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.

Prevalence of noncommunicable disease risk factors among market traders in Jos North Local Government Area, Plateau State Nigeria.

BACKGROUND: Noncommunicable diseases have become a new public health priority in low-and middle-income countries where urbanization and lifestyle changes have approached what obtains in developed countries. AIM: The aim of this study was to estimate the prevalence of noncommunicable disease risk factors among market traders in Jos North Local Government Area of Plateau State. METHOD: This was a descriptive cross-sectional study carried out among adult market traders who were selected through a two-stage sampling technique. Data were collected using a semi-structured interviewer-administered questionnaire adapted from the WHO STEP-wise tool. Anthropometric measurements were taken along with blood pressure readings. Data were analyzed using Epi Info version 3.5.4 and a value of P ≤ 0.05 was considered statistically significant. RESULTS: A total of 271 respondents were studied with a mean age of 36.2 ± 13.3 years. Prevalence of hypertension was 26.6% and diabetes mellitus 9.6%. Overweight and obesity were observed in 26.2% and 31.0% of the population, respectively while inadequate intake of fruits and vegetables was reported by 88.9% and 69.4% of respondents respectively. Current alcohol and cigarette use was 25.5% and 0.7% respectively while 245 (90.4%) respondents were sedentary. Current alcohol use, inadequate fruit and vegetable intake and obesity were associated with hypertension just as current alcohol use, sedentary lifestyle and consumption of carbonated drinks were associated with diabetes mellitus. CONCLUSION: The prevalence of hypertension and diabetes mellitus and their associated risk factors was high among these market traders. Therefore, there is need for focused preventive interventions in this neglected group.

Public-private mix in tuberculosis control: an assessment of level of implementation in Jos, Plateau State.

AIMS AND OBJECTIVES: After the initial gains in Tuberculosis case detection and cure rates, progress became stunted by persisting constraints and challenges in the implementation of the Directly Observed Treatment Short course strategy. This prompted the Stop Tuberculosis partners in 2006 to adopt innovative approaches including the Public-Private Mix, to improve access to and quality of care. This paper assesses the level of Public-Private Mix in Tuberculosis control in Jos, Plateau State. MATERIALS AND METHODS: This was a facility-based, cross sectional study where data from all consenting private health care facilities owned by medically trained personnel and private medical practitioners in Jos North and Jos South Local Government Areas was collected using structured questionnaires. RESULTS: Eight (47.1%) of all 17 facilities assessed gave anti Tuberculosis drugs on clinical suspicion of Tuberculosis, 5(29.4%) required Acid Fast Bacillus result and 3(17.6%) referred elsewhere for the Tuberculosis management. Only 6 facilities (35.3%) were microscopy, treatment centres, or both. Ten (58.8%) of the facilities had the Directly Observed Treatment Short course guidelines, but these could be sighted in only 5 (29.4%), while six (35.3%) had Tuberculosis record and referral forms. In 13 (76.5%) of the facilities, no local government Tuberculosis and Leprosy supervisors had ever visited them. Only 30 (57.7%) medical practitioners had access to the Directly Observed Treatment Short course. Thirty two (61.5%) respondents treated Tuberculosis according to the Directly Observed Treatment Short course strategy, but 19 (36.5%) still used the conventional method. Only 22(42.3%) practitioners had ever received any training on the Directly Observed Treatment Short course strategy. CONCLUSION: The level of Public-Private Mix in Tuberculosis control in Jos is low.

Prevalence of urinary schistosomiasis in school-aged children in Langai, Plateau State: pre- and post-intervention.

BACKGROUND: Schistosomiasis poses a public health challenges, but for several reasons it is not considered a priority in national and local health policies and programmes. The objective of this study was to determine the effect of health education and drug treatment on the prevalence of Urinary Schistosomiasis among school-aged children in Langai community of Plateau state. METHODS: Two hundred and eighteen children (218) subjects who were selected by multi-staged sampling methods were administered semi-structured questionnaires and their urine samples were assayed for S. haematobium ova using the sedimentation method before and after drug treatment with Praziquantel tablets RESULTS: Pre-intervention, fourteen (14) respondent had urinary Schistosomiasis, giving a prevalence of 6.4% with males (64.3%) having the higher prevalence both pre- and post-intervention. Six weeks after intervention, prevalence had reduced to 0.9%, giving a cure rate of about 92%. Of the 22 respondents (10.1%) who had ever noticed 'blood in their urine', only 6 (27.3%) had Schistosoma ova present in their urine samples at the time of the study. CONCLUSION: It was concluded that drug treatment with Praziquantel, especially when combined with Health Education was effective in reducing the prevalence of Urinary Schistosomiasis among school-aged children in Langai Community of Plateau State.

Knowledge and treatment practices of malaria among mothers and caregivers of children in an urban slum in Jos, Nigeria.

BACKGROUND: Malaria is a public health problem in more than 90 countries, inhabited by a total of 2.4 billion people, representing about 40% of the world's population. Major trends over the last few decades point to a worsening situation if effective action is not taken. Sadly, this is in spite of enormous efforts and resources that have been invested in its control. The objective of this study was to describe the level of knowledge of malaria as a disease and the practice of its treatment by mothers and caregivers of under five children in Gangare, an urban slum of Jos City, Nigeria. METHODOLOGY: A cross-sectional descriptive study design, a cluster sampling technique and an interviewer administered questionnaire were used to collect information on socio demographic profiles as well as knowledge and treatment practices of malaria from mothers and caregivers of under five children in Gangare, Jos North Local Government Area of Plateau State, central Nigeria. The data was then analyzed using Epi info2002 epidemiological software. RESULTS: The study revealed a low level of knowledge of malaria with 248 (49.6%) being able to recognize the disease and only 124 (24.9%) attributing it to the mosquito bite. The attitude of most respondents towards malaria as an illness was however good as 275 (55%) viewed it as a very serious illness and most of them 328 (65.6%) would use hospitals/clinics for treatment. Majority of them; 462 (92.4%) have not heard of Artemisinin Combination Therapy (ACT) and only 19 (50%) of those who had heard of ACT had ever used it for the treatment of malaria. Generally their knowledge of malaria and treatment seeking practice are influenced by cost of treatment, perceived safety and level of their education. (p < 0.05). CONCLUSION: Among mothers and caregivers living in slums in Jos, their ability to recognize malaria is poor. So also is their awareness and use of Artemisinin Combination Therapy. An improvement in their level of education and their economic power could improve their knowledge and treatment practices.

Knowledge and Treatment Practices of Malaria among Mothers and Caregivers of Children in an Urban Slum in Jos; Nigeria

A cross-sectional descriptive study design; a cluster sampling technique and an interviewer administered questionnaire were used to collect information on socio demographic profiles as well as knowledge and treatment practices of malaria from mothers and caregivers of underfive children in Gangare; Jos North Local Government Area of Plateau State;central Nigeria. The data was then analyzed using Epi info2002 epidemiological software. The study revealed a low level of knowledge ofmalaria with 248(49.6) being able to recognize the disease and only 124(24.9) attributing it to the mosquito bite. The attitude of most respondents towards malaria as an illness was however good as 275(55) viewed it as a very serious illness and most of them 328(65.6) woulduse hospitals/clinics for treatment. Majority of them; 462(92.4) have not heard of Artemisinin Combination Therapy (ACT) and only 19(50) of those who had heard of ACT had ever used it for the treatment of malaria.Generally; their knowledge of malaria and treatment seeking practice are influenced by cost of treatment; perceived safety and level of their education. (p

Impact of health education on sexual risk behaviour of secondary school students in Jos, Nigeria.

BACKGROUND: Secondary school students are a high risk group for HIV transmission. They could also be easily reached with health education interventions. There is as yet no global consensus on the nature, content and effectiveness of this intervention among this group. It is also not known how effective this intervention is in reducing sexual risk behaviour among secondary school students in our environment. The aim of the study was to find out the impact of HIV/AIDS health education intervention on the sexual risk behaviour of secondary school students. METHODS: This was an interventional follow-up study among senior secondary school students with controls selected from similar schools. The students' sexual risk behaviour was assessed at baseline followed by a HIV/AIDS health education intervention. The risk behaviour was then re-assessed 6 months after the intervention. RESULT: Students who lived in urban areas and those who lived with both parents were less likely to have experienced sexual intercourse at baseline than those who lived in the rural areas (but school in Jos during school sessions), and those who lived with single parents and other relations. Health education delayed sexual debut among students who were sexually naïve but had no effect on the sexual activity of those who were already sexually experienced. CONCLUSION: Health Education intervention has a place in reducing secondary school students' sexual risk behaviourif commenced before their sexual debut.

Impact of health education on sexual risk behaviour of secondary school students in Jos, Nigeria

BACKGROUND:Secondary school students are a high risk group for HIV transmission. They could also be easily reached with health education interventions. There is as yet no global consensus on the nature, content and effectiveness of this intervention among this group. It is also not known how effective this intervention is in reducing sexual risk behaviour among secondary school students in our environment. The aim of the study was to find out the impact of HIV/AIDS health education intervention on the sexual risk behaviour of secondary school students.METHODS:This was an interventional follow-up study among senior secondary school students with controls selected from similar schools. The students' sexual risk behaviour was assessed at baseline followed by a HIV/AIDS health education intervention. The risk behaviour was then re-assessed 6 months after the intervention.RESULT: Students who lived in urban areas and those who lived with both parents were less likely to have experienced sexual intercourse at baseline than those who lived in the rural areas (but school in Jos during school sessions), and those who lived with single parents and other relations. Health education delayed sexual debut among students who were sexually naïve but had no effect on the sexual activity of those who were already sexually experienced.CONCLUSION:Health Education intervention has a place in reducing secondary school students' sexual risk behaviourif commenced before their sexual debut

Current knowledge and practice of exclusive breastfeeding among mothers in Jos, Nigeria.

BACKGROUND: Exclusive Breastfeeding has been recommended the world over as the optimal feeding mode for young infants. A cross sectional study to determine the current level of knowledge and practice of nursing mothers on exclusive breastfeeding in Jos was carried out. METHODS: The target population of interest was nursing mothers who have infants aged 6-12 months in Jos, a cosmopolitan city in the north central zone of Nigeria. A pre-tested, structured close ended interviewer questionnaire was used. Four hundred and seventy nursing mothers who consented were recruited for the study through a house-to-house visit. Three assistants (two females and a male) were recruited and trained on the questionnaire administration. Data analysis was by SPSS software and chi-square test of proportion for statistical significance of association was done. RESULTS: Out of the 470 nursing mothers studied 387 (82.3%) were able to define correctly exclusive breastfeeding while 315 (67.0%) practiced or were practicing exclusive breastfeeding at the time of this study. The knowledge and practice of exclusive breastfeeding was found to increase with increasing age and better educational status of the women. Ninety six (20.4%) nursing mothers said they never breastfed their babies while in public place. CONCLUSION: Although knowledge and practice of exclusive breastfeeding among the women were considerably high, the younger age brackets were less knowledgeable arid adherent to the practice. Targeting adolescents for exclusive breastfeeding education and sensitization is necessary in preparing them for motherhood.