Predictors of Undernutrition among School-Age Children in Abakaliki, Nigeria.

BACKGROUND: Undernutrition remains a major public health problem, especially in developing countries. Identification of factors affecting undernutrition among school-age children will guide prioritization of interventions. We determined the predictors of underweight, thinness and stunting among this age group. METHODS: A descriptive, cross-sectional study was conducted among 780 school children aged 6 to 12 years using a multistage probability sampling method. An interviewer-administered questionnaire was used to document sociodemographic information and potential predictors of undernutrition. Weight and height were measured using SECA® weighing scale and stadiometer. Body Mass Index (BMI), Z scores of the weight-for-age, BMI-for-age and height-for-age were calculated using the WHO Anthro plus software. Data was entered and analyzed using the Epi Info version 7.2. Multiple logistic regression was used to identify the predictors of undernutrition at 5% level of significance. RESULTS: Of a total of 751 pupils, 397 (52.9%) were females and 595 (79.2%) were in public schools. Significant predictors of underweight were lower maternal education (adjusted odds ratio (aOR) 2.7; 95%CI: 1.33-5.44) and age 10-12years (aOR 5.0; 95%CI:1.49-17.05). Thinness was predicted by age 10-12years (aOR 3.1; 95%CI 1.32-7.27) and rural dwelling (aOR 2.2; 95%CI:1.2-4.08) whereas stunting was predicted by age 10-12 years (aOR 5.2; 95%CI:2.14-12.68) and rural dwelling (aOR 2.3; 95%CI 1.3-4.1). CONCLUSION: Undernutrition was higher among rural dwellers, at age 10 to 12 years and with low maternal education.

BACKGROUND: La dénutrition reste un problème majeur de santé publique, en particulier dans les pays en développement. L'identification des facteurs affectant la dénutrition chez les enfants d'âge scolaire guidera la priorisation des interventions. Nous avons déterminé les prédicteurs de l'insuffisance pondérale, de la maigreur et du retard de croissance dans ce groupe d'âge. MÉTHODES: Une étude descriptive et transversale a été menée auprès de 780 écoliers âgés de 6 à 12 ans en utilisant une méthode d'échantillonnage probabiliste à plusieurs degrés. Un questionnaire administré par un enquêteur a été utilisé pour documenter les informations sociodémographiques et les prédicteurs potentiels de la dénutrition. Le poids et la taille ont été mesurés à l'aide d'un pèsepersonne SECA® et d'un stadiomètre. L'indice de masse corporelle (IMC), les scores Z du poids pour l'âge, de l'IMC pour l'âge et de la taille pour l'âge ont été calculés à l'aide du logiciel Anthro plus de l'OMS. Les données ont été saisies et analysées à l'aide du logiciel Epi Info version 7.2. La régression logistique multiple a été utilisée pour identifier les prédicteurs de la dénutrition au niveau de signification de 5%. RÉSULTATS: Sur un total de 751 élèves, 397 (52,9%) étaient des femmes et 595 (79,2%) étaient dans des écoles publiques. Les prédicteurs significatifs de l'insuffisance pondérale étaient le faible niveau d'éducation de la mère (odds ratio ajusté (aOR) 2,7 ; 95%CI :1,33-5,44) et l'âge de 10-12 ans (aOR 5,0 ; 95%CI:1,49-17,05). La maigreur était prédite par l'âge de 10-12 ans (aOR 3,1 ; 95%CI 1,32-7,27) et le logement rural (aOR 2,2 ; 95%CI:1,2-4,08) tandis que le retard de croissance était prédit par l'âge de 10-12 ans (aOR 5,2 ;95%CI:2,14-12,68) et le logement rural (aOR 2,3 ; 95%CI 1,3-4,1). CONCLUSION: La dénutrition était plus élevée chez les habitants des zones rurales, à l'âge de 10 à 12 ans et avec une faible éducation maternelle. Mots clés: Prédicteur ; Dénutrition; Enfants d'âge scolaire; Retard de croissance; Maigreur; Insuffisance pondérale.

Prevalence and Predictors of Metabolic Syndrome among Adults in North-Central, Nigeria.

BACKGROUND: Metabolic syndrome contributes to the burden of non-communicable diseases and is a growing public health problem in both developed and developing countries. We determined the prevalence and predictors of metabolic syndrome among adults in Benue State, North-Central, Nigeria to guide targeted interventions. METHODS: We conducted a community-based cross-sectional study in Benue State, North-Central, Nigeria. Multistage sampling technique was used to recruit 823 respondents. We defined metabolic syndrome using the National Cholesterol Education Programme Adult Treatment Panel III guideline and adapted a component of the WHO Stepwise questionnaire for data collection. Prevalence of metabolic syndrome and the associated risk factors were estimated using Chi square test and logistic regression at 5% level of significance. Statistical analysis was done using SPSS version 23.0. RESULTS: The mean age of the respondents was 40.1± 15.7 years. Most of the respondents were literate (86.8%) and married (67.0%). The prevalence of metabolic syndrome was 19.4%. One in every four of the respondents had pre-metabolic syndrome (25.6%) and this was more in females (28.2%) compared to males (22.9%). Thirty-four percent of the respondents had only one whereas 20.7% did not have any of the risk factors for metabolic syndrome. Age [aOR:10.3; 95%CI: 4.8-22.2], sex [aOR:2.4; 95% CI: 1.7-3.5] and education [aOR:2.9; 95%CI: 1.4-6.1] were significantly associated with metabolic syndrome among the respondents. CONCLUSION: The prevalence of metabolic syndrome was high. The associated risk factors were age, gender and educational status. Therefore, interventions should be targeted at young adults to reduce the long-term impact of the disease.

CONTEXTE: Le syndrome métabolique contribue à la fardeau des maladies non transmissibles et est un public croissant problème de santé dans les pays développés comme dans les pays en développement. Nous avons déterminé la prévalence et les prédicteurs du metabolism syndrome chez les adultes dans l'État de Benue, centrenord du Nigéria pour orienter les interventions ciblées. MÉTHODES: Nous avons mené une enquête transversale communautaire étude dans l'État de Benue, centre-nord du Nigéria. Multistage la technique d'échantillonnage a été utilisée pour recruter 823 répondants. Nous avons define syndrome metabolique à l'aide du National Cholesterol Programme d'éducation Groupe de traitement des adultes III lignes directrices eta adapté une composante du questionnaire Par étapes de l'OMS pour collecte de données. Prévalence du syndrome métabolique et des facteurs de risque associés ont été estimés à l'aide du test du chi carré et la régression logistique à un niveau de signification de 5 %. Statistique l'analyse a été effectuée à l'aide de SPSS version 23.0. RÉSULTATS: L'âge moyen des répondants était de 40.1 ± 15,7 ans.La plupart des répondants étaient alphabétisés (86.8 %) et mariés(67.0%). La prévalence du syndrome métabolique était de 19.4%.Un répondant sur quatre avait un prémétabolique (25.6 %) et c'était plus fréquent chez les femmes (28.2 %)comparativement aux hommes (22.9 %). Trente-quatre pour cent des n'en avaient qu'un, alors que 20.7 % n'en avaient aucun les facteurs de risque du syndrome métabolique. Âge [aOR:10.3; IC à 95 %:4.8-22.2], le sexe [aOR:2.4; IC à 95 %: 1.7-3.5] et l'éducation [aOR:2.9;IC à 95 % : 1.4 à 6.1] étaient significativement associés au metabolism chez les répondants. CONCLUSION: La prévalence du syndrome métabolique était haut. Les facteurs de risque associés étaient l'âge, le sexe et le statut scolaire. Par conséquent, les interventions devraient être ciblées chez les jeunes adultes pour réduire l'impact à long terme de la maladie. Mots-clés: Prévalence, facteurs de risque, syndrome métabolique, Nigéria.

Determinants of Non-Institutional Deliveries in Urban and Rural Communities of Ebonyi State Nigeria: Implications for Policy.

OBJECTIVE: Determine factors associated with noninstitutional deliveries (NIDs) in urban and rural communities of Ebonyi state, Nigeria. METHODS: Community based cross-sectional comparative study design was used. Two stage sampling technique was used to select 660 women in 4 out of 13 local government areas. Information was obtained using a pre-tested, interviewer administered questionnaire. Respondents were womenwho have delivered in past one year irrespective of place of delivery. Outcome measure was proportion of women who did not deliver with a skilled birth attendant. RESULTS: Comparable proportion of respondents delivered outside health facilities, (urban, 14.5%; rural, 10%) (p=0.075). Decisions were made mainly during labour (urban, 43.8%; rural, 36.4%). Predictors of NID in urban areas included receiving no formal antenatal care, (AOR = 50.4; 95%CI: 14.4-177.2), being <30 years, (AOR = 2.9; 95%CI:1.1- 8.0) and previous history of Caesarean section, (AOR = 0.05, 95%CI: 0.01-0.5). Predictor of NID in rural areas was not receiving formal antenatal care, (AOR = 43.9; 95%CI:13.0-148.3). CONCLUSION: Minor proportion of respondents delivered outside heath facilities in urban and rural communities. Good utilization of primary health centers is essential in improving maternal health in Nigeria especially in rural communities. There is a need for all women to receive antenatal care from skilled providers as this increases the likelihood of delivering with skilled birth attendants. Ensuring deliveries with skilled birth attendants will improve the poor maternal health index in Nigeria.

OBJECTIF: Déterminer les facteurs associés aux accouchements non institutionnels (JNV) dans les communautés urbaines et rurales de l'État d'Ebonyi, au Nigéria. MÉTHODES: Un plan d'étude comparatif transversal basé sur la communauté a été utilisé. Une technique d'échantillonnage en deux étapes a été utilisée pour sélectionner 660 femmes dans 4 des 13 collectivités locales. Les informations ont été obtenues à l'aide d'un questionnaire pré-testé administré par un intervieweur. Les répondants étaient des femmes qui ont accouché au cours de la dernière année, quel que soit le lieu de l'accouchement. La mesure du résultat était la proportion de femmes qui n'avaient pas accouché avec une accoucheuse qualifiée. RÉSULTATS: Proportion comparable de répondants livrés en dehors des établissements de santé, (urbain, 14,5%; rural, 10%) (p = 0,075). Les décisions ont été prises principalement pendant le travail (urbain, 43,8%; rural, 36,4%). Les prédicteurs de la NID dans les zones urbaines comprenaient l'absence de soins prénatals formels (AOR = 50,4; IC à 95%: 14,4 à 177,2), étant <30 ans, (AOR = 2,9; IC à 95%: 1,1 à 8,0) et antécédents de césarienne section, (AOR = 0,05, IC à 95%: 0,01­0,5). Le prédicteur de la NID dans les zones rurales ne recevait pas de soins prénatals formels (AOR = 43,9; IC à 95%: 13,0-148,3). CONCLUSION: Une faible proportion de répondants ont accouché à l'extérieur des établissements de santé dans les communautés urbaines et rurales. Une bonne utilisation des centres de santé primaires est essentielle pour améliorer la santé maternelle au Nigéria, en particulier dans les communautés rurales. Il est nécessaire que toutes les femmes reçoivent des soins prénatals de prestataires qualifiés car cela augmente la probabilité d'accoucher avec des accoucheuses qualifiées. Assurer les accouchements avec des accoucheuses qualifiées améliorera le mauvais indice de santé maternelle au Nigéria.

Risk Perception and Factors associated with Compliance to COVID-19 Preventive Measures among Commercial Drivers in Abakaliki Nigeria: An Imperative for Targeted Intervention.

BACKGROUND: Despite efforts to control COVID-19 pandemic, the outbreak has continued to ravage the world with high morbidity, mortality and economic hardship. The World Health Organisation reported that people are becoming complacent and their risk perceptions are lowering. Commercial drivers play significant role in outbreak control because of their regular mix with commuters from various sources. OBJECTIVES: We investigated risk perception and factors associated with compliance to COVID-19 preventive measures among commercial drivers. METHODS: This study involved 502 commercial drivers in Abakaliki Nigeria using cross-sectional analytic design. Data was collected with interviewer-administered questionnaire and analyzed with IBM-SPSS version 23. Inferential statistics were done using Chi-square and binary logistic regression tests with significance set at p-value of 0.05. RESULTS: The response rate was 502(98.4%) and mean age was 35.5±10.8 years. Majority of them were married 368(73.3%), had secondary education 279(55.6%) and operated commercial driving for 1-5 years 297(59.2%). There was high awareness, high-risk perception and good compliance with COVID-19 preventive measures in 99.8%, 69.1% and 54.4% of respondents respectively. Attaining tertiary education (aOR=6.5, 95% CI=1.5-28.1, p=0.012) and good knowledge of COVID-19 (aOR=4.3, 95% CI=2.7-6.8, p<0.001) significantly predicted high-risk perception while good knowledge of the disease alone predicted good compliance (aOR=5.5, 95% CI=3.6-8.3; p<0.001). CONCLUSION: The awareness of COVID-19 is high but there is relatively lower risk perception and compliance with the preventive measures. We recommend improved public education, sensitization and risk communication as well as review of policies and adoption of new approaches about COVID-19 outbreak control.

CONTEXTE: Malgré les efforts déployés pour contrôler la pandémie de COVID-19, l'épidémie a continué de ravager le monde avec une morbidité, une mortalité et des difficultés économiques élevées. L'Organisation mondiale de la santé a signalé que les gens deviennent complaisants et que leur perception des risques diminue. Les chauffeurs commerciaux jouent un rôle important dans le contrôle des épidémies en raison de leur mélange régulier avec des navetteurs de diverses sources. OBJECTIFS: Nous avons étudié la perception du risque et les facteurs associés à la conformité aux mesures préventives COVID-19 chez les conducteurs commerciaux. METHODES: Cette étude a porté sur 502 chauffeurs commerciaux à Abakaliki au Nigeria en utilisant une conception analytique transversale. Les données ont été collectées à l'aide d'un questionnaire administré par l'intervieweur et analysées avec IBM-SPSS version 23. Les statistiques inférentielles ont été effectuées à l'aide de tests de régression logistique du chi carré et binaire avec une signification statistique définie à une valeur p de 0,05. RESULTATS: Le taux de réponse était de 502 (98,4 %) et l'âge moyen était de 35,5 ± 10,8 ans. La majorité d'entre eux étaient mariés 368 (73,3 %), avaient fait des études secondaires 279 (55,6 %) et avaient conduit pendant 1 à 5 ans 297 (59,2 %). Il y avait une sensibilisation élevée, une perception à haut risque et une bonne conformité aux mesures préventives COVID-19 chez 99,8 %, 69,1 % et 54,4 % des répondants respectivement. L'obtention d'un diplôme de l'enseignement supérieur (aOR=6.5, 95 % IC=1.5-28.1, p=0.012) et une bonne connaissance du COVID-19 (aOR=4.3, 95 % IC=2.7-6.8, p<0,001) prédisaient de manière significative la perception du risque élevé alors qu'une bonne connaissance de la maladie seule prédisait une bonne observance (aOR=5,5, IC à 95 %=3,6-8,3 ; p<0,001). CONCLUSION: La sensibilisation au COVID-19 est élevée, mais la perception des risques et le respect des mesures préventives sont relativement plus faibles. Nous recommandons d'améliorer l'éducation, la sensibilisation et la communication sur les risques du public, ainsi que l'examen des politiques et l'adoption de nouvelles approches concernant le contrôle de l'épidémie de COVID-19. MOTS CLÉS: chauffeurs commerciaux, perception des risques, COVID-19, conformité, mesures préventives.

Knowledge, attitude and practice of infection prevention and control among healthcare workers: one year after an outbreak of nosocomial Lassa fever in a tertiary hospital in southeast Nigeria

Background: With the rise in cases of Lassa fever in recent times in West Africa, the healthcare setting continues to pose significant risk especially among healthcare workers (HCWs) for diseases like Lassa fever that are transmitted via contact with blood and other body fluids. We therefore assessed the knowledge, attitude and practice (KAP) of infection prevention and control (IPC) one year after an outbreak of nosocomial transmission of Lassa fever in the study hospital. Methodology: A cross-sectional study of HCWs was conducted in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, a tertiary hospital designated for Lassa fever treatment in southeast Nigeria. A total of 631 HCWs selected by systematic random sampling were surveyed using self-administered questionnaire to determine the KAP of IPC. Data analysis was done with EPI INFO version 7.2 and Microsoft Excel 2016, and Chi square statistic was used to examine relationship between variables at 5% level of significance. Results: Only 287 (51.1%) of the 562 respondent HCWs had good knowledge of IPC, 442 (78.6%) had good attitude towards IPC, and 268 (47.7%) had good practice of IPC. Socio-demographic predictors of IPC knowledge included being a medical laboratory scientist (AOR=0.5; 95% CI=0.29-0.83; p=0.009), tertiary education level (AOR=7.0; 95% CI=1.11-44.60; p=0.038), and work experience of ≥ 7 years (AOR=2.3; 95% CI=1.47-3.57; p<0.001). Male gender (AOR=1.9; 95% CI=1.06-3.42; p=0.031), nurse professional (AOR=6.5; 95% CI=2.67-15.81; p<0.001) and work experience of ≥ 7 years (AOR=2.5; 95% CI=1.37-4.54; p=0.003) were predictors of good attitude towards IPC. Also, nurse professional (AOR=3.1; 95% CI=1.79-5.20; p<0.001) and married status (AOR=1.6; 95% CI=1.05-2.55; p=0.028) were predictors of good practice of IPC among the respondents. Conclusions: The study demonstrated that knowledge and practice of IPC was low in the study location despite the interventions that had been instituted to improve the IPC framework. Therefore, there is need to adapt approaches that will influence behavior change towards IPC in the course of the in-service trainings being conducted in the hospital.

Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February-6 June 2020.

The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31-40 years (25.5%) and 61-70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.

Population-based prevalence and associated risk factors of hypertension among adults in Benue State, Nigeria.

BACKGROUND: The increasing prevalence of hypertension in low- and middle-income countries is associated with increased morbidity and mortality. AIM: To determine the prevalence of hypertension and associated risk factors in Benin state, Nigeria. MATERIALS AND METHODS: A population-based cross-sectional study was conducted among 1265 adults selected by multistage sampling technique. The World Health Organization (WHO) STEPwise approach was used to collect data. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 23.0 (IBM). We estimated prevalence and odds of hypertension at 5% level of significance. RESULTS: The prevalence of hypertension was 35.6%. The odds of hypertension was higher among age 30-39 (aOR: 2.0; 95% CI: 1.3-3.1) compared to age 18-29 years, males (aOR: 1.4; 95% CI: 1.1-2.0) compared to females, overweight (aOR: 2.3; 95%CI: 1.6-3.2), and obesity (aOR: 4.9; 95%CI: 3.2-7.7) compared to normal weight, and high cholesterol (aOR: 1.6; 95% CI: 1.1-2.3) compared to normal cholesterol. CONCLUSION: The prevalence of hypertension was high among young adults in Benue State. The associated risk factors for hypertension were age, sex, overweight, obesity, and high total cholesterol.

Antibiotic use among surgical inpatients at a tertiary health facility: a case for a standardized protocol for presumptive antimicrobial therapy in the developing world.

BACKGROUND: Indiscriminate antimicrobial use is one of the greatest contributors to antimicrobial resistance. A low level of asepsis in hospitals and inadequate laboratory support have been adduced as reasons for indiscriminate use of antimicrobials among surgical patients. At present, there are no guidelines for presumptive antibiotic use in Nigeria and sub-Saharan Africa. AIM: Surgical inpatients at the study hospital were surveyed to determine the level of antimicrobial use and degree of compliance with prescription quality indicators. METHODS: A cross-sectional survey was conducted among all surgical inpatients in May 2019 using a standardized tool developed by the University of Antwerp to assess the point prevalence of antimicrobials. Inpatients who were admitted from 08:00 h on the day of the survey were included. Data on patients' demographics, indication for antimicrobial use, reason for antimicrobial use, stop/review date, adherence to guidelines and laboratory use were collected. The prevalence of antimicrobial use in the surgical department was estimated. RESULTS: Eighty-two inpatients were included in the survey. Of these, 97.6% were receiving at least one antimicrobial agent. Only 5.4% of the prescriptions were targeted, and 37.6% of prescriptions were for empirical treatment of infections. Approximately half (50.7%) of the patients were receiving presumptive antibiotics, and 6% were receiving prophylactic antibiotics. In total, 58.7% of prescriptions were administered parenterally, and 98.2% of patients had documentation of a stop/review date. Metronidazole (P=32.3%, T=29.2%), ceftriaxone (P=28.4%, T=19.8%) and ciprofloxacin (P=14.2%, T=14.6%) were the most common antimicrobials used. CONCLUSIONS: There is a high rate of antimicrobial use among surgical inpatients, and the rate of indiscriminate antimicrobial prescribing among these patients needs to be reduced. This can be achieved by developing antimicrobial guidelines for presumptive antimicrobial therapy.

Appraisal of willingness to vaccinate daughters with human papilloma virus vaccine and cervical cancer screening uptake among mothers of adolescent students in Abakaliki, Nigeria.

BACKGROUND: By the end of 2017, human papillomavirus (HPV) vaccine had been introduced in 80 countries, but Nigeria proposes introducing the vaccine into her routine immunization program from late 2020 or early 2021. The current mode of HPV access in the country is through out-of-pocket purchase with only 1.4% of adolescent girls being vaccinated. Cervical cancer has remained the second highest cancer among women in Nigeria, and the incidence rate is significantly higher than the global rate. This study assessed the factors associated with HPV awareness and willingness to vaccinate daughters among mothers of female secondary school students in Abakaliki. MATERIALS AND METHODS: A cross-sectional study was carried out among 290 mothers of female students selected through multistage sampling technique using a pretested self-administered questionnaire. Data were analyzed with Epi Info™ version 7. RESULTS: The mean age of the mothers was 42 ± 8 years, and 72.8% attained at least secondary education, while 37.2% were traders. Their awareness of HPV and uptake of cervical cancer screening were low, 42.8% and 9%, respectively. Although 89.1% were willing to vaccinate their daughters, only 6.9% of their daughters had ever received HPV vaccine. Lack of awareness on HPV vaccine and cost of purchase were the most cited reasons for low vaccine uptake. Education, screening status, mother-daughter vaccination status, and willingness to encourage others on HPV vaccine for daughters were significantly associated with HPV awareness. CONCLUSION: Most of the mothers were willing to vaccinate their daughters with HPV vaccine, but they lack awareness and the financial resources for the access. There is an urgent need for vigorous enlightenment campaigns on HPV vaccine and cervical cancer screening. Adding HPV vaccine in the routine immunization program will improve universal access and address financial concerns.