Diabetic foot ulcer: risk factors among patients of a secondary healthcare facility in south west Nigeria

Background: Diabetic foot ulcer is a common long term complication of diabetes and the most common cause of non-traumatic amputation and prolonged hospitalization. These increases disease burden and further worsen quality of life.Aim: This study evaluated exposure risk factors for foot ulcers among diabetics attending a secondary healthcare facility in Southwest Nigeria.Methods: A case control study of exposure risk factors for diabetes foot ulcer (DFU) at General Hospital Marina Lagos. Using a structured interviewer administered questionnaire, information on foot care education, 24-hour dietary recall, medical history, anthropometric indices and social habits of participants were obtained and analyzed.Results: There were 636 participants in this study (106 cases and 530 controls) with median age of 61.1±11.0 years in both study groups and mostly females, (75.5% in cases and 78.7% controls) with female to male ratio of 3:1. Majority, (83% in cases and 85% in controls) were in the low socioeconomic class and had lived with DM for more than 5years. Of the studied risk factors, lacking foot care education, diagnosis of visual impairment and hypertension, dietary intake of large proportion of carbohydrate meal at breakfast and dinner and obesity occured in significantly higher proportion of cases and controls and were associated with presence of DFU. (p<0.05) Conclusions: Lack of foot care education, diagnosis of visual impairment, hypertension and poor dietary habit are associated with presence of DFU. Addressing these factors from point of diagnosis will go a long way in stemming the burden of diabetes foot ulcer.  Funding: Self-funding. Keywords: Diabetes, foot ulcer, exposure risk factors, Southwest Nigeria.

Determinants of insecticide treated nets use among youth corp members in Edo State, Nigeria

<p>Abstract</p> <p>Background</p> <p>The Africa Malaria Report shows that many countries are quite far from reaching the universal coverage targets of 80% coverage by 2010 and maintain it at this level. This paper examines ITN use and the factors associated with its adoption among the youths in Nigeria. This information will help in the design of effective methods of providing and distributing the nets in order to enhance its adoption and maximize the public health benefits of ITNs.</p> <p>Methods</p> <p>This cross-sectional survey was carried out in 2006 among university leavers serving compulsory national service (youth corpers) using total sampling technique. The study was conducted using a self-administered questionnaire.</p> <p>Results</p> <p>A total of 656 youth corp members were interviewed. Only 23.8% of these youths ever use ITN while 4.3% currently use ITN before reporting in camp. A significant proportion of the youths acquired information on ITN from Mass Media (p = 0.0001). Other statistically significant factors that encourage the use of ITN include inexpensive market price of ITN (p = 0.0001), frequency of Malaria infestation (p = 0.019) and perceived malaria preventive action of ITN ( p = 0.000).</p> <p>Following logistic regression analysis, perceived effective malaria preventive action of ITN [OR = 29.3, C.I = 17.17-50.0] and high frequency of Malaria infestation [OR = 1.55, C.I = 0.97-2.47] were predictors of ITN use.</p> <p>Conclusion</p> <p>The study shows that the use of ITN for the prevention of Malaria is low among these Nigerian youths. The major factors determining the adoption of ITN among the youths were perceived effective Malaria prevention action of ITN and high frequency of Malaria attack. These factors should be considered in the design of sustainable and effective locally relevant strategies for scale-up adoption of ITNs among a youthful African population.</p

Male Involvement in Birth Preparedness in Ogun State, Nigeria: A Rural/Urban Comparative Cross-sectional Study

Though male involvement is associated with improved maternal and child health outcomes, the practice is low in developing counties like Nigeria. This comparative cross-sectional study described and compared male involvement in birth preparedness between rural and urban areas of Ogun State, Nigeria. It was carried out among 440 fathers of under-fives each from rural and urban local governments using multistage sampling to select participants. Data were collected using an interviewer-administered questionnaire and Focused Group Discussions (FGDs) and analyzed using SPSS version 20. Thematic analysis of FGD was done. Relevant descriptive and inferential statistics were calculated and results presented in frequency tables. Male involvement was statistically significantly better in rural areas than in urban areas (P=&lt;0.001). Tertiary education (AOR= 2.446, 95% C. I= 1.559-3.838) remained significant predictor of male involvement in birth preparedness in the urban area while predictors in rural area were young paternal age (AOR 0.465, 95% C.I= 0.223-0.967) and tertiary education (AOR= 6.241, 95% C.I=1.827-21.317). This implies that male involvement in birth preparedness was better among educated men in both urban and rural areas. Keywords: Male involvement, Birth preparedness, rural, urban, Ogun StateBien que la participation des hommes soit associée à de meilleurs résultats en matière de santé maternelle et infantile, la pratique est faible dans les pays en développement comme le Nigéria. Cette étude transversale comparative a décrit et comparé la participation des hommes à la préparation à la naissance entre les zones rurales et urbaines de l'État d'Ogun, au Nigéria. Elle a été réalisée auprès de 440 pères de moins de cinq ans issus de collectivités locales rurales et urbaines à l'aide d'un échantillonnage à plusieurs degrés pour sélectionner les participants. Les données ont été recueillies à l'aide d'un questionnaire administré par un intervieweur et de discussions de groupe ciblées (FGD) et analysées à l'aide de SPSS version 20. Une analyse thématique des FGD a été effectuée. Des statistiques descriptives et déductives pertinentes ont été calculées et les résultats présentés dans des tableaux de fréquences. La participation des hommes était statistiquement significativement meilleure dans les zones rurales que dans les zones urbaines (P = &lt;0,001). L'enseignement supérieur (AOR = 2,446, 95% C.I = 1,559-3,838) est resté un indicateur important de la participation des hommes à la préparation à l'accouchement en zone urbaine tandis que les indicateurs en zone rurale étaient le jeune âge paternel (AOR 0,465, IC 95% = 0,223-0,967) et l'enseignement supérieur (AOR = 6,241, IC à 95% = 1,827-21,317). Cela implique que la participation des hommes à la préparation aux naissances était meilleure chez les hommes instruits dans les zones urbaines et rurales. Mots-clés: Participation des hommes, préparation à la naissance, rural, urbain, état d'Ogu

A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria

Abstract Introduction Teenagers younger than 15 are five times more likely to die during pregnancy or childbirth than women in their twenties and mortality rates for their infants are higher as well. This study was therefore designed to determine the recent prevalence and identify factors associated with teenage pregnancy in a rural town in Nigeria. Methods This study is an analytical comparative cross-sectional study. A total sample of all pregnant women attending the primary health care in Sagamu local government area, Ogun State within a 2 months period were recruited into the study. Results A total of 225 pregnant women were recruited into the study. The prevalence of teenage pregnancy was 22.9%. Teenagers [48.2%] reported more unwanted pregnancy when compared with the older age group [13.6%] [OR = 5.91, C.I = 2.83-12.43]. About half 33 [41.1%] of the teenage pregnant women and 28.6% of the older pregnant women did not know how to correctly use condom to prevent pregnancy [OR = 0.57, C.I = 0.29-1.13]. Predictors of teenage pregnancy were low social class (OR = 2.25, C.I = 1.31-3.85], Religion (OR = 0.44, C.I = 0.21-0.91], being a student (OR = 3.27, C.I = 1.02-10.46) and having a white collar job (OR = 0.09, C.I = 0.01-0.81). Conclusion The study concludes that employment in an established organization (white collar job) is highly protective against teenage pregnancy while students are becoming increasingly prone to early pregnancy. Government should structure employment in low income countries in such a way as to give a quota to adolescents who are unable to continue their education.</p

Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria

Abstract Background Malaria infection in pregnancy is a major risk factor for maternal and child death, and substantially increases the risk of miscarriage, stillbirth and low birthweight. The aim of this study therefore is to assess the prevalence and determinants of Intermittent preventive treatment of Malaria [IPTp] utilization by pregnant women in a rural town in Western Nigeria. Methods This study is an analytical cross-sectional study. All pregnant women that were due for delivery and were attending the three primary health care center in Sagamu town, Nigeria within a 2 months period were recruited into the study. A semi- structured questionnaire was used to collect relevant information. Results A total of 255 pregnant women were recruited into the study. The mean age of respondents was 28.07 ± 5.12 years. The mean parity and booking age was 2.7 ± 1.67 and 4.42 ± 1.7 months respectively. The prevalence of Malaria attack in the last 3 months was 122(47.8%). Only 107/255 (40.4%) practice IPTp for malaria prevention during the current pregnancy, with only 14.6% of them taking the second dose during pregnancy as recommended. Chloroquine [27.1%] was the most frequently used medication for the treatment of Malaria in Pregnancy. Early booking age [OR = 1.11, C.I = 0.61–2.01], adverse last pregnancy outcome [OR = 1.23, C.I = 0.36–4.22], and parity [OR = 1.87, C.I = 0.25–16.09] were not statistically significantly associated with IPTp utilization. The only predictor of IPTp use was the knowledge of prophylaxis for malaria prevention [OR = 2.47, C.I = 1.06–3.52] using multivariate analysis. Conclusion The study concludes that most women who attend ANC in rural areas in Nigeria do not receive IPTp as expected. A major determinant of utilization of IPTp among the study population was the knowledge of prophylaxis for malaria prevention. This study highlights the importance of health education of the pregnant women in increasing IPTp uptake despite the regular drug stock out at the facility level in rural areas in low resource countries.</p

The effect of health education intervention on the home management of malaria among the caregivers of children aged under 5 years in Ogun State, Nigeria

Abstract Background Malaria is currently the most important cause of death and disability in children aged under 5 years in Africa. A health education interventional study of this nature is essential in primary control of an endemic communicable disease such as malaria. This study was therefore designed to determine the effect of health education on the home management of Malaria among the caregivers of children under 5 years old in Ogun State, Nigeria. Methods The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi-structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational program based on a course content adapted from the national malaria control program. A total of 400 respondents were recruited into the study, with 200 each in both the experimental and control groups, and were followed up for a period of 3 months when the knowledge and uptake of insecticide treated net was reassessed. Results There was no statistically significant differences observed between the experimental and control groups in terms of sociodemographic characteristics such as age (P = 0.99), marital status (P = 0.48), religion (P = 0.1), and income (P = 0.51). The majority in both the experimental (75.0%) and control (71.5%) groups use arthemisinin-based combination therapy as first line home treatment drugs pre intervention. Post health education intervention, the degree of change in the knowledge of referral signs and symptoms in the experimental group was 52.8% (P P = 0.93). Tepid sponging improved by 45.0%, paracetamol use by 55.3%, and the use of herbs and other drugs were not significantly influenced in the experimental (P = 0.65 and 0.99) and control group (P = 0.89 and 0.88), respectively. Furthermore, there was a 55.7% (P = 0.001) increase in the proportion of respondents using the correct dose of arthemisinin-based combination therapy in the home management of malaria and 23.9% (P  Conclusions The study concludes that there is a shift in the home management of malaria with the use of current and effective antimalarial drugs. It also demonstrated the effect of health education on the promptness of appropriate actions taken among the respondents for early diagnosis and treatment. Early diagnosis and appropriate treatment can be guaranteed if caregivers are knowledgeable on prompt actions to be taken in the home management of malaria.</p

Impact of health education intervention on insecticide treated nets uptake among nursing mothers in rural communities in Nigeria

<p>Abstract</p> <p>Background</p> <p>ITN use is generally poor in Nigeria among all categories of people. Although use of ITNs has been shown to reduce malarial morbidity and mortality, this measure needs to be supported by an adequate healthcare system providing ITN possibly at the household level. This study was therefore designed to determine the effect of health education on the uptake of ITN among nursing mothers in rural communities in Nigeria.</p> <p>Methods</p> <p>The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi- structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational programme based on a course content adapted from the national malaria control programme. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months when the knowledge and uptake of ITN was reassessed.</p> <p>Result</p> <p>There was no significant difference (P >0.05) observed between the experimental and control groups in terms of socio-dermographic characteristics such as age, marital status, religion, and income. The ITN ever users in experimental group were 59 [29.5%] and 138 [72.6%] in pre and post intervention period, respectively (p value =0.0001). These proportions of ITN ever users were 55 [27.5%] and 57 [31.6%] in control group, during the pre and post intervention periods (p = 0.37). Post health education intervention, degree of change in knowledge of ITN re-treatment [37.0%] and mounting [33.5%], readiness to use if given free [30.5%] and belief in efficacy [36.9%] improved significantly in the experimental group while there was no significant change in the control group [p = 0.84, 0.51, 0.68 &0.69 respectively]. Majority [89%] of the respondents were willing to buy ITN for between US$1.5 to US$ 3.0. There was no statistically significant change (P >0.05) despite intervention in the amount the respondents were willing to pay to own an ITN in both the experimental and control groups.</p> <p>Conclusion</p> <p>The study concludes that the use of ITN in the study population was significantly increase by health education and that the free distribution of ITN may not guarantee its use. Uptake of ITN can be significantly improved in rural areas if the nets are made available and backed up with appropriate health education intervention.</p

HIV/aids related home based care practices among primary health care workers in Ogun state, Nigeria

<p>Abstract</p> <p>Background</p> <p>HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria.</p> <p>Methods</p> <p>This study is an analytical cross-sectional study. A multistage cluster sampling technique was used to obtain a representative sample of the primary health care workers in Ogun state. An interviewer administered structured questionnaire was administered by trained health workers to elicit the required information.</p> <p>Result</p> <p>A total of 350 health care workers were interviewed, 70% of the respondents could adequately describe the components of home based care. Only 38.7% were aware of the National guideline on home based care practices and 17.1% believe that home based care will not significantly improve the prognosis of PLWAs. Few 19.1% had ever been trained or ever involved 16.6% in home based care practices. Only 20 [5.7%] are involved on a weekly basis, 16 [4.6%] monthly and 22 [6.3%] quarterly. Reasons given for non implementation of home based care are inadequate number of healthcare workers 45%, lack of political will 24.4%, lack of implementation by facility managers 14% and inadequate funds 16.6%.</p> <p>Factors that were significantly associated with the practice of home based care were perception of its relevance in improving prognosis [OR = 54.21, C.I = 23.22-129.52] and presence of a support group in the facility [OR = 4.80, C.I = 2.40-9.57]. There was however no statistically significant relationship between adequate knowledge of home based care [OR = 0.78, C.I = 0.39-1.54] and previous training on home based care (OR = 1.43, C.I = 0.66-3.06].</p> <p>Conclusion</p> <p>The practice of home based care for HIV/AIDS among the study population is low and it is greatly influenced by perception of its effectiveness and relevance. The study recommends that the health care workers should be adequately educated on the importance of home based care in the management of chronic illnesses in order to enhance its practice.</p

A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

<p>Abstract</p> <p>Introduction</p> <p>Most HIV/AIDS infections in women occur at a younger age, during the first few years after sexual debut. This study was therefore designed to assess factors associated with the knowledge and utilization of the prevention of mother-to-child transmission (PMTCT) services by the teenage pregnant women when compared to mature pregnant women in Ogun state, Nigeria.</p> <p>Methods</p> <p>This study is an analytical cross-sectional study. A total sample of all pregnant women [52 teenagers and 148 adults] attending the primary health care centres in Sagamu local government area, Ogun State, Nigeria within a 2 months period were recruited into the study.</p> <p>Results</p> <p>A total of 225 respondents were recruited into the study. The overall point prevalence of HIV/AIDS infection among those that had been tested and disclosed their result was 4 [2.8%]. The prevalence of HIV among the teenagers was 2 [7.4%] compared with 2 [1.8%] among older women. Only 85 [37.8%] of all respondents were tested through the Voluntary counseling and testing (VCCT) programme and 53 (23.7%) were aware of antiretroviral therapy while 35 (15.6%) have ever used the PMTCT services before.</p> <p>There was no statistically significant difference in the knowledge of the teenage pregnant women when compared with the older women about mother to child transmission (MTCT) [OR = 1.47, C.I = 0.57-3.95] and its prevention [OR = 0.83, C.I = 0.38-1.84]. The teenagers were 3 times less likely to use the services when compared with the older women. [OR = 0.34, C.I = 0.10-1.00]. Those from the low socio-economic background were about 6 times more likely to utilize PMTCT facilities when compared to those from high socioeconomic background [OR = 6.01, C.I = 1.91-19.19].</p> <p>Conclusion</p> <p>The study concludes that the teenage pregnant women who were more vulnerable to HIV/AIDS infection did not utilize PMTCT services as much as the older pregnant women. Special consideration should be given to teenagers and those from high socioeconomic group in the design of scale up programmes to improve the uptake of PMTCT services in Nigeria and other low income countries.</p