Family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in eastern Nigeria.

BACKGROUND: As the distribution and awareness of free insecticide treated nets (ITNs) for malaria control continues to grow in Nigeria in order to meet the coverage target for the year 2010, a large gap exists between acquiring them, using them, and adhering to its use by families of under-five children. Therefore, the family biosocial variables driving its adherence need to be explored if the potential benefits of the nets are to be fully harnessed by families of under-five children in Nigeria. This study was aimed at describing family biosocial variables driving adherence to the use of insecticide treated nets among under-five children managed for malaria in a rural hospital in Eastern Nigeria. MATERIALS AND METHODS: This was descriptive hospital-based study carried out from June 2008 to June 2010 on a cross section of 220 mothers of under-five children who were managed for confirmed malaria within the study period and met the selection criteria were interviewed using a pretested, structured researcher administered questionnaire. The questionnaire instrument elicited information on family biosocial variables. Adherence was assessed in the previous 6 months and graded using an ordinal scoring system of 1-4 points: score of 4 points indicated adherence while scores of 1-3 points meant nonadherence. Operationally, an adherent respondent was defined as one who scored 4 points. An under-five child was defined to have malaria if the mother gave complaint of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5 degrees C with the asexual forms Plasmodium falciparum detected on the peripheral blood film. Reasons for nonadherence were also sought. RESULTS: The adherence rate was 33.2%. The family biosocial variables significantly associated with adherence were maternal age =30 years (p-value = 0.03), maternal occupation (house wives) (p-value = 0.03), family size less than 4 (p-value = 0.026) and spouse living together (p-value = 0.01.). Others included family belief, in the benefits of ITNs (p-value = 0.002 and source of ITNs (p-value = 0.03). The most significant predictor of adherence was living together of spouse (p-value = 0.000, OR = 3.851, CI = 1.76-6.01). The commonest reason for non-adherence was forgetfulness (p-value = 0.003). CONCLUSION: Despite high family belief in the benefits of ITNs, adherence to its use was low. Some family biosocial variables played significant roles in driving its adherence. Measures targeted at these variables and widespread family-oriented health promotion programmes are recommended in order to improve on adherence leading to family friendly ITNs communities.

The magnitude of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria.

BACKGROUND: The relevance of dyslipidaemia in the management of cardiovascular diseases, especially hypertension is an important health care challenge that is increasing worldwide. Of great concern in Nigeria is that most geriatric hypertensives with dyslipidaemia are not routinely diagnosed and therefore do not receive appropriate treatment. OBJECTIVE: This study is aimed at describing the magnitude (prevalence and pattern) of atherogenic dyslipidaemia among geriatric Nigerians with systemic hypertension in a rural hospital in Eastern Nigeria. METHODS: A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The fasting lipid profile was determined by enzymatic method. Dyslipidaemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included age and sex. RESULTS: Fifty-four (44.3%) out of 122 patients had at least one dyslipidaemia. The age of the patients ranged from 65 years to 91 years with mean age of 69 +/- 2.10 years. There were 51 (41.8%) males and 71 (58.2) females with male to female ratio of 1: 1.4. The commonest lipid abnormality was low high density lipoprotein-cholesterol (38.5%). Others included high low density cholesterol (23.8%), high total cholesterol (17.2%) and high triglyceride (14.8%). CONCLUSION: This study has shown that dyslipidaemia exist among geriatric hypertensives in the study area with low HDL-C being the most frequent lipid abnormality suggesting that low HDL may be the major form of dyslipidaemia and a marker of dyslipidaemic cardiometabolic risk among them. Screening for dyslipidaemia should therefore form an important part of clinical care of geriatric hypertensives and those with dyslipidaemia should become target for lipid lowering treatment in addition to lifestyle modification.

Common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria.

BACKGROUND: The geriatric health, wellness and illness states in Nigeria are largely influenced by communicable diseases. OBJECTIVE: This study was aimed at describing the pattern of common geriatric morbidity from communicable diseases in a rural hospital in Eastern Nigeria. METHODS: This study was a descriptive hospital-based study carried out from June 2008 to June 2010 on geriatric patients at St Vincent De Paul Hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. The data collected included age, sex and diagnoses made. RESULTS: Eight hundred and seventy two patients out of a total patient population of 9885 were 65 years and above. The geriatric patients' constituted 8.8% of total patients' population. Out of these, 530 (60.8%) had communicable diseases consisting of 235 males and 295 females with a male to female ratio of 1: 1.3. The top five communicable diseases were malaria (67.1%), skin infections (43.6%), urinary tract infections (36.0%), intestinal helminthiasis (20.6%) and gastroenteritis (17.9%). CONCLUSION: This study shows that geriatric patients suffer acute and chronic communicable diseases with the commonest being malaria, skin infections, urinary tract infections and neglected tropical disease such as ascariasis and hookworm infestation. Effective measures are needed to control the scourge of communicable diseases which are largely preventable among the elderly patients particularly in rural Nigeria.