Disease perception, impacts and coping strategies for onchocerciasis in Southeast Nigeria: a qualitative study among patients and program managers.

BACKGROUND: Onchocerciasis is a disease of public health concern due to the devastating consequences of the disease which impacts negatively on the lives of the people. The negative impact of the disease may affect its perception and lead to the adoption of some coping strategies. Therefore, understanding the disease perception, impacts and coping strategies used by onchocerciasis patients will help plan health interventions aimed at improving their general well-being. METHODS: This was a community-based study that employed a qualitative method through Key informant interviews (KII) with program managers and focus group discussions (FGD) among people who had Onchocerciasis. Four sessions of FGDs with a total of thirty-two (32) participants and eleven KIIs were conducted to ascertain their in-depth experience in five thematic areas. RESULTS: In these communities, onchocerciasis is perceived to have been caused mainly by the bite of blackflies. Other presumed causes by the patients included drinking polluted water, poor environmental sanitation and witchcraft. The disease had a significant detrimental influence on both the physical and financial aspects of life with limited emotional and social impacts. The long-term clinical manifestations of onchocerciasis triggered pain and insufficient mobility. Thus, onchocerciasis patients experienced impairment in normal daily life activities (farming, etc.), dependency, depression and inability to participate in social events. These manifestations stimulated various coping strategies, mainly, nodulectomy by traditional healers. Others included self-medication, taking an overdose of ivermectin, and the use of alcohol. CONCLUSION: Misconceptions about the cause of onchocerciasis still exist among people with the disease. The consequences of the disease impact negatively on various aspects of their lives and stimulate various coping strategies. Therefore, health promotion messages to the public should aim at dispelling misconceptions about the disease and promote healthy coping strategies.

Polycyclic aromatic hydrocarbon in community drinking water, Nsisioken, Nigeria: Source and health risk assessment.

In 2011, the United Nations Environment Programme discovered high levels of hydrocarbon pollution in drinking water wells in Nsisioken Agbi Ogale Rivers State, Nigeria. However, the level of polycyclic aromatic hydrocarbons (PAHs) in the same community's water supply was unknown. A comprehensive study of PAHs in three household dug wells and three boreholes was conducted using Agilent 7890B gas chromatography and 5975A mass spectrometry. The detected PAHs were mainly 4 - 5 ringed PAHs, such as Chrysene, Fluoranthene, Pyrene, Benzo[a]anthracene, and Benzo[b]fluoranthene. The total mean concentration was 5.8 ± 2.3 µg/L, with values ranging from not detected in borehole 3 to 8.0 µg/L at well 2. Source identification analysis suggested that the PAHs originated from fuel and biomass combustion. The incremental lifetime cancer risk for children and adults due to groundwater ingestion and skin contact ranged from ND to 7.448 × 10-3 and ND to 1.83 × 10-3 respectively. The Risk index (RI) values from ingestion and dermal routes were 1.5 ×10-2 and 2.4 × 10-2, indicating high risk of cancer. The hazard quotient for the two non-carcinogenic PAHs was greater than 1, indicating high toxicity. The PAH concentrations exceeded the maximum contamination limits set by the World Health Organization and the U.S. environmental Protection Agency, highlighting potential health risks associated with water use in the community. Authorities should provide a safe alternative water source for the community.

Disability and its determinants among individuals with onchocerciasis in Southeast Nigeria: a cross-sectional study.

Introduction: although onchocerciasis is rarely a life-threatening disease, it causes chronic morbidity which ultimately leads to disability due to late detection and treatment of the infected people. Disability in Onchocerciasis results in activity limitation and social exclusion of the affected individuals through stigma. This study aimed at assessing the level of disability and its determinants among persons with onchocerciasis. Methods: multi-stage sampling technique was used to recruit 340 respondents from the randomly selected wards. Disability was assessed using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) tool. Chi-square test and multivariate analysis using binary logistic regression were used to determine factors associated with disability. The level of statistical significance was determined by a p-value of < 0.05. Results: the highest proportion (35.6%) of the respondents was 55 years and above with a mean age of 46.8±17.5. About three-quarters (76.2%) of them had some form of disability and the disability domains mainly affected were participation in community activities (61.8%) and getting along with other people (54.1%) while the least affected were self-care (26.2%) and life activities including domestic responsibilities (45.0%). The Predictor of disability included being ≥48 years old, (AOR=0.2; 95%CI: 0.1-0.4). Conclusion: most people with onchocerciasis experience some form of disability and the major determinant for disability is being in the older age group. Thus, there is a need for stakeholders in the onchocerciasis control program to formulate and implement disability screening programs in the communities for early detection of onchocerciasis-associated disability, especially among the older age group.

An assessment of infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic (February-May 2020).

Background: Infection prevention and control (IPC) activities play a large role in preventing the transmission of SARS-CoV-2 in healthcare settings. This study describes the state of IPC preparedness within health facilities in Nigeria during the early phase of coronavirus disease (COVID-19) pandemic. Methods: We carried out a cross sectional study of health facilities across Nigeria using a COVID-19 IPC checklist adapted from the U.S Centers for Disease Control and Prevention. The IPC aspects assessed were the existence of IPC committee and teams with terms of reference and workplans, IPC training, availability of personal protective equipment and having systems in place for screening, isolation and notification of COVID-19 patients. Existence of the assessed aspects was regarded as preparedness in that aspect. Results: In total, 461 health facilities comprising, 350 (75.9%) private and 111 (24.1%) public health facilities participated. Only 19 (4.1%) health facilities were COVID-19 treatment centres with 68% of these being public health facilities. Public health facilities were better prepared in the areas of IPC programme with 69.7% of them having an IPC focal point versus 32.3% of private facilities. More public facilities (59.6%) had an IPC workplan versus 26.8% of private facilities. Neither the public nor the private facilities were adequately prepared for triaging, screening, and notifying suspected cases, as well as having trained staff and equipment to implement triaging. Conclusions: The results highlight the need for government, organisations and policymakers to establish conducive IPC structures to reduce the risk of COVID-19 transmission in healthcare settings.

Systematic Review of Exposure to Polycyclic Aromatic Hydrocarbons and Obstructive Lung Disease.

BACKGROUND: There is fast-growing epidemiologic evidence of the effects of environmental chemicals on respiratory health. Polycyclic aromatic hydrocarbons (PAHs) have been linked with airway obstruction common in asthma and/or asthma exacerbation, and chronic bronchitis and emphysema. OBJECTIVES: A systematic review of the association between exposure to PAHs and obstructive lung diseases is not yet available. The present systematic review aims to evaluate the evidence available in epidemiological studies that have associated PAHs with obstructive lung diseases such as asthma, chronic bronchitis, emphysema. METHODS: We performed a systematic literature search on PubMed, Google Scholar, and Scopus databases using relevant keywords and guided by predesigned eligibility criteria. RESULTS: From the total of 30 articles reviewed, 16 articles examined the link between PAHs and lung function in both adults and children. Twelve articles investigated the association between PAHs and asthma, asthma biomarkers, and/or asthma symptoms in children. Two articles studied the relationship between PAHs and fractional exhaled nitric oxide (FeNO), a biomarker of airway inflammation and the relationship between PAHs and obstructive lung diseases and infections, respectively. One study assessed exposure to daily ambient PAHs and cough occurrence. DISCUSSION: Twenty-seven studies found an association between PAHs and asthma and reduced lung function. In children it is reinforced by studies on prenatal and postnatal exposure, whereas in adults, reductions in lung function tests marked by low forced expiratory volume in 1 second, (FEV1), forced vital capacity (FVC), and forced expiratory flow (FEF25-75%) were the major health outcomes. Some studies recorded contrasting results: insignificant and/or no association between the two variables of interest. The studies reviewed had limitations ranging from small sample size, to the use of cross-sectional rather than longitudinal study design. CONCLUSIONS: The literature reviewed in the present study largely suggest positive correlations between PAHs and obstructive lung diseases marked mainly by asthma and reduced respiratory function. This review was registered with PROSPERO (Registration no: CRD42020212894). COMPETING INTERESTS: The authors declare no competing financial interests.