Health Communication and Behavioural Practice towards Ending Hepatitis B Virus in Southwest Nigeria

Responding to the international call for strategic information to understand viral hepatitis, this study investigated the health communication practice on hepatitis B virus in Southwest Nigeria. Existing studies on HBV in Nigeria have primarily concentrated on health practitioners and their patients while neglecting detailed empirical data on semiurban and urban demographic information. This study examines health communication channels as predictors of knowledge, attitude, and behavioural practices with an emphasis on three Southwest states (Lagos, Oyo, and Ogun) in Nigeria that have the highest prevalence rate of HBV. Data were gathered through a survey from a total of 600 respondents of Southwest Nigeria randomly selected through the multistage sampling technique. The hypotheses were tested with the use of multiple regression. The result reveals that health communication channels for hepatitis B virus management had a significant influence on knowledge (F = 12.708, Df = 581, P<0.05, Sig. at 0.000), attitude (F = 3.430, Df = 581, P<0.05, Sig. at 0.000), and preventive practices (F = 11.075, Df = 581, P<0.05, Sig. at 0.000) of residents of Southwest Nigeria, respectively. The study concludes that health communication channels such as the television, Internet, radio, newspaper, and health workers positively influence the behavioural practices of residents of Southwest Nigeria. The study recommends the development of a nationwide communication system on HBV targeted at putting an end to the disease in line with the 2030 global elimination objective of Sustainable Development Goal 3

National Health Insurance Scheme: An Assessment of Service Quality and Clients’ Dissatisfaction

BACKGROUND: Health Insurance Scheme (NHIS), a medical package to start with a fraction of Nigerians at its inception, with the expectation of optimal services to all in the long The Nigerian government established National run. However, there are complaints and dissatisfaction of enrolees of the scheme. This study determined factors responsible for enrolees’ dissatisfaction of services in a general hospital within the federal capital territory, Abuja.METHOD: Three hundred enrolees of National Health Insurance Scheme at the Kubwa general hospital were enrolled. Semi structured questionnaires were used to obtain information on socio-demography, education, enrolee status, perception of the scheme and factors responsible for enrolees’ dissatisfaction. SPSS version 22 was used to analyse Data using percentage.RESULTS: Majority (66.3%) of the respondents were between 35 and 54years while 28.5% were below 35years and 11.8% (32) were above 54years with the male to female ratio was 1.03:1. Sixty percent (179) of the respondents had a minimum of tertiary education with just 1.8% having primary education. Most (69.9% and 79.6%) respondents were principal enrolees and public servants respectively. Seventy percent of the respondents have been enrolled in NHIS for more than 3years and had a good perspective of the scheme. However, 30% of the respondents were not satisfied with NHIS services with 8.6% and 15.4% describing the services as substandard and below expectations respectively. Half (50.7%) of the respondents would consider an alternative to NHIS suggesting their dissatisfaction. The major factors responsible for dissatisfaction were billing system, long waiting hours and staff attitude accounting for 46.9%, 59.4% and 7.8% respectively.CONCLUSION: This study revealed that the level of clients’ dissatisfaction with NHIS services is high despite their acceptance of the scheme with the major areas of concern being the billing system, waiting time and staff attitude. Therefore, it is necessary for the providers to look more into these areas as targets for service delivery improvement

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Spatial exploration and analysis of electricity poverty: a case study of Ibadan, Southwestern, Nigeria

Energy poverty is a global phenomenon, with varying intensity across countries. Electricity is unarguably an important source of energy essential in satisfying the demand for modern energy services for socio-economic well-being, households‘ productivity and economic development of a nation. Despite the abundance of energy resources in Nigeria, an estimated 113 million people, representing about 70 per cent of the population, lack access to electricity, while the remaining 30 per cent have only intermittent and unreliable access. The thesis identifies and examines the causes and consequences of energy poverty and the role of energy (specifically electricity) in poverty reduction and as an engine of households‘ economic growth and prosperity. The study provides a pragmatic methodology of Geographic Information System (GIS) as an interface between development studies and energy geography. The thesis contributes to energy geography and resource management based on the deprivation experienced by households attributable to the failure of the public energy service delivery system. The poor reliability of the grid-based system has created an ―energy services gap‖ that is met by alternative costly backup off grid-solution of self-generation of electricity. The use of generators in most households is now the mainstay of electricity provision and has become the electricity provider, while the electricity provider is now standby. Households are consequently climbing down the energy ladder because electricity that is at the top of the ladder is not always available. The socio-economic suppression, depression and deprivation along with the financial burden on households‘ income are the bane of energy poverty in the study area. The study establishes that access is not the problem in an urban area in Nigeria but the inadequacy and unreliability of electricity supply in substantial quantity and reliable quality. To promote living and economic growth, it is desirable that households have secure and affordable electricity

Cultural Practices and Adoption of National Family Planning Communication Campaigns on Select Ethnic Groups in Nigeria

This study evaluated the extent to which married Idoma (Benue State) and Igala people (Kogi State) in North-Central Nigeria were exposed to the 2017 National Family Planning Communication Campaigns. The study also examined their level of knowledge, the extent to which they adopted the campaign messages, and how Alekwu/Ibegwu and other socio-cultural factors influenced their level of adoption of the campaign messages. The study adopted a quantitative (questionnaire survey) research method. The data were subjected to a descriptive analysis, correlation, ANOVA, Pearson Product Movement Correlation (PPMC), and Binary Logistics Regression. The findings showed that the majority of the people were exposed to information on condoms, implants, and Intrauterine Contraceptive Devices (IUCDs) (Cuppar T) in the course of the campaign; however, most of them were not exposed to information on Oral Pills, Vasectomies, Tubal ligation and Injections. Findings also revealed that knowledge of modern family planning in the study areas (51.2%) was below the 85.8% national family planning knowledge threshold and far below the expected 95% target of the 2017–2020 family planning communication campaign goal. Findings equally showed poor adoption of the campaign messages due to their cultural beliefs. The study concluded that family planning was often accepted among people whose ways of life have been significantly altered in favour of the idea

Effects of industrialization on groundwater quality in Shagamu and Ota industrial areas of Ogun State, Nigeria

In recent years, there has been an increasing ecological and global public health concern associated with environmental contamination by heavy metals on groundwater resources especially in the developing countries. Hence, this study assessed the impacts of industrialization on the quality of groundwater in Shagamu and Ota industrial areas of Ogun State, Nigeria between the period of July and December 2018, covering both wet and dry season. A total of 80 samples was collected from the industrial areas while a total of four control samples was also collected from the residential areas of the study locations across both wet and dry season using a random sampling technique. The water samples were then analyzed in the laboratory for their physico-chemical parameters (using standard procedures) and heavy metals using the Atomic Absorption Spectrophotometer (AAS). The results were evaluated for descriptive and inferential statistics using SPSS for Windows version 20.0. The mean range of values for the measured parameters was: pH (4.35–9.42), EC (18.50–684.0 μScm 1 ), hardness (3.83–396.06 mg/L), Ca2þ (0.18–138.75 mg/L) and that of heavy metals concentrations in the water sample were: Pb (0.003–0.199 mg/L), Cd (0.002–0.013 mg/L), Ni (0.004–0.259 mg/L), Cr (0.002–0.54 mg/L), Mn (0.015–1.940 mg/L), Fe (0.02–2.01 mg/L), Cu (0.012–0.72 mg/L), Zn (0.004–0.500 mg/L). A comparison of the obtained results with the World Health Organization standards (for drinking water) revealed that the levels of pH, Ca, Pb, Ni, Mn, Fe, Cd, and Cr were higher than the prescribed values. It was observed that groundwater sources for the dry season in both Ota and Shagamu have higher heavy metal concentrations that are above the permissible limits than the wet season, implying that more industrial activities were probably conducted during the dry season under the sampling period. The result of the heavy metals was in the magnitude according to the trend Fe > Mn > Cu > Cr > Zn > Ni > Pb > Cd. This study revealed that these industrialized areas contained high concentrations of heavy metals which can cause health disorders and behavioral defects. Thus, the water in the study locations is not suitable for consumption without prior treatment. It is therefore, recommends that the water in the study locations should be treated before were used for various domestic purposes, and the construction of the boreholes and dug wells are proposed here to follow proper siting regulations.The University of Pretoria, South Africa, the National Research Foundation-the World Academy of Sciences for the Doctoral scholarship and the National Research Foundation S&F Extended Support for Scholarships and Fellowships.http://www.heliyon.compm2021Chemistr