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Akpan U, Edet E, Arogundade K, Akpanika C, Ekott M, Etuk S. Implementation of the Revised National Malaria Control Guidelines: Compliance and Challenges in Public Health Facilities in a Southern Nigerian State. Health Serv Insights 2023; 16:11786329231211779. [PMID: 38028122 PMCID: PMC10658768 DOI: 10.1177/11786329231211779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background There has been a concerted effort to reduce malaria burden and bring malaria related mortality to zero. The objectives of this survey were to assess the level of adherence to the current revised malaria control guidelines in the public health facilities in Cross River State of Nigeria and to identify the challenges as well as suggest ways for improvement in treatment outcomes. Methods This was a mixed observational and qualitative survey conducted in 32 public health facilities from 21st to 25th June 2022. Treatment records on malaria were assessed for adherence to the National guidelines. In-depth interviews were conducted with 36 key informants and 4 purposefully selected stakeholders to identify the successes and challenges. Quantitative data were summarized and presented in simple proportions and percentages while qualitative information was recorded, the transcripts thematically coded, analyzed and presented using NVivo 11 software. Results The survey revealed that vector control program was poorly implemented across the state. For case management, presumptive treatment was frequently practiced especially at secondary health facilities for uncomplicated malaria. More than 60% of uncomplicated malaria were being treated with parenteral artemether instead of oral artemisinin combination therapy (ACTs) as recommended. Severe malaria were not treated with Intravenous (IV) Artesunate as first line drug in about 40% of the secondary health facilities. Key successes were noted in malaria management in pregnancy. Major challenges identified include: stock out of commodities, shortage of clinical man power, and low trust in parasitological diagnosis. Conclusion The survey showed that adherence to the key recommendations in various categories of malaria control among health care providers in the public health facilities was below expectation. Malaria preventive treatment in pregnancy with SP fared better perhaps because of its inclusion in ANC packages.
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Affiliation(s)
- Ubong Akpan
- Maternal-Foetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Calabar, Cross River State, Calabar, Nigeria
| | - Ekpo Edet
- Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Cross River State, Calabar, Nigeria
| | | | - Chinyere Akpanika
- Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Cross River State, Calabar, Nigeria
| | - Mabel Ekott
- Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Cross River State, Calabar, Nigeria
| | - Saturday Etuk
- Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Cross River State, Calabar, Nigeria
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Oyeyemi OT, Okunlola OA. Soil-transmitted helminthiasis (STH) endemicity and performance of preventive chemotherapy intervention programme in Nigeria (in year 2021). Sci Rep 2023; 13:10155. [PMID: 37349411 PMCID: PMC10287726 DOI: 10.1038/s41598-023-37402-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
Preventive chemotherapy (PC) is an important tool to address transmission and reduce morbidities associated with soil-transmitted helminths (STHs). The aim of the study is to assess the PC implementation programme coverage and relate the same to the endemicity of STH in Nigeria. The secondary data collected by the World Health Organization (WHO) through the expanded special project for elimination of neglected tropical diseases (ESPEN) and made available at the ESPEN portal was used for the study. The PC implementation coverage and frequency of treatment were evaluated and related to STH endemicity levels in Nigeria. STH was actively transmitted in all six geopolitical zones of Nigeria. The southern part of Nigeria was more endemic compared with northern Nigeria. There was no PC intervention in preschoolers and effective PC coverage (19.3%) fell below the WHO ≥ 75% PC coverage index benchmark in school children. The percentages of children that harbour low, moderate, and high STH infections were 41.5, 41.6, and 13.4%, respectively. Multiple treatments did not necessarily reduce the endemicity of STH on certain occasions. STH continues to be a public health threat in Nigeria. The current treatment strategies should be reviewed to accommodate preschoolers in PC implementation programmes. Treatment should be integrated with the WASH programme in order to achieve a lasting impact.
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Affiliation(s)
- Oyetunde T Oyeyemi
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo City, Ondo State, Nigeria.
| | - Oluyemi A Okunlola
- Department of Mathematical and Computer Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
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Samenjo KT, Bengtson M, Onasanya A, Zambrano JCI, Oladunni O, Oladepo O, van Engelen J, Diehl JC. Stakeholders’ Perspectives on the Application of New Diagnostic Devices for Urinary Schistosomiasis in Oyo State, Nigeria: A Q-Methodology Approach. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00780. [PMID: 36041843 PMCID: PMC9426976 DOI: 10.9745/ghsp-d-21-00780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
New diagnostic devices for schistosomiasis should be designed to function best within the local endemic health care context and support stakeholders at various levels of the health care system in performing the tasks to help control and eventually eliminate schistosomiasis. Urinary schistosomiasis is a waterborne parasitic infection caused by Schistosoma haematobium that affects approximately 30 million people annually in Nigeria. Treatment and eradication of this infection require effective diagnostics. However, current diagnostic tests have critical shortcomings and consequently are of limited value to stakeholders throughout the health care system who are involved in targeting the diagnosis and subsequent control of schistosomiasis. New diagnostic devices that fit the local health care infrastructure and support the different stakeholder diagnostic strategies remain a critical need. This study focuses on understanding, by means of Q-methodology, the context of use and application of a new diagnostic device that is needed to effectively diagnose urinary schistosomiasis in Oyo State, Nigeria. Q-methodology is a technique that investigates subjectivity by exploring how stakeholders rank-order opinion statements about a phenomenon. In this study, 40 statements were administered to evaluate stakeholder perspectives on the context of use and application of potential new diagnostic devices and how these perspectives or viewpoints are shared with other stakeholders. Potential new diagnostic devices will need to be deployable to remote or distant communities, be affordable, identify and confirm infection status before treatment in patients whose diagnosis of urinary schistosomiasis is based on self-reporting, and equip health care facilities with diagnostic devices optimized for the local setting while requiring local minimal infrastructural settings. Similarly, the context of use and application of a potential new diagnostic device for urinary schistosomiasis is primarily associated with the tasks stakeholders throughout the health care system perform or procedures employed. These findings will guide the development of new diagnostic devices for schistosomiasis that match the contextual landscape and diagnostic strategies in Oyo.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Juan Carlo Intriago Zambrano
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, Netherlands
| | - Opeyemi Oladunni
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Iya AM, Beyer K, Kotecha P, Kibaru J, Abdullahi M, Alhassan SU, Mustapha MI, Ahmad A, Lawal Y, Rabiu Ibrahim J, Aminu A, Abubakar A, Saleh A, Bryan RT, Van Hemelrijck M, Russell B. Scoping review: bladder cancer in Nigeria - what are the gaps in clinical care and research? BMJ Open 2022; 12:e049241. [PMID: 35260447 PMCID: PMC8905928 DOI: 10.1136/bmjopen-2021-049241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES There are currently no national guidelines regarding bladder cancer treatment and clinical care pathways in Nigeria. The aim of this scoping review was to identify any gaps in the knowledge of epidemiology, clinical care and translational research in order to aid the development of a defined clinical care pathway and guide future research. METHODS A scoping review was conducted by searching Medline, Ovid Gateway, The Cochrane library and Open Grey literature using predefined search terms from date of inception to June 2020. Studies were included if they discussed the epidemiology or treatment pathway of bladder cancer. All data were charted and were analysed in a descriptive manner. A consultation phase was also conducted consisting of a multidisciplinary team of clinicians and bladder cancer survivors. RESULTS A total of 19 studies were deemed suitable for inclusion. The themes included the epidemiology of bladder cancer (high prevalence of schistosomiasis), research surrounding the biology of the disease and translational research including potential biomarkers. The consultation phase highlighted some possible sociocultural and infrastructural issues relating to both the diagnosis and treatment of bladder cancer, with poor knowledge of bladder cancer and its symptoms within the general population identified as a key issue. CONCLUSION Even though the factors surrounding the relationship between schistosomiasis and the histopathology of bladder cancer remain unclear, there is potential for screening for schistosomiasis in endemic regions of sub-Saharan Africa. Other key areas for future research include the dissemination of information to the general population surrounding bladder cancer and its symptoms to encourage prompt diagnosis.
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Affiliation(s)
| | - Katharina Beyer
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Pinky Kotecha
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Joyce Kibaru
- Translational Oncology and Urology Research, King's College London, London, UK
| | - Muzzammil Abdullahi
- Urology Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
- Urology, Bayero University College of Health Sciences, Kano, Nigeria
| | | | | | | | - Yusuf Lawal
- Radiology Department, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Aliyu Aminu
- Microbiology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Abdullahi Saleh
- Nursing department, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Richard T Bryan
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Beth Russell
- Translational Oncology and Urology Research, King's College London, London, UK
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David N, Duguru M, Akpa P, Davwar P, Okwute A, Makpu J, Dallang B, Omaiye P, Okeke E. Intestinal schistosomiasis with colonic polyps. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_92_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Umoke M, Sage P, Bjoernsen T, Umoke PCI, Ezeugworie C, Ejiofor D, Agha O, Nwalieji CA, Onwe RN, Nwafor IE, Chukwu OJ. Co-infection and Risk Factors Associated with STIs among Pregnant Women in Rural Health Facilities in Nigeria: A Retrospective Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:46958021992912. [PMID: 33736517 PMCID: PMC7983409 DOI: 10.1177/0046958021992912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/06/2021] [Accepted: 01/12/2020] [Indexed: 11/20/2022]
Abstract
Globally, sexually transmitted infections are recognized as a public and reproductive health challenge. The study determined the prevalence, co-infection, and risk factors associated with HBV, HCV, HIV, and Syphilis infections among pregnant women receiving antenatal care in rural health facilities in Ebonyi State, Nigeria. A retrospective study was conducted from January to December 2018 in 8 primary healthcare facilities using antenatal records of all the 4657 pregnant women who attended ANC within the period. Data were analyzed using descriptive and inferential statistics with IBM SPSS statistics version 20 and hypotheses tested at P < .05. The findings indicated a medium prevalence of HBV (4.1%), a high prevalence of HCV (4.1%) and syphilis (1.8%), and a low prevalence of HIV (0.9%). An overall co-infection rate of 0.623% that was not significant (P > .05) was observed. Also, prevalence was more among the younger mothers (<20 years), those with secondary education. And the history of blood transfusion was significantly associated with HBV and HCV prevalence (χ2 = 7.865; P = .05*), 11.8%. conclusively, due to medium HBV prevalence and a high prevalence of HCV and syphilis observed, attention should be paid to blood screening before transfusion by health workers. Relevant stakeholders should provide intensive health education and appropriate free treatment services particularly for younger mothers and the less educated.
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Affiliation(s)
- MaryJoy Umoke
- Ebonyi State Ministry of Health Abakaliki, Abakaliki, Ebonyi, Nigeria
| | - Peter Sage
- AMURT Global Coordinating Office, Washington, DC, USA
| | | | | | | | | | | | | | - Rosemary N. Onwe
- Ebonyi State Ministry of Health Abakaliki, Abakaliki, Ebonyi, Nigeria
| | | | - Obinna Jude Chukwu
- Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria
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Oyeyemi OT, de Jesus Jeremias W, Grenfell RFQ. Schistosomiasis in Nigeria: Gleaning from the past to improve current efforts towards control. One Health 2020; 11:100183. [PMID: 33072838 PMCID: PMC7553878 DOI: 10.1016/j.onehlt.2020.100183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/25/2020] [Accepted: 10/07/2020] [Indexed: 11/25/2022] Open
Abstract
The effort to control schistosomiasis in Nigeria has been scaled up the past few years. Schistosomiasis affects all age groups, however, school children are at the highest risk of the disease. In the past years, global partners in schistosomiasis control have renewed their commitments. Many countries including few in Africa are working towards eliminating the disease. In Nigeria, the transmission of schistosomiasis is still active. This poses a serious health challenge as morbidity builds up in infected individuals. Mass drug administration (MDA) has helped to reduce morbidity but it is not adequate to abate transmission in many areas of the country. The integration of other aspects of control will provide a more sustainable result. This review attempted to discuss schistosomiasis transmission patterns in Nigeria in different eras. We identified some pitfalls in efforts towards the control of schistosomiasis in Nigeria. We recommended research priority in areas of neglect and advocated for integrated control.
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Affiliation(s)
- Oyetunde Timothy Oyeyemi
- Department of Biological Sciences, University of Medical Sciences, Ondo, Ondo State, Nigeria
- The Laboratory of the Diagnosis and Therapy of Infectious Diseases and Cancer, Rene Rachou Institute, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, MG, Brazil
| | - Wander de Jesus Jeremias
- The Laboratory of the Diagnosis and Therapy of Infectious Diseases and Cancer, Rene Rachou Institute, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, MG, Brazil
- Federal University of Ouro Preto, School of Pharmacy, Department of Pharmacy, MG, Brazil
| | - Rafaella Fortini Queiroz Grenfell
- The Laboratory of the Diagnosis and Therapy of Infectious Diseases and Cancer, Rene Rachou Institute, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, MG, Brazil
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