Assessment of mothers' knowledge and use of oral rehydration therapy for diarrhoea in children under 5 years in Ife, Nigeria

Diarrhoeadisease is the second leading cause of death in children under 5 years old, and is responsible for killing about 300, 000 children annually in Nigeria. Oral rehydration therapy (ORT) is the preferred treatment for fluid and electrolyte losses due to diarrhoea in children with mild to moderate dehydration. This study aimed to assess the knowledge and use of ORT in the management of diarrhoea in children under 5 years at Seventh Day Adventist Hospital (SDAH, Ife).Method: A structured questionnaire was adopted for this study design and data was collected using a self-structured questionnaire both self-administered and interviewer administered.Results: Of 80 participants, 44 (55%) of the respondents had heard of ORT before this study, while 36 (45%) had not. 48 (60%) responded that they use oral rehydration solution while 32 (40%) of mothers said they had not used ORT. There was significant difference in both outcomes. The result revealed that there was significant difference in morbidity and mortality between mothers who use ORT and those who do not. But there was no significant difference between the knowledge of ORT compared with its use.Conclusion:Appropriate knowledge of the therapy will positively influence its use which will drastically prevent morbidity associated with diarrhoea as well as contain the incidence of mortality

COVID-19 vaccine acceptance and its determinants in the Bono Region of Ghana

Objective: The study assessed willingness to accept the COVID-19 vaccine among out-patient department (OPD) attendants in the Bono Region in Ghana. Design: This was an analytical cross-sectional study Setting: The study was conducted at the Wenchi Methodist Hospital (WMH) OPD, Bono Region, Ghana. The region had not yet been earmarked for vaccination at the time of the study. Participants: Three hundred and twenty-five (325) participants aged ≥18 years, accessing care at the OPD of WMH and willing to give informed consent, were interviewed.Main outcome measures: The proportion of participants willing to accept the COVID-19 vaccine and its determinants. Results: Of 325 participants interviewed, 32 (9.8%) had been vaccinated already. 82.6% (242/293) indicated COVID19 vaccine acceptance among the unvaccinated. The major reason for vaccine acceptance was "it could protect against COVID-19" (96.7%, 234/242). "Fear of vaccine side effects and "perception of not being susceptible to COVID-19" were among the reasons for vaccine refusal. Perceived susceptibility to COVID-19 (AOR 4.09, 95% CI 1.79, 9.34), knowledge of COVID-19 and COVID-19 vaccine (AOR 3.62, 95% CI 1.14, 11.46) and willingness to pay for the vaccine (AOR 5.20, 95% CI 2.49, 10.43) were associated with vaccine acceptance. Conclusions: Adequate knowledge of COVID-19 and the vaccine may drive vaccine acceptance in the study area and possibly other areas in Ghana. Campaign messages aimed at increasing COVID-19 vaccine coverage must emphasise its safety, likely side effects and management in order to help rid the population of misconceptions

Psychosocial determinants of depression and maladaptive behaviour in adolescence: two tested models

Objective: Self-esteem has been identified as a strong predictor of depression and maladaptive behaviours in adolescents. Two relational models (A and B) were tested on the antecedent and consequent variables of self-esteem.Methods: A representative sample of 610 Spanish adolescents (52% boys) ranging in age from 11 to 16 years of age (mean age = 13.38 years, SD = 1.70 years) was used. The participants completed a battery of instruments measuring self-esteem, self-concept, importance of self-concept domains, depression symptoms, and problem behaviour. Covariance structure analysis (path analysis) from LISREL 8.54 was employed.Results: Model B presented a better fit (χ2difference (A­B) = 160.29, p < 0.001). Perceived social support (parents and classmates), and perceptions of competence in domains deemed important were positively related to self-esteem. While both self-esteem and social support (parents and classmates) were negatively related to depression symptoms, only social support (parents and teacher) appeared negatively related to behavioural problems.Conclusions: While self-esteem constitutes a strong correlate of affective symptoms in Spanish adolescents, it is unrelated to maladaptive behaviour. Social support emerged as an important protective factor. Concrete proposals for future research and prevention are discussed

Avaliação das práticas de higiene nos serviços de restauração da Universidade Eduardo Mondlane / Evaluation of hygiene practices in the food services of the Eduardo Mondlane University Mondlane University (UEM)

O presente trabalho tinha como objectivo avaliar as práticas de higiene associadas aos factores de riscos de doenças bacterianas de origem alimentar nos serviços de restauração da Universidade Eduardo Mondlane. O estudo foi realizado nos serviços de restauração da UEM de Maputo e Inhambane. Foram inqueridos, através de um questionário de perguntas semi-estruturadas, 37 trabalhadores com a categoria de cozinheiros e auxiliares de cozinha, foram visitadas as instalações e tiraram-se algumas fotografias por meio de uma máquina fotográfica digital da marca SAMSUNG. 80% dos inquiridos tinha escolaridade básica; 48% eram do sexo feminino e 52% masculino, a idade dos inquiridos variava de 22 a 57 anos e o tempo de serviço de 3 a 31 anos. Segundo os resultados do estudo os inquiridos têm consciência da necessidade de implementação das práticas correctas de higiene no decurso das suas actividades de modo a prevenir as doenças de origem alimentar. Contudo, foram observadas práticas que constituem factores de risco para a ocorrência de doenças bacterianas de origem alimentar. Os factores de risco observados estavam relacionados a prática incorrectas de armazenamento, higiene pessoal e geral, manipulação das sobras de alimentos, acondicionamento de lixo e controle de pragas. Conclui-se que a falta de observância de práticas correctas de higiene nos serviços de restauração concorre para o surgimento de doenças bacterianas de origem alimentar. Recomenda-se a implementação de programas educativos integrados regulares no sector, supervisão permanente e encorajamento de mudanças de comportamento na manipulação de alimentos.

The objective of the present study was to assess the practices of hygiene associated to the risks of foodborne diseases at restauration services of Eduardo Mondlane University (UEM). The study took place at services of restauration of UEM of Maputo and Inhambane; the data was collated using a questionnaire, with semi-structure questions. The questionnaire was submitted to 37 works namely cookers and auxiliaries of cookers, the installations were visited and some photography was taken using a SUMSUNG digital camera. 80% of the enquired has basic education; 48% were female and 52 were male; the age of the enquired varied from 22 to 57 years and the period of time of work varied from 3 to 31 years. According to the results of the study the inquired was aware about the need of the implementation of correct practices of hygiene during the work in order to avoid the foodborne diseases. However, was observed practices which constitute risk factor to the occurrence of foodborne diseases. The risk factors observed were related to storage, general and personal hygiene and handle of leftover, waste and pest control. It was concluded that the lack of correct practices of hygiene in the service of restauration constitute risk factor for the occurrence of foodborne diseases. It recommends the implementation of regular program of education, permanent supervision and encouraging of change of behaver in the handle of food.

Behavior modifying myths practices and effect on health seeking behavior among pregnant Yoruba women, south western Nigeria ­ a cross-sectional study

INTRODUCTION: Cultural practices and beliefs influence and underpin the behavior of women during pregnancy and childbirth; this behavioral change could influence the health-seeking behavior as well as the outcome of pregnancy. OBJECTIVES: The objective of this study was to determine the behavior modifying myths among pregnant Yoruba women and their sources. METHODS: This descriptive cross-sectional study was carried out among 250 pregnant Yoruba women attending the antenatal clinics of Bowen University Teaching Hospital, Ogbomoso and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso. A structured, interviewer-administered questionnaire was undertaken. Consent was sought verbally. RESULTS: The age of the respondents ranged from 15-45 years with a mean age of 27 years (±3.5). Most of the women were married n=239 (95.6%) and primarily Christian n=184 (73.6%). 127 (50.8%) of the women had a tertiary education while only 13 (5.2%) had no formal education. 41 (16.3%) of the respondents being primigravida. Six myths were identified with food taboos being the most common. These were being practiced by 61.2% of the respondents. The reasons given for modifying their behavior varied from warding off ghosts to the delivery of a well-formed child. The most frequent source of information were their relatives (42.4%). CONCLUSION: The practice of the myths was neither influenced by educational status nor religion. The majority of these practices do not have a deleterious effect and did not influence health-seeking behavior or outcome of pregnancy based on the reasons adduced for the practice

Lifestyle counselling and behavioural change: role among adult hypertensives in a rural tertiary institution

Background: In spite of the availability of myriads of antihypertensive medications, the control of high blood pressure is still low.Studies on effect of lifestyle behavioural changes through counselling on blood pressure control are scant in Nigeria. Therefore,this study set out to determine the role of lifestyle counselling on behavioural change among hypertensive patients attending the Federal Medical Centre, Ido-Ekiti.Methods: A total of 322 adult hypertensive participants who had been on treatment for at least three consecutive months were randomised into two groups. Relevant data were collected using an interviewer-administered semi-structured questionnaire and clinical parameters were measured pre- and post-intervention. The intervention group was counselled on lifestyle behaviours, namely regular exercise, eating adequate fruits and vegetables, moderate alcohol intake and cessation of smoking. Results: Post-intervention, among the intervention group 22.4%, 71.4% and 100%, as compared with the control group at 6.2%, 41.0% and 87.6%, met recommendations for physical activity, fruit and vegetable consumption and alcohol consumption respectively. The difference in each category was statistically significant (p < 0.001). However, the difference in smoking habits between the two groups (83.9% vs. 79.5%) was not statistically significant (p = 0.313). There was a statistically significant difference (p ≤ 0.001) in the difference in mean arterial pressure (96.4 ± 8.1 vs 106.2 ± 7.6 mmHg) between the intervention and control group post-intervention.Conclusion: Lifestyle modifications form part of an important and effective treatment modality for hypertension. It is desirable that primary care physicians devise and implement clinical and public health strategies that promote and maintain a combination of pharmacologic interventions and lifestyle modifications

Knowledge, attitudes, perception and behaviours of HIV/AIDS among end-cycle students in Cote d'Ivoire: Cross-sectional survey

In Cote d'Ivoire, the prevalence of HIV/AIDS has declined significantly in the last decade as a result ofpublic health actions. An assessment of knowledge, attitudes, perception and behaviours was carriedout to assess the outcome of the strategies for raising awareness and communicating with students about HIV/AIDS. A descriptive cross-sectional study was conducted in 2014 among students enrolled in third year at the university. An anonymous self-questionnaire including a consent form was provided. Mean scores were calculated from the items in the questionnaire to assess the level of knowledge, attitude, perception and behaviours of these students with regard to HIV/AIDS. The chi square test was used to compare the qualitative variables, and the quantitative variables were compared with the test of student. Among 561 students who participated in the study, 41.7, 26.7 and 31.6% were respectively registered in the sectors of human and social sciences (HSS), biosciences and health sciences. The mean age was 25.9 ± 3.4 years with a sex ratio of 1.3. The mean knowledge score of certain modes of transmission was 4.9 ± 0.36 out of 5 while that of condom positive perception was 6.4 ± 2.2 out of 12. This perception score was significantly higher in women than in men (6.1 vs. 6.9, p = 0.0001). The mean acceptance score was 7.3 ± 2.2 out of 10. The results of this work show good knowledge about HIV/AIDS among the students surveyed. However, the positive perception of the condom is far from being integrated in the student environment. This study also showed the persistence of HIV risk behaviour is out of sync with the level of Knowledge. It would be important to review marketing and communication strategies about HIV

Patients' knowledge of health rights and satisfaction with outpatient services at the tertiary hospitals in Enugu state, Nigeria

BACKGROUND: Patient satisfaction is a key indicator for measuring the success of the health system goals, delivery quality care that is safe, equitable, patient-centered, evidence-based, timely and efficient, through interprofessional collaborative team work. Equally, patient's knowledge of their health rights will enhance better provider-patient's relationship, patient satisfaction, and effective care management. OBJECTIVES: The aim of this study was to compare patients' knowledge of health rights, satisfaction with the physicians' conducts and outpatient services across three tertiary hospitals in Enugu, Nigeria. METHODS: A descriptive cross-sectional study of 304 patients selected from the outpatient clinics of the University of Nigeria Teaching hospital (UNTH), National Orthopaedic Hospital (NOHE), and Enugu State University of Science and Technology Teaching Hospital (ESUTH), from October to December, 2015 was conducted. A four point Likert scale, dissatisfied (1), very dissatisfied (2), moderately satisfied (3), and very satisfied (4) was applied. Knowledge of health rights were scored as follows, 0-5 poor knowledge, 6-10 good knowledge, 11 and above very good knowledge. A minimum sample size of 91 patients was calculated for each of the study hospital, but increased to100 each, to enhance precision, reduce error margin, and to contend possible nonresponses and incompleteness. A multi-stage sampling technique was applied. The data were analyzed using SPSS version 16.0.RESULTS: Knowledge of health rights was poor in 5.9%, 20.8%, and 14.9% of patients (X2 =9.61, p=0.000), and very good in 70.6%, 2 46.5% and 59.4% patients (X2 =12.14, p=0.000) from UNTH, NOHE, and ESUTH respectively. The mean knowledge scores were 10.50 ±3.240 for UNTH; 8.72±2.953 for NOHE; and 9.93±3.151 for the ESUTH. The overall mean knowledge scores of the patients across the three hospitals was not statistically significant (F=0.000, P =1.000). Patients' overall mean satisfaction with physicians' conduct and services was 3.63±0.525 for UNTH, 3.45±0.741 for NOHE, and 3.47±0.609 for ESUTH, with no statistically significant difference (F=0.000, P =1.000). Overall mean satisfaction scores for the general outpatient services were 3.19±0.728, 3.15±0.713, and 3.00±0.721 for UNTH, NOHE, and ESUT respectively. The observed differences in the overall mean satisfaction for the general services provisions across the hospitals was not statistically significant (F=0.000, P=1.000). Patients' mean knowledge scores were statistically (p=0.000) associated with mean satisfaction with the physicians' conduct and services provision across hospitals. CONCLUSION: Patients knowledge of health rights and satisfaction with physicians' conducts and outpatient services across the hospitals were generally good and satisfactory, but differed statistically in-between hospitals

Family planning in sub-Saharan Africa: progress or stagnation?

Objective To review progress towards adoption of contraception among married or cohabiting women in western and eastern Africa between 1991 and 2004 by examining subjective need; approval; access and use. Methods Indicators of attitudes towards and use of contraception were derived from Demographic and Health Surveys; which are nationally representative and yield internationally comparable data. Trends were examined for 24 countries that had conducted at least two surveys between 1986 and 2007. Findings In western Africa; the subjective need for contraception remained unchanged; about 46of married or cohabiting women reported a desire to stop and/or postpone childbearing for at least two years. The percentage of women who approved of contraception rose from 32 to 39 and the percentage with access to contraceptive methods rose from 8 to 29. The proportion of women who were using a modern method when interviewed increased from 7 to 15(equivalent to an average annual increase of 0.6 percentage points). In eastern African countries; trends were much more favourable; with contraceptive use showing an average annual increase of 1.4 percentage points (from 16in 1986 to 33in 2007). Conclusion In western Africa; progress towards adoption of contraception has been dismally slow. Attitudinal resistance remains a barrier and access to contraceptives; though improving; is still shockingly limited. If this situation does not change radically in the short run; the United Nations population projections for this subregion are likely to be exceeded. In eastern Africa; the prospects for a future decline in fertility are much more positive

Mobilising Indigenous Resources for Anthropologically Designed HIV-Prevention and Behaviour-Change Interventions in Southern Africa

HIV prevention is often implemented as if African culture were either nonexistent or 4a series of obstacles to overcome in order to achieve an effective; gender-equitable; human rights-based set of interventions. Similarly; traditional or indigenous leaders; such as chiefs and members of royal families; have been largely excluded from HIV/AIDS responses in Africa. This qualitative study used focus group discussions and in-depth interviews with traditional leaders and 'ritual specialists' to better understand cultural patterns and ways of working with; rather than against; culture and traditional leaders in HIV-prevention efforts. The research was carried out in four southern African countries (Botswana; Lesotho; South Africa and Swaziland). The purpose was to discover what aspects of indigenous leadership and cultural resources might be accessed and developed to influence individual behaviour as well as the prevailing community norms; values; sanctions and social controls that are related to sexual behaviour. The indigenous leaders participating in the research largely felt bypassed and marginalised by organised efforts to prevent HIV infections and also believed that HIV-prevention programmes typically confronted; circumvented; criticised or condemned traditional culture. However; indigenous leaders may possess innovative ideas about ways to change individuals' sexual behaviour in general. The participants discussed ways to revive traditional social structures and cultural mechanisms as a means to incorporate HIV-prevention and gender-sensitivity training into existing cultural platforms; such as rites of passage; chiefs' councils and traditional courts

Doctors' Use of Laboratory Tests in the Diagnosis and Treatment of Patients

Abstract:The provincial health budgets in South Africa are under enormous pressure and; annually; budgets are exceeded by most hospitals and clinics. Laboratory tests requested by clinicians are contributing to the problem of over-expenditure. The aim of this study was to determine from patients' files whether doctors were using laboratory tests prudently during their treatment of patients in the outpatient department (OPD) of the National District Hospital in Bloemfontein. A descriptive study was carried out using all the files of patients who visited the OPD in a three-month period (1 July to 30 September 2005) for whom laboratory tests were requested by the attending physician. The majority (31.3) of patients for whom laboratory tests were requested presented to the OPD with cardiovascular complaints or diagnoses; followed by endocrine (27.8) and musculoskeletal (16.3) complaints or diagnoses. Between one and three tests were requested for most patients; i.e. 33 and 15; respectively. The most frequently requested tests were erythrocyte sedimentation rate (8.1); urea and electrolytes (7.7); urine microscopy; culture and sensitivity (6.4); cholesterol (6.1); full blood count (5.7) and thyroid profile (TSH 4.6; T4 2.6 and thyroid functions 2.3). In 70.4 of cases; results were documented and; in 59.1; the physician's management plans indicated the incorporation of laboratory test results into the patient's treatment regimen. Our findings indicated inappropriate documentation and application of test results. Interventions to improve physician behaviour include education; guidelines; feedback; leadership and redesign of requisition forms

Care-Seeking Behaviour and Implications for Malaria Control in Southern Malawi

Abstract:Although malaria is a controllable and preventable disease; it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however; these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1;400 mothers nested within 33 communities; a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80) and child (86) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73) and the main problems encountered at health facilities were long waiting time or absence of health workers (73) and shortage of drugs (35). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [?=0.56; 95 CI:-0.86;-0.26]; bought medication from open markets [?=0.51; 95 CI:0.20;0.82]; and those that used other traditional methods or did nothing [?=0.70; 95

Alcohol Use among School-Going Adolescents in Harare; Zimbabwe: Results from the 2003 Global School-Based Health Survey

Data from the Global School-Based Health Survey (2003) were analysed to estimate the proportions of relevant socio-demographic and behavioural characteristics. Of the 1997 students who participated in the survey; 15.6(17.1males and 14.0females) reported alcohol consumption. Factors associated with consumption of alcohol use were being worried; bullied; smoking cigarettes; truant; and lack of parental supervision. Students who were never worried were 49(AOR=0.51 [95CI (0.36; 0.72)]) less likely to consume alcohol compared to students who were most of the time or always worried. Similarly; students who were never bullied were 42(AOR=0.57 [95CI (0.42; 0.77)]) less likely to take alcohol compared to students who were bullied at least six times in the previous one month to the survey. Compared to students who smoked cigarettes; non-smokers were 71(AOR=0.29 [95CI (0.21; 0.41)]) less likely to consume alcohol. Compared to students who always received parental supervision; students who rarely received parental supervision were more likely (AOR=1.85 [95CI (1.19; 2.90)] to consume alcohol; and those students who sometimes received parental supervision were less likely (AOR=0.70 [95CI (0.50; 0.98)] to consume alcohol. There is a need to implement public health interventions with special attention to the determinants of alcohol consumption in this age group

Alterations in family psychodynamics following a ventriculoperitoneal shunt placement

Background: The emotional stress of a young couple whose child has hydrocephalus can be immense. When a shunt has to be inserted without the parents being thoroughly educated on every aspect of the procedure; the situation can be overwhelming and significant psychosocial problems can develop. Aim: To report the case of behavioural change in the father of a hydrocephalic child who underwent shunt placement and the threat of family collapse due to misconceptions about the procedure. Method: The records of the child; including history; examination; investigations and treatment were evaluated. The mother was extensively interviewed during follow-up out-patient visits. Relevant literature on shunt complications was reviewed. Result: Following shunt insertion for hydrocephalus in an only child of a young couple born after 3 years of marriage; the father started withdrawing from his family and gradually began to manifest symptoms of depressive illness. Recommendations: The parents of every child scheduled to have shunt insertion should be properly counselled together on all aspects of the procedure preoperatively. This would help ensure that any consent given is on the basis of their mutual understanding and acceptance of the situation. Where problems are anticipated; it might be necessary to take pre-emptive measures to forestall their occurrence

Analyse de représentations et des comportements des patients induits par la vaccination dans les districts sanitaires de l'Agneby en Côte d'Ivoire

Cet article fait ressortir les données d'enquêtes, réalisées dans les formations sanitaires des Districts d'Agboville et d'Adzopé, dont le but a visé l'analyse des représentations et des comportements des patients par rapport à la prévention vaccinale et l'évaluation de l'effet de variables sociales sur ces représentations et comportements. Pour recueillir les données, la méthodologie a consisté à l'administration d'un questionnaire à 300 patients des districts sanitaires d'Agboville et d'Adzopé, et une analyse statistique à partir du test de Khi 2. Ces résultats établissent que, lorsque la vaccination provoque des abcès ou des blessures, 21 % des patients pensent que le vaccin n'aura pas d'effet clinique sur eux, 18 % croient qu'ils peuvent contracter la maladie du vaccin et 45 % n'ont pas un bien-être psychologique. Par contre, si la vaccination ne provoque pas des abcès et ou blessures, 36 % des enquêtés se représentent un vaccin cliniquement efficace et 51 % ont un bien-être psychologique. Le comportement des patients, dans le premier cas, est de ne plus se faire vacciner et 12 % ne fréquentent plus les centres de santé. En revanche, dans le second cas, 32 % font régulièrement leurs vaccins et 40 % encouragent leurs amis à se faire vacciner

Perceived sufficiency and usefulness of IEC materials and methods related to HIV/AIDS among High School Youth in Addis Ababa; Ethiopia

This study was conducted to assess the perceived sufficiency and usefulness of HIV/AIDS information; education and communication (IEC) messages and materials as well as to identify preferences for IEC sources and methods. Data were collected using a self-administered questionnaire and focus group discussions. A total of 901 students in Addis Ababa; Ethiopia; participated in the study. Over three quarters of the respondents believed in the usefulness of IEC. IEC materials were perceived to be useful in increasing knowledge about HIV/AIDS by 456 (51 ); to influence attitude by 357 (40 ) and to acquire safer sexual practices by 382 (42 ) of the respondents. None of the information sources and messages available for high school students highly satisfied the sufficiency indicators. Even though no single information source was highly preferred; radio and television ranked top. Life skills training was the most desired intervention by the students. IEC on HIV/AIDS was able to acquaint students with the disease rather than equipping them with knowledge and skill needed in their daily life. Therefore; appropriate and mutually reinforcing IEC messages with emphasis on life skill training are recommended

Etude multicentrique de la communication pour le changement de comportement (CCC) dans le cadre du Programme Elargie de Vaccination (PEV) au District Autonome d'Abidjan : cas du district sanitaire d'Abidjan Sud 3. Periode : 04 Decembre 2002 au 04 Fevrier 2003

Le but de notre etude est d'identifier les facteurs qui entravent l'utilisation efficace des instruments de communication dans l'avancee du programme elargi de vaccination (PEV). Pour atteindre ces objectifs; nous avons effectue une etude prospective portant sur les connaissances;aptitudes et pratiques du personnel vaccinateur; ainsi que la population generale representee par les femmes dans le district d'Abidjan Sud 3. Cette etude s'est deroulee du 04 decembre2002 au 04 fevrier 2003. Les meres ont ete visitees; le personnel a ete interroge avec pour support; un questionnaire. Il ressort de cette etude: -Une insuffisance de personnel qualifie; -Une absence de recyclage des agents vaccinateurs; -L'absence de supervision de CCC dans le district d'Abidjan Sud 3; -L'accueil hostile aux populations; -La confusion d'information chez certaines meres; source d'abandon; -Un manque d'information par les canaux de diffusion; -Le cout eleve de la vaccination; -La rupture des vaccins et consommables. Au terme de notre etude la DC PEV; l'lNHP et le district devront s'appliquer a: -Une supervision formative en matiere de CCC; -Une formation continue du personnel vaccinateur avec recyclage par des seminaires; -Une meilleure mobilisation sociale en matiere de CCC; -Une prise en charge des MAPI et leur consignation dans un registre; -Un renforcement de la surveillance epidemiologique

Human behaviour and schistosomiasis

This paper critically examines the relationship between human behavior and schistosomiasis transmission and control. It argues that human behavior must be studied not only at the individual but also at the family; community and national levels; and that socioeconomic; cultural; political and environmental factors must be considered in health education programs. The qualitative model developed by Dunn is modified and examples from Ethiopia and other African countries are used to indicate the great variety of human behaviours relevant to schistosomiasis transmission; spread and control