Knowledge of tuberculosis management using directly observed treatment short course therapy among final year medical students in South Western Nigeria.

INTRODUCTION: Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. METHODS: A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS. RESULTS: More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline. CONCLUSION: The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.

Perception of Societal Stigma and Discrimination Towards People Living with HIV/AIDS in Lagos, Nigeria: a Qualitative Study.

INTRODUCTION: The perception of People Living with HIV/AIDS (PLWHAs) on how the public feels about them could influence their willingness to seek medical care, interaction with the society and their coping strategies. MATERIAL AND METHODS: This study assessed the perception and behavior of PLWHAs towards societal stigma and discrimination in Lagos, Nigeria. This was a qualitative, descriptive cross sectional study among PLWHAs from three of the three senatorial districts in Lagos State selected using simple random sampling. Six focus group discussions (FGDs), consisting of eight eligible respondents each were held using structured FGD guide. RESULTS: Collected data were analyzed using simple content analysis. About three quarter of all the discussants said life had become miserable following episodes of stigma and discrimination against their personality in public, family, health care settings and the work-place. Some had feelings of guilt and depression towards these actions. About three quarter had coped with the situation by living a low-keyed lifestyle, dissociating themselves from the public and avoiding seeking care in HIV care centers. Majority of respondents were not willing to come out to publicly discuss their positive HIV status for fear of discrimination. CONCLUSION: Discussants recommended continuous awareness campaigns about HIV to further educate the general public towards reduction of societal stigma and discrimination against PLWHAs.

How prepared are Nigerian schools for ebola virus disease prevention and control?

BACKGROUND: Nigeria was one of the West African countries gripped by the fear of the spread of the Ebola virus disease (EVD), leading to a long period of delay in resumption of primary and secondary schools for academic activities in September 2014. The aim of this study was to assess the preparedness of schools in the north central region of Nigeria toward EVD prevention and control within 1 month of resumption of schools. METHODS: This was a descriptive cross-sectional study among 76 schools selected using a multistage sampling method. Research instruments were self-administered, semi-structured questionnaires. Data was analyzed using the SPSS software version 17.0. FINDINGS: Half (38) of the schools reported that some of the children could have traveled to EVD-infected areas during the holiday period; 77.6% (59) had their teachers formally trained on EVD prevention and control before resumption; 50% (38) set up a committee on EVD prevention; and 62.9% (63) carried out awareness-raising activities on school assembly ground. Based on some preventive measures criteria, 55.2% (42) were categorized ready, whereas 44.7% (34) were not ready for EVD prevention and control within 1 month of resumption of students back to school. About 76.3% (58) said they would like to sustain these EVD prevention efforts; 14.5% (11) would like to sustain such efforts at least until the end of the present term. Determinants of readiness for EVD prevention and control include being a private school, being an urban school, belief that children could have traveled to an EVD-infected area, and school having standard operating procedure or policy guidelines on EVD prevention and control. CONCLUSION: The persistent call for postponement of school resumption might have been due to the unpreparedness of many of schools to meet EVD prevention and control guidelines. Schools need to take more proactive and sustainable measures toward effective control of the ongoing epidemic and prevention of future occurrences.

Conflicts in Rights of Disclosure of HIV Status in South Western Nigeria: the Health Care Provider's Perspective.

INTRODUCTION: Close interaction between clients and health care workers as regards disclosure, refusal of treatment and right to know status has been a subject of debate in legal and medical quarters. The objective of this study was to assess perceived rights of health care workers towards disclosure of HIV status in Lagos State in Southwestern Nigeria. METHODS: This was a descriptive cross sectional study carried out among 260 health care workers using multistage sampling technique. Research instruments were semi structured self administered and pre tested questionnaires. Data was analyzed using the SPSS softwares. RESULTS: Mean age of respondents was 39.3(+3.7) years. One hundred and eight four (70.8%) of the health workers studied said that it is the right of health care workers to know the HIV status of clients before commencement of treatments, and 36 (13.8%) agreed that health care workers have the right to refuse to treat or carry out procedure on known HIV positive clients. Twenty (7.7%) said that HIV positive health care workers should not be allowed to handle clients clinically, 72 (27.7%) believed that it is the right of HIV positive clients to know the HIV status of health care workers before attending to them, 36 (13.8%) of respondents has ever disclosed their HIV status to clients before carrying out procedures on them. Fifty six (21.5%) of respondents were willing to show their result results to a HIV positive clients who insist on knowing his or her HIV status, 84 (32.3%) believed that clients has the right to refuse a known HIV positive health care workers to treat or carry out some procedures. DISCUSSION: There was no statistically significant association between readiness to disclose HIV status and believing that health care workers have the right to know the status of clients before given them treatment ({P< 0.05). CONCLUSION: The need to balance out perceived rights of health care workers and clients would assist in provision of quality services to HIV positive clients.

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