Parents' perceptions of timing of initiation of sexuality discussion with adolescents in Anambra State, South Eastern Nigeria.

STUDY OBJECTIVE: This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria. DESIGN: A cross-sectional, descriptive, community-based study. SETTING: The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria. PARTICIPANTS: The study participants were parents with adolescent children resident in the study areas for at least 2 years. RESULTS: Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status. CONCLUSION: Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Utilization of maternal health services in urban and rural communities of Anambra State, Nigeria.

OBJECTIVE: This study determined and compared the level and pattern of utilization of maternal services in urban and rural communities in Anambra State. DESIGN AND METHOD: A comparative cross-sectional study was carried out in two local government areas (LGA); Nnewi North (urban) and Dunukofia (rural). A total of 338 mothers of children aged 0-59 months in each of the two LGAs selected by multistage cluster sampling technique were studied. Data were collected using an interviewer administered questionnaire, analyzed and tests of significance performed with the p-value set at 0.05. RESULTS: Women in the rural area had higher fertility rate (t = 4.53, p < 0.05) and more children than their urban counterparts (t = 4.79, p < 0.05). The mean number of antenatal care (ANC) before delivery in urban and rural areas were 8.0 +/- 4.2 and 5.9 +/- 2.4 respectively and the difference was statistically significant (t = 7.52, p < 0.05). Half of the urban respondents delivered in private hospitals while 43.8% of rural respondents delivered in maternity homes. There was no significant difference in the pattern of post natal care utilization in both localities (chi2 = 0.695, p = 0.405), as most of the women in both localities went for post natal consultation within 6 weeks of delivery. CONCLUSION: Measures to improve maternal health service utilization especially in rural areas should not only address the issue of access to care, but also improvement in quality of care and women empowerment.

Effectiveness of data collection and information transmission process for disease notification in Anambra State, Nigeria.

BACKGROUND: Disease surveillance and notification (DSN) has been shown to be weak in Nigeria, thus, its inability to promptly detect and control epidemics. OBJECTIVE: To examine the completeness and timeliness of data collection and information transmission process for DSN in the Anambra state. MATERIALS AND METHODS: The study was of cross-sectional design and employed the multistage sampling method to select 270 health workers who are involved in DSN in Anambra state. Data were collected by a mix method of interviewer administered questionnaire and observational checklist preceded by key informant interviews and desk review. RESULTS: One hundred (43.9%) health workers reported regular supply of Integrated Disease Surveillance and Response (IDSR) forms, 25% and 16.2% reported it was irregular and usually out of stock, respectively. Most facilities (81.5%) returned completed forms monthly. Secondary health facilities were less likely to submit completed forms, while majority of primary health facilities submitted theirs monthly ( X 2 = 4.42, P = 0.035). With respect to correctness of records, Health Management Information System records (55.6%) were the least correct, while out-patient register (88.9%) was the most correct. Only 10.0% of health facilities submitted completed forms 5 days after completion, 88.9% of them submitted completed IDSR002 forms within 2 days of completion, while the remainder was submitted 4 days later. CONCLUSION: The health workers were not operating the DSN system in the State to optimal functionality. Recommendations were therefore made for the periodic training-retraining of health personnel on DSN, improved funding, provision of logistics, improved supervision, and feedback of information.

Effectiveness of Data Collection and Information Transmission Process for Disease Notification in Anambra State; Nigeria

Background: Disease surveillance and notification (DSN) has been shown to be weak in Nigeria; thus; its inability to promptly detect and control epidemics.Objective: To examine the completeness and timeliness of data collection and information transmission process for DSN in the Anambra state.Materials and Methods: The study was of cross-sectional design and employed the multistage sampling method to select 270 health workers who are involved in DSN in Anambra state. Data were collected by a mix method of interviewer administered questionnaire and observational checklist preceded by key informant interviews and desk review.Results: One hundred (43.9) health workers reported regular supply of Integrated Disease Surveillance and Response (IDSR) forms; 25 and 16.2 reported it was irregular and usually out of stock; respectively. Most facilities (81.5) were the least correct; while out-patient register (88.9) was the most correct. Only 10.0 of health facilities submitted completed forms 5 days after completion; 88.9 of them submitted completed IDSR002 forms within 2 days of completion; while the remainder was submitted 4 days later.Conclusion: The health workers were not operating the DSN system in the State to optimal functionality. Recommendations were therefore made for the periodic training-retraining of health personnel on DSN; improved funding; provision of logistics; improved supervision; and feedback of information

Prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory of Nigeria.

BACKGROUND: In developing countries, biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food, water, nails, and fingers contaminated with faeces. Accordingly, food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. OBJECTIVE: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. MATERIALS AND METHODS: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool, urine, and fingernail analyses were carried out and the result scientifically scrutinized. RESULTS: FINGERNAIL BACTERIA ISOLATES INCLUDE: E. Coli (1.8%), coagulase-negative staphylococcus (17.9%), Staphylococcus aureus(7.1%), Klebsiella species (2.4%), Serratia species (1.2%), Citrobacter species (1.2%), and Enterococcus species (1.8%). The subjects' stool samples tested positive: For A. lumbricoides (14.9%), T. trichuria (1.8%), S. starcolaris (3.0%), E. histolytica (10.7%), G. lambilia (1.8%), S. mansoni (1.2%), and Taenia species (4.8%). Furthermore, 42.3% and 15.5% of the stool specimen tested positive for Salmonella and Shigella species, respectively. CONCLUSION: Food establishments should screen and treat staff with active illness, and regularly train them on good personal and workplace hygiene practices.

Determinants of subjective health status of HIV positive mothers in NAUTH Nnewi.

BACKGROUND: Acquired immune deficiency syndrome (AIDS) caused by human immune deficiency virus (HIV), once dominated by infected males has become feminized especially in sub-Saharan Africa where the majority of adults living with the condition are females. Positive life styles, belonging to social support groups and stigma-free HIV services by providers may have good impact on the quality of life of HIV-positive mothers. This study was aimed at assessing the determinants of subjective health status of HIV-positive mothers accessing prevention-of-mother-to-child-transmission (PMTCT) of HIV services in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. METHODS: This is a descriptive study in which 288 consenting HIV positive mothers were selected using the systematic sampling technique. Data on demographics, life style, social support, contraceptive use and subjective feeling about current health status were collected from the subjects using a pre-tested, structured, interviewer-administered questionnaire. RESULTS: The mean age of the respondents was 30.46 +/- 4.86 years. Majority (89.2%) of them were married while 55.2% were traders. A significantly higher proportion of the mothers on highly active anti retroviral therapy (HAART) (70.8%) than non users (29.2%) described their current health status as 'excellent' (p<0.001). Also a significantly higher proportion of condom users (99%) than pill users (1%) described their health status as 'excellent' (p<0.02). The same significantly higher proportions of 'excellent' response were given by subjects who engage in social support activities (p<0.001), who practice good feeding (p<0.01) andpersonal hygiene (p<0.01). CONCLUSION: Access to family planning services and HAART, participation in support group activities and positive lifestyle practices tend to improve subjective health status and should be comprehensively encouraged among the HIV positive mothers.

Prevalence and Pattern of Bacteria and Intestinal Parasites among Food Handlers in the Federal Capital Territory of Nigeria

Background: In developing countries; biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food; water; nails; and fingers contaminated with faeces. Accordingly; food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. Objective: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. Materials and Methods: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool; urine; and fingernail analyses were carried out and the result scientifically scrutinized. Results: Fingernail bacteria isolates include: E. Coli (1.8); coagulase-negative staphylococcus (17.9); Staphylococcus aureus(7.1); Klebsiella species (2.4); Serratia species (1.2); Serratia species (1.2); Citrobacter species (1.2); and Enterococcus species (1.8). The subjects' stool samples tested positive: For A. lumbricoides (14.9); T. trichuria (1.8); S. starcolaris (3.0); E. histolytica (10.7); G. lambilia (1.8); S. mansoni (1.2); and Taenia species (4.8). Furthermore; 42.3 and 15.5 of the stool specimen tested positive for Salmonella and Shigella species; respectively. Conclusion: Food establishments should screen and treat staff with active illness; and regularly train them on good personal and workplace hygiene practices

Perception of quality of care in HIV/AIDS programmes among patients in a tertiary health care facility in Anambra State.

BACKGROUND: Continuous quality improvement is linked to the use of timely and useful feedback from clients in Human Immuno-deficiency Virus (HIV) care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction ofAnti-Retroviral Treatment (ART) services in Nigeria has significantly impacted positively on the overall well being of People Living with HIV and Acquired Immune Deficiency Syndrome (PLWHA). However, there is little understanding of their satisfaction and perception of quality of care provided. Consequently, this study was carried out to assess patients' satisfaction with ambulatory HIV/AIDS care in a tertiary health facility in Anambra State. METHODS: The study design is cross-sectional. A total of 150 patients from Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi were selected using systematic sampling technique from the daily AntiRetroviral (ARV) clinic register obtained from the medical records department of the centre. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. RESULTS: The mean age of the respondents was 38.3 +/- 9.1. Majority (50.7%) of the patients was married, and most of them (74.7%) were semi-skilled workers. There was a statistically significant difference in the numbers of those who spent >240 naira for transportation to the clinic, compared to those who spent < or = 240 naira (98 versus 52). Similarly, the number of subjects that spent >30 minutes are significantly larger than the number that spent < or = 30 minutes to reach the clinic (142 versus 8). Also significantly greater number of participants spend >750 naira than those who spend <750 naira on non-HIV related laboratory (20 versus 9) tests. PLWHAs in this facility were least satisfied with access to care, while they expressed greatest satisfaction with good patient care and quality of service by staff. The overall satisfaction score of the subjects was 4.04 +/- 0.33. CONCLUSION: HIV patients' overall satisfaction with the services provided to them was quite high. Therefore, there is need to sustain the current level of quality of care provided to the patients and if possible improve upon it. However, efforts should be made to further decentralize ART services to make them more accessible to the growing number of PLWHAs needing care and support.

Predictors of road traffic accident, road traffic injury and death among commercial motorcyclists in an urban area of Nigeria.

BACKGROUND: Road traffic accidents, injuries and deaths remain important public health problems in both developed and developing countries. These problems have since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the urbanizing slum of Nnewi, Anambra state of Nigeria. METHOD: Using a semi-structured, interviewer-administered questionnaire, relevant data on socio-demographic and motorcycle characteristics were collected from a sample of 291 commercial motorcyclists selected by systematic sampling technique. Data on RTA, RTI and death were also collected from them overa period of three months. RESULT: The result showed that young commercial motorcyclists {<30 years of age}, experienced higher fatal injury rate than older ones {> or =30 years of age}, {p < 0.01}. Motorcyclists with some formal education experienced RTA and RTI incidence rates that were significantly lower than those of motorcyclists with no formal education, {p < 0.01}. In the same vein, medical condition and social vices such as alcohol intake among the motorcyclists were found to be obvious predictors of RTA, RTI and death. Furthermore, motorcyclists who used >100 cc engine capacity motorcycles had significantly higher RTA incidence rate {478.8/100 MCY}, RTI rate {223.2/100 MCY} and FIR {410/100 MCY} than users of <100 cc engine motorcycles who recorded RTA incidence of 258.9/100 MCY, RTI rate of 49/100 MCY and zero fatal injury respectively {p < 0.01, p < 0.001, p < 0.001 respectively}. CONCLUSION: A careful consideration of all these predictors individually and collectively, will enable stakeholders in transport industry plan effective RTA, RTI and death control measures. Rather than an outright ban of motorcycle transportation, evening classes can be organized for the motorcyclists at subsidized rates to improve their literacy levels to run side by side with road safety informational lessons delivered at their places of work.

Predictors of road traffic accident, road traffic injury and death among commercial motorcyclists in an urban area of Nigeria

Background: Road traffic accidents, injuries and deaths remain important public health problems in both developed and developing countries. These problems have since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the urbanizing slum of Nnewi, Anambra state of Nigeria. Method: Using a semi-structured, interviewer administered questionnaire, relevant data on socio-demographic and motorcycle characteristics were collected from a sample of 291 commercial motorcyclists selected by systematic sampling technique. Data on RTA, RTI and death were also collected from them over a period of three months. Result: The result showed that young commercial motorcyclists {<30 years of age}, experienced higher fatal injury rate than older ones {>30 years of age}, {p<0.01}. Motorcyclists with some formal education experienced RTA and RTI incidence rates that were significantly lower than those of motorcyclists with no formal education, {p<0.01}. In the same vein, medical condition and social vices such as alcohol intake among the motorcyclists were found to be obvious predictors of RTA, RTI and death. Furthermore, motorcyclists who used >100cc engine capacity motorcycles had significantly higher RTA incidence rate {478.8/100 MCY}, RTI rate {223.2/100MCY}and FIR {410/100MCY} than users of <100cc engine motorcycles who recorded RTA incidence of 258.9/100MCY, RTI rate of 49/100MCY and zero fatal injury respectively {p<0.01, p<0.001, p<0.001 respectively}. Conclusion: A careful consideration of all these predictors individually and collectively, will enable stakeholders in transport industry plan effective RTA, RTI and death control measures. Rather than an outright ban of motorcycle transportation, evening classes can be organized for the motorcyclists at subsidized rates to improve their literacy levels to run side by side with road safety informational lessons delivered at their places of work