Catastrophic Health Expenditure and Impoverishment from Non- Communicable Diseases: A comparison of Private and Public Health Facilities in Ekiti State, Southwest Nigeria

Background: Catastrophic health expenditure and impoverishment are the outcomes of poor financing mechanisms. Little is known about the  prevalence and predictors of these outcomes among non-communicable disease patients in private and public health facilities. Methods: A health facility-based comparative cross-sectional study was conducted among 360 patients with non-communicable diseases (180 per  group) selected through multistage sampling. Data were collected with a semi-structured, intervieweradministered questionnaire and analyzed with  IBM SPSS for Windows, Version 22.0. Two prevalences of catastrophic health expenditure were calculated utilizing both the World Bank (CHE1)  and the WHO (CHE2) methodological thresholds. Results: The prevalence of CHE1 (Private:42.2%, Public:21.7%, p<0.001) and CHE2 (Private:46.8%, Public:28.0%, p<0.001) were higher in private  health facilities. However, there was no significant difference between the proportion of impoverishment (Private:24.3%, Public:30.9%, p=0.170). The  identified predictors were occupation, number of complications and clinic visits for catastrophic health expenditure and socioeconomic status for  impoverishment in private health facilities. Level of education, occupation, socioeconomic status, number of complications and alcohol predicted  catastrophic health expenditure while the level of education, socioeconomic status and the number of admissions predicted impoverishment in  public health facilities. Conclusion: Catastrophic health expenditure and impoverishment were high among the patients, with the former more prevalent in private health  facilities. Therefore, we recommend expanding the coverage and scope of national health insurance among these patients to provide them with  financial risk protection. Identified predictors should be taken into account by the government and other stakeholders when designing policies to  limit catastrophic health expenditure and impoverishment among them.&nbsp

Practice of Safety Measures among Inter-City Commercial Vehicle Drivers in Kwara State, Nigeria

Background: The incidence of Road Traffic Crashes (RTC) is rising world-wide, with 1.24 million people killed on the world’s roads in 2010 due to non-compliance with safety measures.The objectives of the study was to determine the practice of safety measures and prevalence of road crashes among inter-city commercial vehicle drivers in Kwara State, Nigeria.Materials and Methods: It was a descriptive cross-sectional study done by interviewer administered questionnaire and blood alcohol concentration of respondents was determined using Breathalyzers. A total of 410 respondents were involved by multi-stage sampling technique and data analysis was done using EPI INFO version 3.5.1 software package. An appropriate test of significance were used and the level of significance was < 0.05 at 95% confidence level.Results: There was statistically significant p = 0.057 relationship in good safety practices among drivers in the age group 26-55 years compared with those ≤ 25 years and > 55 years. More respondents who practiced safety measures carried out driving test before issuance of license compared with those who did not (p = 0.001). Some respondents tested positive for alcohol and the mean blood alcohol concentration was 23.28± 23.32µg/dl. About a third of the respondents had experienced road traffic crashes in the past.Conclusion: The middle age respondents had good safety practices compared with others. Safety practices were influenced by driving test before issuance of license and alcohol intake was a factor in RTC. Orientation of drivers and enforcement of laws are critical in road safety

Mapping knowledge management resources of maternal, newborn and child health (MNCH) among people living in rural and urban settings of Ilorin, Nigeria

Introduction: Lack of access to information and knowledge about mother and child health was identified as a major contributor to poor maternal and child health in Nigeria. The Partnership for Maternal, Newborn and Child Health (PMNCH) has recognized mapping the knowledge management of Maternal Newborn and Child Health (MNCH) as one of the major strategies to be deployed in improving the health of these vulnerable groups. The main aim of this study is to map the knowledge management resources of  Maternal, Newborn and Child Health (MNCH) in rural and urban settings of Ilorin West LGA of Kwara state Nigeria. Methods: It is a descriptive cross-sectional study with a comparative analysis of findings from urban and rural settings. Epi-mapping was used to carve out the LGA and map responses. The p-value of less than 0.05 was considered significant at 95% confidence level.Results: The study showed that  traditional leader was responsible for more than half of the traditional way of obtaining information by rural (66.7%) and urban (56.2%) respondents while documentation accounts for the main MNCH knowledge preservation for the rural (40.6%) and the urban (50%) dwellers. Traditional leaders (32.2%) and elders (46.7%) were the main people responsible for dissemination of knowledge in rural areas whereas elders (35.9%) and Parents (19.9%) were the main people responsible in urban areas.Conclusion: It was concluded that traditional and family institutions are important in the knowledge management of MNCH in both rural and urban settings of Nigeria.Key words: Maternal, child, newborn, knowledge management, mapping

Molecular detection of Human Papillomavirus from abnormal cervical cytology of women attending a tertiary health facility in Ido-ekiti, Southwest Nigeria

ABSTRACTBackground: Human papillomavirus (HPV) has been implicated as one of the principal causes of cervical cancer, which is the second highest cause of cancer deaths among Nigerian women. Objective: This study was aimed at determining the presence of HPV DNA in abnormal cervical cytology of a group of women who were screened using Papanicolaou staining technique.Methodology: A total of 200 women attending the Obstetrics and Gyneacology clinic of Federal Teaching Hospital, Ido-Ekiti were screened using the convectional Pap smear screening, while positive samples were subjected to molecular analyses using DNA isolation techniques and polymerase chain reaction (PCR).Result: Results revealed that 14 (7%) of the subjects were positive for abnormal cytology. Abnormalities found among the subjects included; low grade squamous intraepithelial lesions (LSIL) which constituted 50 % of the total abnormal smears, high grade squamous intraepithelial lesion (HSIL) and atypical squamous cells of undetermined significance (ASCUS) which were 28.6% and 21.4% respectively. Results of molecular analyses showed that all the samples from abnormal cervical cytology subjected to HPV DNA extraction and gene amplification all contained the HPV DNA.Conclusion: The high prevalence of HPV DNA in abnormal cytology, gives credence to the fact that HPV presence is a critical indicator in the development of cervical cancer, thus more efforts should be put into vaccine production and distribution to reduce the incidence of cervical cancer in Nigeria Keywords: Cervical, cytology, DNA, molecular, wome

Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria

Introduction: Unintended pregnancy and unsafe abortion pose a major reproductive health challenge to adolescents. Emergency contraception is safe and effective in preventing unplanned pregnancy. The objective of this study was to assess the student's knowledge and use of emergency contraception. Methods: This cross-sectional study was carried out in Ilorin, Nigeria, using multi-stage sampling method. Data was collected using pre-tested semi-structured self-administered questionnaire. Knowledge was scored and analysed. SPSS version 21.0 was used for data analysis. A p-value <0.05 was considered statistically significant. Results: 27.8% of the respondents had good knowledge of emergency contraception. Majority of respondents (87.2%) had never used emergency contraception. Majority of those who had ever used emergency contraception (85.7%) used it incorrectly, using it more than 72 hours after sexual intercourse (p=0.928). Conclusion: Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents.Pan African Medical Journal 2016; 2

Pattern of Blood Component Request and Utilization in a Tertiary Hospital in Nigeria

Background: Blood transfusion being a life‑saving procedure plays a vital role in the management of patients in the clinical practice. The challenges of inadequate voluntary blood donors and poor storage facilities made availability of sufficient safe blood difficult in developing countries. All efforts should therefore be put in place to ensure judicious use of the available blood by separating each unit of blood donated into components and giving individual patient only the required blood component rather than giving whole blood. Aim: This study was conducted to look into the pattern of blood components request and utilization in a tertiary hospital in Nigeria to assess its effectiveness in reducing blood wastage. Materials and Methods: This is a hospital‑based retrospective study. Blood Bank registers for blood component request and utilization were analyzed over a period of 20 months. Units of blood products requested and units used were considered during this period with emphasis on request to transfusion ratio. Results: Highest blood product request was from pediatrics ward. Total blood product request for male was higher than for female. Highest blood product request was packed cell with request to transfusion ratio of 1.01, followed by fresh‑frozen plasma, request to transfusion ratio 1.0 and platelet, request to transfusion ratio 1.14. Conclusion: Appropriate blood product request maximizes utilization, minimizes wastage, thereby increasing efficiency of the blood bank staff by reducing the unnecessary workload of cross matching, issuing of blood and wastage of reagents

Psychological, Socioeconomic Effects of COVID-19 Pandemic and Associated Prevalent Self-Reported Vulnerability Factors among Residents of Southwest Nigeria

Background: Infectious diseases wrecked havoc in global economies, especially when outbreak or pandemic occurs. The present  COVID‑19 pandemic has not only caused disruption to global activities but also of businesses, trades, movements, and academic activities. Southwest Nigeria has the highest burden of COVID‑19 of all the six geopolitical zones in the country. This study, therefore, aims at determining the psychological, socioeconomic effect of COVID‑19 pandemic and associated vulnerability factors among residents of Southwest Nigeria.Methods: This survey is a cross‑sectional study in the six southwest states of Nigeria via Google questionnaire sent electronically to obtaininformation from respondents. Targeted sampling and snowball techniques were used to reach the respondents. Data were analyzed using SPSS 23, and the level of statistical significance was at P < 0.05. Results: The mean age of the respondents is 32.89 ± 9.59 years and age range of 16–57 years. Majority of the respondents were males, married with tertiary education. Majority (83.9%) of the respondents have severe psychological effects, 78.2% have their family income affected, while diabetes, asthma, cardiovascular diseases, cancers,  previous contact with a confirmed case and travel history outside Nigeria were among the self‑reported vulnerable factors of COVID‑19.  Conclusion: The study concluded that the psychological and economic effects of COVID‑19 are high in Southwest Nigeria and major self‑reported vulnerable factors include cardiovascular diseases, diabetes, asthma, and cancers. Scale‑up of public awareness,  subsidization of personal protective equipment, and financial stimulus are recommended measures against the disease. Keywords: COVID‑19, effect, Nigeria, vulnerabilit

Determination of Normal and Variant Hemoglobin using Capillary Electrophoresis among Voluntary Blood Donors in North Central Nigeria: Implications on Blood Transfusion Services

Background: Voluntary non-remunerated blood donation is a strategy adopted by World Health Organization aimed at ensuring safety and adequacy of blood supply. Sub-Saharan Africa has a high prevalence of hemoglobin disorders and therefore needs to adopt stringent measures in donor selection to ensure safety for the recipient of blood transfusion. This study aimed to analyze normal and variant hemoglobin among voluntary blood donors. Methods: In this descriptive cross-sectional study, 100 prospective blood donors including 55 (55%) males and 45 (45%) females, aged 18–34 years were recruited. Capillary electrophoresis using the Minicap system was used for determining the hemoglobin variants in alkaline buffer (PH 9.4). Data analysis was done using SPSS version 20 and p-value < 0.05 was considered as the level of significance Results: The mean age of the participants was 22.23 ± 3.3 SD years. The proportion of participants with genotype AA was 67 (67%), those with AS were 17 (22 %), while those with AC were 11 (11 %). While Hb A ≥ 90% was noted in 67 (67%) blood donors, Hb S was seen in 22 (22%) and Hb A2 > 3.5% in 57 (57%). Hb F > 2% was observed in 3% of the studied participants Conclusion: Variant hemoglobin is common among blood donors and this should be taken into consideration whenever blood is being crossmatched for recipients of blood transfusion. Data from this study will be useful in raising awareness and genetic counseling. Keywords: prevalence, hemoglobin variants, capillary electrophoresi

Pattern of utilization of ante-natal and delivery services in a semi-urban community of North-Central Nigeria.

Background: Nigeria accounts for only 2% of the world\u2019s population, but contributes up to 10 % of the global estimates of maternal deaths. The study assesses the utilization of antenatal and delivery services by women of reproductive age in Afon community. Methodology: It was a descriptive cross-sectional study that collected both quantitative and qualitative data using semi-structured interviewer administered questionnaire and focus group discussions (FGD). Interviews were house-hold based. FGD had two homogenous groups. Data was analysed using Epi-info version 3.5.1 software package. Level of statistical significance was set at p <0.05. Results: There was a high level of utilization of antenatal/delivery services in the community. Barriers to utilization of ANC/ delivery services include lack of money, distance from health facility, long waiting time, poor attitude of health workers and no permission from husbands. Level of education and employment status were significantly associated with utilization of ANC/ delivery services. Conclusion: Girl- child education and women empowerment are required to improve utilization of services. Ante-natal care providers need to be trained to improve quality of care in the discharge of their duties

Adherence to combined Antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria

Introduction: this study aims to assess the treatment adherence rate among People Living With HIV/AIDS (PLWHA) receiving treatment in a Nigerian tertiary Hospital. Methods: this was a cross-sectional study that assessed self-reported treatment adherence among adults aged 18 years and above who were accessing drugs for the treatment of HIV. Systematic random sampling method was used to select 550 participants and data were collected by structured interviewer administered questionnaire. Results: the mean age of respondents was 39.9±10 years. Adherence rate for HIV patients was 92.6%. Factors affecting adherence include lack of money for transportation to the hospital (75%), traveling (68.8%), forgetting (66.7%), avoiding side effects (66.7%), and avoiding being seen (63.6%). Conclusion: the adherence rate was less than optimal despite advancements in treatment programmes. Adherence monitoring plans such as home visit and care should be sustained