Perceived severity of diabetes and associated factors among patients attending a referral hospital in Port Harcourt, Nigeria

Background: Nigeria has recorded a rising profile of diabetes in recent times due to urbanization and transition to westernized lifestyles. Perceived severity, the extent to which people deem their ailment to be severe, is an attitudinal construct that partly explains how likely people would modify their health behaviours. The study aimed to determine the level and associated factors influencing perceived severity among type 2 diabetes patients in Port Harcourt, Nigeria.Methods: A cross-sectional study was conducted among 119 adults at the University of Port Harcourt Teaching Hospital. They responded to a structured interviewer-administered questionnaire that included a 7-item scale on perceived severity, and socio-demographic and medical-related characteristics.Results: The mean age was 56.84 ± 11.51 years; 42.0% were males and 58.0% females. Mean diabetes duration was 7.60±5.58 years and 48.7% reported hypertension as a co-morbidity. About half (56.3%) had low Perceived Severity Score (mean score0.05).Conclusions: This study revealed an equal prevalence of low and high perceived severity of diabetes. Findings suggested that an unemployed Christian female with over 5 years’ diabetes history and no co-existing illness was likely to have a low perceived severity. We recommend further studies to examine other attitudinal constructs, beyond perceived severity, for better understanding of beliefs underpinning the health behavior of diabetes patients in different settings

Hepatitis B, C and Human Immunodeficiency Virus (HIV) Co-infection in Nigerian Children with Sickle Cell Anaemia

Background: Nigeria which has one of the world's highest burden of children living with Sickle cell anaemia is also endemic for hepatitis B, C and the Human immunodeficiency virus (HIV). This study set out to determine the prevalence of Hepatitis B surface antigen (HBsAg), antibodies to Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) among children with Sickle cell anaemia (SCA) at the University of Port Harcourt Teaching Hospital (UPTH).Methods: This was a prospective hospital based study of children with sickle cell anaemia aged 0.5 years to 18 years presenting at the haematology clinic of UPTH. A serological screening was carried out over a period of five months to determine the presence of hepatitis B virus (HBV), HCV and HIV 1 and 2 infection. Other data obtained included sex, age and other demographic data.Results: There were 182 SCA patients with 72 (54.5%) males and 60 (45.5%) females. Results of HCV anti-body, HBSAg, and HIV were available for 84 patients. Mean age was 7.45 ± 1.6 years, age range was 0.5-18years Seventy-eight (59.1%) had no previous blood transfusion, forty (80.8%) had one previous transfusion while eight (6.1%) had more than one previous transfusions. HBsAg was positive in three patients giving a prevalence of 8.6%; Anti-HCV antibody was not found in any patient while two (2.4%) were positive for HIV 1. There was no patient with Hepatitis, HIV and SCA.Conclusion: This study showed no co-infection with Hepatitis B, C and HIV viral infection among children with SCA at UPTH, Nigeria.Keywords: HBsAg; Anti-HCV antibody; HIV; SCA, Co-infectio

Proceedings of the 39th Annual Scientific Conference of The Association of Public Health Physicians of Nigeria

No Abstract

Perceived severity of diabetes and associated factors among patients attending a referral hospital in Port Harcourt, Nigeria

Background: Nigeria has recorded a rising profile of diabetes in recent times due to urbanization and transition to westernized lifestyles. Perceived severity, the extent to which people deem their ailment to be severe, is an attitudinal construct that partly explains how likely people would modify their health behaviours. The study aimed to determine the level and associated factors influencing perceived severity among type 2 diabetes patients in Port Harcourt, Nigeria.Methods: A cross-sectional study was conducted among 119 adults at the University of Port Harcourt Teaching Hospital. They responded to a structured interviewer-administered questionnaire that included a 7-item scale on perceived severity, and socio-demographic and medical-related characteristics.Results: The mean age was 56.84 ± 11.51 years; 42.0% were males and 58.0% females. Mean diabetes duration was 7.60±5.58 years and 48.7% reported hypertension as a co-morbidity. About half (56.3%) had low Perceived Severity Score (mean score<3) versus 43.7% with high Perceived Severity Score (c2=3.782, p=0.052). Sex, employment status, religion, duration of diabetes and presence of co-morbidity appeared to show an inverse relationship with perceived severity, however there was no valid association (p>0.05).Conclusions: This study revealed an equal prevalence of low and high perceived severity of diabetes. Findings suggested that an unemployed Christian female with over 5 years’ diabetes history and no co-existing illness was likely to have a low perceived severity. We recommend further studies to examine other attitudinal constructs, beyond perceived severity, for better understanding of beliefs underpinning the health behavior of diabetes patients in different settings

Status of Emergency Obstetric Care in a Local Government Area in South-South Nigeria

This study assessed the status of the availability and performance of Emergency Obstetric Care (EmOC) in 12 functional public health facilities out of the existing 19 in Gokana Local Government Area of Rivers State in South- South Nigeria, prior to the Midwives Service Scheme (MSS) launch in 2009. No facility qualified as Basic EmOC, while one had Comprehensive EmOC status. Signal functions that required supply of medical consumables were performed by more facilities than services that required special training, equipment and maintenance. Only two facilities (16.67%) had the minimum requirement of ≥4 midwives for 24-hour EmOC service; while only 2.2% of expected births occurred at the facilities. The poor state of maternal health resources in the study area requires urgent interventions by Local and State Governments for infrastructure upgrade and deployment and training of staff towards attainment of MDG-5. A follow-up evaluation would be required since the commencement of the MSS (Afr J Reprod Health 2012; 16[3]:170-179).Cette étude a évalué l'état de la disponibilité et la performance des soins obstétricaux d'urgence (SOU) dans 12 établissements de santé publics fonctionnels sur les 19 qui se trouvaient dans la région de l'administration local de Gokana, dans l'Etat de Rivers dans le sud-sud du Nigeria, avant le régime de service sages-femmes (MSS ) qui a été lancé en 2009. Aucun établissement n'est qualifié d'assurer le SOU, tandis que l'un avait étendu le statut de rendre le service compréhensif de SOU. Les fonctions de signalisation qui avaient besoin de consommables médicaux ont été effectuées par plus des établissements que les services qui avaient besoin d'une formation spéciale, de l'équipement et de l'entretien. Seuls deux établissements (16,67%) ont eu l'exigence minimale de ≥ 4 sages-femmes pour 24 heures de service SOU, tandis que seulement 2,2% des naissances attendues s'est produite dans les établissements. Le mauvais état des ressources de santé maternelle dans la zone d'étude nécessite des interventions urgentes par les administrations locales et des états pour la mise à niveau des infrastructures, le déploiement et la formation du personnel en vue de la réalisation des OMD-5. Une évaluation de suivi serait nécessaire depuis le commencement du MSS (Afr J Reprod Health 2012; 16[3]:170-179)

HIV-Related Stigma Among Black Mothers in Two North American and One African Cities

HIV-related stigma is a negative attitude or behaviour towards persons living with HIV, and is detrimental to effective care, management, and treatment of HIV. Using a revised 10-item stigma scale, we compared levels of HIV-related stigma and its correlates among Black women living with HIV in Ottawa, Canada, and Miami, FL, USA, with those in Port Harcourt, Nigeria. HIV-related stigma scores were calculated, with a maximum score of 10 and averaged 4.71 in Ottawa, 5.06 in Miami, and 3.78 in Port Harcourt. No significant difference in HIV-related stigma scores between Ottawa and Miami. HIV-related stigma was significantly (p < 0.05) higher among women in the North American cities compared with women in the African city. Hierarchical linear modelling shows that psychosocial variables contributed to variations in HIV-related stigma in Ottawa (22.3%), Miami (36.3%), and Port Harcourt (14.1%). At p < 0.05, discrimination was a significant predictor of increased HIV-related stigma in Ottawa (β = 0.077), Miami (β = 0.092), and Port Harcourt (β = 0.068). Functional social support had a significant diminishing effect on HIV-related stigma in Miami (β = − 0.108) and Port Harcourt (β = − 0.035). Tackling HIV-related sigma requires sociocultural considerations within specific regional and national contexts

Private sector malaria RDT initiative in Nigeria: lessons from an end-of-project stakeholder engagement meeting

Abstract The malaria rapid diagnosis testing (RDT) landscape is rapidly evolving in health care delivery in Nigeria with many stakeholders playing or having potential for critical roles. A recent UNITAID grant supported a pilot project on the deployment of quality-assured RDTs among formal and informal private service outlets in three states in Nigeria. This paper describes findings from a series of stakeholder engagement meetings held at the conclusion of the project. The agreed meeting structure was a combination of plenary presentations, structured facilitated discussions, and nominal group techniques to achieve consensus. Rapporteurs recorded the meeting proceeding and summaries of the major areas of discussion and consensus points through a retrospective thematic analysis of the submitted meeting reports. Key findings indicate that private providers were confident in the use of RDTs for malaria diagnosis and believed it has improved the quality of their services. However, concerns were raised about continued access to quality-assured RDT kits. Going forward, stakeholders recommended increasing client-driven demand, and continuous training and supervision of providers through integration with existing monitoring and supervision mechanisms

Determinants of Adherence to National Infant Feeding Guidelines by Black Mothers Living with HIV

Worldwide, 160,000 children were newly infected with HIV in 2018; half of these were infected through breastfeeding. Infant feeding guidelines are distinct depending on each country's resources and national or sub-national guidelines. Because of divergent guidelines, the best infant feeding approach to prevent mother-to-child transmission can become unclear. The purpose of this study was to examine the sociocultural and psychosocial factors related to adherence to infant feeding guidelines through a city-level, North-South comparison of Black mothers living with HIV in Nigeria, Canada, and the United States. Using a cross-sectional multi-country survey, a convenience sample of 690 mothers were recruited from June 2016 - December 2019. Socio-cultural and psychosocial factors influencing infant feeding practices were measured. Using binary logistic regression, infant feeding attitudes (OR = 1.10), motherhood experiences (OR = 1.08), low hyper-vigilance score (OR = .93), paternal support (OR = 1.10) and perception that the health care provider supported adherence to infant feeding guidelines (OR = 2.43) were associated with guideline adherence. Mothers who had cultural beliefs that were inconsistent with infant feeding guidelines and mothers with low incomes (OR = 2.62) were less likely adherent with their country's guidelines. City-level factors were not found to influence adherence to infant feeding guidelines; however, socio-cultural and psychosocial factors at community, family and individual levels were significant. Policy formulation and targeted interventions must be cognizant of cultural expectations of motherhood and mindful of psychosocial determinants of adherence to infant feeding guidelines