Recognition and interpretation of road signs by commercial drivers in Enugu Nigeria

Background: Sub-Saharan Africa has the highest road injury death rate of all regions in the world with Nigeria being one of the four countries accounting for half of all these deaths. Road, traffic signs or codes are salient ways of communication to road users geared towards reducing road traffic accident and studies that traffic violation are considered to be amongst the causes of road traffic accidents. Recognition, interpretation and observance of road signs could be of great importance in reducing the incidence of road accidents. This study was aimed at assessing the knowledge of road signs by commercial drivers in Enugu South-East Nigeria.Methods: This was a cross sectional descriptive study carried out in Enugu metropolis over a period of 3 months using a pre-tested structured questionnaire. Commercial drivers in Enugu participated in the study. Common road signs in their usual colors were showed to the drivers to test their ability to correctly identify the signs.Results: The mean age of the respondents was 42.4±9.6 years. Majority of the respondents, 59.4% are on intra-city transport route. Over 65% of the driver’s attained secondary education and beyond. Nearly a half (49.4%) of the drivers had poor knowledge of road signs. Drivers who have attained primary education and less (AOR=0.2, 95% CI: 0.1-0.3); who are on intra-city transport route (AOR=0.08, 95% CI: 0.05-0.1) or had less than 11 years driving experience (AOR=0.3, 95% CI: 0.1-0.5) were less likely to have good knowledge of road signs.Conclusions: Significant gaps still exist in knowledge of road signs among commercial drivers in Enugu, Nigeria.

Snakebites in a Nigerian children population: A 5-year review

Background: Snakebite envenomation is a worldwide problem, which is an important cause of death in the developing countries and still remains a neglected public health problem. Children sustain more severe toxicity from envenomation compared to adults and thus have different outcomes.Objectives: This study was carried out to review the demographics, risk factors, interventions,outcomes of snakebite victims in the pediatric age group in Enugu, Southeast Nigeria, to improve the existing database.Materials and Methods: This was a descriptive, retrospective study conducted at the children emergency room (CHER) of Enugu State University Teaching Hospital (ESUTH), Enugu. The admission records of all the children that were admitted into CHER of ESUTH over a 5­year period (January 2012 to December 2016) were reviewed. Analysis was mainly descriptive. Frequency distributions of all relevant variables were reported as tables and prose. Test of significance for discrete variables was done using the Chi­square test. P <0.05 was regarded as statistically significant. Results: There were 5182 admissions with 13 cases of snakebite, giving a prevalence rate of 0.25%. Late presentation was significantly associated with longer duration of hospitalization (P = 0.026, χ2 = 4.952).Five (30.8%) patients had complications distributed as follows: one gangrenous limb (7.7%), one necrotic ulcer (7.7%), and three compartment syndromes (23.1%). Prehospital visit interventions included visit to the native doctor, local incision, application of herbs, tourniquet, and black stone application. One of the patients died, giving a case fatality rate of 7.7%. Conclusions: The prehospital emergency interventions given to snakebite victims still reflect practices that are harmful. It is possible that the majority of snakebite cases in our environment do not present to the health facilities. More efforts are required to improve the health­seeking behavior and emergency interventions for snakebite victims

Assessment of School Health Instruction Implementation in Primary Schools in a Local Community in South-East Nigeria: A Comparative Study between Private and Public Schools.

Schools have the responsibility to educate their students and encourage them to live healthy and hygienic behavior. This descriptive cross-sectional study aimed to determine the status of the school health instruction in 56 randomly selected schools in Nnewi North Local Government area of Anambra state using the school health program evaluation scale. It also assessed the extent of implementation of provisions of school health instruction in these schools. Forty six (78.6%) of the 56 schools surveyed had adequate implementation of school health instruction. The proportion of school that met the requisite score (16) for adequate implementation of school health instruction was not significantly different between private and public schools [24(73%) vs. 20(87%), P=0.389]. There was also no significant difference in mean scores attained for school health instruction between private and public schools (17.6±4.4 vs. 17.6±3.6; P=0.939). Private school had more non classroom related heath activity compared to public schools (75.8% vs. 21.7%, P=0.000) while public schools, had significantly more qualified health instructors, ten (43.5%) compared to private schools six (18.2%), P=0.040. Training and retraining of primary school teachers coupled with effective school health policies would be essential in ensuring adequate and optimal implementation of school health instructions in primary schools.

Infant Feeding Practices and Growth Pattern in the First Six Months of Life: A Cross-Sectional Study of Babies Attending the Infant Welfare Clinic of the Nnamdi Azikiwe University Teaching Hospital.

Background: Malnutrition which mostly is a consequence of improper feeding practices has been shown to contribute to over 50% of under-5 mortality. This means that appropriate age-specific nutritional prescription is the surest way of significantly shrinking childhood mortality especially in sub-Saharan Africa. Aim: This cross-sectional descriptive and analytical study aims to determine the relationship between different infant feeding practices and the nutritional status of apparently healthy infants below six months of age attending the infant welfare clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Methods: Mother infant pairs attending the infant welfare clinic that meets the inclusion criteria were consecutively enrolled over a six months period. Results: Four hundred infants were enrolled for this study. Educational level (P=0.003), socioeconomic class (P=0.010), occupation (P=0.025) and infants age (P=0.001) significantly determined exclusive breast feeding (EBF) practice. Exclusively breast feed infants showed higher weight and length indices for age and sex compared to infants in other feeding group (P=0.001). Significantly lower proportion of infants in the EBF group (1.9%) compared to infants in the predominant breast feeding (PBF) 5.2% and complementary breast feeding (CBF) 9.7% feeding group showed evidence of under-weight (P=0.015). Binary logistic regression analysis showed that EBF infants were 0.12 and 0.51 times less likely to be under-weight (OR 0.12; CI 0.02-0.93) and stunted (OR 0.51; CI 0.27-0.96) respectively. Conclusion: Since malnutrition is a major contributor to neonatal and infant’s mortality in Africa, the campaign for EBF practice should not only be sustained but further strengthened as a way of halting and possibly reversing the gloomy trend.

Umbilical Cord Care Practices and Incidence of Febrile Illnesses in the First Month of Life among Newborns-A Population Based Study.

Background: Infection accounts for 13% of the approximately three million newborns deaths that occur globally every year. Poor umbilical cord hygiene in the first week of life is a well documented risk factor that increases the likelihood of neonatal infections. To curb this trend in developing countries, the World health Organization in 2013 enlisted the use of antiseptic solution as an essential medicine for cord care. Aim: This study aims to describe umbilical cord care practices among mothers in Nigeria and its association with development of fever in newborns in the first month of life. Methods: This is a population based descriptive study using nationally representative data from the 2013 edition of the Nigeria Demographic and Health survey (NDHS). For this study, 12113 women aged 15-49 years were randomly selected from households using a stratified two-stage cluster design. Logistic regression and chi-square was used in data analysis. Results: Unhealthy umbilical cord care was practiced by 27.8% of the respondents. The World Health Organization and national policy recommendation of cord care was significantly practiced by older women (P=0.002), literate mothers (P=0.001), mothers with higher educational attainment (P=0.001), mothers in the higher wealth class (P=0.001), those with access to print and electronic media (P=0.001), mother who uses hospital based postnatal check-up (P=0.001) and mothers resident in urban areas (P=0.001). Compared to newborns whose mothers applied nothing to their umbilical stumps, the odds of developing fever in the first month of life was higher in newborns whose mothers applied Oil (OR 1.79 CI 0.39-8.87); Ash (OR 3.37 CI 0.09-29.51); Toothpaste (OR 4.10 CI 1.01-16.68); Animal dung (OR 11.01 CI 1.11-111); and Other concoction (OR 2.58 CI 0.30- 22.22) to the umbilical stump and lower in newborns whose mothers applied Methylated spirit or Chlorhexidine solutions (OR 0.68 CI 0.10-5.6) to the umbilical stump. Conclusion: The need for proper hygiene of the umbilical cord using the recommended antiseptic solution must be re-emphasized among health care providers particularly targeting traditional birth attendants in rural settings. Female education and empowerment which has long been designated as one of the child survival strategy and also highlighted in this study as a strong determinant of healthy cord care practices is needed to promote this low cost and highly effective practices amongst mothers.

Maternal Sociodemographic Factors that Influence Full Child Immunisation Uptake in Nigeria

Background. With vaccine-preventable disease accounting for many 5-year deaths in most developing countries; it is imperative to determine the factors responsible for poor immunisation coverage in these countries. Objective. To identify maternal sociodemographic factors associated with child immunisation uptake in Nigeria. Methods. Data from a nationally representative sample of mothers (aged 15 - 49 years) were obtained from the 2008 Nigeria demographic and health survey. Logistic regressions were used to examine the association between maternal sociodemographic variables and child immunisation uptake.Results. The overall uptake of full immunisation based on the National Programme on Immunisation schedule was 30.6. There was wide variation in full immunisation uptake in the different regions in Nigeria; with 51 in the South-West; 46.5 in the South-East; 39.5 in the South-South; 6.4 in the North-West; 11.8 in the North-East and 28.2 in the North-Central. Approximately 40.2 of children surveyed had never received any form of vaccination. The most common reasons given for non-vaccination of these children were lack of information about immunisation; fear of side-effects and the immunisation centres being too far away. It was noted that uptake of vaccines with multiple dosing schedules dropped with each successive dose. Decreased likelihood for full immunisation was seen in mothers 18?years old (odds ratio (OR) 0.53; confidence interval (CI) 0.34 - 0.84) and mothers residing in the northern regions. Increased likelihood for full immunisation was seen in mothers from middle and rich classes (OR 1.26; CI 1.03 - 1.66 and OR 1.69; CI 1.27 - 2.25; respectively); mothers with higher educational level (OR 3.77; CI 1.52 - 9.32); mothers with access to media (OR 1.84; CI 1.21 - 1.68); mothers resident in urban areas (OR 1.36; CI 1.22 - 1.51) and mothers who had institutional deliveries (OR 1.86; CI 1.44 - 2.40).Conclusion. Full immunisation uptake in Nigeria is poor. Cultural disparity in different regions of Nigeria may account for the wide variation in immunisation coverage observed