Maternal Instruction About Jaundice and the Incidence of Acute Bilirubin Encephalopathy in Nigeria.

OBJECTIVE: To evaluate whether teaching mothers about neonatal jaundice will decrease the incidence of acute bilirubin encephalopathy among infants admitted for jaundice. STUDY DESIGN: This was a multicenter, before-after and cross-sectional study. Baseline incidences of encephalopathy were obtained at 4 collaborating medical centers between January 2014 and May 2015 (Phase 1). Structured jaundice instruction was then offered (May to November 2015; Phase 2) in antenatal clinics and postpartum. Descriptive statistics and logistic regression models compared 3 groups: 843 Phase 1 controls, 338 Phase 2 infants whose mothers received both antenatal and postnatal instruction (group A), and 215 Phase 2 infants whose mothers received no instruction (group B) either because the program was not offered to them or by choice. RESULTS: Acute bilirubin encephalopathy occurred in 147 of 843 (17%) Phase 1 and 85 of 659 (13%) Phase 2 admissions, which included 63 of 215 (29%) group B and 5 of 338 (1.5%) group A infants. OR for having acute bilirubin encephalopathy, comparing group A and group B infants adjusted for confounding risk factors, was 0.12 (95% CI 0.03-0.60). Delayed care-seeking (defined as an admission total bilirubin ≥18 mg/dL at age ≥48 hours) was the strongest single predictor of acute bilirubin encephalopathy (OR 11.4; 6.6-19.5). Instruction decreased delay from 49% to 17%. Other major risk factors were home births (OR 2.67; 1.69-4.22) and hemolytic disease (hematocrit ≤35% plus bilirubin ≥20 mg/dL) (OR 3.03; 1.77-5.18). The greater rate of acute bilirubin encephalopathy with home vs hospital birth disappeared if mothers received jaundice instruction. CONCLUSIONS: Providing information about jaundice to mothers was associated with a reduction in the incidence of bilirubin encephalopathy per hospital admission.

Use of Complementary and Alternative Medicine Among Patients on Long Term Treatment in a Tertiary Health Institution in Jos Nigeria.

Background: The use of Complementary and Alternative Medicine (CAM) is on the increase globally and found to be more pronounced among those with chronic illnesses even in the face of insufficient scientific evidence to support its efficacy. Hence, this study was conducted to assess the level of use of CAM and its predictors among patients on long term care in tertiary health institution. Methods: This was a cross-sectional study conducted among 176 patients accessing treatment for chronic medical conditions in Jos University Teaching Hospital using quantitative method of data collection. Epi Info statistical software version 7 was used for data analysis and a value of P < 0.05 was considered statistically significant. Results: The median age of respondents was 50 (IQR 30-84) years with 83 (47.2%) being 51 years and above. Utilization of CAM was reported among 72 (40.9%) with herbal preparation ranking highest among 56 (77.8%) the respondents. Absence of side effects (AOR = 2.23; 95% CI = 1.6918-3.2135) and consistency with culture (AOR = 4.46; 95% CI = 1.4695-6.1851) were identified predictors of CAM use. Conclusions: This study has demonstrated a relatively high level of CAM use with perceived absence of side effects, peer influence, and consistency with culture predicting its use.

Retention in HIV care and its predictors among HIV-infected men who have sex with men in Plateau state, North Central Nigeria.

BACKGROUND: Retention in HIV care is the constancy of engagement in HIV treatment, care and support services which is essential to reducing morbidity and mortality associated with the infection as well as halting the development of resistance to antiretroviral therapy (ART). In most African countries, Nigeria inclusive, men who have sex with men (MSM) are major contributors to HIV/AIDS burden. HIV-positive MSM are generally understudied and mostly underserved due to social, political and legislation factors resulting in limited characterization and documentation of the existing health disparities particularly with regards to retention in HIV care. It was against this backdrop that we conducted this study to assess the level of retention in HIV care and its predictors among MSM linked to HIV care. METHODS: A cross-sectional study conducted among 114 HIV-positive MSM in 2019 using interviewer-administered questionnaire. Data analysis was carried out using version 7 of Epi Info statistical software version 7 and a probability value of less than 0.05 used as the cut-off for drawing statistically significant conclusion. RESULTS: The average age in years of the respondents was 26.0 ± 5.4 while 43 (37.7%) of the participants were adequately retained in HIV care. Adequate retention in HIV care was found to be predicted by awareness of regular male partner's HIV status (AOR = 11.2; 95% confidence interval [CI] = 1.924-65.167) and financial difficulty (AOR = 0.1; 95% CI = 0.022-0.840). CONCLUSIONS: A suboptimal level of retention in HIV care was demonstrated in the study with awareness of male partner's HIV status and financial buoyancy as its main predictors.

Workplace Bullying and Its Associated Factors Among Medical Doctors in Residency Training in a Tertiary Health Institution in Plateau State Nigeria.

BACKGROUND: Bullying is public health problem globally in workplaces with untold deleterious effects on the health and well-being of individuals at the receiving end. Bullying has been found to disrupt social interaction at workplace thereby creating an unhealthy and seemingly unproductive work environment. Studies have reported varying rates of workplace bullying as high as 83% in Europe, 65% in the Americas and 55% in Asia with very little documented in the contemporary African setting and Nigeria in particular. It therefore became imperative to assess the level of bullying and its associated factors among medical doctors in residency training in a tertiary health institution in Plateau state Nigeria. METHODOLOGY: This was a cross sectional study conducted among resident doctors in Jos University Teaching Hospital between November 2019 and February 2020 using quantitative method of data collection and SPSS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a p-value of ≤0.05 considered statistically significant. RESULTS: The mean age of the respondents was 32.3 ± 3.9 years with 78 (62.9%) being 31 years and above. Bullying was currently being experienced by 74 (59.7%) of the respondents with verbal aggression and threats as well as insult and use of derogatory remarks being the forms of bullying experienced by 85.1 and 74.3% of the respondents, respectively. Furthermore, witnessing a colleague being bullied was the sole factor found to be significantly associated with workplace bullying (AOR = 0.18; 95% CI = 0.068-0.449; p < 0.001). CONCLUSION: Workplace bullying has been found to be in existence and relatively high among medical doctors in residency training in this setting with witnessing someone being bullied as its sole associated factor.

Disclosure of Sexual Orientation and its Predictors among HIV-Positive Men Who Have Sex with Men in a Contemporary African Setting.

BACKGROUND: Sexual orientation disclosure has been reported to promote good peer support, improve psychological health, as well as access to STIs and HIV prevention services. Hence, this study sought to assess the level of disclosure sexual orientation and its predictors among HIV-positive men who have sex with men (MSM) in Plateau state Nigeria. METHODS: This was a cross-sectional study design conducted between October 2018 and December 2019 among 114 HIV-infected MSM through respondent driven sampling technique. Epi Info version 7 was used for the data analysis with adjusted odds ratio and 95% confidence interval (CI) used as point and interval estimates on the logistic regression model and P < 0.05 considered statistically significant. RESULTS: The mean age of the respondents was 26.0 ± 5.4 years with disclosure of sexual orientation to nonpartner being reported by 45 (39.5%). Positive family history of same sex practice was found to significantly predict self disclosure of sexual orientation (adjusted odds ratio: 3.30; 95% CI: 1.2356-8.8038; P = 0.017). CONCLUSIONS: This study has revealed a low level of disclosure of sexual orientation among HIV-positive MSM in Plateau state with a positive family history of same sex involvement as its predictor.

Assessment of safe handling practices among resident doctors in Jos University Teaching Hospital Plateau state, Nigeria.

BACKGROUND: Standard safety precautions are essential in health care delivery regardless of the presumed infectious state of the patients. Safe handling practices as detailed in the universal safety precaution guidelines are available to health care workers globally. However, there have been documentation of suboptimal adherence to it especially in the developing countries including Nigeria. Hence, this study was conducted to assess the level of safe handling practices and its determinants among resident doctors in Jos University Teaching Hospital, Plateau state, Nigeria. METHODS: This was a cross sectional study conducted among 192 resident doctors using quantitative method of data collection in 2018.SPSS version 20 was used for data analysis with chi square test used to identify the determinants of safe handling practices. Crude odds ratio as well as 95% confidence interval were used with a p-value of < 0.05 considered statistically significant. RESULTS: The mean age of the respondents in the study was 33 ± 3 years with 119 (62.0%) of the respondents being males. Good knowledge of infection, prevention and control was reported among 120 (62.5%) while 137 (71.3%) were found to have engaged in safe handling practices. Sex (OR = 4.5; 95% CI = 2.05-9.85) and level of knowledge (OR = 1.97; 95% CI = 1.05-3.72) were found as the determinants of safe handling practice. CONCLUSION: This study has brought to light the need for improvement in the level of compliance with safe handling practices as it is far from the optimum.

The impact of Highly Active Antiretroviral Therapy (HAART) on the clinical features of HIV - related oral lesions in Nigeria.

BACKGROUND: This study aimed to determine the therapeutic effects of highly active anti-retroviral therapy (HAART) on the clinical presentations of HIV related oral lesions (HIV-ROLs) in an adult Nigerian population. METHODS: A 5 month prospective study on HAART naïve HIV positive adults recruited into the HAART program of an AIDS referral centre. HIV-ROLs were diagnosed clinically by the EEC Clearinghouse on oral problems related to HIV infection. Baseline clinical features of HIV-ROLs was documented by clinical photographs using SONY(R) 5.2 M Cybershot digital camera. Post HAART monthly review was conducted using clinical photographs. RESULTS: A total of 142 patients were seen. Age range was 19 - 75 years. Mean age was 35.6 +/- 10.5 (SD). Eighty (56.3%) were females. Prevalence of HIV-ROLs was 43.7%. Oral candidiasis (22.4%) was the most prevalent HIV-ROL. 114 (83.2%) patients had clinical AIDS at presentation (CDC 1993). 89.4% were placed on Tenofovir/Emtricitabine +;Nevirapine, 9.9% on Tenofovir/Emtricitabine + Efavirenz. There was strong decline in the clinical features of oral candidiasis from a month of commencing HAART. Oral hairy leukoplakia was slow in responding to HAART. Parotid gland enlargement, melanotic hyperpigmentation and Kaposi's sarcoma were more persistent and had slower response to HAART. There was no clinical change noticed in linear gingival erythema. CONCLUSION: HAART has different clinical effects on HIV related oral lesions depending on the size, duration of treatment and etiology of the lesions. HIV-ROLs of fungal origin have the fastest response to HAART. These lesions alongside immunologic parameters can be used as indicators of success or failure of antiretroviral therapy.

Preference for complementary and alternative medicine among patients on long-term treatment in Jos university teaching hospital, Nigeria.

BACKGROUND: The use of complementary and alternative medicines(CAM) is on the increase globally particularly among those with chronic medical conditions. Imperatively, the treatment outcomes of management of chronic illness is hinged on adherence to prescribed conventional treatment with little or no attention paid to the intent to use or concomitant use of alternative medicines in most treatment settings. Hence, this study assessed the preference for CAM and its predictors as among patients on long-term treatment in Jos University Teaching Hospital. METHODS: This was a cross-sectional study conducted among 176 patients accessing treatment for chronic medical conditions in Jos University Teaching Hospital using quantitative method of data collection. Epi Info statistical software version 7 was used for data analysis with odds ratio and 95% confidence interval used as point and interval estimates respectively while a P-value of <0.05 was considered statistically significant. RESULTS: The median age of respondents was 50 (IQR 30-84) years with 83 (47.2%) being 51 years and above. Preference for CAM was reported by 26 (14.8%) with absence of side effects (AOR = 11.3; 95% CI= 5.8299-15.1185) being the sole predictor of preference for CAM. CONCLUSION: This study has demonstrated some level of preference for CAM among patients on long term conventional treatment with perceived absence of side effects influencing this preference level.

Knowledge of electronic medical records system among frontline health care workers in Jos University teaching hospital, Plateau State Nigeria.

BACKGROUND: Electronic Medical Records system (EMRs) in any healthcare system has the potential to transform healthcare in terms of saving costs, reducing medical errors, improving service quality, increasing patients' safety, decision-making, saving time, data confidentiality, and sharing medical. Evidence on the current state of EMR system in Nigeria health system particularly its knowledge among health professionals is limited. Hence, this study was conducted to assess the level of knowledge EMRs among frontline health care workers in a tertiary health institution in Jos, Plateau State. METHODS: This was a cross-sectional study conducted between April and August 2019 among 228 frontline health care workers in Jos University Teaching Hospital using quantitative method of data collection. SPSS version 20 was used for data analysis and a p-value of ≤ 0.05 considered statistically significant. RESULTS: The mean age of the respondents in this study was 35±8 years with 93 (40.8%) being 36 years and above. The overall level of knowledge of EMRs was adjudged to be good among 163 (71.5%) of the participants. Category (pharmacists) of the respondents was found to influence good knowledge of EMRs (OR=1.37; 95% CI=1.007-1.865; p=0.045). CONCLUSIONS: This study has demonstrated a relatively high level of good knowledge of EMRs with variation existing along the categories of health care workers bringing to light the existence of a good knowledge base in the light of future EMRs implementation.

Sexual Behaviors of HIV-Infected Men who Have Sex with Men in Jos, Plateau State, North Central Nigeria.

BACKGROUND: Sub-Saharan Africa region remains heavily plagued by HIV/AIDS with recent information suggesting that sex between men is a significant contributor to the spread of this infection. It was against this backdrop that this study was conducted to examine the sexual behaviors of HIV-infected men who have sex with men (MSM) in Jos, Plateau state, North Central Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 114 HIV-infected MSM 18 years and above using a quantitative method of data collection. Respondent-driven sampling technique was employed in sampling the study participants, and EpiInfo statistical software version 7 was used for the data analysis. RESULTS: The mean age of the respondents was 26.0 ± 5.4 years with condom use in the last anal sex being 77 (67.5%), while majority (83.3%) of the respondents was adjudged to have been engaged in risky sexual behaviors. CONCLUSIONS: This study has brought to light a significant level of risky sexual behaviors among HIV-infected MSM with condom use, multiple same sexual engagement, transactional sex, and bisexual concurrency as areas of possible interventions.

Clinical and laboratory characteristics of COVID-19 among adult patients admitted to the isolation centre at Abubakar Tafawa Balewa Teaching Hospital Bauchi, Northeast Nigeria.

INTRODUCTION: as the epidemiological trend of COVID-19 infection continue to evolve with increasing prevalence and incidence globally, management of cases in low-resource health care settings require basic detailed clinical and laboratory characteristics. This study retrospectively described the clinical and laboratory characteristics of confirmed COVID-19 cases admitted into the isolation centre of ATBUTH, Bauchi. METHODS: clinical and laboratory data of 84 confirmed COVID-19 cases admitted into the isolation centre of ATBUTH, Bauchi according to NCDC guidelines were used. Diagnosis was based on nasal and nasopharyngeal swab positive result of reverse transcriptase-polymerase chain reaction (RT-PCR) result. Data extracted includes demographic, clinical presentations and laboratory characteristics. RESULTS: the 84 COVID-19 patients comprised of 72% (59) males and 28% (25) females with mean age of 41.0±10.5 years, majority of the patients were within age-group 21-40 years. Forty-one percent presented with mild to moderate symptoms, 3.6% (3) presented with severe symptoms while 58.3% (49) were asymptomatic with mean body temperature of 36.60C ± Sá. The common clinical manifestations were fever 23.4% (19) and cough 20.7% (17). About 29.3% of the patients had comorbidities, 17.1% (14) were hypertensive while 12.2% of the diabetic. Thirty percent (10) of the patients with DM required intensive care unit (ICU) admission with 10% mortality. Biochemical parameters were within normal range for all the patients. However, haematological parameters showed increased neutrophil (10, 43.5%) and lymphocyte count (19 (59.4%). CONCLUSION: the study findings revealed high number of asymptomatic cases, similarity in clinical manifestation and relatively normal laboratory characteristics. More experience with increase in number of patients may provide additional information. Interrupting community transmission will require early detection and contact trace of asymptomatic cases.

Profile of children with COVID-19 infection: a cross sectional study from North-East Nigeria.

INTRODUCTION: available evidence suggests that children infected with COVID-19 tend to have a less severe form of the disease. However, most of the studies that have established this largely emanate from outside sub-Saharan Africa. The pandemic nature of the infection makes it instructive to evaluate its pattern among children across different climes, including ours. This study was set out to describe the clinical characteristics of children with COVID-19 in Bauchi State, North-East Nigeria. METHODS: this was a cross sectional study that involved 53 children between the ages of 0 and 18 years, who had RT-PCR confirmed COVID-19 infection between March and June 2020 in Bauchi State, Nigeria. Data on epidemiological and clinical characteristics was analysed using IBM SPSS Statistics V 21.® Relationship between categorical variables was established using the chi square test. The level of statistical significance was set at < 0.05, at a confidence interval (CI) of 95%. RESULTS: the mean age was 12.63 ± 4.31 years with a slight preponderance of males (1.1: 1). Majority were asymptomatic (60.4%), while 32.1% and 7.5% had mild and moderate diseases respectively. The most common symptoms were cough (20.8%), fever (17%), and sneezing (15.1%). Five children (9.4%) complained of loss of taste while anosmia was documented in one child (1.9%). We observed a significant relationship between age category and the presence of symptoms. In fact, children younger than 10 years (pre-adolescents) were five times more likely to be symptomatic when compared to those above this age (p = 0.029, C I 1.08-21.56). CONCLUSION: our findings have shown a mild pattern of disease and good outcome among infected children. However, we must be mindful of the higher vulnerability among younger children, especially those below 10 years.

Treatment compliance and retention in care among out-patient clients in a tertiary health institution in plateau state North Central Nigeria.

BACKGROUND: Compliance with prescribed treatment and retention in care are key components in the management of chronic diseases which is vital in averting the long term complications that could arise from such conditions. Failure to comply with treatment recommendations is often associated with poor retention in care. In view of this, this study was conducted to determine the level of treatment compliance and retention in care among patients with hypertension and diabetes in Jos University Teaching Hospital. METHODS: This was a cross sectional study conducted among 290 eligible respondents between September and November 2017 using quantitative method of data collection. SPSS version 20 was used for data analysis with adjusted odds ratio and 95% confidence interval used as point and interval estimates while p-value of ≤0.05 was considered statistically significant. RESULTS: The mean age of the respondents was 54.5±13.1 years with 43.8% of the respondents found to have satisfactorily complied with prescribed treatment while 117 (40.3%) were uninterruptedly retained in care within the last 6 months' clinic appointments prior to the study. CONCLUSIONS: This study has demonstrated the levels of compliance with treatment and retention in care bringing to bear the need to provide structured interventions targeted at attaining improvement in compliance with treatment and retention in care among individuals on long term care.

Cord Care Practices: A Perspective of Contemporary African Setting.

BACKGROUND: Cord care is the series of steps applied in handling of the umbilical cord after delivery of the new born. Globally, an estimated 4 million deaths occur annually within the first 4 weeks of life and 1.5 million of these deaths are attributable to infections. In Nigeria, studies have reported umbilical cord infections accounting for between 10 and 19% of neonatal admissions and resultant estimated 30-49% neonatal deaths. Hence, this study was conducted to assess the knowledge and practice of cord care within a contemporary setting. METHODOLOGY: This was a cross-sectional study conducted among 324 mothers of children less than 59 months using a multistage sampling technique and SSPS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a P-value of ≤0.05 considered statistically significant. RESULTS: The mean age of the mothers in the study was 27.5 ± 6 years with majority of them having good overall knowledge and practice of cord care. Factors such residence in rural community (AOR = 0.26; 95% CI = 0.0915-0.7230) and heath facility delivery (AOR = 7.0; 95% CI = 4.7877-9.3948) were predictors of cord care practices. CONCLUSION: This study has brought to light the level of cord care practices with health facility delivery, place of residence, and knowledge of cord care as its determinants.

The Knowledge and Uptake of Travel Vaccine Among Medical Doctors in a Tertiary Health Institution in Plateau State, North Central Nigeria.

BACKGROUND: Travelers play a significant role in the spread of infectious diseases across international borders, through their travel patterns and behaviors. Travel maybe the only risk factor for infectious diseases that are well controlled in the travelers' country of residence, particularly vaccine-preventable diseases. The role of vaccination among travelers is an essential component of the control of travel-associated infectious diseases. This study was conducted to assess the knowledge and uptake of travel vaccine among medical doctors in Jos University Teaching Hospital (JUTH). MATERIALS AND METHODS: This was a descriptive cross-sectional study conducted in 2013 using quantitative method of data collection among 189 medical doctors. Epi Info™ statistical software package version 3.5.4 was used for data analysis and a P ≤ 0.05 was considered statistically significant. RESULT: The mean age of the respondents was 33.8 ± 4.5 years, majority of the respondents (96.3%) were aware of travel vaccines with 45 (71.4%) of the 63 respondents who had embarked on international travel prior to the study had taken travel vaccine in their last travel. Knowledge of travel vaccination was found to have statistically significant relationship with uptake of travel vaccine (P = 0.013). CONCLUSION: This study has revealed the need to improve the knowledge and uptake of travel vaccine among medical doctors.

Effect of health education on knowledge of malaria and long lasting insecticide-treated nets among clients accessing care in the out-patient Department of a Secondary Health Facility in Plateau State, Nigeria.

BACKGROUND: Malaria is a mosquito borne disease transmitted by female anopheles mosquito; it is life-threatening, preventable, and treatable. Approximately, 40% of the world's population is at risk of malaria. Most cases and deaths due to malaria are in sub Saharan Africa although Asia, Latin America, the Middle East and some parts of Europe are also affected. OBJECTIVE: To assess the knowledge of malaria and long lasting insecticide treated nets (LLITNs) among clients assessing out-patient services in Seventh day Adventist (SDA) Hospital. METHODOLOGY: A quasi experimental study conducted in 2013 among client assessing care at the Out-Patient Department of SDA Hospital Jengre, Bassa Local Government Area of Plateau State to determine the knowledge of malaria and LLITNs. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≤ 0.05 considered as statistically significant. RESULT: The mean age of the respondents in this study was 36.04 ± 9.60 years. The level of knowledge on malaria improved significantly after the training (P < 0.001). Majority (98.8%) of the respondents had good knowledge of LLITNs after the training as against 77.4% who had same before the training (X2 = 17.93; P < 0.001). CONCLUSION: This study has demonstrated the effectiveness of health education as vital tool for improving the knowledge of malaria and LLITNs.

Training: A vital tool for improving the knowledge and practice of food safety and hygiene among food handlers in boarding secondary schools in Plateau State.

BACKGROUND: Food is an important basic necessity, its procurement, preparation and consumption are vital for the sustenance of life. Food handlers have been found to play prominent roles in the transmission of food borne diseases, therefore training of food handlers on food safety and hygiene is crucial to the prevention of food borne diseases. METHODOLOGY: A quasi-experimental study carried out among food handlers in boarding secondary schools in Jos North Local Government Area to determine the effect of training on the knowledge and practice of food safety and hygiene. EPI info statistical software version 3.5.4 was used for data analysis and 95% confidence interval was used in this study with a P ≥ 0.05 considered statistically significant. RESULT: The mean age of the food handlers in the study was 42.07 ± 8.71 years with the mean years of work experience as 11.59 ± 8.05 years. The level of knowledge of food safety and hygiene improved significantly after the training (P < 0.001). Majority (98.5%) of the food handlers had good practice of food safety and hygiene after the training as against 51.5% who had same before the training (χ2 = 76.6; P < 0.001). CONCLUSION: This study has demonstrated the effectiveness of training in improving the knowledge and practice of food safety and hygiene among food handlers.

Effect of health education on the uptake of HIV counseling and testing among long distance drivers in Jos North Local Government Areas of Plateau State.

BACKGROUND: The impact of HIV/AIDS has been felt in virtually all aspects of life. Long distance drivers are of particular concern to HIV prevention and care programs because they constitute a high risk group. HIV Counseling and Testing (HCT) is an intervention, which gives the client an opportunity to confidentially discuss his or her HIV risks and be assisted to learn his/her HIV status for purposes of prevention, treatment, care and support. The objective of this study was to determine the effect of health education on the uptake of HCT among Long Distance Drivers (LDDs) in Plateau State. METHODOLOGY: This was a quasi-experimental study with a pre and post intervention phase carried out among 161 LDDs in Jos North Local Government Areas. Health education intervention was provided using a structured health education guide in the form of lecture and discussion. Epi-info™ statistical software version 3.5.4 developed by Centre for Disease and Control and Prevention (CDC) 1600 Clifton Rd. Atlanta, GA 30333 usa was used for data analysis and 95% confidence interval was used for the study and P ≤ 0.05 was considered as statistically significant. RESULTS: The mean age of the respondent in this study was 41.0 ± 7.9 years with majority (92.5%) of the LDDs married and 91.3% resident within the state. Knowledge and uptake of HCT among LDDs improved significantly from 4.17 ± 1.43 to 6.70 ± 1.55 and 18.6-57.2% following the intervention (P < 0.001) respectively. CONCLUSION: This study has shown that health education is an effective tool in improving the uptake of HCT among long distance drivers. Therefore, it should be used to improve HCT uptake among high risk groups.

Supportive supervision: an effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria.

BACKGROUND: Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. MATERIALS AND METHODS: This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. RESULTS: The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. CONCLUSIONS: This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.