Rural-urban disparities in maternal immunization knowledge and childhood health-seeking behavior in Nigeria: a mixed method study.

BACKGROUND: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths. OBJECTIVES: To compare maternal knowledge about immunization, use of growth chart and childhood health-seeking behavior in rural and urban areas. METHODS: A cross-sectional comparative study done in Lagos, Nigeria. Questionnaire survey and focus group discussions were done. 300 respondents were selected by multi-stage sampling while discussants were purposively selected. RESULTS: Awareness of immunization was high but knowledge of vaccine preventable diseases (VPDs) was poor in both areas. Urban women utilized preventive services more; growth monitoring (p<0.001) and immunization (p<0.001) while higher proportions of rural women utilized nutritional counseling (p=0.005) and treatment of illness (p<0.001). Growth chart utilization was better in the urban areas (p<0.001). Increasing maternal education increased use of growth chart in both areas. Both groups of women use multiple treatment sources for children (more in urban), determined by cost, time, perceived severity of illness and type of ailment (urban) and peculiarity of illness (rural). There is a preference for orthodox care in the rural area. CONCLUSIONS: Knowledge of VPDs was poor and multiple treatment sources were common among rural and urban women. Education is vital to improve immunization knowledge and health-seeking behavior in both areas.

Rural-urban Disparities in Maternal Immunization Knowledge and Childhood Health-Seeking Behavior in Nigeria: a Mixed Method Study

Background: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths. Objectives: To compare maternal knowledge about immunization; use of growth chart and childhood health-seeking behavior in rural and urban areas. Methods: A cross-sectional comparative study done in Lagos; Nigeria. Questionnaire survey and focus group discussions were done. 300 respondents were selected by multi-stage sampling while discussants were purposively selected. Results: Awareness of immunization was high but knowledge of vaccine preventable diseases (VPDs) was poor in both areas. Urban women utilized preventive services more; growth monitoring (p0.001) and immunization (p0.001) while higher proportions of rural women utilized nutritional counseling (p

Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria.

BACKGROUND/OBJECTIVE: Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over-speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers' knowledge of selected road safety measures, i.e. the pre-requisites for driver's license, road signs and speed limits. MATERIALS AND METHODS: This was a cross-sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre-tested, structured, interviewer-administered questionnaire and analyzed with epi-info statistical software. RESULTS: Two hundred and sixty-one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver's license and 53.8% knew the correct minimum age for obtaining driver's license. Only 1% of the drivers had correct knowledge of the driver's license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. CONCLUSION: The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledge.

Use of complementary medicine amongst patients on antiretroviral drugs in an HIV treatment centre in Lagos, Nigeria.

Traditional herbal remedies have been used to treat many ailments in Nigeria but the safety of herbal remedies has been the major concerns to many people especially when the chemical constituents of the products are not known. This study is therefore designed to evaluate the prevalence of use of complementary drugs with antiretroviral (ARV) therapy and possible treatment outcome of the concurrent utilization of these therapeutic agents. A descriptive cross-sectional survey of 354 HIV patients attending APIN clinics in LUTH using a consecutive sampling technique was used. There was also correlation of the data obtained from the patients with their clinical case notes. Results showed that only 8.2 % of the respondents' used herbal medicine concurrently with ARV therapy. Ninety percent of the participants were on a two nucleoside and one non-nucleoside based ARV therapy. The most common regimen (55%) was Zidovudine/lamivudine/Nevirapine fixed dose combination while 10% use a protease inhibitor based regimen. The commonly herbal drugs used ranges from Jobelyn [Sorghum bicolor plant leaves (13.8%)], Garlic [Allicin, γ-glutamyl- (s)-ally-L-Cysteine] (10.3%), Ginger [Essential oil] (17.2%) and Aloe vera [Hydroxyanthracene derivatives expressed as Barbaloin] (10.3%). The major reason for the commencement of herbal medicine is the perception that the medicine will boost their immunity (65.5%). However, there was a marginal improvement though not significant (p ≥ 0.05) in the CD4 counts (489.8 ± 195.2; 419.1 ± 236.2) and viral load (5117.8 ± 26092.0; 31136.7 ± 197954.6) of HIV patients on herbal drugs compared to those who are not on herbal drugs. Herbal medicines have potentials to interact with ARVs and thus result in adverse reactions and possibly therapeutic failure. There is need for thorough investigation of the pharmacological action of these herbal medicines in HIV treatment taking into consideration their pharmacokinetic and toxicological profile.

Cancer distribution pattern in south-western Nigeria.

The burden of cancer in Nigeria is appreciable with about 100,000 new cancer cases being reported in the country each year. This study aimed to determine the level of occurrence and pattern of distribution of different cancer types in two major functional cancer registries in south-western Nigeria. A desk review of the level of occurrence and pattern of distribution of different cancer types in Lagos and Ibadan cancer registries over a 5 year period (2005-2009) was carried out. The results obtained showed a total number of 5094 cancer patients registered between 2005 and 2009 in both Lagos (60%) and Ibadan (40%) cancer registries. Breast cancer accounted for the majority of cases (20.2%), followed by cervical cancer (7.9 %), fibroid (4.4%), liver (4.4%), stomach (4.3%), brain (3.9%), pancreas (3.8%), prostate (3.3%), lung (3.0%) and cancer of the kidney (0.7%). There were significant differences (P ≤ 0.05) in the level of occurrence between cancers of the breast, cervix, prostate, liver, ovary and all other cancers. Liver cancer (147; 77) and bone cancer (91; 37) were predominant in females than males while lung cancer (89; 65), stomach cancer (112; 109), and kidney cancer (24; 14) were predominant in males than females. In conclusion, the findings of this study provide insights to cancer epidemiology in the western region of Nigeria. This study confirms earlier findings that breast, prostate, liver and cervical cancers account for the majority of cases of cancers in Nigeria. Thus, there is need to organize a wider scale suitable methods for early detection of these diseases.

Knowledge, treatment seeking and preventive practices in respect of malaria among patients with HIV attending Lagos University Teaching Hospital, Nigeria.

The synergistic interaction between Human Immunodeficiency virus (HIV) disease and malaria makes it mandatory for patients with HIV to respond appropriately in preventing and treating malaria. Such response will help to control the two diseases. This study assessed the knowledge of 495 patients attending the HIV clinic, in Lagos University Teaching Hospital, Nigeria. Their treatment seeking, preventive practices with regards to malaria, as well as the impact of socio-demographic / socioeconomic status were assessed. Out of these patients, 245 (49.5%) used insecticide treated bed nets; this practice was not influenced by sociodemographic or socioeconomic factors. However, knowledge of the cause, knowledge of prevention of malaria, appropriate use of antimalarial drugs and seeking treatment from the right source increased with increasing level of education (P < 0.05). A greater proportion of the patients, 321 (64.9%) utilized hospitals, pharmacy outlets or health centres when they perceived an attack of malaria. Educational intervention may result in these patients seeking treatment from the right place when an attack of malaria fever is perceived.