Hepatitis B vaccination coverage, knowledge and sociodemographic determinants of uptake in high risk public safety workers in Kaduna State, Nigeria: a cross sectional survey

ObjectivesTo estimate hepatitis B vaccination (HBVc) coverage, and knowledge and sociodemographic determinants of full dose uptake in Federal Road Safety Corps (FRSC) members, Kaduna State, Nigeria, to inform relevant targeted vaccination policies.DesignA cross sectional survey of FRSC members, Kaduna Sector Command.SettingsSix randomly selected unit commands under Kaduna Sector Command, Kaduna State, Nigeria.ParticipantsA pilot tested, structured, self-administered questionnaire was administered to 341 participants aged ≥18 years with ≥6 months of service between 17 June and 22 July 2015. Excluded were FRSC members in road safety 1 zonal command headquarters as the zonal command includes other states beyond the study scope.Primary outcomeHBVc status of participants categorised as 'not vaccinated' for uptake of AnalysisDescriptive analysis estimated HBVc coverage while logistic regression ascertained associations.ResultsMost participants were men, aged 30-39 years, with 3-10 years of service and of marshal cadre. HBVc coverage was 60.9% for ≥1 dose and 30.5% for ≥3 doses. Less than 47% of participants scored above the mean knowledge score for hepatitis B virus (HBV) and HBVc. Female sex (AOR 2.28, 95% CI 1.15 to 4.52, pConclusionsHBVc coverage and knowledge were poor among FRSC members, Kaduna Sector Command. Educational intervention, geared towards improving FRSC members' knowledge of HBVc and perception of risk of occupational exposure to HBV, is recommended for these vulnerable public safety workers. Such enlightenment could be a cheap and easy way of improving HBVc coverage in the study population

Risk factors for gambling and problem gambling: a protocol for a rapid umbrella review of systematic reviews and meta-analyses.

BackgroundGambling and problem gambling are increasingly being viewed as a public health issue. European surveys have reported a high prevalence of gambling, and according to the Gambling Commission, in 2018, almost half of the general population aged 16 and over in England had participated in gambling in the 4 weeks prior to being surveyed. The potential harms associated with gambling and problem are broad, including harms to individuals, their friends and family, and society. There is a need to better understand the nature of this issue, including its risk factors. The purpose of this study is to identify and examine the risk factors associated with gambling and problem gambling.MethodsAn umbrella review will be conducted, where systematic approaches will be used to identify, appraise and synthesise systematic reviews and meta-analyses of risk factors for gambling and problem gambling. The review will include systematic reviews and meta-analyses published between 2005 and 2019, in English language, focused on any population and any risk factor, and of quantitative or qualitative studies. Electronic searches will be conducted in Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, NICE Evidence and SocIndex via EBSCO, and a range of websites will be searched for grey literature. Reference lists will be scanned for additional papers and experts will be contacted. Screening, quality assessment and data extraction will be conducted in duplicate, and quality assessment will be conducted using AMSTAR-2. A narrative synthesis will be used to summarise the results.DiscussionThe results of this review will provide a comprehensive and up-to-date understanding of the risk factors associated with gambling and problem gambling. It will be used by Public Health England as part of a broader evidence review of gambling-related harms.Systematic review registrationPROSPERO CRD42019151520

Harms associated with gambling: abbreviated systematic review protocol

BackgroundAccording to the Gambling Commission, in 2018, almost half of the general population aged 16 and over had participated in gambling in the 4 weeks before being surveyed. Such surveys suggest that the proportion of people who are classed as 'problem' gamblers is relatively small; however, this may be related to the ways data are collected and gambling behaviour is classified. Concern about the harms associated with gambling is rising, and in response, Public Health England (PHE) has initiated this review to identify the harms associated with this activity. Harms to the gambler, their close associates and the wider society will all be included.MethodsAbbreviated systematic review processes will be employed. Ovid MEDLINE, Ovid Embase, Ovid Psycinfo, NICE Evidence and EBSCO SocIndex; a range of websites (for grey literature); and reference lists of included studies will be searched. Experts will be asked to identify other relevant literature. Literature published in years 2005-2019, published in English, from a country within the Organisation for Economic Development (OECD) and following an observational, qualitative or systematic review design will be included. AMSTAR2 (systematic reviews), the Newcastle-Ottawa Scale (observational studies) and the Critical Appraisal Skills Programme (CASP) qualitative checklist (qualitative studies) will be used to assess the risk of bias. A narrative synthesis will be used to summarise the results. The body of evidence will also be assessed according to the principles laid out in the CERQual approach.DiscussionThis protocol provides details of the framework that has been set up to guide this systematic review. The results of this review will provide an extensive assessment of the breadth and magnitude of harms associated with gambling. This will be one of the most comprehensive reviews of gambling-related harms undertaken to date.Systematic review registrationPROSPERO CRD42019154757

The impact of citrate introduction at UK syringe exchange programmes: a retrospective cohort study in Cheshire and Merseyside, UK

<p>Abstract</p> <p>Background</p> <p>In 2003, it became legal in the UK for syringe exchange programmes (SEPs) to provide citrate to injecting drug users to solubilise heroin. Little work has been undertaken on the effect of policy change on SEP function. Here, we examine whether the introduction of citrate in Cheshire and Merseyside SEPs has altered the number of heroin/crack injectors accessing SEPs, the frequency at which heroin/crack injectors visited SEPs and the number of syringes dispensed.</p> <p>Methods</p> <p>Eleven SEPs in Cheshire and Merseyside commenced citrate provision in 2003. SEP-specific data for the six months before and six months after citrate was introduced were extracted from routine monitoring systems relating to heroin and crack injectors. Analyses compared all individuals attending pre and post citrate and matched analyses only those individuals attending in both periods (defined as 'longitudinal attenders'). Non-parametric tests were used throughout.</p> <p>Results</p> <p>Neither new (first seen in either six months period) nor established clients visited SEPs more frequently post citrate. New clients collected significantly less syringes per visit post citrate, than pre citrate (14.5,10.0; z = 1.992, P < 0.05). Matched pair analysis showed that the median number of visits for 'longitudinal attenders' (i.e. those who attended in both pre and post citrate periods) increased from four pre citrate to five post citrate (z = 2.187, P < 0.05) but the number of syringes collected remained unchanged. These changes were not due to seasonal variation or other changes in service configuration.</p> <p>Conclusion</p> <p>The introduction of citrate did not negatively affect SEP attendance. 'Longitudinal attenders' visited SEPs more frequently post citrate, providing staff with greater opportunity for intervention and referral. As the number of syringes they collected each visit remained unchanged the total number of clean syringes made available to this group of injectors increased very slightly between the pre and post citrate periods. However, new clients collected significantly less syringes post citrate than pre citrate, possibly due to staff concerns regarding the amount of citrate (and thus syringes) to dispense safely to new clients. These concerns should not be allowed to negatively impact on the number of syringes dispensed.</p

Tobacco use among blue collar workers in Nigeria: A survey of Construction Artisans in Ekiti state

The prevalence of tobacco use among blue-collar workers such as construction artisans is disproportionately higher than in the general population, yet very limited studies have been conducted about such workers in Nigeria, the most populous country in sub-Sahara African (SSA). Therefore, this study aims to assess the prevalence and the associated risk factors of tobacco use among construction artisans in Ekiti State, Nigeria. This cross-sectional study employed a multi-stage stratified sampling technique to select participants (carpenters and bricklayers) artisans, journeymen, and their apprentices who were working in Ekiti State. Chi-square and logistic regression were conducted to delineate factors that are associated with tobacco use in this population. The results show that the prevalence of ever-smoke amongst respondents was 19.3%, and multivariate analysis showed that artisans who were within the age range 31-40 years were four times more likely to use tobacco (aOR=3.410; CI=1.476-7.878), compared with those that are less than 20 years. Additionally, being in school (aOR 2.007; CI= 1.026-3.927) and divorced/separated (aOR4.240; CI=1.307-13.759) were associated with tobacco use, compared with the respective populations. The increased prevalence of tobacco use among construction artisans is noteworthy, and few self-reported cases of addiction amongst users demand action from communities and government at all levels. There is need to improved access of artisans to accurate information and tailored messages on dangers of tobacco use. Moreover, smoking and worksite regulations and policies would be needed to curtail the smoking tendencies of these worker

Water, Sanitation and Hygiene Conditions in Kenyan Rural Schools: Are Schools Meeting the Needs of Menstruating Girls?

Water, sanitation and hygiene (WASH) programs in African schools have received increased attention, particularly around the potential impact of poor menstrual hygiene management (MHM) on equity for girls’ education. This study was conducted prior to a menstrual feasibility study in rural Kenya, to examine current WASH in primary schools and the resources available for menstruating schoolgirls. Cross-sectional surveys were performed in 62 primary schools during unannounced visits. Of these, 60% had handwashing water, 13% had washing water in latrines for menstruating girls, and 2% had soap. Latrines were structurally sound and 16% were clean. Most schools (84%) had separate latrines for girls, but the majority (77%) had no lock. Non-governmental organizations (NGOs) supported WASH in 76% of schools. Schools receiving WASH interventions were more likely to have: cleaner latrines (Risk Ratio (RR) 1.5; 95% Confidence Intervals [CI] 1.0, 2.1), handwashing facilities (RR 1.6, CI 1.1, 2.5), handwashing water (RR 2.7; CI 1.4, 5.2), and water in girls’ latrines (RR 4.0; CI 1.4, 11.6). Schools continue to lack essential WASH facilities for menstruating girls. While external support for school WASH interventions improved MHM quality, the impact of these contributions remains insufficient. Further support is required to meet international recommendations for healthy, gender-equitable schools

Self reported health status, and health service contact, of illicit drug users aged 50 and over: a qualitative interview study in Merseyside, United Kingdom

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; The populations of industrialised countries are ageing; as this occurs, those who continue to use alcohol and illicit drugs age also. While alcohol use among older people is well documented, use of illicit drugs continues to be perceived as behaviour of young people and is a neglected area of research. This is the first published qualitative research on the experiences of older drug users in the United Kingdom.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; Semi-structured interviews were conducted in Merseyside, in 2008, with drug users aged 50 and over recruited through drug treatment services. Interviews were recorded and transcribed and analysed thematically. Only health status and health service contact are reported here.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Nine men and one woman were interviewed (age range: 54 to 61 years); all but one had been using drugs continuously or intermittently for at least 30 years. Interviewees exhibited high levels of physical and mental morbidity; hepatitis C was particularly prevalent. Injecting-related damage to arm veins resulted in interviewees switching to riskier injecting practices. Poor mental health was evident and interviewees described their lives as depressing. The death of drug-using friends was a common theme and social isolation was apparent. Interviewees also described a deterioration of memory. Generic healthcare was not always perceived as optimal, while issues relating to drug specific services were similar to those arising among younger cohorts of drug users, for example, complaints about inadequate doses of prescribed medication.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusion:&lt;/b&gt; The concurrent effects of drug use and ageing are not well understood but are thought to exacerbate, or accelerate the onset of, medical conditions which are more prevalent in older age. Here, interviewees had poor physical and mental health but low expectations of health services. Older drug users who are not in contact with services are likely to have greater unmet needs. The number of drug users aged 50 and over is increasing in Europe and America; this group represent a vulnerable, and in Europe, a largely hidden population. Further work to evaluate the impact of this change in demography is urgently needed.&lt;/p&gt

Factors predicting drop out from, and retention in, specialist drug treatment services: A case control study in the North West of England

<p>Abstract</p> <p>Background:</p> <p>In the United Kingdom (UK), the National Treatment Agency for Substance Misuse (NTA) considers retention to be the best available measure of drug treatment effectiveness. Accordingly, the NTA has set local treatment systems the annual target of retaining 75% of clients for 12 weeks or more, yet little assessment of this target or factors that improve retention has occurred. This study aims to quantify the proportion of people retained in treatment for 12 weeks in the North West of England and to identify factors associated with premature drop out.</p> <p>Methods:</p> <p>The North West National Drug Treatment Monitoring System (NDTMS) was used to identify treatment durations for everyone beginning a treatment episode between 1^stApril 2005 and 31^stMarch 2006 (N = 16626). Odds ratios, chi-square and logistic regression analyses compared clients retained for 12 weeks to clients whose discharge record showed they had prematurely dropped out before 12 weeks. Individuals with other outcomes were excluded from analyses.</p> <p>Results:</p> <p>75% of clients (N = 12230) were retained for 12 weeks and 10% (N = 1649) dropped out prematurely. Multivariate analysis showed drop out was more likely among Asian drug users (adjusted odds ratio 1.52, 95% CI 1.12 to 2.08) than their white equivalents. Drop out was more likely among residents of Cumbria and Lancashire (adjusted odds ratio 1.80, 95% CI 1.51 to 2.15) and Greater Manchester (adjusted odds ratio 2.00, 95% CI 1.74 to 2.29) than Cheshire and Merseyside and less likely among alcohol users (adjusted odds ratio 0.73, 95% CI 0.59 to 0.91). A significant interaction between age and deprivation was observed. For those aged 18 to 24 years and 25 to 34 years, drop out was significantly more likely among those living in affluent areas. For those in the older age groups the converse effect was observed.</p> <p>Conclusion:</p> <p>In combination, the drug treatment systems of the North West achieved the Government's retention target in 2005/06. A number of factors associated with drop out were identified; these should be considered in strategies that aim to improve retention. Drop out and retention are measures that capture the joint effect of many factors. Further work is required to evaluate the effect of deprivation.</p