Clustering of cardiovascular disease risk‑factors in semi‑urban population in Northern Nigeria

Introduction: Non‑communicable diseases (NCDs) are major causes of morbidity and mortality particularly for developing countries. Large proportion of all NCDs deaths are occurring in low‑ and ‑middle‑income countries are estimated to occur in people under 70‑years‑old. These low‑ and middle‑income are undergoing epidemiological transition which allows the concomitant occurrence of both communicable and NCDs due to adoption of western life‑style that predisposes them to development of these diseases. It is also known that there are risk‑factors that tend to cluster in individuals and make them more susceptible to NCDs especially cardiovascular diseases (CVDs). Among NCDs, CVDs constitute the largest share responsible for 48% of all deaths due to NCDs. To determine extend of clustering of these risk‑factors in a semi‑urban community in northern Nigeria, a population‑based study was carried out.Materials and Methods: This study was conducted in Dakace, a semi‑urban settlement near Zaria. A simple random sampling of 199 eligible respondents out of 424 was adopted to select study participants. An interviewer‑administered questionnaire was used to collect socio‑demographic information, smoking habits, alcohol consumption as well as level of physical activity. The following measurements were carried out on these respondents: Blood pressure (BP), fasting blood glucose, serum lipids, weight, and height to calculate body mass index (BMI).Results: There were of 199 participants: 94 males (47.2%) and 105 females (52.8%) with an overall mean age of 39.9 ± 15.6 years. About 20% had no risk factor; more females than males had risk‑factors. Proportion of subjects with risk‑factors increase with increasing BMI, particularly high BP; physical activity does not protect subjects from developing risk‑factors.Conclusion: This study clearly shows that CVD risk‑factors are prevalent even in segment of the population that hitherto may be considered free and the prevalence of these risk‑factors are high compared to some obtained from other part of Nigeria.Keywords: Cardiovascular, clustering, Dakace, Northern Nigeria, risk‑factorsNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Effectiveness of public – private mix of tuberculosis programme in Kaduna State, Nigeria.

Background: In an effort to increase tuberculosis (TB) case detection, the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program.Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed.Results: Except for the lower use of sputum microscopy for diagnosis, adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients, an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities, 13.1% and 12.2%respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7%) compared to 78.6% in the public health facilities.Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated

Impact Of Health Education On Home Treatment And Prevention Of Malaria In Jengre, North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A preintervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The postintervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P = .012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P < .001), knowledge (P < .001), malaria prevention practice (P = .001), first line treatment option (P = .031) and the type of treatment given to the children with fever (P = .048). Conclusion: Health education impacted positively caregivers' knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level. Keywords: Health education, home treatment, malaria, prevention Annals of African Medicine Vol. 7 (3) 2008: pp. 112-11

Out-of-pocket health expenditure for under-five illnesses in a semi-urban community in Northern Nigeria

Background: Household expenditure on health is increasingly becoming a major source of health care financing in Nigeria. Recognizing the limitations of this pattern of financing health care, the government has introduced a social health insurance scheme policy that has provided for government meeting the health care costs of children. However, there is a dearth of information on the pattern and costs of under-five illnesses at community level. This study therefore sought to determine the magnitude and causes of illnesses among under-fives, sources of healthcare and out of pocket expenditure among children under-five in Layin Zomo, a semi-urban area of Northern Nigeria Methodology: A cross-sectional community-based descriptive study design was used to study a population of under-fives in the settlement. A 50% sample of all under-fives in the settlement was drawn using systematic sampling method. Information was sought from the mothers/caregivers on illness episodes in the three months preceding the study, place and cost of treatment among the 324 sampled population. Result: The findings showed that 26. 9% of the children had been ill within three months of the study with fever; cough and diarrhoea being the leading causes of illness. Majority of respondents, 41.7% sought treatment from patent medicine vendors. The median out of pocket expenditure on treatment per illness episode was 171 Naira ($1.2) and the estimated annual per capita out of pocket treatment cost per child was 255 Naira ($1.8). Conclusion: While the study has provided some data for computation of the out of pocket health expenditure for treatment of under-five illnesses, the poverty context within which such expenditures are incurred limits the utilization of such information to determine the premium rate for the proposed children under five programme under the National Health Insurance Scheme. Key Words: Healthcare; Out-of-pocket expenditure; Under-fives; Zaria Journal of Community Medicine & Primary Health Care Vol.16(1) 2004: 29-3

Sexual behaviour, contraceptive practice and reproductive health outcomes among Nigerian university students

Context: The continued poor reproductive health behaviour and outcomes among youths informed the investigation of the knowledge, attitudes, sexual behaviour, outcomes and care-seeking among university students in Zaria, north western Nigeria. Methods: Using a cross-sectional descriptive study design, self-administered structured questionnaires were administered to a sample of 400 undergraduate students of Ahmadu Bello University students drawn by multi-staged sampling to collect information on their reproductive health knowledge and behaviour. Findings: Knowledge of most aspects of reproductive health was high. However, gaps where found in some specific areas. Apart from ethnicity and faculty of study, no significant associations were found between knowledge and other demographic variables. Attitudes to reproductive health were generally negative. Overall, 64.1% of the respondents had had sexual intercourse; 65.4% of the males and 60.2% of the females students sexually experienced. The mean age at sexual exposure for females and males were 17.8 and 19.2 years, respectively. The mean number of lifetime sexual partners was 3.4 for males and 2.4 for the females. Of the 54.7% currently sexually active respondents, 53.5% of the males and 48.0% of the females were involved in multiple sexual relationships. Only 32.4% of the sexually exposed respondents had ever used or were currently using a method of contraception. Condom use was only 30% among the sexually active respondents with use higher among the males; however, the use was inconsistent. Use of effective contraceptives was very low. Overall, 23.3% of the respondents had experienced symptoms suggestive of sexually transmitted infections within six months preceding the study, and self medication was the predominant method of treatment. Utilization of the university health services for their reproductive health needs was found to be abysmally low. Conclusion: The gaps in reproductive health knowledge, negative attitudes, high prevalence of risky sexual activity and poor reproductive health care seeking behaviour call for mounting of educational intervention programmes and development of youth-friendly reproductive health services on campus. KEY WORDS: University students; Reproductive health knowledge; Sexual behaviour; Contraceptive use; Reproductive health outcomes Journal of Community Medicine & Primary Health Care Vol.16(2) 2004: 8-1

Perceptions of working conditions amongst health workers in state-owned facilities in northeastern Nigeria

Background: The health care sector depends to a large extent on human labor. Poor worker motivation can greatly affect health outcomes and patient safety. There is little information on the health workers' perceptions of working conditions in resource-poor settings. Method: Three state-owned facilities in each state were selected by simple random sampling technique. The selected facilities were visited on weekdays between 9 and 10 a.m. A self-administered structured questionnaire was given to all health care workers on duty in the facility at the time of visit. Results: A total of 299 questionnaires were returned. The response rate was 85.43%. Two hundred four (68.2%) workers experienced general satisfaction with their current jobs. The relationships between general job satisfaction and presence of conflict at work ( P = 0.001), freedom of expression ( P > 0.001), managerial support for staff welfare ( P > 0.001), managerial support for staff career development ( P > 0.001), availability of tools and consumables in the workplace ( P > 0.001) and progress towards personal professional goals ( P = 0.001) were statistically significant. Conclusion: The level of general job satisfaction was high. Though salaries were important, presence of conflict at work, freedom of expression, managerial support for staff welfare, managerial support for staff career development, availability of tools and consumables in the workplace and progress towards personal professional goals appear to play a role in worker motivation

Serum Lipids Profiles and Pattern of Hyperlipidaemias in a Semi-Urban Community in Northern Nigeria

Background: Little information is available about the distributions of blood lipid concentrations and prevalences of hyperlipidaemias in Nigeria. Data on mean levels and prevalences of hyperlipidaemias are scanty or at best fragmentary in Nigeria. The aim of this study was to determine the levels of lipids in a semi-urban settlement in northern Nigeria. Methodology: This study was based in Dakace village, near Zaria in northern Nigeria. Cluster sampling method was used to select respondents. Two clusters (Angwas) were selected using simple random sampling. In each of the sampled cluster, all eligible respondents were identified by a house-to-house enumeration and this constituted the sampling frame. In all 199 subjects were selected using a systematic random sampling from the frame of the eligible respondents already prepared. The sub-sampled respondents for lipid analysis were asked to do an overnight fast of at least 14 hours following which, about 5mls of venous blood was taken and analyzed for various lipids fractions. Results: There were 94 males (47.2%) and 105 females (52.8%) with a mean age of 39.9 years ± 15.6 years. Forty-two subjects (21.1%) had elevated cholesterol level of more than 5.17mmo/L; mean was 4.44 ± 1.27mmo/L, (95%CI: 4.27, 4.62). Mean of LDL cholesterol was 2.19± 1.02 mm/L (95%CI: 2.06, 2.34); twenty-one subjects (10.6%) had elevated LDL cholesterol of >3.36mmol/L. The mean serum level of HDL cholesterol was 1.02 ± 0.40mmol/ L; (95%CI: 0.97, 1.08). Sixty-four subjects (32.2%) had decreased serum level of less than 0.91mmol/L.Only one person (0.5%), a male was found to have elevated serum triglyceride level of above 2.26mmol/L. The mean triglyceride level for the study population was 0.82 ± 0.64mmol/L, (95%CI: 0.73, 0.91). Conclusion: This study demonstrates that dysperlipidaemias are prevalent in Nigeria and for that matter in a semi-urban settlement that is generally thought to be free of these risk factors. It is therefore necessary to undertake nationwide survey to assess the pattern of distributions of blood lipids profiles and prevalence of dysperlipidaemias in the general population. Keywords: serum lipids, Hyperlipidaemias, Northern Nigeria. Nigerian Medical Journal Vol. 48 (3) 2007: pp. 51-5

Fertility Behaviour of Men and Women in Three Communities in Kaduna State, Nigeria

The UN Millennium Project aims to reduce poverty, hunger, and disease while promoting education, health, gender equity, and environmental sustainability. Fertility is not mentioned anywhere within the eight goals, but population growth rates profoundly impact the achievability of all goals by increasing the budgets required to meet the population’s basic needs. This paper describes the fertility patterns of men and women in three communities in Kaduna State, Nigeria. The findings reveal a total fertility rate (TFR) of 7.97, which surpasses the TFR of 7.3 reported from northwest Nigeria in the 2008 NDHS. Among both men and women, desired family size was high, with 37% of women citing 5-9 children as ideal and 32% citing 10-14 children as ideal. Fewer than 20% of women wanted less than five children, but as education increased, desired fertility significantly decreased. Among men there were significant associations between age, educational status, number of current wives and religion with the mean number of children ever fathered (Afr. J. Reprod. Health 2010; 14[3]: 97-105).Key words: Male fertility, female fertility, fertility intentions, reproductive behaviour, polygamy, desired family size, northern Nigeria