FACULTY OF PUBLIC HEALTH
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Item Effect of peer education on deaf secondary school students' HIV/AIDS knowledge, attitudes and sexual behaviour(2000) Osowole, O. S.; Oladepo, O.This study evaluated the effect of an AIDS education program on deaf secondary school students' knowledge, attitude and perceived susceptibility to AIDS using peer education. Two secondary schools matched for ownership (government), composition (mixture of hearing and deaf and teaching arrangement (separate teaching of deaf students using sign language) were used, and each school was randomly allocated the intervention or control status. All students completed a questionnaire on AIDS at baseline and post-intervention following baseline, volunteers from the intervention group received four weeks training as peer educators, after which they provided HIV/AIDS information to their peers on one-to-one basis and in group, using a variety of approaches for a period of eight months, while the control subjects did not Pre-post group differential scores for knowledge of the causes, modes of transmission and methods of prevention of AIDS among intervention group compared with the control group were significant (p<0,0000001) but not to perceived personal susceptibility (p=0.64217). This study suggests the influence of peer education on health knowledge of youth but a limitation in changing perception of susceptibility.Item Factors associated with malaria treatment failures in Ibadan(2005) Yusuf, O. B.; Oladepo, O.; Odunbaku, S. O.; Alaba, O.; Osowole, O. S.This study aims to find out factors associated with anti-malaria drug resistance in some selected areas in Ibadan. One thousand one hundred and two subjects were interviewed viewed using a semi structured questionnaire. Respondents were put into two different groups (high and low resistant areas). The result revealed a high level of drug use for treating malaria particularly chloroquine and sulfadoxinepyrimethamine (“Fansidar”). The Results also showed that the two groups were not significantly different with respect to clearance of infection, but there was a significant difference between clearance of infection and whether or not the respondent completed the course of treatment in each group (P<0.05). When both groups were combined, the Mantel-Haenszel test showed that the response difference between the two groups was significant. (OR= 3.44 (Cl= 1.8 to 6.51) i.e those that completed the treatment were 3 times more likely to have their infection cleared than those that did not complete the treatment. A significant finding was that non-compliance with treatment was a major factor associated with treatment failure. The prevalence of drug resistance was a little higher in the high resistant group compared to the low resistant group but this difference was not statistically significant. These results underscore the need for adequate health education about the treatment of malaria and the importance of compliance in this community.Item A survey of treatment practices for febrile illnesses among traditional healers in the Nigerian middle belt zone(2005) Osowole, O.; Ajaiyeoba, E.; Bolaji, O.; Akinboye, D.; Fawole, O.; Gbotosho, C. G.; Ogbole, O.; Ashidi, J.; Abiodun, O.; Falade, C.; Sama, W.; Oladepo, O.; Itiola, O.; Oduola, A.This survey was conducted to investigate the pattern of treatment practices for febrile illnesses among one hundred and eighty five traditional healers from the Nigerian Middle belt zone ethnomedicine. Data collection was through use of the semi structure questionnaire administered by trained interviewers recruited from the study sites – Gboko and Katsina Ala Local Government Areas. A total of 176 (95.1%) reportedly diagnosed through the presenting complaints and symptoms and 3 (1.6%) made diagnoses through divination. All the respondents indicated their referral practices, with 100 (54.1 %) of the respondents reported that they had once referred clients. Respondents listed 164 plants used in the preparation of the various treatment modalities. Institution of treatment follows this diagnostic practice. Treatment of different febrile illnesses involve the use of 338 liquid herbs, powdered herbs, medicinal scarifications, incantations and sacrifices which suggests the confidence this group has in the efficacy of their herbs for treating febrile illnesses. An appreciable level of referral 54.1% practice was also found among the traditional healers. The findings of this study strengthen the need to recognize the traditional health practitioners in the treatment of health problems especially febrile illnesses, and to establish quality control mechanism in partnership with them to improve their treatment practices.Item Knowledge dissemination and evaluation in a cervical cancer screening implementation program in Nigeria(Elsevier Inc., 2007) Miller, D.; Okolo, C. A.; Mirabal, Y.; Guillaud, M.; Arulogun, O. S.; Oladepo, O.; Crain, B.; Follen, M.; Adewole, I. F.Objectives: Our goals were to train health professionals in Nigeria using the text, "Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers", and then evaluate the knowledge dissemination process using a pre- and post-test assessment. The manual was developed by the ACCP, WHO, TARC, PATT-T,Engender Health, TI-TPTEGO, and PAT-TO with funding from the Gates Foundation. It is an inclusive guide to implementation and maintenance of screen-and-treat cervical cancer prevention clinics and is ideally suited for programs operating in the developing world. Methods. Training took place at a conference in Ibadan, Nigeria. Participants included teams of physicians, nurses, bioengineers, data managers, and administrators who met in joint and parallel sessions to "train the trainers". This meeting was designed to provide both training and equipment to personnel to be involved in the implementation of a cervical cancer control initiative in Nigeria. A 36 item pre-test was administered prior to a group study sessions. A slide presentation summarized salient points before the post-test was given. The results were entered into an MS Excel spreadsheet for descriptive statistics about (I) the participants, (2) the test, (3) an examination of profession, years of work experience, years of education, and gender as predictors of two outcomes (low pre-test score and large difference between pre- and post-tests) and (4) overall performance on the exam. Results. There were 70 participants and trainers, of which 53 took the exam. Most of the examinees were physicians. Some participants did not fill out the post-test, leaving their tests inevaluable. A closer look at the test revealed eight questions that were confusing and nine that were too easy. All participant subgroups performed better on the post-test than the pre-test; the improvements were statistically significant. While profession impacted the results, profession was not statistically significant. Years of work experience, years of education, and gender did not affect test results. Conclusions. While the study suffers from a small sample size, a few ambiguous questions, and the need for pilot testing the instrument prior to the meeting, the report evaluates the manual very favorably. The authors showed a significant gain in knowledge. The manual gives "the big picture" and does so with clarity. The text and supplementary material outline the work that needs to proceed in an organized program, and the material was easily understandable in Nigeria. Future evaluations could benefit from more participants and varied learning structures.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 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 Enhancing treatment compliance in the home management of childhood malaria: The use of a participatory approach in ensuring intervention appropriateness(Baywood Publishing Co., inc, 2004) Asa, A.wole, O. S.||Oladepo, O.; Adegbenro, C. A.; Dare, F. O.; Adeniyi, J. D.; Osowole, O. S.; Oladepo, O.The study employs a participatory approach in ensuring intervention appropriateness and compliance with prescribed chloroquine regimen for children perceived to be suffering from malaria. The study showed that tailoring education intervention to the special needs of mothers, health workers, and patent medicine sellers and involving them in the design of interventions are some of the best ways of achieving intervetion effectiveness. It also reveals that treatments with tablets predispose to higher compliance rates than syrups. Public participation in the diagnosis of management problems and proffering of interventions has shifted the role of researchers from interventionists to a supportive role of these populations. This strategy can save cost and ensure the permanence of interventions beyond the lifespan of researchItem 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 Efficacy of herbal remedies used by herbalists in Oyo State Nigeria for treatment of Plasmodium falciparum infections a survey and an observation(2004) Ajaiyeoba, E. O.; Falade, C. O.; Fawole, O. I.; Akinboye, D. O.; Gbotosho, G. O.; Bolaji, O. M.; Ashidi, J. S.; Abiodun, O. O.; Osowole, O. S.; Itiola, O. A.|; Oladepo, O.; Sowunmi, A.; Oduola, A. M. J.In the course of evaluating the contribution of phytomedicine to possible drug discovery of antimalarial drugs, an ethnomedical survey of specialized children traditional clinics was done. In the observational multi center study, efficacy of eight different herbal remedies, each consisting of 3-8 ingredients and administered by herbalists were investigated in clients enrolled in the six traditional clinics in Oyo (urban center) and Otu (rural center) of Oyo State, Nigeria. The clients, aged between six months and fifteen years with clinical symptoms of malaria were enrolled in the clinics of the herbalists, as their usual practice. Oral informed consents were obtained from their parents or guardians. Microscopic diagnosis of malaria infection was used, to evaluate parasitaemia and validate efficacy of herbal remedies. Results of the analyzed shows that, of the 163 clients of the herbalists, only 62 (30 Oyo, 32 from Otu) had microscopically confirmed P. falciparum infection. Only results from 54 clients (29/30 (Oyo) and 25/32 (Otu) with P. falciparurn infection could be evaluated. Plasmodium falciparum infection in 88% (23/29) of clients from Oyo responded to treatment with the herbal remedies while cure rate in clients from Otu was 42% (13/25). Parasite densities ranged from 171 to 53,613 parasites/ul blood and 87 to 36,209 parasites/ul blood in patients from Oyo and Otu respectively. The herbalists administered the remedies and Gossypium arboreum, Anarcudium occidentalis, Citrus medica, Phyllanthus amarus and Lippia multiflora were the main ingredients in the efficacious remedies. The herbalists gave detailed descriptions of each of the 8 herbal remedies proffered. The results confirm the efficacy of two of the eight herbal remedies, thereby validating the role of ethnomedicine as a possible source for the discovery of new cherno-therapeutic agents in the treatment of P. falciparum malaria.Item Indigenous surgical practices in rural southwestern Nigeria: implications for disease prevention(Oxford University Press, 1995) Ajuwon, A. J.; Brieger, W. R.; Oladepo, O.; Adeniyi, J. D.A qualitative, community-based study was conducted in the rural community of Ago Are in southwestern Nigeria to learn about indigenous surgical practices and their potential for disease transmission. Community leaders as key informants assisted in identifying two types of indigenous practitioner whose work involved blood contact, whose work was observed. The olola are surgeons who specialize in circumcision and making traditional facial-markings, while the generic term for healer, onisegun, performed gbeere, that is making incisions into which medicinal herbs are rubbed. Although the onisegun used a clean blade for his procedures, he rubbed the herbs into the cuts with his bare hands. The olola used the same knife for all operations and cleaned it simply by rinsing it in a bowl of water. The potential for HIV transmission between practitioner and clients and among clients during these procedures is discussed-as is the potential of health education for reducing the demand for female circumcision and training indigenous healers in hygienic methods.