Prevalence of hypertension and associated factors in a rural community in Bayelsa State

Background: Hypertension is considered among the most common non-communicable diseases globally with significant morbidity and mortality. Closely related to it is pre-hypertension, a category between hypertension and normotension which is believed to be a forerunner to hypertension and cardiovascular disease. Hypertension has been on the increase in recent times, even in rural communities which were previously less affected. The study was carried during the world health day as a screening exercise to determine the prevalence of hypertension and its associated factors in a rural community.Methods: This cross-sectional study was conducted in Ogboloma village, a small rural community in Bayelsa State, Ngeria Consecutive sampling of all eligible participants who presented for the screening exercise was done. Socio-demographic data, clinical history, anthropometry and blood pressure were taken. Data was stored and analyzed using SPSS version 20.0.Results: One hundred and thirty-one participants completed the study. There were 49(37.4%) males. The prevalence of hypertension was 50.4% while pre-hypertension was found in another 41.2%. Factors associated with hypertension on univariate analysis were age (p <0.001) body mass index (p=0.038) waist hip ratio (p=0.008) hyperglycemia (p=0.030) and smoking (p=0.009) However, only age (p=0.004) and smoking (p=0.037) remained significant on multivariate analysis.Conclusions: Hypertension and Pre-hypertension were highly prevalent in this rural community. Age and smoking were significant predictors of hypertension. Hypertension screening and control programmes should therefore target rural communities and smokers

Patent Medicine Vendors in Rural Areas of Lagos Nigeria: Compliance with Regulatory Guidelines and Implications for Malaria Control

Purpose: To determine the compliance of patent medicine vendors (PMVs) in rural areas of Lagos State, Nigeria with set guidelines to regulate their practice and its implications for malaria control. Methods: A baseline cross-sectional study was conducted as part of an intervention study in two rural local government areas (LGAs) of Lagos State Nigeria. One hundred and eighty PMVs were randomly selected and interviewed using structured questionnaire. In addition, an observational checklist was used to monitor the drug shops for compliance with regulatory guidelines. Indicators of compliance used include proportion of PMVs with valid practicing license and proportion of shops with duly registered anti-malaria drugs. Results: Most 148 (82.2 %) of the respondents were shop owners with 170 (94.4 %) aged ≥ 21 years (the minimum age required by law) and a mean of 30.9 ± 8 years (range 16 - 67years). Only two (1.1 %) PMVs had a valid annual practicing licence and only three (1.7 %) of the drug shops had specified sign-posts. The shops stocked various kinds of anti-malaria drugs including those that are no longer recommended. All the sampled drugs were duly registered with NAFDAC and within expiry dates. Conclusion: There was poor compliance with regulatory guidelines. A strict enforcement of the guidelines by the regulatory agency is recommended to ensure that only licensed persons sell appropriate anti-malaria drugs

Neonatal tetanus surveillance in Bayelsa state of Nigeria: a five-year review

ObjectiveTo assess the performance of neonatal tetanus surveillance in Bayelsa state of Nigeria.IntroductionNeonatal tetanus (NT) though a preventable disease, remains a disturbing cause of neonatal morbidity and mortality particularly in low income countries where maternal and child care are substandard and antitetanus immunization coverage is still poor. The disease, which is mostly fatal, is particularly common in hard to reach and rural areas where deliveries take place at home or with untrained attendants without adequate sterile procedures and in unclean environment. Since eliminating NT became a global target, significant reductions in NT deaths have been reported. The most recent estimates by WHO (2015) put death of newborns due to NT at 34,019, a 96% reduction from the situation in the late 1980s.All countries are committed to “elimination” of maternal and neonatal tetanus (MNT), i.e., a reduction of NT incidence to below one case per 1000 live births per year in every district. A strong neonatal tetanus surveillance (NTS) is however required to achieve this. As of March 2018, only 14 countries were yet to eliminate MNT and this includes Nigeria.The different types of NTS recommended are conducted to varying degrees of efficiency and effectiveness in Nigeria under the major surveillance strategy – the Integrated Disease Surveillance and Response (IDSR). These include routine monthly surveillance, zero reporting, active surveillance and retrospective record review.Nigeria comprises six geopolitical zones, 36 states and a Federal Capital territory (FCT), and is made up of 774 Local Government areas (LGA) (districts) – an LGA being the lowest administrative level. This study was conducted in Bayelsa state – one of the six states in the south zone. It is made up of eight LGAs, more than half of which are riverine and consists of many hard-to-reach communities, where formal functional health facilities are few and far between. Health workers are in short supply and funding of health care delivery is poor in the state.MethodsThis was a retrospective review of all confirmed cases of neonatal tetanus that were managed at the two tertiary hospitals in the state - Niger Delta University Teaching Hospital Okolobiri (NDUTH), and Federal Medical Centre Yenagoa (FMC) - between January 2009 and December 2013. These were the only two public facilities that had the capacity to manage NT cases in the state. Relevant data including sociodemographics, pregnancy and birth history of patients, cord care and tetanus toxoid immunization of mothers were abstracted from the case files. The cases were traced to the office of the State Epidemiologist, where all cases were expected to be documented and investigated in line with the existing neonatal tetanus surveillance. Ethical approval was obtained from the Research and Ethics Committee of NDUTH for the research and permission was given to access case files.ResultsA total of 48 cases were managed in both facilities (36/75.0% in NDUTH and 12/25.0% in FMC) in the period under review but only 13 cases (27.1%) were reported to the office of the State Epidemiologist. Figure 1 shows the number of cases per year of review. The cases were resident in seven out of the eight LGAs. The mean age of cases was 8.98 (SD = 5.14) days and 29 (60.4%) were male while 19 (39.6%) were female. Available evidence showed that only 2.1% of the cases were protected at birth (mothers had TT2+); 91.7% of mothers did not have antenatal care and all the mothers were delivered by traditional birth attendants; 70.8% had their umbilical cord cut with new (?sterile) blade; and 43.8% had their cord treated with methylated spirit, others were treated with just water or some herbal preparation. Educational attainment of mothers of cases was primary (54.2%) and secondary (45.8%).ConclusionsThere were gaps in Neonatal Tetanus Surveillance in Bayelsa State as only 27.1% of cases were captured at the state level. Many mothers and their newborns were still not protected against tetanus, and delivery and cord care were done in unhygienic conditions. There is an urgent need to strengthen NT surveillance, improve vaccination against tetanus, and encourage skilled birth attendance in the state.References1. WHO. Immunization, Vaccines and Biologicals: Tetanus. http://www.who.int/immunization/diseases/tetanus/en/. Accessed on 23 Jul 20182. WHO. Immunization, Vaccines and Biologicals: Maternal and Neonatal Tetanus Elimination (MNTE): The initiative and challenges.http://www.who.int/immunization/diseases/MNTE_initiative/en/ Accessed on 23 Jul 2018.3. WHO. WHO-recommended standards for surveillance of selected vaccine-preventable disease. WHO. 20034. Bayelsa State Ministry of Health. Health facilities and their distribution across the Local Government Areas of Bayelsa State. 2010.

Responding to the Call through Translating Science into Impact: Building an Evidence-Based Approaches to Effectively Curb Public Health Emergencies [Covid-19 Crisis]

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the population burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward reretrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which includes effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision-makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission

The 2017 human monkeypox outbreak in Nigeria-Report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria.

BackgroundIn September 2017, Nigeria experienced a large outbreak of human monkeypox (HMPX). In this study, we report the outbreak experience and response in the Niger Delta University Teaching Hospital (NDUTH), Bayelsa state, where the index case and majority of suspected cases were reported.MethodsIn a cross-sectional study between September 25th and 31st December 2017, we reviewed the clinical and laboratory characteristics of all suspected and confirmed cases of HMPX seen at the NDUTH and appraised the plans, activities and challenges of the hospital in response to the outbreak based on documented observations of the hospital's infection control committee (IPC). Monkeypox cases were defined using the interim national guidelines as provided by the Nigerian Centre for Disease Control (NCDC).ResultsOf 38 suspected cases of HMPX, 18(47.4%) were laboratory confirmed, 3(7.9%) were probable, while 17 (18.4%) did not fit the case definition for HMPX. Majority of the confirmed/probable cases were adults (80.9%) and males (80.9%). There was concomitant chicken pox, syphilis and HIV-1 infections in two confirmed cases and a case of nosocomial infection in one healthcare worker (HCW). The hospital established a make-shift isolation ward for case management, constituted a HMPX response team and provided IPC resources. At the outset, some HCWs were reluctant to participate in the outbreak and others avoided suspected patients. Some patients and their family members experienced stigma and discrimination and there were cases of refusal of isolation. Repeated trainings and collaborative efforts by all stakeholders addressed some of these challenges and eventually led to successful containment of the outbreak.ConclusionWhile the 2017 outbreak of human monkeypox in Nigeria was contained, our report reveals gaps in outbreak response that could serve as lessons to other hospitals to strengthen epidemic preparedness and response activities in the hospital setting

Preparation and Response to the 2014 Ebola Virus Disease Epidemic in Nigeria—The Experience of a Tertiary Hospital in Nigeria

<div><p>Introduction</p><p>The 2014 Ebola Virus Disease (EVD) outbreak elicited global attention and challenged health systems around the world, Nigeria inclusive. We hereby report the preparation and response to the outbreak by a tertiary teaching hospital in Bayelsa State, Nigeria.</p><p>Method</p><p>Between 4th August and 31st October 2014, we conducted a mixed cross sectional and qualitative study to ascertain the EVD-related fear, myths and misconceptions among healthcare workers (HCWs), and to evaluate the plans, activities and challenges faced by the hospital during the outbreak. Data was collected using a self-administered questionnaire as well as by documented observations during the outbreak. HCWs were asked to rate their fear of EVD from 1 (no fear) to 10 (highest fear).</p><p>Results</p><p>Out of 189 respondents, majority (>75%) reported uncertainty about the myth that EVD can be prevented by drinking salt water or eating Garcinia kola, while 82% of respondents believed that EVD can be prevented by avoiding crowded places. About 40% of respondents expressed fear ratings of EVD of ≥ 7 out of 10. In response to the outbreak, the hospital established an EVD response team, organised EVD-sensitization and training programmes and commenced routine EVD surveillance activities. An EVD-isolation ward was constructed from an existing ward, a field incinerator was designed, hand sanitizers were produced locally and personal protective equipment were procured. No case of EVD was reported in the hospital, although three false alarms caused panic. Some HCWs adopted overly protective and avoidance behaviours, but these behaviours were abandoned after the outbreak was declared over.</p><p>Conclusion</p><p>Our results suggest that the fear, myth and misconceptions were common among HCW during the outbreak. The EVD outbreak, however, helped to strengthen gaps in infection control and emergency preparedness in the hospital. Strategies to allay fear are required to contain future outbreaks of EVD in Nigeria hospitals.</p></div

Professional Differences in Rating of Fear of Ebola.

<p>Professional Differences in Rating of Fear of Ebola.</p