Tolulope O Afolaranmi

Supportive supervision: An effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria

BACKGROUND Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. MATERIALS AND METHODS This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. RESULTS The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. CONCLUSIONS This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.

Situational analysis of Orphans and Vulnerable Children in urban and rural communities of Plateau State

BACKGROUND Orphans and Vulnerable Children (OVC) are children affected by HIV and AIDS by virtue of, among others, living in a household where one or more people are ill, dying or deceased, or which fosters orphans, and children whose care givers are too ill or old to continue to care for them. They often have more health needs than their peers. This study was carried out to obtain baseline information on the needs of OVC in North-Central Nigeria as a basis for provision of relief services. METHODS A house to house cross-sectional survey of OVC recruited via a multistage sampling technique was carried out in four LGAs of Plateau State, Nigeria. The Child Status Index (CSI) tool was used to obtain information from the respondents and/or their caregivers. Vulnerability of the children was assessed using a Vulnerability Index (VI) scoring which ranged from 1-21, with 1-9 being vulnerable, 10-14 more vulnerable, and 15-21 being most vulnerable. RESULTS A total of 825 OVC ages ranging from 0-17 years and mean age of 9.8 ± 4.5 years were studied. 432 were males (52.4%) and 393 females (47.6%). 64.8% lived in households headed by women out of which 77.6% were widows. Six hundred and one (72.8%) household heads were farmers. Paternal orphans made up 59.8% of the respondents and 12.1% had lost both parents. Prevalence of abuse/exploitation was 17.7% and 66.7% experienced household food insecurity. Four hundred and seventy-eight (57.9%) OVC lived in households with no source of income. One hundred and fifty-one (18.3%) children (54.9% boys and 45.1% girls) had never been to school. 55.0% had minimal health problems. Majority of them (60.3%) lived in dilapidated shelter and 3.3% were living on the street. CONCLUSION This survey revealed the various needs of OVC. Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as education, shelter and clothing, but also on long-term developmental needs that reduce childrens vulnerability such as life skills, child protection, vocational training, food security and household economic strengthening.

Cord Care Practices: A Perspective of Contemporary African Setting

Background Cord care is the series of steps applied in handling of the umbilical cord after delivery of the new born. Globally, an estimated 4 million deaths occur annually within the first 4 weeks of life and 1.5 million of these deaths are attributable to infections. In Nigeria, studies have reported umbilical cord infections accounting for between 10 and 19% of neonatal admissions and resultant estimated 30–49% neonatal deaths. Hence, this study was conducted to assess the knowledge and practice of cord care within a contemporary setting. Methodology This was a cross-sectional study conducted among 324 mothers of children less than 59 months using a multistage sampling technique and SSPS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a P-value of ≤0.05 considered statistically significant. Results The mean age of the mothers in the study was 27.5 ± 6 years with majority of them having good overall knowledge and practice of cord care. Factors such residence in rural community (AOR = 0.26; 95% CI = 0.0915–0.7230) and heath facility delivery (AOR = 7.0; 95% CI = 4.7877–9.3948) were predictors of cord care practices. Conclusion This study has brought to light the level of cord care practices with health facility delivery, place of residence, and knowledge of cord care as its determinants.

The knowledge and uptake of travel vaccine among medical doctors in a tertiary health institution in Plateau State, North Central Nigeria

Background: Travelers play a significant role in the spread of infectious diseases across international borders, through their travel patterns and behaviors. Travel maybe the only risk factor for infectious diseases that are well controlled in the travelers’ country of residence, particularly vaccine-preventable diseases. The role of vaccination among travelers is an essential component of the control of travel-associated infectious diseases. This study was conducted to assess the knowledge and uptake of travel vaccine among medical doctors in Jos University Teaching Hospital (JUTH). Materials and Methods: This was a descriptive cross-sectional study conducted in 2013 using quantitative method of data collection among 189 medical doctors. Epi Info™ statistical software package version 3.5.4 was used for data analysis and a P ≤ 0.05 was considered statistically significant. Result: The mean age of the respondents was 33.8 ± 4.5 years, majority of the respondents (96.3%) were aware of travel vaccines with 45 (71.4%) of the 63 respondents who had embarked on international travel prior to the study had taken travel vaccine in their last travel. Knowledge of travel vaccination was found to have statistically significant relationship with uptake of travel vaccine (P = 0.013). Conclusion: This study has revealed the need to improve the knowledge and uptake of travel vaccine among medical doctors.

Effect of health education on the uptake of HIV counseling and testing among long distance drivers in Jos North Local Government Areas of Plateau State

Background: The impact of HIV/AIDS has been felt in virtually all aspects of life. Long distance drivers are of particular concern to HIV prevention and care programs because they constitute a high risk group. HIV Counseling and Testing (HCT) is an intervention which gives the client an opportunity to confidentially discuss his or her HIV risks and be assisted to learn his/her HIV status for purposes of prevention treatment care and support. The objective of this study was to determine the effect of health education on the uptake of HCT among Long Distance Drivers (LDDs) in Plateau State. Methodology: This was a quasi-experimental study with a pre and post intervention phase carried out among 161 LDDs in Jos North Local Government Areas. Health education intervention was provided using a structured health education guide in the form of lecture and discussion. Epi-infoTM statistical software version 3.5.4 developed by Centre for Disease and Control and Prevention (CDC) 1600 Clifton Rd. Atlanta GA 30333 usa was used for data analysis and 95% confidence interval was used for the study and P = 0.05 was considered as statistically significant. Results: The mean age of the respondent in this study was 41.0 ± 7.9 years with majority (92.5%) of the LDDs married and 91.3% resident within the state. Knowledge and uptake of HCT among LDDs improved significantly from 4.17 ± 1.43 to 6.70 ± 1.55 and 18.6-57.2% following the intervention (P < 0.001) respectively. Conclusion: This study has shown that health education is an effective tool in improving the uptake of HCT among long distance drivers. Therefore it should be used to improve HCT uptake among high risk groups.

The necessity of full sepsis screen in neonatal sepsis: Experience in a resource-limited setting

Background: Diagnostic tests that differentiate infected from noninfected neonates have the potential to make a significant impact on neonatal care. A full sepsis screen may be necessary to make a diagnosis of neonatal sepsis. Objective: The objective of this study was to evaluate the necessity of routinely collecting blood, urine, and cerebrospinal fluid (CSF) samples from every neonate suspected of sepsis. Materials and Methods: This was a cross-sectional study conducted in a Tertiary Care Hospital in Nigeria. The Integrated Management of Childhood Illnesses (IMCI) criteria for diagnosis of neonatal sepsis were used to select subjects into the study. Blood samples, CSF, and urine samples were collected from 165 neonates and processed by standard microbiologic methods. Results: A total of 68 isolates were recovered from 165 sets of blood culture samples representing 41.2% positive blood culture results. Only 3 (1.8%) organisms were isolated from 165 CSF samples. Five (3%) isolates were recovered from 165 urine samples. The three isolates from CSF were the same with blood isolates from the same neonates. Similarly, four of the five neonates with urine isolates also had blood isolates of the same organism. Conclusion: The findings of this study suggest that a properly collected blood culture sample is the most appropriate sample for recovering the causative organism in neonatal sepsis whereas other samples such as CSF and urine should be collected only when there are specific indications such as an obvious focus of infection in these sites. A full sepsis screen may not be necessary in most cases so as not to put the already sick neonate through unnecessary and sometimes harmful procedures.

Effect of health education on knowledge of malaria and long lasting insecticide-treated nets among clients accessing care in the out-patient Department of a Secondary Health Facility in Plateau State, Nigeria

Background: Malaria is a mosquito borne disease transmitted by female anopheles mosquito; it is life-threatening, preventable, and treatable. Approximately, 40% of the world′s population is at risk of malaria. Most cases and deaths due to malaria are in sub Saharan Africa although Asia, Latin America, the Middle East and some parts of Europe are also affected. Objective: To assess the knowledge of malaria and long lasting insecticide treated nets (LLITNs) among clients assessing out-patient services in Seventh day Adventist (SDA) Hospital. Methodology: A quasi experimental study conducted in 2013 among client assessing care at the Out-Patient Department of SDA Hospital Jengre, Bassa Local Government Area of Plateau State to determine the knowledge of malaria and LLITNs. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≤ 0.05 considered as statistically significant. Result: The mean age of the respondents in this study was 36.04 ± 9.60 years. The level of knowledge on malaria improved significantly after the training (P < 0.001). Majority (98.8%) of the respondents had good knowledge of LLITNs after the training as against 77.4% who had same before the training (X 2 = 17.93; P < 0.001). Conclusion: This study has demonstrated the effectiveness of health education as vital tool for improving the knowledge of malaria and LLITNs.

Use of community volunteers to improve knowledge and uptake of tuberculosis and human immunodeficiency virus screening services among community members in Qu'an Pan Local Government Area, Plateau State

Background: The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV) / AIDS is one of the major public health challenges of our time. Ignorance fear stigma and poverty have promoted the course of TB and HIV infections particularly among people residing in the rural areas despite the availability of free diagnostic and treatment services. Community volunteers (CV) have been used successfully to promote and sustain knowledge and utilization of health services in various parts of the world. This study sought to determine the impact of the use of CV on knowledge and uptake of TB / HIV screening services in the study population. Methodology: The study design was a community-based quasi-experimental study. A multistage sampling technique was used to select the study participants. The Primary Health Care (PHC centres offering TB and HIV screening services were the primary sampling units while the communities close to the PHCs were the secondary sampling units. The intervention involved a CV in each community providing education and services on TB and HIV / AIDS infections to the community members. Knowledge and uptake of TB and HIV screening services among the community members were assessed before and after the intervention. Results: A total of 1305 people were recruited into the study and five communities each were selected per PHC. Postintervention there was an increase in the knowledge of the cause mode of transmission symptoms and treatment of TB among community members from a mean score of 2.23 +or- 2.31 to 5.37 +or- 2.64 (P < 0.0001). There was also an increase in the knowledge of the modes of transmission symptoms and prevention of HIV / AIDS among community members from a mean score of 6.66 +or- 2.92 to 8.36 +or- 3.35 (P < 0.0001). Uptake of TB screening rose from 59.4% to 75.0% (P = 0.0161) among community members with a history of chronic cough and uptake of HIV counselling and testing (HCT) also rose from 53.8% to 64.1% (P = 0.0215) among the community members. Conclusion: Community Volunteers were found to improve the people’s knowledge of TB and HIV / AIDS infections as well as uptake of HCT and TB screening services. Their use will help improve TB and HIV collaborative activities and also contribute to the reduction of morbidity and mortality associated with TB and HIV infections.

Training: A vital tool for improving the knowledge and practice of food safety and hygiene among food handlers in boarding secondary schools in Plateau State

Background: Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food handlers have been found to play prominent roles in the transmission of food borne diseases, therefore training of food handlers on food safety and hygiene is crucial to the prevention of food borne diseases. Methodology: A quasi-experimental study carried out among food handlers in boarding secondary schools in Jos North Local Government Area to determine the effect of training on the knowledge and practice of food safety and hygiene. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≤ 0.05 considered statistically significant. Result: The mean age of the food handlers in the study was 42.07 ± 8.71 years with the mean years of work experience as 11.59 ± 8.05 years. The level of knowledge of food safety and hygiene improved significantly after the training ( P χ 2 = 76.6; P < 0.001). Conclusion: This study has demonstrated the effectiveness of training in improving the knowledge and practice of food safety and hygiene among food handlers.