A study on presumptive diagnosis and home management of childhood malaria among Nomadic Fulani in Demsa, Nigeria

Magister Public Health - MPHDespite their high level of exposure, vulnerability and uniquely itinerant culture, the local knowledge of the nomadic Fulani population is not taken into account in the development of Nigeria’s home management of malaria policy. Programme-relevant information for extending access to an ethnographic study of factors that nomads use for presumption of malaria in children was collected from dry-season campsites in Demsa Local Government Area of Northeastern Nigeria. Mothers of under-five children with previous experiences at presumptive malaria management from 9 randomly selected nomadic Fulani camps were interviewed. The obtained information was used to develop a guide for key informant interviews of nomadic Fulani cultural consultants and elders, health service providers and policymakers. Findings indicate that nomads presume malaria when a child has “hot body” or lack appetite. Nomads believe that fever accumulates in the body as one steps on wet grounds during the rains. The nascent disease is triggered by the consumption of fruits that resemble the colour of urine such as the light complexioned skin of the Fulani. Fever is therefore regarded as natural affliction of the Fulani for which there is no cure. All fevers are referred to as paboje and expected to go away on the third recrudescence. Fever that persists after the third recurrence is called djonte which is treated at home without health facility support. Besides physical accessibility, the unfriendliness and lack of respect of health personnel for nomadic Fulani culture were reasons for avoiding health facilities. These factors encourage home management of djonte with antimalaria on the presumption that they are all malaria-induced. The nomads are willing to participate in interventions that will improve management of fevers and malaria among them. Although this preliminary study provides the foundation for appreciating the basis of home management of malaria among the nomads, complementary quantitative information will be required for holistic understanding of how these factors may interrelate to influence malaria intervention programme for the nomadic Fulani.South Afric

Illness-related practices for the management of childhood malaria among the Bwatiye people of north-eastern Nigeria

BACKGROUND: A wide range of childhood illnesses are accompanied by fever,, including malaria. Child mortality due to malaria has been attributed to poor health service delivery system and ignorance. An assessment of a mother's ability to recognize malaria in children under-five was carried out among the Bwatiye, a poorly-served minority ethnic group in north-eastern Nigeria. METHODS: A three-stage research design involving interviews, participatory observation and laboratory tests was used to seek information from 186 Bwatiye mothers about their illness-related experiences with childhood fevers. RESULTS: Mothers classified malaria into male (fever that persists for longer than three days) and female (fever that goes away within three days) and had a system of determining when febrile illness would not be regarded as malaria. Most often, malaria would be ignored in the first 2 days before seeking active treatment. Self-medication was the preferred option. Treatment practices and sources of help were influenced by local beliefs, the parity of the mother and previous experience with child mortality. CONCLUSION: The need to educate mothers to suspect malaria in every case of febrile illness and take appropriate action in order to expose the underlying "evil" will be more acceptable than an insistence on replacing local knowledge with biological epidemiology of malaria. The challenge facing health workers is to identify and exploit local beliefs about aetiology in effecting management procedures among culturally different peoples, who may not accept the concept of biological epidemiology

The female teacher trainee scholarship scheme: operational research study for UNICEF Girls Education Project Phase 3 (GEP3)

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IDEAS project - Scaling-up innovations to improve maternal and newborn health - Nigeria case study resources

The IDEAS project sought to improve the health and survival of mothers and babies through generating evidence to inform policy and practice in Ethiopia, northeast Nigeria and Uttar Pradesh, India. This data collection contains interview field notes and supporting information produced as part of a case study to investigate how an emergency transport scheme for pregnant women and newborn babies introduced in Gombe state had been scaled up to Adamawa state by Transaid and the Society for Family Health, working with National Union of Transport Workers

Zoonotic Enteric Parasites among Pastoralists, Cattle, and Soil in the Upper Benue Trough of Northeastern Nigeria

The occupation, lifestyle, and lack of formal education among pastoralists place them at higher risk of zoonoses. Moreover, zoonoses among pastoralists and their livestock in the Upper Benue Trough in northeastern Nigeria has not been studied holistically. Therefore, we investigated zoonotic enteric parasite (ZEP) infections by Entamoba spp., Cryptosporidium spp., Giardia intestinalis, Fasciola spp., Taenia spp. and Trichostrongylus spp. among this group. Demographic information and faecal samples were collected from humans and cattle in 12 pastoral communities along the trough using a cross-sectional, observational study design. Soil samples were also collected from homes. Specimens were examined microscopically for ZEPs and the data were analysed. The prevalence of ZEPs was 40.3% among humans, 48.2% among cattle, and 74.6% in home soil. The prevalence of ZEP infections among humans did not differ significantly with respect to gender and husbandry practices, but did differ significantly with respect to age and clan. There was a strong correlation (R=0.750) between ZEP prevalence in humans, cattle, and soil across study communities. The correlation between the distribution of ZEPs in different sample categories across communities strongly suggests that zoonotic transmission of ZEP is ongoing in the study area. Adopting an integrated approach to intervention will potentially be more effective in disease control. Further investigation, continuous monitoring, and surveillance are recommended to forestall enteric infection outbreaks

Factors Affecting Perceived Stigma in Leprosy Affected Persons in Western Nepal

Background There are various factors which construct the perception of stigma in both leprosy affected persons and unaffected persons. The main purpose of this study was to determine the level of perceived stigma and the risk factors contributing to it among leprosy affected person attending the Green Pastures Hospital, Pokhara municipality of western Nepal. Methods A cross-sectional study was conducted among 135 people affected by leprosy at Green Pastures Hospital and Rehabilitation Centre. Persons above the age of 18 were interviewed using a set of questionnaire form and Explanatory Model Interview Catalogue (EMIC). In addition, two sets of focused group discussions each containing 10 participants from the ward were conducted with the objectives of answering the frequently affected EMIC items. Results Among 135 leprosy affected persons, the median score of perceived stigma was 10 while it ranged from 0–34. Higher perceived stigma score was found in illiterate persons (p = 0.008), participants whose incomes were self-described as inadequate (p = 0.014) and who had changed their occupation due to leprosy (p = 0.018). Patients who lacked information on leprosy (p = 0.025), knowledge about the causes (p = 0.02) and transmission of leprosy (p = 0.046) and those who had perception that leprosy is a severe disease (p<0.001) and is difficult to treat (p<0.001) had higher perceived stigma score. Participants with disfigurement or deformities (p = 0.014), ulcers (p = 0.022) and odorous ulcers (p = 0.043) had higher perceived stigma score. Conclusion The factors associated with higher stigma were illiteracy, perceived economical inadequacy, change of occupation due to leprosy, lack of knowledge about leprosy, perception of leprosy as a severe disease and difficult to treat. Similarly, visible deformities and ulcers were associated with higher stigma. There is an urgent need of stigma reduction strategies focused on health education and health awareness programs in addition to the necessary rehabilitation support

Challenges and opportunities for control and elimination of soil-transmitted helminth infection beyond 2020.

More than half of the world’s population lives in places endemic for soil-transmitted helminths (STHs), and an estimated 1.45 billion people are infected. In 2017, the global burden of STH infection (Ascaris lumbricoides, hookworm, and Trichuris trichiura) was estimated at 1.9 million disability-adjusted life years (DALYs). Moderate and heavy infection intensity and chronic STH infection are associated with anemia, malnutrition, educational loss, and cognitive deficits, but recent systematic reviews and meta-analyses produced conflicting results on the impact of preventive chemotherapy (PC). The Soil-Transmitted Helminthiasis Advisory Committee (hereafter called “the Committee”) is a group of independent experts with a broad range of expertise. It is convened annually by Children Without Worms (CWW), an organization whose purpose is to utilize available evidence to identify best practices and opportunities for the prevention and control of STH infection. On November 1 and 2, 2017, the Committee met in Baltimore, Maryland, United States of America, in order to discuss the critical need to develop a data-driven guide to the STH endgame on late-stage program functioning, processes, and surveillance. The focus was on research and field experiences from countries approaching the “elimination of STH infection as a public health problem” after consecutive years of PC and countries that are now considering scaling down their PC frequency but may be concerned about infection rebound. Emphasis was placed on interim recommendations for monitoring and decision-making for national program managers desiring to achieve the World Health Organization (WHO) goal of eliminating STH infection as a public health problem by 2020, particularly related to STH infections in risk groups other than school-age children (SAC), namely preschool-age children (PSAC) and women of reproductive age (WRA) [8]. The following is the Committee’s recommendations stemming from the Baltimore meeting in November 2017. It complements and updates the publication derived by the Committee’s meeting a year earlier in Basel, Switzerland, and was instrumental in shaping the agenda for the October 2018 meeting, convened jointly by CWW and WHO, with recommendations to be reported elsewhere.Fil: Freeman, Matthew C.. University of Emory; Estados UnidosFil: Akogun, Oladele. Modibbo Adama University of Technology; NigeriaFil: Belizario, Vicente. University of The Philippines Manila; FilipinasFil: Brooker, Simon J.. Bill And Melinda Gates Foundation; Estados UnidosFil: Gyorkos, Theresa W.. McGill University; CanadáFil: Imtiaz, Rubina. The Task Force for Global Health; Estados UnidosFil: Krolewiecki, Alejandro Javier. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; ArgentinaFil: Lee, Seung Hwa. Save the Children; Estados UnidosFil: Matendechero, Sultani H.. Ministry of Health; KeniaFil: Pullan, Rachel L.. London School of Hygiene & Tropical Medicine; Reino UnidoFil: Utzinger, Jürg. Swiss Tropical and Public Health Institute; Suiza. University of Basel; Suiz

Assessing the Effectiveness of a Community Intervention for Monkeypox Prevention in the Congo Basin

Human monkeypox is a potentially severe illness that begins with a high fever soon followed by the development of a smallpox-like rash. Both monkeypox and smallpox are caused by infection with viruses in the genus Orthopoxvirus. But smallpox, which only affected humans, has been eradicated, whereas monkeypox continues to occur when humans come into contact with infected animals. There are currently no drugs specifically available for the treatment of monkeypox, and the use of vaccines for prevention is limited due to safety concerns. Therefore, monkeypox prevention depends on diminishing human contact with infected animals and preventing person-to-person spread of the virus. The authors describe a film-based method for community outreach intended to increase monkeypox knowledge among residents of communities in the Republic of the Congo. Outreach was performed to ∼23,600 rural Congolese. The effectiveness of the outreach was evaluated using a sample of individuals who attended small-group sessions. The authors found that among the participants, the ability to recognize monkeypox symptoms and the willingness to take ill family members to the hospital was significantly increased after seeing the films. In contrast, the willingness to deter some high-risk behaviors, such as eating animal carcasses found in the forest, remained fundamentally unchanged