Prevalence of Needle Stick and Sharps Injury and Hepatitis B Vaccination among Healthcare Workers in a South-East Nigerian Tertiary Hospital.

BACKGROUND: Daily, HCWs are exposed to needle stick and sharps injury (NSSI) and associated risk of life-threatening infections. AIM: A cross-sectional study was conducted to determine the prevalence of NSSI and HBV vaccination among 341 HCWs at NAUTH, Nnewi. METHODS: Data was collected using a self-administered. questionnaire and interview of key staff. RESULTS: The mean age of participants was 33.4±11.9 years while male: female ratio was 1:1.7. Prevalence of NSSI in the preceding 12 months was 25.5% with doctors (43.0% [34/79]), laboratory scientists (27.5%[14/51]) and nurses (21.8%[17/78]) leading (p=0.014). Noncompliance with standard precaution (SP) and non-display of relevant SP SOPs in prominent places were significantly associated with NSSI (p=0.001). Among those exposed to NSSI, only 33.7% (28/83) consulted a doctor, while 16.9%(14/83) took post-exposure prophylaxis. Two-third (68.8% [190/276]) of respondents correctly cited HBV/HCV as vaccine-preventable blood-borne healthcare-associated infection (HAI) while half (50.9% [161/316]) had received HBV vaccination. Profession (p=0.018), display of SOPs in prominent places (p=0.015), ability to cite HBV/HCV as vaccine-preventable blood-borne HAI (p=0.001), and compliance with SP (p<0.001) were significantly associated with HBV vaccination. Unit heads' responses implied lack of written policy on HBV vaccination, adequate training on NSSI prevention, and HBV vaccination support. CONCLUSION: Among HCWs, NSSI is high but under-reported while HBV vaccination rate is unimpressive. Profession, display of relevant SOPs, and compliance with SP positively affected both NSSI occurrence and HBV vaccination while knowledge about vaccine-preventable blood-borne HAI also influence HBV vaccination status. Written policies on HBV vaccination and NSSI prevention/ management, their communication and enforcement among HCWs, adequate training/retraining, display of SOPs in prominent places, and free HBV vaccination are recommended.

CONTEXTE: Les travailleurs de la santé sont quotidiennement exposés aux blessures par piqûre d'aiguille et par objets tranchants (NSSI) et au risque associé. blessures par aiguilles et objets tranchants (NSSI) et au risque associé d'infections potentiellement mortelles. OBJECTIF: Une étude transversale a été menée pour déterminer la prévalence des blessures par aiguilles et objets tranchants et de la vaccination contre le VHB parmi 341 travailleurs de la santé à NAUTH, Nnewi. MÉTHODES: Les données ont été recueillies à l'aide d'un questionnaire autoadministré et d'un entretien avec un informateur clé. RÉSULTATS: L'âge moyen des participants était de 33,4±11,9 ans et le rapport hommes/femmes était de 1:1. le rapport hommes/femmes était de 1:1,7. La prévalence de l'INSS au cours des 12 mois précédents était de 25,5 %. mois précédents était de 25,5 %, avec des médecins (43,0 % [34/79]), des scientifiques de laboratoire (27,5 % [14/51]) et des professionnels de la santé. (27,5% [14/51]) et les infirmières (21,8% [17/78]) en tête (p=0,014). Le non-complaisance avec la précaution standard (SP) et le non-affichage des PONs pertinentes de la SP dans des endroits bien en vue étaient significativement associés à la NSSI (p=0.001). Parmi les personnes exposées aux MSSN, seuls 33,7 % (28/83) ont consulté un médecin, tandis que 16,9 % (28/83) ont consulté un médecin, tandis que 16,9% (14/83) ont pris une prophylaxie post-exposition. Deux tiers (68,8% [190/276]) des personnes interrogées ont correctement cité le VHB/VHC comme une infection transmissible par le sang et prévenue par un vaccin, tandis que la moitié (50,9% [161/316]) avait été vaccinée contre le VHB. La profession (p=0,018), l'affichage des SOPs dans des dans des endroits bien en vue (p=0,015), la capacité à citer le VHB/ VHC comme une IHA hématogène évitable par la vaccination (p=0,001) et la conformité à la PS (p<0,001) étaient significativement associés à la vaccination contre le VHB. Les réponses des chefs d'unité impliquaient l'absence de politique écrite sur la vaccination contre le VHB, de formation adéquate sur la prévention des INSS et de soutien à la vaccination contre le VHB. CONCLUSION: Parmi les travailleurs de la santé, l'INSS est élevée mais sous-déclarée tandis que le taux de vaccination contre le VHB n'est pas impressionnant. La profession, l'affichage de procédures opératoires normalisées (PON) pertinentes et la conformité à la PS ont eu un effet positif sur l'occurrence des INSS et la vaccination contre le VHB, tandis que les connaissances sur les infections hématogènes évitables par la vaccination influencent également le statut de la vaccination contre le VHB. Les politiques écrites sur la vaccination contre le VHB et la prévention et la gestion des INSS, leur communication et leur application parmi les établissements de soins de santé, une formation et un recyclage adéquats, l'affichage des procédures opérationnelles standard dans des endroits bien en vue, et la vaccination gratuite contre le VHB sont recommandées. MOTS CLÉS: Prévention, risques professionnels, personnel hospitalier, infections transmissibles par le sang, Nnewi.

Evaluation of hormonal changes in menstrual cycle of women infected with pulmonary tuberculosis in Nnewi, south eastern Nigeria.

BACKGROUND & OBJECTIVE: The present study was designed to evaluate the hormonal changes in menstrual cycle of premenopausal women infected with pulmonary tuberculosis in Nnamdi Azikiwe University Teaching Hospital Nnewi. MATERIAL AND METHODS: A prospective study involving sixty-seven (67) female participants within the child-bearing age were randomly recruited and grouped based on their tuberculosis status as: Symptomatic TB infected females (n=20), Symptomatic TB infected females on ATT (n=20) and Control females (n=27). After due consent, a detailed medical history was obtained and routine investigations of pulmonary tuberculosis and confirmation using Ziehl Neelsen and sputum culture techniques for AFB and chest x-ray were done. Blood samples collected from the participants were used for hormonal assay using immunoenzymometric method. RESULTS: The results showed that the serum levels of FSH and LH (IU/ml) were significantly higher while progesterone and estradiol were significantly lower in Symptomatic TB females compared to Symptomatic TB females on ATT at follicular and luteal phases of menstrual cycle (P<0.05). The serum levels of FSH and LH were significantly reduced in Symptomatic TB females on ATT while progesterone and estradiol were significantly increased at follicular and luteal phases of menstrual cycle (P<0.05). FSH was significantly higher at follicular phase while estradiol was significantly higher at luteal phase of menstrual cycle in Symptomatic TB females on ATT. CONCLUSION: Tuberculosis induced hypogonadism in affected women which seemed to be reversed on treatment. Routine investigation for Tuberculosis should be done for women presenting with infertility, since early treatment can reverse the abnormality.

Parents' perceptions of timing of initiation of sexuality discussion with adolescents in Anambra State, South Eastern Nigeria.

STUDY OBJECTIVE: This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria. DESIGN: A cross-sectional, descriptive, community-based study. SETTING: The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria. PARTICIPANTS: The study participants were parents with adolescent children resident in the study areas for at least 2 years. RESULTS: Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status. CONCLUSION: Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Postpartum practices among the Igbos in Nnewi Southeast, Nigeria.

BACKGROUND: Women all over the world engage in some forms of postpartum practices aimed at keeping mother and child healthy. Although some of the practices are beneficial, some are of no value while some are out rightly harmful. The objective of this study was to determine the prevailing postpartum practices engaged in by Igbo women of South Eastern Nigeria. The above knowledge could be used to reinforce the beneficial ones while discouraging the harmful ones. METHODS: This is a questionnaire survey of mothers attending infant welfare clinic of our hospital augmented by in-depth interviews of patients, nurses and nurse midwives. RESULTS: Three hundred and thirty (330) mothers were studied. The peak age group was 26 to 30 years (30%), 93% were currently married while trading was the most common occupation. Most of the mothers, 270 (81.8%) regularly drink hot water, 282(85.5%) bathed with hot water while another 270(81.8%) consistently took hot food. Three-quarter of the women or 250(75.8%) took very peppery food, 218(66.1%) tied cloth across the abdomen, 210(63.6%) applied hot compresses to the abdomen while 230(69.7%) regularly did sitz bath with hot water. One hundred and forty six (44.2%) resumed sexual intercourse within 12 weeks of delivery while menstruation returned within 12 weeks in 68(20.6%) of the mothers. Fifty four mothers(16.4%) test breast milk with ants to detect spoilt milk while 64(19.4%), 100(30.3%) and 176(53.3%) took hot water, palm wine and tea respectively to improve the flow of breast milk. Ninety four (28.5%) regularly apply mascara to their babies eyes to 'clear' the eyes. CONCLUSION: Although some of the postpartum practices engaged in by Igbo women were neither useful nor harmful, some were out rightly dangerous and should be discouraged. The findings would be incorporated in antenatal health talks.

Pulmonary problems among quarry workers of stone crushing industrial site at Umuoghara, Ebonyi State, Nigeria.

BACKGROUND: Respiratory problem is one of the major health hazards in dust-exposed workers; it is a major cause of morbidity and mortality all over the world. OBJECTIVE: To determine the prevalence of respiratory problems and lung function impairment among quarry workers in Ebonyi State, Nigeria. METHODS: Respiratory problems and lung function were studied in 403 quarry workers aged 10-60 years. Respiratory problems were investigated with a questionnaire based on international models adapted for the study population. Lung function was assessed by spirometry and chest roentgenography. RESULTS: The respiratory problems found were chest pain (47.6%), occasional cough (40.7%), occasional shortness of breath (6.5%) and wheezing (5.2%). The mean±SD FEV1 and FVC values were significantly decreased with length of exposure-respectively, 3.52±0.77 and 3.91±0.72 L for <5 years; 2.79±0.68 and 3.09±0.87 L for 5-10 years; and 2.03±0.92 and 2.86±0.83 L for >10 years of exposure. Moreover, the mean±SD FEV1 and FVC values of smoker (3.37±0.81 and 3.56±1.02 L, respectively) were significantly (p<0.05) lower than that of non-smokers (3.68±1.02 and 3.89±0.99 L, respectively) working in the quarry site. CONCLUSION: Chronic exposure to dust due to stone quarrying may increase the risk of respiratory problems and impaired lung function-cigarette smokers are at higher risk.

Prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory of Nigeria.

BACKGROUND: In developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food, water, nails, and fingers contaminated with faeces. Accordingly, food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. OBJECTIVE: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. MATERIALS AND METHODS: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool, urine, and fingernail analyses were carried out and the result scientifically scrutinized. RESULTS: FINGERNAIL BACTERIA ISOLATES INCLUDE: E. Coli (1.8%), coagulase-negative staphylococcus (17.9%), Staphylococcus aureus(7.1%), Klebsiella species (2.4%), Serratia species (1.2%), Citrobacter species (1.2%), and Enterococcus species (1.8%). The subjects' stool samples tested positive: For A. lumbricoides (14.9%), T. trichuria (1.8%), S. starcolaris (3.0%), E. histolytica (10.7%), G. lambilia (1.8%), S. mansoni (1.2%), and Taenia species (4.8%). Furthermore, 42.3% and 15.5% of the stool specimen tested positive for Salmonella and Shigella species, respectively. CONCLUSION: Food establishments should screen and treat staff with active illness, and regularly train them on good personal and workplace hygiene practices.

Patients characteristics and perception of quality of care in a teaching hospital in Anambra State, Nigeria.

INTRODUCTION: Patients' assessment of quality of health care despite its importance in uptake of available services has not been closely examined in developing countries. The main objective of this study was to assess patient's perception of the quality of healthcare services as offered at the General Outpatients Department (GOPD) of a teaching hospital in order to obtain rational information for effective policy formulation on improved patient care in our hospitals. METHODOLOGY: This was a four-week duration descriptive cross-sectional study involving three hundred and ninety (390) new adult patients seen at the General Out-Patients' Department of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Using a self-administered pre-tested, semi-structured questionnaire in English language, relevant information was obtained from the participants. RESULTS: A total of 390 adult new patients with mean age 31.4 years participated in the study of which females 216 (55.5%) were slightly more than males 174 (45.5%). About 225 (57.7%) of the respondents received at most a primary school education. The major reasons for seeking care at the GOPD were expectations of being attended to by qualified doctors and nurses (38%); receiving efficient and quality service (36%) and obtaining cheaper and affordable drugs (14.5%). A quarter ofthe patients (25%) waited for up to one hour to register, while 38% spent more than an hour before being attended to by a doctor. Seventy percent (70%) of thepatients opined that the nurses were friendly, 94.5% of the patients rated the doctors as being friendly while 82.5% expressed satisfaction with the care received from the doctors. The conditions of the waiting hall were deemed very comfortable by 42%,and 42% felt hat it was uncomfortable. In all 79% of the patients felt at the quality of care was good and 82% were willing to return for consultations in future if need be. CONCLUSIONS: The waiting time for obtaining the patients card and doctors' consultation appeared to be acceptably long in this hospital and some respondents were not satisfied with the services rendered. Further studies should be directed at ascertaining the cause of their dissatisfaction and strategies put promptly in place to reverse them. Y WORDS: quality of care, policy formulati atient consultation, GOPD

Pattern of substance use among senior students of command secondary schools in Ibadan, Nigeria.

BACKGROUND: The aim of this study was to assess the pattern of drug use among senior secondary school students within military locations in Ibadan, Nigeria. METHODS: A cross-sectional survey was carried out in 2006. RESULTS: Five hundred ten students participated with a mean age of 15.0 +/- 1.2 years. The prevalence of lifetime use of any substance was 15.3%. Alcohol (33.9%), solvents (17.3%), and tobacco (10.6%) were the most commonly used substances. Only gender and age were associated with the lifetime use of tobacco and solvents (p < 0.05). CONCLUSION: The information provided a useful baseline on which subsequent interventions could be based and evaluated.

Pattern of substance use among senior students of command secondary schools in Ibadan, Nigeria.

BACKGROUND: The aim of this study was to assess the pattern of drug use among senior secondary school students within military locations in Ibadan, Nigeria. METHODS: A cross-sectional survey was carried out in 2006. RESULTS: Five hundred ten students participated with a mean age of 15.0 +/- 1.2 years. The prevalence of lifetime use of any substance was 15.3%. Alcohol (33.9%), solvents (17.3%), and tobacco (10.6%) were the most commonly used substances. Only gender and age were associated with the lifetime use of tobacco and solvents (p < 0.05). CONCLUSION: The information provided a useful baseline on which subsequent interventions could be based and evaluated.

Religious leaders' perceptions and support of reproductive health of young people in Anambra State, Nigeria.

OBJECTIVES: This article assesses religious leaders' perceptions of young people's reproductive health in Anambra State. PATIENTS AND METHODS: Through self-administered semi-structured questionnaires, and in depth interviews, religious leaders perceptions of young peoples reproductive health in Anambra State Nigeria was elicited from two hundred and fifty religious leaders selected by multistage random sampling. RESULTS: Over 85% of the religious leaders thought that young people are sexually active, and are involved in high risk behaviour for unintended pregnancy, unsafe abortion, and STD and HIV/AIDS. Eighty five per cent felt that there is need for sexuality education in schools, and that sexuality education will reduce unintended pregnancy, abortion, STDS and HIV/AIDS among young people. However 52.2% felt that sexuality education in school would increase promiscuity. Some religious leaders did not support teaching of contraception and safe abortion in schools. CONCLUSION: Religious leaders in Anambra State have a high awareness of young people's reproductive health problem, and are in support of sexuality education in schools. They differ however in what should be the content of the curriculum. There is need to harmonise and agree on programme contents to minimise sending conflicting and confusing messages to young people.