International health regulations and pre-travel health practices of international travelers at Nigerian airport: a cross-sectional study.

BACKGROUND: International Health Regulations (IHR) were developed by the World Health Organization (WHO) to curb the trans-border spread of epidemics. To our knowledge, no airport-based studies have assessed travelers' health practices against a combination of diseases subject to IHR 2005. Therefore, we aimed to generate and describe the baseline travelers' pre-travel health practices towards Cholera, Yellow Fever (YF), and Plague at Murtala Muhammed International Airport (MMIA) in Nigeria. METHODS: A cross-sectional study was employed to collect data from 486 international travelers using a multistage sampling technique. Pre-travel health practices (a combination of pre-travel consultation, pre-travel vaccination, and preventive measures against insect bites) were assessed using an interviewer-administered questionnaire. Logistic regression models were used to estimates the association between selected variables and pre-travel health practices. Statistical significance level was set at 5%. RESULTS: A total of 479 complete questionnaires were analyzed. The median age of respondents was 34.0 years Interquartile range (IQR) = 28.0, 44.0). Of the total respondents, 311 (64.3%) were aware of pre-travel health consultation and sources of information, amongst others, including friends/relatives in 180 (37.6%) travelers, social media/internet in 155 (32.4%) travelers, and health professionals in 102 (21.3%) travelers. Two hundred and seventy-one (56.6%) had pre-travel consultation, 156 (32.6%) had YF vaccination, and 226 (47.2%) were prepared to use preventive measures against insect bites. Only 10.6% had good pre-travel practices against the diseases subject to 2 International Health Regulations (IHR). Travelers with bachelor/college degrees, when compared to those with secondary/high education, had 2.91 times higher odds of having good practices when adjusting for other factors (95% C.I: 1.10, 7.70; p < 0.03). Also, those traveling to destinations endemic for YF infection, when compared to those who are not traveling to endemic countries/areas, had 48% lower odds of having good practices after adjusting for other factors (95% C.I: 1.41, 7.77; p < 0.01). CONCLUSIONS: Our study revealed a low prevalence of good pre-travel health practices among participants. Educational level and endemicity of YF at the destination were predictors of pre-travel health practices. Introducing topics on travelers' health into schools' curriculums may have a ripple positive effect on health practices among international travelers. Also, there is a need for public enlightenment programs on pre-travel health practices using social media platforms.

Health insurance in private and public health facilities in Southwestern Nigeria: what determines clients´ satisfaction with quality of service?

INTRODUCTION: insured-persons have complained about poor quality of services rendered by health care providers, which has consequently affected their satisfaction with care received. The objectives of this study aimed to identify the determinants of satisfaction and compare the level of clients´ satisfaction with quality of care received in both public and private health care facilities, in Oyo-State, Nigeria. METHODS: this was a cross sectional study, comparative in design. A total number of 300 clients were recruited from selected public and private health facilities in Oyo-state, using a multistage sampling technique. Data were analyzed using IBM SPSS version 24, and the level of significance was set at p-value < 0.05. RESULTS: the mean age of the respondents in private and public health facilities was 39.9 ± 10.0 years and 42.4 ± 10.1 years respectively. About 74% and 41.3% of the enrolees in the public and private health facilities respectively were dissatisfied with waiting time before receiving care with a statically significant difference of p=0.002. Majority of the respondents (82.7%) in the public health facilities and only 42.7% of those using private health care facilities were satisfied with the quality of drugs given to them at their respective pharmacies. This finding was statistically significantly different with p=0.001. Overall level of satisfaction with quality of care was 60% and 40% among enrolees using public and private health facilities respectively. There was a statistically significance difference (p=0.028) between the overall level of satisfaction and the type of health facility used by the clients. The determinants of clients´ satisfaction with quality of care in both private and public health facilities in this study were mainly socio-demographic characteristics; age (p=0.007), level of education (p=0.046) and occupation (p=0.004), the waiting time experience and the type of facility where services were accessed. CONCLUSION: clients attending public health facilities were more satisfied with care received under NHIS, compared with those using private health facilities. Efforts should be made to reduce waiting time and improve quality of drugs in the public and private facilities respectively.

Evaluation of the Effectiveness of Peer Education in Improving HIV Knowledge, Attitude, and Sexual Behaviours among In-School Adolescents in Osun State, Nigeria.

Introduction. Young people are at the centre of the global HIV/AIDS epidemic. This study therefore aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and preventive practices among in-school adolescents in Osun State, Nigeria. Methods. This was an intervention study that was carried out among in-school adolescents attending mixed secondary schools in Osun State, Nigeria. The study was in three stages: before intervention, intervention, and after intervention. The impact of peer education was evaluated twelve weeks after intervention. Data were collected using pretested semistructured questionnaires and data analysis was done with SPSS version 16. Results. At the preintervention stage, the study and control groups were similar in their sociodemographic characteristics, HIV knowledge, attitude, and preventive practices, including high risk behaviours for HIV/AIDS transmission. After the peer education intervention, those with good knowledge and positive attitudes towards HIV/AIDS increased significantly from 50.0% to 86.7% and from 49.0% to 85.6%, respectively (P < 0.05). Conclusion. The study showed that peer education is effective in improving knowledge, attitude, and some preventive practices towards HIV/AIDS among in-school adolescents. Educational programmes about HIV/AIDS should therefore be designed to target this age group putting into consideration their unique characteristics.

A Comparative study of awareness and attitude to nosocomial infections among levels of health care workers in Southwestern Nigeria

Introduction: Hospital acquired infections (HAIs) continue to be a threat to hospital admissions and workers thus contributing to mortalities and morbidities. Complexity and type of services rendered by health facilities may determine health worker's attitude towards combating these infections. The objective of this study is to compare knowledge; attitude and practice of HAIs among health workers at the three levels of health care in Southwestern Nigeria. Methods: - This descriptive; comparative cross sectional study was carried out among 273 health workers in Osogbo in Southwestern Nigeria; using multistage sampling method. Pre-coded semi structured self administered and pre-tested questionnaires were administered on sampled health workers. Data was analyzed using the SPSS software 13.0 Results: - All health care workers at the three levels have good awareness that patients could be a source of HAIs. Awareness of common HAIs; awareness of hospital staffs and equipments and the environment as sources of transmission of HAIs were good for health care workers in both tertiary and secondary level care; but poor among primary health care workers. There was poor awareness of presence of hospital policy on HAI and presence of hospital committee on infection control among health care workers at the three levels of health care; but this is worst among primary health care providers. More health care workers in tertiary care has reported themselves to staff clinics when sick; more always washed their hands before and after touching clients and equipments while more has also ever notified HAIs before; when compared to secondary and primary. Attitude towards willingness to report HAIs was better in both secondary and tertiary health care workers. There is a good attitude towards readiness to wear protective devices; towards washing of hand s before and after touching patients and self reporting to staff clinic when sick among health care workers at the three levels of care Conclusion: Good knowledge and attitude; but poor practice characterizes nosocomial infections among tertiary and secondary level health care workers in Osogbo. These indices are worst and ranges from fair to poor among health workers at the primary health care level. Routine seminars on factors associated with occurrence of nosocomial infections could help to improve awareness and reduce its prevalence in our hospital settings

Sexual behavior and risk of HIV/AIDS among adolescents in public secondary schools in Osogbo, Osun State, Nigeria.

UNLABELLED: Young people are particularly vulnerable to unplanned sexual activities. This study sought to identify the sexual behaviors and risk of HIV among public secondary schools students in Nigeria. METHODS: A cross-sectional survey of 521 students in eight randomly selected public secondary schools. Respondents were selected by a multistage sampling technique from amongst the study population. Using a self-administered, semi-structured, pre-tested questionnaire, data were obtained concerning their sexual behaviors and influencing factors. RESULTS: Most respondents (n = 387, 74.3%) were in late adolescence. Many knew the consequences of premarital sex as unplanned pregnancy, STI/HIV/AIDS, incomplete schooling, and guilt feelings. About 40% of the respondents had been involved in sexual activities with partners who were classmates, neighbors, 'sugar daddies', teachers, or strangers (party-mates or prostitutes). Heterosexual, oral, and anal forms of sex were practiced respectively by 78.1%, 13.3%, and 12.4% of those who were sexually active. Sexual debut was 15.2 +/- 1.62 years. About 36% of those sexually active had more than one partner, and about 14.8% were aware that their partners had other partners. Only 8.6% used a condom on a consistent basis, whereas 41.9% had never used a condom at all. More than half the sexual activities were not pre-planned. The reasons given for engaging in such practices were peer influence, financial reward, drug influence, fun, or experimentation. CONCLUSIONS: Despite their 'above average' level of knowledge of the consequences, the students were still involved in risky sexual behaviors. Behavioral change communications should be intensified among these adolescents.