Traditional societies and social change in Nigeria: a study of Ekpe among the people of Cross River State

The paper critically examined the Ekpe society in its indigenous form and nature prior the advent of Christianity, Western education and Western influence. It described the religion, social, economic and political structures of the society as progressive and dynamic. But, Ekpe in the course of the colonial period underwent a wide range of fundamental changes in their structure, roles, status and activities. The attitude of colonial agencies, the tenets of colonial enterprise – Christianity, Western education and commerce and the pursuit of these tenets as well as some activities of the societies themselves, conduced inevitably to a series of measures adopted by colonial authorities to suppress the societies in question. The acts of suppression altered the pattern of relationship of these societies to their communities and people by altering (diminishing) their roles, status and activities. The aim of this paper is to examine the role and activities of this society, its confrontation with colonial authorities as well as its contemporary standing. Essentially, this is an examination of the themes of change and continuity. The methodology adopted in the course of researching is the primary and secondary sourcesKeywords: Traditional Societies, Social Change, Ekpe, Cross River Stat

Profitability of snail marketing in Benin Metropolis, Edo State, Nigeria

The study examined the profitability of snail marketing in Benin metropolis, Edo state, Nigeria. Random sampling procedure was used to select 60 respondents from selected markets in the study area. Structured questionnaire and interview schedule were used to collect primary data from the respondents. The data were analyzed using descriptive statistics, market margin, gross margin and marketing efficiency ratio. The results showed that marketing of snail in Benin metropolis was predominantly a female activity. The result also shows that 44.9% of the respondents were above 50 years of age. Majority (58.3%) of the respondents had household size of five or less than five persons. The predominant channel of distribution for snail marketers was from hunters/producers, to wholesalers, to retailers and finally to the consumers. Snail marketing was found to be profitable with the marketers making a gross margin of ₦3,255.90 per 196 small size snails sold in the study area per week. Some of the constraints faced by the marketers were high cost purchase, high cost of transportation and inadequate storage facilities. It was recommended from the findings of the study among others, that snail marketers should form cooperative societies so as to tackle the problem associated with high cost of purchase.Keywords: marketing margin, gross margin, marketing efficiency ratio, snai

Plasmodium falciparum malaria and antimalarial interventions in sub-Saharan Africa: Challenges and opportunities

Plasmodium falciparum malaria is one of the most important parasitic diseases affecting sub-Saharan Africa, despite the availability of interventions. It exerts tremendous socio-economic and medical burden on the continent, particularly in under five children and pregnant women. In this review, we have attempted to highlight the problems, constraints and the opportunities that are available for effective prevention and control within the region

Profile of Antimicrobial Drug Use Patterns in a Nigerian Metropolitan City

Purpose: To evaluate self-medication practices and prescribing patterns of antimicrobial agents. Methods: The study was carried out in Port Harcourt, Nigeria in 6 hospitals/clinics, 4 community pharmacies and the campus of University of Port Harcourt. 1,200 case files or charts of outpatients treated at the selected hospitals/clinics were reviewed for relevant information. Thereafter, independent physician assessors evaluated the “appropriateness” of antimicrobial prescribing. The antibiotic self-medication practices were assessed at the university campus and selected community pharmacies. Results: Metronidazole, ampicillin/cloxacillin (19%), amoxicillin (16%) and co-trimoxazole (12%) were the most frequently prescribed antimicrobials. Malaria (21%), followed by upper respiratory tract infection (19%), were the most frequent medical conditions in which antimicrobials were used. Over onehalf (56%) of the antimicrobial prescriptions were considered “appropriate” by the physician assesors; 23% of the cases “inappropriate”, while in 17% and 4% of cases, there were disagreement and query, respectively. There was a significant difference in the patterns of antimicrobial prescribing by physicians at both public and private hospitals, (χ2 = 16.808, df = 3, P< 0.01). Cough (20%), stomach upset (20%) and boils (20%) were the most frequent conditions in which the respondents self-medicated with antimicrobials. Ampicillin (23%), co-trimoxazole (17%) and tetracycline (16%) were the frequently used antimicrobial agents. Conclusion: Antimicrobial drug use was common. Sometimes, the agents were inappropriately used by the public and private health facilities as well as members of the public through self-medication.Keywords: Antimicrobial drug, Prescribing patterns, Self-medication, Surve

Patients’ Assessment of Pharmacists’ Medication Counseling in a Psychiatric Hospital in Nigeria

Purpose: To assess the impact of an educational intervention on pharmacists’ medication counselling practice, and evaluate the reliability of an instrument to assess medication counselling in a psychiatric setting.Methods: The study was undertaken on a sample of 297 psychiatric patients. Pre- and post-intervention surveys were conducted immediately after the patients had been attended to at the hospital’s outpatient pharmacy, using a self-administered questionnaire, comprising 4 components. Internal consistency of the questionnaire was computed using Cronbach’s alpha. Differences between means or proportions of variables were evaluated using Student’s t-test or Chi-square test, as appropriate.Results: The study achieved a response rate of 89 and 92 % for pre– and post–intervention surveys, respectively. Cronbach’s alpha reliability of the instrument was found to be 0.74. The mean values for the different components evaluated during the pre- and post–intervention surveys were: Needs assessment, 1.89± 0.76 and 2.58 ± 0.61; Precaution and warning, 1.50 ± 0.67 and 2.15 ± 0.63; Managing therapy, 1.87 ± 0.89 and 2.46 ± 0.78, and Communication, 2.23 ± 0.77 and 2.69 ± 0.62, respectively. The post–intervention results were significantly higher in all the components (p < 0.05). Conclusion: The educational intervention provided for pharmacists resulted in an improvement in patient counselling. The survey instrument achieved a fairly satisfactory reliability result in a psychiatric setting. Efforts to sustain this intervention are recommended.Keywords: Assessment, Patient counselling, Pharmacists, Psychiatric settin

Assessment of Knowledge, Interventional Practices for, and Impact of Malaria in Pregnancy among Parturient Women in a Nigerian Tertiary Healthcare Facility

Purpose: To assess knowledge of and intervention for malaria in pregnancy among immediate postpartum women, as well as the impact of malaria on some specific birth outcomes.Methods: A cross-sectional study in which 358 immediate postpartum women were recruited in the labour and maternity wards of University Benin Teaching Hospital, Benin City, Nigeria. Information on demographics, knowledge of malaria, and utilization of malaria interventions were assessed. Immediately after expulsion of placentae, both maternal and placental blood samples were collected from a subset (236) of the study group for parasitaemia and haematocrit determination.Results: The mean age of the women was 29.5 ± 4.55 years. Poor knowledge of adverse effects of malaria during pregnancy was observed. Using an arbitrary scale, low, average and high knowledge of malaria were recorded in 22.4, 50.3 and 27.3 % of the respondents, respectively. Use of insecticidetreated net (ITN) was reported by 48.9, 19.1 and 14.3 % of women with high, average and low knowledge of malaria respectively (p = 0.004) while there was no statistical difference in the use of sulphadoxine/pyrimethamine (IPTp-SP) among the different levels of knowledge of malaria as its practice was reported by 61, 70 and 78.7 % of women with high, average, and low knowledge of malaria, respectively, (p = 0.078). Incidence rates of parasitaemia of 4.0, 1.6 and 6.25 % were obtained using peripheral microscopy, placental microscopy and peripheral rapid diagnostic test (RDT), respectively. Maternal infection was significantly associated with low birth weight (p = 0.020, peripheral microscopy; p = 0.020, placental microscopy) and maternal anaemia (p = 0.009, peripheral microscopy; p = 0.000, peripheral RDT).Conclusion: Knowledge gap still exists with regard to malaria and its interventions among mothers. Knowledge of malaria significantly influences the use of insecticide-treated bed nets. The negative impact of malaria infection during pregnancy is maternal anaemia and low birth weight infants.Keywords: Insecticide-treated bed nets, Low birth weight, Malaria in pregnancy, Maternal anaemia

Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

<p>Abstract</p> <p>Background</p> <p>There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among women of child bearing age.</p> <p>Methods</p> <p>1105 women of child bearing age were interviewed in their households using a structured questionnaire about their knowledge of malaria in general, MIP and use of preventive measures. Thereafter, a peer education campaign was launched to raise the level of knowledge in the community. The interviews were repeated after the campaign and the responses between the pre- and post-intervention were compared.</p> <p>Results</p> <p>In the pre-assessment women on average answered 64.8% of the question on malaria and its possibility to prevent malaria correctly. The peer education campaign had a significant impact in raising the level of knowledge among the women; after the campaign the respondents answered on average 73.8% of the questions correctly. Stratified analysis on pre and post assessment scores for malaria in general (68.8 & 72.9%) and MIP (61.7 & 76.3%) showed also significant increase. Uptake of bed nets was reported to be low: 11.6%</p> <p>Conclusion</p> <p>Peer education led to a significant increase in knowledge of malaria and its prevention but we could not asses its influence on the use of preventive measures.</p

Evidence of superficial knowledge regarding antibiotics and their use: Results of two cross-sectional surveys in an urban informal settlement in Kenya

<div><p>We assessed knowledge and practices related to antibiotic use in Kibera, an urban informal settlement in Kenya. Surveys was employed at the beginning (entry) and again at the end (exit) of a 5-month longitudinal study of AMR. Two-hundred households were interviewed at entry, of which 149 were also interviewed at exit. The majority (>65%) of respondents in both surveys could name at least one antibiotic, with amoxicillin and cotrimoxazole jointly accounting for 85% and 77% of antibiotics mentioned during entry and exit, respectively. More than 80% of respondents felt antibiotics should not be shared or discontinued following the alleviation of symptoms. Nevertheless, 66% and 74% of respondents considered antibiotics effective for treating colds and flu in the entry and exit surveys, respectively. There was a high (87%, entry; 70% exit) level of reported antibiotic use (past 12 months) mainly for colds/flu, coughs and fever, with >80% of respondents obtaining antibiotics from health facilities and pharmacies. Less than half of respondents remembered getting information on the correct use of antibiotics, although 100% of those who did reported improved attitudes towards antibiotic use. Clinicians and community pharmacists were highly trusted information sources. Paired household responses (n = 149) generally showed improved knowledge and attitudes by the exit survey although practices were largely unchanged. Weak agreement (κ = -0.003 to 0.22) between survey responses suggest both that unintended learning had not occurred, and that participant responses were not based on established knowledge or behaviors. Targeted public education regarding antibiotics is needed to address this gap.</p></div

Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Intermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake.</p> <p>Methods</p> <p>A cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic random sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State, Nigeria. Information on knowledge of IPT, delivery, adherence and acceptability was obtained using an interviewer administered questionnaire. Descriptive statistics such as means, range, proportions were used. Chi-square test was used to examine association between categorical variables. All analyses were performed at 5% level of significance.</p> <p>Results</p> <p>One hundred and nine of 209 (52.2%) respondents have heard about IPTp but only 26 (23.9%) were able to define it. Fifty seven (27.3%) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp (52.3%). Twenty one of the 57 (36.8%) took the SP in the clinic. Only three of the twenty-one (14.3%) were supervised by a health worker. Twenty two of the 36 women (61.1%) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups. Almost half (43.9%) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies. Periodic shortages of SP in the clinics were also reported.</p> <p>Conclusion</p> <p>In this study, IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Concerted effort should be made to increase awareness of IPTp among the public especially women of child bearing age. Health workers should also be trained and monitored to ensure adherence.</p

Social and Cultural Factors Affecting Uptake of Interventions for Malaria in Pregnancy in Africa: A Systematic Review of the Qualitative Research

Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management. Besides their clinical efficacy, the effectiveness of these interventions depends on the attitudes and behaviours of pregnant women and the wider community, which are shaped by social and cultural factors. Although these factors have been studied largely using quantitative methods, qualitative research also offers important insights. This article provides a comprehensive overview of qualitative research on social and cultural factors relevant to uptake of MiP interventions in sub-Saharan Africa.A systematic search strategy was employed: literature searches were undertaken in several databases (OVID SP, IS Web of Knowledge, MiP Consortium library). MiP-related original research, on social/cultural factors relevant to MiP interventions, in Africa, with findings derived from qualitative methods was included. Non-English language articles were excluded. A meta-ethnographic approach was taken to analysing and synthesizing findings. Thirty-seven studies were identified. Fourteen concentrated on MiP. Others focused on malaria treatment and prevention, antenatal care (ANC), anaemia during pregnancy or reproductive loss. Themes identified included concepts of malaria and risk in pregnancy, attitudes towards interventions, structural factors affecting delivery and uptake, and perceptions of ANC.Although malaria risk is associated with pregnancy, women's vulnerability is often considered less disease-specific and MiP interpreted in locally defined categories. Furthermore, local discourses and health workers' ideas and comments influence concerns about MiP interventions. Understandings of ANC, health worker-client interactions, household decision-making, gender relations, cost and distance to health facilities affect pregnant women's access to MiP interventions and lack of healthcare infrastructure limits provision of interventions. Further qualitative research is however required: many studies were principally descriptive and an in-depth comparative approach is recommended