Perception and willingness to accept COVID-19 Vaccines: A cross-sectional survey of the general population of Sokoto State, Nigeria.

The number of confirmed cases of COVID-19 globally is well over 400 million, however, the number of cases is showing a downward trend especially in developed countries largely as a result of effective vaccination against COVID-19. In developing countries, vaccination coverage is still very low as a result of vaccine hesitancy, which could be attributed to misconceptions about COVID-19 itself and its newly developed vaccines. This study assessed COVID-19 vaccine acceptance and perception amongst the adult population in Sokoto state, Nigeria. A cross-sectional study was conducted in Sokoto state among 854 respondents selected via a multi-stage sampling technique. Data was collected electronically using a set of structured questionnaire and analysis was done using IBM SPSS version 25. Respondents' perception was assessed using a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5). Respondents having a score of 3 and below were graded as having poor perception and those having scores above 3 were graded as having good perception. Respondents' ages ranged from 17 to 76 years, with a mean of 34.8±12.07; more than half [474(53.7%)] of the respondents were males, 667(75.5%) were married and 539(61.0%) had formal education. The majority [839(95.0%)] of the respondents had a good perception of COVID -19 vaccine; 49.9% agreed enough research would be required on the safety of the vaccine. The majority, (72.4%) expressed their willingness to accept the COVID- 19 vaccine (male 38.4% vs. female 34.0%); 410(47.4%) said they can spend more than one hour to get the vaccine. Significant predictors of willingness to accept COVID 19 vaccine include age (p = 0.006; aOR = 0.223; 95% CI = 0.077-0.645), education (p<0.001; aOR = 1.720; 95% CI = 1.274-2.321) and perception of COVID 19 vaccine (p<0.001; aOR = 0.020; 95% CI = 0.009-0.044). The majority of the respondents had a good perception of COVID- 19 vaccine and more than two-thirds were willing to be vaccinated with the vaccine. Government should make the vaccine available for vaccination since a significant proportion of the respondents expressed their willingness to accept the vaccine.

Effect of food hygiene training on food handlers' knowledge in Sokoto Metropolis: a quasi-experimental study.

INTRODUCTION: training intervention for food handlers is necessary to increase their knowledge and awareness about food hygiene. Research in this area has been given low attention in Nigeria, especially in the Northern part of the country. Therefore, we assessed the effect of food hygiene training on the knowledge of food hygiene among food handlers in Sokoto metropolis. METHODS: we conducted a quasi-experimental study between January and July 2019. We used a multistage sampling technique to select 360 food handlers randomized into intervention and control groups. We conducted a training intervention after the baseline data collection. Post-intervention data collection was conducted six months after the intervention. We estimated the proportion of respondents with good knowledge at baseline and post-intervention. We assessed the difference in pre-and post-intervention proportions using McNemars Marginal Homogeneity test at 5% level of significance. RESULTS: in the intervention and control groups, 19 (10.6%) and 18 (10.0%) had primary education respectively, p = 0.231. At baseline, 23 (12.8%) and 22 (12.2%) in intervention and control groups respectively had good knowledge, p= 0.515. At post-intervention, the proportion of those with good knowledge in the intervention group increased to 56.7%, p < 0.001; while in the control group, there was no significant difference in the proportion of those with good knowledge, p = 0.248. CONCLUSION: the training intervention has significantly improved the knowledge of the food handlers. We recommend that the National Food and Drug Agency, in collaboration with restaurant owners, ensure regular on-the-job training of food handlers.

A cross-sectional survey of knowledge, attitude, and practices toward dengue fever among health workers in a tertiary health institution in Sokoto state, Nigeria.

INTRODUCTION: Dengue fever (DF) has become a disease of public health concern. It is a mosquito-borne virus infection caused by one of the four serotypes of the dengue virus, and the disease is prevalent in the tropical and subtropical regions of the world, with a global burden in the Americas. Yearly, about 390 million cases of new infection are estimated to occur. AIMS OF THE STUDY: This study was aimed atdetermining the knowledge, attitude and practices regarding dengue fever amongst health workers in a tertiary health institution in Sokoto state , Nigeria. METHODS: A descriptive cross-sectional study was carried out at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, among 367 health-care workers who had worked in the hospital for at least 1 year before the study were selected using a systematic sampling method. Data were collected by trained resident doctors using a standardized, pretested questionnaire and analyzed using SPSS version 20 with a significance set at P > 0.05. RESULTS: There was high awareness (95.1%) among the respondents, with seminars and lectures in school as the most familiar information sources. A more significant proportion, 87.8%, 93.2%, and 76.6%, of the respondents had adequate knowledge, positive attitude, and appropriate DF practice, respectively. Nurses and laboratory scientists had higher practice scores compared to other health-care workers (P = 0.016). CONCLUSION: Capacity building of health-care workers, especially the primary care physicians on surveillance, proper diagnosis, and treatment, is needed to avoid missing cases or misdiagnosis of cases, especially in developing and underdeveloped countries with limited health resources care service delivery.

Determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis, Nigeria.

Background: Roadside automobile mechanics are in the course of their work exposed to several hazards that put them at risk of severe debilitating health challenges. This group of workers, however, is reported not to know much about such hazards and to have little or no training on workplace safety. Aim: The study aimed to identify the determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis. Methodology: This was a descriptive, cross-sectional study, and using a two-stage sampling technique, a total of 205 roadside mechanics were recruited for the study. A semi-structured interviewer-administered questionnaire was used, and the data were imputed into and analyzed using IBM SPSS. Results: The mean age of the respondents was 31.10 ± 10.19 years, and over one-third of them (38.1%) were general vehicle repairers. Majority of the respondents had good knowledge of and attitude toward workplace hazards. However, a good proportion (91.0%) of the mechanics felt that their occupation was a risky one and 80.1% ate and 86.1% drank while working. Type of training and job description were the predictors of knowledge of workplace hazards. Job description was the only predictor of attitude. Burns, bruises, headache/dizziness, and cuts were the most reported work-related illnesses and injuries. Conclusion: Although most of the auto-mechanics were aware and had good knowledge of workplace hazards, they did not adhere to safety practices in the workplace, mostly due to nonavailability of protective apparels. There is, therefore, need for continuous health education under the platform of the auto-mechanics association so that they can voluntarily adopt safety practices in their workplace.

RésuméContexte: Au cours de leur travail, les mécaniciens d'automobiles au bord de la route sont exposés à plusieurs risques qui les exposent à de graves problèmes de santé débilitants. Cependant, ce groupe de travailleurs ne connaît pas grand-chose à ces dangers et n'a pas ou peu de formation sur la sécurité au travail. Objectif: L'étude visait à identifier les déterminants des risques professionnels en matière de santé chez les mécaniciens automobiles de Sokoto Metropolis. Matériel et Méthodes: Il s'agissait d'une étude transversale descriptive et, en utilisant une technique d'échantillonnage en deux étapes, un total de 205 mécaniciens de bord de route ont été recrutés pour l'étude. Un questionnaire administré par un intervieweur semi-structuré a été utilisé et les données ont été imputées et analysées à l'aide d'IBM SPSS. Résultats: L 'âge moyen des répondants était de 31.10 ± 10.19 et plus d' un tiers d 'entre eux (38.1%) étaient des réparateurs de véhicules généraux. La majorité des répondants avaient de bonnes connaissances et une bonne attitude à l'égard des dangers au travail. Cependant, une bonne partie des mécaniciens estimaient que leur profession était risquée 183 (91,0%) et majoritaire, en mangeait 161 (80,1%) et en buvait 173 (86,1%) pendant qu'ils travaillaient. Le type de formation et la description de poste étaient des prédicteurs de la connaissance des dangers au travail. La description de travail était le seul prédicteur de l'attitude. Les brûlures, les ecchymoses, les maux de tête/vertiges et les coupures étaient les maladies et les blessures liées au travail les plus souvent rapportées. Conclusion: Bien que la plupart des mécaniciens et des mécaniciennes d'automobiles aient été au courant et aient une bonne connaissance des risques au travail, ils n'ont pas respecté les pratiques de sécurité sur le lieu de travail. Il existe donc un besoin d'éducation continue en matière de santé dans le cadre de la plate-forme de l'association de mécanique automobile afin qu'ils puissent adopter volontairement des pratiques de sécurité sur leur lieu de travail.

Intimate Partner Violence in Pregnancy: Knowledge and Experiences of Pregnant Women and Controlling Behavior of Male Partners in Sokoto, Northwest Nigeria.

BACKGROUND: Violence against women perpetrated by an intimate partner is an important public health issue. In recent years, attention has focused also on intimate partner violence (IPV) during pregnancy due to its prevalence, adverse health consequences, and intervention potentials. AIM: To determine the knowledge, experiences, and factors influencing IPV, including the controlling behaviors of male partners of pregnant women attending an antenatal clinic (ANC) of a tertiary health facility in Sokoto. Materials and method. A descriptive cross-sectional study was conducted among 260 pregnant women attending ANC in a tertiary health facility in the Sokoto metropolis. They were selected using a systematic sampling technique, and a set of pretested questionnaire items was used for data collection. Data were analysed using IBM SPSS version 20. RESULTS: The respondents' ages ranged from 19 to 40 years with a mean of 29.09 ± 4.99 years, and up to 83.5% of them were in a monogamous setting. Three-quarters of them were Muslims mostly from urban areas (72.1%), and 36.4% had a university or HND degree. Majority of them responded correctly to questions on IPV; overall, up to 99.2% of them had good knowledge of IPV. About 33% of the respondents have experienced IPV while pregnant and up to 61.7% of them said they did nothing because of fear. Some of the controlling behaviors of male partners included always asking for permission before seeing friends and family members and also controlling their finances. Factors associated with IPV include tribe, place of residence, and partner consuming alcohol. CONCLUSION: Majority of the respondents had good knowledge of IPV with about one-third of them ever experiencing it. Respondent's partners were mostly jealous and exhibited some form of controlling behaviors. Physical violence was the most prevalent form, and most of the victims did nothing about it. Government and women's right groups should push for the implementation of tougher punitive measures against perpetrators of IPV.

Assessment of Knowledge, Attitude and Experience of Sexual Violence among Female Employees in Sokoto Metropolis, Northwest Nigeria.

This descriptive cross-sectional study was carried out to determine the knowledge, attitude and experiences of sexual violence among female employees in Sokoto metropolis. Multistage sampling technique was used to select 191 participants and a set of pre-tested structured questionnaire was used to obtain data from the participants. Data was analysed using IBM SPSS version 20. The mean age of the respondents was 28.9years ±6 with 102(53%) of them aged between 20-30 years. Up to 112(63.6%) of them were unmarried, 127(73%) were Muslims and 96(54.5%) in the upper socio-economic class (SEC). About 50% of respondents in both formal and informal settings had good knowledge of sexual violence and up to 36% and 64% of respondents in the formal and informal settings respectively have positive attitude towards sexual violence (SV). Overall prevalence of SV in the workplace was 63.8% (N=113) and significant predictors of SV in the work place include tribe (p=0.006), work setting (p=0.02) and society's perception of SV (P <0.001). Respondents in this study showed high levels of awareness and knowledge regarding SV in the workplace. The study revealed a high prevalence of SV in the workplace especially among females in formal settings with several factors including, perception of the society on sexual violence and working in the formal sector were found to have influenced respondents' experience of SV in the workplace. There is the need, therefore for the government and relevant stake holders to put in place measures to curb SV in the workplace and protect victims of such practices with relevant legislations.

Sexual activities of pregnant women attending antenatal clinic of a tertiary hospital in North-West Nigeria.

INTRODUCTION: myths about sex during pregnancy harming fetus and leading to preterm labor or miscarriage are very strong factors releasing fear and leading to avoidance of sexual contact during gestation. We therefore evaluated the attitude, sexual experiences and changes in sexual function during pregnancy. METHODS: a cross-sectional study was conducted among 170 pregnant women who were selected using systematic sampling. Data were collected using an interviewer-administered questionnaire. Data was analysed using IBM SPSS® version 22.0. Descriptive statistics, Chi-square test and Cochran´s Q-test were estimated. RESULTS: the mean age of respondents was 27.2 ± 6.2 years. Most of the respondents, 107 (62.7%) had formal education. One-fifth of the respondents, 34 (20.2%) have been married for over 10 years. More than half of them were multiparous, 112 (68.3%) and in the third trimester of pregnancy, 99 (59.6%). Majority of the respondents, 153 (87.9%) thought coitus was safe in pregnancy. More than half 89 (58.2%) had coitus at least thrice a week before pregnancy and 98.8% have engaged in sexual activities during pregnancy. Most of the respondents, 105 (61.1%) enjoyed coitus during pregnancy. The desire for coitus significantly reduced in the third trimester, p=0.001. CONCLUSION: sexual intercourse during pregnancy was universal and respondents engaged in sexual activities during different stages of pregnancy. Although sexual frequency declined in pregnancy compared to pre-pregnancy period, most of the respondents desired and enjoyed it. We recommend that couples are well educated to understand the normal fluctuations in sexual interest and practices during pregnancy.

Prevalence and factors associated with the use of traditional medicines among human immunodeficiency virus and acquired immunodeficiency syndrome patients in Sokoto, Nigeria.

Background: In resource-scarce settings like Nigeria, access to conventional drugs and antiretroviral therapy (ART) is highly limited, hence the resort to use of traditional herbal medicine by a significant number of people living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). Traditional medicine (TM) continues to provide health coverage for most of the people in developing countries, and it is equally becoming increasingly popular in western countries. Aim: This study aims to present the status and use of TM and determine the factors associated with its use among patients with HIV/AIDS on highly active ART in a tertiary health institution in Sokoto, Northwest Nigeria. Methodology: This was a descriptive, cross-sectional study involving HIV/AIDS patients attending antiretroviral treatment center of the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. The study population comprised PLWHAs attending the ART clinic of the hospital (UDUTH). A total of 271 respondents were recruited into the study and administered a set of pretested structured questionnaire. Ethical approval for this study was obtained from the ethical committee of the teaching hospital. Results: Only 11 (4.2%) of the respondents had used TM before, of whom 9 (5%) were females and 2 (2.7%) were males with P = 0.399. Only one of the respondents had side effects following the use of TM, and the most common reason for the use of TM was as a result of too much weight loss. Conclusion: Although the use of TM among the study participants in Sokoto was low, there is need to educate PLWHAs about the possible risks of interactions following the concurrent use of TM and ART.

Determinants of appropriate knowledge on human immunodeficiency virus postexposure prophylaxis among professional health-care workers in Sokoto, Nigeria.

INTRODUCTION: The prevention of human immunodeficiency virus (HIV/AIDS) among health-care workers (HCWs) has remained a major topical issue worldwide. Accidental transmission of HIV infection to HCWs during occupational exposure is a real threat today. The study aimed to assess the knowledge, attitude, and practice of postexposure prophylaxis (PEP) among HCWs in a tertiary health institution in Sokoto, Northwestern Nigeria. METHODOLOGY: The study was carried out at Usmanu Danfodiyo University Teaching Hospital, Sokoto, through a cross-sectional descriptive study design; a total of 156 participants were recruited using a stratified sampling technique. Data were collected using a semi-structured, self-administered questionnaire and analyzed using SPSS computer software after obtaining ethical clearance from the Health Ethics and Research Committee of the teaching hospital. RESULTS: A total of 87.2% (136) of the respondents had heard of PEP and 71.8% (112) thought that HIV/AIDs could be prevented through PEP. A total of 71.2% (111) had good knowledge about PEP, whereas 86.8% (118) had a positive attitude toward PEP. CONCLUSION: Although the study demonstrated high knowledge and positive attitude toward PEP, the observance of safety measures against needlestick injuries that could result in HIV infections was abysmally low. There is the need to create more awareness and strengthen the use of PEP protocol by all cadres of health workers as this will go a long way in minimizing blood-borne infections.

Factors influencing complementary and weaning practices among women in rural communities of Sokoto state, Nigeria.

INTRODUCTION: When breast milk alone is no longer sufficient to meet a child's nutritional needs, foods other than breast milk are introduced gradually into the baby's diet, first to complement breast feeding and progressively to replace it and get the child used to adult diet. This study aimed to assess the factors influencing complementary and weaning practices among women in rural communities of Sokoto state, Nigeria. METHODS: It was a cross-sectional study. Using a multi-staged sampling technique, 296 mothers of children 6-24 months were recruited. Data was collected using a pretested structured questionnaire and analyzed using IBM SPSS version 20. Chi square test was used to test associations between categorical variables. Binary logistic and multinomial regression was used to compute the determinants of complementary and weaning practices. The level of significance was set at p < 0.05. Ethical approval was obtained from the State Ethical Committee. RESULTS: Timely introduction of complementary feeds was commenced in 54% of the children. Only 6.2% weaned their children at 6 months; 90.5% weaned their children gradually and 63.5% bottle fed. Factors influencing complementary and weaning practices was found to be child's age; maternal age and family setting. CONCLUSION: The respect of World Health Organization (WHO) recommendations on complementary and weaning practices was suboptimal. It was also evident from this study that complementary and weaning practices were influenced by maternal and house-hold factors. It is therefore important to develop interventions aimed at bridging the gap between these practices in rural settings and WHO recommendations.

Attitude of nurses and pharmacists on adverse drug reactions reporting in selected hospitals in Sokoto, Northwest Nigeria.

OBJECTIVE: Objective of this study was to assess the attitude of nurses and pharmacists towards adverse drug reactions (ADRs) reporting. METHODS: The questionnaire was designed based on extended "Inman seven deadly sins." Two hundred and seventy-two respondents were selected by stratified sampling technique. The questionnaires were delivered to the respondents at their places of practice. The data generated were analyzed by Sigma XL Software Inc. FINDINGS: There was no statistically significant relationship between demographic profiles and reporting attitude except for qualification. On extended "Inman seven deadly sins" awareness of reporting protocol and nearby center for ADRs reporting were low 27.3 and 7.5%, respectively. However, respondents' score on components of attitude of ADRs reporting is generally encouraging. On comparative basis, no statistical significance exists between pharmacists and nurses. CONCLUSION: The study showed that attitude of respondents towards ADRs reporting is good. However, there is a need for targeted health education intervention among these cadres of health-care professionals, especially on aspects of awareness of reporting protocol and reporting center.

Risk factors for low birth weight in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey.

BACKGROUND: Low birth weight (LBW) continues to be the primary cause of infant morbidity and mortality. OBJECTIVE: This study was undertaken to identify the predictors of LBW in Nigeria. DESIGN: The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. Several questionnaires were used in the survey, some covering questions on pregnancy characteristics. The inclusion criteria include mothers who gave birth to a child 5 years before the interview and aged 15-49 years who were either permanent residents or visitors present in the household on the night before the survey conducted. The birth weight of the infants was recorded from written records from the hospital cards or the mothers' recall. RESULTS: The prevalence of LBW in this study was 7.3%. Multiple logistic regression analysis showed an adjusted significant odds ratio for mothers from North West region (aOR 10.67; 95% CI [5.83-19.5]), twin pregnancy (aOR 5.11; 95% CI [3.11-8.39]), primiparous mother (aOR 2.08; 95% CI [1.15-3.77]), maternal weight of less than 70 kg (aOR 1.92; 95% CI [1.32-2.78]), and manual paternal employment (aOR 1.91; 95% CI [1.08-3.37]). CONCLUSIONS: The risk factors for LBW identified in this study are modifiable. In order to reduce this menace in Nigeria, holistic approaches such as health education, maternal nutrition, improvement in socio-economic indices, and increasing the quality and quantity of the antenatal care services are of paramount importance.

HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population.

BACKGROUND: HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria. METHODS: The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15-49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS. RESULTS: A total of 56 307 men and women aged 15-49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education. CONCLUSION: There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.

Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria.

INTRODUCTION: Utilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average. METHODS: We analysed the 2013 Nigeria DHS to determine factors associated with utilization of these health MCH indicators by employing both bivariate and multivariate logistic regressions. RESULTS: Overall, 54% of women had at least four ANC visits, 37% delivered in health facility and 29% of new born had postnatal care within two of births. Factors that consistently predict the utilization of the three MCH services are maternal and husband's level education, place of residence, wealth level and parity. Antenatal care strongly predicts both health facility delivery (OR = 2.16, 95%CI: 1.99-2.34) and postnatal care utilization (OR = 4.67, 95%CI: 3.95-5.54); while health facility delivery equally predicting postnatal care (OR = 2.84, 95%CI: 2.20-2.80). CONCLUSION: Improving utilization of these three MCH indicators will require targeting women in the rural areas and those with low level of education as well as creating demand for health facility delivery. Improving ANC use by making it available and accessible will have a multiplier effect of improving facility delivery which will lead to improved postnatal care utilization.

Using women advocacy groups to enhance knowledge and home management of febrile convulsion amongst mothers in a rural community of Sokoto State, Nigeria.

INTRODUCTION: Febrile convulsions (FC) are a common paediatric problem worldwide. Between 1 and 4% of children will have a febrile convulsion with about 4% of cases arising before the age of six months. Although FC is benign and does not cause death, brain damage or learning disorders, it is quite frightening to observers and parents who witness an episode of FC, would think the child is going to die. METHODS: This was a quasi-experimental study (a pre and post-test interventional, one group), aimed at assessing the impact of health education on knowledge and home management of febrile convulsion amongst mothers in a rural community in North Western Nigeria. A one in three samples of fifty mothers that met the eligibility criteria where selected using systematic random sampling. Structured interviewer administered questionnaire with close and open-ended questions was administered to obtain data at pre- and post intervention. RESULTS: The ages of the mothers ranged from 18-47 with a mean age of 33 ± 7.14 years. The perceived causes of febrile convulsion included fever (28%), witch craft (80%) with majority (98%) of the mothers administering traditional medications. Proportion of study subjects with adequate knowledge of febrile convulsion at baseline and post intervention were 4% (mean knowledge score of 35.3 ± 9.48) and 96.0% (mean knowledge score of 77.69 ± 10.75) respectively (P < 0.0001). CONCLUSION: Although inadequate knowledge and inappropriate home practices about FC were rampant in the study community, using community members to teach and sensitize the mothers on FC improved their knowledge base significantly. The use of effective educational intervention programmes and parental support groups will go a long way in reducing the incidence of FC among children in our communities.

Knowledge of HIV/AIDS and use of mandatory premarital HIV testing as a prerequisite for marriages among religious leaders in Sokoto, North Western Nigeria.

BACKGROUND: In Sub-Saharan Africa, an estimated 1.8 million became infected with the HIV in 2009 and Nigeria currently has about 3.4 million people living with HIV. Measures put in place by religious organizations to combat HIV/AIDS in Nigeria include mandatory premarital HIV testing. The knowledge of HIV/AIDS amongst religious leaders in Nigeria has not been sufficiently explored . In this study, we assessed the knowledge of HIV/AIDS amongst religious leaders in Sokoto and if they routinely demand for mandatory premarital HIV testing for all intending couples. METHODS: This was a descriptive cross-sectional study involving 158 religious leaders (30 Christians and 128 Muslims) who officiate or assist during marriages. Data was collected using interviewer and self administered questionnaire which sought such information as biodata, knowledge of HIV/AIDS , speaking to congregation about AIDS and using Premarital HIV status as a pre-requisite for contracting marriages. Data was entered into and analysed using Epi-info computer soft ware program. Level of statistical significance was put at P = 0.05. RESULTS: The ages of the respondents ranged from 35 to 78 years with a mean age of 26.3 ± 20.3 years. Forty nine percent of the respondents had adequate knowledge of HIV/AIDS with more Christian clerics compared to Muslim Clerics having better knowledge of HIV/AIDS (P < 0.0001). All the Christian clerics opined that they would insist on mandatory premarital HIV testing for their subjects before joining them in marriages. CONCLUSION: The results of the study have shown that most of the religious leaders lacked adequate knowledge of HIV/AIDS and the use of mandatory premarital HIV testing is yet to be adopted by the Muslim clerics. Awareness campaigns should be intensified for the religious leaders to improve their knowledge of HIV/AIDS.

Using community volunteers to promote exclusive breastfeeding in Sokoto State, Nigeria.

BACKGROUND: Exclusive Breastfeeding (EBF) refers to the practice of feeding breast milk only, (including expressed breast milk) to infants; and excluding water, other liquids, breast milk substitutes, and solid foods. Inadequately breastfed infants are likely to be undernourished and have childhood infections. EBF knowledge and infant feeding practices have not been studied sufficiently in Sokoto State, Nigeria. We describe the results of a randomized community trial to promote Exclusive Breastfeeding (EBF) in two local government areas Kware and Bodinga selected as intervention and control groups respectively. METHODS: During advocacy meetings with community leaders, a Committee was formed. Members of the Committee were consulted for informed consent and selection of ten female volunteers who would educate mothers about breastfeeding during home visits. Participants comprised mothers of infants who were breastfeeding at the time of the study. A total of 179 mothers were recruited through systematic random sampling from each community. Volunteers conducted in-person interviews using a structured questionnaire and counseled mothers in the intervention group only. RESULTS: At baseline, intervention and control groups differed significantly regarding maternal occupation (P=0.07), and age of the index child (P=0.07). 42% of infants in the intervention group were up to 6 months old and about 30% of them were exclusively breastfed. Intention to EBF was significantly associated with maternal age (P=0.01), education (P=0.00) and women who were exclusively breastfeeding (P=0.00). After counseling, all infants up to 6 months of age were exclusively breastfed. The proportion of mothers with intention to EBF increased significantly with maternal age (P=0.00), occupation (P=0.00) and women who were exclusively breastfeeding (P=0.01). Post-intervention surveys showed that source of information and late initiation of breastfeeding was not significantly associated with intention to EBF. Mothers who reported practicing EBF for 6 months, were older (P=0.00) multi-parous (P=0.05) and more educated (P=0.00) compared to those who did not practice EBF. Among them, significantly increased proportion of women agreed that EBF should be continued during the night (P=0.03), infant should be fed on demand (P=0.05), sick child could be given medication (P=0.02), EBF offered protection against childhood diarrhea (P=0.01), and helped mothers with birth spacing (P=0.00). CONCLUSION: This study shows that there is a need for reaching women with reliable information about infant nutrition in Sokoto State. The results show decreased EBF practice among working mothers, young women, mothers with poor education and fewer than five children. Counseling is a useful strategy for promoting the duration of EBF for six months and for developing support systems for nursing mothers. Working mothers may need additional resources in this setting to enable them to practice EBF.