Comparative Study of Patients' Adherence between Hospital-based and Communitybased Treatment for Multidrug Resistant Tuberculosis (MDR-TB) in Kaduna State,

Background: Multidrug-Resistant Tuberculosis (MDR-TB) epidemic is threatening the global control of TB. It is driven by the programme, health system  and patient related factors. This study aimed at comparing the level of adherence to treatment among MDR-TB patients treated in hospital-based and  community-based models of care. Methods: This was a comparative cross-sectional survey conducted in 2019 with mixed methods of data collection. The study population were 360 MDR-  TB patients treated in hospital-based and community-based facilities in Kaduna between 2013 and 2018. Questionnaire, FGD and KII guides respectively  were the quantitative and qualitative data collection tools used. Statistical Package for Social Sciences (SPSS) version 25.0 was used to analyze the  quantitative data while thematic analysis was used for analysing qualitative data. The quantitative results were presented in descriptive statistics with  level of significance set at p<0.05 and the qualitative results were presented as prose. Results: The majority were males in the community-based 135 (71.8%) and the hospital-based model 126 (73.3%), with median (IQR) ages of 33 (27-40)  years and 34 (27-43) years respectively. Adherence to treatment was significantly higher among patients in hospital-based (64%) compared to  community-based (36%), (p 0.001). Availability of family and community support encourages adherence while lack of food supplies, dissatisfaction with  services and drug side effects were factors against adherence to treatment. Treatment success rate was similar in both models. Conclusion: Adherence was better among patients initiated on treatment in the hospital-based model. Adherence should be strengthened in the  community-based model by regular counselling and health education

Informed Consent among Hansen’s Disease Patients – A Nigerian Perspective

Background: Informed consent entails providing potential participants with adequate information needed to decide whether or not to participate in research. In Nigeria, Hansen's disease has remained a disease of public health importance. The associated stigmatization often renders patients vulnerable and prone to exploitation. The act of obtaining informed consent from these patients remain an issue of ethical importance. The study aimed to determine the willingness of Hansen's disease patients to give consent to use their data in the form of pictures, videos and/or oral interviews by a third party. Materials and Method: This descriptive cross-sectional study was carried out in three states in Nigeria; Ebonyi, Ogun and Cross River States. Data was collected from consenting participants using researcher-administered semi-structured questionnaires. Results: The study included 93 respondents with a mean (SD) age of 44.9 (20.1) years. The majority 57 (61.29%) of the respondents were farmers while the majority 67 (72.04%) attained primary education. A total of 26 (27.96%) respondents had suffered discrimination in the course of their disease. In their responses, 83 (89.2%) would allow the use of their pictures, 80 (86.0%) their videos and 86 (92.5%) their recorded oral interviews. Among those who would not give consent, the commonest reasons adduced were an intrusion into privacy and lack of trust. Conclusion: Though a majority of the patients would give consent for use of their data intrusion into privacy and lack of trust were major constraints for those not willing to give consent. Caregivers and stakeholders should put more effort into trying to win patients' trust before seeking informed consent

Climate Change Awareness and related Tree Planting Practices in a Rural Community in North-Western Nigeria

Background: Tree cutting is one of the causes of climate change and a common practice in Africa, a continent under significant threat from climate change. Therefore, climate change awareness and mitigation are vital to reducing its impacts in the region. Reforestation through planting of trees is an important carbon emission reduction strategy. This study assessed climate change awareness and related tree planting practices among household heads in a Nigerian rural community.Methods: A community-based descriptive, cross-sectional study was conducted in April 2019 among all household heads in Nasarawan Buhari community. An interviewer-administered questionnaire was used to collect data from the 104 household heads (or their representatives). Data was analyzed using SPSS (version 21.0) and statistical significance was set at p value of < 0.05.Results: The mean age of respondents was 40.6±12.6 years, and most of them (87.5%) were males. Half (50.0%) were aware of climate change, and their main source of information was radio (63.5%). Most (98.1%) used fire wood for cooking. Only a minority (27.9%) planted at least a tree in the year preceding the study. There was a statistically significant association between climate change awareness and occupation (p=0.038) but not with tree planting (p=0.827).Conclusion: The results indicated that only half of respondents were aware of climate change. There was high use of wood as cooking fuel with low tree planting. Tree planting was not associated with climate change awareness. There is therefore a need for continuous climate change education and mitigation campaign in the community