Knowledge of the National Health Act among Physicians in two Tertiary Hospitals in Southern Nigeria

Objective: Knowledge of provisions of the National Health Act among physicians and stakeholders is pivotal to its successful implementation. This study aimed to assess the knowledge of the National Health Act (NHA) among Physicians in two tertiary hospitals in Nigeria. Methods: This was a cross-sectional study conducted in two tertiary hospitals in Southern Nigeria. The consecutively recruited eligible respondents were assessed for knowledge of NHA using a 24-item self-administered close-ended structured questionnaire. The total obtainable score was 26.  Those with <13 points had poor knowledge, 13-21 points had good knowledge and >21 points had excellent knowledge. Data were analyzed using SPSS version 21 software. P-value of < 0.05 was taken as significant. Results: One hundred and ninety-five doctors with a male: female ratio of 1.9:1 participated in the study. The majority (91.8%) were ≤40 years and 129(66.2%) of the participants were ≤ 10 years post qualification. The frequency of correctly answered questions ranged between 7.7% - 89.2%. According to overall knowledge scores; 64.6% had poor knowledge; 35.4% had good knowledge and none had excellent scores. There was no statistically significant association between knowledge of NHA and gender, age, and number of years post-qualification (p > 0.05). Conclusion: This study showed that only about a third of the participants had good knowledge of key provisions of the NHA. We strongly recommend that relevant sections of the Act should be incorporated into the medical curriculum both at the undergraduate and postgraduate levels

Effects of processing conditions on the hardness of cassava pellets

In this study, an experimental rig attached to a Testometrics Universal Testing machine for the purpose of extrusion was used to investigate the effects of processing conditions on hardness property of cassava pellets. The parameters considered were machine speeds of 1.5, 2.5, 3.5, 4.5 mm/min, die diameters of 6, 8, 10, 12 mm and cassava dough of moisture content levels 48.5, 50.5, 52.5 and 54.5%w.b. Result of the statistical analysis of variance showed that all the parameters and their interactions were significant on hardness property of cassava pellets at 5% level. Further analysis byDuncan’s Multiple Range Test reveals that hardness increased with increase in the process condition. Quality pellets can be obtained when cassava dough is conditioned into moisture contents level of above 45.5%w.b and below moisture content level 45.5%w.b

A comparative assessment of public and private dots laboratories in the Lagos state TB control programme

Background: The purpose of the laboratory services within the framework of the NTP is to provide bacteriologic evidence for the diagnosis, follow-up of TB patients and to document cure at the end of treatment. However to be fully functional, laboratory commodities should be available as needed. This study compared the laboratory hygiene practices and availability of laboratory equipment and other consumables for making diagnosis of TB in public and private DOTS laboratories in Lagos State.Methods: A descriptive comparative cross sectional study comparing availability of commodities in public and private laboratories involved in TB services in Lagos State.Results: Seventeen DOTS laboratories and 34 laboratory scientist/technician were recruited for this study. About three quarter and two thirds of the public and private DOTS laboratories respectively had reagents for smear microscopy. A significantly higher proportion of the public DOTS laboratories had separate area for TB work and separate table for smear preparation (p <0.05). A higher proportion (71.4%) of the laboratory scientist/ technicians at the public compared with 38.5% of those at the private DOTS laboratories had good knowledge of the laboratory diagnosis of TB.Conclusion: Laboratories involved in TB service are not functioning optimally and need to be strengthened.Key Words: Laboratory, DOTS, Consumables, Hygiene.French AbstractContexte : L’objet des services des laboratoires dans le cadre du NTP est de fournir les preuves bactériologiques pour le diagnostic, de suivre les patients tuberculeux et de documenter la guérison a la fin du traitement. Toutefois, pour être pleinement fonctionnel, les produits de laboratoire devraient être disponibles au besoin. Cette recherche comparait les pratiques hygiènes de laboratoire et la disponibilité des équipements de laboratoire et autres consommables pour faire le diagnostic de la tuberculose aux laboratoires de DOTS publics et prives dans l’État de Lagos.Méthodes : Une étude transversale comparative et transversale descriptive comparant la disponibilité des produits aux laboratoires publics et prives  concernes a fournir aux services tuberculeux dans l’état de Lagos.Résultats : Dix – sept laboratoires de DOTS et 34 scientifiques/techniciens ont été recrutés pour cette recherche. Environ trois quarts et deux tiers des laboratoires de DOT publics et prives ont eu réactif respectivement pour la microscopie des frottis. Une proportion significativement plus élevée des laboratoires de DOTS publics a eu un espace séparé pour les travaux de la tuberculose et une table séparée pour la préparation des frottis (p<0,05). Une proportion élevée(71,4%) des scientifiques/techniciens des laboratoires publics comparativement a 38,5% de ceux des laboratoires de DOTS prives avaient une bonne connaissance de diagnostic laboratoire de la tuberculose.Conclusion : Les laboratoires qui ont concerné a fournir les services tuberculeux ne fonctionnent pas de la façon optimale et doivent être renforcés.Mots– clés : Laboratoire, DOTS, consommables, Hygiène

Physiological response of rabbit bucks to prolonged feeding of cotton seed cake-based diets supplemented with vitamin E

Sixty-four (64) weanling rabbit bucks, 5 to 6 weeks old, were involved in a 2 x 4 factorial experiment to evaluate the effects of prolonged feeding of cottonseed cake (CSC) – based diets with or without vitamin E supplementation on the physiological response of the bucks. There were eight treatment combinations comprising four CSC (0, 5, 10 and 15%) levels and two vitamin E supplementation levels (0 and 30 mg/kg diet). Bucks were fed treatment diets for a period of twenty weeks after which blood was collected for haematological and serum analyses. The haematological parameters assessed include: Packed cell volume (PCV), red blood cell (RBC), haemoglobin concentration (Hb), white blood cell (WBC) and the differential counts. The serum parameters include the serum glucose, urea, creatinine, alanine transaminase (ALT), aspartate transaminase (AST), total protein, albumin, globulin and total cholesterol. The PCV, RBC and neutrophils declined (P < 0.05) with increase in CSC level; while the WBC and lymphocytes increased (P < 0.05) with increasing level of CSC. Other haematological parameters were not significantly (P > 0.05) affected by CSC level. Bucks that were fed 0, 5, 10 and 15% CSC supplemented with vitamin E recorded higher values for PCV, RBC and Hb than those that were not supplemented. At 15% CSC level, supplementing the diet with vitamin E significantly (P < 0.05) reduced WBC and lymphocyte counts. Serum urea, total protein and albumin were significantly (P < 0.05) lowered by the increasing level of CSC. Significant (P < 0.05) increase was observed in ALT and AST with increase in CSC level. Glucose and total cholesterol were not affected by CSC level. Supplementing the diet with vitamin E at all CSC levels reduced creatinine, ALT and AST levels significantly (P < 0.05). It was concluded that prolonged feeding of CSC – based diets to rabbit bucks had adverse effects on blood constituents of the bucks. However, supplementing such diets with 30 mg/kg diet of vitamin E ameliorated the adverse effects.Key words: Rabbit bucks, haematology, serum chemistry, cottonseed cake, vitamin E

Analysis of some selected toxic metals in registered herbal products manufactured in Nigeria

The use of herbal medicine has been on the increase in many developing and industrialized countries and Nigerians in particular has been using herbal medicine for many centuries. The approval of these herbal remedies by regulatory bodies has further encouraged the use of herbal remedies. The safety of these herbal remedies is however poorly understood. This study investigated the concentration of arsenic, cadmium, lead and mercury in twenty registered ready to use herbal products. Twenty brands of herbal remedies were purchased randomly from the Pharmacy shops in Lagos, digested with aquaregia (3:1 HCl: HNO3) and were analysed using atomic absorption spectroscopy (Buck 205 Atomic Absorption Spectrophotometer). There was no detectable lead in any of the 20 herbal samples; however, all the samples contained a detectable amount of one or more of the other metals of interest. The Oral Component Limit (OCL) for arsenic, cadmium and mercury as stated by USP are 1.5, 0.5 and 1.5 μg/g, respectively. All the samples contained arsenic and mercury below the USP OCL, while sixtyfive percent contained cadmium out of which fifty-five percent were above USP OCL. The results obtained from this study suggest a significant risk to consumers’ health considering the toxicity of these heavy metals.Key words: Herbal remedies, toxic heavy metals, atomic absorption spectrophotometry

An ecological study of the factors associated with childhood Tuberculosis in Nigeria

Background: Childhood tuberculosis (TB) account for about 6% of the global TB burden, but there is a paucity of data on childhood TB at the national and state level in many countries in Sub-Saharan Africa. Objective: To assess the childhood TB case notification rates and explore associated factors at the state level in Nigeria. Methods: A retrospective ecological study was carried out to determine the childhood TB case notification rates in the 36 states and the Federal Capital Territory (FCT) in Nigeria. TB data was retrieved from the National TB and Leprosy Control Programme (NTBLCP) 2014 Annual Report using a proforma. The association between TB case notification rate at the state level and the six selected explanatory variables (Human Development Index, Bacillus Calmette-Guerin [BCG] coverage, percentage underweight, HIV positivity rate, mean household size and population density) were carried out using negative binomial regression in R statistical software. Results: A total of 91, 353 TB patients were notified to the World Health Organization (WHO) in 2014 by the NTBLCP. Of these, 5463 (6%) were children aged 0-14 years. The childhood TB notification rate was 6.99/100,000 population. The highest childhood TB case notification rate was recorded in Nasarawa State followed by Lagos and Oyo States. There were significant associations between childhood TB case notification rate and HIV positivity rate, percentage underweight, household size, population density and BCG coverage. Conclusion: The study showed that childhood TB case notification rate in Nigeria was low. TB case notification rate was associated with high HIV rate, percentage underweight, household size, population density and BCG coverage. There is the urgent need to address the associated risk factors to effectively control childhood TB in Nigeria

Evaluation of Revenue Channels and Challenges in Sustainable Management of Oyo State Forest Reserves, Nigeria

Forest revenue system is an instrument used by government to achieve various goals and objectives in forest management. This paper evaluates the various challenges of revenue collection and remittance in Oyo forestry service in Nigeria. A total of 94 forest officials were identified and reached (100%) in all the forestry administrative zones in Oyo State, including the headquarters through a set of structured questionnaire and data obtained were analyzed using descriptive statistics and logit regression at \u3b10.05. Theaverage age of the respondents was 39.7\ub16.5 years, mostly male (71%), married (75.6%) and had secondary education (63%). Challenges confronting adequate revenue collection included lack of proper law enforcement, payment of cash by revenue collectors and inability of field officers to withstand armed illegal fellers with odds-ratio of 55694.85, 668.78 and 20.79 respectively. Problems facing adequate revenue remittance were remittance by field staff, inaccessibility of bank on time, lack of provision of incentives for running cost by the government and possibilities of field officers indulging in printing of fake receipts with odds-ratio of 140.18, 116.80, 3.65 and 3.44 respectively. The study exposed the various challenges facing adequate revenue collection and remittance in Oyo State forestry service, it is therefore necessary for the forest managers in the State to utilize this information wisely for the betterment of revenue generation

The effect of health sector industrial actions on TB and TB/HIV case finding in Ogun State, Nigeria: Is Public-Private Mix a viable solution?

Background: Though industrial disputes are a global phenomenon, there is a rising concern of its frequent occurrence in Sub-Saharan Africa. Objective: To assess the effect of industrial actions embarked upon by the health workers during the year 2014 on Tuberculosis (TB) notification in Ogun State, Nigeria. Methods: A retrospective review of TB notification in 2013 and 2014 was conducted. Quarterly TB case notification, the proportions of Human Immunodeficiency Virus (HIV) test, Co-trimoxazole (CPT) uptake and Antiretroviral Therapy (ART) uptake in the years 2013 and 2014 were compared using the Epi-info software. Results: There was a decline in the proportion of TB cases reported by the public sector health services and an increase in the proportion of TB cases reported by the private health facilities during the period of industrial disputes in the public health sector (doctors and non-doctors) (p = 0.001). Compared to the year 2013, the proportion of presumptive TB cases tested for HIV declined significantly during the period of the strike actions by the non-doctors but not during the strike actions by doctors in 2014. There was no difference in the uptake of Co-trimoxazole (p = 0.456 and 0.511) and Anti-retroviral Therapy (p = 0.192 and 0.544) by TB/HIV co-infected patients during the strike actions by the doctors and the non-doctors respectively. Conclusion: This study demonstrated the importance of Public-Private–Mix for TB case finding efforts in the developing countries, where there are incessant strike actions by health workers in the public sector

Preferred Place Of Delivery By Women In A Rural Community Of Lagos State

Background:  Maternal mortality ratio of 800 per 100,000 in Nigeria is about one hundred times higher than that of Europe. The uptake of health facility delivery in Nigeria is said to be 35% and the choice of the place of delivery is dependent on several factors. This study was conducted to assess the factors influencing the place of delivery by women in a rural community in Lagos, Nigeria.Methods:  A descriptive cross sectional study involving women aged between 15 – 45 years in Agbowa, a rural community in Lagos State.Results:  A total of 420 women were recruited, mean age was 31± 1.5 years. About 81% of the respondents preferred to deliver at the hospital, however 41% eventually delivered at the hospital during their last delivery. Cost, bad attitudes of hospital staff, long waiting time, long distance and poor hospital environment were reasons responsible for the non utilization of health facilities by women during their last deliveries. There was significant association between the educational statuses of the respondents and their spouses as well as the place of delivery.Conclusion; There is need for the government to reorganize the health sector in such a way as to enhance access to the health facilities especially by the underserved rural communities.Keywords: Place of delivery, women, reproductive age, rural