Dietary habits, physical activity and sleep pattern among in-school adolescents in Lagos, Nigeria

Background: Overnutrition has been documented at epidemic levels in children and adults. The associated risk factors may include poor dietary habits, sedentary behaviour, inadequate sleep and low parental education. Objective: To describe dietary habits, physical activity and sleep patterns among secondary school adolescents. Methods: A cross-sectional study of 1,120 adolescents recruited from public and private secondary schools in Lagos, Nigeria, was carried out to study the dietary habits, sleep patterns and physical activity in relation to nutritional status. Results: Ten per cent of the adolescents skipped breakfast, while 28% had fruits on up to five days of the week. Eleven per cent had a sweetened drink every day, while 20 % had a sweetened drink on most days of the week. One out of four (26%) adolescents had more than two hours of screen time daily, and only 5% engaged in sporting activities up to five times weekly. One-third of the students slept for less than six hours daily and experienced sleeping difficulties. Multivariate analysis showed that females were twice as likely not to participate in sports (OR = 2.38, CI = 1.3-4.37, p = 0.002 and to have a higher intake of confectionaries (OR = 1.47, CI = 1.07-2.04, p = 0.01. Conclusion: Poor dietary habits, inadequate physical activity and insufficient sleep were observed among secondary school adolescents. A multi-pronged approach to improve these behaviours is recommended

Determinants of Adherence among Patients on Highly Active Anti-Retroviral Therapy in Lagos State, Nigeria.

BACKGROUND: Poor medication adherence in HIV treatment is a public health problem as it leads to increased morbidity and mortality, as well as the development of drug resistance. There is limited information on the determinants of adherence among people living with HIV/AIDS especially in sub-Saharan Africa. This study aimed at assessing the determinants of adherence to HAART among people living with HIV/AIDS in Lagos State, Nigeria. METHODS: A descriptive cross-sectional survey was conducted among 302 respondents selected from three public health facilities across the state. The study instrument was an interviewer-administered questionnaire adapted from the Medication Adherence Report Scale (MARS). Data analysis was performed using Epi Info software. Logistic regression analysis was used to identify the determinants of adherence. Level of significance for all the tests was set at p-value <0.05. RESULTS: Seventy percent of respondents reported being adherent to medication. There were statistically significant associations between respondents' age, having children, good knowledge of HIV and medication adherence. In addition, it was observed that the type of anti-retroviral (ARV) drug schedule, never missing an appointment, belonging to a support group and disclosure of status were associated with HAART adherence. Controlling for other variables, those that had disclosed their status were twice as likely to adhere to HIV medication (aOR: 2.3; 95% CI: 1.1-4.8). Also, those who had never missed a clinic appointment were three times more likely to adhere to prescribed medication (aOR: 3.4; 95% CI: 1.7-6.5). CONCLUSION: Disclosure of HIV status and clinic attendance were key determinants of adherence among patients on HAART in Lagos, Nigeria.

RÉSUMÉ: La mauvaise adhésion aux médicaments dans le traitement du VIH est un problème de santé publique car elle entraîne une augmentation de la morbidité et de la mortalité, ainsi que le développement d'une résistance aux médicaments. Il existe peu d'informations sur les déterminants de l'adhésion chez les personnes vivant avec le VIH/SIDA, en particulier en Afrique subsaharienne. Cette étude visait à évaluer les déterminants de l'adhésion au HAART chez les personnes vivant avec le VIH/SIDA dans l'État de Lagos, au Nigéria. MÉTHODES: Une enquête transversale descriptive a été menée auprès de 302 répondants sélectionnés dans trois établissements de santé publics à travers l'État. L'instrument de l'étude était un questionnaire administré par l'intervieweur, adapté de la Medication Adherence Report Scale (MARS). L'analyse des données a été réalisée à l'aide du logiciel Epi Info. Une analyse de régression logistique a été utilisée pour identifier les déterminants de l'adhésion. Le niveau de signification pour tous les tests a été fixé à une valeur p < 0,05. RÉSULTATS: Soixante-dix pour cent des répondants ont déclaré être adhérents aux médicaments. Il y avait des associations statistiquement significatives entre l'âge des répondants, le fait d'avoir des enfants, une bonne connaissance du VIH et l'observance du traitement. De plus, il a été observé que le type d'horaire des médicaments antirétroviraux (ARV), ne jamais manquer un rendez-vous, appartenir à un groupe de soutien et la divulgation du statut étaient associés à l'adhésion au HAART. En contrôlant les autres variables, ceux qui avaient divulgué leur statut étaient deux fois plus susceptibles d'adhérer aux médicaments anti-VIH (aOR : 2,3 ; IC à 95 % : 1,1­4,8). De plus, ceux qui n'avaient jamais manqué un rendez-vous à la clinique étaient trois fois plus susceptibles de respecter les médicaments prescrits (aOR : 3,4 ; IC à 95 % : 1,7-6,5). CONCLUSION: La divulgation du statut VIH et la fréquentation de la clinique étaient des déterminants clés de l'adhésion chez les patients sous HAART à Lagos, au Nigeria. MOTS CLÉS: Déterminants, compliance médicamenteuse, Thérapie antirétrovirale, PVVIH.

Tuberculosis infection prevention and control measures in DOTS centres in Lagos State, Nigeria.

Nigeria is a high tuberculosis (TB) burden country. However, there is limited evidence on implementation of tuberculous infection prevention and control (TBIC) practices in Nigeria. To assess TBIC practices, and barriers to their implementation, in TB-DOTS centres in Lagos State, Nigeria. A descriptive cross-sectional study was used to assess 112 TB-DOTS centres in primary and secondary health facilities in Lagos State using mixed methods. Quantitative data comprised a survey and measurement of the air exchange rate in a subsample of centres. The qualitative aspect comprised focus-group discussions to highlight health care workers' (HCWs') perceptions of TBIC guidelines and barriers to their implementation. The majority of the DOTS centres had a dedicated TBIC officer, while a fifth (21%) had documented TBIC plans. About 57% of DOTS centres had staff that had been trained on TBIC and 37% provided some form of personal respiratory protection (face masks/tissue papers) for staff or patients. The air exchange rate was adequate in 21% of centres. The HCWs' perception of being at risk of contracting TB was reported to affect the way they relate to TB patients. The key barrier to implementing TBIC was the design of DOTS centres. TBIC measures at study centres were inadequate. Institutional commitment, renovation of existing and appropriate design of new DOTS centres in the future to improve TBIC implementation is recommended. .

Tuberculosis infection control measures in health care facilities offering tb services in Ikeja local government area, Lagos, South West, Nigeria.

BACKGROUND: Tuberculosis infection among health care workers is capable of worsening the existing health human resource problems of low--and middle-income countries. Tuberculosis infection control is often weakly implemented in these parts of the world therefore, understanding the reasons for poor implementation of tuberculosis infection control guidelines are important. This study was aimed at assessing tuberculosis infection control practices and barriers to its implementation in Ikeja, Nigeria. METHODS: A cross-sectional study in 20 tuberculosis care facilities (16 public and 4 private) in Ikeja, Lagos was conducted. The study included a facility survey to assess the availability of tuberculosis infection control guidelines, the adequacy of facilities to prevent transmission of tuberculosis and observations of practices to assess the implementation of tuberculosis infection control guidelines. Four focus group discussions were carried out to highlight HCWs' perceptions on tuberculosis infection control guidelines and barriers to its implementation. RESULTS: The observational study showed that none of the clinics had a tuberculosis infection control plan. No clinic was consistently screening patients for cough. Twelve facilities (60%) consistently provided masks to patients who were coughing. Ventilation in the waiting areas was assessed to be adequate in 60% of the clinics while four clinics (20%) possessed N-95 respirators. Findings from the focus group discussions showed weak managerial support, poor funding, under-staffing, lack of space and not wanting to be seen as stigmatizing against tuberculosis patients as barriers that hindered the implementation of TB infection control measures. CONCLUSION: Tuberculosis infection control measures were not adequately implemented in health facilities in Ikeja, Nigeria. A multi-pronged approach is required to address the identified barriers to the implementation of tuberculosis infection control guidelines.