Description of the design of a mixed-methods study to assess the burden and determinants of malaria transmission for tailoring of interventions (microstratification) in Ibadan and Kano metropolis.

BACKGROUND: Rapid urbanization in Nigerian cities may lead to localized variations in malaria transmission, particularly with a higher burden in informal settlements and slums. However, there is a lack of available data to quantify the variations in transmission risk at the city level and inform the selection of appropriate interventions. To bridge this gap, field studies will be undertaken in Ibadan and Kano, two major Nigerian cities. These studies will involve a blend of cross-sectional and longitudinal epidemiological research, coupled with longitudinal entomological studies. The primary objective is to gain insights into the variation of malaria risk at the smallest administrative units, known as wards, within these cities. METHODS/RESULTS: The findings will contribute to the tailoring of interventions as part of Nigeria's National Malaria Strategic Plan. The study design incorporates a combination of model-based clustering and on-site visits for ground-truthing, enabling the identification of environmental archetypes at the ward-level to establish the study's framework. Furthermore, community participatory approaches will be utilized to refine study instruments and sampling strategies. The data gathered through cross-sectional and longitudinal studies will contribute to an enhanced understanding of malaria risk in the metropolises of Kano and Ibadan. CONCLUSIONS: This paper outlines pioneering field study methods aimed at collecting data to inform the tailoring of malaria interventions in urban settings. The integration of multiple study types will provide valuable data for mapping malaria risk and comprehending the underlying determinants. Given the importance of location-specific data for microstratification, this study presents a systematic process and provides adaptable tools that can be employed in cities with limited data availability.

Knowledge and perceptions of date rape among female undergraduates of a Nigerian university.

This paper focuses on knowledge and perceptions of Date Rape (DR) among female undergraduates of the University of Ibadan. The cross-sectional survey was conducted among 651 female undergraduates selected using a four-stage random sampling technique. A semi-structured questionnaire which included a 6-point knowledge scale and a 21-points perceptions scale was used to collect data. Knowledge scores of 0- 2, 3- 4 and 5- 6 were rated as poor, fair and good respectively. Perception scores of 0-10 and 11-21 were categorized as supportive and non-supportive perception of DR respectively. Data were analyzed using descriptive statistics and Chi-square at p < 0.05. Mean knowledge score was 2.3 +/- 2.1 and 50.0% participants had poor knowledge of DR. Knowledge of DR increased significantly by level of study. Participants' had a mean perception score of 9.1 +/- 2.8 and 66.9% had perceptions supportive of DR. Campus-based educational programme have potentials for addressing the phenomenon.

Prevalence, determinants and coercive strategies relating to marital rape among women in Oyo State, Nigeria.

Objectives: The study assessed the prevalence, determinants and coercive strategies relating to Marital Rape (MR) among women in Oyo State, Nigeria. Design: A cross-sectional survey. Setting: The study was conducted in 120 communities, 30 wards, 6 Local Government Areas in Oyo State. Participants: A total of 1200 ever-married women aged 18-60 years were recruited using a multi-stage sampling. Methods: The participants were interviewed using a semi-structured questionnaire which captured MR-related experiences and coercive strategies. Data were analysed using descriptive statistics, Chi-square, and logistic regression. Odds ratios (OR) and their corresponding 95% Confidence Interval (CI) were reported. Results: Respondents' mean age was 36.6±9.6 years, while husbands' mean age was 42.1±10.3 years. Most (n=1094, 91.2%) respondents had ever married once and 82.8% (n=993) were currently married. The prevalence of MR was 15.3%. Physical force (n=153, 25.9%), followed by threat (n=139, 23.5%) topped the list of coercive strategies involved in MR. Currently, married women were at a higher risk of MR (OR: 2.73, CI: 1.39-5.37, P = 0.04) relative to divorced women. Respondents whose husbands were aged <30 years were at lower risk of MR (OR:0.03, CI: 0.002-0.47, P=0.01). Women who take decisions on sex alone were more likely to suffer MR (OR:3.95, CI: 1.38 - 11.31, P=0.01). Conclusions: Marital rape existed among women with increased risk among those who were currently married, married to older partners or sole decision-makers on sex. Physical force was the commonest coercive strategy used to facilitate MR. Community-based MR -related interventions are recommended. Funding: None declared.

Community acceptance, satisfaction, and support for case management of malaria of various degrees in selected rural communities in Ibadan, Oyo-State.

Objectives: This study aimed to assess communities' perception and adoption of the evidenced-based malaria diagnosis and case management intervention targeted at under-five children. The effectiveness of trained Volunteer Community Health Workers (VCHWs) to diagnose malaria among under-five children using rapid diagnostic testing kit, provide treatment using Artemisinin Combination Therapy and rectal Artesunate were assessed. Design: A qualitative evaluation study was conducted in October 2015. Setting: Communities in the 6 rural wards in Ona-Ara Local Government Area, Oyo State Nigeria. Participants: Caregivers of under-five children, community-based frontline health workers, and community leaders selected using purposively sampling. Methods: Nine Focus Group Discussions and 15 Key Informant Interviews were conducted using a pre-tested guide. Data were subjected to thematic analysis. Results: It was disclosed that VCHWs promoted people's access to prompt and appropriate malaria treatment. The communities accepted the VCHWs; the reasons given for this included the following: effectiveness of VCHWs in case management of malaria; good inter-personal relationship with caregivers; and the positive health outcomes associated with services provided by them. In addition, community members expressed satisfaction with the VCHWs and provided them with all the support needed to function throughout the malaria case management intervention. The VCHWs considered the support as a great source of encouragement. Conclusions: The use of VCHWs to treat malaria was adjudged to be effective and considered acceptable to the communities. The adoption of the intervention and its integration into the primary health system by the government is advocated for in medically underserved rural communities. Funding: This work was supported by UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID: A80550 [Nigeria] through funds made available by the European Commission (FP7) for research to improve community access to health interventions in Africa.