A revised scoring scheme for the classification of socio-economic status in Nigeria

Background: Researchers in medicine and related fields in Nigeria have usually made recourse to the instrument developed by Olusanya et al and Oyedeji in the past three-and-a half decades for determination of socioeconomic status (SES). Beside the question of their age, however, these instruments were purposive and might no longer be suitable because of the changes in the parameters on which they were based.Objective: To develop a robust but generic scheme that takes into consideration the changes in the nation’s socioeconomic space in the succeeding three and a half decades.Methods: A detailed and comprehensive review of the extant schemes was undertaken with a view to identifying their inherent weaknesses. The latter were then factored into the design of a new scheme taking into consideration the emergent restructuring of career positions in the civil/public service as well as the place of private and informal sectors of the economy. The new scheme was validated at the University of Beninand Irrua Specialist Teaching Hospitals.Results: The new scheme had a remarkably high Inter-rater reliability (r = 0.947, p<0.001), raterre- rater reliability (r = 0.984, p <0.001) and % agreement (with modified Oyedeji’s tool as standard) of 67% (K coefficient = 0.47, r = 0.71, p<0.001)Conclusion/Recommendation: The new scheme could be a viable tool for the assessment of SES of families and individuals, which not only takes into consideration current realities of the nation’s economy, but also is readily adaptable to meet foreseeable changes

Cord care education and its content given to mothers at antenatal clinics in various health facilities in Edo state, Nigeria

Introduction: Hygienic umbilical cord care is necessary for the well-.being of the newborn. Health education is a strong tool for lifestyle modification aimed at healthy living. This ought to extend to mothers who care for their infants' umbilical cord stump in various ways especially after discharge from hospital. The content of health education on cord care given to mothers (if any) at various health institutions which they accessed for antenatal care is thus worth evaluating. Objective: To evaluate the content of health education on cord care given to mothers at various health facilities which served as their places of antenatal care in Benin City, Nigeria. Methods: The study subjects included mothers who brought their babies to Well Baby/Immunization Clinic of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. A structured questionnaire was used to assess their biodata, places of antenatal care, whether health education on cord care constituted part of the services received in health facilities and the content of the cord care education. Results: Of the 497 subjects studied, 487 (98.0%) received antenatal care (ANC) in both orthodox and unorthodox facilities. Amongst these, 352 (72.3%) received health education on cord care while 135 (27.7%) did not. Teaching and private hospitals contributed 116 (48.9%) and 103 (43.5%) respectively to the total documentation of the advice concerning use of methylated spirit alone. The relationship between content of health education on cord care and method of cord care practiced by mothers was statistically significant. Conclusion: Health education on cord care is lacking in some of our health facilities and where available, content may not be evidence-.based. We must equip health workers with facts required to enlighten patients. A standard and universal method of cord care should be adopted to reduce or abolish the confusion which mothers presently encounter in caring for their babies' umbilical cords

Impact of home-based management on malaria outcome in under-fives presenting in a tertiary health institution in Nigeria

Abstract Background Home-based management of malaria involves prompt delivery of effective malaria treatment at the community by untrained caregiver. The aim of this study was to document home-based treatment of suspected malaria by non-medical caregivers and to identify its health impact on malaria outcome (severe malaria prevalence, parasite load and mortality) in children (6–59 months). Methods A descriptive cross-sectional study carried out from June 2012–July 2013. Data was obtained by researcher-administered questionnaire and malaria was confirmed in each child by microscopy. Analysis was by Statistical Package for Scientific Solutions version 16. Results Of the 290 caregivers (31.2 ± 6.1 years)/child (21.3 ± 14.4 months) pairs recruited, 222 (76.6%) caregivers managed malaria at home before presenting their children to hospital. Majority (99.0%) practiced inappropriate home-based malaria treatment. While only 35 (15.8%) caregivers used the recommended artemisinin-based combination therapy, most others used paracetamol either solely or in combination with anti-malarial monotherapy [153 (69.0%)]. There was no significant difference in mean [±] parasites count (2055.71 ± 1655.06/µL) of children who received home-based treatment and those who did not (2405.27 ± 1905.77/µL) (t = 1.02, p = 0.31). Prevalence of severe malaria in this study was 111 (38.3%), which was statistically significantly higher in children who received home-based malaria treatment [90.0%] (χ2 = 18.4, OR 4.2, p = 0.00). The mortality rate was 62 per 1000 and all the children that died received home-based treatment (p < 0.001). While low socio-economic class was the significant predictor of prevalence of severe malaria (β = 0.90, OR 2.5, p = 0.00), late presentation significantly predicted mortality (β = 1.87, OR 6.5, p = 0.02). Conclusions The expected benefits of home-based management of malaria in under-fives were undermined by inappropriate treatment practices by the caregivers leading to high incidence of severe malaria and mortality

Lipid content of breast milk of lactating women in Benin City, Nigeria

A study on the lipid profile of breast milk expressed from women in Benin City as influenced by age, parity, lactation duration, socio-economic status of the mother and sex of the baby was embarked upon. All the women chosen in the study practice exclusive breast feeding and, nursing successfully their evidently healthy infants. The age of the mother did not have any significant change on the total lipid, cholesterol and phospholipid composition of breast milk. Also, the sex of the baby did not affect lipid composition of breast milk of the mother. However, the results obtained show that parity (i.e. number of previous births), lactation period and socio-economic status of the mother separately altered milk lipid profile. While there was a gradual significant increase in total lipid as the lactation duration increased, a decrease in cholesterol and phospholipid was observed. Total lipid, cholesterol and phospholipid contents of breast milk increased as the number of previous births increases. Lastly, milk total lipid of lactating women from rich socio-economic background was higher than women with poor background. (Global Journal of Medical Science, 2004, 3 (1&2): 23-27

Assessment of use of national guidelines for malaria case management among paediatric resident doctors attending an update course in Benin City, Nigeria

Introduction: The National Malaria Guideline is a veritable tool for appropriate case management of malaria. Whether the pediatric residents who are the primary caregivers of children know and make use of this guideline in their routine practice is not yet assessed. Aim: The aim of the study is to assess the awareness of the Nigerian pediatric residents of the national guidelines for malaria case management (including antimalarial prescription for uncomplicated and severe malaria). Settings and Design: The descriptive study carried out during the 2017 National Postgraduate Medical College of Nigeria, Faculty of Paediatrics Update Course in Benin City. Subjects and Methods: Data were obtained using a self‑administered questionnaire which was given to all pediatric residents who participated at the update course and who had given written informed consent. Statistical Analysis Used: The statistical analysis was done using the Statistical Package for the Social Sciences version 16.0 (Inc., Chicago, Illinois, USA). Results: Of the 108 participants whose questionnaires were analyzed, 75.0% were Part 1 candidates and 25.0% Part 2 candidates; mean age 34.0 ± 4.5 years (range 26–51 years) and 42 (39.0%) males while 66 (61.0%) were female. Ninety‑four (87.0%) were aware of the current national guidelines for management of malaria and 45 (41.7%) had read the guidelines. Correctness of prescription was obtained from 39 (36.0%) respondents in uncomplicated malaria cases and 44 (40.7%) in severe malaria cases.This finding did not significantly associate with the years of practice, level of practice, practicing institutions, awareness, and reading of the national guideline. Conclusions: Most pediatric residents have not read nor use the national guidelines for management of malaria which reflected in poor prescription pattern of antimalarial drugs in routine practice

Placental Malaria histological features and the burden of congenital malaria among HIV/ malaria co-infected mothers in Benin City, Edo State

&nbsp;Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. Coinfection with both diseases is also well documented. Malaria parasites infecting the placenta lead to inflammation, intervillous fibrin deposition and infarction. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria). Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy. Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p=0.017 in subjects and p= 0.000 in controls respectively) Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status. This risk (chronic type) is highest in mothers with HIV; therefore, all babies born to HIV positive mothers should be screened for congenital malaria and managed as appropriate