Information transmission process for disease notification and feedback in the community-based disease surveillance system in Anambra State, Nigeria

Disease surveillance and notification (DSN) system has been shown to be weak in Nigeria and still needs to be built up for effective detection and response to some communities. The aim of this paper is to assess the reporting and feedback mechanisms in the Community-based surveillance System (CBSS) in Anambra State, Nigeria. This was a cross-sectional descriptive study of 360 community-based focal points in Anambra State selected by multistage sampling technique. Data collection was by interview using a pre-tested, semi-structured questionnaire. Data were analysed using SPSS version 20, associations between variables were tested using Chi square, Fisher's exact and t tests as appropriate (p<0.05). Forty-one (13.1%) focal points sent in reports for at least four times, (72.2%) received feedback within the last one year and (44.6%) was via the phone. However, 229 (63.6%) of the respondents gave the feedback to the community mainly via the village health committees (44.1%). Respondents' occupation, ever detected notifiable disease; source of information; person the detected disease was reported to; records of notified disease kept by focal points; number of times reports were sent in the last one year, received feedback given to community members, availability of supervisors for focal points and volunteer benefit from being focal points were found to have associations with receipt of feedback on disease case notification (p<0.05). This study found poor reporting but good feedback mechanisms. However, there is need to reform the State CBSS in line with the above findings in order to make it more functional.

Violence against women: awareness, knowledge and attitudes of male civil servants at the ministries, departments and agencies in Owerri, Nigeria

Background: Violence against women (VAW) remains a huge and protracted public health concern. Also, there is growing recognition that the role men play in changing these inequalities in gender based power relations is critical. Documenting the trends of the aforestated role is essential to developing public health interventions to tackle VAW. Objective: To determine the awareness, knowledge and attitudes to VAW among male civil servants at the state and federal government ministries and agencies (MDAs) in Owerri, Nigeria. Materials and methods: This was a cross sectional survey of 326 male civil servants at the State and Federal Government MDAs in Owerri Nigeria, selected using multistage sampling technique from August 2016 to January 2017. Data were collected using pretested self-administered semi- structured questionnaires. Data were analysed using SPSS V.22. Statistical associations between variables were tested using Chi square, at p -value < 0.05. Results: The mean age of respondents was 40.6 ± 9.8. Three hundred and two (92.6%) of them were aware of VAW. Sources of information on VAW include: 184(57.9%) television, 171(53.8%) radio, 167(52.5%) print media, 152(47.8%) social media. The form of VAW mostly cited 227(70.7%) was rape, while the mostly practiced form of VAW 201(62.4%) was physical violence. Only 65 (20%) had good knowledge, while 151 (46.3%) had a good attitude towards VAW. There were statistically significant associations between respondent's attitudes towards VAW and (religion [p =0.000], tribe [p =0.017]). Conclusions: This study revealed high awareness on VAW, poor knowledge about VAW and poor attitude towards the practice of VAW. We recommend sustained awareness and improved comprehensive gender equity cum attitudinal change education

Sociodemographic determinants of maternal knowledge, attitude and uptake of routine immunization in ‘Sabo’ and ‘Non-Sabo’ communities in Awka, Nigeria

Background: Routine immunization coverage has been reportedly hampered by migration, and user characteristics, such as maternal knowledge and attitude. An understanding of these maternal variables could help modify preventive strategies. The objective of the present study was to assess and compare the Sabo and non-Sabo communities in Awka, Nigeria for sociodemographic determinants of maternal knowledge, attitude and uptake of routine immunizationMethods: A community based comparative study of 420 mothers and caregivers in Awka selected via multistage sampling technique, was conducted between July and October 2015. Data collection was by interview using semi-structured questionnaire, while analysis was done with Statistical Package for Social Sciences version 22.0. Chi-square, Fisher’s exact, Yates correction and student’s t tests were used to determine statistically significant associations between variables at p value of < 0.05.Results: There was normal distribution of age groups of respondents for both communities. Married women (53.0%) in Sabo communities had better knowledge of routine immunization than (47.0%) in non-Sabo communities (p= 0.000). Self-employed women were the most knowledgeable in routine immunization 310 (74.0%) (p= 0.042). Married women in the Sabo communities (53.0%) had better attitude than (47.0%) (p= 0.000).in non-Sabo communities. The maternal uptake of routine immunization among the different communities, ethnic and religious groups were higher in non-Sabo, Igbo/others and Christian groups than the Sabo, Hausa/Fulani and Muslim groups. (p= 0.010).Conclusions: This study found differences in baseline socio-demographic characteristics of the two communities, as well as better knowledge, attitude and uptake of routine immunization among the non-Sabo (Ibo/others and Christians) than the Sabo (Hausa/Fulani and Muslims). Addressing issues of factors identified to affect routine immunization will greatly assist in boosting uptake of routine immunization in both communities.

Awareness, gender variations, consequences of sexual risk behavior and adopted solutions among senior secondary schools adolescents in Owerri, Nigeria

In our area, there is dearth of accurate sex education that could equip adolescents in making informed decisions on sexual issues. This scenario has been linked to a high prevalence of sexual risk behaviors, consequences and poor choices with regard to solutions. Objective: To determine the awareness, gender variations, consequences of sexual risk behavior, and adopted solutions among senior secondary school adolescents in Owerri, Nigeria. Methodology: This was a cross sectional survey of 384 in-school adolescents in Owerri, Nigeria, selected using a multistage sampling technique. Data were collected using pretested self-administered semi- structured questionnaires. Data were analyzed using SPSS v.22 (p<0.05). Results: The majority of adolescents, i.e. 306 (82.5%), were aware of sexual risk behaviors, 340 (91.6%) had received some sex education, and 296 (79.8%) were aware of contraceptives. Key sources of information on sexuality were schools and parents. In total, 54 (14.1%) participants were sexually active, 12 (22.2%) reported ever having an STI, and 9 (75%) had been treated in hospital. Also, 8 (14.8%) of the 54 had dealt with a pregnancy; 7 (87.5%) had undergone an abortion, 3 (42.9%) in a hospital. Sexual risk behaviors among males were associated with age (p=0.002), school type (p=0.002), and alcohol intake (p=0.000), while the residence of the parents had a stronger influence among females (p=0.014). Conclusions: This study found high awareness of sexual issues, mainly sourced from schools and parents. Associations were made between sexual risk behaviors and gender differences (age, school type, and alcohol intake in males, parental residence among females). The consequences of sexual risk behaviors were early pregnancy and STIs, with poor solutions adopted.

Adverse Drug Reaction Reporting by Different Categories of Healthcare Workers in Nnewi, Nigeria: Awareness, Knowledge and Attitudes.

Aim: To determine the level of awareness, knowledge and attitudes among health workers in different settings of health care in Nnewi, Nigeria towards the reporting of adverse drug reactions (ADRs). Methods: A descriptive cross-sectional study of 372 health workers in different health facilities in Nnewi North LGA of Anambra state, Nigeria was done. The participants were doctors, pharmacists and nurses, selected using multistage sampling technique. Data collection employed pretested, self-administered structured questionnaires. Data was analysed using statistical package for social sciences version 17. Chi-square test for proportions was used to document statistical significance among variables. A p value of < 0.05 was considered significant. Results: Two hundred and fifty five (68.5%) were females and 117 (31.5%) were males. This comprises 241 (64.8%) nurses/related cadres, 109 (29.3%) doctors and 22 (5.9%) pharmacists. Majority of them, 221 (59.4%) were not aware of the existence of the national ADR reporting scheme/guideline. The Pharmacists were more aware compared to other health professionals (P=.000). Respondents from tertiary health facility showed greatest awareness (43.2%). A total of 131 (35.2%) respondents have knowledge of the criteria for reporting ADR though it does not have a relationship with profession (P=.71) and does not depend on the level of the health facility where one worked (P=.30). Conclusion: This study showed poor awareness, knowledge gaps and poor attitude to ADR reporting across the professional groups. There is need for regular sensitization, training and retraining as well as attitudinal changes of health care providers to ADR reporting.

Survey of Knowledge and Source of Information Relating to Reproduction and Sexually Transmitted Infections among Senior Secondary Schools Students in a Military Barracks in Nigeria.

Context: Adolescents seek health information from diverse sources. When such information is appropriately sought, correct and complete, it ensures an understanding of their reproductive health needs and encourages healthy sexual decision making and behaviors. Objective: To determine the level of knowledge and source of information about reproduction and sexually transmitted infections among senior secondary schools students in Ojo military barracks, Lagos. Materials and Methods: A cross-sectional study of 400 senior secondary schools students in Ojo military barracks, Lagos, selected using multistage sampling technique was done. Data collection employed pretested, self- administered structured questionnaires. Data was analysed using statistical package for social sciences version 17. Tests of statistical significance were carried out using chi square and t tests. A p value of <.05 was considered significant. Results: Majority of them 391(97.8%), were in the age group (10-19 years) while the mean age was 152.4 for males and 152.2 for females respectively. Information on sexual and reproductive health was sought from the electronic media by 238(59.5%), 115 (52.0%) males and 123 (68.7%) females; peer group 231(57.8%), 120 (54.3%) males and 111 (62.0%) females as well as print media and other sources with a statistically significant difference in this practice between the males and females (P=.01). Only 38 (9.5%) had very good knowledge. The sexually experienced were less knowledgeable than the non-experienced (3.71.3 and 3.91.3 respectively; P<.05). Knowledge was found to increase with age (P<.05). Females had more knowledge than males (P<.05). Conclusions: Overall knowledge was assessed as fairly good, while key sources of information were the electronic media and peer groups. Interventions including peer education are recommended to ensure that these sources provide veritable information on reproductive health.

Awareness and Knowledge of Disease Surveillance and Notification by Health-Care Workers and Availability of Facility Records in Anambra State; Nigeria

Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases; personnel; and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN; and availability of facility records in Anambra State; Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews; whereas an observational checklist; preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8 of the health-care workers were aware of the DSN system; only 33.3; 31.1; and 33.7 of them knew the specific uses of forms IDSR 001; IDSR 002; and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response); respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low; although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (?[2]=7.67; P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms; copies of the standard case definitions; and other necessary logistics to the health-care facilities by the local and state governments