Socio - demographic characteristics of child street vendors in Nnewi, Nigeria

Background: Involvement of children in street trading is inimical, contrary to the Rights of the Child, and threatens holistic child development. Objective: To describe the sociodemographic characteristics of child street vendors in Nnewi. Method: A cross-sectional questionnaire survey of children selling wares on the streets of Nnewi, southeast Nigeria. Results: 147 children (90 boys and 57 girls) aged 8 – 19 years were interviewed: 57 (38.8%) lived with their parents, 63 (42.9%) with relations and friends, while 27 (18.3%) lived alone. Also, 27 (18.4%) were Anambra state indigenes, others hailing from surrounding states. The parents of all the subjects were of low socioeconomic status. Trading was taking place during school hours for financial gains of the family. As many as 42.9% of the subjects had completed primary education: 89 (60.5%) had completely dropped out of school for varying periods. Nine girls (6.1%) had been sexually abused and 46 children (32.7%) had at sometime lost their earnings to robbers. Majority (79.6%) aspired to higher education if given the opportunity. Conclusion: Many parents in the low socioeconomic groups still keep their children out of school to work and help boost the family income. It is recommended that legislation be made against children trading during school hours.Key Words: child labour, street children, child vendors, Nigeria

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

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Nutritional Contents of Lunch Packs of Primary School Children in Nnewi, Nigeria

Background: Lunch packs play a significant role in the nutritional status and academic performance of school children. Available data show a high prevalence of malnutrition among school‑age children. Aims: The aim of this study is to document the nutritional contents of lunch packs of primary school children in Nnewi, Anambra state, Nigeria.Subjects and Methods: A cross‑sectional study was conducted among 1018 primary 1‑6 pupils selected by stratified systematic random sampling from six primary schools, two each of private, – mission, – and government (public) – owned schools in Nnewi metropolis with the aid of the semi‑structured questionnaire. Lunch packs of the pupils were examined.Results: Majority of the pupils (77.8% [792/1018]) had lunch packs although about half of pupils in public schools had no lunch pack. Only 12.4% (98/792) and 19.2% (152/792) of pupils with lunch packs had balanced meals and fruits/vegetables in their lunch packs, respectively. The odds of not coming to school with packed lunch was about 13 and 12 times higher for mothers with no formal education or only primary education, respectively, compared with those with tertiary education. Type of school had a strong influence on possession and contents of lunch pack (χ2 = 2.88, P &lt; 0.001, phi coefficient = 0.72). Pupils in private (97.5% [198/203]) and mission (94.4% [388/411]) schools were more likely to have a lunch pack compared with public schools (51.0% [206/404]). However, pupils in private schools were most likely to have a balanced meal (32.5% [66/203] vs. 5.8% [24/411] in mission and 2.0% [8/404] in public schools) and fruits/vegetables (48.3% [98/203] vs. 10.2% [42/411] in mission and 3.0% [12/404] in public schools) in their lunch packs. Mothers’ educational status and parents’ occupation were significantly associated with lunch pack contents. Conclusion: Majority of the lunch packs of primary school pupils contain poor quality food especially in public schools. Mother’s educational status and parent’s occupation are important determinants of the nutritional contents of lunch packs.Keywords: Lunch, Nigeria, Nutrition, School childre

Bacteriological quality of freshwater fish caught from two natural lakes in the rainforest region of South-Eastern Nigeria

The study evaluated the bacteria quality of freshwater fish caught from Oguta and Agulu Lakes. A total of 24 fish samples consisting of 12 samples from each Lake were sampled for four months. The fish samples were transported to the laboratory, processed and compared. Using a sterile scapel and a pair of sterile scissors, section of fish scales, gills, gut, skin, liver, intestine and gonads were removed and subjected for bacteriological analysis. A total of eight (8) bacteria isolates were  identified from the fish samples. The bacterial isolates were Escherichia coli, Aerobic mesophlic bacteria, Salmonella typhi, Listera monocytogen, Vibrio cholerae, Coliforms and Staphylococcus aureus. The gill yielded the maximum isolation rate of 4310(22.3%) of the total bacteria isolates from fish of Oguta Lake, while scale had the maximum isolation rate of  2530(27.1%) of the total isolates from fish of Agulu Lake. The common isolates namely Escherichia coli, Salmonella typhi and Coliforms of the family Enterobacteriaceae formed 79.9% of the total bacteria isolates from Oguta Lake fish and 74.1% from Agulu Lake fish. Staphylococcus aureus was insignificant in Oguta Lake fish (19, 0.1%) but was prominent in Agulu Lake fish where it contributed 150 (1.6%) of the total isolates. Of all the bacteria species identified, only Escherichia coli was isolated from the body parts of fish of both Lakes. Aerobic mesophilic bacteria and Staphylococcus aureus were encountered only in the scales and gut of fish of both Lakes. Salmonella typhi occurred only in the scale of Oguta fish. Vibrio parahaemolyticus was recorded only in the gonads of fish of Oguta Lake and in the intestinal parts of fish of Agulu Lake. The study revealed that the fish from both Lakes is of poor quality and this has a serious health implication. Therefore, sewage should be properly treated before disposal into aquatic ecosystems. Fish should be harvested with unpolluted water as well as handled with caution at post harvest. Keywords: Bacteria, Freshwater, Fish, Lakes, Public health, Oguta, Agulu, Rainforest, Nigeri

Association between caregivers' knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries

BACKGROUND: Pneumonia is the main cause of child mortality world-wide and most of these deaths occur in sub-Saharan Africa (SSA). Treatment with effective antibiotics is crucial to prevent these deaths; nevertheless only 2 out of 5 children with symptoms of pneumonia are taken to an appropriate care provider in SSA. While various factors associated with care seeking have been identified, the relationship between caregivers’ knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia is not well researched. METHODS: Based on data from Multiple Indicator Cluster Surveys, we assessed the association between caregivers’ knowledge of symptoms related to pneumonia – namely fast or difficulty breathing – and care seeking behaviour for these symptoms. We analysed data of 4,163 children with symptoms of pneumonia and their caregivers. A Chi-square tests and multivariable logistic regression was performed to assess the association between care seeking and knowledge of at least one symptom (i.e., fast or difficulty breathing). RESULTS: Across all 6 countries only around 30% of caregivers were aware of at least one of the two symptoms of pneumonia (i.e., fast or difficulty breathing). Our study shows that in the Democratic Republic of the Congo and Nigeria there was a positive association between knowledge and care seeking (P ≤ 0.01), even after adjusting for key variables (including wealth, residence, education). We found no association between caregivers’ knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia in Central African Republic, Chad, Malawi, and Sierra Leone. CONCLUSIONS: These findings reveal an urgent need to increase community awareness of pneumonia symptoms, while simultaneously designing context specific strategies to address the fundamental challenges associated with timely care seeking