Towards Malaria Control In Nigeria: Review Of Multiple Aetiological Factor

Malaria is a principal cause of morbidity and mortality in the very young children and pregnant women in sub-Saharan Africa. Although Plasmodium falciparum, the most dangerous of the four human malaria parasites, is responsible for infections in the area, other aetiological factors exert a lot of influence on occurrence and transmission of malaria. For malaria to be effectively controlled and prevented, such factors which include environmental, host, vector and parasite factors must be attacked through a multi-pronged approach, in line with the strategies of the Roll Back Malaria initiative. This review highlights the various aetiological factors of malaria, and suggests ways of combating the infection in Nigeria. Key Words: Malaria, aetiological factors, Roll Back Malaria initiative, prevention and control Orient Journal of Medicine Vol.16(2) 2004: 24-3

Tobacco use, determinants and effects on treatment among persons living with HIV/AIDS at a Military Hospital in Makurdi, Benue State, Nigeria

Aim and objective To assess the prevalence, determinants and effects on treatment among persons living with HIV/AIDS at a Military Hospital in Makurdi, Benue State, Nigeria. Methods Study was at a military Hospital, in Benue State. The centre cares for both military and civilian population, with over 98% being civilian clients. Analytical cross-sectional design was used. Patients ≥18 years on care for ≥12 months were studied excluding those with frank psychosis, poor record of CD4 count or viral load, chronic health condition known to interfere with CD4count. Patient’s folder records, Questionnaire and DAST-10 tool were tools used. Ethical clearance and written informed consent were obtained. Results Majority of the patients were aged 31-60 years 61(8.3%) and females 441(63.0%). Prevalence of Tobacco use were 138(19.7%) for ever used and 66(9.4%) for use in past 3 months. Also 114(16.3%) used Tobacco and other substances; 90(12.9%) Alcohol, 73(10.4%) Kola nut, 8(1.1%) Cannabis and 5(0.7%) Cocaine with Tobacco. No statistical significant associations between ever used, use in past 3 months or degree of Tobacco use with Viral load CD4 count. Predictors of use includes; males sex (AOR 0.23; 95% CI 0.15-0.35) and earning <18,000 (AOR 2.23; 95% CI 1.05-4.70). Conclusions Use of Tobacco was high as well as use with other substances. Tobacco use had no effect on CD4 count and viral load. Sex and Family income predicts use of substance. There is serious and urgent need for improved tobacco prevention and control interventions in the country especially among PLWHA

Risk factors for acute otitis media in Nigerian infants

Objective: The risk factors for acute otitis media (AOM) have been well documented in studies mostly conducted in temperate, developed countries. The present study seeks to determine the relevance of five selectedrisk factors in a tropical developing country. Method: A cross-sectional study of two hundred and ten (210) infants was done in Enugu, eastern Nigeria. Their mothers were interviewed with structured questionnaires. Results: The risk for AOM increased more with pacifier use (odds ratio = 1.278) and thumb sucking (odds ratio = 1.258) than with parental smoking (odds ratio = 1.144) and day care attendance (odds ratio = 1.092). Conclusion: It is concluded that primary prevention of AOM may be achieved by strategies that can eliminate or reduce these risk factors since they are potentially modifiable.Keywords: Risk factors, otitis media, Nigerian infants Orient Journal of Medicine Vol. 17 (1&2) 2005: 18-2

Attitude of antenatal patients in Enugu toward HIV screening

Objective: To assess attitude towards antenatal Human Immuno Deficiency Virus (HIV) screening in Enugu, Nigeria.Method: A self-report questionnaire was administered to two hundred and nine women attending antenatal booking clinics at the University of Nigerian Teaching Hospital, Enugu. Results: The mean age was 29.7 years. One hundred and sixty three patients 78.0% were aware of HIV Screenng before booking while 22.0% were not aware at the time of booking. A total of 123 women (58.9%) had previous HIV Screening while the rest (41.1%) accepted the screening for the first time. Educational Level has a significant effect on uptake of HIV test 2 = 8.97, p = 0.003 df = 2 and on the perceived benefit of HIV Screening x2 = 16.6, p = 0.00005 df = 3 but has no significant effect on the awareness of vertical transmission x2 = 0.62, p = 0.43, df = 2. The reason for declining HIV Screening was that AIDS has no known cure, followed by fear of positive result. Conclusion: The awareness and attitude of Nigeria pregnant women towards HIV Screening and uptake of the test is good. Educational level has a significant effect on the uptake and perceived benefit of the test. Antenatal women should be offered routine voluntary counseling and testing. Keywords: antenatal, HIV screening, NigeriaTropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 156-15

Domestic Violence Against Pregnant Nigerian Women

Context:Domestic violence against women is known to be common and violence against pregnant women can create an adverse outcome both for the mother and the fetus. Objectives: To estimate the prevalence of domestic violence against pregnant women in Enugu, Nigeria and to identify the risk factors promoting such violence. Study Design, Setting and Subjects:Trained personnel administered a self-reporting domestic-abuse questionnaire to 409 women attending antenatal clinics at the University of Nigeria Teaching Hospital between May and August 2000. Results:A total of 424 women were attending antenatal clinics at the time of the study, of whom 409 agreed to participate in the study. One hundred and fifty two (37.2%) had a previous history of abuse. Fifty-three women (13.0%) had been abused in the preceding twelve months and 45 (11.0%) during the index pregnancy. Eleven women (2.7%) had been sexually abused in the preceding one year, while 3.4% reported being afraid of their husbands. The risk factors for being the victim of domestic abuse, in descending order of magnitude, were financial problems (17.7%), having only female children (11.1%), unplanned pregnancy (8.8%), unemployment (4.4%) and previous caesarean section (4.4%). Conclusion:Prevalence of domestic violence was high among Nigerian pregnant women. Routine screening of prenatal women for domestic violence should be introduced during antenatal care. Key Words: Domestic Violence, Pregnancy, Partners, Screening [Trop J Obstet Gynaecol, 2003, 20: 116-118

Awareness and knowledge of disease surveillance and notification by health‑care workers and availability of facility records in Anambra state, Nigeria

Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases, personnel, and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health‑care workers about DSN, and availability of facility records in Anambra State, Nigeria. Materials and Methods: The study was a descriptive cross‑sectional one in which relevant data were collected from health‑care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews, whereas an observational checklist, preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8% of the health‑care workers were aware of the DSN system, only 33.3, 31.1, and 33.7% of them knew the specific uses of forms IDSR 001, IDSR 002, and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response), respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low, although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health‑care facilities. HMIS forms were less likely to be available in secondary health‑care facilities (χ2=7.67, P=0.005). Conclusions: Regular training and retraining of concerned health‑care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms, copies of the standard case definitions, and other necessary logistics to the health‑care facilities by the local and state governments.Keywords: Awareness, disease surveillance and notification, facility records, knowledgeNigerian Medical Journal | Vol. 53 | Issue 4 | October-December | 201

Disparities in tobacco use by adolescents in southeast, Nigeria using Global Youth Tobacco Survey (GYTS) approach

Abstract Background Tobacco use during adolescence is a substantial problem and adolescents are at higher risk of addiction and prolonged use. To reduce the burden of tobacco-related morbidity and mortality, monitoring of adolescent tobacco use is imperative. We aimed to determine the prevalence of tobacco use among adolescents in urban and rural secondary schools in Enugu State, southeast Nigeria. Methods A cross-sectional study of 4332 adolescents in 8th to 10th grades in 25 urban and 24 rural secondary schools in Enugu, Nigeria was done using Global Youth Tobacco Survey (GYTS) methodology. Students were asked about previous and current tobacco use, smoking cessation, and susceptibility to smoking initiation among non-smokers. Geographical, age and sex prevalence differences were examined. Analyses were performed for all adolescents (10–19 years) and for a subset of students, 13–15 years of age for comparison with previous GYTS surveys. All analyses were weighted to account for the complex survey design and for differential non-response at school, class and student levels. Results About 28.9% of students reported ever smoking cigarettes; 19.4% reported current tobacco use among all adolescents (13.3, 5.8 and 7.8% for cigarettes, other smoked tobacco, and smokeless tobacco, respectively) while 18.6% reported current tobacco use among 13–15 year olds (12.6, 5.2 and 7.5% for cigarettes, other smoked tobacco and smokeless tobacco respectively). Prevalence of all types of tobacco use was higher in rural schools (vs. urban schools), and among boys (vs. girls). Susceptibility to smoking initiation among non-smokers was 9.3% (95% CI: 8.1–10.7) among all adolescents, and 9% (95% CI: 7.6–10.7) among 13–15 year olds. About 88.1% of all adolescent smokers desired to quit and 57.9% of them had never received help to quit smoking. Conclusions Nearly one in every five school-going adolescents currently uses at least one type of tobacco in Enugu State, southeast Nigeria. Prevalence of tobacco use is higher in rural schools and among boys in this setting. Most adolescent current smokers desire to quit and need smoking cessation support