FACULTY OF PUBLIC HEALTH
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Item Acceptability of child adoption as management option for infertility in Nigeria: evidence from focus group discussions(2009) Oladokun, A.; Arulogun, O.; Oladokun, R.; Morhason-Bello, I. O; Bamgboye, E. A.; Adewole, I. F.; Ojengbede, O. A.Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by Nigerians. Twelve focus group discussions were held involving three communities stratified into inner core, transitory and peripheral, within Ibadan metropolis, South-Western Nigeria from May to July 2008. The participants were purposively selected based on gender and age group. The barriers mentioned were cultural practices, stigmatization, financial implications, and procedural bottle-necks. Measures suggested to curb these negative attitudes were advocacy, community mobilization and enactment of supportive law that will protect all parties involvedItem ADHERENCE TO CURRENT GUIDELINES ON PRESCRIPTION OF ANTIMALARIALS AND ASSOCIATED FACTORS AMONG HEALTHCARE PROVIDERS IN LOKOJA LOCAL GOVERNMENT AREA, KOGI STATE, NIGERIA(2015-04) WELLE, Sylvanus ChimaAdherence to current treatment guidelines on prescription of antimalarials by healthcare providers can promote better malarial treatment outcomes. However, adherence rate and factors influencing adherence to treatment guidelines have not been well explored. This study was carried out to assess adherence to current guidelines on prescription of antimalarials and associated factors among healthcare providers in Lokoja Local Government Area, Kogi State, Nigeria. The study was cross-sectional in design. A total of 404 healthcare providers aged 18-65 years were selected through proportional allocation from public health facilities and patent medicine stores. Using a semi-structured, interviewer-administered questionnaire, data were collected on socio-demographic characteristics of respondents, knowledge and training on current guidelines and prescription practice. Adherence was defined as correct prescription of artemisinin-based combination therapy for uncomplicated malaria in a child and adult. Knowledge of current guidelines was assessed on a 5-point scale and scores ≥3 were categorised as good knowledge while scores <3 were categorised as poor. Data were analysed using descriptive statistics, Chi-square test and logistic regression with significance level set at 0.05. Mean age of respondents was 36.9 years (SD = 9.2 years). Respondents comprised of nurses (36.6%), patent medicine vendors (30.0%), doctors (18.3%), community health extension workers (9.7%), pharmacists (3.2%) and community health officers (2.2%). Over half (53.0%) were males and about three-quarters (74.4%) were married. Half (50.0%) had good knowledge of the guidelines of which 34.2% were doctors and 4.0% each were community health officers and pharmacists. A total of 270 (66.8%) of respondents claimed they requested for confirmatory test before treatment of malaria. In all, 54.2% had been trained on the guidelines of which 36.1% were patent medicine vendors while only 1.4% was pharmacists. Overall adherence to guidelines on anti-malaria prescription was 39.6%. The adherence among doctors was 67.6%, community health officers (55.6%), pharmacists (19.8%). Respondents who were trained on the guidelines were twice more likely to adhere to guidelines. (AOR=2.28; CI=1.41-3.69) while respondents with good knowledge were four times more likely to adhere to guidelines compared to those with poor knowledge (AOR=3.99; CI=2.39-6.69). Knowledge of and adherence to current guidelines on antimalarials prescription was generally low in Lokoja among community health officers, nurses, pharmacists and patent medicine vendors in the study. Government should train these categories of health care providers to improve their knowledge and adherence to the guidelines. Keywords: Treatment guidelines, Antimalarial prescription, Health care providers, Malaria confirmatory test. Word count: 384Item AN APPRAISAL OF PRIMARY HEALTH CARE STAFFING SITUATION IN THE FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA(2012-07) IBRAHIM, CHRISTIANAH MORONWITANHealth personnel are central to the effective implementation of Primary Health Care (PHC). The Federal Capital Territory (FCT), Nigeria by virtue of its political status is expected to be a model regarding the effective implementation of PHC. One of the indicators of quality PHC implementation is adequate health manpower. This information with regard to the FCT is needed to ascertain the fulfillment of this expectation as a model. Hence, this study was conducted to assess Health Manpower availability in PHC facilities. A cross-sectional study was carried out among all the 809 health personnel in 180 PHC facilities in FCT. Population figure was obtained from national census, 2006. Data were collected with a pre-tested, structured, self-administered questionnaire which focused on respondents’ socio-demographic characteristics and their perception of personnel availability. In-Depth Interviews (IDI) were conducted with all heads of the six PHC departments. Four randomly selected PHC centres were visited for five consecutive days to record absentees using a register review checklist. Staff Population Ratio (SPR) was compared with the minimum standard set by the National Primary Health Care Development Agency (NPHCDA). Data analysis was done using descriptive statistics, Chi-square and thematic approach. Respondents’ mean age and years of work experience were 33±7.4 and 8.1±6.7 years respectively while 98.6% had post secondary education. The respondents included senior Community Health Extension Workers (CHEWs) (40%), junior CHEWs (23.3%), Nurse/Midwives (18.8%), Community Health Officers (CHOs) (5.0%), Laboratory Technicians (2.5%), Medical Record Officers (MROs) (1.7%) and, Medical Officers (1.4%). Others (7.1%) included Pharmacy Technicians, Environmental Health Officers, and Laboratory Scientists. The SPR per 100,000 population for various cadres were 1.0 Medical Officers), 3.2 (CHOs), 32.0 (senior CHEWs), 18.0 (junior CHEWs), 5.8 (Nurse/Midwives), 0.9 (MROs), 1.0 (Pharmacy Technicians) and 2.2 (Laboratory Technicians) compared with the NPHCDA minimum SPR of 2.3, 2.3, 24.6, 50.2, 9.1, 2.3, 2.2, and 2.0 respectively. Majority (69.5%) of the respondents perceived that health personnel were adequate in their health facilities. The IDIs revealed that services rendered met most of the patients’ requirements and lapses occasionally observed were due to lack of functioning equipments and frequent drug stock-outs. The respondents stated that opportunity for continuing education (60.3%), availability of working materials (53.3%), and matching skill to task (51.5%), substantially encouraged staff retention. Major reasons given by respondents for inadequate health personnel were lack of recruitment by the government (75.3%), non-provision of equipment (16.9%) and basic infrastructure (9.0%). Both IDI and observation revealed staff absenteeism was mostly due to ill health and lack of accommodation for staff. Absenteeism rate in the observed facilities was 10.7%. All PHC services except oral and mental health care were provided in observed health facilities. Availability of primary health care personnel in the Federal Capital Territory fell short of the minimum standard for most primary health care cadres. There is a need to plan for adequate primary health care personnel in the Federal Capital Territory to achieve comprehensive health care delivery.Item ASSESSMENT OF SELECTED HEAVY METALS IN PARTS OF SLAUGHTERED CATTLE AND GOATS CENTRAL ABATTOIR FROM AKINYELE, IBADAN(2015-04) OLADIPO, T. A.Meat and offal obtained from cattle and goats sold in open markets serve as sources of protein, but may be susceptible to heavy metal contamination due to illicit disposal and emission in the environment. Consumers’ knowledge on the possible exposure to heavy metal contamination in meat and its associated health risks is low. Therefore, this study aimed at assessing heavy metal levels in these products. A cross-sectional study design with observational and laboratory analysis components was adopted. Lead, cadmium and chromium residues in blood, muscle, liver and kidney of cattle and goats slaughtered in central abattoir, Akinyele, Ibadan were determined. The abattoir was selected because it is the largest abattoir supplying live animals and meat to residents of Ibadan. A total of 40 animals (20 each of white Fulani cattle and red Sokoto goats) were purposively selected over a period of 8 weeks in conformity with FAO quality control guidelines. Values were compared with Joint FAO/WHO guidelines. These animals were of different sexes and ages (determined by the use of their dentition). Samples of blood was collected from jugular vein at slaughter using 5ml syringe and 21 gauge needle, external abdominus muscles, liver apical lobes and kidney cortices were collected. Samples were analysed using Atomic Absorption Spectrophotometer (AAS) for lead, chromium and cadmium. Statistical analysis was done using descriptive statistics and t-test at 5% level of significance. Age of 14 male and 6 female cattle was 49.5±14.7 months while the age of 12 male and 8 female goats was 28.8±8 months. Cadmium was found in 115 samples (71.9%), lead in 26 samples (16.3%) and chromium in 17 samples (10.6%). Chromium value in blood of cattle (0.6±0.0µg/ml) was significantly lower compared to goats’ (2.4±2.6µg/ml). In muscle tissue, liver and kidney, chromium values for cattle and goats were 0.6±0.0, 1.3±0.9 and 2.3±3.0 mg/kg and 0.0, 0.6±0.0 and 0.0mg/kg respectively. Chromium residues were higher in liver and kidney of cattle and goats’ blood than permissible limits of 1mg/kg. Cadmium value in blood of cattle (5.7±2.1 µg/ml) was significantly lower compared to goats’ (6.8±3.0µg/ml). In muscle tissue, liver and kidney of cattle and goats cadmium values were 3.8±2.1, 5.2±2.3 and 5.7±2.3mg/kg and 5.4±1.9, 5.5±2.9 and 4.8±1.9mg/kg respectively. These values were higher than permissible limit of 0.5-1.0mg/kg. Lead residual values in blood of cattle and goats were 0.5±0.6 and 0.0µg/ml, while in muscle, liver and kidney of cattle and goats were 0.1±0.2, 0.0 and 0.0mg/kg and 0.0, 0.0 and 0.0mg/kg respectively. These values were within the permissible limits (0.1-0.5mg/kg). Cattle were found to have higher levels of bioaccumulation for lead, cadmium and chromium residues when compared to those of goats. From central abattoir, Akinyele, Ibadan, cattle and goat meat contained high levels of cadmium and chromium which could pose health risk to consumers. Therefore, public health awareness on the risk associated with cadmium and chromium ingestion and measures to reduce them in meat and meat products should be advocated.Item ASSESSMENTS OF THE MATERNAL CARE KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN IBADAN, OYO STATE, NIGERIA(2012-08) OLUKOTUN, E. A.Traditional Birth Attendants (TBAs) are lay persons who attend to deliveries and concerted efforts have been made to train them. Anecdotal reports suggest that many expectant mothers patronize TBAs in Ibadan. However, there is dearth of information relating to the TBAs’ maternal care knowledge and practices. This study was therefore conducted to assess TBAs’ knowledge and practices relating to maternal care in Ibadan, Oyo State. A cross-sectional survey of 407 out of 608 TBAs who consented to be involved in the survey, in the 11 Local Government Areas (LGAs) in Ibadan was conducted. The three categories of TBAs were; 93 local government trained-TBAs, 221 church-based TBAs and 93 TBAs who practice in herbal homes. A semi-structured questionnaire was used to obtain information on respondents’ demographic characteristics, knowledge and practices of maternal care. Knowledge and practice scores were computed with the maximum obtainable scores being 43 and 47 respectively. Data were analyzed using descriptive statistics, Independent t- test, correlation and Chi-square statistics. Respondents’ mean age was 47.0±10.8 years, 86.0% had at least primary education and majority (84.8%) were females. Seventy-eight percent had formal TBA training; of these 63.0% reported that they were regularly supervised by skilled health workers. None of the untrained TBAs had regular supervision. Overall mean knowledge score was 79.7±20.3%. Majority (80.6%) of TBAs recognized blood pressure measurement as an essential aspect of Antenatal Care (ANC). Majority were aware of the necessity of wearing sterile gloves in taking delivery (83.0%) and prompt referral of high risk cases (76.7%). Trained TBAs had a significantly higher maternal care knowledge score compared with the untrained TBAs (p<0.05). Blood pressure measurement during ANC visits, wearing of sterile gloves, and referral of high risk cases were reported by 66.0%, 44.0% and 51.8% respectively. Trained TBAs had a significantly higher mean practice score compared to the untrained TBAs (p<0.05). A significantly higher proportion of the regularly supervised trained TBAs reported referring of high risk cases (83.8%) compared with unsupervised trained TBAs (53%) (p< 0.05). There was a poor correlation between the maternal care knowledge and practice of the trained TBAs (r=0.435, p<0.05). The practices of untrained and unsupervised traditional birth attendants fell short of professional expectation and knowledge-practice gaps were identified among all categories of traditional birth attendants. Training and regular retraining of traditional birth attendants as well as supportive supervision by health staff of the State Ministry of Health, Local Government Area Primary Health Care departments and relevant non-governmental organizations are needed to enhance maternal care practices of traditional birth attendants in Ibadan.Item Attitude of health care workers to the involvement of alternative healthcare providers in the home management of childhood malaria(Baywood Publishing Co., inc, 2005) Falade, C. O.; Osowole, O. S.; Adeniyi, J. D.; Oladepo, O.; Oduola, A. M. J.The attitudes of 193 healthcare workers (Nurses (35.7%), auxiliary nurses' (35.7%), followed by community health officers (26.4%) in 55 primary and secondary healthcare facilities to home management of malaria were evaluated in four local government areas in Southwestern Nigeria. Results showed that mothers and patent medicine sellers were perceived as offering useful services in home management of malaria by giving first aid and selling antimalaria drugs, respectively. Although 79% of respondents expressed the opinion that mothers are the most appropriate to give first line management to children suffering from malaria, 56% were also of the view that such children should receive definitive treatment in a formal health care facility. Furthermore, 45% of the respondents felt that only formal healthcare workers should treat children who have malaria irrespective of the location of the treatment because mothers, patent medicine sellers, and traditional healers have not been formally trained. Healthcare workers were willing to train mothers and patent medicine sellers on effective management of childhood malaria, but were not favorably disposed toward collaboration with traditional healers in the home management of malaria. There is an urgent need for formal healthcare workers to seek better understanding of traditional healers' practices as well as their cooperation for improved home management of childhood malaria among indigenous groups.Item Audiometric assessment in patients with carcinoma of the larynx(2000-12) Osowole, O. S.; Nwaorgu, O. G. B.Audiometric assessment was carried out on twelve patients with advanced carcinoma of the larynx who were on admission on the Ear, Nose and Throat Ward of the University College Hospital, Ibadan, Nigeria between October 1995 and June 1996. The sharp dropping curve was the most common type of audiograph observed. Fifty percent of the patients had very sharp dropping curve at 200Hz, 33.3% had mild dropping curve at 4000Hz and 8000Hz while 16.7% had a flat curve within the social adequacy range. Implications of this in the treatment and rehabilitation of such patients is discussed.Item AWARENESS, ATTITUDE AND PRACTICES OF PRE-MARITAL GENOTYPE TEST AMONG UN-MARRIED STUDENTS OF THE POLYTECHNIC, IBADAN, NIGERIA(2014-04) OTEVWOYERE, V. E.Sickle Cell Anaemia (SCA) is one of the major causes of morbidity and mortality and a strategic way of reducing the problem is to educate the public and create more awareness on its causes and prevention. There is need for adequate information on awareness and attitude of young adults in tertiary institutions to undertake Pre-marital Genotype Test (PGT).Therefore, this study was aimed at determining the awareness, attitude, and practices of PGT among unmarried students of The Polytechnic, Ibadan. A cross sectional survey was conducted among 382 students who were randomly selected from the four halls of residence in The Polytechnic Ibadan, using a multistage sampling technique. A semi-structured questionnaire which included information on socio-demographic characteristics, awareness about SCA and PGT, 40- point attitude scale relating to PGT, practice of PGT and intention to undertake the test was administered on the respondents. Scores of < 20 and ≥ 20 were classified as negative and positive respectively. Descriptive statistics and Chi-square test were used to analyse the data with level of significance set at 5%. The mean age of respondents was 21.6 ± 3.1 years, 56.6% were females, 68.6% were Christians and 35.5% were in their first year of the National Diploma (ND) course. Respondents’ awareness of SCA and PGT were 89.0% and 92.3% respectively. Major sources of information on SCA and PGT were television (67.9% and 59.8%), friends (54.9% and 50.6%), parents (44.1% and 59.8%) and health workers (47.4% and 50.3%) for both sexes. More than half of the respondents (58.4%) knew their Haemoglobin (Hb) genotype. Of those that claimed to know their Haemoglobin (Hb) genotype, 37.3%, 17.1%, 3.1% and 0.9% were AA, AS, SS and AC respectively. Parents were the major decision makers for respective Hb genotype testing. Of those that knew their Hb genotype, 18.2% and 26.2% of males and females respectively had informed their partners of the result. In respect to respondent’s attitude to PGT, 54.0% had positive and 46.0% had negative attitude. Less than quarter (23.4%) of the respondents would not marry anyone with SCA, 58.4% agreed that it should not be a hindrance to marriage, while 55.4% affirmed their right to know their partner’s genotype before marriage and 37.3% reported that their partner’s genotype result would affect their selection of spouse. Furthermore, majority (85.3%) knew the importance of PGT. About 35.0% of those who did not know their Hb genotype intend to undertake the test before marriage. There was significant relationship between respondent’s awareness about SCA and awareness about genotype testing (p= 0.001). Awareness and practice in respect to sickle cell anaemia and pre-marital genotype test among respondents were high. Partner’s result affects the decision of respondents especially those with positive attitude towards premarital genotype test as critical factor. More awareness programmes should be created by the stakeholders during fresher’s orientation programme by educating the students on premarital genotype test and the consequences of actions guiding their choice of partner.Item Case management of childhood fever by traditional healers in Southwest Nigeria: Identification of training and collaborative needs(Baywood Publishing Co., inc, 2008) Fawole, O. I.; Akinboye, D. O.; Falade, C. O.; Arulogun, O. S.; Adeniyi, J. D.Traditional healers play an important role in the provision of healthcare in many communities in Africa. This study aimed to improve home management of malaria in children by assessing the healer's knowledge and practice. A semi-structured questionnaire interview of 127 traditional healers selected by proportionate sampling technique from two rural and two urban local government areas (LGAs) of southwestern Nigeria was followed by a training program. Malaria ranked first (87%) among the illnesses managed by the healers. Diagnosis of fever was often (72%) based on client history, physical examination (24.4%), consulting oracles (18.9%), and interpretation of dreams (3.1%). Treatment of malaria was with boiled herbs ("agbo"; 72%), ground herbs ("agunmu"; 14%), and incisions and scarifications (3%). Forty-one (32.5%) healers had referred febrile children to a health facility. Younger healers and those who had at least a secondary education were more likely to refer patients (p < 0.05 in both cases). Thirty-six healers (28.4%) had previous formal training on management of fevers, most of whom were the younger (p < 0.(5), educated healers (p> 0.05), with fewer years of practice (p> 0.05). Research into traditional herbs (48%), better acknowledgment by government (23.6%); and collaboration with other health sectors were suggestions to improve practice. Traditional healers, especially the older, less-educated, and long-practicing healers, urgently require formal training and collaboration with other healthcare providers to improve knowledge and promote early referral of children with fever.Item CHARACTERIZATION OF TRAFFIC-RELATED AIR POLLUTANTS AND ASSESSMENT OF RESPIRATORY CONDITIONS OF TRAFFIC WARDENS ACROSS TWO SELECTED LOCAL GOVERNMENT AREAS OF IBADAN, NIGERIA.(2013-04) OLAMIJULO, J. O.Traffic-related emissions contribute immensely to ambient air pollution in urban areas and Traffic Wardens (TW) have been reported to be at high risk of respiratory problems. Although data on road traffic emissions are available in Nigeria, information on personal exposure of traffic wardens to particulate matter is lacking. This study was designed to characterize traffic emissions and compare lung function status of TW with Regular Policemen (RP) in two Local Government Areas (LGA) of Ibadan. A comparative cross-sectional study was conducted involving all 122 TW (exposed group) in the study area and 125 RP (unexposed group). Ibadan North and Northeast LGAs were purposely selected based on high traffic density. Thirteen Study Locations (SL) were randomly chosen from eighteen identified SL in the two LGAs. Levels of sulphur dioxide (SO2), nitrogen dioxide (NO2) and carbon (II) oxide (CO) emissions were measured using calibrated SO2, NO2 and CO metre respectively according to WHO guideline. Respirable Suspended Particulate Matter (RSPM) was measured using personal respirable dust sampler within 30cm range of the TW nasal region and values were compared with WHO guideline limit. Measurements were taken in the morning (6am - 8am), afternoon (12pm - 2pm) and evening (4pm - 6pm) for 12 weeks. Traffic density was estimated via manual counting using tally system. An interviewer-administered questionnaire was used to elicit information from the 247 respondents on work hours and respiratory problems. A calibrated spirometer was used to determine the Force Expiratory Volume in 1 second (FEV1) in 61 of the 122(TW) and 63 of the 125RP. Data were analyzed using descriptive statistics, Chi-square and Pearson correlation tests at p ≤ 0.05. Mean gaseous emissions level were CO (38.6 ± 22.2ppm), SO2 (1.0 ± 0.7ppm), NO2 (0.2 ± 0.1ppm) and RSPM (28.1 ± 11.5µg/m3). These values exceeded the WHO guideline limit for CO (10ppm), SO2 (0.17ppm), NO2 (0.17ppm) and RSPM (25µg/m3). The peak CO emission level (165ppm) was recorded in the evening (4pm-6pm). Mean total traffic density at the SL was 3478 ± 1043.4/hr. Mean concentration of traffic emissions were elevated with increase in traffic density at SL. There was a significant positive correlation between SO2 and traffic density (r= 0.48). Mean age of TW and RP were 37.7 ± 9.3 years and 37.0 ± 7.7 years respectively. Majority (54.9%) of the TW spend more than 8hours at road intersections. Reported respiratory problems experienced included: breathing difficulty (TW: 66.4%; RP 6.4%), chest pain (TW: 72.1%; RP: 5.6%), sore throat (TW: 60.7%; RP: 14.4%) and catarrh (TW: 68.9%; RP: 41.6%). There was a significant difference between the observed FEV1 among TW (2.2 ± 0.7l) and RP (3.4 ± 0.5l). A negative correlation was observed between RSPM and the actual FEV1 of TW (r= -0.6). Ambient air emissions at study locations exceeded the World Health Organization guideline limit for occupational exposures and respiratory problems were higher among traffic wardens. Routine air monitoring of motor ways and the use of personal protective equipment by traffic wardens while on duty is advocated.Item Childhood blindness, Eye disease screening checklist, Primary eye care, Sensitivity and Specificity(2021-03) OLUSANYA, B.A.Approximately seventy per 100,000 children are blind worldwide. Early detection and prompt treatment play vital roles in prevention of blindness from cataract and other eye diseases in children. However, there are no established screening programmes for blinding eye diseases among infants in Nigeria. This has contributed to delayed presentation to hospital among children with blinding eye diseases. Therefore, this study was conducted to develop and validate a simple screening tool for the early detection of blinding eye diseases among infants as well as assess the perceptions of health care workers regarding the feasibility of using the tool. This cross-sectional study was conducted in 3 phases. The first phase was the development and validation of a screening checklist. This entailed a literature review, expert opinion, stakeholders’ input, content validation and pretesting of the checklist. The second phase was a diagnostic accuracy study which compared the newly developed checklist to a gold standard, which was eye examination by an ophthalmologist. This phase was carried out on 1214 infants receiving immunisation in eight primary health care centres located in four urban Local Government Areas in Ibadan metropolis. Each infant was first screened by a primary health worker (immunisation staff) using the checklist and subsequently examined by the ophthalmologist. The sensitivity, specificity, positive and negative predictive values as well as reliability indices of the checklist were determined. The third phase was a questionnaire survey to assess the perceptions of all the participating immunisation staff (38 in number) about the feasibility of using the checklist. Data were analysed using descriptive statistics. Level of significance was set at α0.05. A checklist with two sections and 11 items was developed. The first section consisted of six questions that the health workers asked the infants’ mothers or caregivers; while the second section contained five questions that were answered by the health workers after a quick examination of the children’s eyes. The mean age of the infants was 5.2±3.8 months and 52.5% were males. The screening checklist had a sensitivity of 70.0% for detection of blinding eye disease. In addition, it had a specificity of 94.8% for detection of blinding eye disease. The inter-observer agreement was 96.6% (Kappa = 0.71); while test-retest reliability showed an intra-class correlation coefficient of 0.90. All the immunisation staff were females, with a mean age of 43.1±7.6 years. They all reported that the checklist was useful in screening for eye diseases among infants. Majority (81.6%) reported that the checklist was very easy to use. About one-third (34.2%) experienced challenges, such as poor cooperation from mother or child, while using the checklist. A screening tool with good sensitivity, high specificity and high reliability was developed for the early detection of blinding eye diseases in infants. Primary health care workers found the checklist to be easy to administer and useful for screening. Adoption of this checklist as a screening tool at the primary health care level could be instrumental in the establishment of screening programmes and early detection of blinding eye diseases among children.Item Community gate keepers' awareness and perception of prevention of mother-to-child transmission of HIV services in Ibadan, Nigeria(2007) Arulogun, O. S.; Adewole, I. F.; Olayinka-Alli, L.; Adesina, A. O.Each year, around half a million children aged under 15 become infected with HIV and more than 90% are the result of mother-to-child transrnission. Services to prevent mother-to-child HIV transmission (PMTCT) are therefore important entry points for HIV AIDS Prevention, treatment and care services for women, their children and families. The study aimed at identifying level of awareness and knowledge of PMTCT services that can be utilized in improving access. The methodology consisted of 20 individual in-depth interviews spread over Adabeji, Adeoyo/Agbadagbudu, Jakiru/Onipasan and Eleta communities, in Ibadan among household heads, religious and community based leaders. Key factors identified were low knowledge of mother to child transmission, lack of knowledge of the PMTCT services, inadequate community sensitization, inadequate health care facilities. The success of PMTCT programmes demands a shift towards a more community-based approach which calls for strong advocacy, enlightenment and community mobilization for improved awareness and utilization of PMTCT servicesItem Community-directed interventions for priority health problems in Africa: results of a multicountry study(2010) Ajuwon, A. J.Objective: To deterrnine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. Methods: A three-year experirnental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Carneroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. Findings with the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for Short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problerns with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. Conclusion The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.Item Comparison of blood pressure in deaf secondary school children and their hearing counterparts: association between noise and blood pressure(2006-12) Nwaorgu, O. G. B.; Arulogun, O. SBackground and Objective: High blood pressure has been known to be one of the problems that could develop as a result of exposure to noise. Consequently, those who are hearing impaired are thought to be immune to this. This study assessed the relationship between noise exposure and blood pressure. Methodology: This is a comparative prospective study involving participants (consisting of the hearing and the hearing impaired) drawn from a school environment that is situated close to a major highway and railway and evaluating the impact of noise on their blood pressure. Results: The study population consisted of 299 secondary school students. The noise sensitive group comprised 220 participants with normal hearing while the noise-insensitive group comprised 79 hearing impaired from the same school. More participants 6 (85.7%) from the noise insensitive group were found to have significantly higher blood pressure than their hearing counterparts 1 (14.3%). In addition, majority of the participants (63.1 %) irrespective of their level of noise sensitivity were underweight. Conclusion: This study finds liaise exposure alone not sufficient to bring about an increase in blood pressure of the studied population. This not withstanding we advocate for policy measures aimed at controlling the source of environmental noise around educational institution which will aid in reducing the adverse effects of noise on the school children.Item COMPARISON OF EFFECT OF STRUVITE PREPARED FROM SOURCE-SEPARATED HUMAN URINE WITH INORGANIC FERTILIZER ON AMARANTHUS CAUDATUS(2015-11) ALUKO, O. R.In Nigeria, use of urine for fertigation has been limited because of its liquid form, odour and the unsanitary disposal methods. This poses great hazard to man and the environment. Converting urine into dry fertilizer product (struvite) helps extract nutrients contained in urine and also eliminates handling problems. The study was aimed at converting urine to struvite and comparing its effectiveness on plant growth with inorganic fertilizer (NPK). The study involved the extraction of struvite from human urine and its use as fertilizer for raising Amaranthus caudatus in a screen house. Fourteen students selected randomly from the students' hostel at the University College Hospital produced 100 litres of urine which was stored for three months in order to reduce the microbial load. Triplicate samples of fresh and stored (stale) urine collected from the same set were analyzed for physico-chemical [pH, ammonia (NH3), nitrogen (N), phosphate (PO43-) and potassium (K)] parameters using standard methods at the point of collection and three months after. Magnesium Chloride (MgCl2) with concentrations: 1.2M, 1.5M and 1.8M was added to 20 litres of stale urine to produce struvite of varying concentrations. Amaranth vegetable seeds were planted in 15 pots (of three replicates each) containing 2kg of soil treated with struvite and inorganic fertilizer while soil without either struvite or inorganic fertilizer was used as control. Plant height and stem width were measured and number of leaves were counted the second week of planting. Plants were harvested after the fourth week; with the wet and dry weight of the leaves, stem and root taken. Data were analyzed using descriptive statistics, t- test and ANOVA at p=0.05. Mean pH of fresh and stored urine were 6.50±0.10 and 9.03±0.15 respectively. Mean concentration (mg/l) of NH3, N, PO43- and K were: 0.26±0.20, 1080.33±145.22; 46.00±1.00, 32.00±3.00; and 29.66±4.72, 1358.66±183.90, 45.66±3.05 and 35.33±0.57 for fresh and stored urine respectively. Mean concentration (mg/l) of N, PO43-, K present in struvite were 193.33±56.5, 471.66±61.71 and 34.56±2.18, with PO43-being significantly different when compared with stored urine. Mean plant height (cm) for control, struvite produced from 1.2M, 1.5M, 1.8M of MgCl2 solution and inorganic fertilizer at the fourth week were 20.00±0.90, 20.16±4.36, 29.08±0.87, 28.00±0.86 and 20.00±7.76 respectively. Mean stem width (cm) of control, struvite 1.2M, 1.5M and 1.8M and inorganic fertilizer were 0.34±0.02, 0.39±0.07, 0.48±0.02, 0.46±0.03 and 0.40±0.21 respectively while the mean numbers of leaves were 13.00±0.50, 12.50±1.50, 15.16±0.76, 15.16±0.76 and 13.00±2.64 respectively. Plant height and stem width of struvite 1.5M and 1.8M treated vegetable were significantly (p=0.05) higher and thicker respectively when compared with other treatments. Mean wet and dry weights (g) were: 11.58±2.77 and 1.76±0.38 (control), 14.90±11.09 and 2.39±2.19 (struvite 1.2M), 32.11±5.35 and 5.85±0.77 (struvite 1.5M), 28.81±3.84 and 5.45±0.92 (struvite 1.8M), 9.97±8.87 and 1.34±1.24 (inorganic fertilizer) respectively. Weights of struvite-treated vegetable were significantly higher when compared with other treatments. The highest dry weight (5.85 ± 0.77) was obtained with Amaranthus caudatus planted on struvite-treated soil. Struvite production and use in agriculture should be explored on a larger scale and could be employed as organic fertilizer to improve plant yield and indirectly improving environmental sanitation.Item Contribution of the indigenous health care givers to the herbal management of febrile illnesses in Rivers state, South-south, Nigeria(2005-12) Ebong, O. O.; Ajaiyeoba, E. O.; Ononiwu, I. M.; Eteng, M. J.; Akinbiye, D. O.; Gbotosho, G. O.; Falade, C. O.; Bolaji, O. M.; Oladepo, O.; Osowole, O. S.; Happi, T. C.; Fawole, O. F.; Ogundahunsi, O. A. T.; Agbagwa, I. M.; Oduola, O.; Oduola, A. M. J.This study was carried out in two rural communities; kaani and Boue, in Khana Local Government Area (LGA) and in one urban community, Elomo, in Elomo LGA, all in Rivers state, South-south, Nigeria. The investigations involved in-depth interview conducted with 104 health care givers comprising indigenous healers: herberlists, sellers of herbal remedies and community elders. Information was obtained on types of fevers (febrile illnesses) treated, symptoms and methods of establishing illnesses, and traditional herbs used in the prevention and treatment of febrile illnesses. On types of febrile illnesses treated, respondents presented the following: malaria (78.8%), typhoid (23.1%), yellow fever (21.2%), high fever (19.2%), convulsion (15.4%), and pregnancy fever (2.9%). Other illnesses treated were yellow eyes (4.8%), headache (11.5%), waist pain (14.4%), and joint pains (8.7%). Respondents determined whether a person had fever by the following: physical examination (85.4%), listening to patients' complaints (9.4%), through divination and inspiration (9.4%), while others (0.2%) were not quite explicit on their methods of diagnosis. On the treatment of febrile illnesees, respondents used herb teas (88.5%), herb powders (42.3%), incantation (3.3%), and performance of sacrifice (4.8%) or use of special fluids (27.9%). Majority of the respondents in describing the best herbal medicines for the treatment of febrile illnesses, 62.5% said that dogonyaro (Azadiracta indica) was the best medicine. Other responses were: lemon grass (Cymbepegon papaya) leaf/fruit (20.2%): guava (Psidium guajava) leaf (18.3%), akpagbogoro (Salacia nitida), 7.7%, plantain (Musa sapientum) sucker (6.7%), lipton tea (3.8%) and scent leaf (Ocimum gratissimum), 1.9%Item Cultural categorization of febrile illnesses in correlation with herbal remedies used for treatment in Southwestern Nigeria(Elsevier Science Ireland Ltd, 2003) Ajaiyeoba, E. O.; Oladepo, O.; Fawole, O. l.; Bolaji, A. M.; Akinboye, D. O.; Ogundahunsi, O. A. T.; Falade, C. O.; Gbotosho, G. O.; Itiola, O. A.; Happi, T. C.; Ebong, O. O.; Ononiwu, I. M.; Osowole, O. S.; Oduola, O. O.; Ashidi, J. S.; Oduola, A. M. J.The ethnographic study was conducted in two communities in Oyo state in Southwestern Nigeria. The study sites consisted of a rural and an urban local government area located in the tropical rain forest zone of Nigeria. The study was designed to obtain information on febrile illnesses and herbal remedies for treatment with the aim of identifying potential antimalarial drugs. The study revealed that fever is a general term for describing illnesses associated with elevated body temperature. The indigenous Yoruba ethnic population has categorized fever based on symptoms and causes. The present communication is the result of focus group discussion and semi-structured questionnaire administered to traditional healers, herb sellers, elders and mothers. This was on types of fevers, symptoms and causes of febrile illnesses. The investigation also included use of traditional herbs in the prevention and treatment of the illnesses in the two communities. A total 514 respondents were interviewed. This was made up of 266 (51.8%) from Atiba local government area (LGA), an urban centre while 248 (48.2%) respondents were interviewed from Itesiwaju LGA, a rural community. The LGAs are located in Oyo State of Nigeria. The respondents proffered 12 types of febrile illnesses in a multiple response answering system in Yoruba language. The most common ones (direct translation into English) were: yellow fever (39.1%), typhoid (34.8%), ordinary (28.8%), rainy season (20.8%) and headache (10.5%) fevers respectively. Perceived causes each of the febrile illnesses included stress, mosquito bites, unclean water, rains and over exposure to the sun. Methods of fever prevention were mainly with the use of herbal decoctions, powdered herbs, orthodox medications and maintenance of proper hygiene. Of a total or 112 different herbal remedies used in the treatment or the febrile illnesses compiled from the study, 25 recipes are presented. Recipes consisted of 2-7 ingredients. Oral decoctions (84%), oral powders (63%). use as soaps and creams (40%) in a multiple response system, were the most prevalent routes of administration of prepared herbs used in the treatment of the fevers. Boiling in water or alcohol was the most common method used in the preparation of the remedies. The four most frequently mentioned (multiple response system) plants in the Southwest ethnobotany for fevers were Azadirachta indica (87.5%). Mangifera indica (75.0%), Morinda lucida (68.8%) and Citrus medica (68.8%).Item DATE RAPE EXPERIENCES AND HELP-SEEKING BEHAVIOUR AMONG FEMALE UNDERGRADUATE STUDENTS OF UNIVERSITY OF IBADAN, NIGERIA(2012-08) OGUNWALE, A. O.Date Rape (DR) which is mainly experienced by young women is a public health concern worldwide and is characterised by physical, psychological and social consequences. In Nigeria, there is dearth of information on DR among Female Undergraduates (FUs) in the Universities. This study was therefore designed to determine the prevalence, context of occurence, help-seeking behaviour and level of knowledge relating to DR among FUs of the University of Ibadan. This cross-sectional survey involved the conduct of eight Focus Group Discussions (FGDs) in all the four FU halls of residence. Thereafter, FGD responses were used to develop a semi-structured questionnaire that was used to interview 610 FUs selected using a four-stage random sampling technique. The FUs were selected proportionately from halls of residence, blocks and rooms. Thereafter, one FU per room was interviewed. The instrument included a 6-point knowledge scale and questions relating to DR experiences, context in which DR occurred and victims’ health seeking behaviour. Knowledge scores of 0- 2, 3- 4 and 5- 6 were rated as poor, fair and good respectively. In-depth Interviews (IDI) were subsequently conducted among eight consenting victims of DR. Data were analyzed using thematic approach, as well as descriptive statistics and logistic regression at p = 0.05. The identified forms of DR that could be experienced by FUs were Forced Vaginal Sex (FVS), Forced Anal Sex (FAS), Forced Oral Sex (FOS) and Forced Insertion of Fingers (FIF) into the private part of a woman. It was disclosed that male chauvinism, indecent dressing and alcohol abuse contributed to DR. Respondents’ mean age was 21.0 ± 2.5 years and their median knowledge score was 2.0 (0 – 6). The prevalence of DR was 11.8% and the forms of DR ever experienced were FVS (80.3%), FAS (10.5%), FOS (15.8%) and FIF (32.9%). Only 8.9% of the FUs experienced DR within the year preceding the study. Majority (73.6%) of the respondents who experienced DR had it when they became undergraduates and 52.1% of the perpetrators were fellow students of the University. Respondents aged over 21.0 years (41.5%) were at higher risk of DR (OR: 2.91, 95%CI: 1.36- 6.25). Respondents who had experienced attempted DR (32.2%) were at lower risk of DR (OR: 0.30, 95%CI: 0.14 - 0.64). Majority (83.3%) experienced DR off-campus and 73.3% occurred in dating partners’ houses. Ninety three percent of victims of DR never sought any medical help and reasons included lack of serious physical injury (53.0%) and fear of being stigmatized (10.6%). Most (91.7%) never sought counselling services and 60.5% of them felt it was not necessary. The IDI revealed that the experienced health consequences of DR included -vagina injuries, vagina bleeding, loss of virginity and depression. Date rape occurred among female undergraduates and mostly in perpetrators’ houses outside the University campus. Despite the health effects experienced, victims did not seek help due to psycho-social challenges. Advocacy and public enlightenment aimed at promoting the reproductive rights of females as well as life-skill-training and social support are needed to address the phenomenon.Item EFFECT OF EDUCATIONAL INTERVENTIONS ON HIV/AIDS KNOWLEDGE, SEXUAL BEHAVIOR AND PERCEIVED SELF-EFFICACY AMONG FEMALE APPRENTICES IN BENIN-CITY, NIGERIA.(2013-08) Akinbami, A. A.Globally female youths are disproportionately affected by HIV. They tend to participate in more risky sexual activities especially those in apprenticeship. In Nigeria, interventions addressing the reproductive health needs of female youths are scarce. This study was carried out to compare the relative effectiveness of three interventions: peer education, education by instructors and a combination of the two on HIV prevention and safer sex among female apprentices in Benin-City. Benin-City was purposively selected as study site. The quasi-experimental study involved systematically selected 804 female apprentices drawn from 200 shops (120 tailoring and 80 hairdressing saloons). The shops were assigned to three intervention groups and a control. The apprentices’ baseline information was obtained using a semi-structured questionnaire consisting of 21-point HIV knowledge, 26-point risky sexual activities and 21-point perceived self–efficacy scales. The intervention groups were shops whose apprentices received Peer Education alone (PE), Education by Apprentices’ Instructors alone (EAI); and combination of both (PE+EAI) relating to HIV prevention. The interventions consisted of training of randomly selected 100 apprentices as peer educators on HIV prevention and counselling. They administered the intervention on the apprentices in their shops for six months, completed in March 2010; the control received no intervention. Post-intervention evaluation was conducted at intervals of three and six months. The number of participants at baseline, three and six months were 201, 199 and 200 for PE; 200, 200 and 200 for EAI; 201, 198 and 200 for PE+EAI; and 202, 198 and 198 for the control group. Data were analysed using descriptive statistics, Chi square, t-test and ANOVA at p=0.05. Mean ages of respondents in PE, EAI, PE+EAI and control were 21.9 3.8, 21.5 2.8, 21.8 2.9 and 22.1 3.6 years respectively. Majority were singles: PE (86.6%), EAI (96.0%), PE+EAI (82.6%) and control (75.7%). Apprentices who completed Senior Secondary School education were PE (38.8%), EAI (58.0%), PE+AEI (27.4%) and control (48.0%). Mean knowledge scores at baseline were 10.8±3.6 (PE); 14.0±2.3 (EAI); 9.6±2.9 (PE+EAI) and 10.2±3.2 (control); these increased to 16.3±1.2, 15.8±1.9, 16.8±0.8 and 15.5±1.5 at three months; to 16.5±1.2; 17.1±0.7; 17.0±0.5 and 14.3±1.5 at six months for PE, EAI, PE+EAI and control respectively; there was significant increase in knowledge among intervention groups. At six months, there were significant reductions in proportions of respondents who had >1 sexual partner from 16.4% to 0.0% (PE), 3.0% to 0.0% (PE+EAI), 22.9% to 4.0% (control) but in EAI it increased from 0.0% to 2.1%. Comparing baseline with post-intervention data, respondents who reported condom use increased from 77.5% to 95.5% (PE), 82.0% to 85.6% (EAI), 49.0% to 76.8% (PE+EAI) and 58% to 60.3% (control) with significant differences only in the experimental groups. Difference between baseline and post-intervention mean score for perceived self-efficacy increased significantly in PE (from 12.1±2.9 to 16.6±3.7) and PE+EAI (10.4±5.0 to 13.6±2.8), but marginal increase in EAI (11.6±3.5 to 13.5±1.7) and control (11.2±2.9 to12.8±3.4). Combination of education by peers and apprentices’ instructors yielded more positive impact in knowledge and use of condom than single approach. It is recommended for use among female apprentices and policies should be formulated to support more interventions among this population.Item Effect of hemodialysis on the hearing function of patients with chronic renal failure(2006-12) Lasisi, A. O.; Salako, B. L.; Osowole, O.; Osisanya, W. P.; Amusaf, M. A.Sensorineural hearing impairment (SHI) has been reported in chronic renal failure (CRF) patients with a prevalence of 20-40%. The aetiopathogenetic mechanisms reported included osmotic alteration resulting in loss of hair cells and in some, complications of haemodialysis have been hypothesized' We have in the past reported 2 cases of CRF patients who developed acute SHL following hemodialysis. This is a report of investigation of the effect of hemodialysis on the hearing function of CRF patients using pure tone audiometry findings. Thirty-three CRF patients were recruited for Pure Tone Audiometry (PTA) at admission and after three sessions of hemodialysis. The pure tone audiometry was done with a computer audiometer BA 20 Kamplex in the sound - proof (acoustic) booth in the ENT clinic. The duration of illness, dosage of diuretics and blood pressure were also noted. Similar age and sex-matched control were selected among volunteers who were otherwise clinically healthy. The data was processed using the Statistical Package for the Social Sciences (SPSS Inc, Chicago, Illinois, USA). Thirty-three CRF patients treated with haemodialysis and 28 healthy controls completed the study, 34 males and 27 females, age range was 16 - 72 years, mean of 45.30 (SDI6.20) for subjects and 49.7 for controls. Hearing loss was found in 22/34 (67%) at recruitment and 27/34 (79%) after 3 sessions of hemodialysis. There was a significant difference between the mean pre- and post-hemodialysis PT A values, P =0.0008. There was also a signiticant correlation between post-hemodialysis hearing threshold and (i) duration of illness (P = 0.00340) and (ii) creatinine levels of the patients (P=0.035). In conclusion, there was a significant depression in the hearing threshold of patients with CRF following three sessions of hemodialysis. This could be caused by changes induced by hemodialysis or effects of the duration and severity of disease.