Common childhood illnesses: a cross-sectional study of commodity stocking patterns and management knowledge among patent and proprietary medicine vendors in Nigeria.

BACKGROUND: The trio of commonest illnesses and causes mortality among children under five (Malaria, Pneumonia and Diarrhea) are easily treatable through timely exposure to cost effective interventions at the community level. Patent and proprietary medicine vendors (PPMVs) are a leading source of care for illnesses among under-five children in Nigeria. This study was designed to explore child health services offering, particularly commodity stocking patterns and case management knowledge for common childhood illnesses among PPMVs in Ebonyi and Kaduna States. METHODS: A descriptive cross-sectional study was conducted among PPMVs in four local government areas across Ebonyi and Kaduna States. Data was collected using semi-structured interviewer-administered questionnaires. Information was obtained on medicine and supplies, knowledge of common childhood illnesses management and referral practices. RESULTS: A total of 374 PPMVs were interviewed; the mean age was 33.7 ± 9.8 years. Among the 132 health trained respondents, 59.0% offer treatment services for sick children while 83.5% of the non-health trained respondents offer the same service. At least, 88.0% of the respondents keep stock ACTs, Amoxycilin DT, ORS and Zinc. About 38.5% reported stock-out of ACTs in the month preceding the study, 55.1% reported stock out lasting only 0 to 6 days. Only 83 (22.2%) of respondents knew the correct diagnosis of fast breathing among children aged 2 to less than 12 months old. Education and health training background were associated with a good knowledge of common childhood illnesses management (X2 = 44.88, p < 0.001; X2 = 27.14, p < 0.001). CONCLUSION: The relative constant availability of medicines and commodities for managing childhood illnesses positions PPMVs as a preferred source of care for these illnesses. There is a need to complement steady stock availability with provision of quality services by exposing PPMVs to trainings on integrated community case management of childhood illnesses and implementation of robust supervision mechanism to monitor them.

Psychological distress and burden of care among family caregivers of patients with mental illness in a neuropsychiatric outpatient clinic in Nigeria.

BACKGROUND: The wellbeing of family caregivers of mentally ill persons has often been ignored, despite that family caregivers can be predisposed to psychiatric morbidities and burden in caring for their mentally ill family members. This study examined the levels of psychological distress and burden of care experienced by family caregivers who care for their mentally ill relatives in Edo State, Nigeria. METHODS: This study assessed psychological distress using the General Health Questionnaire (GHQ-12). Burden of care was measured using the 22-item Zarit Burden Interview (ZBI) questionnaire. Multiple linear regression was done to determine factors associated with burden of care and psychological distress, while factor analysis was used to determine the underlying forms of burden of care and psychological distress among participants. RESULTS: Caregivers studied were relatives of patients diagnosed for depression (25.1%), substance use disorder (22.2%), schizophrenia (20.2%) and bipolar affective disorder (11.1%). Approximately 15% experienced no-to-mild burden, 51.3% mild-to-moderate burden and 34.0% high-or-severe burden. Nearly halve (49.0%) of participants experienced psychological distress. Severe rate of psychological distress was observed among subjects caring for patients with schizophrenia (60.7%), epilepsy (60.0%), substance use disorder (52.2%) and depression (49.0%). High burden of care was more preponderant among caregivers of relatives with mental retardation and epilepsy (50% each) and schizophrenia (39.3%). Having a higher educational qualification and being self-employed was a predictor of psychological distress. Gender of caregiver and the diagnosis schizophrenia among relatives of caregivers predisposed to burden of care. Three factors including social and emotional dysfunction, psychological distress and cognitive dysfunction were identified as components of psychological health through factor analysis. On the burden scale, six factor components were identified as: personal strain, role strain, intolerance, patients' dependence, guilt and interference in personal life. CONCLUSION: There is a high prevalence of psychological morbidity and burden of care among family caregivers providing care for persons with mental illness.

Utilization rate and factors influencing the use of HIV counseling and testing services among young females: a community-based study from Nigeria.

OBJECTIVES: This study aims to explore the utilization rate and factors influencing the use of HCT services among young females in Ikorodu, Lagos State, Nigeria. METHODS: This study was a descriptive cross-sectional survey of 404 females, aged 15-24 years, residing in Ikorodu, Nigeria. Study tool was a questionnaire. Collected data was analyzed using the SPSS version 16 software. RESULTS: The mean age (±SD) of the respondents was 19.3 (±2.6) years and 90.1% were single. Only 148 (36.6%) respondents had ever utilized the HCT service, of which only 40.5% of them were adolescents. Amongst those that had ever utilized HCT services (n=148), only 60.1% of them did so within 12 months prior to the study while only 33.8% of them initiated the demand for testing themselves. According to the respondents, the top two barriers to the utilization of HCT services were: fear of discrimination (82.9%); and fear of unavailability of access to treatment (68.0%), while the top two factors that facilitates its use were: the adoption of counseling-before-testing approach in the HCT service centers (85.9%); and peoples' need for HIV status declaration prior to getting a job employment/marriage partner (85.1%). CONCLUSIONS: The study shows that utilization of HCT service remains low among the respondents. There is an urgent need to encourage the utilization of HCT services among young females in Ikorodu, Nigeria.