Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study.

BACKGROUND: Cervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings. OBJECTIVES: This qualitative study was done prior to the introduction of a cervical cancer screening program in two slum areas in Lagos Nigeria and explored women's knowledge about cervical cancer, and their perceived barriers and recommendations for the program. METHOD: Four focus group discussions(FGD) were conducted among 35 women between the ages of 21-65 years residing in two urban slums in Lagos, Nigeria from February to April 2019. Each FGD was limited to 8-10 participants of women of similar ages. Voice recordings were transcribed verbatim and thematic analysis was done. RESULTS: Most of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby primary health center, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women's poorly perceived susceptibility to cervical cancer. CONCLUSION: Interventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge of cervical cancer and address barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered.

Body image dissatisfaction, nutritional status and weight control strategies among university undergraduates in Lagos: a descriptive cross-sectional study.

Introduction: body image dissatisfaction has been associated with poor nutritional status and unhealthy weight management strategies. This study determined the prevalence and relationships between body image dissatisfaction, nutritional status, and weight management strategies among university undergraduate students in Lagos, Nigeria. Methods: a descriptive cross-sectional study employed a multi-stage sampling technique to select 865 undergraduates in Lagos. A pretested self-administered questionnaire was used to assess the variables. Stunkard figure rating scale was used to determine body image dissatisfaction. Body mass index (BMI) was calculated to determine nutritional status. A standard weight control strategy scale was adopted to determine weight management strategies. SPSS (version 23) was used for analysis and the association between variables was determined using Chi-square. The level of significance was set at P= <0.05. Results: the prevalence of body image dissatisfaction was high (63.5%) but not associated with gender. The majority (65.1%) had normal BMI, 10.6% were overweight and 7.2% were obese. Majority of the respondents (93.3%) engaged in weight management practices with dietary control being the most employed strategy. The most commonly employed unhealthy practice is strict dieting (37.7%). Body image dissatisfaction was significantly associated with overweight/obesity (P=0.001) but not with weight management practices. Age and overweight/obesity were predictors of BID. Conclusion: prevalence of body image dissatisfaction, overweight and obesity, and unhealthy weight management strategies were high. Body image dissatisfaction was associated with obesity but not associated with weight management strategies. All undergraduates need health education on body image and appropriate weight management strategies.

Tuberculosis preventive practices among treatment supporters in Lagos, Nigeria.

Context: Tuberculosis (TB) treatment support is one of the recommended strategies to enhance treatment adherence and outcomes. Treatment supporters are at risk of contracting TB and adequate knowledge of TB and good preventive practices are required for their protection. Aims: This study aimed at assessing the knowledge and preventive practices of TB treatment supporters at Directly Observed Treatment Short-course (DOTS) centers in Lagos Mainland Local Government Area of Lagos state, Nigeria. Settings and Design: This cross-sectional study was conducted among 196 TB treatment supporters selected from five DOTS centers in Lagos. Methods: Data were obtained using an adapted pretested questionnaire. Statistical Analysis Used: Bivariate and multivariate analyses were performed to determine the factors associated with self-protection practices. A P < 0.05 was considered statistically significant. Results: The mean age of the participants was 37.3 ± 12.1 years. More than half of the respondents were females (59.2%) and immediate family members (61.3%). Overall, 22.5% had good knowledge of TB, while 53.0% had positive attitudes toward TB. Only 26.0% adequately protected themselves from infection. The caregiver's level of education (P = 0.001) and their relationship to the patient (P = 0.001) were significantly associated with good preventive practices in bivariate analysis. Not being related to the patient was a predictor of adequate TB prevention practices (adjusted odds ratio = 2.852; P = 0.006; 95% confidence interval = 1.360-5.984). Conclusions: This study revealed low levels of TB knowledge and fair preventive practices, especially among caregivers who are relatives. There is, therefore, a need to improve population literacy about TB and its prevention and a more focused orientation of relatives who volunteer as treatment supporters, through health education, with periodic monitoring during clinic visits, of how they prevent TB.

Résumé Contexte: Le soutien au traitement de la tuberculose (TB) est l'une des stratégies recommandées pour améliorer l'observance du traitement et les résultats. Traitement les supporters courent le risque de contracter la tuberculose et une connaissance adéquate de la tuberculose et de bonnes pratiques préventives sont nécessaires pour leur protection. Objectifs: Cette étude visait à évaluer les connaissances et les pratiques préventives des accompagnants du traitement de la tuberculose au traitement directement observé Centres de formation courte (DOTS) dans la zone de gouvernement local de Lagos Mainland, dans l'État de Lagos, au Nigéria. Réglages et conception : Cette section transversale L'étude a été menée auprès de 196 agents de soutien au traitement de la tuberculose sélectionnés dans cinq centres DOTS à Lagos. Méthodes: Les données ont été obtenues à l'aide de un questionnaire prétesté adapté. Analyse statistique utilisée : Des analyses bivariées et multivariées ont été effectuées pour déterminer les facteurs associés aux pratiques d'autoprotection. Un P < 0.05 était considéré comme statistiquement significatif. Résultats: L'âge moyen des participants était 37.3 ± 12.1 ans. Plus de la moitié des répondants étaient des femmes (59.2 %) et des membres de la famille immédiate (61.3 %). Dans l'ensemble, 22.5 % avaient bonne connaissance de la tuberculose, tandis que 53.0 % avaient des attitudes positives à l'égard de la tuberculose. Seuls 26.0% se sont protégés de manière adéquate contre l'infection. Les le niveau d'instruction de l'aidant (P = 0.001) et sa relation avec le patient (P = 0.001) étaient significativement associés à une bonne prévention. pratiques en analyse bivariée. Ne pas être apparenté au patient était un facteur prédictif de pratiques adéquates de prévention de la tuberculose (rapport de cotes ajusté = 2.852 ; P = 0.006 ; Intervalle de confiance à 95 % = 1.360­5.984). Conclusions: Cette étude a révélé de faibles niveaux de connaissances sur la tuberculose et des pratiques préventives équitables, surtout chez les soignants qui sont des proches. Il est donc nécessaire d'améliorer les connaissances de la population sur la tuberculose et sa prévention et de une orientation plus ciblée des proches qui se portent volontaires pour soutenir le traitement, par le biais d'une éducation à la santé, avec un suivi périodique pendant la cliniquevisites, de la façon dont ils préviennent la tuberculose. Mots-clés: Lagos, Nigéria, soutien au traitement, tuberculose.

Knowledge, attitude and premarital screening practices for sickle cell disease among young unmarried adults in an urban community in Lagos, Nigeria.

Introduction: sickle cell disease (SCD) refers to a group of inherited blood disorders that are life-long and affect many people globally. An estimate of 2.3% of the Nigerian population suffer from SCD and about 25% of adults have the sickle cell gene. Premarital screening for sickle cell gene is considered one of the methods of preventing new births of children with SCD among the young adults. The study assessed the knowledge, attitude, willingness to take premarital screening test for SCD and factors influencing knowledge among young unmarried adults in an urban community in Lagos, Nigeria. Methods: the study was cross-sectional descriptive among 300 respondents who were selected using multistage sampling technique. Data were collected using a pre-tested, interviewer-administered questionnaire and analyzed using SPSS software, version 25. Univariate and bivariate analysis were conducted with level of significance at p ≤ 0.05. Results: the mean age of respondents was 21.2± 3.5 years, and most 188 (62.7%) were males. About 139 (46.3%) and 165 (55.0%) of the respondents respectively had good knowledge and positive attitude towards SCD and premarital screening. Only 43% of the respondents knew their haemoglobin phenotype, however, majority (92.4%) were willing to have Hb phenotype test done. Knowledge of SCD and premarital screening was statistically significant with age, level of education and occupation of respondents (p<0.001). Conclusion: this study found less than half of the respondents with good knowledge, about half had positive attitude and poor premarital screening practices of SCD. Therefore, community-based health education and awareness programs on SCD and premarital screening among young adults is recommended.

Stigma, discrimination and non-disclosure among young people living with HIV in Lagos, Nigeria.

Introduction: young people living with HIV (YPLH) constitute a significant population towards ending the AIDS epidemic. About half of YPLH are undiagnosed and one-third of new infections occurring among them. Stigma and discrimination remaina predominant enigma in the social response to HIV. Methods: this was a descriptive cross-sectional study among 124 YPLH aged 15-24 years selected by non-probability sampling from four antiretroviral centres targeted at young people across Lagos State. Ethical approval and informed consent were obtained. Data analysis was done using Epi info software version 7 and the level of significance was set at p<0.05. Results: the mean age of the participants was 19.4±3.2 years. Among the stigma variants, public stigma was the highest (48.4%), followed by anticipated stigma (20.2%), internalized stigma (14.5%), and enacted stigma (10.7%) while 7.3% of respondents experienced all forms. Thirty-seven percent of respondents had experienced one form of discrimination, with the most common form being 'treated with hostility by strangers´ (14.5%). The disclosure level was 56.5%. The most predominant reasons for non-disclosure were fear of rejection by other people (57.3%). Diagnosis at an earlier age and living with a single parent were associated with lower disclosure levels (p<0.001). Conclusion: overall stigma levels were found to be low, with differences in the individual stigma variants. The most common form of HIV-related discrimination reported in this study was being treated with hostility by strangers. Fear of rejection by other people was the main reason for non-disclosure among YPLH. The use of a multidisciplinary approach is needed to reduce the impact of stigma and discrimination among YPLH.

An internet-based cross-sectional study on infection control practices and drug use for COVID-19 prevention in Nigerian adults.

Introduction: COVID-19 has affected several millions of people globally and various means have been employed to curb the spread. This nationwide survey investigated adherence to infection control protocols and drug uptake among Nigerian adults. Methods: this was a descriptive cross-sectional survey using an internet-based questionnaire to investigate adherence to infection control practices and drug use among adults, who have been resident in Nigeria for at least 6 months. The data was analyzed using Stata software version 16 with levels of significance at p<0.05. Results: a total of 1235 adults participated in the study. The respondents were aged 18-78 years with a mean age of 36.3 ±11.1 years. Over half (53.0%) of the participants were between 31-50 years. The male to female ratio was 1: 1.45. Majority (92.6%) had a minimum of tertiary educational qualification. One hundred (27.1%) reported a positive test result for COVID-19. A total of 1,204 (97.5%) admitted to wearing of face masks, 1,125 (91.1%) washed hands regularly, 1,142 (92.5%) used hand sanitizers while physical distancing was maintained in 985 (79.8%). A total of 854 (69.2%) were on at least a drug or herbal based therapy. Herbal based remedies were used in 112 (9.1%), supplements in 763 (61.8%), antibiotics in 210 (17%), ivermectin in 205 (16.6%), and antimalarials in 128 (10.4%) participants. Conclusion: adherence to behavioural measures was high among the population, with widespread uptake of supplements, antibiotics, and antimalarial drugs. The high uptake of antibiotics emphasizes the need to step up regulatory policies for antibiotic use.