Assessment of primary health care workers' knowledge and skill for COPD and asthma screening and diagnosis in Jos LGA of Plateau State.

Introduction: chronic obstructive pulmonary disease and asthma are the commonest of the group of Chronic Respiratory Diseases. Primary Health Care workers play a role in the prevention of these diseases. The aim of this study was to determine the knowledge and diagnostic skills of PHC workers on COPD and asthma in a local government area of Plateau State, Nigeria. Methods: it was a cross-sectional study conducted among 146 primary healthcare workers selected through a multistage sampling technique. Data was collected through a self -administered questionnaire. Data processing and analysis were done with Epi-Info epidemiological software. The categories of knowledge that were of interest were scored and graded. A confidence level of 95% was used and a p-value of <0.05 was considered significant for this study. Results: the mean age of respondents was 41.4 ± 10.1 years, junior community health extension workers made up the largest group and the mean years of service was 14.9 ± 8.9 years. The overall knowledge of COPD and asthma was fair in 68.5 % of health workers though the mean knowledge scores of asthma were statistically significantly higher than that of COPD (p = 0.000). Knowledge was found to be statistically significantly associated with age, sex and cadre. None of the respondents was able to operate a peak flow meter. Conclusion: the study concluded that though there was fair level of knowledge among the respondents on COPD and asthma, they lacked the necessary skills to screen for and diagnose these diseases.

Fertility Desires and its Predictors among Persons Living with HIV in a Secondary Health Facility in Northcentral Nigeria.

Introduction: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment and also improved sexual and reproductive health services. Fertility desires can result in increased risk of HIV transmission, especially in unprotected heterosexual intercourse. There is limited information regarding the fertility desires and predictors among PLHIV in our environment. Methods: This study was aimed at assessing the fertility desires and predictors in PLHIV in Northcentral Nigeria. Study was descriptive cross-sectional. Semi-structured interviewer administered pretested questionnaires was used to get information from 170 PLHIV accessing care in a secondary health-care facility selected by the systematic sampling technique. Data were analyzed using the SPSS software version 23.0. At 95% confidence interval (CI), a P < 0.05 was considered to be statistically significant. Chi-square and logistic regression. Results: Fertility desire was found among 64.1% of the respondents. Younger age (odds ratio [OR] = 0.2270; 95% CI = 0.0662-0.7791, P = 0.0184), having no child or a smaller number of children (OR = 0.0432; CI = 0.0046-0.4050; P = 0.0059) and suppressed viral loads (OR = 4.1069; CI = 1.1650-14.4784; P = 0.0280) were the predictors for fertility desire. Conclusion: This study showed that PLHIV had high fertility desires but do not know any safe method of conception, hence intensified effort should be made by primary care providers and other health-care workers to include sexual and reproductive health counselling during routine HIV clinic visits to enable PLHIV make informed decision about their fertility desires.

Socio-demographic predictors of food security among rural households in Langai district in Plateau-Nigeria: a cross-sectional study.

Introduction: household food insecurity is a critical social determinant of health globally. There is a rising global prevalence of food insecurity which affects households' access to food of adequate quantity and quality. This study assessed the level of food security and its socio-demographic determinants among rural households. Methods: this is a cross-sectional community survey among 201 rural households in Langai district representing a total population of 1,284. Reported food security was assessed using Food Consumption Scores and Coping Strategy Index. Data were analysed with SPSS 21. Analysis was done to assess the level of food-security associated factors. Multivariable analysis was done to assess determinants of food security. P-value <0.05 is considered significant. Results: forty-three percent of all households have a total income greater than the national minimum wage. Overall, 21.4% are quality-food insecure (FCS), 6.5% have severe coping behaviour (CSI-food insecure) and 34.8% are highly economically vulnerable to food insecurity. Significant predictors of household food security include women earning than the basic monthly wage (AOR: 4.29 [95%CI: 1.34-13.71]; p=0.014); those without marital partners (AOR: 4.91 [95%CI: 1.01-23.90]; p=0.049); smaller household size (≤ 5) (AOR: 2.69 [95%CI: 1.16-6.24]; p=0.021); and those not receiving financial support (AOR: 2.68 [95%CI: 1.17-6.13]; p=0.020). Conclusion: almost a quarter of all households' experience food insecurity with more than one-third being highly vulnerable to food insecurity. Efforts should be made to cushion the effect of global food insecurity among vulnerable populations and improve livelihood through improved agricultural practices to have sustainable and equitable food security.

Knowledge on mother-to-child transmission of HIV, and sexuality and fertility desires among people living with HIV in North-Central, Nigeria.

INTRODUCTION: mother-to-child transmission (MTCT) is the transmission of HIV from a mother to the child during pregnancy, labour and breastfeeding. People living with HIV (PLHIV) are sexually active and also HIV can be transmitted while trying to achieve pregnancy involving unprotected hetero-sexual intercourse. Fertility desire among PLHIV is increasing due to improved quality of life and survival following commencement of anti-retroviral treatment and available reproductive health services. The objective of the study was to determine the association between knowledge on MTCT of HIV and sexuality and fertility desire. METHODS: this study was descriptive cross-sectional applying systematic sampling technique among PLHIV using semi-structured interviewer administered questionnaires. Data was analysed using SPSS version 23.0. Chi square test was used for statistical analysis. At 95% confidence interval a P-value of <0.05 was considered to be statistically significant. RESULTS: a total of 168 PLHIV were studied, 63.3% females and 36.7% males. Majority (81.5%) of the respondents were sexually active and 64.1% had fertility desire. On awareness of MTCT 62.5% had heard of MTCT but only 28.2% had good knowledge. No association was found between knowledge of MTCT and sexuality and fertility desire respectively. CONCLUSION: PLHIV had high awareness but poor knowledge on MTCT of HIV, hence the need for healthcare workers to provide sexual and reproductive health counselling including information on MTCT to both male and female PLHIV during routine clinic visits.

Disclosure of Sexual Orientation and its Predictors among HIV-Positive Men Who Have Sex with Men in a Contemporary African Setting.

BACKGROUND: Sexual orientation disclosure has been reported to promote good peer support, improve psychological health, as well as access to STIs and HIV prevention services. Hence, this study sought to assess the level of disclosure sexual orientation and its predictors among HIV-positive men who have sex with men (MSM) in Plateau state Nigeria. METHODS: This was a cross-sectional study design conducted between October 2018 and December 2019 among 114 HIV-infected MSM through respondent driven sampling technique. Epi Info version 7 was used for the data analysis with adjusted odds ratio and 95% confidence interval (CI) used as point and interval estimates on the logistic regression model and P < 0.05 considered statistically significant. RESULTS: The mean age of the respondents was 26.0 ± 5.4 years with disclosure of sexual orientation to nonpartner being reported by 45 (39.5%). Positive family history of same sex practice was found to significantly predict self disclosure of sexual orientation (adjusted odds ratio: 3.30; 95% CI: 1.2356-8.8038; P = 0.017). CONCLUSIONS: This study has revealed a low level of disclosure of sexual orientation among HIV-positive MSM in Plateau state with a positive family history of same sex involvement as its predictor.

Sexual Behaviors of HIV-Infected Men who Have Sex with Men in Jos, Plateau State, North Central Nigeria.

BACKGROUND: Sub-Saharan Africa region remains heavily plagued by HIV/AIDS with recent information suggesting that sex between men is a significant contributor to the spread of this infection. It was against this backdrop that this study was conducted to examine the sexual behaviors of HIV-infected men who have sex with men (MSM) in Jos, Plateau state, North Central Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 114 HIV-infected MSM 18 years and above using a quantitative method of data collection. Respondent-driven sampling technique was employed in sampling the study participants, and EpiInfo statistical software version 7 was used for the data analysis. RESULTS: The mean age of the respondents was 26.0 ± 5.4 years with condom use in the last anal sex being 77 (67.5%), while majority (83.3%) of the respondents was adjudged to have been engaged in risky sexual behaviors. CONCLUSIONS: This study has brought to light a significant level of risky sexual behaviors among HIV-infected MSM with condom use, multiple same sexual engagement, transactional sex, and bisexual concurrency as areas of possible interventions.

Predictors of Mortality From a Population-Based Cancer Registry Data in Jos, Nigeria: A Resource-Limited Setting.

Background: It is a well-documented fact that world-wide cancer incidence and mortality remains high in Human Immunodeficiency Virus (HIV) infected population despite potent antiretroviral therapy. With the current capture of HIV status of cancer patients in our cancer registry at Jos Nigeria, this study aims to assess the effect of HIV on cancer mortality outcomes. Methodology: We conducted a 2-year retrospective cohort study of cancer registry data from Jos, north central Nigeria. The cancers were grouped into cervical, breast, liver, hematologic, colonic, AIDS defining, prostate and others in this study. Patients were followed up to determine their patient time contribution from time at initiation of cancer treatment to death or the end of study period. Those lost to follow-up were censored at date of their last known follow-up in clinic. Results: Out of 930 cancer cases evaluated, 52 (5.6%) were HIV positive, 507 (54.5%) were HIV negative and 371 (39.9%) did not know their HIV status. After 525,223 person- days of follow-up, there were 232 deaths leading to a crude mortality rate of 4.3 per 10,000 person-days. Median survival probability for both HIV-infected and HIV uninfected patients were equal (1,013 days). Unadjusted hazard of death was associated with greater age, HR 0.99 (95% CI: 0.98,0.99, p = 0.002); hepatitis virus, HR 2.40 (95% CI: 1.69,3.43, p = 0.001); liver cancer, HR 2.25 (95% CI:1.11,4.55, p = 0.024); prostate cancer, HR 0.17 (95% CI: 0.06,0.393, p = 0.001). In an adjusted model, only prostate cancer AHR 0.23 (95% CI: 0.12, 0.42, p < 0.001) and liver cancer AHR 2.45 (95% CI: 1.78, 5.51, p < 0.001) remained significantly associated with death regardless of HIV status. Conclusion: Having liver cancer increases risk for mortality among our cancer patients. Screening, early detection and treatment are therefore key to improving dismal outcomes.

Supportive supervision: an effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria.

BACKGROUND: Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. MATERIALS AND METHODS: This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. RESULTS: The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. CONCLUSIONS: This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.