Hygiene practices in abattoir and slaughter slab, determinants and assessment of abattoir and slaughter slab facilities in Abakaliki, Ebonyi State South-East Nigeria

Background: Workers in slaughterhouses engaging in unhygienic practices create conducive environments for zoonoses and meat contamination. Knowledge of hygiene practices and their determinants provides evidence for the design of targetedinterventions.Objectives: We investigated knowledge and determinants of hygiene practices among workers in slaughterhouses and assessed slaughterhouse facilities in Abakaliki.Methods: Workers in the Central Meat Market abattoir and Slaughter slab Abakaliki were interviewed in a cross-sectional quantitative study to ascertain their knowledge and hygiene practices while abattoir facilities were assessed using a checklist. Associations were analysed with Chi-square while predictors were determined using binary logistic model.Results: We interviewed 188 workers 75.5% and 85.6% of whom had good knowledge and good hygiene practices respectively. However, hand-washing before and after handling meat (44.1%), cleaning work surfaces with soap and water (45.2%) and sanitary disposal of waste (6.9%) were suboptimal. Knowledge of good hygiene practice was a predictor of good hygiene practice (AOR: 4.6, 95% CI: 2.0-11.3, p=0.001). Well water and borehole were present in both slaughterhouses and cold rooms were available in Central Meat market abattoir.Conclusions: The level of good knowledge was high and this was a determinant of good hygienic practices. Training on hygiene practices is recommended to prevent meat contamination and zoonoses. Keywords: Knowledge; Hygiene Practices; Abattoir; Slaughter slab; Determinants; Ebonyi; Nigeria

Primary Health Care under One Roof: Knowledge and Predictors among Primary Health Care Workers in Enugu State, South East, Nigeria

Background: The concept of “Primary Health Care Under One Roof” (PHCUOR) is a new governance reform to improve primary health care (PHC) implementation and integration. This study aimed at assessing the level of knowledge of this concept and its predictors among PHC Workers. Materials and Methods: This was a cross-sectional descriptive study of PHC workers in Enugu State. Respondents were selected using systematic sampling method. Data were collected with self-administered questionnaire and analyzed using IBM-SPSS version 25. Levelof statistical significance was set at 5% and confidence interval (CI) of 95%. Results: A total of 292 responses out of 337 questionnaires were retrieved, giving a response rate of 86.6%. Majority of the respondents were female (257, 88.0%) and greater than half were in the age range of 41–50 years (151, 51.7%). Most of the respondents had overall good knowledge of PHCUOR (210, 71.9%) but there was poor understanding of some concepts. Bivariate analysis showed that having good knowledge of PHCUOR was associated with duration of practice (χ2= 6.013, P = 0.018) and age (χ2 = 4.495, P = 0.036) but on binary logistic regression, males were found to be 2.8 times more likely to have good knowledge of the concept compared to females (adjusted odds ratio = 2.763.; 95% CI = 1.022–7.469, P = 0.045). Conclusion: There was overall good knowledge of PHCUOR but the knowledge of rationale, gateway, and minimum service package (MSP) was poor. Males were approximately 2.8 times more likely to have good knowledge compared to females. Regular training of PHC workers on the concepts of PHCUOR especially the rationale, gateway, and MSP is needed to improve their knowledge and service delivery. Keywords: Enugu, knowledge, predictors, primary health care under one roof&nbsp

Patterns of Antimicrobial Use in a Specialized Surgical Hospital in Southeast Nigeria: Need for a Standardized Protocol of Antimicrobial Use in the Tropics

Background: Antimicrobial resistance remains a growing global health menace. One of the key actions to curb this menace by the World Health Organization is antimicrobial stewardship (AMS). A prescription protocol is one of the cost‑effective AMS interventions in surgery. This study determines the patterns of antimicrobial usage in a hospital specialized in orthopedic and plastic surgeries care in Nigeria. Methods: A cross-sectional survey was carried out at National Orthopaedic Hospital Enugu, a tertiary hospital specialized in orthopedic and plastic surgeries in Southeast Nigeria in May 2019. All the inpatients were included in the study. A standardized tool for point prevalence survey was used to collect data. Data were analyzed using Epi Info version 7.2.4. Results: A total of 127 inpatients  participated in the survey with 387 antimicrobial encounters. The most common reasons for antimicrobial use were for the treatment of community-acquired infections (65.0%) and prophylaxis (29.4%). The decision for their use was made majorly on an empirical basis (92.4%). The reasons for antimicrobial prescriptions were documented in the majority (97.5%) of the cases and stop review dates in all (100%) of the prescriptions. Ceftriaxone (25.7%), tinidazole (21.9%), and metronidazole (14.6%) were the commonest antimicrobials prescribed among the patients. Conclusion: Orthopedic and plastic surgery practices require tailored prophylactic antibiotic regimens in the tropics due to peculiarities of both the specialties and the subregion. The claim that existing protocols in the temperate regions may apply in the tropics has been questioned due to the microbial profile on the tropics. Keywords: Antimicrobial protocol in surgery, antimicrobial resistance, antimicrobial stewardship, prophylactic antibiotic

International Best Practice: Understanding the Core Difference between Medical Laboratory Science and Clinical Laboratory Medicine in Nigeria

Introduction: International best practice (IBP) in the healthcare sector is an approach that is put in place globally, acceptable  standards to ensure patients’ safety while providing quality healthcare to the community. It achieves such standards by defining the job roles of various professionals in the healthcare sector. In the Nigerian healthcare sector, despite the clear definition of the job roles of the medical laboratory scientist and clinical laboratory physicians (pathologist) by the various Acts of Law of the Federal Republic of Nigeria that established these two professions, there seems to be a misapprehension of the differences between these two  professions. This study aimed to evaluate the knowledge of the health workers as it concerns the IBP on the scope of practice of medical laboratory science (MLS) and clinical laboratory medicine in Nigeria. Materials and Methods: Across-sectional, observational design was used for this prospective study involving 427 health workers from the six geopolitical zones in Nigerian and Abuja, using a proportionate sampling technique. It was facility‑based research usinga validated semi-structured self-administered questionnaire. Results: Over 50% of the participants believed that MLS was the same as clinical laboratory medicine. Two hundred and ten  participants (49.2%) did not know that analyses of samples in a clinical laboratory was the job responsibility of a laboratory physician. Conclusion: There was knowledge gap in the practices of both the MLS and the clinical laboratory medicine by health workers. Therefore, there is a need to create awareness through interprofessional education, workshops, and seminars to ensure understanding of job roles as this may promote harmony between these two professions in the health sector. Keywords: Clinical laboratory medicine, international best practice, medical laboratory scienc

Containing COVID-19 in Nigeria: An Appraisal of Lockdown and Surveillance at Inter‑State Borders to Control Disease Spread

Introduction: The outbreak of coronavirus disease 2019 (COVID‑19) in Nigeria prompted decision‑making at the various levels of  governance. Ebonyi State Government in South‑east Nigeria closed her borders with neighboring states as a preventive measure for the spread of the pandemic. This study was an assessment of the effectiveness and challenges of border closure and surveillance activities in controlling the dispersion of the disease across states. Materials and Methods: The five major borders of Ebonyi State with her neighboring States of Enugu, Cross River, and Abia were visited. Information was collected about movement restrictions and surveillance at the borders using an observation checklist and key informant interviews. Data collected were analyzed using IBM‑SPSS and thematic interpretation. Results: Commuters on essential duty were enforced to wear face masks, perform hand hygiene, and undergo screening for the  symptoms of COVID‑19 before entering the State. All the first 13 COVID‑19 confirmed persons in the State were from those picked up as suspected cases by surveillance at the State borders. People who travelled hundreds of kilometers across several States were stopped from entering Ebonyi State. However, movement restriction at the borders was undermined by some security personnel who were bribed by commuters to allow them crossover during night hours. Conclusion: The lockdown and surveillance activities at the borders were effective in controlling the spread of COVID‑19, but alternative routes of entry and corrupt act during odd hours constituted serious risks. Uniformity of movement restriction across all the states borders with vigilante groups manning inter‑community boundaries may control the disease spread across regions. Keywords: Coronavirus disease 2019 surveillance, infection control, inter‑state borders, lockdown, suspected case

Factors associated with the practice of and intention to perform female genital mutilation on a female child among married women in Abakaliki Nigeria

Abstract Background Female Genital Mutilation (FGM), also known as Female Genital Cutting or Female Circumcision is the harmful excision of the female genital organs for non-medical reasons. According to WHO, approximately 200 million girls and women have been genitally mutilated globally. Its recognition internationally as human rights violation has led to initiatives to stop FGM. This study investigated factors associated with the practice and intention to perform FGM among married women. Methods A cross-sectional study was conducted among 421 married women from communities in Abakaliki Nigeria. The participants were selected through multistage sampling. Data were collected through the interviewer’s administration of a validated questionnaire. Data were analyzed using IBM-SPSS version 25. Chi-square and logistic regression tests were employed to determine factors associated with the practice and intention to perform FGM at a p-value of ≤ 0.05 and confidence level of 95%. Results The mean age of respondents is 40.5 ± 14.9 years. A majority, 96.7% were aware of FGM. On a scale of 15, their mean knowledge score was 8.1 ± 4.3 marks. Whereas 50.4% of the respondents were genitally mutilated, 20.2% have also genitally mutilated their daughters, and 7.4% have plan to genitally mutilate their future daughters. On a scale of 6, their mean practice score was 4.8 ± 1.2 marks. The top reasons for FGM are tradition (82.9%), a rite of passage into womanhood (64.4%), suppression of sexuality (64.4%), and promiscuity (62.5%). Women with at least secondary education are less likely to genitally mutilate their daughters (Adjusted Odds Ratio [AOR] = 0.248, 95% Confidence Interval [CI] = 0.094–0.652). Women who are genitally mutilated are more likely to genitally mutilate their daughters (AOR = 28.732, 95% CI = 6.171–133.768), and those who have previously genitally mutilated their daughters have greater intention to genitally mutilate future ones (AOR = 141.786; 95% CI = 9.584–209.592). Conclusions Women who underwent FGM have a greater propensity to perpetuate the practice but attaining at least secondary education promotes its abandonment. Targeted intervention to dispel any harboured erroneous beliefs of the sexual, health, or socio-cultural benefits of FGM and improved public legislation with enforcement against FGM are recommended