Common under-five morbidity in South-Eastern Nigeria: a study of its pattern in a rural mission general hospital in Imo State.

BACKGROUND: The under-five children are the most vulnerable group that bears the burden of diseases to a large extent in Nigeria. This study was aimed at describing the common and pattern of under-five morbidity in a rural Mission General Hospital in Imo state, South-Eastern Nigeria. METHODS: A cross sectional descriptive hospital-based study was carried out from June 2008 to June 2009 on 244 under-five children aged 4 days to 58 months. The under-five children seen within the study period who met the selection criteria were studied. The data collected included age, sex and diagnosis made. RESULTS: One hundred and seven (43.8%) out of a total of 244 under-five children studied were aged 37-60 months, eighty one (33.2%) were aged 13-36 months and fifty six (23.0%) were aged 0-12 months. There were 141 (57.8%)males and 103 (42.2%) females. The three commonest causes of morbidity were malaria infections (80.3%), acute respiratory infections (32.0%) and skin infections (29.1%). The age group 37-60 months bears the greatest burden of malaria infections (49.0%), acute respiratory infections (55.1%) and skin infections (53.5%). CONCLUSION: This study shows that the three commonest causes of under-five morbidity (malaria, acute respiratory infections and skin infections) are largely preventable and infectious diseases still remaining major causes of morbidity; and similar to the under-five morbidity pattern documented at the beginning of the implementation of Primary Health Care and Child Survival Strategies in Nigeria. Identification, implementation, monitoring and evaluation of multidisciplinary and multisectoral intervention strategies targeted at the common under-five morbidity that are culturally acceptable, scientifically proven, patient-, family- and community-friendly and centred are recommended.

Obesity in adult Nigerians: a study of its pattern and common primary co-morbidities in a rural Mission General Hospital in Imo state,South-Eastern Nigeria.

OBJECTIVES: This study was generally aimed at determining the prevalence and pattern of obesity using body mass index (BMI) criterion and specifically screening for its common primary co-morbidities among adult Nigerians attending a rural Mission General Hospital in Imo state, South-Eastern Nigeria. MATERIALS AND METHODS: A descriptive study was carried out from June 2008 to May 2009. A total of 2156 consecutive new adult patients aged 18-90 years were screened for obesity using the BMI criterion, and 129 patients had BMI ≥ 30 kg/m² and met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, social class, weight, height and blood pressure, fasting blood sugar and lipid profile. RESULTS: The prevalence of obesity was 6.0%, with class I obesity (86.1%) being the most common pattern. Hypertension (16.3%) was the most common primary co-morbidity; others included low high-density lipoprotein-cholesterol (21.7%), high low-density lipoprotein-cholesterol (9.3%), high total cholesterol (7.8%), high triglyceridemia (4.7%) and diabetes mellitus (3.9%). CONCLUSIONS: This study has shown that obesity and its primary co-morbidities are emerging as a serious health problem among the study population, with class I obesity being the most common pattern and hypertension being the most common primary co-morbidity. Anthropometric determination of obesity and screening for its common primary co-morbidities should be integrated as part of the clinic baseline assessment of adult Nigerians attending rural hospitals to facilitate their early detection and institutionalization of appropriate preventive and therapeutic measures.

Perceptions on the use of insecticide treated nets in parts of the Imo River Basin, Nigeria: implications for preventing malaria in pregnancy.

This study aimed at assessing perceptions on use of ITNs in parts of the Imo River Basin, Nigeria and its implications in preventing malaria in pregnancy. Data was collected using focus group discussions, key informant interviews and structured questionnaires. Results showed high awareness on the benefits of ITNs. Factors affecting use of ITNs included its high cost, perceptions of chemicals used to treat them as having dangerous effects on pregnancy, low utilization of antenatal care, husband's lack of interest in malaria prevention and perceptions that adolescent girls are at low risk of getting malaria. The implications of these findings include demystifying the negative perceptions on the chemicals used for net treatment and subsidizing the cost of ITNs to increase access. These findings provide important lessons for malaria programmes that aim at increasing access to ITNs by pregnant women in developing countries.

Obesity in adult Nigerians: a study of its prevalence and common primary co-morbidities in a semi-urban Mission General Hospital in South-Eastern Nigeria.

BACKGROUND: Obesity is socially and culturally acceptable in Nigeria and therefore not usually recognized as a medical problem. This study is aimed at determining the prevalence of obesity using body mass index (BMI) criterion and its common primary comorbidities among adult Nigerians attending a semi-urban Mission General Hospital in Imo state, SouthEastern, Nigeria. METHODS: A descriptive study using primary data collection technique was carried out from October 2007 to December 2008. A total of 9296 consecutive new adult patients aged 18-88 years were screened for obesity using BMI criterion and 684 patients who had BMI = 30 kg/m2 met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, weight (kilogram), height (meters), and blood pressure; fasting blood sugar and fasting lipid profile. Obese patients' perception of their obese condition and knowledge of lifestyle modification were also assessed. RESULTS: Six hundred and eighty-four (7.4%) out of a total of 9296 patients screened for obesity were obese. Hypertension (18.4%) was the commonest primary comorbidity, others include high triglyceridaemia (9.2%), high total cholesterol (8.2%), high LDL-cholesterol (6.0%) and diabetes mellitus (3.4%). One hundred and one (14.8%) obese patients were aware of their obese condition and majority, 72 (71.3%) of them were informed of their obese condition by healthcare professionals. Forty seven (46.5%) of those who were aware of their obese condition had knowledge of lifestyle modification. However, majority (72.3%) of those who had knowledge of lifestyle modification demonstrated low knowledge level of lifestyle modification. CONCLUSION: This study has shown the existence of obesity and its common primary co-morbidities among the study population. Anthropometric determination of obesity and screening for its common primary comorbidities should be integrated as part of clinic baseline assessment of adult Nigerians attending semi-urban hospitals. Those who had obesity-related primary co morbidities should become secondary target for risk reduction therapy and appropriate management.

The knowledge, attitude and practices of food handlers in food sanitation in a metropolis in south eastern Nigeria.

The spread of diseases through food is still a common problem which results in appreciable morbidity and occasional mortality. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation. This study was designed to determine knowledge, attitude and practice of food handlers towards food-borne diseases and food safety. A total of 430 food handlers were randomly selected from Owerri Metropolis of Imo State Nigeria and interviewed using structured pretested questionnaire. Almost half (48.4%) of the respondents had poor knowledge of food sanitation. Multiple logistic regression showed type of premise [Odd Ratio (OR) = 4.0, 95% confidence interval (CI) = 1.8 - 7.5, P = 0.0004], educational level (OR = 0.4, 95% CI = 1.8 -7.4, P = 0.0003) and job status of food handlers (OR = 0.5, 95%, CI = 0.3 - 0.8, P = 0.0031) significantly influenced the score level of knowledge. There was no significant difference in attitude and practice between trained and untrained food handlers. Findings of this study may be important in planning health education intervention programs for food handlers in order to improve their knowledge, attitude and practice towards food borne diseases and food safety. This will help in reducing morbidity and mortality due to food-borne diseases.

Treatment of childhood fevers and other illnesses in three rural Nigerian communities.

The seeking of healthcare for childhood illnesses was studied in three rural Nigerian communities of approximately 10,000 population each. The aim was to provide a baseline understanding of illness behaviour on which to build a programme for the promotion of prepackaged chloroquine and cotrimoxazole for early and appropriate treatment of childhood fevers at the community level. A total of 3117 parents of children who had been ill during the 2 weeks prior to interview responded to questions about the nature of the illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illness and the actions taken. Local illness terms were elicited, and the most prevalent recent illnesses were 'hot body' (43.9 per cent), malaria, known as iba (17.7 per cent), and cough (7.4 per cent). The most common form of first-line treatment was drugs from a patent medicine vendor or drug hawker (49.6 per cent). Only 3.6 per cent did nothing. Most who sought care (77.5 per cent) were satisfied with their first line of action, and did not seek further treatment. The average cost of an illness episode was less than US$2.00 with a median of US$1.00. Specifically, chloroquine tablets cost an average of US 29 cents per course. Analysis found a configuration of signs and symptoms associated with chloroquine use, to include perception of the child having malaria, high temperature and loss of appetite. The configuration positively associated with antibiotic use consisted of cough and difficult breathing. The ability of the child's care-givers, both parental and professional, to make these distinctions in medication use will provide the foundation for health education in the promotion of appropriate early treatment of childhood fevers in the three study sites.