Reducing HIV-related stigma among traders in model markets in Lagos, Nigeria through HIV education.

Background: HIV/AIDS is a major Public health problem in Nigeria where the National seroprevalence rate is 4.1%. The objective of this study was to determine the effect of health education on knowledge of HIV and the stigmatization of people living with HIV/AIDS among traders in model markets in Lagos State.Methodology: This study was a quasi-experimental study. The intervention and control markets were selected by simple random sampling method while systematic sampling method was used to select the participants in each market. A total of 400 participants were recruited into this study. The study phases were a baseline survey in both markets, a health education programme in the intervention market and a post-intervention survey in both markets. Epi Info 2002 (Windows version 3.5.1) statistical software was used for data analysis.Results: After the intervention, the proportion of respondents who had correct knowledge of HIV/AIDS increased significantly by 27.9% in the intervention group (p<0.001). A slight increase (3.6%) was also observed  in the control group but this was not significant. The proportion of traders in the intervention group who had a positive attitude towards PLWHA also increased significantly by 12.6% (p=0.006). However in the control group, there was no increase in the proportion of traders who had a positive attitude towards PLWHA.Conclusion: Health education significantly increased knowledge of HIV/AIDS and reduced HIV-related stigma among the traders. Periodic HIV/AIDS education should be provided for the traders. Further research is recommended to assess sustained changes in stigma related attitude over time.Keywords: HIV, AIDS, PLWHA, traders, Preintervention and postintervention

Visual Acuity in Primary School Pupils in Lagos, Nigeria

Background: Visual impairment is usually due to conditions that could be diagnosed and corrected if discovered early. However many cases go undiagnosed. Restoration of sight is among the most cost-effective interventions in health care.Methodology: This is a descriptive cross-sectional study, carried out to determine the prevalence of refractive error, squint, and colour vision defect among primary school students. One hundred and eighty three pupils, aged 5-11 years were selected. Visual Acuity was measured using the Snellen chart. Colour vision and squint were assessed using the Ishikara colour vision test plates and corneal reflex test respectively. The tests were conducted by two optometrists with the assistance of a teacher and a class assistant.Results: Most (78% ) of the study population were found to have good visual acuity, 18.6 percent had fair vision , while 3.3 percent had poor vision. Prevalence (%) of refractive error, colour vision and squint among the study population were 21, 0.04 and 1.6, respectively. Majority of the students had good visual acuity and refractive error was the major cause (95%) of all reduction in visual acuity.Conclusion: Eye defects occur among school children with potential negative effects. Pre-school entry eye examinations and regular screening is advocated and glasses should be made available for children with refractive error.Keywords: Visual Acuity, Screening, School Children, School Health

Knowledge, Attitude and Practice of School Health among Primary School Teachers in Ogun State, Nigeria

Background: The School health programme is designed to promote the optimal physical, emotional, social and educational development of students. Teachers play a major role in the promotion and successful implementation of the Programme.Objective: To determine and compare teachers knowledge, attitude and practice of the school health programme in urban and rural schools in Ogun state, Nigeria.Methodology: This cross sectional descriptive study was conducted in public primary schools in Ifo (urban) and Ikenne (rural) Local Government Areas (LGAs) of Ogun State. A multistage sampling method was used to select teachers in each Local Government Area. Data was collected using self administered questionnaires and analysed using the EPI Info 6 statistical software.Results: Although majority of the respondents in both LGAs were aware of the school health programme, (Ifo 97.4%, Ikenne 97.3%), more than half of the respondents, (Ifo 57.0%, Ikenne 54.5%) had poor knowledge of school health. Majority of the respondents in Ifo (98.7%) and Ikenne(98.3%) felt that the school health programme is desirable and necessary. School health programme is in place in most schools in both LGAs ( Ifo 77.3%, Ikenne 73.2%). However many key components are poorly practiced.Conclusion: There was no statistically significant difference in the knowledge (p= 0.209) and practice (p=0.313) of school health in rural and urban LGAs. In service training on school health should be provided for teachers and the needed resources should be made available for the full implementation of all components of school health in all schools.Keywords: School Health, Teachers, Primary School, Knowledge and Practic

Use of insecticide-treated mosquito nets for children under five years in an urban area of Lagos State, Nigeria

Background: Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an urban area of Lagos State.Materials and Methods: A community-based, cross sectional study was carried out in Lagos State in April 2007 among three hundred and forty (340) care givers primarily responsible for child care at home. They were selected by a multistage sampling method using a pre-tested, interviewer-administered, structured questionnaire.Results: ITN use rate for under-fives was high (61.8%) and this was significantly determined by care giver’s marital status (P < 0.001) and the number of children under five years in the household (P = 0.006). Educational level of care giver and occupation of head of the household were not significant determinants.Conclusion: There is need for health campaigns on ITNs targeted at unmarried care givers of young children. In addition, we also recommend social marketing of modern family planning methods to reduce family size, thereby increasing chances of ITN use among children less than five years to reduce malaria burden

Effectiveness of road safety education in Nigeria using a quasi-experimental trial: Findings from the Road Safety Intervention Project

Road traffic injuries pose a serious public health problem worldwide, especially in low-income countries. The aim of this study was to determine the effectiveness of a post-license road safety education intervention programme in terms of increased knowledge and self-reported behaviour among commercial minibus drivers in Lagos, Nigeria. This was a quasi-experimental study conducted in three phases. Participating motor parks (selected by simple random sampling) were assigned to either the intervention or control group. All eligible minibus drivers were included with no matching. Data analysis was done with Epi-info version 3.5.1. Comparison was done in terms of group driver education versus no education, and pre- versus post-intervention. Out of an estimated 500 male drivers, 407 participated in the study. Most had some form of formal education. For both groups, pre-intervention knowledge scores were poor but improved significantly post-intervention in the intervention group. None of the drivers in the intervention group had good scores but this increased to 66,1% post-intervention. Their mean score increased from 34,4 ± 9,1 to 72,3 ± 10,2. Adherence to speed limits did not improve. The control group showed no significant changes. Post-license road safety education significantly improved knowledge but not self-reported adherence to speed limits. Similar, sustainable programmes should be offered to improve commercial drivers’ poor knowledge. Further studies are needed to determine deterrent factors to behaviour change.Keywords: road safety, intervention, commercial drivers, Nigeri

Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria

Background: Globally, postpartum depression is one of the most common but often unrecognized complications of childbirth, yearly affecting about 10\u201315% of postnatal women. This study aimed to determine the prevalence of postpartum depression and its predictors among postnatal women in Lagos. Methods: A descriptive cross-sectional study was conducted among 250 mothers in Eti-Osa Local Government Area of Lagos State, Nigeria, attending six Primary Health Care centers for infant immunization at six weeks post-delivery. Data was collected using a pretested semi-structured interviewer administered questionnaire which included the Edinburgh Postnatal Depression Scale. Analysis was carried out using SPSS version 23TM. Chi-square and logistic regression analyses were used to determine associations and predictive relationships between various factors and the presence of postpartum depression. The level of significance was set at <0.05. Results: The prevalence of postpartum depression was 35.6%. Multiparity, delivery by cesarean section, mother being unwell after delivery, and not exclusively breastfeeding the baby were the factors linked with postpartum depression. Following multiple logistic regression, having postpartum blues (p=0.000; OR=32.77; 95%CI=7.23-148.58)., not getting help with caring for the baby (p=0.008; OR=2.64; 95%CI=1.29-5.42), experiencing intimate partner violence (p=0.000; OR=5.2; 95%CI=2.23-11.91) and having an unsupportive partner (p=0.018; OR=2.6; 95%CI=1.17-5.78) were identified as predictors of postpartum depression. Conclusion: This study revealed a high prevalence of postpartum depression, identifying both the obstetric and psychosocial predictors. Social support for women both in the pre- and postnatal periods and routine screening of women for postpartum depression should be encouraged for early detection and immediate intervention

Tobacco use amongst out of school adolescents in a Local Government Area in Nigeria

Abstract Introduction Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents.Peer Reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London