Cardiovascular Risk Factors in the 21st Century in a Semi-Urban Slum in North-Central Nigeria.

INTRODUCTION: Cardiovascular disease is prevalent in most low- and middle-income countries, and it is a major cause of disability and low quality of life. Stroke incidence is rising in tandem with the prevalence of its risk factors. Our research aims to identify stroke risk factors in a semi-urban slum in northcentral Nigeria. METHODS: This community-based, cross-sectional study was conducted in July 2017 to determine the prevalence of stroke risk factors among adult (≥18 years) residents of the Kabong community, in Jos, north central Nigeria. A total of 196 participants were recruited by multistage sampling technique. An adapted WHO STEPS questionnaire was used for the study and blood samples were obtained for lipid biochemistry. RESULTS: We studied 196 participants, of whom 118 (60.2%) were females. The participants' median age was 48 (29) years, with those ≥ 65 years accounting for 17.3%. Generalized and abdominal obesity, hypertension, and diabetes mellitus were all prevalent in 39.1%, 52.3%, 37.1% and 17.8% of the population respectively. A LDL/HDL cholesterol ratio of >2.5 was observed in 74.1% of participants, elevated total cholesterol in 52.3%, elevated LDL-cholesterol in 57.4%, low HDL-cholesterol in 68.5% and high triglycerides in 13.2%. Current smoking and alcohol consumption were found in 4.1% and 32% of respondents, respectively. CONCLUSION: There is a high prevalence of cardiovascular risk factors in this young population. Elevated blood pressure, hypertriglyceridemia, and illiteracy were all predictors of cardiovascular events. Health education, screening, and lifestyle changes are needed to reduce future cardiovascular disease burden.

INTRODUCTION: Les maladies cardiovasculaires sont répandues dans la plupart des pays à revenu faible ou intermédiaire et constituent une cause majeure d'invalidité et de mauvaise qualité de vie. L'incidence des accidents vasculaires cérébraux augmente parallèlement à la prévalence de leurs facteurs de risque. Notre recherche vise à identifier les facteurs de risque d'AVC dans un bidonville semi-urbain du centrenord du Nigeria. MÉTHODES: Cette étude transversale à base communautaire a été menée en juillet 2017 pour déterminer la prévalence des facteurs de risque d'AVC chez les résidents adultes (≥18 ans) de la communauté de Kabong, à Jos, dans le centre-nord du Nigéria. Au total, 196 participants ont été recrutés par une technique d'échantillonnage à plusieurs degrés. Un questionnaire STEPS adapté de l'OMS a été utilisé pour l'étude et des échantillons de sang ont été prélevés pour la biochimie des lipides. RÉSULTATS: Nous avons étudié 196 participants, dont 118 (60,2 %) étaient des femmes. L'âge médian des participants était de 48 (29) ans, les participants ≥65 ans représentant 17,3 %. L'obésité généralisée et abdominale, l'hypertension et le diabète sucré concernaient respectivement 39,1 %, 52,3 %, 37,1 % et 17,8 % de la population. Un rapport A LDL/HDL-cholestérol > 2,5 a été observé chez 74,1 % des participants, un taux élevé de cholestérol total chez 52,3 %, un taux élevé de LDL-cholestérol chez 57,4 %, un faible taux de HDLcholestérol chez 68,5 % et un taux élevé de triglycérides chez 13,2 %. Le tabagisme et la consommation d'alcool ont été constatés chez 4,1 % et 32 % des personnes interrogées, respectivement. CONCLUSION: La prévalence des facteurs de risque cardiovasculaire est élevée dans cette jeune population. Une pression artérielle élevée, une hypertriglycéridémie et l'analphabétisme sont des facteurs prédictifs d'événements cardiovasculaires. L'éducation à la santé, le dépistage et les changements de mode de vie sont nécessaires pour réduire le fardeau des maladies cardiovasculaires à l'avenir. Mots-clés: Maladies cardiovasculaires, Facteurs de risque, Semiurbain, Centre-nord, Nigeria.

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.

Predictors and Prognosis of Stroke in Jos, North-Central Nigeria.

BACKGROUND: Stroke is the second leading cause of death worldwide. Stroke mortality has been shown to be higher in blacks in multiracial studies. It is also a very important cause of disability with its attendant deterioration in the quality of life in survivors. OBJECTIVE: The study sought to determine the risk and prognostic factors associated with stroke in Jos, North Central Nigeria. METHODS: A prospective cohort study of stroke patients that were followed up for 90 days to determine outcomes. The stroke patients were admitted into the neurology unit of Jos University Teaching Hospital between September 2016 and August 2018. RESULTS: We recruited a total of 246 subjects comprising 131 (53.3%) males aged 59.5 ± 13.1 years and 115 (46.6%) females aged 56.7 ± 14.2 years. Obesity, hypertension, dyslipidaemia and alcohol consumption were the commonest risk factors identified. The 90-day case fatality rate of stroke was 22%. Elevated glycated haemoglobin (p = 0.001), loss of consciousness at presentation (p <0.001), atrial fibrillation (p= 0.022), cardiac disease (p < 0.001) and HIV infection (p = 0.001) were significantly associated with poor outcome for stroke. Furthermore, subjects with a high NIHSS had three times the risk of death compared with those with low scores (RR = 2.93; 95% CI = 2.38 - 3.61, p <0.001). CONCLUSION: The prognosis of stroke was poor. The predictors of poor stroke outcome were coma, HIV infection, cardiac disease, high NIHSS and total cholesterol.

HISTORIQUE: L'AVC est la deuxième cause de décès dans le monde. La mortalité par accident vasculaire cérébral s'est avérée plus élevée chez les Noirs dans les études multiraciales. C'est également une cause très importante d'invalidité avec la détérioration de la qualité de vie des survivants. OBJECTIF: L'étude visait à déterminer le risque et les facteurs pronostiques associés à un AVC à Jos, au centre-nord du Nigéria. MÉTHODES: Une étude de cohorte prospective de patients victimes d'un AVC qui a été suivie pendant 90 jours pour déterminer les résultats. Les patients victimes d'unAVC ont été admis dans l'unité de neurologie de l'hôpital universitaire de Jos entre septembre 2016 et août 2018. RÉSULTATS: Nous avons recruté un total de 246 sujets comprenant 131 (53,3%) hommes âgés de 59,5 ± 13,1 ans et 115 (46,6%) femmes âgées de 56,7 ± 14,2 ans. L'obésité, l'hypertension, la dyslipidémie et la consommation d'alcool étaient les facteurs de risque les plus courants identifiés. Le taux de mortalité par accident vasculaire cérébral à 90 jours était de 22%. L'hémoglobine glyquée élevée (p = 0,001), la perte de conscience à la présentation (p <0,001), la fibrillation auriculaire (p = 0,022), les maladies cardiaques (p <0,001) et l'infection à VIH (p = 0,001) étaient significativement associées à de mauvais résultats pour coup. En outre, les sujets avec un NIHSS élevé avaient trois fois le risque de décès par rapport à ceux avec desscores faibles (RR = 2,93; IC à 95% = 2,38 - 3,61, p <0,001). CONCLUSION: Le pronostic de l'AVC était mauvais. Les facteurs prédictifs d'un mauvais pronostic d'AVC étaient le coma, l'infection par le VIH, les maladies cardiaques, un NIHSS élevé et le cholestérol total. MOTS CLÉS: Prédicteurs, pronostic, accident vasculaire cérébral.

Prevalence of hepatitis B virus infection among pregnant women in Jos, Nigeria.

Objectives: The study sought to determine the prevalence and risk factors associated with Hepatitis B surface antigenemia (HBsAg) positivity among pregnant women in Jos, Nigeria. Methodology: This was a cross-sectional study carried out among the pregnant population in five healthcare facilities in Jos, between November 1, 2017 and April 30, 2018. Informed consent was obtained, and data on sociodemographic and risk factors for hepatitis B virus (HBV) infection were collected. Hepatitis B viral infection was assessed using the in vitro HBsAg diagnostic rapid kit (Acon Laboratories, USA). Descriptive statistics, Chi-square test, and logistic regression were performed to identify predictors of HBV infection in the study population. All statistical analyses were carried out on STATA version 15. Results: Of the 3,238 women enrolled, 7.4% (241/3238) (95% confidence interval [CI] = 6.6% to 8.4%) were HBsAg positive. The absence of HBV vaccination (adjusted odds ratio [AOR] = 2.49; 95% CI = 1.49-4.09; P < 0.001), co-infection with HIV (AOR = 1.90; 95% CI = 1.18-3.08; P = 0.009), and higher parity (AOR = 1.37; 95% CI = 1.04-1.79; P = 0.024) were independently associated with HBV infection in pregnancy. Conclusions: The prevalence of HBV infection among pregnant women was high, especially among those without prior vaccination for HBV, those with HIV co-infection and higher parity.

RésuméObjectifs: L'étude visait à déterminer la prévalence et les facteurs de risque associés à la positivité à l'antigénémie de surface de l'hépatite B (AgHBs) chez les femmes enceintes à Jos, Nigéria. Méthodologie: Il s'agit d'une étude transversale réalisée auprès de la population enceinte dans cinq dans les établissements de santé de Jos, entre le 1er novembre 2017 et le 30 avril 2018. Un consentement éclairé a été obtenu et des données sociodémographiques et des facteurs de risque d'infection par le virus de l'hépatite B (VHB) ont été collectés. L'infection virale de l'hépatite B a été évaluée à l'aide du diagnostic in vitro de l'HBsAg kit rapide (Acon Laboratories, USA). Des statistiques descriptives, un test du chi carré et une régression logistique ont été effectués pour identifier les prédicteurs de Infection par le VHB dans la population étudiée. Toutes les analyses statistiques ont été effectuées sur STATA version 15. Résultats: Sur les 3 238 femmes inscrites, 7,4% (241/3238) (intervalle de confiance à 95% [IC] = 6,6% à 8,4%) étaient positifs pour l'AgHBs. L'absence de vaccination contre le VHB (cotes ajustées rapport [AOR] = 2,49; IC à 95% = 1,49­4,09; P <0,001), co-infection par le VIH (AOR = 1,90; IC à 95% = 1,18­3,08; P = 0,009) et plus la parité (AOR = 1,37; IC à 95% = 1,04-1,79; P = 0,024) était indépendamment associée à l'infection par le VHB pendant la grossesse. Conclusions: le la prévalence de l'infection par le VHB était élevée chez les femmes enceintes, en particulier chez celles qui n'avaient pas été vaccinées contre le VHB, celles avec le VIH co-infection et parité plus élevée.

Neonatal Blood Pressure and Anthropometric Indices in Newborns of Pre-Eclamptic and Normal Mothers in Jos, Nigeria.

BACKGROUND AND OBJECTIVES: Preeclampsia is a significant public health problem associated with increased risk of hypertension for offsprings. We compared the blood pressure and presence of hypertension between neonates born to women with preeclampsia and those with normal pregnancy as well as its relationship to anthropometric indices. METHODS: This is a comparative cross-sectional study of 40 neonates born to women with preeclampsia and those born following normal pregnancy in four tertiary health facilities located in Jos, Nigeria. Anthropometric and blood pressure values were measured within 6-12 hours of delivery using standard protocols. SPSS version 25 was used in all analyses. Statistical significance was taken at p <0.05. RESULTS: The mean birth weight for neonates of preeclamptic women was 2,476.1±810.8 grams, compared with 2,994.2±529.6 grams in babies of normal pregnancy (p=0.002). The mean birth length for neonates of preeclamptic women was 45.4±6.2 cm compared with 49.8±3.1 cm in babies of normal pregnancy (p<0.001). The mean ponderal index (PI) in neonates of preeclamptic women was 2.6±0.6 g/cm3 compared with 2.4±0.4 g/cm3 in babies of normal pregnancy (p=0.17). The mean systolic blood pressure in neonates of women with preeclampsia was 74.53±16.99 mmHg compared with 75.26±15.20 mmHg in neonates following normal pregnancy (p=0.85). The mean diastolic blood pressure in neonates born following preeclampsia was 47.52±15.76 mmHg compared with 45.12±16.9 mmHg in those following normal pregnancy (p=0.46). Six (16%) of the neonates born to women with preeclampsia had systolic hypertension compared with 3(8%) of neonates of women with normal pregnancy. Similarly, 5(14%) of neonates born to women with preeclampsia had diastolic hypertension compared with 2(5%) of neonates of women with normal pregnancy. No significant association between neonatal hypertension and anthropometric indices. CONCLUSION: Newborns of women with preeclampsia have associated higher odds of elevated blood pressure. Elevated blood pressure has no significant relationship to birthweight, length or ponderal index. Early infant blood pressure surveillance is advocated in order to monitor and hence prevent complications ensuing in later life.

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.

Predictors of male condom utilization in Plateau State, Nigeria.

BACKGROUND: Nigerian men play major roles in the reproductive decision-making process, including issues concerning fertility. Despite efforts made by the government to reduce the incidence of HIV by using condom as a means of dual protection, the utilization of male condom is still relatively low in Nigeria. This study aimed to assess the condom utilization and predictors of condom use among male respondents in Plateau State. METHODOLOGY: An analysis of secondary data of the 2013 Nigeria Demographic Health Survey dataset was done. Data were collected through a cross-sectional study using multistage cluster sampling technique from 393 consenting males aged 15-49 years in Plateau State using a semistructured, closed-ended questionnaire. Survey data quality was ascertained using field check tables during data entry. The dataset was analyzed using SPSS version 21.0 software (SPSS, IBM Corp, Armonk, NY, USA). Condom utilization prevalence rate was calculated for the 393 males, while predictors were determined by logistic regression. P ≤ 0.05 was considered statistically significant. RESULTS: Mean age of the respondents was 31.05 ± 9.395 years. Most (90.3%) of the respondents were aware of at least one of the various family planning methods. The prevalence of condom use among them was 15.5% with the 20-29 years' age group having the highest proportion (28.8%). Significant associations were found between condom use and age, level of wealth, level of education, marital status, knowledge of contraception, occupation, and religion. Predictors of condom use include level of wealth (middle class), not being married, and primary level education. CONCLUSIONS: The prevalence of male condom use is low in Plateau State. The predictors of condom use are level of wealth, being unmarried, and primary level of education. Having only a primary level of education and been in the middle class reduces the likelihood of using condoms while being unmarried increases it.

Risk perception of hepatitis B infection and uptake of hepatitis B vaccine among students of tertiary institution in Jos.

BACKGROUND: Hepatitis B virus (HBV) Infection is endemic in Nigeria. Healthcare students are more vulnerable because of direct contact with patients' body fluids and blood. Risk perception of HBV and HB vaccine uptake are also poor. The aim of this study was to assess the level of risk perception of hepatitis B infection, and uptake of the HBV vaccine, between medical and other students of the University of Jos. METHODS: A comparative cross sectional study was conducted among 1,200 students of the departments of Medicine, Nursing sciences and Public Administration, University of Jos (400 from each arm) using a pretested self-administered questionnaire. A five point Likert scoring system was used to assess risk perception. Data was analyzed using SPSS version 20. A P -value of <0.05 was considered significant. RESULTS: Awareness on HB vaccine prevention was high (88.4%) among University of Jos students. Awareness was similar among medical and nursing students (36.2% and 36.0% respectively) but lower among public administration student (27.8%), P< 0.001. The overall risk perception was 76.8%. This was also similar for medical and nursing students (40.7% and 40.1% respectively), but lower for public administration students (9.1%), P< 0.001. Risk perception is 5x higher among medical students compared to public administration students (OR = 5.22, 95% CI = 2.19 - 12.93; P < 0.001). The uptake of full dose HB vaccine was 60.2%, 20.6% and 15.1% for medical, nursing and public administration students respectively. Medical students are 4x more likely to go for HB vaccination compared with public administration students (OR=3.62; 95% CI=2.39 - 5.48; P< 0.001). CONCLUSIONS: Awareness and risk perception on HBV infection are high among University of Jos students, but uptake of HB vaccine is low. Findings are worst for non-health students.

Malaria among antenatal clients attending primary health care facilities in Kano state, Nigeria.

BACKGROUND: Malaria in pregnancy remains a major public health problem especially in sub-Saharan Africa. However, the prevalence of clinical and asymptomatic infection among antenatal client (ANC) attendees is largely unknown, especially at primary health care (PHC) level in northern Nigeria. This study assessed the prevalence of fever, malarial parasitemia and anemia among pregnant women attending PHC facilities in Kano, northern Nigeria. METHODS: A cross-sectional descriptive study was conducted among 360 ANCs attending PHC facilities in two Local Government Areas (LGAs) in Kano state. Data were collected using a pre-tested semi-structured interviewer administered questionnaire. Blood samples were also obtained for thin blood smear for malaria parasite using Giemsa staining technique. Hemoglobin was estimated from the Packed Cell Volume (PCV) determined using hematocrit. RESULTS: Age of the subjects ranged from 15 to 42 years with a mean +/- SD of 24.0 +/- 6.0. Up to 39.2% (n = 141) (95% Confidence Interval = 34.1-44.4%) of the subjects were found to have malarial parasitemia. Exactly 36.2% (n = 51) of those with parasitemia had fever (temperature >or= 37.5 degrees C) while 63.8% (n = 90) of them were asymptomatic. Anemia, (hemoglobin of

The prevalence and severity of dental fluorosis in the high and low altitude parts of Central Plateau, Nigeria.

OBJECTIVE: To compare the prevalence and severity of dental fluorosis in the high and low altitude parts of the Central Senatorial District of Plateau State. BASIC RESEARCH DESIGN: The study was cross-sectional and descriptive. SETTING: The community based study was carried out in Central Plateau Nigeria, in 2005. PARTICIPANTS: The study subjects were 12-15 year old life long residents selected using the multistage sampling technique. One Local Government Area each was randomly selected from the high and low altitude parts of the district and from each selected Local Government Area two health districts were randomly selected with probability proportional to size. From each of the selected health Districts two major settlements were selected again with probability proportional to size. 12-15 year old life long residents of the selected settlements were studied. Each respondent completed an interviewer administered questionnaire after which he/she was clinically examined to ascertain his/her fluorosis status. Samples of water were collected from water sources consumed by the respondents in each settlement. MAIN OUTCOME MEASURES: The main outcome measures were presence and severity of dental fluorosis as measured by the Thylstrup and Fejerskov index. (TF score). RESULTS: One thousand one hundred children were studied, 554 (50.4%) from the high altitude part of the district and 546 (49.6%) from the low altitude part. Fluorosis prevalence was 12.9% in the district, but significantly higher (22.2%) in the high altitude areas compared to the low altitude ones (3.5%). The severest form of fluorosis in the district was TF 6 for tooth 14 and TF 5 for tooth 11. CONCLUSION: The prevalence and severity of dental fluorosis is significantly higher in the high altitude parts of the District compared to the low altitude ones. Efforts are needed to further investigate and control the problem.

Home treatment of malaria, amongst under fives presenting with fever in PHC facilities in Jos North LGA of Plateau State.

BACKGROUND: Malaria is one of the major causes of morbidity and mortality in Nigeria. It accounts for 30-50% of morbidity generally and 25% of mortality among under fives. Over the counter treatment of malaria is practiced in almost every household in Nigeria. Therefore this study was carried out to determine the pattern of Home treatment of Malaria amongst under fives seen at PHC facilities in Jos, Plateau State. Nigeria METHODS: A cross-sectional descriptive study design was adopted. Data were generated from 260 systematically selected under fives using interviewer administered structured questionnaires. The informants were their mothers who brought them to PHC facilities with the history of fever. RESULTS: One hundred and fifty nine (57.3%) of the 260 were positive for malaria parasite. One hundred and thirty five (51.9%) did not take any Antimalarial before presentation. Eighty seven (33.5%) took chloroquine, nine (3.5%) had chloroquine with paracetamol, fourteen (5.4%) had nivaquine, nine (3.5%) took paracetamol alone and six (2.3%) were given a combination of orthodox and traditional medicines. Only 21.6% of the mothers gave correct dosage of the Antimalarial. There was no statistically significant relationship between home treatment and parasitaemia among the under fives. CONCLUSION: Home treatment of malaria is a strategy that if properly done will reduce the morbidity and mortality of malaria but this study showed that the knowledge of home treatment of malaria was poor and even when done was not completed because of unavailability of pre-packaged antimalaria.

Management audit for Primary Health Care Facilities in Plateau State.

BACKGROUND: The health care system in Nigeria has been developed at three levels, the extension of health care to all people has been an objective of all National Health Systems for many years since the Alma - Ata conference on Primary Health Care (PHC) in 1978. Decades after the take off of PHC in all parts of this country, the goal of health for all and beyond is still far from being attained. METHOD: The management activities of Primary Health Care Facilities in Plateau State were investigated. A multistage sampling method was used to select 30 PHC facilities from 10 randomly selected LGAs out of the 17 Local Government Areas (LGAs) of Plateau State. All the heads, the secretaries and the chief matrons of the selected facilities were interviewed using self-administered structured questionnaires. Responses were scored using a dichotomous scale and categorized into poor, fair, good and excellent performances, and analyzed using Epi info 2.3.05 2003 statistical software. RESULTS: Out of the 90 workers interviewed, 68.9% were females and 85.6% were married. Seventy four point four percent of the respondents were between 30-44 years of age, and 43.3% of the workers worked at the Basic Health Clinics (BHCs) while 20% of them worked in Comprehensive Health Centre (CHCs). Up to 40% of the LGAs had poor management performance, while the remaining 60% performed only fairly. Overall, PHC facilities in Langtang north did better in management of their facilities, while Shendam LGA scored least in management performance. In this study, no significant difference in scores of the various management activities between the LGAs was observed (F = 7.084, p > 0.05). However, a statistically significant difference in scores of management activities between the various types of PHC facilities was observed (F = 2.81, p < 0.05). CONCLUSION: The management staff in most of the primary health care facilities lack resources at their disposal and this hinders the efficient and effective running of the facilities. Lack of transportation and poor maintenance of those available would seem to be the major constraint to the effective running of the health facilities.

Impact of health education on home treatment and prevention of malaria in Jengre, North Central Nigeria.

BACKGROUND: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. METHODS: The study was a community based intervention study conducted in three stages: A preintervention stage, where 150 caregivers, were selected through a multistage sampling te chnique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The postintervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. RESULTS: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P<.001), knowledge (P<.001), malaria prevention practice (P=.001), first line treatment option (P=.031) and the type of treatment given to the children with fever (P=.048). CONCLUSION: Health education impacted positively caregivers' knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level.

Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre; North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment; by teaching women to respond promptly when their children have fever; can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition; treatment and prevention among caregivers of children under five in Jengre; North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre- intervention stage; where 150 caregivers; were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6) had adequate knowledge concerning malaria causation; transmission; prevention and treatment. Twenty eight (56) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P.001); knowledge (P.001); malaria preven- tion practice (P

Prevalence of malnutrition using Z-scores and absolute values in children under five years of age in Utan village, Jos, Plateau State, Nigeria.

OBJECTIVE: To compare the use of Z scores and absolute measurements in determining the prevalence of malnutrition among under-five children in the Plateau State, Nigeria. DESIGN: A community based, cross sectional study of under-five children. SETTING: An urban slum, Utan village, Jos, Plateau State, Nigeria. POPULATION: The village has a projected population of 3,000 people; 15% of whom are under-fives. STUDY POPULATION: Four hundred and twenty six under-five children. MAIN OUTCOME MEASURES: Absolute measures of weight for age, weight for height and height for age; and Z scores for the same indicators. INTERVENTION: Mass chemotherapy (antihelminths) and nutrition education were carried out after the study was done in 1993. RESULTS: Based on absolute measurements, 23.7% of the children had low weight for age; 34.9% of the under-fives were stunted (height for age), while 11.1% had low weight for height. Using Z-scores, 25.3% of the under-fives were malnourished based on weight for age, 37% were stunted (height for age), while 8.7% had low weight for height. CONCLUSION: Stunting is still prevalent in the under-five children surveyed in spite of the siting of the PHC clinic which offers promotive, preventive and curative services. Small scale industry could be set up to empower the women economically so that they can provide enough food for their households. A credit/loan scheme would also be beneficial. Emphasis should be placed on growth monitoring to help the women discover when the weight of their children is faltering. The use of oral rehydration therapy against diarrhoeal diseases and immunisation against the common childhood diseases that also affect the nutritional status of the children is important. Nutrition education and family planning programmes should be effectively organised for mothers.

Absence of vitamin D deficiency in young Nigerian children.

OBJECTIVE: To determine the prevalence of vitamin D deficiency in young Nigerian children residing in an area where nutritional rickets is common. STUDY DESIGN: A randomized cluster sample of children aged 6 to 35 months in Jos, Nigeria. RESULTS: Of 218 children evaluated, no child in the study had a 25-hydroxyvitamin D (25-OHD) concentration <10 ng/mL (the generally held definition of vitamin D deficiency). Children spent an average of 8.3 hours per day outside of the home. Twenty children (9.2%) had clinical findings of rickets. Children with clinical signs of rickets were more likely to be not currently breast fed and have significantly lower serum calcium concentrations than those without signs of rickets (9.1 vs 9.4 mg/dL, respectively, P =.01). Yet, 25-OHD levels were not significantly different between those children with clinical signs of rickets and those without such clinical signs. CONCLUSION: Vitamin D deficiency was not found in this population of young children in whom clinical rickets is common. This is consistent with the hypothesis that dietary calcium insufficiency, without preexisting vitamin D deficiency, accounts for the development of clinical rickets in Nigerian children.

PIP: Deficiencies of either calcium or vitamin D can cause nutritional rickets. Findings are reported from a study conducted to assess the prevalence of vitamin D deficiency in young Nigerian children living in an area where nutritional rickets is common. A random sample of 218 children aged 6-35 months in Jos, Nigeria, was evaluated. The children were of mean age 22 months. No child had a 25-hydroxyvitamin D (25-OHD) concentration of less than 10 ng/ml, the generally held definition of vitamin D deficiency. Children spent an average of 8.3 hours/day outside of the home, and 20 children (9.2%) had clinical findings of rickets. Children with clinical signs of rickets were more likely to be not currently breast-fed and have significantly lower serum calcium concentrations than those with no signs of rickets. 25-OHD levels were not significantly different between children with clinical signs of rickets and those without such clinical signs. The failure to find vitamin D deficiency in this population of young children in whom clinical rickets is common is consistent with the hypothesis that dietary calcium insufficiency, without preexisting vitamin D deficiency, accounts for the development of rickets in Nigerian children.