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1.
J Infect Prev ; 24(5): 199-205, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37736122

RESUMO

Background: Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities. Aim: Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness and existing preventive measures at the facilities. Methods: Onsite assessments were conducted at ALFs using a modified CDC Infection Control Assessment and Response (ICAR) Tool. Data was obtained on IPC measures, training, testing, vaccination etc. Data was analyzed, frequencies generated, and bivariate associations determined. Results: A total of 118 facilities were assessed and categorized into small scale 46 (39%), medium scale 47 (40%), and large scale 25 (21%). The facilities had 2431 residents and 2290 staff. Thirty-one (26%) facilities reported an outbreak in 2020, while 14 (12%) had an ongoing outbreak. Twenty-three (97%) large-scale and 12 (26%) small-scale facilities had COVID-19 testing program. Vaccination coverage among residents ranged from 99% in large-scale to 40% in small-scale facilities but was smaller among staff at 748 (45%) in large scale, 71 (36%) in small scale, and 193 (45%) in medium scale. While 24 (96%) large-scale and 34 (77%) of small-scale facilities conducted staff training staff on IPC practices, 22 (92%) of large-scale and 19 (56%) of small-scale facility staff demonstrated capacity (p = 0.01), respectively. Visitor screening was done at 100% of large-scale and 80% of small-scale and the medium-scale ALFs. Discussion: Assisted living facilities within the city of Houston are at various levels of preparedness and interventions with respect to COVID-19 response.

2.
Pan Afr Med J ; 38: 54, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854683

RESUMO

INTRODUCTION: option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja. METHODS: we enrolled 284 HIV positive pregnant women and lactating mothers in a hospital-based cross-sectional study. We sampled respondents using two-staged sampling technique. We collected data on socio-demographic characteristics, level of adherence, patients and healthcare related factors affecting adherence, knowledge of clients on HIV, ART and MTCT. Focused group discussion guide, data abstraction form and key informant interview guide were used for PMTCT focal persons. We conducted bivariate analysis and logistic regression using Epi-Info version 7 at 5% level of significance. RESULTS: the mean age of respondents was 30.12 years (SD±4.86) with mean knowledge score of 16.7 and 75.5%% of them had good knowledge. The level of good adherence was 83.3%. Independent factors associated with non-adherence to ART included: Forgetfulness (OR 20.02; 95% CI 6.42-62.48), having side effects (OR 39.6; 95% C.I: 4.46-352.32), lack of food (OR 34.76; 95% C.I: 2.37-509.33), disclosure of HIV status (OR 2.51; 95% CI 1.22-5.15), being too busy (OR 13.96; 95% CI 3.89-49.98). Encountering challenge in ART initiation (OR 2.05; 95% CI 1.01-4.72) and level of Knowledge (OR 2.12; 95% CI 1.06-5.42). CONCLUSION: the level of adherence would improve study if the Public health department of Federal Ministry of Health (FMOH), Federal Capital Development Authority (FCDA) and National Agency for the Control of AIDS (NACA) sponsors public enlightenment on HIV/AIDS through the media which may help reduce stigma and encourage voluntary HIV status disclosure. Reminders should be used by patients to help them overcome forgetfulness.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Adesão à Medicação , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactação , Pessoa de Meia-Idade , Nigéria , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/virologia , Estigma Social , Revelação da Verdade , Carga Viral , Adulto Jovem
3.
Pan Afr Med J ; 33: 101, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489079

RESUMO

INTRODUCTION: Despite the effectiveness of intermittent preventive treatment in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), the uptake and coverage in southwest Nigeria are low. We assessed the factors influencing utilisation of IPTp-SP. METHODS: A multistage sampling technique was used to select 400 pregnant women from six primary healthcare centers in Oyo State. Data on socio-demographic characteristics, knowledge, attitude towards IPTp-SP and its utilisation were obtained using a semi-structured questionnaire. Data were analyzed using SPSS software. Focus group discussions (FGD) and key informant interviews (KII) were held for pregnant women and healthcare workers and analysed thematically. RESULTS: Mean age of respondents was 27.2 (SD ± 5.5) years. Mean gestational age was 29.5 weeks (SD ± 5.4). Overall, 320 (80.0%) took SP, of which 152 (47.5%) took 2 doses and 112 (35.0%) took under directly observed therapy (DOT). We found that early booking for ANC, more than two visits to ANC (adjusted odds ratio (aOR) = 5.6; 95% CI: 1.2 - 26.6), good knowledge on IPTp (aOR = 9.3; 95% CI: 5.4 - 16.0), positive attitude towards IPTp (aOR = 2.1; 95% CI: 1.5 - 2.9) and being employed (aOR = 1.4; 95% CI: 1.1 - 1.7) were factors associated with IPTp-SP utilisation. The FGD and KII revealed that IPTp-SP drugs were mostly taken at home due to stock out. CONCLUSION: Late ANC booking with stock out of IPTp-SP drugs was responsible for its low utilisation. There is need to encourage pregnant women to book early for ANC. Adherence to the practice of DOT scheme is recommended to improve IPTp-SP utilisation.


Assuntos
Antimaláricos/administração & dosagem , Malária/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Pirimetamina/administração & dosagem , Sulfadoxina/administração & dosagem , Adulto , Terapia Diretamente Observada , Combinação de Medicamentos , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Nigéria , Gravidez , Cuidado Pré-Natal/métodos , Atenção Primária à Saúde/métodos , Inquéritos e Questionários , Adulto Jovem
4.
Pan Afr Med J ; 32(Suppl 1): 9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949284

RESUMO

INTRODUCTION: Despite the availability of vaccines, pertussis outbreaks still occur in developing countries. In December 2015 we investigated a pertussis outbreak in Kaltungo, Nigeria to identify determinants of infection and institute control measures. METHODS: We enrolled 155 cases and 310 unmatched controls. We defined cases as residents of Kaltungo with paroxysmal or whooping cough lasting 2 weeks with or without vomiting and randomly selected neighborhood controls. Using structured questionnaire, we collected data on socio-demographics, clinical and risk factors. We collected twelve nasopharyngeal swabs for laboratory analysis using Polymerase Chain Reaction. RESULTS: Median age was 24 months (range 1-132 months) for cases and 27 months (range 1-189 months) for controls. Female cases and controls were 86 (55.5%) and 150 (48.4%) respectively. A total of 83 (56.6%) cases were in age group 12-59 months. Age-specific-attack-rate was 83/1,786 (4.7%); Age-specific-case-fatality-rate was 21/83 (25.3%); Age-specific-proportional-mortality-ratio was 21/24 (87.5%). A total of 61 (39.4%) zero doses and 30.1% Pentavalent dropouts were documented. Multivariate analysis revealed parental refusal (adjusted OR = 27.8; CI = 8.8-87.7), contact with a case (AOR = 7.9, CI = 4.3-14.7, P = 0.000), belonging to the Muslim faith (AOR = 2.0; CI = 1.1-3.5) and having mothers with informal education only (AOR = 4.7, CI-2.6-8.4) as independent predictors of pertussis infection. CONCLUSION: Sub-optimal vaccination due to parental refusal and informal education of mothers were major determinants of pertussis infection. We conducted awareness campaigns of key immunization messages targeted at the informal education sector. We ensured appropriate case management, contact vaccination and health education in public gatherings, worship places and schools.


Assuntos
Surtos de Doenças , Vacina contra Coqueluche/administração & dosagem , Cobertura Vacinal , Coqueluche/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Escolaridade , Feminino , Humanos , Lactente , Masculino , Análise Multivariada , Nigéria/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Recusa de Vacinação/estatística & dados numéricos , Coqueluche/prevenção & controle
5.
Pan Afr Med J ; 32(Suppl 1): 14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949288

RESUMO

INTRODUCTION: Intimate Partner Violence (IPV) is an under-reported public health problem. This study determined the prevalence of IPV and types of IPV, complications and factors associated with IPV among women accessing health services. METHODS: we conducted a cross-sectional survey of 702 women accessing maternal and child health services in Enugu State, Nigeria using multi-stage sampling technique. Quantitative data was collected using semi-structured questionnaire, qualitative data by key informant interview (KII). We analysed data using descriptive statistics, bivariate and multivariate logistic regression analysis. The level of statistical significance was set at p-value < 0.05. Qualitative data was analysed using thematic content analysis. RESULTS: mean age of respondents was 27.71 ± 5.14 years and 654 (93.2%) were married. Prevalence of IPV, a year before last pregnancy, was 307 (43.7%) and during last pregnancy was 261 (37.2%). Frequent involvement in physical fights with other men, controlling behaviour and younger aged partners (< 40 years) were independent predictors of IPV experience both before and during pregnancy. Independent predictors of IPV experience before and during pregnancy were younger aged partners (< 40 years). [Adjusted Odds Ratio AOR 1.72; 95% confidence interval (CI) = 1.17, 2.53], partner having controlling behaviour AOR 2.24; 95% C.I=1.51-3.32) and Partner's frequent involvement in physical fights (AOR 2.29; 95% C.I = 1.43-3.66). Having a male child and married/cohabiting were protective against violence. KII revealed poverty, lack of education and infidelity as common triggers of IPV. CONCLUSION: the prevalence of IPV and types of IPV was high and the predisposing factors of IPV in Enugu were multifactorial. Couple counselling sessions that focus on non-violence conflict resolution techniques is crucial to end IPV.


Assuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Parceiros Sexuais , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Análise Multivariada , Nigéria/epidemiologia , Gravidez , Prevalência , Fatores de Proteção , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
6.
Pan Afr Med J ; 32(Suppl 1): 16, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949289

RESUMO

INTRODUCTION: vital events registration is not accurately done in Nigeria. Hence, mortality data is often not available. Health facility-based data can provide useful information on the trends in mortality of a population. This study describes the trend of deaths in a tertiary health facility. METHODS: a retrospective review of the medical records of all patients that died in the Federal Medical Centre, Owo, Ondo State, Nigeria from 2006 to 2014 was conducted. Data extracted from the records included age, sex, primary cause of death and date of admission and death. Frequencies were done and the median age of male and female deaths were compared using Mann-Whitney U test. RESULTS: a total of 1,326 deaths occurred in the hospital. The median age at death was 46 years (range: 0-110), median age was 49 years in males and 43 years in females (p = 0.025). One fifth (20.9%) of deaths was in infants. The median length of hospital stay was 4 days (range: 0-277). The highest proportion of death (16.4%) was in 2009 and on Wednesdays (15.9%). More deaths occurred in January (11.5%) and (10.3%) in February than in other months. The leading cause of communicable disease death in age 1 and above were HIV (15.2%) and TB (2.5%). Birth asphyxia (39.3%) and low birth weight (46%) were the commonest cause of death in infants. CONCLUSION: over the years the leading causes of mortality were preventable. Infant mortality remains a public health problem. Hospital mortality data could guide health decision making and interventions in Nigeria. Interventions to reduce death from communicable diseases and in infants are urgently recommended.


Assuntos
Causas de Morte/tendências , Doenças Transmissíveis/mortalidade , Mortalidade Hospitalar/tendências , Mortalidade Infantil/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doenças Transmissíveis/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Estações do Ano , Estatísticas não Paramétricas , Fatores de Tempo , Adulto Jovem
7.
Pan Afr Med J ; 32(Suppl 1): 2, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984324

RESUMO

INTRODUCTION: The Ebola Virus Disease (EVD) epidemic devastated West Africa, with Sierra Leone recording over 50% of the 28,610 cases across the three most affected countries. Enhanced surveillance system was developed for improved identification of cases and response in Sierra Leone. Here, we evaluated the surveillance system to determine its strengths and challenges in meeting the set objectives. METHODS: The EVD surveillance system in Tonkolili District, Sierra Leone, was assessed using the CDC updated guidelines for evaluating public health surveillance. In particular, the simplicity, stability, acceptability, flexibility, representativeness, sensitivity, positive predictive value and data quality of the system were assessed using EVD surveillance data and information from key informant interviews with program stakeholders. RESULTS: The EVD surveillance system in Tonkolili District provided information and data on disease trends and outbreak report through official and rumours sources. Case definitions were well understood by participants, with willingness to continue surveillance activities after the EVD outbreak. Standardized data collection tools were in place and data communication was clear with feedback to surveillance units at all levels. The EVD surveillance was not operated within the Integrated Disease Surveillance and Response framework (IDSR). Data completeness was about 91%, consistency existed but data quality was poor (incompletely filled data and missing data existed). Regarding timeliness, samples arrived designated laboratory within 24 - 48 hours in 174 (84.9%). Sensitivity of the surveillance system was 88.5%. Predictive value positive was 25.8%. The stability was questionable since the government of Sierra Leone were not fully in charge of the system. CONCLUSION: While the simplicity of the EVD surveillance system in Tonkolili District facilitated its implementation, users suggested that the system did not meet expectations in terms of timeliness, flexibility and acceptability. There was a need to channel efforts towards integrating EVD surveillance into the IDSR. Data completeness and timeliness needed more attention. The District Health Management Team need to take ownership of the surveillance system for sustainability.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Vigilância da População/métodos , Epidemias , Humanos , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Serra Leoa/epidemiologia , Fatores de Tempo
8.
Pan Afr Med J ; 32(Suppl 1): 7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984328

RESUMO

INTRODUCTION: tuberculosis (TB) is the commonest opportunistic infection and cause of death in patients with Human Immunodeficiency Virus (HIV) in developing countries. World Health Organization (WHO) recommends 85% treatment success rate for all TB cases as an indicator of TB control. The study aimed at determining TB treatment success rate among TB-HIV co-infected patients and identifying predictors of successful treatment among patients in TB treatment sites in Abeokuta, Nigeria. METHODS: it was a cross-sectional study among HIV-TB co-infected patients in the two major health facilities in Abeokuta, Nigeria. Socio-demographic characteristics with treatment history were obtained using a semi-structured questionnaire. Sputum samples were collected and tested for acid-fast bacilli (AFB) using a standard method according to national guideline for TB treatment to determine treatment success rate. Treatment success was defined as any HIV positive patient with a diagnosis of TB by acid-fast bacilli (AFB) smear positivity at diagnosis, who after 6 months of complete treatment becomes smear negative. Adjusted odds ratio was used to identify independent predictors of successful treatment outcome with confidence interval set at 95% and level of significance set at P < 0.05. RESULTS: a total of 109 HIV-TB co-infected patients were enrolled for this study. Fifty-nine (54.1%) were females, 106 (97.3%) were newly treated for TB. Eighty-five (78.0%) were treated in a private health facility. A total of 91 had successful treatment outcome with a treatment success rate (TSR) of 83.5%. Eleven (10.1%) died, 5 (4.6%) defaulted, 1 (0.9%) failed treatment, 1 (0.9%) was transferred out. Successful treatment was associated with being newly registered (i.e. receiving TB treatment under the DOTS program for the first time), receiving TB treatment for the first time (adjusted OR = 18, 95%CI: 1.5-482.3) and being treated at a private health facility (adjusted OR = 14.1, 95%CI 4.27-48.4). CONCLUSION: treatment success rate of TB among HIV-TB co-infected patients in this study slightly falls below the WHO target. Registration status and health facility type were predictors of treatment outcome among study patients. Patients and healthcare workers in public facilities were educated on HIV-TB co-infection management.


Assuntos
Antituberculosos/administração & dosagem , Coinfecção , Infecções por HIV/complicações , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Criança , Estudos Transversais , Terapia Diretamente Observada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Escarro/microbiologia , Resultado do Tratamento , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adulto Jovem
9.
Malar J ; 17(1): 231, 2018 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-29914488

RESUMO

BACKGROUND: Utilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children. The 2013 Nigeria Demographic and Health Survey revealed Osun State had the least proportion (5.7%) of under-five children (U5) who slept under LLIN the night before the survey. A study was conducted to assess caregivers' knowledge about LLIN, utilization of LLIN and factors influencing LLIN use among U5 in Osun State, Nigeria. METHODS: A cross-sectional study was carried out among 1020 mothers/caregivers of U5 selected from six communities in Osun State using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on socio-demographic characteristics, mothers' knowledge about LLIN, ownership and utilization of LLIN and factors influencing use of LLIN in U5. Questions on knowledge about LLIN were scored and categorized into good (scored ≥ 5) and poor (score < 5) knowledge out of a maximum obtainable score of seven. Utilization of LLIN was defined as the proportion of U5 who slept under net the night before the survey. Data were analysed using descriptive statistics, Chi square test and logistic regression at α < 0.05. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers' perspectives on utilization and factors affecting use of LLIN among U5. RESULTS: Majority of the respondents 588 (58.3%) fall between age 25-34 years, with a mean age of 30.0 ± 6.3 years. All were aware of LLIN but only 76.1% had good knowledge and 59.0% reported use of LLIN among their U5. Reported barriers to utilizing LLIN were; heat (96.4%), reactions to the chemical (75.5%) and unpleasant odour (41.3%). These were corroborated at FGD. Those with formal education [adjusted odds ratio (aOR) = 1.4; 95% CI 1.0-2.1] and those with good knowledge of LLIN (aOR = 1.8; 95% CI 1.4-2.5) were more likely to use LLIN than their counterparts without formal education and those with poor knowledge of LLIN respectively. CONCLUSIONS: The level of knowledge of respondents about LLIN was high and the utilization of LLIN among U5 was above average, however, it is still far below the 80% target. Efforts should be made to further improve utilization of LLIN through intensified promotion and health education.


Assuntos
Cuidadores/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Controle de Mosquitos , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Grupos Focais , Humanos , Lactente , Recém-Nascido , Nigéria , Adulto Jovem
10.
Int J Ment Health Syst ; 11: 26, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28413440

RESUMO

BACKGROUND: Snakebite though neglected, affects 5 million people yearly. More neglected is the psychological effect of envenomation. We determined prevalence and pattern of depression among patients admitted into snakebite wards of Kaltungo General Hospital Nigeria, and percentage recognized by clinicians. We also assessed for factors associated with depression. METHODS: In a descriptive hospital based study, we used Patient Health questionnaire (PHQ-9) to make diagnosis of depression among the patients. We reviewed patients' clinical records to determine clinicians' recognition of depression. RESULTS: Of 187 interviews analyzed, 47 (25%) had depression with none recognized by attending clinicians. Patients with snakebite complications (odd ratio [OR] 3.1, 95% CI 1.1-8.5), and previous history of snakebites (OR 2.7, 95% CI 1.1-6.1) were associated with mild depression. Worrying about family welfare (OR 31.5, 95% CI 6.5-152.9), financial loss (OR 14.6, 95% CI 1.8-121.5) and time loss (OR 14.6, 95% CI 1.8-121.5), past history of snakebites (OR 8.3, 95% CI 1.9-36.5) and lower income (Mean difference -25,069 [84 USD], 95% CI 35,509 [118 USD]-14,630 [49 USD]) were associated with severe depression. CONCLUSION: A quarter of in-patients of snakebite wards of the general hospital had comorbid depression that went unrecognized. Independent predictors of depression such as past history of snakebite, worrying about relations and having snakebite complications could help clinicians anticipate depression among patients. We recommend training of clinicians in the hospital on recognition of common psychological disorders like depression.

11.
BMC Public Health ; 16(1): 828, 2016 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-27538947

RESUMO

BACKGROUND: Malaria case management remains a vital component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, anecdotal evidence shows some deviations from the guidelines in malaria case management. This study assessed factors influencing adherence to malaria diagnosis and treatment guidelines among healthcare workers in public and private sectors in Ogun State, Nigeria. METHODS: A comparative cross-sectional study was carried out among 432 (216 public and 216 private) healthcare workers selected from nine Local Government Areas using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on availability and use of malaria Rapid Diagnostic Test (mRDT) and artemisinin combination therapy (ACT), for management of uncomplicated malaria. Adherence was defined as when choice of antimalarials for parasitological confirmed malaria cases was restricted to recommended antimalarial medicines. Association between adherence and independent variables were tested using Chi-square at 5 % level of significance. RESULTS: Malaria RDT was available in 81.9 % of the public health facilities and 19.4 % of the private health facilities (p = 0.001). Its use was higher among public healthcare workers (85.2 %) compared to 32.9 % in private facilities (p = 0.000). Presumptive diagnosis of malaria was higher among private healthcare workers (94.9 %) compared to 22.7 % public facilities (p = <0.0001). The main reason for non-usage of mRDT among private healthcare workers was its perceived unreliability of mRDT (40.9 %). Monotherapy including artesunate (58.3 % vs 12.5 %), amodiaquine (38.9 % vs 8.3 %) and chloroquine (26.4 % vs 4.2 %) were significantly more available in private than public health facilities, respectively. Adherence to guidelines was significantly higher among public healthcare workers (60.6 %) compared to those in private facilities (27.3 %). Availability of antimalarial medicine was the main factor that influenced treatment prescription in both healthcare settings (p = 0.27). However, drug promotion by manufactures (45.8 %) has a major influence on private healthcare workers' prescription practice. CONCLUSION: The findings of this study demonstrate significant difference between public and private healthcare workers on adherence to national malaria diagnosis and treatment guidelines. Interventions to improve private sector engagement in implementation of the guidelines, training and supply of recommended antimalarial medicines should be intensified.


Assuntos
Antimaláricos/uso terapêutico , Atenção à Saúde/normas , Prescrições de Medicamentos/normas , Fidelidade a Diretrizes , Instalações de Saúde/normas , Pessoal de Saúde , Malária/tratamento farmacológico , Adulto , Amodiaquina/uso terapêutico , Antimaláricos/provisão & distribuição , Artemisininas/uso terapêutico , Artesunato , Administração de Caso/organização & administração , Estudos Transversais , Testes Diagnósticos de Rotina/métodos , Quimioterapia Combinada , Feminino , Humanos , Malária/diagnóstico , Masculino , Pessoa de Meia-Idade , Nigéria , Guias de Prática Clínica como Assunto , Setor Privado , Setor Público , Adulto Jovem
12.
Trop Med Int Health ; 20(9): 1162-1170, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25943138

RESUMO

OBJECTIVE: Healthcare workers (HCWs) play pivotal roles in outbreak responses. Ebola virus disease (EVD) outbreak spread to Lagos, Nigeria, in July 2014, infecting 11 HCWs (case fatality rate of 45%). This study was conducted during the outbreak to assess HCWs' EVD-related knowledge and practices. METHODS: A health facility-based cross-sectional study was conducted among HCWs across Lagos State using stratified sampling technique. An interviewer-administered questionnaire was administered to elicit respondents' socio-demographic characteristics, knowledge and practices. A checklist assessing health facility's level of preparedness and HCWs' EVD-related training was employed. HCWs' knowledge and practices were scored and classified as either good or poor. Multivariate analysis was performed with confidence interval set at 95%. RESULTS: A total of 112 health facilities with 637 HCWs were recruited. Mean age of respondents was 40.1 ± 10.9 years. Overall, 72.5% had good knowledge; doctors knew most. However, only 4.6% of HCWs reported good practices. 16.6% reported having been trained in identifying suspected EVD patient(s); 12.2% had a triaging area for febrile patients in their facilities. Higher proportions of HCWs with good knowledge and training reported good practices. HCWs with EVD-related training were three times more likely to adopt good practices. CONCLUSION: Lagos State HCWs had good knowledge of EVD without a corresponding level of good practices. Training was a predictor of good practices.

13.
PLoS Curr ; 72015 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-25914860

RESUMO

BACKGROUND: The first ever outbreak of Ebola virus disease (EVD) in Nigeria was declared in July, 2014. Level of public knowledge, perception and adequacy of information on EVD were unknown. We assessed the public preparedness level to adopt disease preventive behavior which is premised on appropriate knowledge, perception and adequate information. METHODS: We enrolled 5,322 respondents in a community-based cross-sectional study. We used interviewer-administered questionnaire to collect data on socio-demographic characteristics, EVD-related knowledge, perception and source of information. We performed univariate and bivariate data analysis using Epi-Info software setting p-value of 0.05 as cut-off for statistical significance. RESULTS: Mean age of respondents was 34 years (± 11.4 years), 52.3% were males. Forty one percent possessed satisfactory general knowledge; 44% and 43.1% possessed satisfactory knowledge on mode of spread and preventive measures, respectively. Residing in EVD cases districts, male respondents and possessing at least secondary education were positively associated with satisfactory general knowledge (p-value: 0.01, 0.001 and 0.000004, respectively). Seventy one percent perceived EVD as a public health problem while 61% believed they cannot contract the disease. Sixty two percent and 64% of respondents will not shake hands and hug a successfully treated EVD patient respectively. Only 2.2% of respondents practice good hand-washing practice. Television (68.8%) and radio (55.0%) are the most common sources of information on EVD. CONCLUSIONS: Gaps in EVD-related knowledge and perception exist. Targeted public health messages to raise knowledge level, correct misconception and discourage stigmatization should be widely disseminated, with television and radio as media of choice.

14.
Pan Afr Med J ; 18 Suppl 1: 13, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25328632

RESUMO

INTRODUCTION: Non-communicable diseases (NCDs) are a leading cause of adult mortality globally, accounting for 63% of all deaths in 2008 with nearly 80% of those deaths occurring in developing countries. These NCDs which include hypertension and obesity alongside their complications accounted for 27% of all deaths in Nigeria, in 2008. We conducted a study among Kaduna State civil servants to determine the prevalence of hypertension, overweight/obesity and also to identify associated behavioural factors. METHODS: A cross-sectional design, with multi-stage cluster sampling technique was used. A structured questionnaire was used in gathering data on socio-demographics, physical activity, dietary habit, tobacco, and alcohol consumption. Blood pressure, body weight and height were measured, and body mass index (BMI) calculated. Descriptive statistics and logistic regression were used in identifying associations between these behavioural factors and hypertension/overweight/obesity. RESULTS: A total of 801 civil servants, mean age 43±9 years were interviewed, of which 62% were male. Prevalence of hypertension, overweight and obesity were 29%, 35% and 27% respectively. Physical inactivity was the most prevalent behavioural factor, 91%, followed by unhealthy diet 90%, and cigarette smoking 6%. Prevalence of overweight/obesity was higher among the senior cadre than the junior cadre (69% versus 54%, p<0.01). Increasing age was an independent predictor of hypertension. Female respondents were four times more likely to be overweight/obese than males (AOR=3.7, 95%CI 2.5-5.4). CONCLUSION: Hypertension and overweight/obesity with their behavioural risks are prevalent among civil servants in Kaduna. Age and gender-specific public health strategies to promote healthy- living in the workplace are being advocated for with concerned authorities.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Adulto , Antropometria , Estudos Transversais , Países em Desenvolvimento , Dieta , Feminino , Órgãos Governamentais , Hábitos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Ocupações , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Estudos de Amostragem , Comportamento Sedentário , Fumar/epidemiologia , Fatores Socioeconômicos
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