Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study

Introduction: In preparation for implementation of primary healthcare (PHC) services in Cross River State, a study to identify perceptions of communities and health systems concerning such interventions was conducted. Methods: Existing PHC practices were documented through observation and document reviews, including facility checklists at frontline levels. Perceptions of consumers and providers on PHC were elucidated through 32 Focus Group Discussions (FGDs) and 78 semi-structured questionnaires. Results: There was some level of implementation of the Nigerian PHC policy in the study districts. However, this policy emphasized curative instead of preventive services. Private partners perceived healthcare programmes as largely donor driven with poor release of allocations for health by government. Conclusion: Both providers and consumers presented similar perceptions on the current PHC implementation and similar perspectives on services to be prioritized. These common views together with their on-going participatory experience are important platforms for strengthening community participation in the delivery of PHC.Key words: Primary Health Care, Community directed Interventions, key informant interviews, focus group discussions, Cross River Stat

Lymphatic filariasis among the Yakurr people of Cross River State, Nigeria

<p>Abstract</p> <p>Background</p> <p>In order to initiate a disease elimination programme for lymphatic filariasis based on mass drug administration, a proper understanding of the geographical distribution and degree of risk is essential.</p> <p>Methods</p> <p>An investigation of lymphatic filariasis due to <it>Wuchereria bancrofti</it> was carried out among 785 people in four communities of Yakurr Local Government Area of Cross River State, Nigeria between March and August, 2009. Finger prick blood smear samples collected from the subjects were examined for <it>W. bancrofti</it> using standard parasitological protocol. The subjects were also screened for clinical manifestations of lymphatic filariasis.</p> <p>Results</p> <p>Of the 785 persons examined, 48 (6.1%) were positive for microfilariae in their thick blood smear. There was a significant difference in the prevalence of lymphatic filariasis among the various age groups (P < 0.01) although peak prevalence occurred between 41 – 60 years. There was no significant difference in prevalence and density with respect to sex (P > 0.05). The overall mean microfilarial density of the infected individuals was 5.6mf/50 μl. There was a significant variation (P < 0.01) in mean microfilarial density within the communities, ranging from 4.7 to 6.4 mf/50 μl. The only clinical sign found in the study area was lymphoedema of the leg recording 2 (0.3%) prevalence.</p> <p>Conclusions</p> <p>The National Lymphatic Filariasis Elimination Programme should intervene by expanding the distribution of albendazole and ivermectin to all endemic areas including Yakurr Local Government Area of Cross River State, Nigeria.</p

The Impact of Intestinal Parasitic Infections on the Nutritional Status of Rural and Urban School-Aged Children in Nigeria

Objectives Intestinal parasitic infection and undernutrition are still major public health problems in poor and developing countries. The objective of this study was to assess the relationship between intestinal parasitic infection and nutritional status in 405 primary school children from rural and urban areas of Akwa Ibom State, Nigeria. Methods This cross-sectional survey in 2009 obtained anthropometric data, height-for-age (HA), weight-for-height (WH) and weight-for-age (WA) Z-scores from each child and fecal samples were also collected and screened for intestinal parasites using standard parasitological protocols. Results The prevalence of infection with any intestinal parasite was 67.4%. A total of six intestinal parasites were detected; hookworm (41.7%) had the highest prevalence. The prevalence of intestinal parasites and undernutrition was significantly higher in rural than in urban children (P<0.001). The prevalence of stunting (HAZ < -2), underweight (WAZ < -2) and wasting (WHZ < -2) for rural and urban children were 42.3% vs. 29.7%; underweight 43.2% vs. 29.6% and wasting 10.9% vs. 6.4%, respectively. With respect to nutritional indicators, the infected children had significantly (P<0.05) higher z-scores than the uninfected children. Multivariate logistic regression analysis showed that only Hookworm and Ascaris lumbricoides were each significantly (P<0.05) associated with stunting, wasting, and underweight. Conclusions and Public Health Implications: Since intestinal parasitic infections are associated with malnutrition, controlling these parasites could increase the physical development and well-being of the affected children. Key Words: Intestinal parasites • malnutrition • children • rural-urban • Nigeria

The Impact of Intestinal Parasitic Infections on the Nutritional Status of Rural and Urban School-Aged Children in Nigeria

Objectives:Intestinal parasitic infection and undernutrition are still major public health problems in poor and developing countries. The objective of this study was to assess the relationship between intestinal parasitic infection and nutritional status in 405 primary school children from rural and urban areas of Akwa Ibom State, Nigeria.Methods:This cross-sectional survey in 2009 obtained anthropometric data, height-for-age (HA), weight-for-height (WH) and weight-for-age (WA) Z-scores from each child and fecal samples were also collected and screened for intestinal parasites using standard parasitological protocols.Results:The prevalence of infection with any intestinal parasite was 67.4%. A total of six intestinal parasites were detected; hookworm (41.7%) had the highest prevalence. The prevalence of intestinal parasites and undernutrition was significantly higher in rural than in urban children (P<0.001). The prevalence of stunting (HAZ < -2), underweight (WAZ < -2) and wasting (WHZ < -2) for rural and urban children were 42.3% vs. 29.7%; underweight 43.2% vs. 29.6% and wasting 10.9% vs. 6.4%, respectively. With respect to nutritional indicators, the infected children had significantly (P<0.05) higher z-scores than the uninfected children. Multivariate logistic regression analysis showed that only Hookworm and Ascaris lumbricoides were each significantly (P<0.05) associated with stunting, wasting, and underweight.Conclusions and Public Health Implications:Since intestinal parasitic infections are associated with malnutrition, controlling these parasites could increase the physical development and well-being of the affected children