A mixed methods evaluation of an integrated training package for skin neglected tropical diseases in Kaduna and Ogun, Nigeria.

BACKGROUND: The overall burden of neglected tropical diseases (NTDs) affecting the skin is undetermined. Skin conditions are among the top 10 causes of disability worldwide. Affected persons seek treatment at advanced stages of the disease, resulting in morbidity and disability. We developed and evaluated an integrated training intervention for early case detection, referral and management of skin NTDs in two states in Nigeria. METHODS: This was a mixed-methods study using participatory approaches to develop specific skin algorithms and training packages for community and primary level health workers. This supported the identification, referral and clinical diagnosis of suspected cases. We used Kirkpatrick's model to evaluate the training package. RESULTS: Participants' knowledge improved after the 2-months intervention. Across both states, knowledge retention appeared more robust for cadres at all levels: state, local government area and primary healthcare. All (100%) participants mentioned that the training assisted them in detecting, referring and managing skin NTDs. Training was understood by participants and training materials were easy to understand. Materials were also effective in educating community members about the symptoms of NTDs and supported referral to facilities for appropriate management. CONCLUSIONS: Community implementers can be trained and supervised to detect people affected by skin NTDs and support appropriate management within the existing patient care pathway.

Attendee's awareness about preventive chemotherapy neglected tropical diseases (PC-NTD) control during the first world neglected tropical diseases day in Ekiti State, Nigeria.

BACKGROUND: The need to control Neglected Tropical Diseases (NTDs) and sustain progress towards elimination through mass administration of medicines requires substantial communal participation. This study, therefore, assessed the knowledge and perception of attendees' regarding NTDs and its control activities during the inaugural World NTD day event in Ekiti State, Nigeria. METHODOLOGY: A cross-sectional study involving the administration of pretested semi-structured questionnaires to consenting attendees at the Inaugural World NTD day event was conducted on the 30th January, 2020. The questionnaire collected data on attendee's demography, knowledge and awareness about NTDs and its control in Nigeria. Quantitative data were analysed using descriptive statistics in SPSS. 20.0 software and expressed as frequencies and percentages. However, qualitative data to support quantitative analysis were obtained using open-ended questionnaires and analysed thematically. PRINCIPAL FINDINGS/CONCLUSION: A total of 309 attendees comprising 167 (54.0%) females, and 142 (46.0%) males participated in this study. By age groupings, majority 206 (66.7%) were within 15-25 years. 167 (54.8%) of the attendees have not heard about NTDs before, whereas 77(35.0%) have heard about NTDs through the advertisement of the event. 181(63.3%) were aware of ongoing NTD control programs in schools and communities. Also, 246 (83.4%) of them have not taken or do not know anyone that has taken drugs donated in schools or communities. The number of attendees 41(13.3%) who incorrectly classified malaria as NTDs is higher than those who recognized onchocerciasis 36 (11.7%) and worm infections 34(11.0%) as NTDs (p>0.05). This study has shown that awareness and knowledge about NTDs control activities in Ekiti State is low, thus justifying the event as an awareness day for addressing NTDs. Public enlightment and regular promotional activities such as media engagement will raise the public appreciation and participation in NTDs control activities.

Emerging and re-emerging bacterial zoonoses in Nigeria: current preventive measures and future approaches to intervention.

A characteristic of bacterial zoonoses, diseases caused by bacteria that can be transmitted to humans from animals, is a propensity to re-emerge. Several studies demonstrate their ongoing transmission in Nigeria, the most populous country in Africa. However, as local epidemiological data on bacterial zoonoses are inadequate the extent and impact of these infectious diseases is under-reported. Consequently, they are not a targeted priority of national public health policies. This limited recognition is despite indications of their possible roles in the widespread prevalence of non-malarial undifferentiated fever in Nigeria. While a number of animal reservoirs and arthropod vectors have been identified in the transmission routes of these diseases, an escalation of cases of undiagnosed febrile illness highlights the urgent need for a comprehensive assessment of other potential reservoirs, vectors and transmission cycles that may increase the local risk of infection with bacterial zoonoses. Animal health interventions have been proposed as a cost-effective strategy. Here, we present a broad overview of bacterial zoonotic infections of humans in Nigeria in the context of evolving epidemiological patterns. Further, we propose that facilitating the operation of a community-based One Health program is essential to providing the comprehensive epidemiological information that is required to improve prioritization of bacterial zoonoses. This would provide a driver for much needed investment in relevant public health interventions in Africa's most populous country.

Assessment of community knowledge and participation in onchocerciasis programme, challenges in ivermectin drug delivery, distribution and non-compliance in Ogun State, southwest Nigeria.

BACKGROUND: This study reports knowledge of onchocerciasis and surrounding factors from the perspective of community members, Community drug distributors and health workers in eight endemic LGAs of Ogun State, Nigeria. METHODS: Using structured questionnaires and Focus Group Discussion, a total of 417 community members, 37 health workers and 42 CDDs across 16 communities participated in the study. RESULTS: Majority (70.7%) of participants knew the disease by its local name, "Inarun". Community members (62%) identified severe itching as a symptom of the disease while (35.9%) (17.6%) and (9.8%) of participants associated bites of black-flies, physical-exertion on farm and allergies to peanuts as the cause of the disease. Majority (62.2%) of health workers reported the insufficiency of drug-storage facilities at community-health centres. Drug distributors also decried the paucity of funds to facilitate wide therapeutic-coverage. Compliance with drug use was affected by adverse reaction by (4%) Community members, pregnancy (9%) and inability to swallow pills (11.6%). CONCLUSION: To improve onchocerciasis control in Ogun State, public-health-education regarding the disease aetiology needs to be improved. Also, treatment rounds need to be increased to accommodate members who unwillingly missed treatment. Finally, government provision of transport logistics to CDDs for ease of logistics is very important.