Healthcare wastes management practices by public health facilities in Oshimili-South LGA of Delta State, South-South Nigeria

Background: The sustainable management of Healthcare waste has continued to generate increasing public interest due to the health problems associated with exposure of human beings to potentially hazardous wastes arising from healthcare. Objectives: To ascertain the healthcare wastes management practices by public health facilities in Oshimili-South LGA of Delta State. Methods: A cross-sectional descriptive study. A multistage sampling technique was used in the selection of LGAs, healthcare facilities and respondents. There was Characterization and measurement (quantification) of waste. The study instrument was English language structured self administered questionnaire. The data obtained were analyzed using SPSS version 17. Results: Practice of wastes reduction 92 (24.2%), wastes recycling 46(12.1%) and wastes weighing 72(18.4%). Fifty nine point four percent (59.4%) of respondents use personal protective equipments when handling wastes. Most 214 (62.2%) reported that burning was their final healthcare wastes disposal methods. The doctors, pharmacists and laboratory scientists all reported 100% use of protective gadgets. While the nurses (56.9%) and the wastes handlers (50.9%) use protective gadgets. On the average, 2.40kg/bed/day of waste was generated by the health facilities. Conclusion: The study revealed that there was poor practice of waste segregation and recycling in all the facilities. There is need for more training

Packed cell volume and serum iron in subjects with HIV-malaria co-infection in Nnewi, South-Eastern Nigeria

The present study was designed to assess the PCV and serum iron in HIV-malaria co-infected subjects in Nnewi, South Eastern Nigeria. 207 participants aged between 16-72 (44 ± 28) years were recruited andclassified as follows based on standard screening and WHO criteria: (i) Asymptomatic HIV stage I subjects with or without malaria. (ii) Symptomatic HIV stage II subjects with or without malaria and not on (ART). (iii) HIV/AIDS subjects with or without malaria and on ART. (vi) HIV seronegative control subjects with or without malaria. Blood sample from these participants were analyzed for HIV seroreactivity, Plasmodium falciparum antigen, parasite density, serum iron concentrations and PCV using Standard Laboratory methods. The result showed that serum iron and PCV were significantly reduced amongst all the groups studied when compared with the control (

Serum iron markers in HIV and HIV-malaria infected participants residing in malaria endemic area of South-Eastern Nigeria

HIV and malaria co-infections affect iron status. The present study was designed to determine the collective predictive power of some iron markers in HIV infected and malaria co-infected participants. For thisstudy, 101 participants were randomly recruited from indivividuals requesting for HIV screening. The participants were grouped as ‘asymptomatic HIV participants (n=36); asymptomatic HIV-malaria co-infected participants (n=19); symptomatic HIV participants (n=16) and HIV uninfected control participants (n=30). Blood analysis were performed for HIV infection, malaria infection, haemoglobin (g/dl), CD4 + T cell count(/mm3), albumin (g/l), iron (ug/dl), UIBC (ug/dl), TIBC (ug/dl) and percent transferrin saturation (TS%). The analysis of variance (ANOVA) showed that the blood concentrations of haemoglobin (f=4.805,

Use of absolute lymphocyte count or neutrophil ingestion rate of nitroblue tetrazolium (NBT) as alternative index to CD4+T-cell count to initiate ART in the management of HIV/AIDS disease

The present study was designed to evaluate absolute lymphocyte count or neutrophil ingestion rate of NBT as alternative indices to CD4+ T cell count in the management of HIV/AIDS subjects. 158 adult participants (male = 70, female = 88) were recruited for the study and grouped as: (i) Symptomatic HIV subjects with or without malaria (ii) Asymptomatic HIV subjects (iii) HIV seronegative subjects with or without malaria. Blood samples taken from these participants were analyzed using standard procedures for absolute lymphocyte count, neutrophil ingestion rate of NBT and CD4+ T cell count. The result showed that the mean absolute lymphocyte and neutrophil ingestion rate of NBT were significantly reduced in both symptomatic and asymptomatic HIV subjects with or without malaria infection when compared to the control group. The CD4+ T cell count was significantly reduced in the two groups and positively correlated with the absolute lymphocyte count (r = 0.301, P<0.05, r = 0.403, P<0.05) and neutrophil ingestion rate of NBT (r = 0.116, P = 0.01, r = 0.359, P<0.01) with or without malaria infection respectively. This finding suggests that in resource limited settings, absolute lymphocyte count or neutrophil ingestion rate of NBT could be used as alternative to CD4 count to monitor or initiate ART where the later is not easily accessible especially in a malaria endemic area.Keywords: Absolute lymphocyte count, NBT, ART, CD4+ T-cell count, HI

CYTOKINES CHANGES ASSOCIATED WITH MENSTRUAL CYCLE IN HIV INFECTED FEMALES AT NAUTH, NNEWI, SOUTH-EAST NIGERIA

Background: HIV infection is characterized by hormonal and immunological changes which may grossly affect the reproductive cycle in affected women. Aim: To evaluate Cytokine changes in HIV infected women during menstrual cycle. Materials and methods: A total of 90 women aged between 15 and 45 years were randomly recruited for the study. 30 of the women were normal healthy seronegative for HIV and served as control. Blood samples were collected under sterile conditions during the follicular and luteal phases of menstrual cycle after due informed consent had been obtained and the samples were analyzed for Cytokines (IL-8, IL-6, IL-4, and TNFα) using Enzyme Linked Immunosorbent Assay (ELISA) method. Results: The Cytokines (IL-8, IL-6, IL-4 and TNFα) were significantly higher at both phases of menstrual cycle in HIV infected women when compared with the Control (P<0.05). Interpretation and Conclusion: The study showed significant cytokine changes with some degree of inflammatory reactions in HIV infected women. The implication of these changes within reproductive life of the women is discussed

Effectiveness of Treatment Outcomes of Public Private Mix Tuberculosis Control Program in Eastern Nigeria

Effective tuberculosis treatment has been shown to have significant effect on the control of tuberculosis. Completion of treatment of active cases is therefore the most important priority of tuberculosis control programmes. Descriptive statistics with a retrospective cohort study design used to analyze secondary data set (2007-2010) of patients accessing TB-DOTS treatment in two facilities (Nnamdi Azikiwe University Teaching Hospital, NAUTH and Department of Health Services Tuberculosis and Leprosy  Control Unit Nnewi North Local Government Area (L.G.A.) Secretariat, DHSTLCU ) as public health facilities and other two facilities ( Immaculate Heart of Catholic Church Hospital, IHCCH  and Diocesan Anglican Communion Hospital, DACH) as private health facilities in Nnewi North L.G.A., Anambra State. Gender of patients were male: female 54%(1016 patients) : 46% (883 patients) and 53%(63 patients) : 47%(56 patients) in public and private health facilities respectively . Using WHO (1996) standards the health facilities adjudged as efficient were: in 2007, private facilities using the indicator  of treatment failure rate; private facilities using the indicator of death rate;  public facilities and private facilities using  the indicator of transfer-out rate ; public facilities using the indicator of  treatment completion rate. In 2008, effective health facilities were: private health facilities using the indicator of failure rate; public and private health facilities using the indicator of transfer-out rate; private facilities using the indicator of treatment completion rate. In 2009, effective health facilities were public and private health facilities using indicator of treatment failure rate; public and private health facilities using the indicator of death rate; public and private facilities using the indicator of transfer out; public and private facilities using the indicator of treatment completion rate. In 2010, effective health facilities were: private health facilities using the indicator of  cure rate; private facilities using the indicator of death rate ; public and private facilities using the indicator of transfer-out; public facilities using the indicator of treatment completion rate. In conclusion, private health facilities were more effective than public health facilities  by the several indicators over the four year period.  Future research is needful to use primary and secondary data sets in assessment of TB control program effectiveness; technical efficiency assessment using non-parametric statistics will assess the validity of assessing effectiveness using only the WHO standards; identify centre-specific factors associated with poor treatment outcome; institutionalizing a reward system for effective TB-DOTS facilities will engender healthy competition in the Public Private Mix for sustained effectiveness; the Monitoring and Evaluation tools especially the treatment card for data capture should be improved upon for comprehensiveness of patients socio-economic history. Keywords: Tuberculosis, Effectiveness, Treatments Outcomes, Public Private Mi

Unintended pregnancy: magnitude and correlates in six urban sites in Senegal

BACKGROUND: In Senegal, unintended pregnancy has become a growing concern in public health circles. It has often been described through the press as a sensational subject with emphasis on the multiple infanticide cases as a main consequence, especially among young unmarried girls. Less scientific evidence is known on this topic, as fertility issues are rarely discussed within couples. In a context where urbanization is strong, economic insecurity is persistent and the population is globalizing, it is important to assess the magnitude of unintended pregnancy among urban women and to identify its main determinants. METHODS: Data were collected in 2011 from a representative sample of 9614 women aged 15–49 years in six urban sites in Senegal. For this analysis, we include 5769 women who have ever been pregnant or were pregnant at the time of the survey. These women were asked if their last pregnancy in the last two years was ‘wanted ’then’, ‘wanted later’ or ‘not wanted’. Pregnancy was considered as unintended if the woman responded ‘wanted later’ or ‘not wanted’. Descriptive analyses were performed to measure the magnitude of unintended pregnancies, while multinomial logistic regression models were used to identify factors associated with the occurrence of unintended pregnancy. The analyses were performed using Stata version 12. All results were weighted. RESULTS: The results show that 14.3% of ever pregnant women reported having a recent unintended pregnancy. The study demonstrates important distinctions between women whose last pregnancy was intended and those whose last pregnancy was unintended. Indeed, this last group is more likely to be poor, from a young age (< 25 years) and multiparous. In addition, it appears that low participation of married women in decision-making within the couple (management of financial resources) and the lack of discussion on family planning issues are associated with greater experience of unintended pregnancy. CONCLUSION: This study suggests a need to implement more targeted programs that guarantee access to family planning for all women in need. In urban areas that are characterized by economic insecurity, as in Senegal, it is important to consider strategies for promoting communication within couples on fertility issues

Harmful lifestyles' clustering among sexually active in-school adolescents in Zambia

<p>Abstract</p> <p>Background</p> <p>HIV is a leading cause of morbidity and mortality in Zambia. Like many other African nations with high HIV burden, heterosexual intercourse is the commonest mode of HIV spread. The estimation of prevalence and factors associated with sexual intercourse among in-school adolescents has potential to inform public health interventions aimed at reducing the burden of sex-related diseases in Zambia.</p> <p>Methods</p> <p>We carried out secondary analysis of the Zambia Global School-Based Health Survey (GSHS) 2004; a cross sectional survey that aims to study health-related behaviors among in-school adolescents. We estimated frequencies of relevant socio-demographic variables. The associations between selected explanatory variables and self-reported history of sexual intercourse within the last 12 months were assessed using logistic regression analysis.</p> <p>Results</p> <p>Data from 2136 in-school adolescents who participated in the Zambia Global School-Based Health Survey of 2004 were available for analysis. Out of these respondents, 13.4% reported that they had sexual intercourse in the past 12 months prior to the survey; 16.4% and 9.7% among males and females respectively. In multivariable logistic regression analysis, with age less than 15 years as the referent the adjusted odds ratio (AOR) of having engaged in sexual intercourse in adolescents of age 15 years, and those aged 16 years or more were 1.06 (95% CI 1.03–1.10) and 1.74 (95% 1.70–1.79) respectively. Compared to adolescents who had no close friends, adolescents who had one close friend were more likely to have had sexual intercourse, AOR = 1.28 (95% CI 1.24–1.32). Compared to adolescents who were not supervised by their parents, adolescents who were rarely or sometimes supervised by their parents were likely to have had sexual intercourse, and adolescents who were most of the time/always supervised by their parents were less likely to have had sexual intercourse; AORs 1.26 (95% CI 1.23–1.26) and 0.92 (95% CI 0.90–0.95) respectively. Compared to adolescents who did not smoke dagga, adolescents who smoked dagga 1 or 2 times, and those who smoked dagga 3 or more times in their lifetime were 70% and 25% more likely to have had sexual intercourse, respectively. Adolescents who drank alcohol in 1 or 2 days, and those who took alcohol in 3 or more days in a month preceding the survey were 12% and 9% more likely to have had sexual intercourse, respectively, compared to adolescents who did not drink alcohol in the 30 days prior to the survey. Furthermore, adolescents who had been drunk 1 or 2 times, and who had been drunk 3 or more times in a life time were 14% and 13% more likely to have had sexual intercourse compared to those who have never been drunk in their lifetime.</p> <p>Conclusion</p> <p>We identified a constellation of potentially harmful behaviours among adolescents in Zambia. Public health interventions aimed at reducing prevalence of sexual intercourse may be designed and implemented in a broader sense having recognized that sexually active adolescents may also be exposed to other problem behaviours.</p

Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?

<p>Abstract</p> <p>Background</p> <p>Intimate partner violence (IPV) against women is a serious public health issue with recognizable direct health consequences. This study assessed the association between IPV and traumatic physical health consequences on women in Nigeria, given that communities exert significant influence on the individuals that are embedded within them, with the nature of influence varying between communities.</p> <p>Methods</p> <p>Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences.</p> <p>Results</p> <p>Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV.</p> <p>Conclusions</p> <p>Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV.</p