Effects of Training on Knowledge, Attitude and Practices of Malaria Prevention and Control among Community Role Model Care Givers in South Western Nigeria

BACKGROUND: Malaria is endemic in Nigeria, with significant records of mortality and morbidity. Adequate community involvement is central to a successful implementation of malaria control programs. This study assessed the effects of a training programme on knowledge of malaria prevention and control among community role model care givers.METHODS: A descriptive cross sectional study of a pre-and post-test design method was conducted among 400 eligible community members in Osun State. Training was given in the form of organized lectures, health education and practical demonstration sessions. Scores of pre-test and post-test conducted after four months interval were compared. Multistage sampling method was adopted in selecting study participants, while data was analyzed using the SPSS software version 17.0.RESULTS: Mean age was 43.8 (+1.4) years. Average knowledge score of cause, transmission, risk factors and consequences, awareness of common symptoms and preventive practices improved during post-training test when compared with pr-training test. The overall descriptive mean knowledge score in pre-test and post-test were 2.1 and 3.5 respectively out of an average maximum score of 5.0, giving an increment of 66.7%. Role model care givers with formal education were twice and three times more likely to know about disease ‘transmission’ (OR 1.9, 95%CI 0.11-0.19, p=0.002) and ‘consequences’ (OR 2.9, 95%CI 0.25-0.65, p=0.040) respectively compared to those without formal education.CONCLUSION: Training on malaria improved the knowledge of malaria prevention and control among role model community care givers towards a successful implementation of malaria control programmes.KEYWORDS: Malaria, Role model care givers, Knowledge, Trainin

Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria

Background: Electrolyte disturbances have been reported in both tuberculosis (TB) infection alone and TB-HIV co-infected patients.Objectives: To evaluate the effects of treatments on the imbalance of some electrolytes among patients infected with Mycobacterium tuberculosis in Osogbo Southwestern Nigeria.Methodology: A total of one hundred and ten patients participated in this study. They were divided into four groups as follows: group 1 contains 50 normal patients without TB or HIV infection (M = 25; F = 25), group 2 20 new positive cases of TB patients without HIV infection (M = 13; F =07), group 3 20 new positive cases of tuberculosis co-infected with HIV infection (M = 10; F = 10), and group 4 20 positive cases of TB patients on anti tuberculous drugs (M = 11; F =09). All patients were screened for the  presence and absence of TB, HIV and the level of some electrolytes in plasma (sodium, potassium, chloride and bicarbonates) were determined using standard methods.Results: Levels of sodium in TB patients on drugs (TBD) were significantly lowered compared to new case tuberculosis (NCT) patients (134.80 ± 5.83 mmol/L vs 142.10± 6.68 mmol/L) while potassium levels were significantly elevated in TB patients on drugs compared with their new case counterparts (3.75 ± 0.15 mmol/L vs 3.07 ± 0.42 mmol/L) P < 0.05 respectively. Chloride levels were significantly decreased in TB patients on treatment compared to new case tuberculosis NCT (99.26± 6.85 mmol/L vs 108.76± 8.42 mmol/L) while serum bicarbonate levels were significantly elevated in TB patients on drug (TBD) compared to their NCT counterparts (24.00± 1.81 mmol/L vs 21.00± 2.05 mmol/L, P< 0.05, respectively).Conclusion: Hyponatraemia, hyperkalaemia, and hypochloremia characterized some of the electrolyte imbalance among TB patients receiving treatments. The raised level of bicarbonate may be attributed to overcorrection of respiratory acidosis often found in patients with tuberculosis. Monitoring electrolytes is therefore an important component of TB management

Carriage of Staphylococcus aureus in Thika Level 5 Hospital, Kenya: a cross-sectional study.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen but little is known about its circulation in hospitals in developing countries. We aimed to describe carriage of S.aureus amongst inpatients in a mid-sized Kenyan government hospital. METHODS: We determined the frequency of S.aureus and MRSA carriage amongst inpatients in Thika Hospital, Kenya by means of repeated cross-sectional ward surveys. For all S.aureus isolates, we performed antibiotic susceptibility tests, genomic profiling using a DNA microarray and spa typing and MLST. RESULTS: In this typical mid-sized Kenyan Government hospital, we performed 950 screens for current carriage of S.aureus amongst inpatients over a four month period. We detected S.aureus carriage (either MSSA or MRSA) in 8.9% (85/950; 95%CI 7.1-10.8) of inpatient screens, but patients with multiple screens were more likely have detection of carriage. MRSA carriage was rare amongst S.aureus strains carried by hospital inpatients - only 7.0% (6/86; 95%CI 1.5-12.5%) of all isolates were MRSA. Most MRSA (5/6) were obtained from burns patients with prolonged admissions, who only represented a small proportion of the inpatient population. All MRSA strains were of the same clone (MLST ST239; spa type t037) with concurrent resistance to multiple antibiotic classes. MSSA isolates were diverse and rarely expressed antibiotic resistance except against benzyl-penicillin and co-trimoxazole. CONCLUSIONS: Although carriage rates for S.aureus and the MRSA prevalence in this Kenyan hospital were both low, burns patient were identified as a high risk group for carriage. The high frequency of genetically indistinguishable isolates suggests that there was local transmission of both MRSA and MSSA