to prescribed antiretroviral (ARV) regimens is required to achieve and maintain suppression of human immunodeficiency virus (HIV) replication and prevent drug resistance. OBJECTIVE This study aimed to determine the possible relationship between psychopathology and ARV medication adherence in Nigeria. METHOD Persons with HIV infection (N=182) completed various questionnaires on sociodemographic and clinical details, general psychopathology, self-esteem, and medication adherence. RESULTS Low medication adherence was reported in 26.9% of the participants; significant correlates included presence of psychopathology and perceived poor social support. CONCLUSION The success of any intervention policy for HIV-infected persons in sub-Saharan Africa must consider both low level of medication adherence and its associated factors.

Effect of community level intervention on nutritional status and feeding practices of under five children in Ile Ife, Nigeria

Introduction Childhood malnutrition remains a widespread problem in developing world like Nigeria. The country ranks second among the ten countries contributing to sixty percent of the worlds wasted under-five children. Community Integrated Management of Childhood illness (CIMCI) is a programme that employs the use of community based counsellors to address child health and nutritional challenges of the under-five and has the potential to reduce the morbidity and mortality resulting from poor nutritional and feeding practices. The study assessed the effect of community level intervention on nutritional status and feeding practices of children in Ile-Ife, Nigeria. Methods A cross-sectional comparative study that employed the use of multi stage cluster sampling techniques in selecting 722 mothers of index under five children. The study was done in two Local Government Areas of Osun State, Nigeria. Quantitative techniques were used in data collection. Data analysis was done using SPSS version 20.0. Descriptive and bivariate analyses was performed. Results The two Local Government Area (LGA) did not differ significantly in their wealth index (p = 0.344). However, more children in the non-implementing LGA (16.1%) had low weight for age compared with 3.6% in the CIMCI implementing LGA (p = 0.000). A statistically significant difference exist in the MUAC measurement of children 12-23 months between the CIMCI implementing and non-implementing communities (p = 0.007). A higher percentage of caregivers (19.3%) introduced complementary feeding earlier than 6 months in the non-implementing area (p < 0.001). Conclusion Using community level nutritional counseling can greatly improve nutritional status and feeding practices of under five children.

A Study of the Primary School Environment in a Local Government Area, South West Nigeria

Background: School environment connotes the physical, biological and social milieu within which members of the school community operate. Its status has great impact on the health of the school children and other members of the community. Objective: To assess the healthfulness of the primary school environment in Ilesa East Local Government Area, Osun State, Southwest Nigeria. Methods: A cross sectional descriptive study of all primary schools in the area was done using a validated healthful school environment checklist. Data was analyzed using SPSS and compared between the two ownership groups of the schools. Results: There were 64 schools in all, of which 34 were public schools and 30 were private schools. All (100%) practiced open dumping and burning of refuse. Sundry health hazards were found in 81% of studied schools. The recommended toilet-pupils ratio existed in only 5.8% of the schools. Water sources were located far away in 24% of the schools with water supply. Dilapidated Classrooms were found in 42.2% of the schools. There was no difference between the scores of the two groups of schools. P=0.923 (Mann-Whitney U Test). Conclusion: The school environment was not healthy in most schools. There is a need to monitor and enforce the implementation of national guidelines on school environment in the study area.

Reducing the risk of nosocomial Hepatitis B virus infections among healthcare workers in Nigeria: a need for policy directive on pre-employment screening and vaccination

Healthcare workers (HCWs) are at increased risk of contracting Hepatitis B virus (HBV) infection and other vaccine-preventable diseases, especially if they are not protected by immunity derived from previous infection or vaccination. Sub-Sahara Africa countries including Nigeria is reported to have the highest rate of HBV. Vaccination of HCWs is essential in protecting them from acute and chronic sequelae of HBV or any other form of vaccine-preventable diseases; however, HCWs vaccination remains a challenge for many developing countries including Nigeria due to lack of policy directive on pre-employment screening and vaccination. Poor political will and inadequate funding of healthcare in the country also impacts negatively on the implementation of effective pre-employment screening and vaccination programmes needed to protect HCWs. The aim of this opinion paper is to promote policy direction on pre-employment screening and vaccination in other to protect HCWs from nosocomial HBV infection. The most appropriate time perhaps for promoting the importance of employee immunisation is during pre-employment screening. The policy options are either for employers to allocate financial resources towards HCWs pre-employment screening and vaccination or alternatively initiate a programme where new HCWs provide evidence of protection against HBV or other vaccine-preventable diseases specified in the policy directive. Protecting HCWs form nosocomial HBV infection requires well-articulated policy directive, proper implementation, supported by adequate funding and good political will on the part of employers and government.

Analysis of the effect of health education activities on selected child health determinants in two communities of Ile Ife, Nigeria

Background Child survival in Nigeria is threatened not just by the direct causes of childhood mortality such as the common childhood diseases but also by the associated child health determinants. Health education activities as part of community integrated management of childhood illness have the potential to improve these child health determinants. The objective of this study was to assess the effect of community level health education activities on selected child health determinants in Ile Ife, Nigeria. Methods A cross-sectional comparative study was carried out among 722 caregivers in two LGAs of Osun State, Nigeria, using a multistage cluster sampling method. Data were collected from mothers of index children aged 0–59 months using an interviewer-administered questionnaire. Results Vitamin A supplementation before the study was received by 89.1% and 79.8% of the children aged 9 months old and above in implementing and non-implementing LGAs (p=0.002). Amongst children age 12–23 months in the implementing LGA, 93.4% received DPT3, (91.8%) received measles compared with non-implementing LGA in which 66.7% received DPT and (64%) measles. Children in the CIMCI implementing LGA were three times more likely to receive DPT Vaccine (Adjusted odds ratio (AOR) 3.02, 95% confidence interval (CI) 1.55–7.98), and five and half times more likely to receive measles vaccine (AOR 5.56, 95% CI 2.76–12.54). Conclusion The study concluded that community level health education activities have a positive effect on child health practices and determinants.

Seroprevalence and Knowledge of Hepatitis B and C Among Health Care Workers in a Specialist Hospital in Nigeria

Hepatitis B (HBV) and hepatitis C (HCV) remain a global health challenge. Health care workers (HCWs) are at high risk of contracting HBV and HCV through their occupation. The study aimed to determine the prevalence and assess knowledge of HBV and HCV infection among HCWs in a specialist hospital, Southwest, Nigeria. A hospital based, descriptive cross-sectional study conducted among 209 HCWs at a specialist hospital in Ondo State, Nigeria. Data on knowledge of HBV and HCV was collected using a structured, self-administered pretested questionnaire. Blood samples were screened for Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies. Data was analysed using SPSS version 20.0. The prevalence of HBsAg was 6.7%, anti-HCV positivity was 8.1% and co-infection of both HBV and HCV was 1.0%. No statistically significant difference exist in the prevalence of HBV (χ2= 2.07, p=0.155) and HCV (χ2= 2.26, p=0.132) between at risk HCW and not at risk HCW. Work duration was the only factor associated with HBV (χ2= 10.24, p=0.006) and HCV (χ2= 13.61, p=0.001) positivity and knowledge score (χ2= 8.06, p= 0.018). Knowledge about HBV and HCV was relatively high. Eighty-nine percent ever heard of HBV and 75.6% ever heard of HCV. This study found a high prevalence of HBV and HCV among this group of HCWs and a higher burden of HCV than was commonly reported. Knowledge of HBV and HCV was also high. There is a need for infection control programme and sustained health education among HCWs.