The social construction of genomics and genetic analysis in ocular diseases in Ibadan, South-western Nigeria.

Genomics, an emerging field to improve public health practice, has potential benefits to understanding ocular diseases. This study explored the social construction of genomics in ocular diseases in the blind community in Ibadan, Nigeria, through two focus group discussions and twelve in-depth interview sessions conducted among people living with ocular disorders. The data were thematic and content-analysed. Although the participants had limited knowledge about ocular diseases, genomics, and their nexus, they maintained a positive attitude toward its potential benefits. This informed their willingness to participate in genomics testing for ocular diseases. The participants preferred saliva-based sample collection over blood-based, and expressed concern for the procedure and accrued benefits of genomics studies. Thus, public sensitisation about ocular diseases and client-centred genomics testing procedures should be engendered.

Adults and Social Supports for Older Parents in Peri-Urban Ibadan, Nigeria.

Introduction: The absence of comprehensive supports systems for older persons in Nigeria has put them on psychosocial challenges at old age. Thus, this study profiled the social supports provided by the adults to older persons in Ibadan, Southwestern Nigeria. Methods: This cross-sectional study utilized mixed method approach to administer a standardized questionnaire among 460 consented adults who had older parents, and conducted twelve in-depth interviews (IDIs) among male and female participants in Apete, a peri-urban community in Ibadan, Nigeria. Quantitative and qualitative data were analyzed respectively using SPSS ver. 20 and content analysis. Results: Most (67.2%) of the respondents were females, and 77.2% were not living with their older parents. Older parents of 32.4% of the respondents relied on children as a source of income, whereas nearly half (47.0%) of the respondents perceived the care of the elderly as government responsibility. Financial care (48.5%) from significant others was perceived the most unmet social needs of the elderly, while lack of money (44.6%) was perceived the cause of the unmet social needs of the elderly. There was significant relationship (χ2 = 0.056) between the average monthly income and the time frame the children give money to older parents. Conclusion: There exist social supports to the elderly in peri-urban Nigeria. The social support systems available to the elderly were influenced by the culture, blessing/prayer-needs from parents, and reciprocity factors.

Ebola outbreak in Nigeria: perceptions from commercial motorcyclists and passengers in Ibadan, Nigeria.

The outbreak of deadliest and most widespread Ebola virus disease (EVD) in West African countries was not only unexpected but also sudden in places like Nigeria. The epidemic was an indication of weak health systems characterised by inadequate precautions and low knowledge of containment. Although Nigeria was able to contain EVD much earlier, people's perception, which also influenced their responses, might enhance the spread and retard containment. This study utilized 25 in-depth interviews conducted with commercial motorcycle-taxi (Okada) riders in key locations in Ibadan, Oyo state, to document their perception about EVD outbreak. Series of sociocultural practices such as handshaking, hugging and embracement identified were favourable to transmission of EVD and affected containment. Regular handwashing was difficult and not cost-effective to practice. The perceived trust in God's intervention could make treatment seeking and prevention slower to achieve. The potential of sociocultural practices, such as handshaking and hugging, as driver for transmission of EVD may influence the perception of motorcycle-taxi riders in the prevention and containment activities in Nigeria. Hence, understanding people's perception on handwashing practices, hugging and butchering of bushmeat should be given priority in designing programmes of EVD prevention and control in Nigeria.

Perceptions of Ebola virus disease in Nigeria: Understanding the influence of imagination on health orientation.

The 2014 Ebola virus disease (EVD) outbreak was officially declared in the West Africa region by the World Health Organization (WHO) on 23 March 2014. This first episode of EVD in Nigeria on 20 July 2014 raised more intense panic globally than the seven occurrences of the disease in Zaire. Although Nigeria was declared Ebola free by the WHO within 3 months, it is imperative to understand people's perceptions of the disease in the country. A discussion of peoples' perception of EVD in Nigeria is the aim of this article. This discussion paper complements secondary data with grey literature to explore how peoples' imagination and personification of thoughts influence their health orientation. Data are sourced from secondary information compiled from 'The Nation Newspaper, 2014'; 'Nairaland online forum, 2014' and 'Giftedgreen online magazine, 2014'. Ebola virus disease was perceived as a spiritual manipulation of witchcraft activities and described as biological terrorism and a means of creating a drug market, among other issues, in the country. Public health professionals should consider the sociocultural milieu to understand and offer health-care services in epidemics. Public health orientation work is urgently required in Nigeria to forestall future occurrence of EVD and other highly infectious diseases.

Service delivery and coverage in primary healthcare in a community-health project in Ibadan, Nigeria.

BACKGROUND: Standard health-service delivery aimed toward improving maternal and child health status remains elusive in Nigeria because of inaccuracies in data documentation leading to a lack of relatively stable evidence. OBJECTIVES: Through a community-health project, this study tested the accuracy of record keeping in primary healthcare services in nine clinics run in Ibadan, Nigeria. METHODS: A validation exercise was performed through a sample of the 10 most recent names extracted from three registers maintained by each clinic. RESULTS: A review of the register covering a period of four years showed a steady increase in: fully-immunised children, registration for antenatal care during the first trimester of pregnancy, the number of women who attended antenatal care at least three times, the overall number of women who booked for antenatal care and women who delivered in Eniosa Community-Health Project facilities over the four-year period. It was possible to trace 86% of those selected from the antenatal care register, 88.9% of those from the birth register and 81.1%of those from the immunisation register. Four women who should have been included for antenatal care, seven who had delivered (but were not in the register) and 13 who reportedly received immunisation but were not listed were found during the validation exercise. CONCLUSION: This study concludes that the names appearing in the register are likely to represent valid events, but that the registers did not capture all such events in the community.

Unmet social needs and teenage pregnancy in Ogbomosho, South-western Nigeria.

BACKGROUND: Consistent high teenage pregnancy rates in South-western Nigeria are characteristically underpinned by the unmet social needs of the teenagers. OBJECTIVE: To elicit intergenerational views on the influence of unmet social needs on teenage pregnancy. METHODS: Through a descriptive and cross-sectional design, a total of 174 respondents who were either pregnant teenagers, teenage mothers during the survey or had been pregnant as teenagers, were interviewed, using questionnaire supplemented with 12 key informant interviews. RESULTS: With the mean age of 16.5 years, and educational status range of between primary and below (25.8%) and tertiary (9.8%) levels, only 39.7% respondents were married, about half (47.7%) remained single while others were separated (12.6%). Less than half (44.9%) of the respondents were engaged in occupational activities. The unmet material and financial supports expected from parents (43.1%), the lack of free education from government up till secondary school level (51.2%), the lack of sex education and knowledge needs for signs of maturity (53.4%) and discouragement from friends not to have boyfriend (66.1%) prone teenagers to unplanned pregnancy. CONCLUSION: Promotion of sexual education and parental care is encouraged as strategy against unplanned pregnancy among teenagers.

Commercial charcoal production in the Ibarapa district of southwestern Nigeria: forestry dividends and welfare implications.

Logging activities have long provided both wood fuel and charcoal for household and commercial use in rural and urban communities in developing countries. However, logging problems range from deforestation to threatened household air quality from burning wood and charcoal. This exploratory case study triangulated 15 in-depth interviews among charcoal bulk buyers and the workers, observations of workers at two èédú (charcoal) commercial depots in Igbo-Ora and of workers in the forest, and review of studies in academic database. Three categories of people are working in the business ranging from the producers in the forests (alaake) to the bulk buyers (olowo) in the middle and the wholesalers (ajagunta) in the city. A small team of 4-8 people can produce three pickup truck loads of charcoal in 2 weeks, and a large team between 7-8 loads. The olowo and the alaake have associations, membership cards, and meet to discuss business progress and regulate members' economic behavior. Close to 35,000 bags of charcoal of 450 pickup trucks may make the journey weekly from Ibarapa. Overall, the charcoal business is informal, and the local people also frown at cutting any useful indigenous trees ascertaining that an individual's actions may affect the whole community. The role of community health educators is important in the dissemination of effects of deforestation through charcoal production.

Perceptions of drug color among drug sellers and consumers in rural southwestern Nigeria.

BACKGROUND: Color is commonly used for branding and coding consumer products including medications. People associate certain colors in tablets and capsules with the effect of the drug and the illness for which it is meant. Color coding was introduced in age-specific prepacked antimalarial drugs for preschool aged children in Nigeria by the National Malaria Control Committee. Yellow was designated for the younger ages and blue for the older. The National Malaria Control Committee did not perform market research to learn how their color codes would be perceived by consumers. OBJECTIVE: The study aimed at determining perceptions of both consumers and sellers of medicines at the community level to learn about color likes and dislikes that might influence acceptance of new color-coded child prepacks of antimalarial drugs. METHODS: Qualitative methods were used to determine perceptions of drug colors. A series of focus group interviews were conducted with male and female community members, and in-depth interviews were held with medicine sellers in the Igbo-Ora community in southwestern Nigeria. RESULTS: Respondents clearly associated medicines with their effects and purpose, for example white drugs for pain relief, red for building blood, blue to aid sleep, and yellow for malaria treatment. Medicine vendors had a low opinion of white colored medicines, but community members were ultimately more concerned about efficacy. The perceived association between yellow and malaria, because of local symptom perceptions of eyes turning yellowish during malaria, yielded a favorable response when consumers were shown the yellow prepacks. The response to blue was noncommittal but consumers indicated that if they were properly educated on the efficacy and function of the new drugs they would likely buy them. CONCLUSIONS: Community members will accept yellow as an antimalarial drug but health education will be needed for promoting the idea of blue for malaria and the notion of age-specific packets. Therefore, the strong medicine vendor-training component that accompanied roll out of these prepacks in the pilot states needs to be replicated nationally.

Ethnic variations in health-seeking behaviours and attitudes between Fulani herders and Oruba farmers in southwestern Nigeria.

Rural Yoruba and Fulani residents of two local governments in Oyo State, Nigeria, were surveyed to determine differences in health-seeking behaviour. Fulani residents were more likely to use private facilities during a recent illness, while Yoruba residents more commonly used government facilities: a fact reflected in the overall attitudes of those surveyed. The need for greater outreach and involvement of minority populations is recommended to enhance public service utilization.

Elderly destitution in Ile-Ife community of Osun State, Nigeria.

Many studies have been conducted on the elderly, but none has ever paid particular attention to the increasing rate of destitution in the rural communities, where the elderly serve as agents for sustenance and transmission of culture. This study is descriptive in nature and has adopted qualitative perspective in order to identify and examine the factors that have contributed to the state of elderly in destitution in Ile-Ife, Nigeria. It has also examined the feelings and reactions of the subjects of the study and has documented how their lifestyles affect their health status. Sixteen elderly people in destitution were traced and interviewed in Ile-Ife community. At each location, where an elderly in destitution was located, at least an elderly chief and a resident were located for interview. Data collected were analysed using Textbase Beta package for qualitative analysis. The study found that communal feud, violence and conflicts were factors that created unhappiness for the elderly, and the lack of adequate support from the immediate households consequently led to their homelessness. The study documented that the elderly in destitution lack good hygiene and nutrition, and equally suffer self-neglect and mental confusion. The study concludes that peaceful coexistence, communal security, and familial care and support are important factors that promote happiness and successful ageing. It also maintains that focused health education is highly essential for the households and caregivers of the elderly in rural community.

Knowledge and perception of HIV/AIDS among pregnant women attending antenatal clinics in Ogun State, Nigeria.

Mother-to-child transmission of HIV (MTCT) is responsible for more than 90% of the cases of HIV infection in infants and children in sub-Saharan Africa. Accurate data on the knowledge and perceptions of HIV/AIDS among women attending antenatal clinics in Nigeria are scarce. A cross-sectional survey of 804 women attending antenatal clinics in Ogun State, South-West Nigeria was done using interviewer-administered questionnaires. Approximately 90% of the women respondents had heard of HIV/AIDS, but only about 27% knew HIV could be transmitted from mother to child; of those, almost 94% believed in the reality of HIV disease; in contrast, the majority (64%) believed they were not at risk of HIV infection, and a slightly greater proportion (70%) did not understand the benefits of voluntary HIV counselling and testing (VCT). Nonetheless, almost 90% of respondents were willing to know their status following health education about VCT. Those that were older, attending public hospitals, and with a higher level of education had more knowledge and better perceptions about HIV. The results suggest an urgent need for public health education on HIV/AIDS and the benefits of VCT to control MTCT, particularly targeting young women and those with little or no education.

Planning health education: Internet and computer resources in southwestern Nigeria. 2000-2001.

The use of the Internet as a health education tool and as a resource in health education planning is widely accepted as the norm in industrialized countries. Unfortunately, access to computers and the Internet is quite limited in developing countries. Not all licensed service providers operate, many users are actually foreign nationals, telephone connections are unreliable, and electricity supplies are intermittent. In this context, computer, e-mail, Internet, and CD-Rom use by health and health education program officers in five states in southwestern Nigeria were assessed to document their present access and use. Eight of the 30 organizations visited were government health ministry departments, while the remainder were non-governmental organizations (NGOs). Six NGOs and four State Ministry of Health (MOH) departments had no computers, but nearly two-thirds of both types of agency had e-mail, less than one-third had Web browsing facilities, and six had CD-Roms, all of whom were NGOs. Only 25 of the 48 individual respondents had computer use skills. Narrative responses from individual employees showed a qualitative difference between computer and Internet access and use and type of agency. NGO staff in organizations with computers indicated having relatively free access to a computer and the Internet and used these for both program planning and administrative purposes. In government offices it appeared that computers were more likely to be located in administrative or statistics offices and used for management tasks like salaries and correspondence, limiting the access of individual health staff. These two different organizational cultures must be considered when plans are made for increasing computer availability and skills for health education planning.

Consumer response and satisfaction to prepackaged antimalarial drugs for children in Aba, Nigeria.

In July 2003, a consortium of three USAID partners launched a project to promote the correct use of color-coded, age-specific, prepackaged drugs (PPDs) to treat malaria promptly in preschool-aged children in Aba, Abia State, Nigeria. A 3-pronged promotional approach included training of patent medicine vendors (PMVs), home visits by community health promoters, and mass media. Five hundred seventy respondents were interviewed in February-March 2004. People heard about the PPDs from medicine sellers (33.4%), health workers (24.3%), the electronic mass media (18.4%), and friends or relatives (13.5%). Most children (81.1%) took Robaquine (chloroquine-CQ), while 108 (18.9%) took Fansidar (sulphadoxine-pyrimethamine-SP). The median amount paid for Robaquine was 50 naira (dollars 0.36) and for Fansidar, 80 naira (dollars 0.57). Respondents rated the effectiveness of the PPD treatment as very effective (86.8%). Most respondents had something positive to say about the drug (94.9%) and the packaging (93.8%). Only 19.5%) had a complaint about either the drug or the packaging. Overall, 454 (83.9%) received the correct age-appropriate packet. Continuing education is needed for the PMVs to ensure that they obtain accurate age information about the child and sell the age-specific packet. Underdosing is just as serious a concern as overdosing in Nigeria where parasite resistance is rapidly developing for both drugs.

Observations of barbers' activities in Oyo State Nigeria: implications for HIV/AIDS transmission.

In Nigeria, most studies concerning HIV/AIDS transmission have looked at the sexual route from both epidemiological and behavioral perspectives. A few have examined the role of blood transfusion and the potential for indigenous surgical practices. None have specifically looked at the transmission of potential barbers. This study distinguished between indigenous barbers who function as surgeons and "modern" barbers who cut hair, and focused on the latter through observations of barbering practices in 77 shops in Igbo-Ora and Apete communities in Oyo State. Igbo-Ora is headquarters of a rural local government, while Apete is a peri-urban community near Ibadan, the state capital. Five barbering sessions were observed in each shop using a checklist during evening hours when shops are busiest. All barbers used clippers to cut hair, either electric or manual. On average, barbers sterilized the clippers in a commercial disinfectant, Jik, or with methylated spirits prior to 4.2 barberings. Sex and age of customer were not associated with wether the clippers were sterilized. Three shop characteristics appeared to influence sterilization behavior. Clippers were more likely to be sterilized if the shop was in Apete, if the shop owner was male, and if the shop had two or more of the following electrical appliances: fan, TV, or radio/cassette layer. There were only two observed cases of the barbers causing a cut, and in both cases the clippers had been sterilized. Overall, 63 (16.3%) of the 385 customers were barbed with non-sterilized clippers. The relatively short time gap between customers implies that the potential for disease transmission exists, though it was not within the scope of this study to study disease transmission itself. In-service training that involves the barbers themselves and addresses both gender and town differences is recommended.

Interactions between patent medicine vendors and customers in urban and rural Nigeria.

Patent medicine vendors (PMVs) supply a large portion of the drugs used by the public in African countries to treat their illnesses. Little has been reported about what actually transpires between PMVs and their customers, but nevertheless, concerns have been raised about the potential for abuse of their position. This study conducted 720 observations of PMV-customer interaction in 444 medicine shops in both the metropolis of Ibadan and the rural town of Igbo-Ora in Oyo State, Nigeria. Each interaction lasted 2 minutes on average. A quarter of the customers shared their illness problems with the shop attendant, 9% presented a prescription and the majority simply requested items for purchase. Most customers (73%) were buying drugs for themselves, while the remainder had been sent to purchase for another person. The former were more likely to be adults, while the latter were more often children and adolescents. The most common PMV behaviours are: selling the requested medicine (69%), giving their own suggestions to the customer (30%), asking questions about the illness (19%) and providing instructions on how to take the medicine (21%). Only three referrals were observed. The large number of specific drug requests was evidence of a public that was actively involved in self-care, and thus the major role of the PMV appeared to be one of salesperson meeting that need. A second role became evident when the customer actually complained about his/her illness, a practice associated with the more active PMVs who asked questions, gave suggestions and provided information. These PMV roles can be enhanced through consumer education, PMV training and policy changes to standardize and legitimize PMV contributions to primary health care.

Stress and coping among mothers of twins in rural southwestern Nigeria.

High rates of twinning have been reported in Africa. This study sought to learn whether mothers of twins experience different stress levels than those who have only singletons. Both twin mothers (101) and singleton mothers (101) were interviewed. Using a scale of 15 stressors the researchers found that the mean stress score was significantly higher for twin mothers than singleton mothers. Higher stress scores were also associated with parity and perceptions of problems in caring for children and inversely related to perceived levels of social support. Confronting stressors or simply accepting them were the two main ways that mothers coped with their problems.