Tuberculosis Case Management and Treatment Outcome: Assessment of the Effectiveness of Public - Private Mix of Tuberculosis Programme in Kaduna State; Nigeria

Background: In an effort to increase tuberculosis (TB) case detection; the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program. Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed. Results: Except for the lower use of sputum microscopy for diagnosis; adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients; an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities; 13.1and 12.2respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7) compared to 78.6in the public health facilities. Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated

Tuberculosis Case Management and Treatment Outcome: Assessment of the Effectiveness of Public - Private Mix of Tuberculosis Programme in Kaduna State; Nigeria

Background: In an effort to increase tuberculosis (TB) case detection; the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program. Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed. Results: Except for the lower use of sputum microscopy for diagnosis; adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients; an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities; 13.1and 12.2respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7) compared to 78.6in the public health facilities. Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated

Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre; North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment; by teaching women to respond promptly when their children have fever; can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition; treatment and prevention among caregivers of children under five in Jengre; North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre- intervention stage; where 150 caregivers; were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6) had adequate knowledge concerning malaria causation; transmission; prevention and treatment. Twenty eight (56) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P.001); knowledge (P.001); malaria preven- tion practice (P

Sexual behaviour; contraceptive practice and reproductive health outcomes among Nigerian university students

Context: The continued poor reproductive health behaviour and outcomes among youths informed the investigation of the knowledge; attitudes; sexual behaviour; outcomes and care-seeking among university students in Zaria; north western Nigeria. Methods: Using a cross-sectional descriptive study design; self-administered structured questionnaires were administered to a sample of 400 undergraduate students of Ahmadu Bello University students drawn by multi-staged sampling to collect information on their reproductive health knowledge and behaviour. Findings: Knowledge of most aspects of reproductive health was high. However; gaps where found in some specific areas. Apart from ethnicity and faculty of study; no significant associations were found between knowledge and other demographic variables. Attitudes to reproductive health were generally negative. Overall; 64.1 of the respondents had had sexual intercourse; 65.4 of the males and 60.2 of the females students sexually experienced. The mean age at sexual exposure for females and males were 17.8 and 19.2 years; respectively. The mean number of lifetime sexual partners was 3.4 for males and 2.4 for the females. Of the 54.7 currently sexually active respondents; 53.5 of the males and 48.0 of the females were involved in multiple sexual relationships. Only 32.4 of the sexually exposed respondents had ever used or were currently using a method of contraception. Condom use was only 30 among the sexually active respondents with use higher among the males; however; the use was inconsistent. Use of effective contraceptives was very low. Overall; 23.3 of the respondents had experienced symptoms suggestive of sexually transmitted infections within six months preceding the study; and self medication was the predominant method of treatment. Utilization of the university health services for their reproductive health needs was found to be abysmally low. Conclusion: The gaps in reproductive health knowledge; negative attitudes; high prevalence of risky sexual activity and poor reproductive health care seeking behaviour call for mounting of educational intervention programmes and development of youth-friendly reproductive health services on campus

Utilization of maternal health services by rural Hausa women in Zaria environs; northern Nigeria: has primary health care made a difference?

Background: Expanding coverage; strengthening of; and increasing access and utilization of maternal health services is one of the key components of Nigeria's Primary Health Care (PHC) efforts ; which was started in 1986. A descriptive study was undertaken to document the level and pattern of utilization of selected maternal health services among rural Hausa women in order to assess progress in PHC implementation. Methods: A cross-sectional descriptive; quantitative study using structured interviewer-administered questionnaire was used to collect data on family planning; antenatal; post natal and delivery services utilization pattern from a total population of 655 currently married women in the reproductive age group in two predominantly Hausa villages in north-western Nigeria. The findings were compared with the baseline data obtained in the local government area at the start of PHC in 1986. Results: About two-thirds of the women had heard of family planning. There were statistically significant associations between age (P0.001); education (p0.05); occupation (p 0.001) and level of knowledge of contraceptive methods. However; utilization of modern contraceptives was very low; only 1.8 had ever used a method while 0.9 was using a method at the time of the study. Only 25.9 of the women had modern antenatal care during their last full term pregnancies with the mean age at booking of 6.6 months and an average of 5.4 visits throughout the pregnancy. There was a significant association between education and antenatal care uptake (p 0.05). Only 9 of their last deliveries took place in hospital while skilled attendants attended to 11 of the deliveries. The data showed a decline in most of the rates compared to the baseline data obtained for the local government at the inception of PHC. Conclusion: Utilization of orthodox maternal health services among the rural Hausa women is abysmally low and PHC implementation has not made any appreciable impact on their maternal health services uptake