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Asuzu CC, Akin-Odanye EO, Asuzu MC, Adedokun T, Ntekem A, Ogundiran T, Henry M, Watson M. Effect of a novel pilot support group on distress and quality of life in breast cancer patients in Nigeria. Psychooncology 2023; 32:133-138. [PMID: 36316969 DOI: 10.1002/pon.6062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the effect of a new breast cancer support group (BCSG) on breast cancer patients' self-reported distress and quality of life. METHODS A single arm pre-post trial providing an eight session healthcare provider led BCSG. Primary outcome variables were distress and quality of life assessed using the National Comprehensive Cancer Network Distress Thermometer (DT) and The Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT-B+4), respectively. Topics in each session addressed a wide range of issues some of which were pre-selected by the patients themselves. DATA ANALYSIS Paired sample t-test was used for data analysis on International Business Machine Statistical Package for the Social Sciences 21. RESULTS The participants (N = 18) had a mean age of 51. Most had secondary school level education (54%), were traders (59%) and had stage 3 or 4 disease (67%). A larger proportion (78% or n = 14) of the patients lived in rural areas, while 4 (22%) of the patients lived in Ibadan. Out of the 8 sessions, 12 (67%) of the participants attended 1-3 sessions while 6 (33%) attended 4-8 sessions. There were, significant improvements in emotional wellbeing (t = -4.253; p < 0.05) and functional wellbeing (t = -2.191; p < 0.05) on the FACT-B+4. There was a significant reduction in the DT score (t = 2.345; p < 0.05) but the number of items on the problem list were not significantly reduced (t = 1.191; p > 0.05). Majority (75%) of the patients rated the support group activities as satisfactory. CONCLUSION These data show that the support group can benefit breast cancer patients in terms of reduced distress levels along with satisfaction and improvement in the functional and emotional wellbeing indices of quality of life.
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Affiliation(s)
- Chioma C Asuzu
- Department of Radiation Oncology, University of Ibadan, Ibadan, Nigeria.,Department of Counselling and Human Development Studies, University of Ibadan, Ibadan, Nigeria
| | | | - Michael C Asuzu
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tunde Adedokun
- Centre for Observational Research, Amgen, Califonia, USA
| | - Atara Ntekem
- Department of Radiation Oncology, University of Ibadan, Ibadan, Nigeria
| | | | - Mellissa Henry
- Department of Oncology, McGill University, Montreal, Quebec, Canada
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Akande OW, Elimian KO, Igumbor E, Dunkwu L, Kaduru C, Olopha OO, Ohanu DO, Nwozor L, Agogo E, Aruna O, Balogun MS, Aderinola O, Ahumibe A, Arinze C, Badaru SO, Nwachukwu W, Dada AO, Erameh C, Hamza K, Mohammed TB, Ndodo N, Obiekea C, Ofoegbunam C, Ogunbode O, Ohonsi C, Tobin EA, Yashe R, Adekaiyaoja A, Asuzu MC, Audu RA, Bello MB, Bello SO, Deeni YY, Disu Y, Joseph G, Ezeokafor C, Habib ZG, Ibeh C, Ike IF, Iwara E, Luka-Lawal RK, Namara G, Okwor T, Olajide L, Ilesanmi OO, Omonigho S, Oyiri F, Takpa K, Ugbogulu NU, Ibekwe P, Oladejo J, Ilori E, Ochu CL, Ihekweazu C. Epidemiological comparison of the first and second waves of the COVID-19 pandemic in Nigeria, February 2020-April 2021. BMJ Glob Health 2021; 6:bmjgh-2021-007076. [PMID: 34794956 PMCID: PMC8602923 DOI: 10.1136/bmjgh-2021-007076] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background With reports of surges in COVID-19 case numbers across over 50 countries, country-level epidemiological analysis is required to inform context-appropriate response strategies for containment and mitigation of the outbreak. We aimed to compare the epidemiological features of the first and second waves of COVID-19 in Nigeria. Methods We conducted a retrospective analysis of the Surveillance Outbreak Response Management and Analysis System data of the first and second epidemiological waves, which were between 27 February and 24 October 2020, and 25 October 2020 to 3 April 2021, respectively. Descriptive statistical measures including frequencies and percentages, test positivity rate (TPR), cumulative incidence (CI) and case fatality rates (CFRs) were compared. A p value of <0.05 was considered statistically significant. All statistical analyses were carried out in STATA V.13. Results There were 802 143 tests recorded during the study period (362 550 and 439 593 in the first and second waves, respectively). Of these, 66 121 (18.2%) and 91 644 (20.8%) tested positive in the first and second waves, respectively. There was a 21.3% increase in the number of tests conducted in the second wave with TPR increasing by 14.3%. CI during the first and second waves were 30.3/100 000 and 42.0/100 000 respectively. During the second wave, confirmed COVID-19 cases increased among females and people 30 years old or younger and decreased among urban residents and individuals with travel history within 14 days of sample collection (p value <0.001). Most confirmed cases were asymptomatic at diagnosis during both waves: 74.9% in the first wave; 79.7% in the second wave. CFR decreased during the second wave (0.7%) compared with the first wave (1.8%). Conclusion Nigeria experienced a larger but less severe second wave of COVID-19. Continued implementation of public health and social measures is needed to mitigate the resurgence of another wave.
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Affiliation(s)
- Oluwatosin Wuraola Akande
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria .,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Kelly Osezele Elimian
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Lauryn Dunkwu
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Chijioke Kaduru
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,IQVIA, Abuja, Nigeria
| | - Olubunmi Omowunmi Olopha
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Dabri Olohije Ohanu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Lilian Nwozor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Emmanuel Agogo
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Resolve to Save Lives, Abuja, Federal Capital Territory, Nigeria
| | - Olusola Aruna
- International Health Regulations (IHR) Strengthening Project, Global Operations, UK Health Security Agency, London, UK
| | | | - Olaolu Aderinola
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Anthony Ahumibe
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinedu Arinze
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Sikiru Olanrewaju Badaru
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - William Nwachukwu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | | | - Cyril Erameh
- Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Tarik Benjamin Mohammed
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Nnaemeka Ndodo
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Celestina Obiekea
- Public Health Laboratory Services, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinenye Ofoegbunam
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oladipo Ogunbode
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Cornelius Ohonsi
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | | | - Rimamdeyati Yashe
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Afolabi Adekaiyaoja
- Tony Blair Institute for Global Change, Abuja, Federal Capital Territory, Nigeria
| | - Michael C Asuzu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Rosemary Ajuma Audu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Muhammad Bashir Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Center for Advanced Medical Research and Training, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Shaibu Oricha Bello
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Pharmacology & Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Sokoto State, Nigeria
| | - Yusuf Yahaya Deeni
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Microbiology & Biotechnology, Federal University Dutse, Dutse, Jigawa State, Nigeria.,Centre for Environmental and Public Health Research and Development, Kano, Kano State, Nigeria
| | - Yahya Disu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Gbenga Joseph
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chidiebere Ezeokafor
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria
| | - Zaiyad Garba Habib
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,University of Abuja Teaching Hospital, Gwagwalada, Abuja, Federal Capital Territory, Nigeria
| | - Christian Ibeh
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | | | - Emem Iwara
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Maryland Global Initiatives Corporation, Abuja, Federal Capital Territory, Nigeria
| | - Rejoice Kudirat Luka-Lawal
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Geoffrey Namara
- World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Tochi Okwor
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Lois Olajide
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oluwafunke Olufemi Ilesanmi
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,World Health Organization, Abuja, Federal Capital Territory, Nigeria
| | - Solomon Omonigho
- Department of Microbiology, University of Benin, Benin, Edo State, Nigeria
| | - Ferdinand Oyiri
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Koubagnine Takpa
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Joint United Nations Programme on AIDS (UNAIDS), Abuja, Federal Capital Territory, Nigeria
| | - Nkem Usha Ugbogulu
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Priscilla Ibekwe
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - John Oladejo
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Elsie Ilori
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Chinwe Lucia Ochu
- Prevention Programmes & Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria.,Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria
| | - Chikwe Ihekweazu
- Nigeria COVID-19 Research Coalition, Abuja, Federal Capital Territory, Nigeria.,Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
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Awolaran O, OlaOlorun FM, Asuzu MC. Experience of intimate partner violence among rural women in Southwest, Nigeria. Afr J Reprod Health 2021; 25:113-124. [PMID: 37585865 DOI: 10.29063/ajrh2021/v25i5.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Intimate partner violence (IPV) is a significant public health issue that affects 1 in 3 women globally. Women's experiences of IPV in rural southwest Nigeria was examined in this study, conducted between July and August, 2019. A total of 677 women participated in this survey which employed a mobile phone application. Results revealed that the prevalence of experience of IPV was 39.4%. Experience of IPV was significantly higher among women who had been married longer (AOR = 2.09, 95% CI: 1.23, 2.93), completed secondary school (AOR = 1.81, 95% CI: 1.07, 3.05), were in the middle or richer wealth tertiles (AOR (95% CI= 1.59, 1.02, 2.51 and 1.84, 1.19, 2.84 respectively), and who justified IPV (AOR = 1.44, 95% CI: 1.00, 2.06). The prevalence of IPV among women in southwest Nigeria is high and determining factors are multi-faceted, hence the need for community sensitization interventions designed to address social norms that justify partner violence.
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Affiliation(s)
- Olusegun Awolaran
- Department of Community Medicine, College of Medicine, University of Ibadan, Oyo State, Nigeria
| | - Funmilola M OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Oyo State, Nigeria
| | - Michael C Asuzu
- Department of Community Medicine, University of Medical Sciences, Ondo, Nigeria
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Asuzu CC, Akin-Odanye EO, Asuzu MC, Holland J. A socio-cultural study of traditional healers role in African health care. Infect Agent Cancer 2019; 14:15. [PMID: 31249608 PMCID: PMC6585125 DOI: 10.1186/s13027-019-0232-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/14/2019] [Indexed: 11/19/2022] Open
Abstract
Background There is a widely held view that a major cause of delay in diagnosis of cancer at an early stage in Africa is the fact that many patients consult traditional healers first and are often treated by them until curative treatment cannot be undertaken. Purpose This qualitative study aimed at identifying cancer patients who have used traditional healers and their traditional healers’ understanding of cancer, its causes and treatment, patients’ motivations for patronizing traditional healers and their opinion about collaboration between physicians of western medicine and traditional healers as part of overall health care system. Methods Ethical approval was obtained from the UI/UCH IRB. Twenty people participated in the study, nine cancer patients, six traditional healers and five faith based healers using three focused group discussions employing a semi structured interview. Data analysis The audio taped recorded responses to the semi structured questions were transcribed and thematically analyzed. The themes that emerged from focus group discussions with the patients and healers relate to the meaning of cancer, the causes of cancer (due to satanic attack), the cure for cancer (being possible through prayers to God and use of herbs), reason for using traditional healers (financial consideration, convenience, incorporation of their spiritual beliefs and recommendation by others) and need for collaboration between orthodox medicine and traditional healers. Conclusion Patients and alternative healers have a poor understanding of the causes and treatment of cancer. They desire to seek a closer collaboration between healers and western physicians to enhance better care for cancer patients. This has implication for policy makers who will facilitate the relationship in order to control cancer care and improve the quality of care of cancer patients in Nigeria.
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Affiliation(s)
- C C Asuzu
- 1Department of Counselling and Human Development Studies, University of Ibadan, Ibadan, Nigeria.,2Department of Radiotherapy, University College Hospital, Ibadan, Nigeria
| | - E O Akin-Odanye
- 3Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - M C Asuzu
- 4Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - J Holland
- 5Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Centre, New York, USA
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5
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Adebimpe WO, Babatunde S, Asuzu MC. Clients' Perception of and Satisfaction with Quality of Directly Observed Treatment Short Course: A Comparative Study of Private and Public Health Facilities in Southwestern Nigeria. West Afr J Med 2019; 36:54-60. [PMID: 30924117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVES One third of the world population are at risk of developing active tuberculosis (TB), resulting in significant mortality and morbidity. The reported low patronage in many TB clinics may not be unrelated to the quality of services received by clients. The objective of this study was to determine clients' perception of and satisfaction with quality of DOTs treatments in private and public health facilities in Oyo State. MATERIALS AND METHODS A descriptive cross sectional study among 410 eligible clients selected using the multistage sampling method was conducted in Oyo State. Research instrument used were a structured pre-tested interviewer-administered questionnaire. Data was analyzed using the SPSS software version 17.0. RESULTS Mean age of respondents was 39.0 + 0.68 years, 211(51.5%) were male while 199 (48.5%) were females. 321(78.3%) worked in public health facilities. Majority of the respondents, 385 (94.0%), had good perception of quality of DOTs treatment received. These include good perception of communication (96.0%); of quality of care (90.4%), and good perception of staff attitude among 93.9% of respondents About 97% of the respondents had good satisfaction with the quality of DOTs treatment received. Good satisfaction was found among 98.3% in terms of adherence counseling received, 98.7% on TB treatment received and 98.7%, on waiting time spent, and these were far higher among private than public health facilities. Statistically significant association was found between the type of facility attended by respondents and having adherence counseling service and waiting period experienced (P-values < 0.05). Having received services in a private health facility is the major predictor of favourable perception and good satisfaction with quality of DOTS treatment among respondents studied. CONCLUSION Though perception of and satisfaction with service delivery were good, this was better in private than in public; thus stressing the need for better monitoring and evaluation of services rendered by health care workers in order to encourage patronage by clients.
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Affiliation(s)
- W O Adebimpe
- Department of Community Medicine, University of Medical Sciences, Ondo State
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Bello S, Adewole DA, Asuzu MC. Job satisfaction, health and psychosocial wellbeing among medical doctors in public hospitals in Calabar, Nigeria: A qualitative study. Niger J Med 2019. [DOI: 10.4103/1115-2613.278599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Background: In the hospital, authority does not usually comes from a single person nor is it exercised in a single chain of command as is obtainable in most formal organizations. Doctors exercise substantial authority within the organizational structure of the hospital and therefore enjoy high autonomy in the hospital setting. This nature of autonomy within the medical and its allied professions has the propensity to incite conflicts within the hospital settings. The study thus sought to examine how the relationship of authority and influence between doctors and nurses within the hospital organization generates conflicts and to evaluate the effectiveness of managerial procedures utilized to resolve doctor–nurse conflict in the selected hospitals. Methods: Semi-structured questionnaires were self-administered to 323 health workers who were sampled from one secondary and the only one tertiary hospital in the state at the time. Focus group discussions (FGDs) were conducted with three groups each of doctors and nurses in the selected hospitals. The organograms of both organizations were also reviewed to evaluate structural relationships of authority between doctors and nurses. Data were analyzed using unadjusted odd ratios at 95% level of significance. Results: Respondents were also twice likely to attest that the command structure and its ability to resolve conflicts was below average in assessment (odds ratio [OR] – 2.05; 95% confidence interval [CI] – 1.27–3.29). Undue advantage (partisan approach) for a particular group by management to conflict resolution was thrice likely to be practiced in both hospitals but more in state hospital compared to the federal medical center (OR – 2.93; 95% CI – 1.54–5.58). Some findings from respondents in the FGDs revealed lackadaisical approach by the management in tackling conflicts among health workers. Conclusion: Doctor–nurse conflict is caused by several organizational and managerial factors. Hospital management must understand the interplay of these factors and institute appropriate managerial policies to tackle the problem appropriately.
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Affiliation(s)
- Taiwo A Obembe
- Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ademola T Olajide
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Michael C Asuzu
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Obembe TA, Adenuga WU, Asuzu MC. Determinants of wasting among schoolchildren in a Southwestern state of Nigeria: Implications to strengthen the nutritional component of primary health-care model. J Family Med Prim Care 2018; 7:671-677. [PMID: 30234036 PMCID: PMC6132000 DOI: 10.4103/jfmpc.jfmpc_324_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Wasting is linked to about one-third of mortality among school-age children. More studies have centered on stunting among under-five children, with few documented studies exploring comparability and determinants of wasting among school pupils in southwestern Nigeria. This study aimed to investigate the comparability and determinants of wasting among schoolchildren in rural and urban communities of Obafemi-Owode local government area, Ogun State, Nigeria. METHODS A cross-sectional study utilizing a quantitative approach was carried out among children both in rural and urban primary schools. Data were collected through interviewer-administered questionnaires. EPI-INFO version 6.03 was used, children were classified as wasted if weight-for-height Z-scores were <2 standard deviations below the National Center for Health Statistics/World Health Organization median. Associations were tested using t-tests and Chi-square test, while predictors were examined with logistic regression at 95% level of significance. RESULTS Male gender was predominant (54.6%). Significantly more pupils from rural areas lived with grandparents and other guardians (60.3%) compared to their urban counterparts (39.7% P = 0.005). Pupils from rural schools were four times more likely to be wasted compared to those located in urban regions (odds ratio [OR]: 4.2; 95 confidence interval [CI] = 2.24-7.69). Male pupils were twice likely to be wasted compared to the female pupils (OR: 2.08; 95 CI = 1.22-3.55). CONCLUSION Conclusively, the study revealed that the prevalence of wasting was higher among children from rural schools than in urban schools. There is an urgent need to implement viable interventions and policies that address nutritional deficiencies in primary school pupils, particularly in rural areas.
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Affiliation(s)
- Taiwo A. Obembe
- Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Winifred U. Adenuga
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Michael C. Asuzu
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Tijani MK, Babalola OA, Odaibo AB, Anumudu CI, Asinobi AO, Morenikeji OA, Asuzu MC, Langer C, Reiling L, Beeson JG, Wahlgren M, Nwuba RI, Persson KEM. Acquisition, maintenance and adaptation of invasion inhibitory antibodies against Plasmodium falciparum invasion ligands involved in immune evasion. PLoS One 2017; 12:e0182187. [PMID: 28787025 PMCID: PMC5546579 DOI: 10.1371/journal.pone.0182187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 07/13/2017] [Indexed: 11/18/2022] Open
Abstract
Erythrocyte-binding antigens (EBAs) and P. falciparum reticulocyte-binding homologue proteins (PfRhs) are two important protein families that can vary in expression and utilization by P. falciparum to evade inhibitory antibodies. We evaluated antibodies at repeated time-points among individuals living in an endemic region in Nigeria over almost one year against these vaccine candidates. Antibody levels against EBA140, EBA175, EBA181, PfRh2, PfRh4, and MSP2, were measured by ELISA. We also used parasites with disrupted EBA140, EBA175 and EBA181 genes to show that all these were targets of invasion inhibitory antibodies. However, antigenic targets of inhibitory antibodies were not stable and changed substantially over time in most individuals, independent of age. Antibodies levels measured by ELISA also varied within and between individuals over time and the antibodies against EBA181, PfRh2 and MSP2 declined more rapidly in younger individuals (≤15 years) compared with older (>15). The breadth of high antibody responses over time was more influenced by age than by the frequency of infection. High antibody levels were associated with a more stable invasion inhibitory response, which could indicate that during the long process of formation of immunity, many changes not only in levels but also in functional responses are needed. This is an important finding in understanding natural immunity against malaria, which is essential for making an efficacious vaccine.
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Affiliation(s)
- Muyideen K. Tijani
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Oluwatoyin A. Babalola
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Alex B. Odaibo
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Chiaka I. Anumudu
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Adanze O. Asinobi
- Department of Paediatrics, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Olajumoke A. Morenikeji
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Michael C. Asuzu
- Department of Preventive Medicine and Primary Care, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Christine Langer
- The Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia
| | - Linda Reiling
- The Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia
| | - James G. Beeson
- The Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia
| | - Mats Wahlgren
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Roseangela I. Nwuba
- Cellular Parasitology Programme, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Kristina E. M. Persson
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
- Department of Laboratory Medicine, University Hospital, Lund University, Lund, Sweden
- * E-mail:
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Ayodapo AO, Sekoni OO, Asuzu MC. Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria. S Afr Fam Pract (2004) 2017. [DOI: 10.4102/safp.v59i2.4523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Intimate partner violence (IPV) is a significant public health problem. Despite being a phenomenon that occurs globally, few studies have reviewed the issue of intimate partner violence among pregnant women as it relates to disclosure of abuse. This study sets out to determine the prevalence and pattern of disclosure of intimate partner violence among pregnant women attending antenatal clinic in Oyo East Local Government of Oyo State.
Methods: A descriptive cross-sectional study among pregnant women aged 18–49 years. A total of 350 pregnant women in the sole secondary health care facility and 3 out of the 18 primary health care facilities randomly selected by balloting were consecutively recruited. A pre-tested semi-structured questionnaire adapted from the WHO Multi-Country Study on Women’s Health and Domestic Violence was used to collect data. Data were analysed with SPSS® version 16.
Results: Of 252 (72.0%) women who had been exposed to violence by their partner in pregnancy, 72 (28.6%) disclosed their IPV experience. The experience was disclosed to relatives, friends and religious leaders. Of the 72 that disclosed their IPV experience, 31 (43.1%) reported for the purpose of seeking redress through religious or local leaders, healthcare professionals and law enforcement agencies.
Conclusion: Intimate partner violence is common among pregnant women, but a culture of silence still persists, making identification of the exposed difficult. These data may encourage healthcare providers to include screening for IPV in the curriculum of the antenatal care.
(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272245
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Ayodapo AO, Sekoni OO, Asuzu MC. Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2016.1272245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- AO Ayodapo
- Department of Family Medicine, Federal Medical Centre, Birnin-Kebbi, Kebbi State, Nigeria
| | - OO Sekoni
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - MC Asuzu
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Asuzu CC, Elumelu-Kupoluyi T, Asuzu MC, Campbell OB, Akin-Odanye EO, Lounsbury D. A pilot study of cancer patients' use of traditional healers in the Radiotherapy Department, University College Hospital, Ibadan, Nigeria. Psychooncology 2015; 26:369-376. [PMID: 26577066 DOI: 10.1002/pon.4033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 09/10/2015] [Accepted: 10/16/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This descriptive cross-sectional study assessed cancer patients' use of traditional healers, the association between delay in coming to this clinic and patients' use of traditional healers, reasons cancer patients use western medicine after trying traditional treatment and the cost of obtaining traditional treatment. METHODS Participants were made of 400 consecutive and consenting new patients in the Department of Radiotherapy, University College Hospital (UCH), Ibadan. A validated interviewer-administered semi-structured questionnaire was used for data collection. Data was analyzed using descriptive and inferential statistics. Focus group discussions were held with some of the clients as well as the traditional healers. RESULTS It showed that 34.5% of the patients patronized traditional healers, while 65.5% used only hospitals. The most common reason given among patients who patronized traditional healers for doing so was their desire to be healed and to be rid of pains (45.9%), while the most common reason they opt for western medicine afterwards was lack of improvement in their health condition (70.1%). The cost of traditional treatment for cancer ranged between no cost to N5,000 (that is approximately $31.25 @ $1 = N160) to be treated. The cost of orthodox care would range from a minimum of N40,000 to several millions of naira. CONCLUSIONS Patients patronize traditional healers to be rid of pains; hence physicians should endeavor to control cancer-related symptoms, especially pains as the patients await diagnosis. Also, the low cost of obtaining traditional treatment, regular assurance of cure and other assistances given to them, could be an enticing factor in its use. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- C C Asuzu
- Department of Guidance & Counselling, University of Ibadan, Ibadan, Nigeria.,Department of Radiotherapy, University of Ibadan, Ibadan, Nigeria
| | | | - M C Asuzu
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - O B Campbell
- Department of Radiotherapy, University of Ibadan, Ibadan, Nigeria
| | - E O Akin-Odanye
- Department of Radiotherapy, University of Ibadan, Ibadan, Nigeria
| | - D Lounsbury
- Department of Population Science, Albert Einstein College of Medicine, New York, USA
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Adebayo AM, Asuzu MC. Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria. Afr J Prim Health Care Fam Med 2015; 7:735. [PMID: 26245600 PMCID: PMC4564905 DOI: 10.4102/phcfm.v7i1.735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 02/09/2015] [Accepted: 10/08/2014] [Indexed: 11/17/2022] Open
Abstract
Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation.
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Affiliation(s)
- Ayodeji M Adebayo
- Department of Preventive Medicine and Primary Care, College of Medicine, University of Ibadan.
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Abstract
Background: The concept of the street child in rural communities
has received little attention. This study describes the sociodemographic
characteristics of the street children found in a group
of rural communities. Method:
This descriptive study is nested in a cross sectional
analytical study of street children in a group of rural communities
undergoing urbanization. A cluster sample of street children as
defined by the United Nations was taken in the seven chosen
political wards. Results:
Majority of the street children (88.9%) were within the
age group 15-17 years with more males (58.3%) than females
(41.7%). Up to 64.7% had attained secondary level education while
only 3.9% had no formal education. A high percentage, (61.4%)
were still attending school and 15.8% had no work. Of those who
work on the streets, being an apprentice (16.4%), petty trading
(15.0%), part-time driving (9.5%) and car washing (5.0%) were
the commonest types of work. Of those still schooling, 41.6%
had no form of part-time work on the streets. None of the street
children lived on the street with 65% still living with parents.
However, 75% had been involved in the street life for 1-2 years
with a median time of 2 years. More than 30% of their parents
work outside town. Conclusion:
The street child in rural communities differs from
the urban perception which often has to do with those living rough
and existing outside the family framework. More studies would
be needed on the driving factors for street life in rural communities
undergoing urbanization.
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Affiliation(s)
- Eme T Owoaje
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - A O Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan
| | - M C Asuzu
- Department of Community Medicine, College of Medicine, University of Ibadan
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Adebiyi AO, Owoaje O, Asuzu MC. Relationships as determinants of substance use amongst street children in a local government area in south-western Nigeria. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2008.10873761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Otokpa AO, Asuzu MC. A cross-sectional study for algorithm in diagnosing simple uncomplicated malaria in children in health facilities without laboratory backup in Nigeria. Niger Postgrad Med J 2014; 21:115-121. [PMID: 25126864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS AND OBJECTIVES The objective of this study was to determine an algorithm for malaria diagnosis using presenting signs and symptoms of children (aged 0-13 years) with uncomplicated malaria in Gwagwalada Area Council of Abuja, Nigeria. MATERIALS AND METHODS A validated questionnaire was used to obtain relevant data from 400 children diagnosed presumptively of simple malaria by clinicians and 400 other children of similar sex and age considered as not having malaria. Giemsa-stained thick blood films were used to determine parasitaemia. Data obtained was analysed using Epi-Info version 3.3.2. RESULTS Thirty-eight per cent of children with presumptive diagnosis of malaria had parasitaemia. Fever, rigor, vomiting, jaundice, pallor and spleen enlargement had significant statistical relationship with parasitaemia on bivariate analysis, but only fever (p=0.00), rigor (p=0.00), vomiting (p=0.00), and pallor (p=0.00) maintained the relationship when subjected to logistic regression analysis. But these symptoms individually had low sensitivity and/or specificity. Candidate algorithms (combinations of symptoms) were then successively subjected to bivariate, logistic and validity analyses. Fever with vomiting gave the highest sensitivity (56.2%), specificity (76.4%) and PPV (60.0%) and were therefore adopted as the algorithm of choice. CONCLUSION AND RECOMMENDATIONS Children presenting with fever and vomiting without any other obvious cause in health facilities without laboratory support in the research area should receive antimalarial treatment, to help reduce the malaria scourge. This algorithm should be field-tested and if found reliable should be adopted to ease the problem of malaria diagnosis in peripheral health facilities.
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Affiliation(s)
- A O Otokpa
- Department of Community Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
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Bello S, Asuzu MC, Ofili AN. JOB SATISFACTION AND PSYCHOLOGICAL HEALTH OF MEDICAL DOCTORS IN CALABAR, SOUTHERN NIGERIA. East Afr Med J 2013; 90:189-194. [PMID: 26859025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria. OBJECTIVE To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria. DESIGN A cross-sectional descriptive survey. SETTING Three major public hospitals in Calabar, Nigeria. SUBJECTS Medical doctors who had worked for at least six months in the hospitals. RESULTS Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statistically significant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder. CONCLUSION Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health.
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Affiliation(s)
- S Bello
- Department of Community Medicine, University of Calabar Teaching Hospital, P. O. Box 1750i Calabar, Nigeria.
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Otokpa AO, Lawoyin TO, Asuzu MC. HIV/AIDS-related knowledge and misconceptions among women attending government-owned antenatal clinics in Gwagwalada Area Council of Abuja, Nigeria. Afr J Reprod Health 2013; 17:114-121. [PMID: 24069740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study assessed the level of knowledge and misconceptions about HIV/AIDS transmission and prevention among women. Using a semi-structured pretested questionnaire we obtained relevant data from 420 respondents in five randomly selected antenatal clinics (ANCs) in Gwagwalada Area Council (GAC) of Abuja, Nigeria. Knowledge about the existence of HIV/AIDS was high (92.8%). Only 52.1% knew the cause of AIDS and 58.6% were aware that AIDS had no cure. About twenty percent of respondents believed that breast-milk could not transmit HIV and 27.9% were unaware that condom protects against HIV. Only 33.3% were aware that HIV infected persons may look and feel healthy. Mothers with at least secondary level education had significantly higher knowledge scores on HIV/AIDS transmission (X2 = 14.8, p = 0.01) than less educated mothers and less educated mothers were more likely to relate HIV infection to past misdeeds (X2 = 13.6, p = 0.01). Significant misconception concerning HIV transmission existed in the study population. More community outreach programmes to intensify HIV education and counseling in GAC is required.
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Affiliation(s)
- Aboh O Otokpa
- Department of Community Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja.
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Abstract
Background: Hitherto efforts to implement data driven prevention guidelines for hospital-acquired infections (HAI) in Nigeria have been limited by the inadequate knowledge of the risks of these infections. This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control unit of the University College Hospital, Ibadan, Nigeria, was done for the years 2005-09. For the 5 years studied 22,941 in-patients were reviewed and the data of those who developed infections during admission were retrieved and analyzed. The prevalence, types, and causative organisms of HAI were determined. The chi-square test was used to evaluate associations. Results: The prevalence of HAI over the 5-year period was 2.6% (95% CI: 2.4–2.8). Surgical and medical wards had the most infections (48.3%) and (20.5%) respectively. Urinary tract infection (UTI) and surgical site infection (30.7%) were the most prevalent (43.9%) HAI. UTIs were significantly higher in surgical and medical wards, surgical site infections in obstetrics and gynecology wards, and soft tissue infections and bacteremia in pediatric wards (P<0.05). Gram-negative infections occurred about four times as often as gram-positive infections with Klebsiella sp. and staphylococcus aureus being the predominant isolates (34.3%) and (20.1%) respectively. Conclusion: Efforts to limit HAI should be guided by local surveillance data if progress is to be made in improving the quality of patient care in Nigeria.
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Affiliation(s)
- O K Ige
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
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Lasebikan VO, Owoaje ET, Asuzu MC. Social network as a determinant of pathway to mental health service utilization among psychotic patients in a Nigerian hospital. Ann Afr Med 2012; 11:12-20. [PMID: 22199042 DOI: 10.4103/1596-3519.91010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The main objectives of the study were to determine the relationship between social network and pathway to service utilization among psychotic patients. MATERIALS AND METHODS This descriptive study was carried out in a psychiatric unit in a general hospital in South West Nigeria. Using structured questionnaires, primary data were collected from 652 psychotic patients on their social network, health behaviors and pathway to current service use. Logistic regression analysis was used to assess the effect of social network on patients' use of services, controlling for sociodemographics, health and functional status. RESULTS Mean age of the respondents was 29.0 ± 7.5 years, range 14-58 years, males constituted 52.6%. Regarding pathway to services, alternative sources of care such as priests, spiritualists, natural therapists, herbalists, was the first port of call for 78.9% of respondents. Family dominated the social network in 51.1% of patients. The presence of some social network and social support structures were significantly associated with the use of general medical and specialty psychiatric services for patients with schizophrenia (P = 0.03), schizoaffective disorder (P = 0.02), bipolar I disorder (P = 0.01), but not with major depression and symptoms of psychological distress. CONCLUSIONS Findings indicate that social support and social network enhanced utilization of mental health services for psychiatric patients except for those with psychotic depression or those with symptoms of psychological distress. In addition, alternative sources of care are still relevant in mental health service delivery in South West Nigeria.
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Okanlawon FA, Asuzu MC. Effect of peer education intervention on secondary school adolescents' reproductive health knowledge in Saki, Nigeria. Afr J Med Med Sci 2011; 40:353-360. [PMID: 22783685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Adolescents' reproductive health needs and problems have become contemporary concerns globally. Of great concern is the high rate of sexually transmitted infections including HIV/AIDS arguably influenced by lack of reproductive health knowledge. OBJECTIVE The study aimed at examining the effect of peer education on school adolescents' reproductive health knowledge in Saki, Southwestern, Nigeria, in a nurse-led concurrently controlled community interventional study. MATERIALS AND METHOD The study employed pre - and post - intervention (quasi - experimental) design. The experimental group was exposed to the peer education programme for six months. Pre and post differential data in the experimental and control groups were compared and analysed using analysis of covariance. RESULTS The intervention had significant effect on adolescents in the experimental group compared with the control group in the area of knowledge of reproductive health issues (F1,519) = 37.117, (p < .05). CONCLUSION The intervention significantly improved the adolescents' reproductive health knowledge. It is recommended that community health nurses as well as other community workers should embrace peer education approach as a strategy to empower adolescents with reproductive health knowledge.
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Affiliation(s)
- F A Okanlawon
- Departments of Nursing, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Ifesanya JU, Ifesanya AO, Asuzu MC, Oke GA. Determinants of good oral hygiene among pregnant women in Ibadan, south-western Nigeria. Ann Ib Postgrad Med 2011; 8:95-100. [PMID: 25161475 PMCID: PMC4111021 DOI: 10.4314/aipm.v8i2.71820] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: The need to attain and maintain good
oral hygiene among pregnant women cannot be over emphasized
as periodontal diseases in pregnancy have been linked with poor
pregnancy outcomes. This study assessed the variables that affect
oral hygiene status among pregnant women in a south-western
Nigerian locality. Methodology: Four hundred and five pregnant Nigerian women
were assessed for their oral hygiene status using the Oral Hygiene
Index-Simplified. Demographic and pregnancy statistics were also
obtained and the relationships between these and oral hygiene status
were determined. Results: The mean age was 25.35 ± 5.02 years. Most of the women
(96.0%) had never visited a dentist or any other oral health care
provider and only 12.5% of those who had been attended by dental
care givers have ever had professional dental cleaning. The oral
hygiene status appeared to worsen as parity increased (p=0.047)
while the use of the toothbrush and paste was associated with good
oral hygiene (p=0.007). Higher education was associated with use
of the tooth brush and paste (p=0.046) and good oral hygiene (p=
0.001). Conclusion: The positive effect of education on oral hygiene
practices is highlighted in this study. However there is still need
for proper health enlightenment in this population with regards to
use of the available oral health care facilities.
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Adinma ED, Brian-D Adinma JI, Obionu CC, Asuzu MC. Effect of government-community healthcare co-financing on maternal and child healthcare in Nigeria. West Afr J Med 2011; 30:35-41. [PMID: 21863587 DOI: 10.4314/wajm.v30i1.69882] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Effective maternal and child healthcare delivery requires a proper and adequate funding of the health sector. OBJECTIVE To determine the effect of government-community healthcare co-financing on maternal and child healthcare services' delivery. METHODS A descriptive, cross-sectional study with an intervention component, conducted amongst 240 women from Igboukwu (intervention area), and Ekwuluobia (control area), of Anambra State of Nigeria. RESULTS The biosocial characteristics of the respondents were essentially similar. Better utilization of health services occurred in the intervention area post-intervention. Quality of service from intervention clients' perspective showed significant improvement post-intervention. Distance less than five km, transportation cost less than N40, and maternal education above secondary level impacted positively on utilization of maternal and child health services. Acceptability of the scheme was better for the intervention facility evident from the higher number of respondents showing "willingness to join", and "willingness to pay". CONCLUSION Health sector funding partnership, positively impacts on maternal and child health services. Government's total commitment, backed with legislation, and community mobilization, will sustain the scheme.
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Affiliation(s)
- E D Adinma
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, P.M.B. 5025, Nnewi, Anambra State, Nigeria
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Fajola A, Asuzu MC, Owoaje ET, Asuzu CC, Ige OK, Oladunjoye OO, Asinobi A. A rural-urban comparison of client-provider interactions in patent medicine shops in South west Nigeria. Int Q Community Health Educ 2011; 32:195-203. [PMID: 23353561 DOI: 10.2190/iq.32.3.c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The increasing prominence of patent medicine vendors (PMVs) in healthcare provision makes information about how they operate of interest. This study assessed consumers' behavior and PMVs' performance in the treatment of childhood illnesses in rural and urban communities in South West Nigeria. Non-participatory observations were carried out in 163 licensed patent medicine stores in Oyo State, Nigeria. Many PMV shops (70.6% rural and 61.9% urban; p = 0.141); stocked non proprietary drugs. Clients often requested for drugs by name (75.4% urban versus 62.2% rural; p = 0.002) and PMVs mostly sold drugs as requested without questions (65.3% urban 57.8% rural; p = 0.07). Inappropriate treatment practices and invasive procedures were observed more often in urban PMVs shops (p < 0.001). PMVs functioned mostly as sales persons supplying clients' drug requests. Strategies to improve PMV treatment practices should include caregiver education to be effective.
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Nwabueze SA, Adogu POU, Ilika AL, Asuzu MC, Adinma ED. Perception of quality of care in HIV/AIDS programmes among patients in a tertiary health care facility in Anambra State. Niger J Med 2011; 20:144-150. [PMID: 21970277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Continuous quality improvement is linked to the use of timely and useful feedback from clients in Human Immuno-deficiency Virus (HIV) care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction ofAnti-Retroviral Treatment (ART) services in Nigeria has significantly impacted positively on the overall well being of People Living with HIV and Acquired Immune Deficiency Syndrome (PLWHA). However, there is little understanding of their satisfaction and perception of quality of care provided. Consequently, this study was carried out to assess patients' satisfaction with ambulatory HIV/AIDS care in a tertiary health facility in Anambra State. METHODS The study design is cross-sectional. A total of 150 patients from Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi were selected using systematic sampling technique from the daily AntiRetroviral (ARV) clinic register obtained from the medical records department of the centre. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. RESULTS The mean age of the respondents was 38.3 +/- 9.1. Majority (50.7%) of the patients was married, and most of them (74.7%) were semi-skilled workers. There was a statistically significant difference in the numbers of those who spent >240 naira for transportation to the clinic, compared to those who spent < or = 240 naira (98 versus 52). Similarly, the number of subjects that spent >30 minutes are significantly larger than the number that spent < or = 30 minutes to reach the clinic (142 versus 8). Also significantly greater number of participants spend >750 naira than those who spend <750 naira on non-HIV related laboratory (20 versus 9) tests. PLWHAs in this facility were least satisfied with access to care, while they expressed greatest satisfaction with good patient care and quality of service by staff. The overall satisfaction score of the subjects was 4.04 +/- 0.33. CONCLUSION HIV patients' overall satisfaction with the services provided to them was quite high. Therefore, there is need to sustain the current level of quality of care provided to the patients and if possible improve upon it. However, efforts should be made to further decentralize ART services to make them more accessible to the growing number of PLWHAs needing care and support.
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Affiliation(s)
- S A Nwabueze
- Department of Community Medicine, Nnamdi Azikiwe University, Nnewi.
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Bekibele CO, Ajav R, Asuzu MC. Eye health of professional drivers of a Nigerian University. Niger Postgrad Med J 2009; 16:256-259. [PMID: 20037620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Safe driving and road traffic accident prevention could be attained through ensuring good condition of vehicles, the road as well as the physical and mental state of the driver among others Objectives: To determine the ocular health status of professional drivers of the University of Ibadan, Nigeria METHODS A cross sectional survey of all drivers in the employment of the University of Ibadan, excluding the College of Medicine, was carried out between March and June 2002 at the University Medical Centre and the eye clinic of the University College Hospital, Ibadan. RESULTS One hundred and ninety seven all male drivers were screened. Their ages ranged from 31 to 64 years (mean 48.3 +/-5.9yr). Less than satisfactory presenting (functional) binocular visual acuity (< 6/18) was found in 11(5.6%) of the drivers. With refraction no driver had binocular vision of <6/18, but three drivers each had corrected visual acuity in the worse eye of 6/12, 6/18 and 6/36 respectively. The commonest visual problems were presbyopia 100 (50.8%), and refractive errors 38 (19.3%). Other ocular pathologies included pterygium 11 (5.6%), optic atrophy 9 (5.0%), colour vision defects 7 (3.6%) cataract 2 (1.0%), age related macular degeneration 4 (2.0%), glaucoma 3 (1.5%) retinal scar 2 (1.0%), exotropia 1 (0.5%), and pingueculum 1 (0.5%), CONCLUSION Periodic screening of driver population of any establishment is a worthwhile task that may help to identify potentially blinding or visually impairing conditions such as glaucoma and refractive-error which can be promptly treated.
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Affiliation(s)
- C O Bekibele
- Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria
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Adinma ED, Ezeama C, Adinma JIB, Asuzu MC. Knowledge and practice of universal precautions against blood borne pathogens amongst house officers and nurses in tertiary health institutions in Southeast Nigeria. Niger J Clin Pract 2009; 12:398-402. [PMID: 20329680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To examine the knowledge and practice, as well as factors influencing universal precautions practices amongst Nigerian House officers and Nurses. METHODS A Cross-sectional descriptive study. Sample selection was by stratified random sampling. Information was elicited using pretested, structured, self-administered questionnaire. Data were analyzed using EPI-info. RESULTS Most Doctors, 66.6%, were aged 26-30 years while the Nurses, 41.1%, were aged 40 years. 57.6% of the Doctors were males, while 85.7% of the nurses were females. Knowledge of universal precautions measures was high for both categories of respondents--97.0% for doctors and 92.0% for nurses, although practice was better for the nurses, 75.0%, compared to the doctors, 15.2%, p < 0.05. The most important factor influencing universal precautions practice is the lack of provision of adequate protective equipments. Other factors, all of which show significant difference between the doctors and nurses (p < 0.05), include carelessness; lack of display of universal precautions guidelines; emergency nature of the procedure; insufficient water supply; patient perceived to be at low risk of blood borne pathogens; pressure of time; and universal precautions equipments interfering with technical skills. CONCLUSIONS Although knowledge of universal precautions is high for both house officers and nurses, practice is however better amongst the latter than the former. The effective knowledge and practice of universal precautions amongst hospital workers are of absolute necessity to prevent infections from blood and body fluid pathogens.
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Affiliation(s)
- E D Adinma
- Department of Obstetrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
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Asuzu MC. Errors on which doctors in Nigeria need to be educated about. Niger J Clin Pract 2009; 12:343-344. [PMID: 19803043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Akpabio II, Asuzu MC, Fajemilehin BR, Ofi B. Effects of parental involvement in HIV/AIDS preventive education on secondary student knowledge about transmission and prevention in Akwa Ibom State, Nigeria. Int Q Community Health Educ 2009; 29:71-87. [PMID: 19342358 DOI: 10.2190/iq.29.1.f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated HIV/AIDS preventive health education involving nurses alone (IG1) and another involving both nurses and trained parents/ guardians (IG2) on students' knowledge of HIV/AIDS' transmission and prevention in Akwa Ibom State, Nigeria. Subjects included 339 students selected through a multistage and stratified random sampling technique. A pre-test/post-test intervention design with control group was used. Data were obtained using questionnaire, and analysis involved the use of analysis of covariance, multiple classification analysis, and Scheffe's post-hoc test. Results show that students exposed to parental involvement had significantly better mean scores on knowledge of prevention (IG2: x=7.51; IG1: x=6.96 control: x=3.82). Furthermore, although the male students had significantly higher mean score with intervention involving only nurses, the females had higher mean score with intervention involving parents/guardians. It is recommended that parents/guardians should be trained and involved in HIV/AIDS' preventive education of secondary school students.
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Affiliation(s)
- I I Akpabio
- Department of Nursing Science, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
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30
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Adebiyi AO, Asuzu MC. Condom use amongst out of school youths in a local government area in Nigeria. Afr Health Sci 2009; 9:92-97. [PMID: 19652742 PMCID: PMC2707047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Reported low condom use amongst out of school requires studying the context in which condom use occurs. METHODS A cross sectional study of 350 out-of-school youth aged 15-24 years in a local government area of Nigeria was enrolled using cluster sampling. RESULTS Those who had ever had sexual intercourse were 74.9%. Of these, 56.5% used no protection while 29.0% used condoms. Up to 78.6% have had sex within the preceding 12 months with 38.9% condom use. The commonest reason for non-condom use was that it reduces sexual enjoyment. Those who believed a single unprotected sexual exposure may result in HIV infection reported more condom use than those who believed otherwise (42% vs 27.2%, P<0.05). Those who had prior discussion with their partners on HIV/AIDS reported more condom use compared to those who had not (50% vs 25%, P<0.05). Also, those who had sexual intercourse occurring as a spontaneous event reported less condom use compared to those who have previously discussed about the possibility of having sex (68.0% vs 51.8%, P<0.05). CONCLUSION Condom use is likely to occur within relationships where opportunity exists for discussion on sexual matters. Thus, further studies are needed on communication and condom use within sexual partnerships.
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Affiliation(s)
- A O Adebiyi
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria. Nigeria.
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Akpabio II, Asuzu MC, Fajemilehin BR, Ofi AB. Effects of school health nursing education interventions on HIV/AIDS-related attitudes of students in Akwa Ibom State, Nigeria. J Adolesc Health 2009; 44:118-123. [PMID: 19167659 DOI: 10.1016/j.jadohealth.2008.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 04/02/2008] [Accepted: 05/12/2008] [Indexed: 11/29/2022]
Abstract
PURPOSE One of the greatest challenges facing school nurses is that of identifying and using appropriate strategies to meet the health education needs of adolescents in regard to prevention of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study examined the effects of HIV/AIDS preventive health education with parental involvement on students' attitude toward HIV/AIDS prevention in Akwa Ibom State, Nigeria. METHODS The study population comprised students from three of nine secondary schools in the study area. The three schools were randomly assigned as Intervention Group 1 (IG1), involving nurses only; Intervention Group 2 (IG2), involving both nurses and parents (IG2); and a control group. A pretest/post-test intervention design was used. A 29-item, validated questionnaire was the instrument for data collection. Sampling involved multistage and stratified random technique to select 120 subjects from each of the three selected schools, with a total of 360 subjects representing 8.3% of the study population. From this number, 339 (94.2%) provided sufficient data for analysis. Data analysis involved analysis of covariance and the Scheffé post hoc test determined at the .05 significance level. RESULTS Results show significant effect of intervention on students attitudes toward preventive measures (F = 234.27, p < .001 *). The intervention that involved nurses only was found to be a more potent strategy in providing favorable attitudes toward HIV/AIDS prevention (IG1 mean, 20.59; IG2 mean, 19.20; control mean, 12.34). Attitudes were influenced by older age but not by gender. CONCLUSION Health education efforts aimed at improving HIV/AIDS-related attitudes should not only focus on children but also on parents so that they in turn could assist to improve on health workers' efforts in educating the children.
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Affiliation(s)
- Idongesit I Akpabio
- Department of Nursing Science, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
| | - Michael C Asuzu
- College of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | | | - Abosede B Ofi
- Department of Nursing, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Oyo State, Nigeria
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Asuzu MC. Post-graduate medical education in Nigeria - an overview. Niger Postgrad Med J 2008; 15 Suppl 1:31-32. [PMID: 19842283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Michael C Asuzu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
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Abstract
Wood dusts are known to cause respiratory disorders like rhinitis and asthma. This study was therefore done to determine the magnitude of the problem among woodworkers in south-eastern Nigeria exposed to high level of wood dust. Five hundred and ninety one woodworkers were selected using a stratified random sampling. The prevalence of woodwork-related rhinitis and asthma were then observed in the study population. Also the peak expiratory flow rate (PEFR) of each woodworker was obtained. The prevalence of occupational rhinitis was 78%, while that of asthma was 6.5%. As period of woodwork increased the prevalence of rhinitis and asthma increased (rhinitis: chi2 trend = 53.015, df = 1, P = 0.000). For asthma, chi2 trend = 19.721, df = 1, P = 0.000). Also the PEFR significantly became low with increasing years of exposure to woodwork (chi2 trend = 75.965, df = 1, P = 0.000). In conclusion the prevalence of rhinitis and asthma in woodworkers was high and significantly increased with years of working as a woodworker.
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Affiliation(s)
- E N Aguwa
- Department of Community Medicine, University of Nigeria Teaching Hospital, P.M.B. 01129, Enugu, Nigeria.
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34
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Amoran OE, Asuzu MC, Osungbade KO. Need assessment for postgraduate training in public health in Nigeria. Ann Ib Postgrad Med 2007. [DOI: 10.4314/aipm.v1i1.39102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
BACKGROUND The degree to which ocular morbidity affects workers productivity in the developing countries has not been studied adequately. A federal government research institute based in Lagos introduced an annual health screen for all its workers, which included eye tests. This provided an opportunity to study the pattern of ocular conditions among workers who were 30 years and above, and to determine the effect of eye diseases on the workers productivity. STUDY DESIGN Detailed eye examination including refraction, was done on every respondent at the institution's clinic by an ophthalmologist. A questionnaire on ocular health status and occupational history was administered independently by an ophthalmic nurse. Sickness absenteeism, use of the clinic were obtained from clinic records, and the results were analysed. RESULTS The common ocular conditions were uncorrected or poorly corrected refractive error, uncorrected or poorly corrected presbyopia and allergic. conjunctivitis. Glaucoma, maculopathy and optic atrophy were causes of severe visual impairment or blindness in 1.9 % of the subjects. Absenteeism and clinic use were more common in subjects with ocular morbidity than those with non-ocular morbidity. Subjects with ocular morbidity had more illnesses, absenteeism and used the clinic more. CONCLUSION Ocular problems which reduce worker's productivity are prevalent among the staff of the institution studied. They are mostly unrecognised.
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Affiliation(s)
- A O Ashaye
- Department of Ophthalmology, College of Medicine, University of lbadan, Nigeria.
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36
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Ijadunola KT, Erhabor GE, Onayade AA, Ijadunola MY, Fatusi AO, Asuzu MC. Pulmonary functions of wheat flour mill workers and controls in Ibadan, Nigeria. Am J Ind Med 2005; 48:308-17. [PMID: 16167348 DOI: 10.1002/ajim.20219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The impact of grain dust exposure on lung functions of grain handlers in Nigeria has remained largely undocumented. Lung functions of wheat flourmill workers and control subjects were assessed, and the prevalence of lung function abnormalities was compared among the occupational groups. METHODS Study subjects consisted of 91 flour-millers, 30 matched internal controls from the maintenance unit of the same flourmill factory and 121 matched external controls. A cross-sectional analytical design is utilized; data were collected using structured interviews, anthropometric measurements, spirometry, and area dust sampling. RESULTS The flour-millers recorded significantly lower mean lung functions compared with control subjects (P < 0.05), for FEV(1) and FVC, when observed values were expressed as percentages of predicted normal values. Furthermore, 29% of flour-millers, compared with 15% of external controls and 10% of internal controls, presented with at least one abnormal test result of ventilatory function. CONCLUSIONS The study concluded that wheat flour-mill workers in Nigeria are at an increased risk of developing abnormalities of lung functions compared with control subjects, and the dominant pattern of respiratory disease among them is airway obstruction.
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Affiliation(s)
- K T Ijadunola
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria
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37
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Ofili AN, Asuzu MC, Isah EC, Ogbeide O. Job satisfaction and psychological health of doctors at the University of Benin Teaching Hospital. Occup Med (Lond) 2004; 54:400-3. [PMID: 15347778 DOI: 10.1093/occmed/kqh081] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Studies on job satisfaction and health have mainly been carried out among Caucasian populations. Similar studies are lacking in Nigeria. AIM To investigate the level of job satisfaction and its relationship to psychological disorder amongst Nigerian doctors. METHODS All 190 doctors at the University of Benin Teaching Hospital were invited to participate in a cross-sectional study. The respondents completed two self-administered questionnaires, a specifically designed (25-item) questionnaire and a standard instrument--the General Health Questionnaire (GHQ 28). RESULTS One hundred and fifty-two doctors responded, giving a response rate of 80%. Twenty-one (14%) doctors had a GHQ score of 4 and above, and were at increased likelihood of having a psychological disorder. Fifty-four per cent were either very dissatisfied or dissatisfied with their jobs, while 30% were very satisfied or satisfied with their jobs. The proportion of doctors with GHQ scores of 4 or above increased with the level of dissatisfaction although this was not statistically significant. The crude odds ratio of psychological disorder (GHQ score 4 and above) in dissatisfied respondents compared to satisfied respondents was 2.2 (95% confidence interval = 0.6-8.4). The odds ratio remained non-significant after controlling for the presence of adolescent children, stress outside work and length of service. CONCLUSION This study showed a high rate of job dissatisfaction among Nigerian doctors compared to their European and North American counterparts. The reason for this is not altogether obvious. Further research is needed to determine the causes of job dissatisfaction amongst Nigerian doctors.
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Affiliation(s)
- A N Ofili
- Department of Community Health, Faculty of Medicine, University of Benin, PMB 1154, Benin City, Edo State, Nigeria.
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Lawoyin TO, Asuzu MC, Kaufman J, Rotimi C, Johnson L, Owoaje E, Cooper R. Using verbal autopsy to identify and proportionally assign cause of death in Ibadan, southwest Nigeria. Niger Postgrad Med J 2004; 11:182-6. [PMID: 15505646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Reliable and accurate data remain scarce on the cause and rates of mortality among adults in sub-Saharan Africa. The Idikan Adult Mortality Study, a prospective community-based study was initiated in order to obtain the overall as well as cause-specific mortality data for a community of adults (15 years and above). Standardised verbal autopsy questionnaire was used to investigate and assign the mode and cause of death. There were 232 reported deaths in the baseline population of 4127 adults over 5 years, giving an unadjusted death rate of 11.2 per 1000 per year. Thirty-nine (16.8% ) of these death occurred suddenly. The commonest known cause of death was due to cardiovascular disease, which was responsible for 43 (18.5% ) of all deaths. It was also the commonest known cause of sudden death accounting for 30.8% of such deaths. Infection was responsible for 28 (12.1% ) deaths while injury accounted for 7 (2.6% ) deaths. Subjects, 50 years and above were more likely to die and also die suddenly than were the younger subject (p<0.0001, p<0.0001) and significantly more death occurred in males than females (6.9% versus 4.7% ) (P<0.01). Deaths were also more likely to have occurred at home and outside the hospital, increasing the probability of these deaths being underreported. Following multivariate logistic regression analysis, respondents between the age of 20 -49 years had significantly reduced risk of dying (p=0.029), while cigarette smoking significantly increased the risk of dying (p=0.012). In the absence of the urgently needed vital statistics, use of verbal autopsies is a potentially useful investigative method for identifying and assigning cause of adult deaths in a community.
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Affiliation(s)
- T O Lawoyin
- Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria.
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Asuzu MC, Ram BP, Salusalu M, Lal M, Tuqa S. Participatory operational research of the dynamics of the primary health care programme in Fiji. Pac Health Dialog 2004; 11:31-37. [PMID: 18181439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
To review the history of primary health care (PFIC) in Fiji, to find out the present PHC policy situation at all the management levels as well as the dynamics of community mobilization and PHC service extension. Findings are to be used to propose the strengthening of the implementation of PHC in the country as the case may be. This is a mail questionnaire study of managers at all three levels of the health services for the historical study and those at the district health system for the PHC implementation. Fiji has had a very active primary health care programme. Community mobilization and health service extension was initially very active and health status indices improved greatly. However, this momentum has dropped due to reduction in following the initial directives for this purpose as at the early part of the programme. It is recommended that the programme of community health service extension be restored as a matter of a national written policy. The medical officers in charge of PHC should be trained in community medicine as before, in order to regain the lost momentum.
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Affiliation(s)
- M C Asuzu
- Department of Preventive and Social Medicine, University College Hospital, Ibadan Nigeria.
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Ijadunola KT, Erhabor GE, Onayade AA, Ijadunola MY, Fatusi AO, Asuzu MC. Prevalence of respiratory symptoms among wheat flour mill workers in Ibadan, Nigeria. Am J Ind Med 2004; 45:251-9. [PMID: 14991852 DOI: 10.1002/ajim.10344] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND While investigations into occupational health problems of various groups of workers have been conducted in Nigeria, so far, very little attention has been paid to the health status of workers in the grain industry. The prevalence of respiratory symptoms among wheat flour mill workers and control groups in a medium size industrial setting in Nigeria was studied. METHODS The study employed a cross-sectional analytical design. Data were collected using structured interviews, work-site observations, and physical examination. Respondents consisted of 91 flour-millers, 30 matched internal controls from the maintenance unit of the same flour mill factory, and 121 matched external controls. RESULTS Fifty-four percent of the flour-millers reported at least one respiratory symptom compared with 30% of the internal controls (P < 0.05) and 19% of the external controls (P < 0.001). Most symptoms were significantly more prevalent among the flour-millers compared with control subjects, and this trend was more evident amongst non-smokers than ex-smokers. CONCLUSIONS The study concluded that wheat flour mill workers in Nigeria, like grain workers elsewhere, were at an increased risk of developing both pulmonary and non-pulmonary symptoms compared with control subjects. The result has implications for improved dust control measures in the grain industry in Nigeria.
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Affiliation(s)
- K T Ijadunola
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Fatiregun AA, Asuzu MC. Structured and unstructured abstracts in journal articles: a review. Niger Postgrad Med J 2003; 10:197-200. [PMID: 14692066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Abstracts in journals are important paragraphs in review or original articles, which help one to decide if such articles are worth reading. The layout and the content of abstracts have undergone tremendous changes over the years from traditional, unstructured to structured, informative format. Many journal editors abroad are moving fast with time in the adoption of the innovation, allowing only articles with structured abstracts to appear in their journals. Journals in Africa especially in Nigeria are lagging behind in this respect. This review article examines the relative advantage of structured abstracts over unstructured abstracts as documented by various reports on the subject and makes a recommendation for structuring abstracts in articles appearing in Nigerian Journals.
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Affiliation(s)
- A A Fatiregun
- Department of Community Medicine, University College Hospital, Ibadan
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Ofili AN, Asuzu MC, Okojie OH. Hospital workers' opinions on the predisposing factors to blood-related work accidents in Central Hospital, Benin City, Edo State, Nigeria. Public Health 2003; 117:333-8. [PMID: 12909423 DOI: 10.1016/s0033-3506(03)00074-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Hospital workers are prone to accidental injuries during their day-to-day activities at work. These accidental injuries are of importance because many of these predispose the workers to blood-borne infections. METHODS A total of 242 hospital workers at Central Hospital, Benin City, Edo State participated in a cross-sectional study carried out between June and August 1999 aimed at finding out the predisposing factors to blood-related work accidents. The study group consisted of 53 doctors, 34 laboratory workers and 155 nurses. All doctors and laboratory workers at Central Hospital were involved in the study, while 50% of the nursing population were involved in the study. The nurses were selected using a stratified random sampling method. The respondents completed a pretested self-administered questionnaire. RESULTS The results showed that the four main factors responsible for accidents among the hospital workers were: non-availability of protective measures; desire to hasten the procedure; type of procedure; and use of inadequate/inappropriate equipment. The major factor responsible for accidents at work among hospital workers was non-availability of protective measures. RECOMMENDATIONS It is therefore recommended that adequate materials and equipment should be provided. This study could be further validated using a qualitative study design (focus group discussions).
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Affiliation(s)
- A N Ofili
- Department of Community Health, School of Medicine, University of Benin, P.M.B. 1154, Benin City, Edo State, Nigeria.
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Ofili AN, Asuzu MC, Okojie OH. Knowledge and practice of universal precautions among nurses in central hospital, Benin-City, Edo State, Nigeria. Niger Postgrad Med J 2003; 10:26-31. [PMID: 12717461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Nurses are faced with professional hazards such as needle pricks and blood-borne infections in their day to day activities in the work place. This study is aimed at finding out the knowledge and practice of universal precautions among nurses at the Central Hospital, Benin City, Edo State, Nigeria. One hundred and fifty-five (155) nurses participated in the cross-sectional study. The nurses were selected using the stratified random sampling method. The nurses had a poor knowledge about universal precautions as only 34.2% of nurses had heard about universal precautions. There was also a poor observance of universal precautions. Knowledge of measures to be taken after the occurrence of occupational accidents/ injuries was also poor, as only 26(16.8%) nurses would report puncture injuries to the clinic, only 13(8.4%) nurses would screen patients for HIV antibody after consent when they sustain work related accident/injuries. Twelve (7.7%) nurses would screen patient to determine hepatitis B status of patient while only 8(5.2%) nurses would go for medical check-up/immunisation with hepatitis B vaccine.
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Affiliation(s)
- A N Ofili
- Department of Community Health, School of Medicine, University of Benin, P.M.B. 1154, Benin-City, Edo State, Nigeria
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Ogunnowo BE, Asuzu MC. Evaluation of rational prescribing practices of doctors and medical students at the Igbo-Ora Comprehensive Hospital, Nigeria. Niger J Med 2003; 12:39-42. [PMID: 12956006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
This study was done to determine the level of rational drug prescribing practices by doctors and medical students as well as to assess the impact of the teaching of rational drug use on the prescribing skills of students. A checklist, developed according to the key indices of a rational prescription, was used to rate prescriptions obtained from randomly selected case notes in the period 1975, 1985 and 1995 by means of a scoring system. Mean score of students increased from 5.5(out of 10) in 1975 to 7.7 in 1985(p < 0.001) but showed a significant decline to 6.8 in the period 1995(p = 0.117). Mean score of doctors was 7.1 in 1975, 6.8 in 1985(p = 0.616) and 6.8 in 1995(p = 0.910). Comparison of mean scores of doctors and students for each period revealed a significant difference only in 1975(p = 0.012) The teaching of rational drug use had improved the rational prescribing practices of medical students. There is need for a sustained effort to maintain rational drug prescribing by students and doctors in Igbo-ora hospital. Similar efforts should be made in other places in the country.
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Affiliation(s)
- B E Ogunnowo
- Department of Community Medicine, University College Hospital, Ibadan
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Lawoyin TO, Asuzu MC, Kaufman J, Rotimi C, Owoaje E, Johnson L, Cooper R. Prevalence of cardiovascular risk factors in an African, urban inner city community. West Afr J Med 2002; 21:208-11. [PMID: 12744569 DOI: 10.4314/wajm.v21i3.28031] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the epidemiological transition phenomenon, more countries are expected to move from a disease pattern dominated by infectious diseases to one characterised by non-communicable diseases. Many developing countries are contending with infectious diseases as well as non-communicable diseases, yet little is known about the prevalence of cardiovascular risk factors in poor urban communities in developing countries. The objective of this community based study was to determine the prevalence of selected cardiovascular risk factors in an urban inner city community which had been followed up prospectively from 1993 to 1998. Results show that the prevalence of hypertension (Blood Pressure BP > 160/95 mm Hg) was 12.4 percent with an age-adjusted rate of 7.4 percent. This is higher than what is found in the rural parts of the country but much lower than what is generally observed in industrialized countries of the world. Though there was no significant difference in the proportion with hypertension by gender (P > 0.05), the mean systolic BP was significantly higher for men (123.9 +/- 23.9) mm Hg) than for women (120.6 +/- 26.8 mg Hg) t = 2.93, p < 0.01. The mean diastolic BP was similarly higher for men (75.8 +/- 14.9) mm Hg than women (74.0 +/- 14.9) mm Hg t = 2.76 p < 0.01). Eight percent of the study population were obese (BMI > 30), and generally, more women than men were obese. However, at ages 15-19 significantly more males than females were obese (X2 = 73, p < 0.01). Both mean systolic and diastolic BP increased with increasing weight. When adjusting for gender, the association between hypertension and other CVD risk factors remained similar for males and females and gender was not a modifier of the factors. Of the CVD risk factors studied, Age > 40 years and obesity, were significantly associated with the presence of hypertension in this community (P < 0.0001 and P < 0.0001), smoking, alcohol intake and gender were not (P > 0.05). It is necessary to implement a national plan for the control of cardiovascular diseases in order to reduce and keep to minimum cardiovascular diseases and its complications in the country.
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Affiliation(s)
- T O Lawoyin
- Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria
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Murdoch ME, Asuzu MC, Hagan M, Makunde WH, Ngoumou P, Ogbuagu KF, Okello D, Ozoh G, Remme J. Onchocerciasis: the clinical and epidemiological burden of skin disease in Africa. Ann Trop Med Parasitol 2002; 96:283-96. [PMID: 12061975 DOI: 10.1179/000349802125000826] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
An attempt was made to assess the true public-health importance of onchocercal skin disease throughout the African region and hence provide an objective basis for the rational planning of onchocerciasis control in the area. The seven collaborative centres that participated in the study (three in Nigeria and one each in Ghana, Cameroon, Tanzania and Uganda) were all in areas of rainforest or savannah-forest mosaic where onchocercal blindness is not common. A cross-sectional dermatological survey was undertaken at each site following a standard protocol. At each site, the aim was to examine at least 750 individuals aged 5 years and living in highly endemic communities and 220-250 individuals aged 5 years and living in a hypo-endemic (control) community. Overall, there were 5459 and 1451 subjects from hyper-and hypo-endemic communities, respectively. In the highly endemic communities, the prevalence of itching increased with age until 20 years and then plateaued, affecting 42% of the population aged 20 years. There was a strong correlation between the prevalence of itching and the level of endemicity (as measured by the prevalence of nodules; r=0.75; P<0.001). The results of a multivariate logistic regression analysis showed that, at the individual level, the presence of onchocercal reactive skin lesions (acute papular onchodermatitis, chronic papular onchodermatitis and/or lichenified onchodermatitis) was the most important risk factor for pruritus, with an odds ratio (OR) of 18.3 and 95% confidence interval (CI) of 15.19-22.04, followed by the presence of palpable onchocercal nodules (OR=4.63; CI=4.05-5.29). In contrast, non-onchocercal skin disease contributed very little to pruritus in the study communities (OR=1.29; CI=1.1-1.51). Onchocercal skin lesions affected 28% of the population in the endemic villages. The commonest type was chronic papular onchodermatitis (13%), followed by depigmentation (10%) and acute papular onchodermatitis (7%). The highest correlation with endemicity was seen for the prevalence of any onchocercal skin lesion and/or pruritus combined (r=0.8; P<0.001). Cutaneous onchocerciasis was found to be a common problem in many endemic areas in Africa which do not have high levels of onchocercal blindness. These findings, together with recent observations that onchocercal skin disease can have major, adverse, psycho-social and socio-economic effects, justify the inclusion of regions with onchocercal skin disease in control programmes based on ivermectin distribution. On the basis of these findings, the World Health Organization launched a control programme for onchocerciasis, the African Programme for Onchocerciasis Control (APOC), that covers 17 endemic countries in Africa.
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Affiliation(s)
- M E Murdoch
- Department of Biology, Imperial College of Science, Technology and Medicine, Prince Consort Road, London SW7 2BB, UK.
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Osungbade KO, Asuzu MC, Kale OO. Community-based treatment of onchocerciasis with ivermectin in southwest Nigeria: dermatological response to a singledose therapy. Afr J Med Med Sci 2001; 30:352-5. [PMID: 14510119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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Asuzu MC, Singh N. Epidemiological applications: a case report of a village epidemic of gastroenteritis. Pac Health Dialog 2001; 8:110-4. [PMID: 12017811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This is a case report of an epidemic of gastroenteritis which was investigated and controlled by epidemiological methods only, before laboratory investigations could be done to confirm the original epidemiological conclusions--from contaminated home made ice-cubes. The case and process are reported in order to encourage similar uses of epidemiology by field public health practitioners, especially within the district or primary health care systems and particularly in places where laboratory support are difficult to avail. The case is used also to discuss the equipments and facilities that ought to be part of the support system for every modern field public health practitioner. These should include computers, modern communication facilities and epidemiological support systems, especially senior epidemiologists; as such senior personnel are available to junior colleagues in the other areas of specialist medical practice.
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Affiliation(s)
- M C Asuzu
- Dept. of Preventive and Social Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria.
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Lal M, Asuzu MC, Salusalu MV, Singh N. Teenage pregnancies in the Rewa medical sub-division, Fiji. Pac Health Dialog 2001; 8:66-70. [PMID: 12017840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
To assess the magnitude of teenage pregnancies in the Rewa Medical Sub-division as well as the socio-demographic characteristics of the affected teenagers so as to provide a baseline for tackling the problem. The study was a 5 year retrospective study (1994-1998) of the medical records of the Nausori Maternity Unit, the only unit for these purposes in the entire Subdivision. Pregnancies that were intentionally terminated were not included, as no such data was available from these our public health services. An average of 11.1% of the 5319 obstetric patients attended to at the centre for the 5 years were teenagers. Their age range was 13 to 19 years. Proportionately more Fijians had such teenage pregnancies than their Indo-Fijian counterparts. The same was true of their being unmarried or being VDRL positive. A larger percentage of the Indian teenagers received assisted deliveries than the Fijians, but this was not statistically significant, being 6% and 4% respectively. Low birth weight was 19% among these teenagers (compared with 5.9% overall). Efforts are needed in the area of family life education to improve on aspects of teenage pregnancies. Since this is an area of education that has many conflicting values in the modern world, it is advocated that parents as well as many agencies as possible should be targets as well as join in this task in order meet the needs as due. Such education should cover and respect all the values concerned.
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Affiliation(s)
- M Lal
- Nausori Health Centre, Nausori
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Asuzu MC, Johnson OO, Owoaje ET, Kaufman JS, Rotimi C, Cooper RS. The Idikan adult mortality study. Afr J Med Med Sci 2000; 29:115-8. [PMID: 11379440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The Idikan adult mortality study is designed to explore the usefulness of the verbal autopsy methodology in the determination of cause-specific adult mortality. Such data have been largely unavailable in developing countries. Members of a stable urban community (4333 adults) were registered in their family units and followed up every 3 months to ascertain deaths, exits and new entries to the study population. Deaths were investigated by means of a verbal autopsy, which was administered by a trained interviewer to the relative closest to the decedent. Two physicians independently studied the results and assigned a cause of death, and these were then confirmed or resolved by a senior physician colleague. Hospitals where deaths occurred were visited and assignable cause of death was obtained where available and compared with the cause assigned by verbal autopsy. Only 8 of the 60 investigated deaths were confirmed to have occurred in a hospital in the first 2 years of the study. The cause of death assigned by verbal autopsy agreed moderately both between the independent coders as well as with the hospital assigned cause of death using the Kappa statistics for agreement beyond chance. We therefore concluded that verbal autopsies appear moderately useful for adult death statistics (Kappa = 0.23 to 0.1). Accumulation of more hospital deaths is needed, however, to make more definite conclusions about the validity of the technique.
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Affiliation(s)
- M C Asuzu
- Department of Preventive and Social Medicine, University College of Hospital, Ibadan, Nigeria
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