Knowledge, care-seeking behavior, and factors associated with patient delay among newly-diagnosed pulmonary tuberculosis patients, Federal Capital Territory, Nigeria, 2010.

INTRODUCTION: Early treatment of Tuberculosis (TB) cases is important for reducing transmission, morbidity and mortality associated with TB. In 2007, Federal Capital Territory (FCT), Nigeria recorded low TB case detection rate (CDR) of 9% which implied that many TB cases were undetected. We assessed the knowledge, care-seeking behavior, and factors associated with patient delay among pulmonary TB patients in FCT. METHODS: We enrolled 160 newly-diagnosed pulmonary TB patients in six directly observed treatment short course (DOTS) hospitals in FCT in a cross-sectional study. We used a structured questionnaire to collect data on socio-demographic variables, knowledge of TB, and care-seeking behavior. Patient delay was defined as > 4 weeks between onset of cough and first hospital contact. RESULTS: Mean age was 32.8 years (± 9 years). Sixty two percent were males. Forty seven percent first sought care in a government hospital, 26% with a patent medicine vendor and 22% in a private hospital. Forty one percent had unsatisfactory knowledge of TB. Forty two percent had patient delay. Having unsatisfactory knowledge of TB (p = 0.046) and multiple care-seeking (p = 0.02) were significantly associated with patient delay. After controlling for travel time and age, multiple care-seeking was independently associated with patient delay (Adjusted Odds Ratio = 2.18, 95% CI = 1.09-4.35). CONCLUSION: Failure to immediately seek care in DOTS centers and having unsatisfactory knowledge of TB are factors contributing to patient delay. Strategies that promote early care-seeking in DOTS centers and sustained awareness on TB should be implemented in FCT.

Determinants of routine immunization coverage in Bungudu, Zamfara State, Northern Nigeria, May 2010.

INTRODUCTION: Immunization is a cost-effective public health intervention to reduce morbidity and mortality associated with infectious diseases. The Nigeria Demographic and Health Survey of 2008 indicated that only 5.4% of children aged 12-23 months in Bungudu, Zamfara State were fully immunized. We conducted this study to identify the determinants of routine immunization coverage in this community. METHODS: We conducted a cross-sectional study. We sampled 450 children aged 12-23 months. We interviewed mothers of these children using structured questionnaire to collect data on socio-demographic characteristics, knowledge on immunization, vaccination status of children and reasons for non-vaccination. We defined a fully immunized child as a child who had received one dose of BCG, three doses of oral polio vaccine, three doses of Diptheria-Pertusis-Tetanus vaccine and one dose of measles vaccine by 12 months of age. We performed bivariate analysis and logistic regression using Epi-info software. RESULTS: The mean age of mothers and children were 27 years (standard error (SE): 0.27 year) and 17 months (SE: 0.8 month) respectively. Seventy nine percent of mothers had no formal education while 84% did not possess satisfactory knowledge on immunization. Only 7.6% of children were fully immunized. Logistic regression showed that possessing satisfactory knowledge (Adjusted OR=18.4, 95% CI=3.6-94.7) and at least secondary education (Adjusted OR=3.6, 95% CI=1.2-10.6) were significantly correlated with full immunization. CONCLUSION: The major determinants of immunization coverage were maternal knowledge and educational status. Raising the level of maternal knowledge and increasing maternal literacy level are essential to improve immunization coverage in this community.

Human brucellosis: seroprevalence and associated exposure factors among abattoir workers in Abuja, Nigeria - 2011.

INTRODUCTION: Brucellosis, a neglected debilitating zoonosis, is a recognized occupational hazard with a high prevalence in developing countries. Transmission to humans can occur through contact with infected animals or animal products. Brucellosis presents with fever. In Nigeria, there is a possibility of missed diagnoses by physicians leading to a long debilitating illness. We conducted a study to determine the seroprevalence and factors associated with Human Brucellosis (HB) among abattoir-workers in Abuja, Nigeria. METHODS: We conducted a cross-sectional study and selected abattoir-workers using stratified random sampling. Structured questionnaires were used to collect data on demographics and exposure-factors. We tested the workers' serum-samples using Rose-Bengal (RBPT) and ELISA tests. A worker with HB was one whose serum tested positive to RBPT or ELISA. We tested differences in proportions between workers with HB and those without HB using odds-ratio and X(2) tests. RESULTS: Of 224 workers, 172 (76.8%) were male and mean age was 30 + 9.0 years. Of 224 sera collected, 54 were positive giving a seroprevalence of 24.1%. Of these, 32 (59.3%) were butchers, and 11 (20.4%) were meat-sellers. Slaughtering animals while having open-wounds (Odds-ratio (OR) = 2.15, 95% Confidence Interval (CI) = 1.15-4.04); occupational-exposure of >5years (OR = 2.30, CI = 1.11-4.78) and eating raw meat (OR = 2.75, CI = 1.21-6.26) were significantly associated with HB. Multivariate analyses showed that occupational-exposure of >5years (Adjusted OR (AOR) =2.45, CI = 1.15 - 5.30) and eating raw-meat (AOR = 2.64, CI = 1.14 - 6.14) remained significantly associated with HB. CONCLUSION: Seroprevalence of HB among abattoir-workers in Abuja was high. Factors associated with HB were occupational-exposure of >5years and eating raw-meat. Abattoir-workers should be discouraged from eating raw-meat and educated on adherence to safe animal-product handling practices.