Methylated spirit versus chlorhexidine gel: A randomized non-inferiority trial for prevention of neonatal umbilical cord infection in Jos, North-Central Nigeria.

BACKGROUND: Omphalitis is an important cause of neonatal sepsis (NNS) and mortality. Quantitative estimates of risk of omphalitis-related neonatal death is about 10%-19%. Topical applications of antiseptics have been shown to reduce this risk burden but has not been well investigated. AIM: To demonstrate non-inferiority of methylated spirit to chlorhexidine (CHX) gel for prevention of omphalitis, NNS and mortality at day 28. METHODS: This was a randomized, non-inferiority trial of methylated spirit versus CHX gel with 161 and 162 mother-baby pairs, respectively, conducted between July 2017 and May 2018. SPSS version 23.0 was used for data analysis to examine for incidence of omphalitis, time-to-cord separation, NNS and mortality. Relative risk and 95% confidence interval were used as point and interval estimates, respectively, with a non-inferiority margin of 10% set for CHX gel while a P values <0.05 was statistically significant. RESULTS: The median age of newborns was 18 h; (IQR: 8-24) h with the risk of omphalitis being 2% higher with CHX gel compared to methylated spirit (RR = 1.020; 95% CI; 0.988-1.053; P = 0.053). The median times-to-cord separation were 7.0 days (IQR: 2-17) and 7.0 days (IQR: 2-18) for methylated spirit and CHX gel, respectively (mean difference: ‒0.2145; 95% CI = ‒0.9085-0.4759; P = 0.544). There was no difference in the risks of NNS and mortality among those treated with methylated spirit compared to those exposed to CHX gel (RR: 1.0; 95% CI = 0.984-1.017; P = 1.000) and (RR: 1.0; 95% CI = 0.994-1.018; P = 0.986) respectively. CONCLUSIONS: There is no evidence that 96% methylated spirit is inferior to 4% CHX gel in preventing neonatal omphalitis; hence, it may be considered a safe and effective alternative where CHX gel is unavailable.

Public-private mix in tuberculosis control: an assessment of level of implementation in Jos, Plateau State.

AIMS AND OBJECTIVES: After the initial gains in Tuberculosis case detection and cure rates, progress became stunted by persisting constraints and challenges in the implementation of the Directly Observed Treatment Short course strategy. This prompted the Stop Tuberculosis partners in 2006 to adopt innovative approaches including the Public-Private Mix, to improve access to and quality of care. This paper assesses the level of Public-Private Mix in Tuberculosis control in Jos, Plateau State. MATERIALS AND METHODS: This was a facility-based, cross sectional study where data from all consenting private health care facilities owned by medically trained personnel and private medical practitioners in Jos North and Jos South Local Government Areas was collected using structured questionnaires. RESULTS: Eight (47.1%) of all 17 facilities assessed gave anti Tuberculosis drugs on clinical suspicion of Tuberculosis, 5(29.4%) required Acid Fast Bacillus result and 3(17.6%) referred elsewhere for the Tuberculosis management. Only 6 facilities (35.3%) were microscopy, treatment centres, or both. Ten (58.8%) of the facilities had the Directly Observed Treatment Short course guidelines, but these could be sighted in only 5 (29.4%), while six (35.3%) had Tuberculosis record and referral forms. In 13 (76.5%) of the facilities, no local government Tuberculosis and Leprosy supervisors had ever visited them. Only 30 (57.7%) medical practitioners had access to the Directly Observed Treatment Short course. Thirty two (61.5%) respondents treated Tuberculosis according to the Directly Observed Treatment Short course strategy, but 19 (36.5%) still used the conventional method. Only 22(42.3%) practitioners had ever received any training on the Directly Observed Treatment Short course strategy. CONCLUSION: The level of Public-Private Mix in Tuberculosis control in Jos is low.

Factors affecting the utilization of long lasting insecticide treated bed nets among people living with HIV/AIDS in Bassa Local Government area of Plateau State, Nigeria.

OBJECTIVE: Malaria and HIV account for over four million deaths per year thereby contributing significantly to the current global health burden. Insecticide Treated Nets (ITNs) represent a practical and effective means to prevent malaria in Africa. This study was conducted to determine the factors affecting the utilization of Long Lasting Insecticide Treated bed Nets (LLITNs) among People Living with HIV/AIDS (PLHIV). METHODS: An interventional study with a before and after design conducted among PLHIV to determine the factors affecting the utilization of LLITNs. EPI info statistical software version 3.5.4 was used for data analysis. Confidence interval for this study was set at 95% with a corresponding P ⩽ 0.05 considered statistically significant. RESULTS: This study reported a mean 33.86 + 11.50 years with statistically significant improvement in the consistency of LLITNs use after the intervention. Furthermore, the likelihood of use of LLITNs was 9 times more among respondents with tertiary education when compared to other levels of education (Odd's ratio = 9.3712; 95% CI = 2.5261 - 34.7652; P = 0.0008). CONCLUSION: This study has demonstrated positive influence of provision of free LLITNs supported with health education on the consistent utilization of LLITNs as well as certain factors that can influence LLITNs use.

OBJECTIF: Le Paludisme et le VIH Compte Pour plus de 4 millions de décèsv parano ainsi contribuant ainsi de manièresignificative à l' insectiade de la charge mondiale de santé actuelle imprégnées (MSA) représentent un moyen pratique et éfficace pour prévenir le paludisme en Afrique. Cette étude a été menée afin de déterminer les facteurs qui influent sur l'utilisation à long terme des Moustiquaires imprégnéesd'insecticide (LLTNS) chez les personnes vivantes avec le VIH le SIDA. MÉTHODE: Une étude interventionnelle avec un avant ou après la conception menée auprès la conception menée auprès dc PVVIH afin, de déterminer les facteurs qui influent sur l'utilisation de LTMII EPI info version du logiciel statistique 3.5.4 a été employé pour analyser des données; confidence de l'intervalle pour cette étude a été fixée à 5% avec un correspondant P ⩽ 0.05 considère comme statistiquement significatif. RÉSULTAT: Cette étude a signalé une moyenne de 33.86 + 11.50 ans avec l'amélioration statistiquement significative dans la cohérence de LTMII employé aprèsl'intervention. En outre, la vraisemblance de l'utilisation des TMII était 9 fois plus chez les répondants ayant l'éducation supérieure par rapport aux autres niveaux de l'éducation(le ratio = 9.3712, 95% Cl = 2.5261 ­ 34.7652; P = 0.0008). CONCLUSION: Cette étude avail démontré les influences positives de la provision de LTMI libres, soutenu à l'éducation sanitaire sur l'utilisation cohérente des (LTMII) ainsi que certains facteurs qui peuvent influencer l'utilisation de LTMII.

Situational analysis of orphans and vulnerable children in urban and rural communities of Plateau State.

BACKGROUND: Orphans and Vulnerable Children (OVC) are children affected by HIV and AIDS by virtue of, among others, living in a household where one or more people are ill, dying or deceased, or which fosters orphans, and children whose care givers are too ill or old to continue to care for them. They often have more health needs than their peers. This study was carried out to obtain baseline information on the needs of OVC in North-Central Nigeria as a basis for provision of relief services. METHODS: A house to house cross-sectional survey of OVC recruited via a multistage sampling technique was carried out in four LGAs of Plateau State, Nigeria. The Child Status Index (CSI) tool was used to obtain information from the respondents and/or their caregivers. Vulnerability of the children was assessed using a Vulnerability Index (VI) scoring which ranged from 1-21, with 1-9 being vulnerable, 10-14 more vulnerable, and 15-21 being most vulnerable. RESULTS: A total of 825 OVC ages ranging from 0-17 years and mean age of 9.8 ± 4.5 years were studied. 432 were males (52.4%) and 393 females (47.6%). 64.8% lived in households headed by women out of which 77.6% were widows. Six hundred and one (72.8%) household heads were farmers. Paternal orphans made up 59.8% of the respondents and 12.1% had lost both parents. Prevalence of abuse/exploitation was 17.7% and 66.7% experienced household food insecurity. Four hundred and seventy-eight (57.9%) OVC lived in households with no source of income. One hundred and fifty-one (18.3%) children (54.9% boys and 45.1% girls) had never been to school. 55.0% had minimal health problems. Majority of them (60.3%) lived in dilapidated shelter and 3.3% were living on the street. CONCLUSION: This survey revealed the various needs of OVC. Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as education, shelter and clothing, but also on long-term developmental needs that reduce children's vulnerability such as life skills, child protection, vocational training, food security and household economic strengthening.