Awareness, Attitude and Willingness of Artisans in Osun State Southwestern Nigeria to Participate in Community Based Health Insurance

Introduction: Community Based Health Insurance Scheme was recently launched in Nigeria with a view to reducing the burden of out-of-pocket expenditure on health most especially among Nigerians in the informal sector. The objective of this study is to assess the awareness, attitude and willingness of artisans in Osun state to take part in Community based health insurance scheme in Nigeria.Methods: Descriptive cross sectional survey of 387 artisans in Osun state in South-western Nigeria. Respondents were selected using multi stage sampling method. Research instruments were semi structured interviewer administered pre tested questionnaires that was divided into five sections. Data was analysed using the SPSS software.Results: Mean age of the artisans was 33.1 ± 11.2 years. One hundred and twenty six (76.4% ) of those who always visit the hospital when ill) used out of pocket as their form of health care financing. One hundred and twelve (28.9%) of the respondents have heard of health insurance before. Only fifteen (3.9%) of the artisans had been on any forms of Health Insurance, of which 13(86.7%) were on the National Health Insurance Scheme (NHIS). Twenty five (6.5%) of artisans had heard of community health insurance before and only 2(0.5%) were enrolled in a form of Community Based Health Insurance (CBHI). Most of the respondents (319; 82.4%) were willing to participate (WTP) in Health Insurance with the preferred organizer being governmen (236; 74.0%). The mean amount of money respondents were willing to contribute monthly per household was 1,121.8 ± 14.04 Naira. There was a statistically significant relationship between awareness about CBHI and educational status (p=0.003), and between WTP in health insurance and monthly income (p=0.014). The amount respondents were willing to pay monthly for health insurance was found to be significantly associated with their monthly income (p<0.001) and their educational status (p<0.001).Conclusion: Artisan's awareness about CBHIS is low. Most artisans showed favourable attitude towards participating in a Government backed and well organised scheme, as well as a good attitude towards willingness to pay in the scheme.Keywords: Artisans, CBHIS, willingness to pay (WTP), Health Insuranc

Knowledge and attitude of civil servants in Osun State, Southwestern Nigeria towards the national health insurance

In Nigeria, inequity and poor accessibility to quality health care has been a persistent problem. This study aimed to determine knowledge and attitude of civil servants in Osun state towards the National Health Insurance Scheme (NHIS). This is a descriptive, cross sectional study of 380 civil servants in the employment of Osun state government, using multi stage sampling method. The research instruments was pre-coded, semi structured, self administered questionnaires. About 60% were aware of out of pocket as the most prevalent form of health care financing, while40% were aware of NHIS, television and billboards were their main sources of awareness, However, none had good knowledge of the components of NHIS, 26.7% knew about its objectives, and 30% knew about whoideally should benefit from the scheme. Personal spending still accounts for a high as 74.7% of health care spending among respondents but respondents believed that this does not cover all their health needs. Only 0.3% have so far benefited from NHIS while 199 (52.5%) of respondents agreed to participate in the scheme. A significant association exists between willingness to participate in the NHIS scheme and awareness of methods of options of health care financing and awareness of NHIS (

Prevalence and Predictors of Erectile Dysfunctions among Men on Antiretroviral Therapy in South‑western Nigeria

Background: Erectile dysfunctions (EDs) are common presentations among men on anti‑retroviral therapy, many of who had a course to discontinue anti‑retroviral drugs or search for alternative treatments.Aim: This study assessed the prevalence and predictors of ED among men on anti‑retro viral therapies (ART) in a Nigerian population.Subjects and Methods: It was a descriptive cross‑sectional survey among 234 HIV‑positive men on anti‑retroviral therapy selected using stratified sampling method after excluding for co‑morbidities. Research instrument was semi‑structured interviewer administered questionnaire, and data were analyzed using the SPSS software version 17.0 (Chicago IL, USA), while binary logistic regression and Chi‑square test were used to demonstrate association between selected categorical variable.Results: Mean age of respondents was 37.1 (1.6) years, 85.6% have not missed their medications, self‑reported adherence was reported as good among 213 [(90.8 %) 213/234], though calculated adherence was 90% among as many as 201 [(85.6%) 201/234]. Pattern of EDs revealed weak erection among 42 [(37.8%) 42/111], 15 [(13.5%) 15/111] said they could no longer achieve erection, 33 [(29.7%) 33/111] said they could not maintain erections, while 27 [(24.3%) 27/111] presented with loss of libido. Delayed and premature ejaculations were reported among 24 [(21.6%) 24/111] and 8 [(7.2%) 8/111] respectively. About 14% (33/234) of respondents said that anti‑retroviral drugs could have caused their ED while 78% (183/234) said it should not. A statistically significant association exists between having weak erections and age above 65 years and calculated the adherence <95%, while none exists between having weak erections and missing pills.Conclusion: Anti‑retroviral drugs are common causes of EDs. Concerns of clients should always be addressed most especially issues that may compromise adherence. Keywords: Adherence, Anti‑retroviral therapy, Erectile dysfunctio

Pattern of arthralgia in an urban community in Southwestern Nigeria

Background: Arthritis is a common presentation among Nigerians, most especially in the elderly population. Easy access to over-the-counter drugs, paucity of data, and non-orthodox medical practice have underscored the need to examine the magnitude of the problem toward morbidity reduction risk factors. The objective of the study was to determine the pattern of arthralgia in Osogbo community in Southwestern Nigeria.Materials and Methods: This was a descriptive cross-sectional study  conducted between September 2010 and August 2011. Respondents were serially recruited as they presented to the randomly selected healthcare facilities. Interviewer administered questionnaires, and modified checklist were used for collecting clients information, physical examination, X-ray, and laboratory results. Data were analyzed using the SPSS software.Results: A total of 90 cases were screened, with a male to female ratio of 1:1.5 and age range of 50-59 years. Females were more affected among the studied respondents, and this was statistically significant (p < 0.05). About half (48.9%) used non-steroidal anti-inflammatory drugs (NSAID) for the pain, while about 17.8% used traditional herbs. Osteoarthritis of the knee was the most common radiological finding, constituting about 86.7% of the 30 respondents that had X-ray done. Only one case tested positive to rheumatoid factor in high-dilution titer. Notable complication of arthralgia in this study was loss of time off work in 46.6% of the respondents.Conclusion: Arthralgia of the knee joint was most common in the studied area, followed by that of hip and the ankle. Weight reduction strategies and prompt diagnosis and treatment were advocated. Since about half of the respondents used NSAID, the use of enteric-coated NSAID tablets would go a long way to minimize the unwanted side effects of NSAID, notably peptic ulceration and erosion.Keywords: Arthralgia, pattern, urban communit

Knowledge, attitude and use of alternative medical therapy amongst urban residents of Osun state, southwestern Nigeria

Alternate medicine which has a long history has been relegated to the background by the evolution of modern medicine. In recent times, however, alternative medical therapy has been growing in popularity and getting increasing attention and interest. This study assessed the knowledge, attitude and use by urban dwellers of alternative medical therapies. This was a cross-sectional descriptive study which used a semi-structured questionnaire to gather information from 812 randomly selected urban respondents. Majority 734 (90.4%) of the respondents were aware of an alternative way of getting treatment for their ailments apart from the orthodox medicine. The forms of alternative medical therapy (AMT) respondents were aware of include: concoction (herbal preparations) 683 (94.2%); herbalists/traditionalists 616 (85.0%); traditional bone setters therapy 434 (59.9%); among others. The main source of information was through radio 439 (70.9%). About half 403 (54.9%) of the respondents were aware of side effects from AMT and these include diarrhea, abdominal pain and vomiting which accounts for 69.7%; 42.2% and 40.2% respectively. About 347 (47.3%) think AMT could be injurious to health. About a third 262 (35.7%) of the respondents who were aware of AMT prefers it to orthodox medicine. Reasons given for the preference were that: AMT is cheap 56 (21.4%); accessible 43 (16.4%) and acceptable 35 (13.4%) to them. About half 367 (50.0%) also believed AMT alone could cure their illness without resort to orthodox medical therapy (OMT). Over half 401 (54.6%) of the 734 respondents that were aware of AMT had patronized or taken one form of alternative medical therapy or the other in the last 12 months prior to the study. Of these number, 323 (80.5%) had taken concoction (herbal preparations). However, there was no relationship between respondents’ age, sex, educational level or religion and the patronage of AMT as all test of associations were not statistically significant p>0.05. This study has revealed that the use of alternative medical therapies is quite popular among the studied population and a high proportion of the respondents use AMT notwithstanding that they live in the urban communities where they have better access to orthodox medical care and medical practitioners. Regulations should be made concerning the advertisement of alternative medicine and practices as orthodox medicine and practices are usually not advertised.Key words: Knowledge, attitude, use, alternative medical therapies, urban dwellers

Hygiene Practices among Workers in Local Eateries of Orolu Community in South Western Nigeria

Background: Activities of local food premises and monitoring of food handlers are usually not regulated.Aim: The objective of this study was to determine food hygiene (FH) practices among food handlers in rural communities in South Western Nigeria.Subjects and Methods: Descriptive cross‑sectional study was carried out among 235 food handlers; data collection was by interviewer administered questionnaires. Using the SPSS software, multivariate analysis in two separate models was done to explore the predictors of correct knowledge and good hygiene practices. The model fit was assessed as good using the Hosmer and Lemeshow test.Results: Mean age of respondents was 31.8 (10.8) years. Of the respondents (134) that had training, 17.2% (23/134) had formal training, and 82.8% (111/134) had apprenticeship; about 31.5% (74/235) of respondents maintained a good level of hygiene in their practices. Significant predictors of correct knowledge were found to be being trained (significant 0.01, odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2–4.8) and receiving the training as an apprentice (significant 0.01, OR – referent group); or in a formal setting (significant 0.01, OR 3.3, 95% CI 1.6–7.0) and having no formal education (significant 0.04, OR – reference group).Conclusion: Good knowledge and attitude but low level of good practices toward FH characterized food handlers under study.Keywords: Attitude and practice, Food handlers, Food hygiene, Knowledge, Local eaterie

Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun State, Nigeria

EO Asekun-Olarinmoye,1 WO Adebimpe,1 JO Bamidele,2 OO Odu,2 IO Asekun-Olarinmoye,3 EO Ojofeitimi41Department of Community Medicine, Faculty of Clinical Sciences, Osun State University, Osogbo, Osun State, Nigeria; 2Department of Community Medicine, Faculty of Clinical Sciences, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria; 3Department of Community Health, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria; 4Department of Community Medicine, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, NigeriaObjectives: To determine the knowledge and attitudes on modern contraceptive use of women living in an inner city area of Osogbo.Materials and methods: Three hundred and fifty nine women of childbearing age were studied utilizing a community-based, descriptive, cross-sectional study design. A multistage random sampling technique was used in recruiting respondents to the study. A four-part questionnaire was applied dually, by interviewers and by respondents' self administration, and the data was analyzed using the SPSS software version 17.0.Results: The mean age of respondents was 28.6 ± 6.65 years. The majority (90.3%) of respondents were aware of modern methods of family planning (FP), 76.0% claimed awareness of where to obtain FP services, and 74.9% knew of at least five methods. However, only 30.6% had ever used contraceptives, while only 13.1% were current users. The most frequently used method was the male condom. The commonly perceived barriers accounting for low use of FP methods were fear of perceived side effects (44.0%), ignorance (32.6%), misinformation (25.1%), superstition (22.0%), and culture (20.3%). Some reasons were proffered for respondents' nonuse of modern contraception. Predictors of use of modern contraceptives include the awareness of a place of FP service provision, respondents' approval of the use of contraceptives, higher education status, and being married.Conclusion: Most of the barriers reported appeared preventable and removable and may be responsible for the reported low point prevalence of use of contraceptives. It is recommended that community-based behavioral-change communication programs be instituted, aimed at improving the perceptions of women with respect to bridging knowledge gaps about contraceptive methods and to changing deep-seated negative beliefs related to contraceptive use in Nigeria.Keywords: childbearing age, family planning, fertility desires, perception, knowledge, attitude, benefit

Treatment Outcomes among Human Immunodeficiency Virus and Tuberculosis Co-Infected Pregnant Women in Resource Poor Settings of South-western Nigeria

The complex interactions between Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) infections may be magnified, in the presence of another potentially stressful condition like pregnancy. Though co-infection among pregnant women is rare, treatment outcomes may depend on accessibility to comprehensive treatment modalities. The objective of this study is to determine treatment outcomes among pregnant HIV and TB co-infected pregnant women in Lagos, South-western Nigeria. This retrospective, analytical study was carried out among ninety four (94) eligible pregnant women co-infected with HIV and TB at selected health-care facilities in Lagos state between January, 2008 and December, 2009. A standard checklist for data collection was used and analysis was carried out using the EPI info software. Mean age of respondents was 30.8 (±3.9) years. Sixteen (17.1%) TB cases were clinically diagnosed for tuberculosis. Among tuberculosis cases identified through sputum microscopy, 60(63.8%) were acid fast bacilli (AFB) positive and 21(22.3%) were identified in the first trimester. The mean percentage adherence to anti-retroviral drugs was 95.9% (±5.3). None of the participant smoked cigarette. Seventy three {73 (77.7%)} had contact with TB infected or suspected person in the last three months. Treatment outcome in mother showed that 74(78.7%) were cured, 8(8.5%) relapsed while 12 (12.8%) had treatment failures. Among the babies, 83(88.3%) were born alive. Women with both poor adherence (<90%) and with positive TB contact, but neither factor alone, were half-fold less likely to be cured compared with women with both good adherence (>95%) and no TB contact (OR=0.59, CI=0.45-0.95 and p=0.014). Cure rate was substantially lower in this study. This calls for extra strategies such as routine TB screening in antenatal clinics, strict adherence to national guidelines in the treatment of HIV/TB co-infections, focused antenatal care and comprehensive Prevention of Mother to Child Transmission (PMTCT) care and treatment

Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria

EO Asekun-Olarinmoye,1 PO Akinwusi,2 WO Adebimpe,1 MA Isawumi,3 MB Hassan,3 OA Olowe,4 OB Makanjuola,4 CO Alebiosu,2 TA Adewole51Department of Community Medicine, 2Department of Medicine, 3Department of Surgery, 4Department of Microbiology, 5Department of Chemical Pathology, College of Health Sciences, Osun State University, Osogbo, Osun State, NigeriaBackground: The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria.Methods: A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17.Results: The mean age of the respondents was 49.7 &plusmn; 1.6 years, 100 (38.6%) were males, 84 (32.4%) were farmers, and 111 (42.9%) were traders. The prevalence of hypertension was 13.16% (present in 34 respondents). Seventeen (6.6%) had isolated systolic hypertension, while 11 (4.2%) had isolated diastolic hypertension. Two hundred and thirty-six (91.1%) undertook daily exercise lasting at least 30 minutes and 48 (18.5%) had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6%) claimed a family history of hypertension. The average body mass index (BMI) among respondents was 23.4 &plusmn; 4.9 kg/m2, 51 (19.6%) had a BMI of 25.0&ndash;29.9, and 30 (11.5%) had a BMI &ge; 30. A significant association existed between age older than 40 years and having hypertension (P < 0.05), while no relationship existed between age and BMI or between gender and hypertension (P > 0.05). Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI < 25 had at least a three times greater likelihood of developing hypertension than those with BMI < 25 (odds ratio 2.9, 95% confidence interval 0.007&ndash;0.056, P = 0.011).Conclusion: The prevalence of hypertension is high in this study population and we recommend scaling up primary prevention efforts to reduce this in Nigerian communities.Keywords: prevalence, hypertension, anthropometry, body mass index, rural communit

Challenges Facing Early Infant Diagnosis of HIV among Infants in Resource Poor Settings

The number of children who have HIV continues to grow. Studies have confirmed dramatic survival benefits and mortality reduction for infants confirmed and managed as early as possible after diagnosis. With the advent of the Polymerase Chain Reaction technology, early infant diagnosis of HIV among children is easier and more reliable worldwide. Most HIV programmes in developing countries are donor dependent with less encouraging moves towards sustainability drive by the local health authority. The health systems also face a lot of challenges while implementing these programmes that would promptly identify HIV exposed babies as well as enrolment into care. This review examined challenges facing early infant diagnosis of HIV among infants in Nigeria.RésuméLe nombre d'enfants qui sont atteints du VIH ne cesse de s’accroitre. Des études ont confirmé les avantages de survie dramatiques et la réduction de la mortalité pour les nourrissons confirmés et gérés le plus tôt possible après le diagnostic. Avec l'avènement de la technologie de Réaction en Chaine de Polymérase, le diagnostic précoce du VIH chez les enfants à travers le monde est plus facile et plus fiable. La plupart des programmes du VIH dans les pays en développement sont dépendent des bailleurs de fonds avec des tentatives moins encourageantes vers la durabilité d'entraînement par l'autorité sanitaire locale. Les systèmes de santé font face également à de nombreux défis lors de l'exécution de ces programmes qui identifieraient rapidement les bébés exposés au VIH ainsi que leur inscription dans les soins. Ce compte rendu a étudié les défis auxquels fait face le diagnostic précoce du VIH chez les nourrissons au Nigeria.Keywords: Early Infant Diagnosis (EID), HIV, Dried Blood Spot (DBS), Polymerase Chain Reaction (PCR