Malaria prevention in pregnancy among traditional birth attendants in rural Lagos, Nigeria

Background: Malaria accounts for approximately 1 million deaths annually and about 300,000 deaths in Nigeria alone. Pregnant women are particularly vulnerable to adverse consequences of malaria. The National Malaria Policy has adopted the use of Intermittent Preventive Treatment and Insecticide Treated Net for prevention of malaria in pregnant women. This study therefore determined the knowledge and practice of Traditional Birth Attendants regarding prevention of malaria in pregnancy in 2 rural Local Government Areas of Lagos State, Nigeria.Method: A cross sectional, descriptive study design was adopted and a total of 68 Traditional Birth Attendants were studied. Data was collected using a structured, interviewer administered questionnaire. Analysis was done with EPI info 2008 and WinPepi statistical softwares.Results: Age range of respondents was 20-75 years and the mean age was 46.4±8.7 years. Most (67.7%) of the respondents were not aware of Intermittent Preventive Treatment. However, most(81.8%) of the respondents who were aware got the information from the health workers, while only 31.6% of those that aware knew the right drugs to be used.Conclusion: Overall knowledge of malaria prevention with Intermittent Preventive Treatment in pregnancy was poor. The knowledge and practice of malaria prevention in pregnancy among the Traditional Birth Attendants in Ikorodu and Badagry Local Government Areas was poor. It is therefore recommended that a sensitization and training of the Traditional Birth Attendants be carried out since a good number of women still patronize them.Keywords: Malaria, Pregnancy, Traditional Birth, Attendants, Rural, Lagos, Nigeri

Community awareness of bird flu and the practice of backyard poultry in a North-Central State of Nigeria

Introduction. The practice of backyard poultry is a very common practice in many homes in Nigeria. Birds raised at home are usually free ranged, which increases close contact between man and birds, thus increasing the risk of transmission of avian influenza virus to man. This study investigated the awareness of bird flu infection and identifies risk factors associated with the practice of backyard/free ranged poultry among the residents of a state in Northern Nigeria. Methods. This cross-sectional study was carried out in Kwara State using 130 wards selected through cluster sampling technique. Households in each ward were sampled through systematic random sampling technique using the primary health care house numbering register. Semi-structured questionnaire was used to generate relevant information through interview and 650 participants consented and were used for the study. Results. Most of the respondents 604 (92.9%) kept birds in their homes and one-third 204 (33.8%) of this group knew that infection from birds can be transmitted to man. However, less than a third186 (30.8%) of those who keep birds were aware of avian influenza (AI) infection. Out of the 186 respondents, 78 (41.9%) had experienced massive bird deaths in the preceding year prior to the interview. Less than half 81 (43.5%) were willing to report AI or massive deaths occurring in flocks of their birds to designated officers / authority. During outbreaks with massive deaths in birds some of the respondents sold infected live birds 45 (57.7%), few slaughtered and dressed the birds before sale 11 (14.1%), while some slaughtered and consumed the birds in their families 19 (24.4%). Conclusion. The practice of backyard poultry is very high with little knowledge and awareness of mechanism and risk of infection associated with it. This was also reflected in their attitude towards reporting of outbreaks in birds. Public awareness campaign and home visit by environmental and veterinary officers are important strategies that can prevent AI infection transmission among domestic birds and man

An Appraisal of Immunisation in Nigeria: Towards Improving Coverage

Nigeria has achieved modest progress in immunization coverage particularly in the 1980-1990 periods. However, coverage has declined since the achievement of this peak. One factor important in sustainability of coverage is routine immunization and increased awareness toincrease the knowledge of mothers on immunization. Within the country also there’s a wide interstate variation in coverage figures with a generally greater percentage of full immunization Coverage obtained in the southern zones than in the Northern zones. Even though the Nigeria’s universal child immunization coverage is said to have improved in the last two years much is still needed to bring the coverage target to at least 75% throughout the nation for effective control of all Vaccine Preventable Diseases. Targeted “mop-up” campaigns should be intensified for the wild polio virus transmission as found limited to a specific focal area, asfound presently in some northern parts of Nigeria. As for the control of  measles, experience globally also shows that routine immunization together with supplemental measles immunization can reduce measles deaths.Key words: Immunization coverage; appraisal; routine immunization; mop-up campaign

Knowledge of Ocular Complications of HIV/AIDS among Hospital Workers in a Tertiary Institution

Since the commencement of the Highly Active Antiretroviral Therapy, there has been increase longevity among people living with HIV/AIDS , a factor which was thought initially to be related to the low prevalence of its ocular complication in Sub-Saharan Africa. In fact some of its ocular signs have been identified as stigmata of HIV. It is therefore important that all health workers and not only eye care workers know about these eye complications. However there seems to be no study on the knowledge of health workers about ocular complications of HIV/AIDS. This study aimed at determining the knowledge of hospital workers in a tertiary institution in Western Nigeria about Ocular Complications of HIV/AIDS. The hospital workers excluding the eye care workers, administrative staff and security staff of Olabisi Onabanjo Teaching Hospital completed a structured self administered questionnaire. The interview covered demographics, cadre in health work, awareness of HIV/AIDS and its transmission, knowledge of its Ocular complications. Their responses were analysed using SPSS statistical package, version 11.0. 72.2% knew that HIV/AIDS could affect the eye which is related to the status of health work (P= 0.00) .About 50% of hospital workers do not know the part of the eye that HIV/AIDS could affect and another 52.5% says it affect the eye only at the late stage. Knowledge about different eye complications was generally low. Only 28.6% knew that it could present first as an eye problem. The knowledge of hospital workers about eye involvement in HIV/AIDS is low there is need to create awareness through regular workshops and seminars, which will in turn help to reduce ocular morbidity and mortality among the people living with HIV/AIDS.Key words: Ocular, HIV/AIDS, Hospital Worker

Gender and TB/HIV Co-Infection: Presentation and Treatment Outcome in Nigeria

TB is the leading single infectious cause of female deaths in the world. Women in their reproductive years have been said to have a higher risk of developing active tuberculosis compared to their male counterpart of the same age. The study aimed to investigate the relationship between gender and the outcome of TB/HIV co-infection among adult patients presenting at the Tuberculosis and Leprosy (TBL) clinic in Sagamu. A retrospective study of 103 HIV positive adults presenting at the TBL clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu between January 1997 and December 2003. Patients were followed up until the completion of the directly observed treatment programme for TB. A favourable outcome was defined as completion of the prescribed treatment for 8 months, while unfavourable outcome were patients who defaulted or died during treatment. Forty-four (42.7%) males and 59(57.3%) females had TB/HIV co-infection. At presentation the mean age was similar but females had a significantly lower body weight compared to males. At the end of 8 months of treatment, 42(71.2%) of females compared with 21(47.7%) of males (OR 2.71, 95% CI 1.11-6.67) had experienced a favourable outcome giving an overall favourable outcome rate of 61.2%. Among the 40 subjects with unfavourable outcome, 22 (55%) had died. There was no significant difference in mortality between male 12(27.3%) and female 10(16.9%). Males had twice the risk of treatment default than females (25% vs 11.9%; p=0.08). Lower body weight at presentation was associated with an unfavourable treatment outcome. Conclusion: Despite differences in presentation, women were more likely than men to adhere to treatment and have a favourable outcome. Men and patients with a lower body mass at presentation need additional support to adhere to treatment so as to have a favourable outcome. Key words: Gender, TB, HIV, Treatment, Outcome Nigerian Medical Practitioner Vol.47(4) 2005: 58-6

Prevalence and Risk Factors for Enuresis in Children

Enuresis is a significant clinical and social disorder in children with associated stigma. To determine the prevalence and risk factors associated with enuresis amongst school children in Nigeria. Cross-sectional descriptive study involving public and private primary school children in a local Government area of South West Nigeria. Five primary schools (public and private) were selected through multi-stage sampling technique. A semi - structured questionnaire was administered on the parents of pupils aged 6 years to 12years old respectively. A total of 424pupils were surveyed. Overall 173(40.8%) pupils had enuresis. Prevalence of enuresis was 40.7% in private school and 41% in the public but this difference was not significant (X2 =0.003,p = 0.954). Factors significantly associated with enuresis were snoring (X2 =26.67, p = 0.001), heavy and late supper (X2 =6.831,6.389,p = 0.009, 0.01) respectively. Sibling history of bedwetting (X2=25.933, p = 0.0001), maternal history of enuresis (X2 = 22.244,p = 0.0001,) and {lack of sleep interruptions - (not been woken up to urinate) (X2=5.234,p = 0.02)were also significantly associated. Using logistic regression, maternal history, sibling history of bedwetting, snoring and heavy supper are strong determinants of bedwetting. Enuresis is a common problem among primary school pupils. Intensive public enlightenment is needed.Key words: Enuresis, risk factors, prevalence, children, social-stigm

Infant Feeding and Lactational Amenorrhea in Sagamu, Nigeria

Five hundred and twenty educated, breastfeeding women in Sagamu, Nigeria, were observed prospectively in order to describe their infant feeding practices and to determine whether any predictors of the return of menses could be identified. The women remained amenorrheic for seven months. Compared with similarly selected women in other countries, they regularly fed their infants with supplements from a very early age, yet breastfeeding frequency and duration did not decline dramatically. Semi-solid food was introduced at about four months and such supplementation, as well as earlier supplementation with milk/milk-based feedings, was associated with the return of menses. The median duration of abstinence was about four months but the mean may have been much longer. No woman became pregnant until her infant was weaned. (Afr J Reprod Health 2002; 6[2]: 3950) Résumé Lallaitement et laménorrhée qui se rapporte à la lactation à Sagamu, au Nigéria. Cinq cent vingt femmes instruites et allaitant à Sagamu ont été observées prospectivement afin de décrire leurs pratiques dallaitement et pour déterminer sil était possible didentifier quelques indices du retour des règles. Les femmes sont restées aménorrhéiques pendant sept mois. Comparées aux femmes qui ont été selectionnées de la même manière dans dautres pays, elles nourrissaient régulierement leurs enfants du supplément dès leur très jeune âge; pourtant la fréquence de lallaitement et la durée nont pas baissé de façon dramatique. A lâge de presque quatre mois, on a initié les enfants à la nourriture semi-solides. Une telle administration dun supplément aussi bien quune administration antérieure dun supplément du lait et dautres nourritures à base du lait, ont été associées au retour des règles. La durée médiane de labstinence était à peu près quatre mois, mais la moyenne a probablement duré plus longtemps. Aucune femme nest devenue enceinte quaprès avoir sevré lenfant. (Rev Afr Santé Reprod 2002; 6[2]: 3950) Key Words: Breastfeeding, fertility, Nigeria, infant feeding, amenorrhea, Afric

Postpartum Sexual Abstinence and Breastfeeding Pattern in Sagamu, Nigeria

This was a prospective study involving 371 mothers. The mean age of the mothers was 27.5 (.3.6) years with a mean years at school (Educational years) of 11.3 (2.9) years. All the mothers had previously breastfed at one of their infants for at least 6 months, while the mothers also breastfed their last child for an average (mean) of 10.3 (4.0) months. The overall mean of previous live births was 1.9 (0.8). In the first month postpartum, 84.6% of the mothers abstained from sexual intercourse, but by the 4th-5th month the proportion had dropped to 18.1%, with just 2.1% of the study population abstaining from sexual intercourse at 11-15 months post-partum. Forty seven (13.5%), 30 (8.6% ) and 3 (0.9 % ) mothers in social classes 2,3 and 1 respectively have resumed sexual intercourse at 4-5 months, while only 12(3.4%) and 4(1.1%) in social classes 2 and 3 respectively continued with sexual intercourse at 11-15 months. More mothers resumed sexual intercourse from 1 to 15 months post-partum when they breast fed for 6-10 minutes and 11-15 minutes than those who breast fed for 1-5 minutes, 16-20 minutes and 21-25 minutes. Also more mothers within the 25-29 years age group resumed sexual intercourse from the first month to the fifteenth month post-partum than mothers in the other age groupsKeywords: Postpartum, Sexual, Abstinence, Breastfeeding, Sexually Transmitted InfectionsAfrican Journal of Reproductive Health Vol. 12 (1) 2008: pp. 96-10