Knowledge and Attitude of Fathers towards Childhood Vaccination in Ogun State, Nigeria: A Comparative Study.

ACKGROUND/OBJECTIVES: Vaccine-preventable diseases (VPDs) have been shown to account for one-fifth of deaths among under-fives. Father's knowledge and attitude greatly influence the approval and uptake of childhood vaccination in patriarchal communities. This study aimed to assess and compare fathers' knowledge and attitude to childhood vaccination in urban and rural communities of Ogun State, Nigeria. METHODS: Four hundred and forty men each were interviewed in rural and urban areas. An interviewer-administered questionnaire was used to elicit data which were analyzed with IBM SPSS version 20. Mean ages of respondents were compared using T-test while chisquare was used in testing association between categorical variables. Results were presented in tables and P < 0.05 was considered statistically significant. RESULTS: There was no statistically significant difference in the mean ages of residents in the urban and rural areas (t = -1.82, p= 0.07). A greater proportion of rural participants (51.4%) had an overall good knowledge of childhood vaccination as against 45.2% of urban men but this difference was not statistically significant with p = 0.069. A greater percentage of participants in the urban area (58.0%) had an overall positive attitude to male participation in childhood vaccination compared to 54.1% of rural men. However, this difference was not statistically significant (p= 0.204). CONCLUSION/RECOMMENDATION: There was better knowledge of childhood vaccination among rural participants. In contrast, attitude towards childhood vaccination was better among urban residents. There is a need for educational interventions that may positively influence the attitude of men towards childhood vaccinations, particularly in rural areas to be conducted by the government, health workers, and other stakeholders through various communication media and adopting diverse health education methods.

CONTEXTE/OBJECTIFS: Il a été démontré que les maladies évitables par la vaccination (MEV) sont responsables d'un cinquième des décès chez les moins de cinq ans. Les connaissances et l'attitude du père influencent grandement l'approbation et l'adoption de la vaccination des enfants dans les communautés patriarcales. Cette étude visait à évaluer et à comparer les connaissances et l'attitude des pères vis-à-vis de la vaccination des enfants dans les communautés urbaines et rurales de l'État d'Ogun, au Nigeria. MÉTHODES: Quatre cent quarante hommes ont été interrogés dans les zones rurales et urbaines. Un questionnaire administré par un enquêteur a été utilisé pour obtenir des données qui ont été analysées avec IBM SPSS version 20. Les âges moyens des répondants ont été comparés à l'aide du test T, tandis que le test du carré a été utilisé pour tester l'association entre les variables catégorielles. Les résultats ont été présentés sous forme de tableaux et P < 0,05 a été considéré comme statistiquement significatif. RÉSULTATS: Il n'y a pas de différence statistiquement significative entre l'âge moyen des résidents des zones urbaines et rurales (t= -1,82, p= 0,07). Une plus grande proportion de participants ruraux (51,4 %) avait une bonne connaissance générale de la vaccination infantile contre 45,2 % des hommes urbains, mais cette différence n'était pas statistiquement significative avec p = 0,069. Un pourcentage plus élevé de participants de la zone urbaine (58,0 %) avait une attitude globalement positive à l'égard de la participation masculine à la vaccination des enfants, contre 54,1 % des hommes en milieu rural. Toutefois, cette différence n'était pas statistiquement significative (p = 0,204). CONCLUSION/RECOMMANDATION: Les participants rurauxavaient une meilleure connaissance de la vaccination des enfants. En revanche, l'attitude envers la vaccination des enfants était meilleure chez les citadins. Il est nécessaire que le gouvernement, les agents de santé et les autres parties prenantes mènent des interventions éducatives susceptibles d'influencer positivement l'attitude des hommes à l'égard des vaccinations infantiles, en particulier dans les zones rurales, par le biais de divers moyens de communication et en adoptant diverses méthodes d'éducation sanitaire. Mots clés: Connaissance, attitude, rural, urbain, vaccination des enfants, État d'Ogun.

The Value of the Combined Assessment of COPD in Accurate Characterization of Stable COPD.

There is evidence showing a tendency to upgrade COPD severity previously staged with spirometric-based GOLD (GOLD 1234) when using the new GOLD combined disease assessment (GOLD ABCD). The aim of our study was to compare the GOLD 1234 classification in a population of stable COPD patients with the GOLD ABCD classification to determine whether stable COPD was upgraded when using this new classification. After an observational study of a stable COPD cohort (n = 112), 61 patients (54.5%) had an increase in their COPD severity when moving from the old GOLD 1234 classification to the current GOLD ABCD assessment (p < 0.01). 42 patients (37.5%) had no change in severity of COPD. 9 patients COPD were assessed to be better on using GOLD ABCD. This study highlights previously missed high-risk patients when reviewing stable COPD. Continued incorporation of GOLD ABCD will translate into better evidence-based management.

The influence of environmental sanitation on prevalence of malaria in a rural town in south-western Nigeria.

INTRODUCTION: The single most significant cause of morbidity and mortality in sub-Saharan Africa and other third world countries is the poor standard of environmental sanitation.This factor plays a major role in disease transmission especially for endemic diseases such as malaria. This study was therefore designed to assess the influence of environmental sanitation on prevalence of Malaria in a rural town in South-Western Nigeria. METHODS: This was an analytical cross-sectional study. A multi stage cluster sampling technique was used to select the participants into the study. One participant per each household was selected into the study. A semistructured questionnaire was used to collect relevant information. RESULT: A total of 300 households were recruited into the study. Only 14 [4.7%] were regularly involved in daily cleaning of the environment outside their houses and 286 [95.3%] were aware that dirty environment increases the risk of contracting malaria. Majority 178 [62.2%] believe that bushes around the house are major facilitators of malaria. 32 [11.2%] mentioned presence of stagnant water while 76 [26.6%] mentioned unclean drainage system. The prevalence of Malaria attack in the last 6 months among respondents was 192 (64.0 %). Regular cleaning of respondent's environment outside their houses was statistically significant associated with prevalence of Malaria in the households studied [OR = 1.88, CI = 2.61-54.13] while the knowledge of environmental impact on malaria [OR = 1.37, Cl = 0.92-2.05] and malaria transmission [OR = 0.70, CI = 0.43-1.12] were not statistically significandy associated with prevalence of malaria. CONCLUSION: The study concludes that regular cleaning of house surroundings was associated with prevalence of malaria infection in rural areas in Nigeria. Sustainable control and elimination of malaria cannot occur in isolation from other sector of the society most especially the environmental health and engineering services.

Awareness and attitudes to noise and its hazards in motor parks in a sub-urban Nigerian town.

AIMS AND OBJECTIVES: The study assessed awareness and attitudes of people working in the environment (users) of the motor parks (but not travelers), in a sub-urban town to environmental noise and its hazards. SUBJECTS AND METHODS: Regular users of major motor parks in Sagamu were administered with pretested structured questionnaire to obtain information on their awareness and attitudes concerning noise and NIHL at the parks. Descriptive and comparative analysis of the data obtained was performed by using SPSS version 15.0. RESULTS: Data from 387 subjects were analysed; 61.2% were males, mean age was 35.5 11.4 years, 56.8% had secondary school education, and 50.6% were vehicle drivers or conductors. 51.2% ascribed vehicular traffic the major source of noise generation at the parks, while average noise level was 84.1 ± 6.0 dBA. Among the subjects, 61.2% approved motor park was noisy, 47.8% (185/387) were aware of NIHL. Awareness did not change with age and sex, but increased significantly with level of education. 51.9% were concerned about the noisy environment, 12.7% (49/387) protected themselves from the effect of the noise, 6.1% used ear plugs. Attitudes of the users did not change with age, sex, and level of education. CONCLUSIONS: Noise level at the motor parks were marginally high, awareness of the users to noise and its hazards was relatively high but attitudes concerning protection from noise hazards was poor. Health education for the users and noise regulation at the parks were recommended.

Predictors of indoor insecticides spray utilization in the prevention of malaria related mosquito bites in Ogun State, Nigeria: a community based study.

BACKGROUND: Modern medicine tends to interpret health in terms of medical interventions and to overemphasize the importance of medical technology. It is important to promote the concept of health as the result of the interaction of human beings and their total environment. METHODS: This was a descriptive cross-sectional study. A cluster sampling technique was used to select the participants into the study. The study was carried out between January 2012 and February 2012. One participant per household was selected into the study. A semi-structured questionnaire was used to collect relevant information which was collated and analyzed using SPSS 15 statistical software. RESULTS: A total of 400 households were recruited into the study. The prevalence of insecticide spray utilization in the last 6months was 18.5%. Source of information on the use of insecticides included the radio/TV 174 (43.5%), Relatives 78 (19.5%), Health workers 54 (13.5%), friends 68 (17.0%) and others 26 (6.5%). Reasons for not using insecticides included being expensive (cost) 94 (23.5%), fear of side effect 16 (4.0%), Inconvenience 38 (9.5%) and un-availability 74 (18.5%). Predictors of utilization of insecticide spray were young age (< 30 yrs) of heads of household (OR = 5.10, CI = 1.06-21.7), tertiary education (OR = 9.14 CI = 1.13-53.08), Nuclear family structure (OR = 2.45 CI = 1.13-3.74) and availability of insecticide spray CONCLUSION: The study shows that households with heads that are young and educated are more likely use insecticide spray. The study indicates that programs that will be geared towards increasing the knowledge and awareness of indoor insecticide spray in the prevention of Malaria should be introduced at the community level.

Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in Ogun State, Nigeria.

INTRODUCTION: Disclosure may reduce the transmission of HIV by raising awareness and decreasing risky behavior, thus status disclosure is an issue to be addressed for HIV prevention and treatment. The objective of this study was to determine the prevalence and determinants of HIV status disclosure to sexual partners among People Living with HIV/ AIDS (PLWAs) in Ogun state, Nigeria. MATERIALS AND METHODS: This study is an analytical cross-sectional study. A sample of people living with HIV/AIDS attending secondary health facilities in Ogun State were recruited into the study. RESULTS: Of the total 637 interviewed, 324 (50.9%) indicated that they have disclosed to their main sexual partner. About 44.6% of the respondents reported that they do not know their partner's HIV status, while 30.3% had a negative partner and 25.1% with HIV-positive partners. Among the participants who disclosed their HIV status, 17.3% disclosed on the day of receiving test result, 15.5% within two weeks, 9.7% in 2 to 4 weeks, 8.3% in 1 or more months. Predictors of disclosure were individuals who were married [OR = 4.52, CI = 2.06-9.92] living within monogamous family [OR = 1.67, CI = 1.10-2.53], had anticipation of partner's support before disclosure [OR = 3.68, CI = 2.36-5.76] with knowledge of partner's sero-status either positive [OR = 4.08, CI = 2.62-6.35] or negative [OR = 2.49, C.I = 1.59-3.90] and had a low self-esteem [OR = 0.61, CI = 0.42-0.89]. CONCLUSION: Disclosure rate was low in this African population. The study implies that PLWAs especially those having a difficult family life should be supported to make effective decisions to disclose their status. HIV sero-status should be addressed in behavioral interventions like counseling on positive living and a multidisciplinary approach to develop positive self-esteem through follow-up counseling.

Parental influence on reproductive health behaviour of youths in Ibadan, Nigeria.

The study was carried out to document parental influence on the reproductive health behaviour of youths in Ibadan, Nigeria. A cross-sectional survey of 274 youths from Idikan community was carried out. Information on the socio-demographic characteristics, parental communication, parental monitoring and sexual practices of respondents were collected using a structured interviewer-administered questionnaire. A total of 274 youths were interviewed, 111 (40.5%) were sexually active. The overall mean age at first sexual exposure was 15.2 +/- 3.0 yrs (males = 15.4 +/- 3.5 yrs, females 14.90 +/- 2.6 yrs). Fifty-two (19.0%) respondents used condom regularly. More out of school youths (42.2%) were more sexually active than those in school (38.7%) (chi2 = 0.32 p = 0.573). Youths (50.8%) with secondary school education used condom regularly than those with primary education 40.4% (p > 0.05). Mothers were more involved in family life education than fathers (40.9% vs. 16.8% p < 0.05) and family life education was found to promote condom use (p < 0.001). Predictors of regular condom use among the youths were comprehensive family life education by mothers (OR = 6.24, C.I = 2.47-15.75, p = 0.001), respondents' level of education (OR = 0.415, C.I = 0.211-0.814 p = 0.011) and occupation (OR = 0.48, C.I = 0.24-0.95 p = 0.034). While comprehensive family life education by mothers (OR = 2.11, C.I = 1.04-4.28, p = 0.038), female sex (OR = 2.2, C.I = 1.28-3.83 p = 0.005) and liberal monitoring pattern by mother (OR = 2.16, C.I = 1.03-4.53 p = 0.04) were predictors of increased sexual activity. Parents particularly mothers can promote safe sexual practices by giving information and education on reproductive health matters.

An evaluation of the informed consent process for elective surgery at a university hospital.

BACKGROUND: To evaluate on a limited scale the process and quality of the consenting process in our local environment following the increasingly important issue of informed consent and its validity to most physicians and hospital administrators in the face of an emerging litigious Nigeria society. METHODS: A 22 item questionnaire was administered on 60 consecutive patients admitted for elective surgery into the general and specialty surgical wards of the University College Hospital over a one month period. RESULTS: No question in our study achieved the ideal standard of 100%. At the time of admission, 57 of the 60 patients knew their clinical diagnosis from the primary surgical team with 90% (n=54) of the subjects expressing varying degrees of satisfaction with the information they had on their condition. Only about 32% of the patients got additional information on the diagnosis and planned surgery from sources other than the admitting surgical team. In this group of participants there was no significant difference in the sufficiency of information obtained between the two sources (p > 0.05) Ninety percent of the subjects however preferred they had all the information about their operation much earlier than the pre-operation day. Patients satisfaction with overall information obtained during the consenting process was only 'very sufficient' in 35% of the cases. CONCLUSIONS: Notwithstanding the information derived by patients from their primary surgeons in addition to alternate sources, satisfaction with overall information obtained was marginal at 35%. There is a need to look into methods of improving the process, quality and validity of informed consent.

Self medication practices among workers in a tertiary hospital in Nigeria.

Studies in most developing countries revealed (70-95%) of illnesses are treated through self medication. Poor accessibility to medical services have been associated with this practice. This study determines the pattern of self medication among workers at the University College Hospital, Ibadan, Nigeria. In a cross sectional study, workers were selected using a stratified random sampling technique. A high proportion of workers (73%) reported the practice of self medication and 95.6% of them correctly use appropriate drugs. About 80% of these workers stock their drugs at home. Also, 80.4% procure their drugs in chemist shops. A higher proportion of workers directly involved with medical care services (90.9%) practice self medication compared to those involved with non-medical care services (62.9%), P < 0.01. Also, the higher the education of workers the more is the proportion that practice self medication. (P < 0.05). Self-medication is commonly practiced among the hospital population who have relatively easy access to medical care services. Thus self medication may be a real health option.

Risk factors associated with mental illness in Oyo State, Nigeria: a community based study.

BACKGROUND: The main objective of this study was to determine the prevalence and factors associated with mental illness in Oyo State at community level using the general health questionnaire as a screening tool. METHOD: This cross-sectional, community- based survey was carried out among adults in three randomly selected LGAs using multi-stage sampling technique. RESULTS: A total of 1105 respondents were assessed in all. The overall prevalence of psychiatric morbidity in Oyo state Nigeria was found to be 21.9%, (18.4% in the urban areas and 28.4% in the rural areas, p = 0.005). Young age < or = 19 yrs (X2 = 20.41, p = 0.00013), Unemployment (X2 = 11.86 p = 0.0005), living condition below average (X2 = 12.21, p = 0.00047), physical health (X2 = 6.07, p = 0.014), and large family size (X2 = 14.09 p = 0.00017) were associated with increase risk for psychiatric morbidity. Following logistic regression analysis, Unemployment (C.I = 1.18-3.70, OR -2.1) and living conditions perceived to be above average (C.I = 1.99-5.50, OR-3.3) were significant predictors of mental illness while family size less than 6 (C.I = 0.86-0.97, OR-0.91) was protective. CONCLUSION: The teenagers and the rural populations are in greater need of mental health promotional services. Family planning should be made freely available in order to reduce the family size and hence incidence of mental illness in the African population.

Job satisfaction among primary health care workers in three selected local government areas in southwest Nigeria.

BACKGROUND: The primary health care system in Nigeria has been impaired by lack of dedicated workers who are willing to work in the rural areas. This study was carried out to examine factors that enhance job satisfaction among health workers in the primary health care system in Nigeria. METHOD: The study is a cross-sectional descriptive study conducted in May 2002. The respondents were selected from three local government areas in southwest Nigeria by multistage sampling technique. A standardized structured pre-coded close-ended self-administered questionnaire to collect relevant information on their socio-demographic characteristics and extent of job satisfaction of respondents. RESULT: A total of 125 health workers were interviewed in all. The mean score on job satisfaction was 26.15 out of the total possible score of 49. There was no statistically significant relationship in job satisfaction among the various cadres of health workers considered (p = 0.824). A larger proportion (66.4%) of the health workers were involved with the community based preventive services when compared with the health centre based curative care 33.4% (p < 0.05), there is however no significant difference in satisfaction between this two groups of personnel (p = 0.133). Age and marital status were found to be statistically significant in relation to job satisfaction (p = 0.000 and 0.034 respectively). CONCLUSION: The study shows no significant difference in job satisfaction among the various cadres of health workers in southwest Nigeria. However age and marital status were found to be significant factors influencing job satisfaction among the primary health care workers in Nigeria.

Road safety practices among commercial motorcyclists in a rural town in Nigeria: implications for health education.

This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 +/- 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly (r = 0.198, p = 0.001, chi2= 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (chi2= 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence of road traffic accidents.