Rural-urban differences on the rates and factors associated with early initiation of breastfeeding in Nigeria: further analysis of the Nigeria demographic and health survey, 2013

Background This study investigates and compares the rates and factors associated with early initiation of breastfeeding (EIBF) within one hour of birth in rural and urban Nigeria. Methods Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were analyzed. The rates of EIBF were reported using frequency tabulation. Associated factors were examined using Chi-Square test and further assessed on multivariable logistic regression analysis. Results The rates of EIBF were 30.8% (95% confidence interval [CI] 29.0, 32.6) and 41.9% (95% CI 39.6, 44.3) in rural and urban residences, respectively (p < 0.001). The North-Central region had the highest EIBF rates both in rural (43.5%) and urban (63.5%) residences. Greater odds of EIBF in rural residence were significantly associated with higher birth order (Adjusted Odds Ratio [AOR] 1.29, 95% CI 1.10, 1.60), large birth size (AOR 1.33, 95% CI 1.10, 1.60), and health facility delivery (AOR 1.46, 95% CI 1.23, 1.72). Rural mothers in the rich wealth index, not working and whose husbands obtained at least a secondary school education had significantly higher odds of early initiation of breastfeeding. Regardless of residence, greater odds of EIBF were significantly associated with non-cesarean delivery (Rural AOR 3.50, 95% CI 1.84, 6.62; Urban AOR 2.48, 95% CI 1.60, 3.80) and living in North-Central (Rural AOR 1.84, 95% CI 1.34, 2.52; Urban AOR 4.40, 95% CI 3.15, 6.15) region. Also, higher odds of EIBF were significantly associated with living in North-East (Rural AOR 1.48, 95% CI 1.05, 2.08; Urban AOR 3.50, 95% CI 2.55, 4.83), South-South (Rural AOR 1.51, 95% CI 1.11, 2.10; Urban AOR 2.84, 95% CI 2.03, 3.97) and North-West (Urban residence only AOR 2.08, 95% CI 1.54, 2.80) regions. Conclusions Rural-urban differences in the rates and factors associated with EIBF exist in Nigeria with rural residence having significantly lower rates. Intervention efforts which address the risk factors identified in this study may contribute to improved EIBF rates. Efforts need to prioritize rural mothers generally, (particularly, those in rural North-West region) as well as mothers in urban South-West region of Nigeria

Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis

Background Healthcare workers (HCWs) are at risk of occupational exposure to blood-borne pathogens through contact with human blood and other body fluids. This study was conducted to estimate the global and regional 1-year prevalence of percutaneous injuries (PCIs) among HCWs. Methods We systematically searched EMBASE, PubMed, CINAHL and PsychInfo databases for studies published from January 2008 to January 2018 that reported the prevalence of PCIs among HCWs. A random-effects meta-analysis was conducted to estimate pooled prevalence of PCIs among HCWs. Results Of the 5205 articles identified, 148 studies from 43 countries met the inclusion criteria. The pooled global 1-year prevalence estimate of PCIs was 36.4% [95% confidence interval (CI): 32.9–40.0]. There were substantial regional variations in the 1-year prevalence of PCIs, ranging from 7.7% (95% CI: 3.1–12.4) in South America to 43.2% (95% CI: 38.3–48.0) in Asia. The estimates for Africa and Europe were comparable with values of 34.5% (95% CI: 29.9–39.1) and 31.8% (95% CI: 25.0–38.5), respectively. The highest 1-year prevalence by job category was among surgeons, at 72.6% (95% CI: 58.0–87.2). The estimates for medical doctors (excluding surgeons), nurses (including midwives) and laboratory staff (including laboratory technicians) were 44.5% (95% CI: 37.5–51.5), 40.9% (95% CI: 35.2–46.7) and 32.4% (95% CI: 20.9–49.3), respectively. PCIs commonly occurred among HCWs working in hospital (41.8%, 95% CI: 37.6–46.0) than non-hospital (7.5%, 95% CI: 5.9–9.1) settings. Conclusions Our findings suggest high rates of PCIs among HCWs with direct patient care across many regions of the world. However, paucity of data from some countries was a major limitation

Global access to antibiotics without prescription in community pharmacies: a systematic review and meta-analysis

Objective: To estimate the proportion of over-the-counter antibiotic requests or consultations that resulted in non-prescription supply of antibiotics in community pharmacies globally. Methods: We systematically searched EMBASE, Medline and CINAHL databases for studies published from January 2000 to September 2017 reporting the frequency of non-prescription sale and supply of antibiotics in community pharmacies across the world. Additional articles were identified by checking reference lists and a Google Scholar search. A random effects meta-analysis was conducted to calculate pooled estimates of non-prescription supply of antibiotics. Results: Of the 3302 articles identified, 38 studies from 24 countries met the inclusion criteria and were included in the review. All the included countries with the exception of one, classified antibiotics as prescription-only medicines. The overall pooled proportion of non-prescription supply of antibiotics was 62% (95% CI 53 – 72). The pooled proportion of non-prescription supply of antibiotics following a patient request was 78% (95% CI 59 - 97) and based on community pharmacy staff recommendation was 58% (95% CI 48 – 68). The regional supply of non-prescription antibiotics was highest in South America, 78% (95% CI 72 - 84). Antibiotics were commonly supplied without a prescription to patients with symptoms of urinary tract infections (68%, 95% CI 42 – 93) and upper respiratory tract infections (67%, 95% CI 55 - 79). Fluoroquinolones and Penicillins respectively were the most commonly supplied antibiotic classes for these indications. Conclusion: Antibiotics are frequently supplied without prescription in many countries. This overuse of antibiotics could facilitate the development and spread of antibiotic resistance

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey

Aim: The aim of this study was to assess the rural–urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural–urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. Results: In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively (p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it. Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study

An evaluation of the impact of Nigeria's trade and investment policy reforms

No Abstract

Hematological profile of Plasmodium falciparum infected patients in Ile- Ife southwest, Nigeria

Hematological profile of Plasmodium falciparum infected patients in Ile- Ife, southwest Nigeria was analyzed across 60 blood samples. Forty of these samples were from confirmrd P. falciparum infected patients attending outpatient clinic at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, while 20 were from apparently healthy individuals not infected with malaria parasites (control). Standard methods were used to determine the haematocrit, erythrocytes sedimentation rate (ESR), plasma and whole blood viscosity and fibrinogen concentration (clot weight). There were statistically significant differences between the mean &#177; SD of infected and control subjects in the haematocrit levels (32.58&#177;8.10 and 42.90&#177;7.76) respectively ERS (24.38&#177;3.00 and 8.20&#177;1.91) and plasma fibrinogen concentration (5.09&#177;1.23 and 3.16&#177;0.73) (p&lt;0.05). The differences in the mean &#177; SD of whole blood viscosity (6.50&#177;0.80 and 5.57&#177;1.42) and mean of plasma viscosity for the control and infected subjects were not statistically significant (p&gt;0.05). The above results showed that Plasmodium falciparum infected patients are at risk of thrombosis.Keywords: Plasmodium falciparum, blood, Hematological, malariaInternational Journal of Natural and Applied Sciences, 6(2): 236-238, 201