Umar Muhammad Lawan

Factors predicting BCG immunization status in northern Nigeria: a behavioral-ecological perspective

This study examines the predictors of Bacille Calmette-Guérin (BCG) immunization status among infants in northern Nigeria using a behavioral-ecological model. The findings show only 37.3 percent of the children had received BCG vaccine, and reveal that BCG immunization status in northern Nigeria is influenced by multiple layers of factors, including childs characteristics, parental or household factors, community characteristics, vaccine supply and the policy environment. At the childs level, place of birth and ownership of an immunization card are the two most significant predictors. The parental and household predictors of BCG immunization status include maternal use of antenatal care, maternal knowledge about immunization, maternal exposure to child health information, social influence and paternal approval of immunization. Both the regularity of vaccine supply to the health facility and the state of residence are associated independently with BCG immunization status. These findings stress the need for interventions at multiple levels in order to increase BCG immunization status.

Predictors of Public Attitude toward Living Organ Donation in Kano, Northern Nigeria

Organ shortage is a major public health challenge for transplant programs globally. The sustenance of such programs as an effective therapy for end-stage organ failure (ESOF) requires an exploration of public awareness and willingness to donate organs. This is imperative, especially in developing countries where ESOF is highly prevalent. We studied the awareness and predictors of public attitude toward organ donation in Kano city in northern Nigeria. Using interviewer-administered questionnaires, we assessed the awareness and willingness to donate solid organs among 400 adults in the Kano metropolis. Three hundred and five of the 383 respondents (79.6%) reported that they had heard about organ donation. There was a significant variation of awareness by education and ethnicity (P <0.05). Most respondents, 303 (79.1%), were willing to donate an organ. Gender [adjusted odds ratio (AOR) = 2.13; 95% confidence interval (CI): 1.40-4.95], educational attainment (AOR = 2.55; 95% CI: 1.35-5.88), marital status (AOR = 4.5; 95% CI: 2.97-9.1), religion (AOR = 3.40; 95% CI: 1.43-8.10) and ethnicity (AOR = 2.36; 95% CI 1.04-5.35) were significant predictors of willingness to donate an organ. Preferred organ recipients were parents (48.9%), children (21.3%), spouses (14.6%) and other relatives (13.4%). Reasons for willingness to donate organs included religion (51.2%), moral obligation (21.4%) and compassion (11.9%), among others. However, there was widespread ignorance of religious precepts concerning organ donation. The high level of awareness and willingness to donate organs in this society could be further enhanced by intensive information, education and communication strategies providing clear messages on societal benefits, religious aspects and bioethical guidance regarding organ donation.

Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINITAB® 12.21 (USA) statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9) and attachment (78.7%) during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2%) of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7%) had “fair” to “good” infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers’ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs), infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to improve the knowledge and practices of mothers on infant feeding.

Does awareness of status and risks of human immunodeficiency virus impact risky transmission behavior among infected adolescents? A case study of clients Attending an Antiretroviral Therapy (ART) clinic in Kano, Kano State, Nigeria

Background: Human immunodeficiency virus (HIV)-positive adolescents by virtue of their position are prone to dangerous behaviors including risk-taking for HIV transmission. Objective: To determine the awareness of HIV status and risk factors for HIV transmission among HIV-positive adolescents, and how these impact their behavior. Materials and Methods: A case study approach was used to study a random sample of 400 HIV-positive adolescent children attending an antiretroviral (ART) clinic in Kano, Kano State, Nigeria. Data were analyzed using Statistical Package for the Social Sciences (SPSS) 16.0 computer statistical software. Result: The mean age of the adolescents was 14.9 ± 3.15 years. The majority were females (54.8%) from a polygamous family (57.5%). About two-thirds or 251 (62.8%) patients knew their HIV status. The age of 14 years and above (z = 11.36, P = 0.0001) and having at least secondary school level of education (z = 2.78, P = 0.005) were significantly associated with awareness of HIV status on binary logistic regression. Up to 311 (77.8%) patients had good awareness of the risks of HIV transmission. Awareness of risk of HIV transmission was associated with awareness of HIV status (X 2 = 166.2, P = 0.0001). There was a significant variation in the behaviors between those who were aware of their HIV status and those who were not. Paradoxically, the percentage differences in risk-taking were remarkably high in all the variables examined, and were all in the direction of the adolescents who had good knowledge of the risk factors for HIV transmission. Conclusion and Recommendation: Health ministries, development partners working in this field, and behavioral change communication experts should develop formidable strategies for addressing this menace. There is also a dire need for further research in this area.

Pattern, awareness and perceptions of health hazards associated with self medication among adult residents of kano metropolis, northwestern Nigeria.

Background: Kano State is the most populous state, and one of those states pronounced with the highest prevalence of drug abuse in Nigeria. However, there is lack of documented data to back the assertion. Objective: We determined the pattern, awareness and perceptions of the adult residents of Kano metropolis about self medication. Materials and Methods: We used a descriptive cross-sectional design to study a random sample of 380 adult in Kano metropolis. Data was collected using semi-structured questionnaires that were pretested outside the study area. Data analysis was with Epi Info® 3.5.1. Results: The mean age of the subjects was 35.43 ± 15.10 years, majority were males (66.32%), singles (47.11%) and had at least secondary education (67.63%). About three-quarter (78.95%) admitted using drug (s) in the past without prescription. Drugs commonly consumed were antimalarials (42.10%), analgesics (40.56%), antibiotics (29.41%), and cough mixtures (13.31%). Common sources of drugs were patent medicine stores (62.54%) and the market (19.81%). Common reasons for self medication were long queues in the hospitals (38.39%), and in-accessibility to doctors (25.08%). About two-thirds (65.00%) correctly perceived that self medication could be hazardous; and half (51.58%) were aware of at least one hazard of self medication. Conclusion/Recommendations: Irrational drug use is a growing challenge to public health in Kano, Nigeria. Thus, drug regulatory agencies in Nigeria should work together to ensure that all drug retail outlets and drug sellers are registered, controlled drugs are dispensed only on prescription of the physicians; and the laws safeguarding drug use are duly enforced. Health authorities should also strengthen efforts towards health educating the public.

Pattern of adverse events following immunization in nourished and malnourished infants in Kano, North-Western Nigeria

Background: Adverse events following immunization (AEFI) occur in both nourished and malnourished babies but are often mislabeled as manifestations or complications of background condition or disease especially among malnourished infants. Aim/Objective: To study the pattern of AEFIs in nourished and malnourished infants in Kano. Materials and Methods: Descriptive cross-sectional design was used to study 372 eligible infants aged 0–11 months old. All infants immunized in the first quarter of 2014 that had up to date immunization card qualified for the study. Data were analyzed using SPSS version 16.0. Results: The mean age of the infants was 3.5 ± 3.1 months, with male being 53.5%, and well nourished being 88.4%. Prevalence of AEFI was 33.1% (nourished), 48.8% (malnourished), and 34.9% overall. Fever occurred in 79.8% nourished and 95.2% malnourished infants. Localized pains and/or swelling occurred in 29.3% nourished and 47.6% malnourished, but abscess or ulceration around vaccination site occurred only in the nourished infants and was significantly associated with the 1st immunization visit. Most AEFI were experienced around the 1st three immunization visits. Majority of the AEFI, experienced, nourished (58.7%), and malnourished (52.4%), occurred within 1–11 h and was mild to moderate in severity in 99.1% and 100% of the respective groups. Conclusion and Recommendation: Focused research on vaccine formulation and safety, and recurrent training of immunization workers on vaccine administration, and early and prompt treatment of AEFI are paramount.

Knowledge and attitudes toward child adoption and fostering among infertile women in northern Nigeria

Background: Infertility is a public health problem in the developing countries. However, the role of child adoption or fostering in the management of infertile couples is underexplored, particularly in northern Nigeria. Materials and Methods: A cross-sectional study involving the use of a structured interview questionnaire was employed to collect information from clients attending the infertility clinic of Aminu Kano University Teaching Hospital (AKTH), Kano. The data were analyzed using MINITAB® 12.21 software. Percentages and means were used to describe categorical and quantitative variables, respectively. The chi-square test was used to assess the significance of associations using a confidence interval of 95%. Results: Majority of the respondents (69.7%) were between 25 and 34 years of age, and of Hausa/Fulani ethnic group (79.6%). Knowledge of child adoption was good in 59.2% of the respondents, while the willingness to adopt versus foster was 28.2% and 44.4%, respectively. Conclusion: There is a need to advocate for infertility counseling services, so as to support infertile clients in taking informed decisions regarding child adoption or fostering as viable options for having their own families.

Health Risks AssociatedWith Air Pollution: Public Perception In Kano, NorthWestern Nigeria.

Setting: This study examined public perception in Kano metropolis, north-western Nigeria about air pollution. Objectives: To determine the awareness and perception of the public in Kano metropolis about common causes of air pollution; associated health risks; ways of control and roles of stakeholders in its control. Methods: using a descriptive cross-sectional design 335 eligible adults were studied using pretested, semi structured, interviewer-administered questionnaires. Data were analysed using Epi info version 3.5.1 statistical software. Results: Majority of the respondents (40.0%) correctly described air pollution. Industrial emission (83.6%), exhaust fumes (74.0%) dusts (68.7%) were perceived as the most common causes of air pollution. Major perceived health effects of air pollution were respiratory problems (100.0%) and eye irritation (65.2%). Industrial workers and residents of industrial areas were perceived to be most at risk of the deleterious effects of air pollution. Most of the respondents (89.6%) believed air pollution should be controlled and 61.0% believed that its control is the combined responsibility of government and the public; while 26.3% believed that only the government was responsible. Environmental sanitation (73.1%) and good town planning (69.0%) were identified as the major ways of controlling air pollution. Nearly half of the respondents (49.0%) described the air they breathe as unclean; and 60.0% were willing to pay extra levy for clean air in Kano. Conclusion: Majority of the public in Kano have a fair awareness of air pollution, the health risks associated with it and the control measures. However a significant percentage wrongly perceived that its control is the sole responsibility of the government. Key words: Public perception; air pollution; health risks