Older persons and malaria treatment in Nigeria

This study examined the prevalence and pattern of health-seeking behavior of older people on malaria fever among the elderly in Nigeria.  Data from the Nigeria Malaria Indicator Survey were used with a weighted sample of 1819 older persons aged 60 and above across the six geopolitical regions in Nigeria. The odds of fever as well as treatment seeking were predicted using logistic regression models. The prevalence rate of fever among the aged in Nigeria is 28%. About half of the respondents did not receive treatment in a standard health facility. There is high patronage of chemist/patient medicine vendor/shops for malaria fever treatment among older people in Nigeria. Findings suggest that older people may use healthcare facility if it is affordable. The lifelong approach that can reduce poverty and illiteracy is recommended since the rural-urban differences in treatment seeking reduced with the inclusion of other socio-demographic variables in the model

Dynamics of Household Role Performance and the Culture of Child Health Production in Igbo-Ora, Southwestern Nigeria

Studies about production of health for children have mainly concentrated on the behavior of one or two key household members compared to the dynamics in households involving three or more members. Health production refers to the process of directing available knowledge, skills, and resources towards ensuring, maintaining, and sustaining the health of the members. This cross-sectional design study explored how the dynamics of household structure and members’ roles influence the process of health production in a rural Nigerian community. An interviewer-moderated questionnaire was administered through a panel survey approach in 576 households. Twelve in-depth interviews and eight group discussion sessions were also conducted in Igbo-Ora, Southwestern Nigeria. Twenty-two roles identified from qualitative narratives, grouped into social interaction, material supports, safe environment, and physical health care supports categories, were ranked on a score of performance by household members. The mean household size was 5.4. Malaria, acute respiratory infection, and diarrhea were reported for children in 41.8% households. Mothers recognized and took action on child’s illnesses, while fathers made payment for treatment than other household members. Household decisions on child’s wellbeing focus more on treatment (84.4%) than preventive (7.3%) actions, while final decision resides more in the fathers’ (58.3%) compared to the mothers’ (15.8%) authorities. Mothers scored the highest points in all the role categories, the fathers scored points next to the mothers in material support, and safe-environment roles, while the children’s older siblings scored points next to the mothers on social interaction and caring roles. Health is produced in Igbo-Ora through the consciousness of growth monitoring, safe environment, and hygiene practice

GPT Models in Construction Industry: Opportunities, Limitations, and a Use Case Validation

Large Language Models(LLMs) trained on large data sets came into prominence in 2018 after Google introduced BERT. Subsequently, different LLMs such as GPT models from OpenAI have been released. These models perform well on diverse tasks and have been gaining widespread applications in fields such as business and education. However, little is known about the opportunities and challenges of using LLMs in the construction industry. Thus, this study aims to assess GPT models in the construction industry. A critical review, expert discussion and case study validation are employed to achieve the study objectives. The findings revealed opportunities for GPT models throughout the project lifecycle. The challenges of leveraging GPT models are highlighted and a use case prototype is developed for materials selection and optimization. The findings of the study would be of benefit to researchers, practitioners and stakeholders, as it presents research vistas for LLMs in the construction industry.Comment: 58 pages, 20 figure

Advanced leiomyosarcoma of the uterus: a case report and literature review

Uterine leiomyosarcoma is a rare malignancy accounting for 1-2% of uterine malignancies with an annual incidence of 0.5-7 per 100,000 women. It occurs mostly between the 5th to 7th decades of life hence found more among postmenopausal women.  The aetiology is mostly unknown however, in 0.2% of cases, it originates from sarcomatous degeneration in a pre-existing benign uterine fibroid. Leiomyosarcoma can be mistaken for uterine leiomyoma also known as the uterine fibroid.  It is an aggressive tumour that has a poor prognosis, with or without treatment. This case report aimed to report and discuss the occurrence of leiomyosarcoma as a differential diagnosis of abnormal uterine bleeding in this environment among other conditions. This will bring to the fore awareness among gynaecologists, pathologists, radiologists and oncologists that leiomyosarcoma of the uterus, though rare, should be considered in cases of menorrhagia with suspected uterine fibroid to avoid mistaking it for a diagnosis of uterine fibroid/leiomyoma. It is, therefore, imperative to consider leiomyosarcoma in a pre-menopausal and perimenopausal women diagnosed of abnormal uterine bleeding with symptomatic uterine fibroid. MRI serves as a good tool in differentiating the two pathologies.

Optimising the performance of frontline implementers engaged in the NTD programme in Nigeria: lessons for strengthening community health systems for universal health coverage

Background: The control and elimination of Neglected Tropical Diseases (NTDs) is dependent on mass administration of medicines (MAM) in communities and schools by community drug distributers (CDDs) who are supported and supervised by health facility staff (FLHF) and teachers. Understanding how to motivate, retain and optimise their performance is essential to ensure communities accept medicines. This study aimed to capture and translate knowledge, problems and solutions, identified by implementers, to enhance NTD programme delivery at the community level in Nigeria. Methods: Qualitative data was collected through participatory stakeholder workshops organised around two themes: (i) identification of problems and (ii) finding solutions. Eighteen problem-focused workshops and 20 solution-focussed workshops were held with FLHF, CDDs and teachers in 12 purposively selected local government areas (LGA) across two states in Nigeria, Ogun and Kaduna States. Result: The problems and solutions identified by frontline implementers were organised into three broad themes: technical support, social support and incentives. Areas identified for technical support included training, supervision, human resource management and workload, equipment and resources and timing of MAM implementation. Social support needs were for more equitable drug distributor selection processes, effective community sensitisation mechanisms and being associated with the health system. Incentives identified were both non-financial and financial including receiving positive community feedback and recognition and monetary remuneration. The results led to the development of the ‘NTD frontline implementer’s framework’ which was adapted from the Community Health Worker (CHW) Generic Logic Model by Naimoli et al. (Hum Resour Health 12:56, 2014). Conclusion: Maximising performance of frontline implementers is key to successful attainment of NTD goals and other health interventions. As NTDs are viewed as a ‘litmus test’ for universal health coverage, the lessons shared here could cut across programmes aiming to achieve equitable coverage. It is critical to strengthen the collaboration between health systems and communities so that together they can jointly provide the necessary support for frontline implementers to deliver health for all. This research presents additional evidence that involving frontline implementers in the planning and implementation of health interventions through regular feedback before, during and after implementation has the potential to strengthen health outcomes. Keywords: Frontline implementers, NTD programme, Optimising performance, Challenges and solutions, Nigeria, Universal health coverage, Health equity, Participatory research method

Alesinloye solid waste generation and management in Ibadan: potentials for prevention of epidemics in work environment

Waste generation, a possible source of epidemics in market or any other work environment could also be made a source of income generation if properly managed. Through an evaluative study in Alesinloye market, Ibadan, it was evident that intervention of Solid waste management in a market place could be effective and efficient, ranging from waste collection stage to the final disposal of waste. Alesinloye market environs was neater and cleaner after the waste management project introduced in 2009. Waste was also consciously disposed by traders daily, while waste recycling became a source of income to the management of the market. The commitment of the management and active involvement of members of the work environment were significant in the prevention of epidemics in the market area

Service delivery and coverage in primary healthcare in a community-health project in Ibadan, Nigeria

Background: Standard health-service delivery aimed toward improving maternal and childhealth status remains elusive in Nigeria because of inaccuracies in data documentation leading to a lack of relatively stable evidence. Objectives: Through a community-health project, this study tested the accuracy of record keeping in primary healthcare services in nine clinics run in Ibadan, Nigeria. Methods: A validation exercise was performed through a sample of the 10 most recent names extracted from three registers maintained by each clinic. Results: A review of the register covering a period of four years showed a steady increase in: fully-immunised children, registration for antenatal care during the first trimester of pregnancy, the number of women who attended antenatal care at least three times, the overall number of women who booked for antenatal care and women who delivered in Eniosa Community-Health Project facilities over the four-year period. It was possible to trace 86% of those selected from the antenatal care register, 88.9% of those from the birth register and 81.1%of those from the immunisation register. Four women who should have been included for antenatal care, seven who had delivered (but were not in the register) and 13 who reportedlyreceived immunisation but were not listed were found during the validation exercise. Conclusion: This study concludes that the names appearing in the register are likely to represent valid events, but that the registers did not capture all such events in the community