The status of tuberculosis infection control measures in health care facilities rendering joint TB/ HIV services in “German Leprosy and Tuberculosis Relief Association” supported states in Nigeria

Objective: To assess the status of tuberculosis (TB) infection control practice in health care facilities implementing joint TB/HIV activities.Materials and Methods: A descriptive survey triangulating self-administered questionnaire (facility survey to Infection Control Officer, individual health worker to general health workers), review of facility case notes and participant observation techniques was carried out. Twelve health facilities from southern Nigeria were assessed.Results: (1) Administrative and work practice control measure: Only 1 (8.3%) facility had a documented TB Infection control policy; 2 (16.7%) facilities had Infection Control Committee; 5 (41.7%) facilities had Infection Control Officer; 2 (16.7%) asked questions at the health records about cough; 1 (8.3%) facility had health workers intermittently checking for patients with cough in the waiting hall; and 2 (16.7%) facilities had Infection Control Officers who have attended some training on infection control. No facility had Information, Education and Communication (IEC) materials reminding patients and health workers of the possibility of TB transmission in the health care setting. While 86.4% of TB patients were screened for HIV, only 54.7% of HIV patients were tested for TB. (2) Environmental control measures: All the waiting halls were well ventilated. Though 66.7% of the consulting rooms were well ventilated, 25% of them were over crowded; 58.3% of the facilities managed sputum smear positive TB patients in the same ward with HIV-positive and other vulnerable patients; no facility had air cleaners.Conclusion: Implementation of the different aspects of the administrative control and work practice component of TB infection control measure range from 8.3% to 41.7% of the facilities. Urgent measures should be taken to reverse this trend in the face of TB burden due to HIV

Prevalence and awareness of hypertension and associated risk factors among bank workers in Owerri, Nigeria

Background: Hypertension is largely asymptomatic and common among adult Nigerians, and considered to be of public health importance. Banking work is associated with stress, a risk for hypertension.Aim: To evaluate the prevalence and awareness of hypertension and its associated risk factors among bankers in Owerri.Methods: This cross-sectional descriptive study was aimed at determining the knowledge, prevalence of hypertension and other risk factors for cardiovascular disease among bank workers in Owerri. We randomly selected banks by balloting in Owerri and assessed 194 bankers using a self-administered questionnaire on their knowledge and social habits. Their blood pressure (mmHg), weight (Kg) and heights (meter) were measured. Results are presented in proportions and odds ratio.Results: We studied 194 bankers; 100 males and 94 females. Most respondents (98%) had a good knowledge of hypertension but 80.4% (156) had poor knowledge of the risk factors of hypertension; 86.6% (118) and 59.3% (115) had poor knowledge of its treatment and complications respectively. The prevalence of hypertension was 12.4% with odds of a male being hypertensive 4.2 (95% CI 1.5 – 11.7), P-value= 0.006. Thirteen (68.4%) bankers with hypertension had good blood pressure control. Alcohol consumption in 12 (50%) and obesity in 9 (37.5%) bankers were the commonest cardiovascular risk factors.Conclusion: Bank workers in Owerri have a good knowledge of hypertension despite a low prevalence of hypertension. Additional educational effort aimed at addressing blood pressure control and life style modification is necessary among bankers.Keywords: Hypertension, prevalence, bankers, awareness, risk factors, cardiovascular diseas

Perception and attitude towards work related ill-health and use of dust mask among crushers of selected quarry (crushed stone) industry in Ebonyi State: effect of health education

Background: Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations and use of control measures like dust mask, with no serious attempt at comprehensive health education. The study sought to assess the effect of health education on the perception and attitude towards work related ill-health, and use of dust mask among crushers of selected quarry industry.Methodology: The study was conducted in the crush stone sites in Abakaliki and environs as the study group, while sites in Ishiagu, Ikenyi and Iyioge Ukwagba were the control group. Study population was 104 crushers, dust mask was provided at all sites, but health education (didactic lectures, demonstrations and interactive sections) for 8weeks was for the study group. Post-intervention evaluations were done at 3 and 6 months. Data was obtained using interviewer administered semi structured questionnaires, tally sheets and bimonthly forms, and analysed using SPSS (16.0) and Mathcad 7.Result: Health education was followed with: significant improvement in the proportion with good perception of work-related ill-health (P<0.00003) in the study group, but not in the control (P<0.639); more significant improvement in the proportion with good perception of dust mask in the study (P<0.00003) than control (P<0.004) group; lesser improvements in attitudes and significant improvement in the proportion that always wore dust mask, 6% to 24% (P<0.003) in the study group.Conclusion: Sustained periodic health education by government and private sectors is necessary, with training on dust mask usage, greater availability and provision of water-cooled caps.Keywords: Quarry Crushers, Ill-health, Dust Mask, Health Education, Ebony

HIV/TB Co-infection Among HIV Positive Children Attending Clinics In Imo State University Teaching Hospital Orlu, Imo State, Nigeria

Background: Human Immunodeficiency Syndrome and tuberculosis are among the leading causes of death from infectious diseases worldwide. The resurgence of tuberculosis in children is partly attributed to the coexisting burden of human immunodeficiency virus infection, which is most pronounced in sub Saharan Africa.Aim: To determine the prevalence and pattern of HIV/TB co-infection among HIV positive children attending clinics at Imo State University Teaching Hospital.Method: This is a retrospective review of HIV/AIDS children attending HIV clinics at Imo State University Teaching Hospital, Orlu, Imo State, Nigeria from January, 2011- December, 2012.Results: Of the total of 128 HIV infected children reviewed during the 24 months period, 16(12.5%) were coinfected with tuberculosis, (95% CI, 10.7% - 14.3%). Among these 16 patients, TB co-infection was diagnosed before commencement of ART in 93.7% of them. Majority of the TB cases (87.5%) presented with pulmonary TB amongst whom only 25.0% were sputum positive. The factors found to affect TB development significantly were stage of HIV disease (p=0.000) and CD4 count level (P=0.021) of patients. The factor with the highest influence on TB development was the clinical stage of HIV disease (Odds ratio =6.013) and that of least influence was sex of patient (Odds ratio= 0.8319).Conclusion: The study revealed a moderately high TB/HIV co-infection rate. Low CD4 count level below 200cell/ml and late clinical stages of HIV disease contribute significantly to the development of TB disease.Key Words: HIV/AIDS, tuberculosis, co-infection, children

Chlamydia trachomatis IgG antibodies seroprevalence among students in two tertiary institutions in Anambra state, Nigeria: a comparative study

Chlamydia infection is a common sexually transmitted infection (STI) in humans caused by the bacterium Chlamydia trachomatis. This study assessed the seroprevalence of Chlamydia trachomatis antibodies among students in two tertiary institutions in Anambra State, Nigeria. It was a comparative cross-sectional survey using enzyme immunoassay kits for the determination of IgG class antibodies, while the multistage sampling technique was used in the selection of participants for the study. The overall prevalence of Chlamydia trachomatis antibodies observed in this survey was 14.3%, which was higher among students from the University (21.6%) than their counterparts from the College of Education (7.4%) (χ2=5.89, df=1p<0.015). Factors found to have significant effect on the seroprevalence of Chlamydia trachomatis in both institutions were: prior sexual exposure (p<0.05); unprotected sexual intercourse in the last one year (p<0.05); multiple sexual partners in the last one year (p<0.05); and presence of symptoms suggestive of STI (p<0.05). Among students in the College of Education, the place of residence significantly affected Chlamydia trachomatis seroprevalence with a preponderance towards students living off-campus (χ2=4.00, df-1, p<0.05). Hence, there is need to institute appropriate prevention and control measures against the transmission of the disease especially among those at risk of contracting the disease.Keywords: Chlamydia trachomatis, seroprevalence, sexual behaviour, students, tertiary institutions

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

BACKGROUND:Sub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions. METHODS: We searched MEDLINE via PubMed, 'Banque de Donnees de Sante Publique' and the database of the 'Institut d'Epidemiologie Neurologique et de Neurologie Tropicale' from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated. RESULTS: In all 144 publications reporting on dementia (n=49 publications, mainly Alzheimer disease), Parkinsonism (PD, n=20), HIV-related neurocognitive impairment (n=47), Huntington disease (HD, n=19), amyotrophic lateral sclerosis (ALS, n=15), cerebellar degeneration (n=4) and Lewy body dementia (n=1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment's prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000). CONCLUSIONS: The body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases

Clinical and urinary findings in children presenting at the children outpatient clinic (CHOP) in a tertiary hospital in Abakiliki, South-East, Nigeria

Background: Childhood renal diseases have been reported to be on the increase globally in recent times and possible reasons are not fully comprehended. This increasing trend may be related to the late presentation of majority of these patients who often are asymptomatic initially.  This study is aimed at determining the prevalence of urinary abnormalities and hypertension using urinary and clinical findings in children who present at the index Hospital's Children's out-patient clinic.  Methods: This was a cross sectional study involving children who were seen at the hospital with varying symptoms. Relevant history and clinical examinations were obtained on each of the study subjects following standard protocols.  Fresh morning urine samples of subjects were subjected to dipstick urinalysis to assess presence of Protein, Blood and Nitrites. Data was analyzed using SPSS 21.0 (p &lt; 0.05).Results: One hundred subjects out of the 157 patients were studied, 60% of whom were males. The most frequent symptoms were headache (72%), abdominal pains (65%), fever (46%) and increased urinary frequency (43%). Twenty-five (25%) had hypertension. Forty-four (44%) children had abnormal urinary findings existing either alone or in combination, with proteinuria being the most common urinary abnormality, occurring in 23% of them.Conclusion: Abnormal urinary findings were observed to be high among the subjects. It becomes pertinent that urinalysis and routine blood pressure measurement be advocated for all children seen at the CHOP irrespective of their presenting symptoms. Abnormal findings should further be evaluated as part of a nephro-preventive strategy. Keywords: Proteinuria, hematuria ,Nitrituria, Hypertension, Outpatients Clinics, Childre

Evaluation of the practice of self-medication among undergraduates of Imo State University (IMSU) Owerri, South-East Nigeria

Background: The concept of self-medication entails the use of drugs, herbs or home remedies on an individual’s own initiative or on the advice of another person within his or her environment without consulting a qualified medical health services provider. It is widely practised in both developing and developed countries, and empirical evidence shows that great populations of persons in our communities indulge in the practice.Objective: To evaluate the practice of self-medication among undergraduates of Imo State University Owerri.Methodology: It was a descriptive cross sectional study. Data was obtained using semi-structured, self-administered questionnaires. Results were analyzed and presented using tables, bar charts and pie charts.Results: Only 38.9% of the respondents consulted qualified doctor when ill, the rest (61.1%) practised self-medication or by using drugs recommended by friends, family members or a paramedical worker. Reasons  given for self-medication include cheaper costs (52%), avoidance of delay at the hospital (51.6%), past experience of the efficacy of the drugs (51.9%).Conclusion: Factors that influence self-medication should be addressed by appropriate stakeholders for it to be curbed.Keywords: Analgesics, Antacids, Anti-malarials, Headaches, Medical Scienc

Antenatal Care Services Utilization among Women of Reproductive Age in Urban and Rural Communities of South East Nigeria: A Comparative Study

Background: Antenatal care is an evidence based intervention that improves maternal and perinatal outcome. Assessment and re-assessment of its utilization by rural and urban women in Nigeria is necessary for planning healthcare programmes and interventions.Aim: This study aims to assess urban – rural differences in antenatal care services utilization among women in South-East Nigeria and factors that influence such.Methodology: This is a cross-sectional study carried out among women of reproductive age in Anambra State, South-East Nigeria. Participants were selected using multistage sampling technique. Data was collected using pre-tested, semi-structured questionnaires which were interviewer-administered. Data obtained was analyzed using SPSS version 17. Tests of significance were done using Chi square test and student T test at 95% confidence intervals.Results: Six hundred women were included in the study; 300 respectively, from urban and rural settings. The mean age of respondents was 33.9+2.7 years. The average month at booking was higher in the rural areas (5.2 months) when compared to the urban (4.4) months, with more respondents in the urban areas booking earlier (P=0.000). More respondents in the urban, 140 (50.8%), attended ANC up to 4 times when compared to their rural counterparts, 102(37.0%) (p= 0.000). Women in the urban areas were more likely to have deliveries supervised by skilled birth attendants (p= 0.000). The estimated cost of antenatal care was higher in the urban areas than the rural (p= 0.000). Satisfaction received from antenatal and delivery services was also higher in the urban settings (p= 0.000).Conclusion: Rural-urban differences exist in the utilization of antenatal care services, with a higher proportion of urban women utilizing these services.Increased health education of women, especially in the rural areas, is advocated.Key Words: Antenatal utilization, Rural, Urban, Women, Nigeria