Psychoactive substance abuse among commercial bus drivers in Umuahia, Abia State, South-Eastern Nigeria: an uncontrolled "epidemic" with attendant road traffic crashes.

BACKGROUND INFORMATION: The unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious global public health challenge, with the use of psychoactive substances among drivers implicated in every three of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State. METHODS: A descriptive cross-sectional design was used for the study. Four hundred commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique from October to December 2020. A pretested, interviewer-administered questionnaire was administered to obtain socio-demographics and information on substance abuse. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square. The level of significance was at 5%. RESULTS: The mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever abused a psychoactive substance was 74.6%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about psychoactive substance abuse. Among the factors found to be significantly associated with substance abuse among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p < 0.001) and poor perception (p < 0.001). However, this study found religion (p = 0.031; OR = 5.469; CI = 1.170 to 25.555), knowledge (p < 0.001; OR = 4.21; CI = 2.201 to 8.287) and perception (p < 0.001; OR = 9.828; CI = 15.572 to 65.052) as factors that were associated with the higher likelihood of psychoactive substance abuse. CONCLUSION: Religion, poor knowledge and perception were associated with the higher likelihood of psychoactive substance abuse among commercial bus drivers. Targeting commercial bus drivers for educational interventions and using religious leaders as conveyor belts may reduce the use of psychoactive substances among them.

Factors influencing tuberculosis preventive practices among people living with HIV/AIDS enrolled in secondary health facilities in Lagos, Nigeria.

Background information: Tuberculosis is the most potent opportunistic infection leading to deaths among patients with Human Immunodeficiency Virus (HIV). Therefore, knowledge, attitude and practices regarding tuberculosis preventive strategy among People Living with HIV/AIDS (PLWHA) is vital in minimizing the risk of developing TB infection which forms the objective of this study. Methodology: A descriptive cross-sectional study carried out using multi-stage sampling technique in selecting 606 respondents. Data was collected using a semi-structured questionnaire and analysed with SPSS version 23. Result: Of all the respondents, 245 (40.4%) were within 28-37 years, 386 (63.7%) were females and 219 (36.1%) had secondary education. Majority of the respondents 500 (82.5%), 423(69.8%) and 411(67.8%) had positive attitude, good practices and good knowledge respectively. Associated factors were age, marital status, religion, educational status, knowledge and attitude with tuberculosis practices. Respondents between 18-27 years were twice less likely to engage in good TB preventive practices (OR-0.44, 95% CI- 0.25-0.78, p = 0.004). Conclusion: Over half of respondents had good tuberculosis preventive practices, influenced by their socio-demographic characteristics, knowledge and attitude towards TB infection. Preventive efforts need to be strengthened among individuals between 18-27 years of age, non-Christians and those with lower educational status.

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.

Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria.

Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential <0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents' age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women.

Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria

Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential statistics were done at p<0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents' age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women