Oral health status and service utilization among a group of rural older Nigerians

Objectives: To determine oral health status and explore factors associated with use professional oral health care among a Nigerian rural older population.Methods: Recruitments of 400 participants aged 60 and above done by multi - stage-sampling method. Pretested structured questionnaire administered with oral examination done.Results: Mean ages of participants were 67.06+/- 8.37 years. Proportion of participants with poor oral hygiene was 49.5%, caries (17.4%), periodontal disease (16.5%), tooth loss (71.3%) and tooth replacement was done by 5.5% of this population. Majority (64.8%) had never used professional oral health care. Main reason for seeking professional care was pain (73.05%). The proportion that went for routine checkup (8.5%) was the least. Proximity to dental service (p = 0.01), presence of oral pain (<0.001), attitude to professional oral care (p = <0.001) and ability to afford professional dental care (p = 0.001) had significant association, with utilization of professional oral care.Discussion: The poor oral health and elevated tooth loss is at variance with universal access to health and the rural older population is deprived of oral health interventions. There are various factors attributed to these, such as financial constraint and negative attitude. All of these may translates to social exclusion of the rural older population.Conclusion: Oral health in the older population studied is poor with an increased tendency to tooth loss and poor utilization of professional oral care. Factors influencing professional oral care were proximity to service centre, attitude to oral health, and perception of cost.Keywords: older, care, oral healt

Physicians’ compliance with malaria treatment guidelines of under-five children in a secondary maternal and child care centre in Lagos State

Background: The global malaria agenda has the ultimate goal of eliminating malaria in all countries of the world by 2030 through universal access to malaria prevention, diagnosis and treatment. Presumptive treatment of malaria with Artemisinin Combination Therapy (ACT) has been associated with the development of resistance, therefore parasitological confirmation of all fevers is crucial in the context of eliminating malaria. This study assessed physicians’ compliance with the national guidelines in the treatment of malaria among under-five (U-5) children and their prescription pattern in a Maternal and Child Care (MCC) centre in Lagos State.Methods: This was a descriptive cross-sectional study conducted as an exit interview among 427 mothers/caregivers of febrile U-5 children who were consecutively sampled.The data was collected using a pre-tested interviewer-administered questionnaire and a proforma. Epi-info version 7.2.1 was used to analyze the data and the level of significance was set as p<0.05.Results: Malaria Rapid Diagnostic Test (mRDT) was done for 75 17.6%) of the children and 37 (49.3%) was positive. Anti-malarial drugs were prescribed at consultation to 400 (93.7%) of the febrile children. Artemisinin Combination Therapy (ACT) was prescribed for 364 (91.0%) of the children. The most prescribed ACT was Artemether-Lumefantrine (AL) in 222 (60.9%).Conclusion: The physician’s compliance with malaria treatment guidelines for febrile illnesses in U-5 children was poor with regards to parasitological confirmation before treatment. However, the use of ACTs was adhered to in almost all cases. Regular training workshops are recommended for health workers to improve adherence to parasitological confirmation before treatment.Keywords: Malaria, Under-fives, Compliance, mRDT, ACTs, Guideline

Human Immunodeficiency Virus (HIV) serodiscordance and associated factors among HIV positive clients accessing anti- retroviral therapy in Ogun State South West Nigeria

Background: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributable to heterosexual transmission. In Nigeria, the bulk of the new infections occurs in persons who are not engaging in high-risk sex, a subpopulation that includes cohabiting or married sexual partners.Objectives: This study was undertaken to determine the prevalence and assess factors associated with HIV serodiscordance status among HIV positive patients accessing ART in secondary health facilities in Ogun State, South West Nigeria.Methods: This is a descriptive cross-sectional study conducted in four secondary health facilities offering HIV services in Ogun State over a six months period. A sample size of 630 was determined using the Cochrane formula and the respondents were consecutively recruited into the study. Data was collected using a structured intervieweradministered questionnaire and analysis were done using the statistical package for social sciences (SPSS) version 17.0. Results were presented using frequency tables, tests of associations was done using the Chi-square test and multiple Logistic regression with level of significance set at 0.05Results: Two hundred and Seventy-eight (43.6%)of the respondents did not know their spouse HIV status while 359 knew partners status. Of the 359, 166 clients are serodiscordant (46.2%) while 193 (53.8%) were seroconcordant. The mean age was 35.8 ± 9.1years. More of the younger age have serodiscordant partners. Significantly more females (74.7%) than males (25.3%) had serodiscordant partners (p-value= 0.002). Clients who did not consume alcohol were significantly more likely to have serodiscordant partners compared with clients who consume alcohol (p-value=0.001). Serodiscordant partners were significantly more among clients with infrequent sexual activities compared with clients with frequent sexual activities (p-value=0.001). Predictors of serodiscordance status among partners were clients who were <35 years old (odd ratio (OR) =1.727, confidence interval (CI) =1.107-2.693) and did not consumed alcohol (OR =2.204, CI = 1.070-4.542), with partners whose occupation were skilled (OR=7.159, CI=1.440-35.604) and semi-skilled (OR=6.189, CI=1.216-31.503) and clients with infrequent sexual activities (OR=3.182, CI=1.437-7.046).Conclusion: The study indicates that HIV positive clients could have serodiscordant partners if they could modify their lifestyle, have infrequent sexual activities (Not more  than twice in a month) with partners that are gainfully engaged. It is therefore recommended that for early identification of at-risk partners, couple HIV counseling and testing needs to be scaled up in addition to group-based interventions in order to pick serodiscordant partners early and provide all the necessary behavioral change support required to remain serodiscordant.Keywords: Factors, HIV Serodiscordance partners, clients, ART, Secondary health facilitie

Birth preparedness and complication readiness among women in Surulere Local Government Area, Lagos State, Nigeria

Background: The progress in maternal and newborn care over the years has been remarkable. In Nigeria many births are still not  attended to by skilled birth attendants (SBA). Hence maternal and newborn mortality remain high. Birth preparedness and complications readiness (BCPR) is a key intervention towards improving these indices, recommended by the World Health Organization and adopted by the governments of many nations including Nigeria. Every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. This study, therefore, aims to address this risk by assessingknowledge, attitude and practice associated with BPCR among women in Surulere Local Government Area in Lagos, Nigeria. Methodology: The study was a descriptive crosssectional study among 216 , selected by multi-stage sampling technique. Data was collected through a using a pretested, interviewer-administered questionnaire and analysis was carried out using Microsoft Excel 2010 and Epi Info 7 statistical software. The level of significance was predetermined at p<0.05. Results: Overall, 46.3% of respondents had good knowledge of the danger signs that could occur before, during or after delivery. Over  half of the women (52.3%) had a positive attitude towards BPCR, while 62.0% of the respondents practiced a good level of birth preparedness and readiness for any complication that might arise during pregnancy and delivery. Good knowledge was associated with level of education (p<0.001), occupation (p=0.022) and number of children (p=0.046). Knowledge was significantly associated with attitude (<0.001) but not practice. Conclusion: The study showed that the respondents had poor knowledge of BPCR and positive attitude towards it. Many of them were  not birth prepared nor complications ready. Interventions aimed at increasing BPCR practices should be focused on educating women, increasing awareness through health education and providing skilled maternal and newborn care services