Quality of care for the treatment for uncomplicated malaria in South-East Nigeria: how important is socioeconomic status?

Introduction: Ensuring equitable coverage of appropriate malaria treatment remains a high priority for the Nigerian government. This study examines the health seeking behaviour, patient-provider interaction and quality of care received by febrile patients of different socio-economic status (SES) groups. Methods: A total of 1642 febrile patients and caregivers exiting public health centres, pharmacies and patent medicine dealers were surveyed in Enugu state, South-East Nigeria to obtain information on treatment seeking behaviour, patient-provider interactions and treatment received. Socioeconomic status was estimated for each patient using exit survey data on household assets in combination with asset ownership data from the 2008 Nigeria Demographic and Health Survey. Results: Among the poorest SES group, 29% sought treatment at public health centres, 13% at pharmacies and 58% at patent medicine dealers (p < 0.01). Very few of those in the richest SES group used public health centres (4%) instead choosing to go to pharmacies (44%) and patent medicine dealers (52%, p < 0.001). During consultations with a healthcare provider, the poorest compared to the richest were significantly more likely to discuss symptoms with the provider, be physically examined and rely on providers for diagnosis and treatment rather than request a specific medicine. Those from the poorest SES group were however, least likely to request or to receive an antimalarial (p < 0.001). The use of artemisinin combination therapy (ACT), the recommended treatment for uncomplicated malaria, was low across all SES groups. Conclusions: The quality of malaria treatment is sub-optimal for all febrile patients. Having greater interaction with the provider also did not translate to better quality care for the poor. The poor face a number of significant barriers to accessing quality treatment especially in relation to treatment seeking behaviour and type of treatment received. Strategies to address these inequities are fundamental to achieving universal coverage of effective malaria treatment and ensuring that the most vulnerable people are not left behind

Success of the control of tuberculosis in Nigeria: a review

Tuberculosis (TB) has emerged as the single leading cause of death from any single infectious agent and has continued to be a major public health problem all over the world. Of the over 14 million cases worldwide reported by World Health Organisation (WHO) in 2008, Nigeria ranked fifth in terms of incidence. Depending on the prevailing social factors such as socioeconomic status of the people, malnutrition, crowded living conditions, incidence of HIV/AIDS, level of development of health infrastructures, quality of available control programmes, degree of drug resistance to anti-tuberculous agents, etc, prevalence, patterns of presentation, and outcomes of treatment from TB can vary from one country to another and from one region of a country to the other. Attempts to deal with the problems of the disease led to the development of Directly Observed Treatment Short Course (DOTS) by WHO in 1995, and more recently the Stop TB strategy in 2006. In Nigeria, the DOTS programme has been implemented in all States and local government areas in the country and 3,000 DOTS centres have been operating across the country since 2006. This article reviewed the available information on the success of the control of TB in Nigeria has observed a significant improvement in TB detection and treatment. However, neither the set target for the detection rate nor the cure rate have been achieved nationally as several challenges have militated against the effective implementation of the DOTS programme. Keywords: Tuberculosis control, treatment success, DOTS programme, Stop TB strategy

Hiv/aids – related knowledge and sexual behaviour among secondary school students in Benin city

Purpose: The high prevalence of HIV/AIDS amongst African youths has been a major problem in recent times, particularly in Nigeria where over 5% of the population is at risk of the disease. We undertook to assess HIV/AIDS related knowledge and sexual behaviour among secondary school students in Benin City. Methods: In a cross-sectional study using a 59-item selfadministered questionnaire, a survey was carried out among 1917 students (48.7% male and 51.3% female; age: 11-24 years) systematically selected from 13 secondary schools in Benin City to assess HIV/AID related knowledge and sexual behaviour. Results: Awareness of HIV/AIDS was high. Misconceptions about the cause and spread was very high (91.4% and 93.1% of respondents, respectively). The knowledge on prevention was poor as only 40.4% of the respondents knew how to avoid contacting HIV/AIDS. While 9.1% of the students indicated ever having sex (with 67.4% of them using condom before sex), only 2.4% engaged in commercial sex. Some of the males (4.2%) are homosexuals. As many as 5.8% of the youths (and 12.4% of those who had done HIV test in the preceding 12 months) were HIV positive. Conclusion: Despite the various educational efforts to address the problems of HIV/AIDS, the knowledge of secondary school students in Benin City is still poor and the adolescents still engage in risky behavours. This calls for educational intervention that will impact in-depth knowledge about HIV/ AIDS among the youths who are at the center of HIV/AIDS pandemic. Keywords: HIV/AIDS knowledge, risky sexual behaviour, questionnaire survey, secondary schools, Benin Cit

Irrational prescribing of calcium channel blockers for the elderly in health facilities: A qualitative study in four hospitals in Benin City , Nigeria

No Abstrac

Birth Weight and Maternal Socio-Demographic Characteristics in a Rural Tertiary Hospital

Birth weight plays an important role in infant survival, child development, and adult metabolic diseases. Maternal characteristics have been variously shown to impact on the progress and outcome of pregnancy, especially those related to birth weight and perinatal mortality. We carried out this study to ascertain the relationship between maternal socio-demographic characteristics and neonatal birth weight. This was a descriptive cross-sectional study carried out in Irrua Specialist Teaching Hospital, a tertiary health facility in a rural area of Edo state, Nigeria. It was carried out from January 2017 to June 2017. A total of 106 pregnant women were recruited for the study. All the pregnant women who attended the antenatal clinic, and subsequently delivered at the labor ward of the hospital within the study period and their newborn were recruited for the study, with the exception of those who declined. An interviewer-administered questionnaire was used to retrieve information on sociodemographic characteristics from the participants. Data from the questionnaire were coded and entered into an electronic spreadsheet. The analysis was done with the aid of IBM SPSS version 21.0 software. Discrete data were presented as tables, diagrams, and proportions (percentages), while normally distributed continuous variables such as age, and birth weight were expressed as means and standard deviation. The statistical test of association was carried out between maternal sociodemographic characteristics and neonatal birth weight. Fishers, the exact test was used to test for association between the variables. Statistical level of significance was set at P&lt;0.05. All the respondents were in the age range of 20-50 years, with the majority (56.6%) of them between 20-30 years. Mean age was 30.12±5.52. All were married and most (58.5%) had tertiary education. Most of the women (58.5%) were multiparous, and also 80.2% of them booked for antenatal care. Most (61.3%) attended antenatal clinic more than four times before delivery, while about 64.1% delivered their babies at term (37-40 weeks). About 64.2% of the babies had normal birth weight, and 50.9% of the babies were males. Neonatal birth weight was significantly associated with booking status, gestational age at delivery, and neonatal sex. There was no significant association between birth weight and parity, time of antenatal booking, and the number of antenatal visits. Our study has shown that the risk factors for LBW include; high parity, unbooked status, few numbers of antenatal visits, and pre-term delivery

A Pattern of Blood Pressure and Family Function in Adult Hypertensive Patients Attending a Tertiary Hospital in a Rural Area

Hypertension (high blood pressure) is common and chronic. Early detection, coupled with the sincere dedication to treatment plans will delay/prevent complications. Late detection, lack of motivation for treatment, unhealthy lifestyle and poor adherence to medications and follow-up visits leads to early onset of complications. Motivation to adhere to therapeutic plans occurs in families with good function, and consequently good support to the hypertensive.This descriptive and cross-sectional study was carried out in the outpatient clinic of a tertiary healthcare facility in a rural area of Edo state, Nigeria. A semi-structured, interviewer-administered questionnaire was used to obtain socio-demographic information, anthropometric parameters, the presence of risk factors for HTN, and relevant information on management. The Smilkstein,s Family System APGAR Item tool was used to assess a family member’s perception of family functioning, by examining his/her satisfaction with family relationships. Data were entered into a spreadsheet and analyzed using IBM-SPSS version 2.1. Out of the 151 participants in the study, 61.6% were females and 45.7% were in the age group 40-59 years, with the mean age 56.97±12.49 years. Majority of the respondents were civil servants (34.4%), had up to the tertiary level of education (39.1%), and were married (84.8%). Most of the respondents (78.8%) had controlled BP (&lt;140/90mmHg). According to the Smilkstein,s Family System APGAR item scoring, 69.6% of the respondents were from highly functional families, while only 5.3% were from dysfunctional families. Seventy five (75) respondents from the highly functional families had controlled BP, while only six participants from the dysfunctional families had controlled BP. There was the significant association between blood pressure and age, and also&nbsp; between blood pressure and frequency of drug intake. However, there was no significant association between blood pressure and family function, sex, educational level, exercise and clinic attendance.Findings from this study show that the control of HTN in primary care population is good. Family involvement in the management of patients with HTN, is of paramount importance to the Family Physician, to enable him/her care for them adequately