Knowledge and Attitude towards Ebola Virus Disease among Secondary School Students in Abakaliki, South-east, Nigeria

Introduction: Ebola virus disease (EVD) is an acute haemorrhagic fever. It is also a zoonotic disease which has posed a serious public health problem in the West African Sub-Region. The study was conducted to determine the level of knowledge and attitude towards EVD among Secondary School Students in Abakaliki, Ebonyi State, Nigeria. Methods: A cross-sectional descriptive study was carried out among 318 secondary school students in Abakaliki, Ebonyi State, selected through multistage sampling method. Information and permission were obtained from the State Ministry of Education, Informed consent from the principals of the schools and their class teachers. Assent was obtained from selected students prior to the study. Data was collected with pre-tested semi-structured questionnaires and analyzed using statistical package for the social science (SPSS) version 20. Results were treated with strict confidentiality. Results: Majority of the respondents (85.5%) were between 15 to 19 years. Students in SSS 2 constituted the greatest proportion of respondents, 57.0% and 48.8% for public and private schools respectively. One hundred percent of the respondents had heard about EVD. Knowledge of EVD was generally poor for majority of the students in both schools, the proportion being higher in the public (65.8%), compared to the private schools (40.6%). Greater proportion (70.6%) of those in private schools had positive attitude to EVD compared to 53.8% in public schools. Conclusion: Respondents from private schools were more knowledgeable and exhibited more positive attitude than respondents from public schools. Recommendation: Sensitisation and health education of secondary school students on EVD

Assessing knowledge of hypertension and diabetes mellitus among informal healthcare providers in urban slums in southeastern Nigeria

Informal healthcare providers (IHPs) often serve as the first point of contact for healthcare services for non-communicable diseases in urban slums and their ability to identify risk factors and symptoms of the diseases is crucial for early detection and management. This paper assesses level of knowledge of hypertension and diabetes mellitus (DM) among IHPs. A cross-sectional survey was conducted in eight slums in Enugu and Onitsha cities in south-eastern Nigeria. Data was collected from 238 IHPs including patent medicine vendors, traditional birth attendants, traditional bonesetters, and herbalists. Knowledge scores were computed for each respondent. Adequate knowledge was set at ≥ 50% score and inadequate knowledge at < 50%. Binary logistic regression analysis was used to identify factors/independent variables associated with adequate knowledge among IHPs. Independent variables in the regression model were seven items that describe the profile of IHPs and can influence their access to information on non-communicable diseases. Knowledge of risk factors and symptoms of hypertension and DM among IHPs was low since only 21 (8.82%) and 19 (7.98%) of them had adequate knowledge of hypertension and DM, respectively. In regression analysis, IHPs who had received formal training in the past demonstrated significantly higher levels of knowledge, with odds of adequate knowledge in hypertension being 14.62 times greater for trained providers, and the odds of adequate knowledge of both non-communicable diseases being 21.34 times greater for trained providers. Training of IHPs is needed to address the critical knowledge deficit of risk factors and symptoms of hypertension and DM. This would contribute to better health outcomes and reduced disease burden in urban slums

Stakeholders’ perspectives and willingness to institutionalize linkages between the formal health system and informal healthcare providers in urban slums in southeast, Nigeria

Background The widely available informal healthcare providers (IHPs) present opportunities to improve access to appropriate essential health services in underserved urban areas in many low- and middle-income countries (LMICs). However, they are not formally linked to the formal health system. This study was conducted to explore the perspectives of key stakeholders about institutionalizing linkages between the formal health systems and IHPs, as a strategy for improving access to appropriate healthcare services in Nigeria. Methods Data was collected from key stakeholders in the formal and informal health systems, whose functions cover the major slums in Enugu and Onitsha cities in southeast Nigeria. Key informant interviews (n = 43) were conducted using semi-structured interview guides among representatives from the formal and informal health sectors. Interview transcripts were read severally, and using thematic content analysis, recurrent themes were identified and used for a narrative synthesis. Results Although the dominant view among respondents is that formalization of linkages between IHPs and the formal health system will likely create synergy and quality improvement in health service delivery, anxieties and defensive pessimism were equally expressed. On the one hand, formal sector respondents are pessimistic about limited skills, poor quality of care, questionable recognition, and the enormous challenges of managing a pluralistic health system. Conversely, the informal sector pessimists expressed uncertainty about the outcomes of a government-led supervision and the potential negative impact on their practice. Some of the proposed strategies for institutionalizing linkages between the two health sub-systems include: sensitizing relevant policymakers and gatekeepers to the necessity of pluralistic healthcare; mapping and documenting of informal providers and respective service their areas for registration and accreditation, among others. Perceived threats to institutionalizing these linkages include: weak supervision and monitoring of informal providers by the State Ministry of Health due to lack of funds for logistics; poor data reporting and late referrals from informal providers; lack of referral feedback from formal to informal providers, among others. Conclusions Opportunities and constraints to institutionalize linkages between the formal health system and IHPs exist in Nigeria. However, there is a need to design an inclusive system that ensures tolerance, dignity, and mutual learning for all stakeholders in the country and in other LMICs

A computational fractional order model for optimal control of wearable healthcare monitoring devices for maternal health

The post-COVID-19 landscape has propelled the global telemedicine sector to a projected valuation of USD 91.2 billion by 2022, with a remarkable compounded annual growth rate (CAGR) of 18.6% from 2023 to 2030. This paper introduces an analytical wearable healthcare monitoring device (WHMD) designed for the timely detection and seamless transmission of crucial health vitals to telemedical cloud agents. The fractional order modeling approach is employed to delineate the efficacy of the WHMD in pregnancy-related contexts. The Caputo fractional calculus framework is harnessed to show the device potential in capturing and communicating vital health data to medical experts precisely at the cloud layer. Our formulation establishes the fractional order model's positivity, existence, and uniqueness, substantiating its mathematical validity. The investigation comprises two major equilibrium points: the disease-free equilibrium and the equilibrium accounting for disease presence, both interconnected with the WHMD. The paper explores the impact of integrating the WHMD during pregnancy cycles. Analytical findings show that the basic reproduction number remains below unity, showing the WHMD efficacy in mitigating health complications. Furthermore, the fractional multi-stage differential transform method (FMSDTM) facilitates optimal control scenarios involving WHMD utilisation among pregnant patients. The proposed approach exhibits robustness and conclusively elucidates the dynamic potential of WHMD in supporting maternal health and disease control throughout pregnancy. This paper significantly contributes to the evolving landscape of analytical wearable healthcare research, highlighting the critical role of WHMDs in safeguarding maternal well-being and mitigating disease risks in edge reconfigurable health architectures

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

Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra state, Nigeria

<p>Abstract</p> <p>Background</p> <p>In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups.</p> <p>Methods</p> <p>A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles.</p> <p>Results</p> <p>It was found that 80.5 % of the households had an LLIN and 64.4 % of the households stated that they actually used the nets the previous night. The findings showed that 42.3 % of pregnant women who had fever within the past month received ACTs, while 37.5 % of children ≪5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1–5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women.</p> <p>Conclusions</p> <p>The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.</p

Isolation, Growth and Identification of Chlorpyrifos Degrading Bacteria from Agricultural Soil in Anambra State, Nigeria

Abstract The extensive use of pesticides is one of the major causes of pollution of soil and water environments. The current method for removing such contaminants from the environment through biodegradation has been shown to be more effective than any other method. Three pesticide degrading bacteria were isolated and identified through cultural and biochemical tests as strains of Pseudomonas aeruginosa, Serretia marcescens and Klebsiella oxytoca. Their growth in mineral salt medium supplemented with 20mg/l of Chlorpyrifos was monitored at optical density of 600nm. The result showed that Pseudomonas aeruginosa had maximum growth in ten days, while Serretia marcescens and Klebsiella oxytoca recorded highest growth after six days of incubation. HPLC analysis of the residual Chlorpyrifos after 14 days incubation showed that Pseudomonas aeruginosa was able to degrade 60% of the pesticide; Klebsiella oxytoca degraded 54%, while Serretia marcescens had 53% reduction of the pesticide concentration in the mineral salt medium. The results of this research indicated that the isolated bacteria can be used for bioremediation of Chlorpyrifos contaminated soil and water ecosystems

Analysing key influences over actors' use of evidence in developing policies and strategies in Nigeria: a retrospective study of the Integrated Maternal Newborn and Child Health strategy

Background Evidence-informed policymaking has been promoted as a means of ensuring better outcomes. However, what counts as evidence in policymaking lies within a spectrum of expert knowledge and scientifically generated information. Since not all forms of evidence share an equal validity or weighting for policymakers, it is important to understand the key factors that influence their preferences for different types of evidence in policy and strategy development. Method A retrospective study was carried out at the national level in Nigeria using a case-study approach to examine the Nigerian Integrated Maternal Newborn and Child Health (IMNCH) strategy. Two frameworks were used for conceptualization and data analysis, namely (1) to analyse the role of evidence in policymaking and (2) the policy triangle. They were used to explore the key contextual and participatory influences on choice of evidence in developing the IMNCH strategy. Data was collected through review of relevant national documents and in-depth interviews of purposively selected key policy and strategic decision makers. Thematic analysis was applied to generate information from collected data. Results The breadth of evidence used was wide, ranging from expert opinions to systematic reviews. The choice of different types of evidence was found to overlap across actor categories. Key influences over actors’ choice of evidence were: (1) perceived robustness of evidence – comprehensive, representative, recent, scientifically sound; (2) roles in evidence process, i.e. their degree and level of participation in evidence generation and dissemination, with regards to their role in the policy process; and (3) contextual factors such as global agenda and influence, timeline for strategy development, availability of resources for evidence generation, and lessons learnt from previous unsuccessful policies/plans. Conclusion Actors’ preferences for different types of evidence for policy are influenced not only by the characteristics of evidence itself, but on actors’ roles in the evidence process, their power to influence the policy, and the context in which evidence is used