Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in Ogun State, Nigeria

Introduction: Disclosure may reduce the transmission of HIV by raising awareness and decreasing risky behavior, thus status disclosure is an issue to be addressed for HIV prevention and treatment. The objective of this study was to determine the prevalence and determinants of HIV status disclosure to sexual partners among People Living with HIV/AIDS (PLWAs) in Ogun state, Nigeria.Materials and Methods: This study is an analytical cross-sectional study. A sample of people living with HIV/AIDS attending secondary health facilities in Ogun State were recruited into the study.Results: Of the total 637 interviewed, 324 (50.9%) indicated that they have disclosed to their main sexual partner. About 44.6% of the respondents reported that they do not know their partner’s HIV status, while 30.3% had a negative partner and 25.1% with HIV-positive partners. Among the participants who disclosed their HIV status, 17.3% disclosed on the day of receiving test result, 15.5% within two weeks, 9.7% in 2 to 4 weeks, 8.3% in 1 or more months. Predictors of disclosure were individuals who were married [OR = 4.52, CI = 2.06–9.92] living within monogamous family [OR = 1.67, CI = 1.10–2.53], had anticipation of partner’s support before disclosure [OR = 3.68, CI = 2.36–5.76] with knowledge ofpartner’s sero-status either positive [OR = 4.08, CI = 2.62–6.35] or negative [OR = 2.49, C.I = 1.59–3.90] and had a low self-esteem [OR = 0.61, CI = 0.42–0.89].Conclusion: Disclosure rate was low in this African population. The study implies that PLWAs especially those having a difficult family life should be supported to make effective decisions to disclose their status. HIV sero-status should be addressed in behavioral interventions like counseling on positive living and a multidisciplinary approach to developpositive self-esteem through follow-up counseling

Knowledge and Attitudes towards Basic Cardiopulmonary Resuscitation (CPR) among Community Nurses in Remo Area of Ogun State, Nigeria

Background: Cardiac arrest is not often discussed as a public health problem. This study assessed the knowledge and attitudes towards Basic Cardiopulmonary Resuscitation (CPR) among Community Nurses in Remo Area of Ogun State, Nigeria with the purpose of improving emergency care at primary health care delivery system.Methodology: It was a questionnaire-based cross-sectional study that involved 70 nurses. The study was carried out between January and August, 2010. The nurses were tested on their theoretical knowledge of basic life support with semi-structured practical questions partly from the resuscitation guideline of 2005 generated by International Liaison Committee on Resuscitation and scores were awarded to ten positive responses. Data were reported using SPSS version 15.0. The mean score was compared for age, marital status, those that were taught CPR, had certified CPR training by using Paired Sample T-test and year of experience by using one way ANOVA. P value < 0.05 was taken as significant.Results: A total of 70 nurses with mean age of 40.2±7.7 years were studied. Majority 58 (82.9%) have heard about CPR mostly at School of Nursing. Only four (5.7%) knew the correct approach to a person with cardiac arrest. Eight (11.4%) had certified CPR training out of which none of those certified had the training within the last two years. Only 13 (18.6%) had correct theoretical knowledge of 2005 guidelines for compression: ventilation ratio. None of the respondents who were unwilling to do mouth-to-mouth rescue breathing knew that compression alone could be life saving for a stranger or relative. There was a better performance in the younger age group p=0.04 and those with less than five years of experience p=0.09.Conclusion: Knowledge of basic CPR amongst nurses at primary health care level is generally poor with the young ones having better performance. This suggests the need for regular CPR training and re-training.Keywords: Basic Life Support, Community Nurses, Knowledge, Ogun Stat

Incidence of road traffic accidents and pattern of injury among commercial motorcyclists in a rural community in south western Nigeria

Background and Objective: Motorcyclists are at high risk of road traffic accidents and the attendant injuries, but few community-based studies have investigated the problem in Nigeria. Therefore, this study was conducted to determine the incidence of accidents and patterns of non-fatal injury among commercial motorcyclists in a rural community in Oyo State, Nigeria. Methodology: A total sample of all the commercial motorcyclists registered in the motor parks of Igbo-Ora, Oyo State was surveyed. An interviewer administered questionnaire was used to collect information on the respondents\' socio-demographic characteristics, occurrence of accidents in the year preceding the study, type of injury sustained, motorcycle riding experience, substance use and other characteristics. Results: Two hundred and ninety nine motorcyclists were interviewed, 136(45.3%) had been involved in a road traffic accident; of these 85 (62.5%) were involved in a single accident, while 51(37.5%) were involved in 2 or more accidents. Motorcycle accident risk factors included age of the motorcyclist, between 20-29 and 30-39 years, OR 10.1 and OR 9.6 respectively, alcohol use, OR 1.18, and visual impairment, OR 1.62. The collisions occurred mainly with cars (28.7%) and other motorcyclists (27.9%). The commonest types of injuries sustained were abrasions and cuts (67 .6%) and fractures of the upper and lower limbs (16.2%). Conclusion: Road traffic accidents occur frequently among commercial motorcyclists in this community. Introduction of road safety education targeted at discouraging alcohol use among these motorcyclists while riding and ensuring periodic visual acuity assessment is recommended. Keywords: commercial motorcyclists, accidents, injuries, risk factors, rural community, NigeriaJournal of Community Medicine and Primary Health Care 2005, 17(1): 7-1

Prevalence of Human Immunodeficiency Virus Infection and Risky Sexual Behaviours among Clients Attending HIV Testing Service in Ogun State, Nigeria

Background: HIV testing services (HTS) are a component of HIV prevention and care programs in developed countries and have proven to be a cost-effective way of monitoring the disease, reducing risky behaviours and leading patients to other services. Objective: To determine the prevalence and risky behavioural factors associated with HIV among the attendees of HIV testing services in a part of Ogun state, Nigeria. Methods: This was a descriptive cross-sectional study of HTS clients in health facilities within Ogun State, Nigeria. A multi-stage sampling technique was used for data collection using a pretested, close-ended, interviewer-administered questionnaire. Results: A total of 800 respondents with a mean age of 32.57±10.39 years were surveyed. The prevalence of HIV was 1.6%. The majority (93.6%) of the respondents were sexually experienced. The percentage tested previously among study participants was 5.0%. This significantly comprised those below the age of 18 years (X2 = 22.01, p = 0.0001) and female respondents (Χ2 = 4.84, p = 0.028). Only 21 (2.6%) have had unprotected sex with a casual partner. Significantly more of the female respondent had been involved in this risky sexual behaviour (X2 = 4.52, p = 0.034). Only 7 (0.9%) had sex with multiple sexual partners in the last three months, and 17 (2.1%) were positive for symptomatic STI screening. Conclusion: The prevalence of HIV was low to be 1.6%, and the percentage tested previously was 5.0%. The practice of free HIV screening should be maintained to encourage more people to undergo the test

Risk factors associated with mental illness in Oyo State, Nigeria: A Community based study

BACKGROUND: The main objective of this study was to determine the prevalence and factors associated with mental illness in Oyo State at community level using the general health questionnaire as a screening tool. METHOD: This cross-sectional, community- based survey was carried out among adults in three randomly selected LGAs using multi-stage sampling technique. RESULTS: A total of 1105 respondents were assessed in all. The overall prevalence of psychiatric morbidity in Oyo state Nigeria was found to be 21.9%, (18.4% in the urban areas and 28.4% in the rural areas, p = 0.005). Young age ≤ 19 yrs (X(2 )= 20.41, p = 0.00013), Unemployment (X(2 )= 11.86 p = 0.0005), living condition below average (X(2 )= 12.21, p = 0.00047), physical health (X(2 )= 6.07, p = 0.014), and large family size (X(2 )= 14.09 p = 0.00017) were associated with increase risk for psychiatric morbidity. Following logistic regression analysis, Unemployment (C.I = 1.18–3.70, OR -2.1) and living conditions perceived to be above average (C.I = 1.99–5.50, OR-3.3) were significant predictors of mental illness while family size less than 6 (C.I = 0.86–0.97, OR-0.91) was protective. CONCLUSION: The teenagers and the rural populations are in greater need of mental health promotional services. Family planning should be made freely available in order to reduce the family size and hence incidence of mental illness in the African population

Predictors of Indoor Insecticides spray utilization in the Prevention of Malaria related mosquito bites in Ogun State, Nigeria: A Community based study

BACKGROUND: Modern medicine tends to interpret health in terms of medical interventions and to overemphasize the importance of medical technology. It is important to promote the concept of health as theresult of the interaction of human beings and their total environment.METHODS: This was a descriptive cross-sectional study. A cluster sampling technique was used to select the participants into the study. The study was carried out between January 2012 and February 2012. One participant per household was selected into the study. A semi- structured questionnaire was used to collect relevant information which was collated and analyzedusing SPSS 15 statistical software.RESULTS: A total of 400 households were recruited into the study. The prevalence of insecticide spray utilization in the last 6months was 18.5%. Source of information on the use of insecticides included the radio/TV 174 (43.5%), Relatives 78 (19.5%), Health workers 54 (13.5%), friends 68 (17.0%) and others 26 (6.5%). Reasons for not using insecticides includedbeing expensive (cost) 94 (23.5%), fear of side effect 16 (4.0%), Inconvenience 38 (9.5%) and un-availability 74 (18.5%). Predictors of utilization of insecticide spray were young age (<30 yrs) of heads of household (O.R=5.10, C.I=1.06-21.7), tertiary education (OR= 9.14C.I=1.13-53.08), Nuclear family structure (OR=2.45 C.I=1.13-3.74) and availability of insecticide spray (OR=2.21 C.I=1.24-4.05).CONCLUSION: The study shows that households with heads that are young and educated are more likely to use insecticide spray. The study indicates that programs that will be geared towards increasing the knowledge and awareness of indoor insecticide spray in the prevention of Malaria should be introduced at the community level

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Abstract Introduction: Disclosure may reduce the transmission of HIV by raising awareness and decreasing risky behavior, thus status disclosure is an issue to be addressed for HIV prevention and treatment. The objective of this study was to determine the prevalence and determinants of HIV status disclosure to sexual partners among People Living with HIV/ AIDS (PLWAs) in Ogun state, Nigeria. Materials and Methods: This study is an analytical cross-sectional study. A sample of people living with HIV/AIDS attending secondary health facilities in Ogun State were recruited into the study. Results: Of the total 637 interviewed, 324 (50.9%) indicated that they have disclosed to their main sexual partner. About 44.6% of the respondents reported that they do not know their partner's HIV status, while 30.3% had a negative partner and 25.1% with HIV-positive partners. Among the participants who disclosed their HIV status, 17.3% disclosed on the day of receiving test result, 15.5% within two weeks, 9.7% in 2 to 4 weeks, 8. Conclusion: Disclosure rate was low in this African population. The study implies that PLWAs especially those having a difficult family life should be supported to make effective decisions to disclose their status. HIV sero-status should be addressed in behavioral interventions like counseling on positive living and a multidisciplinary approach to develop positive self-esteem through follow-up counseling

Oropharyngeal fetus-in fetu in Ilero Nigeria: A case report

Fetus-in-fetu is a rare congenital condition in which a malformed parasitic twin is found within the body of its partner. Although a few had been documented worldwide, none has been reported in Nigeria. In this report, we document the history of a concoction of drugs of an indeterminate nature taken in pregnancy, the wrong diagnosis by the rural based sonographer and the presence of polyhydraminos. Our finding of a previously misdiagnosed oropharyngeal fetus-in fetu with dichorionic and cardiac features calls for a revision of the current definition of fetus-in fetu. It also raises an important hypothesis of the likely associations between drugs, infections, pregnancy induced hypertension and fetus-in-fetu.Key words: Fetal abnormality; oropharyngeal fetus-in fetu; pregnancy

Comparing the Job Satisfaction and Intention to Leave of Different Categories of Health Workers in Tanzania, Malawi, and South Africa.

Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (χ2=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (χ2=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave. We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date

The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

Background - Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods - A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results - The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion - The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change