Comparative Assessment of the Implementation of Integrated Disease Surveillance and Response in Public and Private Health Facilities in Jos North Local Government Area of Plateau State, Nigeria.

Background: Due to the continuous increase in the spread of epidemic-prone diseases and the associated morbidity and mortality, integrated disease surveillance and response (IDSR) was introduced as the main strategy in resource-poor settings for the detection and notification of these diseases. Integrated disease surveillance is a combination of active and passive systems using a single infrastructure that gathers information about multiple diseases or behaviors of interest. Methods: : A comparative cross-sectional study was conducted between March and July 2018 among selected public and private health facilities in Jos North Local Government Area (LGA), Plateau State. Quantitative data were collected with the aid of a semi-structured interviewer-administered questionnaire and facility-based checklist. Data were analyzed using SPSS version 23. Statistical significance level was set at P ≤ 0.05 at a 95% confidence level. Results: A.total of 126 health workers were studied. IDSR-trained health personnel was found in 52.7% of the public health facilities compared with only 16.7% of the private health facilities studied (P < 0.001). Awareness of IDSR was higher in the public health facilities than in the private ones (P < 0.001). IDSR implementation was poorer in the private health facilities 40.7% compared with 76.4% in public health facilities (P < 0.001). Evidence of previous disease notification and reporting was seen only in 33.3% and 16.7% of public and private health facilities, respectively (P < 0.001). Conclusion: This study revealed that awareness and attitude of health workers in public health facilities in Jos North were higher than that of those in private health facilities and there is the sub-optimal implementation of IDSR among the health workers in Jos North LGA, especially among the private health facilities.

RésuméContexte: En raison de l'augmentation continue de la propagation des maladies à potentiel épidémique et de la morbidité et de la mortalité associées, la surveillance intégrée des maladies et la riposte (IDSR) ont été introduites comme principale stratégie dans les milieux pauvres en ressources pour la détection et la notification de ces maladies. La surveillance intégrée des maladies est une combinaison de systèmes actifs et passifs utilisant une infrastructure unique qui recueille des informations sur plusieurs maladies ou comportements d'intérêt. Méthodes: Une étude transversale comparative a été menée entre mars et juillet 2018 auprès d'établissements de santé publics et privés sélectionnés dans la zone de gouvernement local (LGA) de Jos North, dans l'État du Plateau. Les données quantitatives ont été recueillies à l'aide d'un questionnaire semi-structuré administré par un enquêteur et d'une liste de contrôle basée sur l'établissement. Les données ont été analysées à l'aide de la version 23 de SPSS. Le niveau de signification statistique a été fixé à P ≤ 0,05 à un niveau de confiance de 95 %. Résultats: Au total, 126 agents de santé ont été étudiés. Le personnel de santé formé par l'IDSR a été trouvé dans 52,7 % des établissements de santé publics, contre seulement 16,7 % des établissements de santé privés étudiés (P < 0,001). La sensibilisation à la SIMR était plus élevée dans les établissements de santé publics que dans les établissements privés (P < 0,001). La mise en oeuvre de la SIMR était plus faible dans les établissements de santé privés, 40,7 % contre 76,4 % dans les établissements de santé publics (P < 0,001). Des preuves de notification et de notification antérieures de la maladie n'ont été observées que dans 33,3 % et 16,7 % des établissements de santé publics et privés, respectivement (P < 0,001). Conclusion: Cette étude a révélé que la sensibilisation et l'attitude des agents de santé dans les établissements de santé publics de Jos North étaient plus élevées que celles des établissements de santé privés et qu'il existe une mise en oeuvre sous-optimale de la SIMR parmi les agents de santé de Jos North LGA, en particulier parmi les les formations sanitaires privées. Mots-clés : surveillance intégrée des maladies et mise en oeuvre de la riposte, zone de gouvernement local de Jos North, établissements de santé publics et privés.

Translation, Cultural Adaptation and Validation of the Hausa version of the Standardised Mini-Mental State Examination in Northeastern Nigeria.

BACKGROUND: Mini-Mental State Examination (MMSE) is one of the most widely used patient-rated assessment tools but may not be applicable among an overwhelming majority of Nigerians older adults. This is because MMSE was designed and adapted for English speakers, and some of its items are challenging to understand for those with low literacy levels. OBJECTIVES: This study aimed at translating and adapting MMSE into the Hausa language and also evaluates the psychometric properties of the modified Hausa version of MMSE. METHODOLOGY: The MMSE was translated and adapted into Hausa language by an Hausa language expert and focus group of experts and the validity of the adapted Hausa MMSE was evaluated against a gold standard (Diagnostic and Statistical Manual of Mental Disorder V criteria for neurocognitive disorders), among older adults participants (N=100). Descriptive statistics and inferential statistics (Receiver Operating Curve analysis and Cronbach alpha coefficient approach) were employed for data analysis and the alpha level was set at 0.05. RESULTS: The adapted Hausa MMSE has item content validity index of 0.97 and the mean expert proportion relevant rating, across all the experts was 0.99. The adapted Hausa version of MMSE shows 66.7% sensitivity and 84.7% specificity, when the original MMSE cut off point of 24 was used. With ROC analysis, optimal cut-offs derived were 25 and 26 with Area Under Curve of 0.886 (95% CI: 0.816-0.956; Std.Err: 0.036; P=0.000). However, at the optimal cut off of 26, derived using ROC analysis, the modified Hausa MMSE had sensitivity of 93.3% and specificity of 71.8% and the tool internal consistency reliability had alpha value of 0.64. CONCLUSION: Hausa adapted versions of MMSE is a valid cognitive screening tool for Hausa older adult patients although its use for Screening and for monitoring changes warrant considerations for two separate cut- off points.

CONTEXTE: Le mini-examen de l'état mental (MMSE) est l'un des outils d'évaluation évalués par le patient les plus utilisés, mais il n'est peut-être pas applicable chez une écrasante majorité de Nigérians âgés. Cela est dû au fait que le MMSE a été conçu et adapté pour les anglophones et que certains de ses éléments sont difficiles à comprendre pour les personnes ayant un faible niveau d'alphabétisation. OBJECTIFS: Cette étude vise à traduire et à adapter le MMSE en langue haoussa et à évaluer les propriétés psychométriques de la version haoussa modifiée du MMSE. MÉTHODOLOGIE: Le MMSE a été traduit et adapté en langue haoussa par un expert en langue haoussa et un groupe de discussion d'experts, et la validité du MMSE adapté en haoussa a été évaluée par rapport à un étalon-or (critères du Manuel diagnostique et statistique des troubles mentaux V pour les troubles neurocognitifs), parmi des adultes âgés participants (N=100). Des statistiques descriptives et inférentielles (analyse de la courbe d'exploitation du récepteur et approche du coefficient alpha de Cronbach) ont été utilisées pour l'analyse des données et le niveau alpha a été fixé à 0,05. RÉSULTATS: Le MMSE Hausa adapté a un indice de validité de contenu de 0,97 et la note moyenne de pertinence de la proportion d'experts, parmi tous les experts, était de 0,99. La version Hausa adaptée du MMSE présente une sensibilité de 66,7% et une spécificité de 84,7%, lorsque le seuil original du MMSE de 24 est utilisé. Avec l'analyse ROC, les seuils optimaux 25 et 26 avec une aire sous la courbe de 0,886 (IC 95 % : 0,816-0,956 ; Erreur type : 0,036 ; P=0,000). Cependant, au seuil optimal de 26, déterminé à l'aide de l'analyse ROC, le Hausa MMSE modifié avait une sensibilité de 93,3 % et une spécificité de 71,8 %, et la fiabilité de la cohérence interne de l'outil avait une valeur alpha de 0,64. CONCLUSION: La version Hausa adaptée du MMSE est un outil de dépistage cognitif valide pour les patients adultes âgés Hausa bien que son utilisation pour le dépistage et le suivi des changements justifie la prise en compte de deux seuils distincts. Mots clés: Mini examen de l'état mental, évaluation cognitive, adultes âgés, langue Hausa.

The implications of ripening agents on chemical compositions of plantain (Musa paradisiaca).

Foods frequently eaten supply both micro and macro nutrients to humans which are important in the total assessment of public health status of an individual. The analysis of these foods will provide evidence on their nutritional values, guide to appropriate choice of meal and encourage intake of varieties of food with better qualities during illness while preventing diet-associated disorders. In this study, the proximate and mineral composition of unripe, naturally ripe and the effects of ripening agents on plantain (Musa paradisiaca) commonly consumed in Nigeria were examined. The plantain fruits were analysed for proximate and mineral composition. Proximate composition analysis revealed an increase in moisture content and fat content for all the plantain ripened with ripening agents when compared with the naturally ripened plantain. Furthermore, the mineral composition of the plantain fruits was determined by means of Atomic Absorption Spectrophotometry (AAS). The result showed that plantain is a good source of minerals such as calcium (Ca), potassium (K) and iron (Fe). A relatively high level of K of 1690.55 ± 0.02; 1672.35 ± 0.03 mg kg-1 were found for both unripe and natural ripe plantain while the ripening agents had K values of 1677.45 ± 0.01; 1656.10 ± 0.02; 1589.45 ± 0.01 mg kg-1 for Ethylene glycol, Potassium Dihydrogen Phosphate, Calcium carbide respectively. Also, low level of Fe was obtained in plantain ripened with the different ripening agents.

A Review-Based Comparative Analysis of Health Care Delivery System in Nigeria and the United Kingdom.

BACKGROUND: It is a general belief that the healthcare delivery system (HCDS) in Nigeria is bedevilled by frequent workers industrial actions, inter-professional rivalry among healthcare workers and insurance scheme mismanagement and corruption. OBJECTIVE: This study was aimed at comparing the health care system in Nigeria (a lower middle-income country) and the United Kingdom (a high-income country). METHODS: Using keywords including 'primary health care', 'secondary health care', 'tertiary health care', 'health care delivery system', 'Nigeria' and ''United Kingdom, PubMed was searched for studies on health care in Nigeria and the United Kingdom. Databases of the World Bank, World Health Organization, Central Intelligence Agency World Factbook and Index Mundi were also searched for information on health indices and organisational characteristics for Nigeria and the United Kingdom. Retrieved articles and data obtained were analysed and a two-country comparison was performed on HCDS features and health indices. RESULTS: The average Life Expectancy in Nigeria is less than two third of that of the UK (54.8 years vs. 81.2 years) and the probability of dying between 15 and 60 years per thousands of population is 127.8% higher among Nigerians than among UK citizens. The Infant mortality rate per 1,000 live births and the under-five children mortality rate is 16 and 23 times higher in Nigeria than in the UK. The probability of dying on or before the first year of life and before the age of five is 177% and 183% higher respectively, in Nigeria than in the UK. While the UK ranked within the top 2% -10% on health system rating features such as achievement of goals, health care services distribution and overall goal achievement on HCDS, Nigeria is ranked within the bottom 2%-5% in these measures. DISCUSSION: Using the HCDS in the UK as a model, it can be argued that a multi-faceted approach that includes attitudinal and behavioural changes among the healthcare workers, proactive health and social policy implementation and monitoring, preventive and corrective anti-corruption measures, population control and increased healthcare spending may be needed to address challenges and improve Nigeria's healthcare rating and ranking among countries.

Learning Styles of Physiotherapy and Medical Students in a Nigerian University.

BACKGROUND: Knowledge of students learning style is important in order for an instructor to be able to determine and select the appropriate teaching techniques for effectiveness and maximized student learning during a class session. OBJECTIVES: This study was aimed at exploring the learning preferences of physiotherapy and medical students in a regional university in Nigeria. METHODS: A sample of 263 undergraduate physiotherapy and medical students in the clinical phase of their studies at the University of Maiduguri participated in this cross-sectional survey study. The participants completed a two part question-naire. Part I of the questionnaire elicits sociodemographic information such as age, gender and programme and level of study, while part II consists of a 24-item self-administered Learning Style Inventory that elicited information on the students' preferences on learning their subjects. RESULTS: These cohorts of medical and physiotherapy students were evenly divided between visual and auditory learning preferences. While for the medical students, the males tend to be visual learners more frequently than their female counterparts, gender difference in types of learning preference was not observed for the physiotherapy students. CONCLUSION: This study affirms the heterogeneity in students' learning preferences, and also suggests the need for instructors in health disciplines to always consider blending appropriate voice and audios with pictures, photos and visual effects in other to maximize students learning especially during teaching sessions.