EMSEH
Permanent URI for this communityhttps://repository.ui.edu.ng/handle/123456789/379
Browse
9 results
Search Results
Item 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 PREVALENCE AND DETERMINANTS OF INTIMATE PARTNER VIOLENCE TOWARDS FEMALE STUDENTS OF THE UNIVERSITY OF IBADAN, NIGERIA.(2012-05) UMANA, JOSEPH EDEMIntimate Partner Violence (IPV) is pervasive, but under-reported by victims because of the associated stigma and fear of reprisals. In Nigeria, there is paucity of information on IPV burden among female university students. This study was therefore designed to assess the prevalence and determinants of IPV experienced by female students in the University of Ibadan, Nigeria. The study was cross-sectional in design. A four-stage sampling technique was used in selecting the female halls (two undergraduate and one postgraduate), blocks, rooms, and an occupant selected by balloting in each room. A total of 1,100 undergraduate and 255 postgraduate female students were selected. A 43-item self-administered structured questionnaire was used to collect data on the sociodemographic characteristics, prevalence, types, determinants, awareness, and health consequences of IPV. Data were analysed using descriptive statistics and logistic regression at p = 0.05. The mean age of the respondents was 22.8±3.9 years (postgraduate mean: 24.3±3.2 years; undergraduate mean: 20.1±3.2 years) and majority (93.8%) were single. Respondents comprised Yoruba (61.7%), Igbo (24.6%), Hausa (3.6%) and others (10.1%). The proportions of respondents who smoked, consumed alcohol and had a family history of IPV were 6.6%, 22.8% and 26.9% respectively. The life-time prevalence of IPV was 42.3% (postgraduate: 34.5%; undergraduate: 44.1%) and those for psychological, physical and sexual IPV were 41.8%, 7.9% and 6.6% respectively. Majority (61.9%) of the respondents who were aware of IPV did not experience it. Respondents who were less likely to have experienced IPV were postgraduate (OR= 0.64; 95% CI: 0.46-0.87), and married (OR= 0.53; 95% CI: 0.35-0.78) students. Life-time prevalence of IPV was higher among the undergraduates (OR=3.82; 95% CI: 1.08-13.40); smokers (OR= 2.46; 95% CI: 1.58-3.83); alcohol consumers (OR= 2.36; 95% CI: 1.82- 3.06 ); and those with family history of IPV (OR= 2.40; 95% CI: 1.88- 3.07). Recent experience (within the last one year) of violence was also more frequently reported by respondents who had a UNIVERSITY OF IBADAN LIBRARY vi previous history of physical (62.5%) (OR= 2.65; 95% CI: 2.02-3.49) and sexual (53.2%) (OR= 1.63; 95% CI:1.12-2.35) violence. Injuries were sustained by sixty (4.4%) of the IPV victims and these included minor abrassions (60.7%), sprains (17.9%), and facial injuries (15.4%). Adverse effects of IPV on academic performance were reported by 10.3% of victims and these included loss of concentration (71.4%), interruption of studies (17.9%), loss of self-esteem (6.4%) and school absenteeism (4.3%). Majority (60.9%) of the victims of IPV did not seek help. Those who sought help went mainly to religious leaders (12.5%), hospitals (10.5%) and family members (4.9%). The prevalence of intimate partner violence among the female students of the University of Ibadan was high, and the major predicting factors were low level of awareness, family history and previous history of physical and sexual violence. There is the need to design interventions to address modifiable risk factors like smoking and alcohol consumption, and encourage health seeking in order to reduce vulnerability and related health consequences. Keywords: Intimate Partner Violence, University female students, Life-time experience. Word Count: 479Item MOSQUITO AVOIDANCE PRACTICES AND CORRELATES AMONG CARE-GIVERS OF UNDER-FIVE CHILDREN AT SOMOLU LOCAL GOVERNMENT AREA, LAGOS STATE.(2014-08) OJO, OREOLUWA OLUWAFUNKEMalaria control efforts currently lay emphasis on reducing transmission by limiting humanvector contact. Meanwhile, Mosquito-Avoidance Practices (MAPs) have been shown to be sub-optimal in urban areas especially among under-five Children (U-5C) resulting in high child morbidity and mortality. More studies have been carried out on MAPs in rural areas leaving urban areas understudied. This study was therefore designed to investigate MAPs among care-givers of U-5C living in Somolu, an urban Local Government Area (LGA) in Lagos State. A cross-sectional survey involving 394 female care-givers of U-5C selected using the Lot Quality Technique sampling method was conducted. The LGA was stratified into three based on the level of planning and drainage using Geographic Information System: well-planned well drained stratum (S1), well planned poorly drained stratum (S2) and unplanned and poorly drained stratum (S3). Data were collected using a semi-structured, intervieweradministered questionnaire, which elicited information on socio-economic characteristics, number of times U-5C had suspected malaria in the preceeding year, MAPs, bednet ownership and usage. Principal component analysis was used to calculate the household wealth index by listing household assets owned and categorized into five quintiles (poorest, second, third, fourth and richest quintiles). Data were analysed using descriptive statistics and Chi-square test at p=0.05. Age of respondents was 33.6±7.7 years. The proportion that earned ≥₦60,000 monthly in all strata were: S1-5.1%, S2-5.3% and S3-4.3% while those with tertiary education were: S1- 78.0%, S2-10.2% and S3-11.9%. Malaria transmission was attributed mostly to mosquito bites in all strata: S1-58.3%, S2-56.1% and S3-61.4%. The proportion of U-5C who had two episodes of suspected malaria in the preceeding year by strata were: S1-40.1%, S2-38.6% and S3-30.0%. The proportions who mentioned the mosquito net as a MAP by strata were: S1- 59.3%, S2-80.7% and S3-64.3%. The most reported MAP among U-5C was bednet: S1- 64.4%, S2-68.4% and S3-62.9%. Other MAPs reported included: spraying insecticide: S1- 20.5%, S2-26.3% and S3-17.1%, shutting door after sunset: S1-9.6%, S2-10.5% and S3- 11.4%, and clearing surroundings: S1-2.9%, S2-5.3% and S3-2.9%. Ownership of bednet was: S1-76.0%, S2-75.4% and S3-68.6% and out of these, S1-73.1%, S2-70.7% and S3- UNIVERSITY OF IBADAN LIBRARY vii 72.4%, reported that their child slept under the net the night before the survey. The MAPs across strata were not significantly different. Overall, 22.4% were in the richest quintile comprising: S1-79.5%, S2-9.1% and S3-11.4%. Majority of the respondents used just a single measure to prevent mosquito bite: S1-86.5%, S2-84.2% and S3-90.0%. Monthly earning ≥₦60,000, being in the richest wealth quintile, having tertiary education and knowing mosquito breeding site to be stagnant water were significantly associated with the use of multiple MAPs. The most common mosquito-avoidance practice among care-givers of under-five children was the use of bednet and this did not differ by level of planning and drainage of the study site. Therefore, strategies to improve and sustain the use of bednet and promote the use of other effective mosquito-avoidance practices should be encouraged. Keywords: Malaria control, Mosquito-avoidance practices, Care-givers, Under-five children Word count: 471Item KNOWLEDGE, PRACTICES AND FACTORS INFLUENCING REPORTING OF NOTIFIABLE DISEASES AMONG HEALTH WORKERS IN TWO SELECTED RURAL AND URBAN LOCAL GOVERNMENT AREAS OF OYO STATE, NIGERIA(2014-03) GBADAMOSI, OLADEJI ATILOLAReporting of notifiable diseases is essential for control and prevention of outbreak of diseases. In Nigeria, reporting of Notifiable Diseases by health workers has not been adequately documented. This study was conducted to assess health workers knowledge, practices, and factors influencing disease reporting in urban and rural communities in Oyo State, Nigeria. A cross-sectional survey was carried out among the 210 health workers who were responsible for disease reporting at their health facilities. The 33 local government Areas (LGA) of Oyo State were stratified into rural and urban, out of which one rural (Afijio LGA) and one urban (Ibadan North LGA), were randomly selected. All the health facilities in Afijio (39) and Ibadan North (171) were included in the study. One respondent at each health facility (focal person) was then selected and interviewed. A semi-structured, self- administered questionnaire was used to obtain information on knowledge, practices, pattern and factors affecting reporting. The list of diseases included: immediate, routine, international and occupationally notifiable diseases. Knowledge was assessed on a scale of 50 points with score ≥30 as good. Data were analyzed using descriptive statistics; Chi square, t-test and linear regression. Community Health Officers (30.1%), Nurses (26.0%) and Physicians (16.3%), constituted the majority of the respondents. Seventy-two percent (rural- 14.8% and urban- 57.1%) were aware of the existence of disease notification system while 26.5% knew the current strategy for reporting. Mean knowledge score for notifiable diseases among respondents was 27.6±8.4 with group means for rural and urban being 32.0±8.6 and 26.7±8.2 (p<0.001) respectively. About eleven percent (11.2%) of the respondents had good knowledge of the notifiable diseases. Majority (82.8%) of the respondents forwarded their routine health facilities reports to their respective LGA while 17.1% sent theirs to the Ministry of Health. Fifty-six percent of respondents sent reports through their staff while the rest had their facilities report collected by staff from State Ministry of Health and LGA. Main reasons for non-reporting included: lack of training on reporting (84.0%), absence of legal enforcement (58.0%), ignorance of reporting requirements (50.0%) lack of supervision (48.0%) and lack of reporting forms and telephone facilities UNIVERSITY OF IBADAN LIBRARY vi (38.0%). Health workers that were aware of notification system were five times likely to comply with reporting than those that were not aware. (OR=5.0, 95% C.I = 1.5-17.5). Reporting of notifiable diseases was poor among the health workers at the Local Government level in Oyo State. Lack of training on reporting, absence on legal enforcement and ignorance on reporting requirements were major influencing factors. Regular training, effective supervision and logistic support to all notifiable diseases reporting health workers are recommended. Keywords: Notifiable diseases, health workers, reporting system. Word count: 460Item KNOWLEDGE, PRACTICES AND FACTORS INFLUENCING REPORTING OF NOTIFIABLE DISEASES AMONG HEALTH WORKERS IN TWO SELECTED RURAL AND URBAN LOCAL GOVERNMENT AREAS OF OYO STATE, NIGERIA(2014-03) GBADAMOSI, O. A.Reporting of notifiable diseases is essential for control and prevention of outbreak of diseases. In Nigeria, reporting of Notifiable Diseases by health workers has not been adequately documented. This study was conducted to assess health workers knowledge, practices, and factors influencing disease reporting in urban and rural communities in Oyo State, Nigeria. A cross-sectional survey was carried out among the 210 health workers who were responsible for disease reporting at their health facilities. The 33 local government Areas (LGA) of Oyo State were stratified into rural and urban, out of which one rural (Afijio LGA) and one urban (Ibadan North LGA), were randomly selected. All the health facilities in Afijio (39) and Ibadan North (171) were included in the study. One respondent at each health facility (focal person) was then selected and interviewed. A semi-structured, self- administered questionnaire was used to obtain information on knowledge, practices, pattern and factors affecting reporting. The list of diseases included: immediate, routine, international and occupationally notifiable diseases. Knowledge was assessed on a scale of 50 points with score ≥30 as good. Data were analyzed using descriptive statistics; Chi square, t-test and linear regression. Community Health Officers (30.1%), Nurses (26.0%) and Physicians (16.3%), constituted the majority of the respondents. Seventy-two percent (rural- 14.8% and urban- 57.1%) were aware of the existence of disease notification system while 26.5% knew the current strategy for reporting. Mean knowledge score for notifiable diseases among respondents was 27.6±8.4 with group means for rural and urban being 32.0±8.6 and 26.7±8.2 (p<0.001) respectively. About eleven percent (11.2%) of the respondents had good knowledge of the notifiable diseases. Majority (82.8%) of the respondents forwarded their routine health facilities reports to their respective LGA while 17.1% sent theirs to the Ministry of Health. Fifty-six percent of respondents sent reports through their staff while the rest had their facilities report collected by staff from State Ministry of Health and LGA. Main reasons for non-reporting included: lack of training on reporting (84.0%), absence of legal enforcement (58.0%), ignorance of reporting requirements (50.0%) lack of supervision (48.0%) and lack of reporting forms and telephone facilities (38.0%). Health workers that were aware of notification system were five times likely to comply with reporting than those that were not aware. (OR=5.0, 95% C.I = 1.5-17.5). Reporting of notifiable diseases was poor among the health workers at the Local Government level in Oyo State. Lack of training on reporting, absence on legal enforcement and ignorance on reporting requirements were major influencing factors. Regular training, effective supervision and logistic support to all notifiable diseases reporting health workers are recommended.Item EFFECTS OF GNETUM AFRICANUM WELW. AND OCIMUM GRATISSIMUM LINN. AQUEOUS LEAF EXTRACTS ON THE HAEMATOLOGICAL AND BIOCHEMICAL CHANGES IN CYANIDE-TREATED RATTUS RATTUS(2012-07) EMEJI, O.Cyanide toxicity is of public health concern. Cyanide is among the most potent and deadly poisons and sources of potential human exposure to it are numerous, arising through its release into the environment from both natural and anthropogenic sources. Gnetum Africanum (GA) and Ocimum Gratissimum (OG) which contain essential amino acids required to abate cyanide toxicity effects, are widely used local plants for both nutritional and therapeutic purposes in Nigeria. There is dearth of information about ameliorating effects of these plants on cyanide toxicity. The study was aimed at determining the effects of these plants on some indices of cyanide toxicity in Rattus rattus. Thirty 7-week old albino rats of same breed and similar exposure were randomly allocated to five treatment and one control groups of five rats each. Lyophilised aqueous extracts of GA and OG leaves were reconstituted in water to give a concentration of 3mg/L respectively while potassium cyanide (KCN) was prepared at 3mg/L concentration. After acclimatisation period of three weeks, the rats were randomly distributed as follow: group 1(control); group 2 (3mg/kg body weight KCN only); group 3 (3mg/kg body weight each of aqueous GA extract and KCN; group 4 (3mg/kg body weight each of aqueous OG extract and KCN); group 5 (3mg/kg aqueous GA extract only); group 6 (3mg/kg aqueous OG extract only). Treatments were administered by gavage while maintaining the rats on commercial rat pellets and water ad libitum for 14 days during which their body weights were noted daily. After exposure to the various treatments, biochemical analysis and haematological examination were done using the International Council for Standardisation in Haematology (ICSH) standard procedures. The results were analysed using descriptive statistics and Kruskal-Wallis at p=0.05. The mean rat weights (g) were significantly increased in group 3 (95.5+17.3) and group 5 (98.9+11.7) in comparison with the control (88.9+17.9). Slimy nasal discharge was found in 18.6% of rats in group 2 and 10.0% of rats in group 4. No discharge was found in control, group 3, group 5 and group 6. In group 2, 17.1% of the rats had ocular lesion while other groups had no ocular lesion. Mean haemoglobin values (g/dL) were significantly lowered in group 2 (12.9+0.7), group 3 (13.0+0.5), group 4 (13.1+0.5), group 5 (12.6+0.8) and group 6 (13.2+1.5) than the control (14.4+0.7) while mean white blood cell counts (cell/lmm3) were elevated with no significant difference with regards to the control. Total protein (g/dL) were significantly lowered except in group 2 than the control. Globulin production (g/dL) was suppressed significantly in groups 2 to 4 when compared with the control. Mean creatinine values (mg/dL) were increased in groups 2 to 6 than the control. Mean Aspartate aminotransferase values (unit/l) were significantly reduced in group 3 (9.6+2.5) than the control (21.6+5.5). Gnetum africanum and Ocimum gratissimum suppressed the haemopoietic system. Gnetum africanum had more deleterious effects and did not alleviate the haematologic and the biochemical effects of cyanide toxicity. The consumption of these plants with cyanoglycoside-containing food is not recommended.Item KNOWLEDGE, PERCEPTION AND ATTITUDE TO CHOLERA OUTBREAK AMONG RESIDENTS IN IBADAN NORTH-WEST LOCAL GOVERNMENT AREA, NIGERIA(2014-07) DICKSON, E.Cholera outbreaks have profound impacts on the health and well-being of communities. Rapid containment of outbreaks largely depend on people’s knowledge, perceptions and attitude to the disease. Studies have shown an increase of outbreaks in developing countries. Ibadan Northwest (IBNW) Local Government Area (LGA) experienced recurrent cholera outbreaks between June and November 2011 in spite of cholera control programmes in Oyo state. Furthermore several studies have been done on perception of emerging disease outbreak but few on cholera outbreaks. Information on knowledge, perception, attitude to cholera outbreaks are important for planning preventive health educational programmes and this study was conducted to assess knowledge, perception and attitude to cholera outbreak among residents of IBNW LGA. The cross-sectional design used a four-stage sampling technique to select 7 inner core, 4 transitory and 4 peripheral communities out of 28,15 and 17 communities respectively. Household from each community was selected based on sample size proportionate to size and 427 respondents from IBNW LGA. Respondents were interviewed using a semi-structured questionnaire which included questions on socio-demographic characteristics, knowledge, perceived vulnerability (likelihood of being infected by a disease), perceived severity and attitude to cholera outbreak. Knowledge was scored on a 19-point (score of ≤10 rated poor), perceived vulnerability on 15-point (scores of ≤7 rated low) while perceived severity was scored on 25-point (≤12 rated low) scales. A 24-point scale was used to score attitude to cholera outbreak (score of ≤ 12 rated negative). Data were analysed using descriptive statistics, Chi-square and logistic regression at p= 0.05. Respondents’ age was 35.0±11.4 years, 70.7% were females, 69.1% were married and 93.4% were Yoruba. Most (95.3%) of the respondents had good knowledge of cholera. About 71.4% respondents knew the cause of cholera and most (97.2%) knew diarrhoea and (96.3%) vomiting as clinical symptoms of cholera. Many (69.8%) ate food prepared outside the house. The commonest source of information during an outbreak was the radio (38.6%). Majority respondents (62.3%) perceived their vulnerability to cholera to be low while 98.1% perceived severity of cholera to be high. Significantly, more respondents residing in the inner core communities perceived themselves vulnerable to cholera (OR=23.7: CI 9.64-58.31). Majority (71.2%) of the respondents had positive attitude in the mitigating efforts during a cholera outbreak. Respondents aged 18 to 30 years were more likely to have positive attitude in the mitigating efforts during a cholera outbreak (OR=3.24: CI 1.30-8.09). Many (82.4%) had never reported cases while 69.3% were willing to report cases .About 70.0% reported they would submit to being investigated during an outbreak. Respondents’ good knowledge of cholera, high perception of its severity and positive attitude in the mitigating efforts during an outbreak offered windows of opportunity in the control of cholera outbreak. However specific risks communication should be aimed at improving hygiene practices and focus on perceived vulnerability.Item PREVALENCE AND CORRELATES OF VIOLENCE AGAINST FEMALE SEX WORKERS (FSWs) IN ABUJA, NIGERIA(2011-03) DAGUNDURO, T. A.Violence against women (VAW) is a major public health problem affecting women globally. In addition to causing injuries and eroding women’s self esteem, violence increases the risk of reproductive health problems. However, only little is known about the magnitude and determinants of violence in female sex workers (FSWs) in Nigeria. This study assessed the prevalence and the risk factors that contribute to violence against FSWs in Abuja A descriptive cross-sectional study design was adopted. Three hundred and five brothel-based FSWs were selected using stratified random sampling and proportional allocation techniques. One hundred and ten FSWs from the high, 63 from the middle and 132 from the low income areas were interviewed using a semi-structured questionnaire. Information on occurrence of violence and predisposing factors was obtained from the respondents. In-depth interviews were conducted on 10 FSWs to obtain better insight into their recent experiences of violence. Data were analyzed using descriptive statistics, Chi-square tests and logistic regression analysis. Mean age of the respondents was 27+5.7 years. Seventy five percent had at least secondary education and majority (69.5%) were single. The prevalence of violence experienced by FSWs in the last six months was 52.8% of which 61% had been abused between once and thrice at some point in their lives. The forms of violence experienced among respondents included physical (38.7%), sexual (43.3%), psychological (32.5%) and economic (29.2%). The main perpetrators of violence were clients (47.5%), brothel managers/ owners (38.2%), local thugs (8.0%) and police men (4.0%). Bi-variate analysis showed that respondents below 30 years were less prone to physical violence than their older counterparts (P-value= 0.00). FSWs from who never attended school experienced sexual violence than those who ever attended school (p-value= 0.02). The FSWs with no formal education and those with over 10 years work experience in the sex industry were at a higher risk of psychological violence than those with formal education and with less than 10 years work experience (OR=2.6, 95% C.I= 1.37-5.08 and OR=2.3, 95%CI=1.26-4.31 respectively). Respondents with over 10 years experience in sex work were more vulnerable to economic violence than those with less than 10 years sex work experience (OR=1.9, 95%CI=1.01-3.52). Major health consequences reported were physical injury (14.1%), HIV infection (4.3%) and 10.5% reported ever had STI. Sixty percent accessed services at health facilities while 29.3% used traditional healing homes after they experienced violence. The results from the in-depth interviews showed that violence was a common experience among the respondents with clients and policemen being the main perpetrators. The prevalence of violence against FSWs in Abuja was high. Therefore, there is need to educate FSWs on their sexual rights and how to protect themselves from violence. In addition, FSWs require educational and economic empowerment to enable them move on to other more socially acceptable vocations.