Nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State, Southwest Nigeria.

BACKGROUND: Nutritional imbalance is an underlying cause of 2.6million death annually and a third of child's death globally. This study assessed and compared the nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State. METHODS: This is a cross-sectional comparative study carried out among 983 urban and rural primary school children in Ekiti State (495 in urban and 488 in rural) using interviewer-administered semi-structured questionnaire. A multi-stage sampling technique was used and data collected was analyzed using SPSS 23 with level of statistical significance set at p < 0.05. RESULTS: Underweight and stunting were relatively higher in rural (6.5% and 22.7% respectively) than in urban (6.3% and 19.4% respectively) and these differences are not statistically significant (p = 0.898, p = 0.197). However, wasting, overweight and obesity were higher in urban (12.7%, 6.1% and 7.7% respectively) than rural (11.5%, 3.7% and 7.5% respectively) but the difference is not statistically significant. (p = 0.242). Majority of the caregivers in both settings had good knowledge of malnutrition though higher in urban mothers (89.5%) with statistical significance than their rural counterparts (71.5%). However, there is no significant association between caregiver's knowledge and malnutrition in this study. Being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver were the common predictors of malnutrition among the school children in both community settings. CONCLUSION: Generally, the prevalence of malnutrition was high in both urban and rural primary school children in this study. However, while underweight and stunting were more prevalent among the children in the rural communities, wasting, overweight and obesity were more prevalent in the urban. The caregivers in both communities had good knowledge of malnutrition (better in the urban) but this is not good enough to bring a significant relationship with the occurrence of malnutrition in the children. Common predictors of malnutrition in both community settings are being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver. It is therefore recommended that regular continuous public enlightenment, nutritional education programmes and other programmes targeted at improving the economic power of the caregivers are measures that will improve the nutritional status of the primary school children.

Feeding Pattern, Prevalence of Malnutrition and Associated Determinants amongst Primary School Children in Rural and Urban Communities of Ekiti State, Southwest Nigeria.

BACKGROUND: Malnutrition is an increasing health problem amongst children, especially in developing countries. This study assessed and compared the feeding pattern, prevalence and determinants of malnutrition amongst primary school children residing in the rural and the urban communities of Ekiti State, Southwest Nigeria. METHODS: The study employed a cross-sectional comparative study design and was carried out amongst 983 children attending primary schools in Ekiti State, 495 of them from urban and 488 from rural communities using an interviewer-administered semi-structured questionnaire and the World Health Organization AnthroPlus version 1.0.4 to collect data on the nutritional status and anthropometric indices of the schoolchildren. A multistage sampling technique was used and data collected were analysed using SPSS 23 with the level of statistical significance set at P < 0.05. RESULTS: A statistically higher proportion of primary school children in the rural communities (24.8%) had a low dietary diversity score than those in the urban communities (8.5%) (P < 0.001). Less than half of the pupils (47.1% in the urban and 48.6% in the rural communities) were malnourished. Lower birth order, respondents from household with poor toilet facility, lower class in school, low education of caregiver, occupation of household head and father as caregiver were factors associated with malnutrition in both urban and rural communities. CONCLUSION: The prevalence of malnutrition was high in both urban and rural primary school children though higher in rural settings. Furthermore, dietary diversity score and feeding pattern were worse in rural than urban communities.

Cost of illness of non-communicable diseases in private and public health facilities in Nigeria: a qualitative and quantitative approach.

Introduction: the cost of illness (COI) of non-communicable diseases (NCDs) has detrimental effects on healthcare outcomes in addition to the serious economic impact on patients and their families. This study estimated and compared the COI of NCDs and its predictors in private and public health facilities (HF) in Ado-Ekiti, Nigeria. Methods: the study was carried out in selected HF (39 private; 11 public) using a comparative cross-sectional design with a mixed method of data collection. Quantitative data were collected from 348 hypertensive and/or diabetic patients (173 private; 175 public) using a semi-structured, interviewer-administered questionnaire while qualitative data were from 5 key informant interviews (KII) conducted with HF heads or their representatives. Results: the average monthly COI of NCDs was higher among patients in private (₦15,750.38±14,286.47 [US$43.75±39.68]) than in public HF (₦13,283.37±16,432.68 [US$ 36.90±45.65]) (P<0.001), however, the indirect cost was higher in public HF (private, ₦1,561.07 [US$4.34]; public, ₦3,739.26 [US$10.39]) (p<0.001). Predictors of COI of NCDs identified were income and admission in both groups. Additionally, age, payment method, type of NCDs, having two or more complications, and exercise were identified in private while socioeconomic status, length of diagnosis, and alcohol were identified in public HF. The KII revealed a long waiting time for the public HF patients which accounted for the huge indirect cost. Conclusion: the study found a huge indirect cost in the public HF that could be minimized by developing policies that would reduce the waiting time of patients. Government and private interventions targeting identified predictors should be applied to reduce the financial burden of NCD.

Comparative assessment of health-related quality of life among hypertensive patients attending state and federal government teaching hospitals in Ekiti State, Nigeria.

Background: Hypertension is a serious health problem and it is one of the diseases that impair health-related quality of life. The central tenet of care should be to improve health-related quality of life and overall well-being and not just be limited to improving clinical outcomes. This study assesses and compares health-related quality of life and its predictors among hypertensive patients in two government hospitals in Ekiti State, Nigeria. Methods: This was a comparative cross-sectional study involving 440 hypertensive patients (220 in each group), recruited using a systematic sampling technique within the hospitals. Data on socio-demographic, economic and clinical characteristics including the cost of care for hypertension were collected from the patients. The WHOQoL-BREF questionnaire was used to assess health-related quality of life. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Results: All domains of health-related quality of life were better among patients in federal government teaching hospitals, however, only the physical (T = -7.932, p < 0.001) and overall (T = -2.783, p = 0.006) domains were of statistical significance. An inverse relationship between cost and health-related quality of life was found in the two hospitals (State: r = -0.224, p = 0.001; Federal: r = -0.378, p < 0.001). Identified predictors of health-related quality of life were age, locality of residence, income, number of complications, exercise and smoking in both hospitals. Other predictors were marital status, living arrangement, occupation, number of medications, and involvement in religious and spiritual activities among patients in the state government teaching hospital; household size, length of diagnosis, and indirect cost among patients in the federal government teaching hospital. Conclusion: There is a need to support hypertensive patients in the state government teaching hospitals to reduce the inequality of low health-related quality of life among them. Identified predictors should be taken into consideration when putting in place policies that will improve the health-related quality of life of these patients.

Early sexual debut: prevalence and risk factors among secondary school students in Ido-ekiti, Ekiti state, South-West Nigeria.

BACKGROUND: Early adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk factors of early sexual debut among secondary school students in Ido-Ekiti, South-West Nigeria. METHODOLOGY: This was a cross-sectional study. The respondents were selected using multi-stage sampling technique. Pre-tested, semi-structured, self-administered questionnaire was used to collect data. Data was analyzed using SPSS version 15. RESULTS: More than two-thirds, 40(67.8%), had early sexual debut. The prevalence of early sexual debut was about 11%. The mean age of sexual debut was 13.10±2.82; the mean age for early sexual debutants was 11.68±1.98. The mean number of sexual partners was 2.44±1.99. Male gender, having friends who engaged in sexual activities had association with early sexual exposure (p<0.05). Alcohol intake had the strongest strength of association for early sexual debut among the students. CONCLUSION: The high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend. This will help to reduce the devastating negative psycho-social and health sequels.