Effect of Health Education Intervention on Knowledge of HIV/AIDS and Risky Sexual Behaviours amongst Prison Inmates in Kaduna State, Nigeria

The prison population worldwide accommodates a higher proportion of individuals at high risk of HIV infection compared to the general population, and there is recognition of risky sexual activities among the inmates. But for complex political, legal, social, cultural and religious reasons, preventive measures like use of condom in prison are often not permitted and access to community based intervention in prison is limited. In order to make meaningful decisions about their reproductive health, inmates need reliable information. This study assessed the effect of health education on HIV/AIDS related knowledge and risky sexual behaviours amongst prison inmates in Kaduna State, Nigerian

Characteristics of COVID-19 cases and factors associated with their mortality in Katsina State, Nigeria, April-July 2020

Introduction: COVID-19 was first detected in Daura, Katsina State, Nigeria on 4 April 2020. We characterized the cases and outlined factors associated with mortality. Methods: We analysed the COVID-19 data downloaded from Surveillance Outbreak Response, Management and Analysis System between 4 April and 31 July 2020. We defined a case as any person with a positive SARS-CoV-2 test within that period. We described the cases in time, person, and place; calculated the crude and adjusted odds ratios and 95% confidence intervals for factors associated with mortality. Results: We analysed 744 confirmed cases (median age 35, range 1-90), 73% males and 24 deaths (Case fatality rate 3.2%, Attack rate 8.5/100,000). The outbreak affected 31 districts, started in week 14, peaked in week 26, and is ongoing. Highest proportion of cases in the age groups were 26.7% (184) in 30-39, 21.7% (153) in 20-29 years, and 18.3% (129) in 40-49 years. While the highest case fatality rates in the age groups were 35.7% in 70-79, 33.3% in 80-89 years, and 19.4% in 60-69 years. Factors associated with death were cough (AOR: 9.88, 95% CI: 1.29-75.79), age ≥60 years (AOR: 18.42, 95% CI: 7.48-45.38), and male sex (AOR: 4.4, 95% CI: 0.98-20.12). Conclusion: Male contacts below 40 years carried the burden of COVID-19. Also, persons 60 years and above, with cough have an increased risk of dying from COVID-19. Risk communication should advocate for use of preventive measures, protection of persons 60 years and above, and consideration of cough as a red-flag sign

Evaluation of Cholera and Other Diarrheal Disease Surveillance System, Niger State, Nigeria-2012

OBJECTIVE: To determine how the cholera and other diarrheal disease surveillance system in Niger state is meeting its surveillance objectives, to evaluate its performance and attributes and to describe its operation to make recommendations for improvement. INTRODUCTION: Cholera causes frequent outbreaks in Nigeria, resulting in mortality. In 2010 and 2011, 41,936 cases (case fatality rate [CFR]-4.1%) and 23,366 cases (CFR-3.2%) were reported (1). Reported cases in Nigeria by week 26, 2012 was 309 (CFR-1.29%) involving 20 Local Government Areas in 6 States. In Nigeria, there are currently eleven (11) States including Niger state at high risk for cholera/bloodless diarrhea outbreaks. In 2011, Niger state had 2472 cholera cases (CFR-2%) and 45,111 other diarrhea diseases cases, recorded in more than half of state Purpose of surveillance system is to ensure early detection of cholera and other diarrheal cases and to monitor trends towards evidence-based decision for management, prevention and control. METHODS: We conducted evaluation in July, 2012. We used CDC guideline on surveillance system evaluation (2001) as guide to assess operation, performance and attributes (2). We conducted key informant/in-depth interviews with stakeholders. We examined cholera action plans for preparedness and response, conducted laboratory assessment, extracted and analyzed cholera surveillance (2005–2012) for frequencies/proportions using Microsoft Excel. Thematic analysis was done for qualitative data. We shared findings with stakeholders at all levels. RESULTS: Surveillance system was setup for early detection and monitoring towards evidence-based decision. State government funds system. Case definition used is highly sensitive and is any patient aged 5 years or more who develops acute watery diarrhea, with/without vomiting. Though simple case definition, laboratory confirmation makes surveillance complex. A passive system, active during outbreaks; has formal and informal sources of information and part of Integrated Disease Surveillance and Response (IDSR) system and flow(fig.1). It takes 24–48 hours between outbreaks onset, confirmation and response. Line list showed undefined/poorly labeled outcomes. Of 2472 cases in 2011 1320 (49%) were found in line list. 2011 monthly data completeness was 75%. So far in 2012, 5(0.02%) of all diarrhea cases were cholera. System captures only age as sociodemographics. Of 11 suspected cholera cases tested during 2011 epidemic, 7 confirmed as cholera (PPV-63%). Of 3 rumours of cholera outbreaks (January 2011-July 2012), one (PPV-33%) was true. Acceptability of system is high among all stakeholders interviewed. Timeliness of monthly reporting was 68.7% (Table 1). Laboratory can isolate Vibro cholerae isolation but has no Cary Blair transport medium and cholera rapid test kits. CONCLUSIONS: Evaluation revealed that surveillance system is meeting its objectives by early detection and response to cholera outbreaks. System is simple, stable, flexible, sensitive with poor data quality, low PPV, fair laboratory capacity and moderate timeliness. We recommended electronic and internet-based reporting for timeliness and data quality improvement; and provision of laboratory consumables. [Figure: see text

Evaluation of Cholera and Other Diarrheal Disease Surveillance System, Niger State, Nigeria-2012

Cholera outbreaks are frequent in Nigeria. In July, 2012 we conducted surveillance system evaluation for cholera and other diarrheal disease in a Nigerian state (Niger State) to assess objectives, performance and attributes of the system. We used CDC guidelines on surveillance system evaluation and also analyzed 2007-2012 surveillance data. We found that the system was meeting its objectives, simple, flexible, sensitive with poor data quality, low PPV, average laboratory performance and moderate timeliness. Full electronic and internet-based reporting was recommended to improve completeness, timeliness and data quality; and also provision of laboratory consumables

Response to Ebola Virus Disease Outbreak in Nigeria, West Africa: The Zaria experience

ObjectiveTo assess the formation and function of a joint committee of the Ahmadu Bello University (ABU) and the Ahmadu Bello University Teaching Hospital (ABUTH) to prevent and control EVD in Zaria and the North West sub region of Nigeria.IntroductionThe Ebola Virus Disease (EVD) outbreak in West Africa was unprecedented in spread and its attendant response. There were over 15 000 confirmed cases and over 9 000 suspected cases. The response to the outbreak was massive within Africa and beyond. The outbreak in Nigeria affected 19 people and led to 7 deaths (CFR 37%).There were more than 891 contacts of these cases under surveillance as at 23rd September 2014. Nigeria was declared EVD free by the World Health Organization in October 2014.Nationwide there was targeted preparedness to prevent and control EVD. In Zaria, this led to the formation of a joint committee of the Ahmadu Bello University (ABU) and the Ahmadu Bello University Teaching Hospital (ABUTH) to prevent and control EVD in Zaria and the sub region as a whole.MethodsA joint multidisciplinary committee was formed by ABU and ABUTH with representatives from the Department of Community Medicine, Internal Medicine, Nursing sciences, Veterinary Public Health, Medical Microbiology, Mass Communication, Directorate of Public Affairs ABU Zaria, General Administration and Management services division ABUTH, the University Health Services and the Centre for Disease Risk Management under the Department of Geography. Four subcommittees were created steered by the main committee. The subcommittees were Surveillance; Case Management; Infection Control and Social and Mass mobilization subcommitteesResultsThe committee conducted seminars and trainings in case management, surveillance and infection control. Mass media campaigns included radio jingles production and airing as well as production of flyers and posters on EVD prevention and control. There was a phone in live radio programme. Screening exercise for raised temperature was conducted using laser thermometers at main entry points. A case of suspected EVD was managed who turned out to be a case of dengue haemorrhagic fever.ConclusionsThe committee was enriched by its multidisciplinary nature and a blueprint for the control and prevention of EVD was developed in line with national and global standards. The committee was hampered with lack of funds to implement fully the blueprint for the prevention and control of EVD in Zaria and its environs. The committee transformed into the ABU/ABUTH Epidemic Preparedness and Response Committee after the outbreak was over to address other emerging epidemics.ReferencesABU/ABUTH Joint Committee For The Prevention And Control Of Ebola Virus Disease (ABUPACE) Blueprint For Prevention And Control Of Ebola Virus Disease In ABU/ABUTH Zaria 2014. Pages 1-44World Health Organization. WHO declares end of Ebola outbreak in Nigeria www.who.int/mediacentre/news/statements/2014/nigeria-ends-ebola/en/

Demand-related factors influencing caregivers' awareness of malaria tests and health workers' testing practices, in Makarfi, Nigeria.

BackgroundDespite the World Health Organization's recommendation of malaria test-treat strategy, which is the treatment of parasitological confirmed malaria cases with anti-malarials, presumptive diagnosis of malaria remains fairly common in Nigeria. The reasons for this have not been established in Makarfi, Nigeria, despite the high burden of malaria in the area. A study was conducted among caregivers of febrile children less than 5 years presenting for treatment to understand their awareness of malaria diagnostic testing and being offered testing by clinicians, the determinants of these outcomes, and caregivers' perspectives of health workers' testing practices.MethodsUsing mixed-methods, data was combined from sub-analysis of cross-sectional survey data (n = 295) and focus group discussions (n = 4) with caregivers conducted in Makarfi General Hospital (Kaduna State, Nigeria) and surrounding communities in 2011. Bivariate and multivariate analysis of the quantitative survey data was conducted to examine associations of caregivers' sociodemographic characteristics with testing awareness and having ever been offered testing. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers' perspectives on malaria testing.ResultsAmong surveyed caregivers who were predominantly female (81.7%), not formally educated (72.5%), and were housewives (68.8%); only 5.3% were aware of any diagnostic testing for malaria, and only 4.3% had ever been offered a malaria test by a health worker. Having at least a primary level education (adjusted odds ratio [aOR] 20.3, 95% CI 4.5-92.1) and living within 5 km of the hospital (aOR 4.3, 95% CI 1.5-12.5) were determinants of awareness of malaria testing. Also, these were determinants of previously having been offered a test (aOR 9.9, 95% CI 2.1-48.7; and aOR 4.0, 95% CI 1.1-14.7). FGD showed many caregivers believed that malaria testing was for severe illness only, and that proximity to a health facility and cost of treatment influenced the seeking and receiving of care.ConclusionsUptake of malaria testing prior to treatment can be improved by increasing its awareness and addressing misunderstandings among caregivers, promoting testing practices among health workers, and availing caregivers living farther from health centres alternative opportunities for community case management of febrile illnesses

Demand-related factors influencing caregivers’ awareness of malaria tests and health workers’ testing practices, in Makarfi, Nigeria

Abstract Background Despite the World Health Organization’s recommendation of malaria test-treat strategy, which is the treatment of parasitological confirmed malaria cases with anti-malarials, presumptive diagnosis of malaria remains fairly common in Nigeria. The reasons for this have not been established in Makarfi, Nigeria, despite the high burden of malaria in the area. A study was conducted among caregivers of febrile children less than 5 years presenting for treatment to understand their awareness of malaria diagnostic testing and being offered testing by clinicians, the determinants of these outcomes, and caregivers’ perspectives of health workers’ testing practices. Methods Using mixed-methods, data was combined from sub-analysis of cross-sectional survey data (n = 295) and focus group discussions (n = 4) with caregivers conducted in Makarfi General Hospital (Kaduna State, Nigeria) and surrounding communities in 2011. Bivariate and multivariate analysis of the quantitative survey data was conducted to examine associations of caregivers’ sociodemographic characteristics with testing awareness and having ever been offered testing. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers’ perspectives on malaria testing. Results Among surveyed caregivers who were predominantly female (81.7%), not formally educated (72.5%), and were housewives (68.8%); only 5.3% were aware of any diagnostic testing for malaria, and only 4.3% had ever been offered a malaria test by a health worker. Having at least a primary level education (adjusted odds ratio [aOR] 20.3, 95% CI 4.5–92.1) and living within 5 km of the hospital (aOR 4.3, 95% CI 1.5–12.5) were determinants of awareness of malaria testing. Also, these were determinants of previously having been offered a test (aOR 9.9, 95% CI 2.1–48.7; and aOR 4.0, 95% CI 1.1–14.7). FGD showed many caregivers believed that malaria testing was for severe illness only, and that proximity to a health facility and cost of treatment influenced the seeking and receiving of care. Conclusions Uptake of malaria testing prior to treatment can be improved by increasing its awareness and addressing misunderstandings among caregivers, promoting testing practices among health workers, and availing caregivers living farther from health centres alternative opportunities for community case management of febrile illnesses

Prevalence of Boko Haram crisis related depression and post-traumatic stress disorder symptomatology among internally displaced persons in Yobe state, North East, Nigeria

Background: Conflicts and disasters often result in large-scale population displacement due to destruction of properties, means of livelihood and the environment. Internal displacement has a significant effect on the mental health of affected populations. Depression and Post-traumatic stress disorder (PTSD) increase from 10% in the general population to 15%-20% in the crisis-affected population. Aim: To determine the Prevalence depression and PTSD symptomatology and factors that predispose to symptomatic depression and PTSD. Methods: A descriptive cross-sectional study of 450 internally displaced persons (IDPs) was conducted, using a multistage sampling technique. The Hopkins symptom checklist was used to screen participants for symptoms of depression, and the Harvard trauma questionnaire was used to diagnose PTSD. Result: The mean age of the IDPs was 35± 15years.With 55.1% being females. About 94.2% met the criteria for symptoms of PTSD while 98.4% met the criteria for symptomatic depression. Some factors that predispose to both depression and PTSD were female gender and having symptoms of depression while having non-overcrowded accommodation has a protective effect. However only having symptoms of depression remained statistically significant. Conclusion: The study revealed that, PTSD and depression symptomatology were highly prevalent among the internally displaced persons. It is recommended that, Yobe State Government through Emergency Management Agency should develop psychosocial intervention program aimed to reach out to those IDPs for rehabilitation to avoid complications such as suicidal attempts

Prevalence and Determinants of Childhood Lead Poisoning in Zamfara State, Nigeria

Background. Lead poisoning is a great public health concern in the Nigerian state of Zamfara due to widespread gold ore mining by artisan miners using rudimentary and unsafe processing techniques. Children aged ≤6 years are especially vulnerable to lead poisoning, which accounts for 0.6% of the global burden of disease. We undertook this study to find out the prevalence and determinants of childhood lead poisoning in Kawaye, a village located in Zamfara’s Anka local government area (LGA). Methods. We conducted a cross-sectional study in April 2013. Using simple random sampling technique, 307 eligible children aged ≤6 years were recruited. Data were collected using interviewer-administered semi-structured questionnaires. Blood specimens were collected via venous draw for blood lead level (BLL) assessment and soil at individual households was tested for presence of lead contamination using a portable X-ray fluorescence spectrometer. Statistical tests of Chi-square and multivariable logistic regression analyses were performed to evaluate factors potentially associated with elevated childhood BLL (≥5 μg/dL). Results. A total of 307 children ≤6 years old were sampled, with males constituting 51% of the total (171). Mean age of children = 38.5 months ± 18.5 SD. Parents/guardians of the studied children were predominantly farmers (37%) and miners (15%), with 53.7% having some informal education while 4.2% had no education. Processing of ore within the living compound was reported by 4% of the miners; 7.5% returned home wearing working clothes; 7.2% brought tools home. Thirty percent of parents/guardians were living below the poverty line. The prevalence of lead poisoning (BLL ≥5 μg/dL) among the children studied was 92.5%, with 34 children (11.1%) having BLL ≥45 μg/dL. Fourteen percent of the households had soil lead levels >400 mg/kg. Being age 24–35 months, having childhood anemia, using kohl eye cosmetic and the combination of father’s/guardian’s low level of education and low socioeconomic status were found to be significant risk factors associated with childhood lead poisoning in the regression analyses. Conclusions. The prevalence of childhood lead poisoning was high in Kawaye, which may be attributable to widespread unsafe mining and ore processing activities in the community. We recommended beginning treatment in all cases where severe lead poisoning was identified, and that further targeted interventions should be designed to address the identified risk factors in order to control and prevent further lead poisoning in the village and the state at large. Competing Interests. The authors declare no competing financial interests