The dynamics and determinants of household shared sanitation cleanliness in a heterogeneous urban settlement in Southwest Nigeria.

OBJECTIVES: The study assessed the behavioural contexts of household shared sanitation (SS), the factors that could enhance its cleanliness and sustainable maintenance in the study area. STUDY DESIGN: The study design was cross-sectional in nature. METHODS: A pretested, interviewer-administered questionnaire with 113 questions provided information on knowledge, attitude and SS maintenance practices from 312 respondents selected through a four-stage sampling technique. Data were analysed by descriptive, chi-square and logistic regression statistics with attitude and toilet cleanliness as the dependent variables, while the sociodemographic characteristics, knowledge and practice, including the toilet cleanliness index, were the explanatory variables at P < 0.05. RESULTS: The mean age of respondents was 46.1 ± 16.4 years. The majority were women (62.7%), tenants (64.7%) and had a secondary education (61.3%). In addition, 27.9% and 2.7% of respondents had shops and gender-segregated SS, respectively. Their knowledge and attitudes were good (66.3%) and positive (72.1%), while the majority (60.3%) of the SS was dirty. Almost two-thirds (62.8%) and 37.2% of respondents, respectively, had one and two or more compartments of unimproved pit toilets (31.6%) and water closets (28.6%), while 1.4% practiced open defaecation, despite having SS. More than two-fifths of SS were cleaned daily (45.4%) by women (52%), using water and soap (33.4%). Most households (93.4%) complied with the SS cleaning routines, with non-compliance attributed to lack of interest (29.5%), apathy when others defaulted (27.9%), lack of time (26.2%) and inadequate water (14.8%). There was a significant association between attitudes and education (P = 0.025), wealth (P = 0.011) and toilet-cleaning frequency (P = 0.015). The positive behaviour determinants of SS are factual knowledge (P = 0.039), efforts required to clean (P = 0.019), the ability to remember (P = 0.011) and cleaning commitment (P = 0.040), while freedom of expression among households using SS was a positive predictor of avoiding conflict, among the social dilemma factors. CONCLUSIONS: Good knowledge and positive attitudes were reported among users of SS, although with mixed practice and behaviour patterns. Factual knowledge, cleaning commitments and freedom of expressions predict SS cleanliness, which should be reinforced using periodic messages and structured health promotion strategies.

ASSESSMENT OF THE LIVING CONDITIONS OF RURAL BASED PEOPLE LIVING WITH HIV/AIDS WITH CLINICAL PRESENTATIONS IN NIGERIA.

OBJECTIVE: To describe the living conditions of rural based people living with HIV/AIDS (PLWHA) and their clinical presentations DESIGN: descriptive cross-sectional study, SETTING: University College Hospital, Ibadan. SUBJECTS: PLWHA on anti-retroviral therapy. RESULTS: One hundred and fifty PLWHA participated. The mean age of the respondents was 28.7 ± 8.9 years. Majority of the respondents visited had advanced disease (97%), were poor (75%) and presented with opportunistic infections such as oral candidiasis (92%), chronic diarrhoea (70%) and pulmonary tuberculosis (46%). Majority were treated for malaria (72%) and anaemia (61%). All respondents lived in homes predisposed to these opportunistic infections. They drink unsafe water and had poor disposal of their domestic wastes. CONCLUSION: PLWHA visited lived in homes that predispose them to various opportunistic infections. Improved living conditions and economic empowerment will improve the health conditions of PLWHA.

The perception and disposal practices of unused and expired medicines by households in an urban municipality, southwest Nigeria: A comparative cross-sectional study.

Unused, damaged, and expired medicines (UEMs) pose disposal challenges globally, despite their importance. The environmental disposal of UEMs portends public health consequences, hence, this study in high-density (HDS) and low-density (LDS) urban households in Southwest Nigeria. The comparative, cross-sectional study utilised multi-stage samplingto enrol 404 females, experienced in use and medicines safekeeping. The response rate was 93%. Data were analysed by IBM-SPSS, version 20. Continuous and categorical variableswere presentedin tables as mean(±SD), proportions (%), respectively while χ2 and logistic regression statistics determined differences between LDS and HDS (Pα > 0.05). 53.4% and 71.2% of respondents respectively had good knowledge and positive attitudes to safe disposal of UEMs. At least 31.5% of households don't stock medicines while antimalarial (57.3%), analgesics (52.7%) and antibiotics (49.7%) predominate in households and significantly different between LDS and HDS. 72.9% and 67.8%; 47.9% and 55.6% respondents in LDS and HDS, respectively, disposed of solid and liquid UEMs in storage bins, though 34.9% (LDS) and 16.7% (HDS) disposed of liquid UEMs in toilet/sink. There were significant differences in medicines abundance and disposal practices between LDS and HDS for solid and liquid medicines. 37.1% of respondents perceived consequences for the poor UEMs disposal, including accidental ingestion (76.6% vs 26.7%), land pollution (69.6% vs 36.7%), water pollution (72.4% vs 32.8%) and toxicity (58.3% vs 32.8%), respectively in LDS and HDS. Respondents' good knowledge and positive attitudes contrasted with poor UEMs disposal practices, which compromise public health. Legislation, compliance monitoring and enforcement are germane for incentive-driven UEMs recovery.

Determinants of use of insecticide treated bednets among caregivers of under five children in an urban local government area of Osun state, South-Western Nigeria.

In Sub Sahara Africa, the use of Insecticide Treated Nets (ITNs) is one of many strategies of Roll Back Malaria (RBM) initiatives to reduce malaria burden. This study therefore assessed the current use of insecticide treated nets and the determinants of its use among the caregivers of under five children in an urban local government area in Osun state, Nigeria. The study utilised a cross-sectional design among caregivers of under- five children selected from households by multistage sampling technique. The study collected quantitative data using pretested semi structured, interviewer administered questionnaire while factors that determine the current use of ITN were identified using multi linear logistic regression. The study revealed that 54.4% caregivers of under five children were aware of ITNs as one of the malaria preventive measures, 49.1% had good knowledge of ITN and 38% agreed with the use of ITNs. Thirty four percent had access to ITNs, 32.3% owned at least one ITN with 30.3% reported been given free in the health care facilities. Thirty three percent had ever used and the foremost reasons for non-use are not readily available and expensive. Only 18.5% currently used ITNs and challenges faced were not easy to treat, difficult to set up and no place to keep it. Marital status, knowledge of ITN, attitude towards ITN, ownership of ITN and free ITN were factors that determined the use of ITNs amongst the respondents. There is a need to ensure intensive awareness on ITNs through campaigns and embark on its mass distribution to the public to enhance use.