Prevalence of Neonatal Tetanus in Northeastern Nigeria

Although efforts have been made towards improving the health of children across the globe with notable results, neonatal tetanus (NNT) remains a major contributor to the neonatal death rates in Nigeria. This problem calls for a concerted effort by the government to achieve the revised global NNT elimination deadline of 2015. The purpose of this cross-sectional quantitative study using secondary data was to establish the prevalence of NNT in Nigeria\u27s northeast region and to ascertain if there was any significant difference in frequency of antenatal care (ANC), trained traditional birth attendants (TBAs), and umbilical cord treatments, using single sample proportions test and chi-squared tests of independence. The framework for this research was the theory of planned behavior. The participants (N = 312) were mothers of NNT babies. In spite a continual decline in the NNT cases between 2010 (26%) and 2013 (9%), the prevalence rate of NNT was unacceptably high at 28.815%. Also, significant differences existed as mothers who gave birth to NNT babies received significantly fewer or no ANC (p \u3c 0.001), received significantly fewer or no attention from TBAs (p \u3c 0.001), and reported significantly fewer incidences of proper umbilical cord treatments (p \u3c 0.001). The chi-squared tests of independence resulted in significant differences in the frequencies of mothers who received ANC between Nigerian provinces (p \u3c 0.001) and mothers who had their baby\u27s umbilical cord treated (p = 0.005). This study will contribute to social change by guiding health care policy makers and immunization program managers on maternal and newborn health care services and indicate ways to build capacity of the TBAs for safe home delivery/hygienic handling of umbilical cord of newborns

Public Health Leadership Theory In Immunization Campaigns: a look at the Transactional and Transformational Leaderships Styles

The need for public health practitioners to acquire the attributes and the necessary skills that makes up an effective leader should not be over emphasized especially now that the challenges in the public health sector is more than ever before with emerging and re-emerging diseases. We all know that public health leadership aims to protect health of the public, promote good health at a population level, prevent diseases, and to reduce health inequity and inequality. There is no doubt that public health leaders require certain traits and skills to enable them build infrastructure that would prevent diseases, serve people irrespective of their backgrounds, ensure population based approach on public health issues, create strategies aimed at preventing diseases, promoting good health, adhere to timeliness and completeness of data collection, and have community-wide health strategies. The role of transactional and transformational leadership styles in immunization campaigns aims to give the desired leadership for policy makers to understand problems associated with immunization campaigns, so that the end result would be to create awareness on the importance of immunization among parents and other stakeholders, to enlighten the public on benefits associated with eligible children getting vaccinated with the vaccines. It is expected that once the right leadership is at the helm of affairs, social change would be promoted within communities to improve on the country’s the health indicators. Keywords: Public Health, Leadership Theory, Immunization Campaigns, Transactional Leadership and Transformational Leadership, Vaccine Preventable Disease

Globalization and the Spread of Multi-Drug Resistant Tuberculosis

Background Tuberculosis (TB), a disease caused by infection with Mycobacterium tuberculosis, affects more than one-third of the world’s population with approximately 9 million new cases and a death toll of one and a half million in 2013. A disease that is primarily airborne in its transmission in greater majority of cases and thus it is not possible to become infected without being exposed to the causative agent. This disease, which was well under control within the past decade or two, is now re-emerging and posing a threat across the globe and especially the sub-Saharan Africa. There is no doubt that the negative attributes of Globalisation play an important role especially in the spread of the multidrug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR) TB from countries with reported cases through a human host. Moreover, the combination of a large population of HIV-infected susceptible hosts with poor TB treatment success rates coupled with increased level of poverty among the populace, all of which is linked to globalisation, also contribute to the re-emergence of TB, and the emergence of MDR-TB and XDR-TB.Method Review of relevant literatures was conducted using manual library search and Internet articles. Other relevant websites were also visited to source for information. Results Suggested that collaboration between various countries would go a long way to contend the spread of MDR-TB and XDR-TB. This is possible by adopting important measures like the provision of well equipped infection control units at the entry points of various countries, training of TB specialists and medical personnel, provision of effective TB control programmes, enhanced TB surveillance system, economic empowerment of the resource poor communities, re-structuring the health reforms and increase public awareness campaigns.Conclusion Considering the fact that globalization plays an important role in the spread of MDR tuberculosis, there is a need for policy makers and international partner organizations to increase their collaborations and to strengthen all required measures to curtail the spread of this deadly but completely curable disease, whose treatment is, in economic terms, cost effective. Keywords Globalisation, Tuberculosis, Multidrug Resistance TB, and extensively drug-resistant TB (XDR) TB

The future of health informatics and electronic health records: a look at the Canadian surveillance systems

In the 21st century of information and technological advancement, the emergence of health informatics and use of software applications have in no measure transformed the way surveillance is carried out. The investment in bioterrorism and automated surveillance systems has further stimulated new informatics methods in the public health sector. Thus, it suffices to say that informatics methods and systems have the potential to improve the quality and consistency of clinical preventive services. Importantly, there are wide ranges of applications in use in the aspect of surveillance, epidemiology, prevention and control. The importance of sharing surveillance data and health data between and among agencies is essential to early warning systems in terms of disease spread and bioterrorism. It is vital to have a comprehensive and effective surveillance system in place so as to monitor disease trend and to ensure that information delivered are accurate, timely and complete; this strategy aims to prevent outbreaks and to protect the health of the public. However, this is not possible without a functional info-technology system in place such as the availability of a computer system to aid in in effective tracking, identifying, collecting, validating, and analyzing data; this measure would ensure that the public and other stakeholders are well informed on any possible outbreaks for necessary measures to be put in place. There is need for other economically advanced countries to take a leave from Canada as the government is internationally recognized not only as a leader in health care prevention and promotion but also a founder of the healthy communities’ movement; this could not have been possible without the government’s strong commitment to fundamental change towards bringing an enviable healthcare to the door steps of Canadians. Key Words: Electronic health records, Surveillance, Tele-health, Tele-medicine, Syndromic Surveillance, Canad

Prevalence of Neonatal Tetanus in Northeastern Nigeria

Background: Neonatal tetanus (NNT), a deadly vaccine preventable disease and one of the most underreported diseases in the developing countries, is seen in the newborn within the first 28 days of life. NNT remains one of the leading causes of deaths among neonates in the developing countries with about 130,000 neonatal deaths recorded in 2004. In the 1989 World Health Assembly and the 1990 world summit for children, WHO/UNICEF together with partner agencies called for the elimination of tetanus by 1995. Despite the global success recorded in the NNT elimination strategy, Nigeria is still among the 25 remaining countries that are yet to achieve the global NNT elimination target as set by the WHO. Study Design: Retrospective study Methods: This quantitative cross-sectional study involved mothers who gave birth to NNT babies between January 2008 and December 2013. . The study used secondary dataset collected by trained NNT surveillance officers in the northeast zone of Nigeria using a standard tool. Results: Although the trend of NNT in the region showed a decrease in cases with fewer cases 9% (27/306) recorded in 2013, the prevalence rate of NNT was unacceptably high at 28.815%. Conclusion: Though at a slow pace, it is clear that the measures put in place by the Nigerian government towards meeting the 2015 NNT elimination deadline is yielding positive results. In spite this, there is need for policy makers to increase their commitments to ensure that Nigeria meet up with the 2015 NNT elimination deadline

An Evaluation of the Integrated Disease Surveillance and Response (IDSR) in Enugu State, Nigeria

Background: The Integrated Disease Surveillance and Response (IDSR), adopted in 1988 at the 48th World Health Organization Regional Committee for Africa meeting in Harare, Zimbabwe, is a regional strategy to strengthen the weak national surveillance systems in the region. In Nigeria, and prior 1988, there was no coordinated system of disease reporting and surveillance system in place until after a major yellow fever outbreak in 1986/87 that claimed many lives. The IDSR in Enugu state, as supported by the WHO, has 17 disease surveillance and notification officers across the 17 LGAs and 89 reporting sites covering the 3000 health facilities. Method: This study is a prospective cross-sectional study using WHO and CDC assessment protocols modified to reflect the local settings. The study samples were selected based on the IDSR performance indicators for AFP, measles core indicators, status of epidemic-prone diseases, and adequacy of feedback and feedforward of surveillance activities. Using desk review of the EPI/IDSR surveillance reports between 2012 and 2017, and also questionnaires between April and July 2017 to eligible participants, data were obtained, cleaned, and analysed using the SPSS version 24. Results: The Overall average score of IDSR performance indicator for Enugu state from the pooled data was 39% against the expected of >80%. These findings are in disagreement with the globally recommended standard IDSR practice and response. Conclusion: The outcome of this study highlights that Enugu state surveillance and IDSR practice are short of the standard practice as prescribed by WHO and CDC assessment protocols. Main reasons for this include poor disease reporting, poor documentation of conducted activities, and lack of adequate feedback system. Similarly, there is non-involvement of community and private health facilities that made up more than 95% of surveillance networks in the state. However, global polio eradication initiative and change management approaches identified remain a huge opportunity for the improvement of the system. Keywords: Enugu State, IDSR, AFP, Measles, Outbreaks, Yellow Fever, Nigeria, WHO, CDC.

Trends of measles in Nigeria: A systematic review

Background: Measles, a highly infectious viral disease, is endemic in developing countries with a peak of transmission from October to March. The case fatality rate of measles in the developing countries stands at around 3-5%; this could be as high as 10% during epidemics. Although natural infection with the measles virus confers life-long immunity, those vaccinated with the vaccine could get up to 10 years of protection. In spite of the availability of measles vaccines, there have been sporadic measles outbreaks, especially in developing countries, hence the need to know the underlying cause. Study Design: Systematic review. Method: Relevant literature was reviewed on trend of measles. The literature accessed from the W.H.O and UNICEF sites, and also using Google search include case-series studies, community-based studies on age-specific measles case fatality ratios (CFRs), and cohort analysis of surveillance data. Results: The review shows that lowest measles CFR is seen among the vaccinated children and highest seen among the unvaccinated children. Additionally, the broad range of case and death definitions of measles as well as the study population and geography, clearly highlight the complexities in extrapolating results for global public health planning. Conclusion: The outcome of several studies has shown that measles outbreaks are associated with factors that include: weak measles case-based surveillance in some areas, lack of awareness about the disease among parents, vaccine stock-out, and lack of adequate cold chain equipment to preserve the vaccine in remote hard-to-reach areas

Polio eradication in Nigeria: evaluation of the quality of acute flaccid paralysis surveillance documentation in Bauchi state, 2016

Abstract Background Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a cross-sectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. Methods We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders’ knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet. Results Of the 18 LGA Disease Surveillance and Notification Officers (DSNOs), only 2 (11%) and 5 (28%) had reports of polio outbreak investigations and supervisory visits at the lower levels, respectively. Furthermore, only 6 (33%) and 7 (39%) of the DSNOs had minutes of meetings and surveillance work plans, respectively. Of the 31 AFP cases investigated, only 39, 26, 23, and 23% had correct and complete information for the birth day, birth month, date of onset of paralysis, and date of investigation, respectively. Seventy-one percent of the clinicians at the AFP focal sites knew the correct definition for AFP compared with only 30% at the non-focal sites. Of the 38 caregivers (mothers), 16 (42%) did not remember the day or month the AFP investigation was conducted. However, 95% gave a correct number of stool samples collected and 40% mentioned that the samples were collected 24 h apart. Feedback was not given to 26 (68%) of the caregivers. The majority (79%) of the community leaders knew how to recognize a case of AFP and knew that the stool was the specimen required for the investigation, but 21% did not know to whom they should report a case of AFP in their community. Conclusion This study revealed a gap in the quality indicators for polio eradication in the state, especially regarding knowledge and documentation for AFP surveillance at the operational level. Regular training of the DSNOs and focal persons, regular sensitization of clinicians, community education, supplies of reporting tools, and ensuring their judicious use will improve AFP surveillance in the state