Prevalence and Predictors of Hypocalcaemia among Adolescent Girls in Rural Public Secondary Schools in South-South Nigeria.

Background: Adolescent girls are at risk of developing skeletal inadequacy due to an imbalance between calcium intake and high requirements of calcium during this period of increased modeling and skeletal consolidation. This study assessed the prevalence and predictors of hypocalcaemia among adolescent girls in rural public secondary schools in south-south Nigeria. Methods: This was a cross-sectional study conducted to assess the prevalence and predictors of hypocalcaemia among 238 adolescent girls selected by a multi-stage sampling technique. Data was collected using a semi-structured questionnaire which was interviewer-administered. Descriptive and inferential analysis of data collected was carried out using the IBM SPSS version 22 software. Results: Over half (53.3%) and 75.2% of the participants were in their late adolescence period (17-19 years) and belonged to the lower social class level. Over one-quarter (30.7%) of the participants had hypocalcaemia. Participants who were in their mid-adolescence period (14-16 years) (OR= 2.38; 95% CI: 1.23-4.57), who skipped lunch (OR= 2.92; 95% CI: 1.35-6.34), who skipped breakfast (OR= 3.60; 95% CI: 1.65-7.83) and were in senior secondary 1 class (OR= 4.76; 95% CI: 1.21-18.75) had 2, 3, 4, and 5 times higher likelihood respectively of having hypocalcaemia. Participants who consume milk daily, who consume milk weekly and who had normal weight had 81.0%, 60.0% and 72.0% decreased odds respectively of having hypocalcaemia. Conclusion: The study brings to the fore a high prevalence of hypocalcaemia among the participants. Educational interventions targeted at parents to support adolescent girls to take calcium-supplements and calcium-rich meals should be implemented.

A cross-sectional analysis of respiratory ill-health among charcoal workers and its implications for strengthening occupational health services in southern Nigeria.

OBJECTIVES: This study was conducted to assess the concentration of air pollutants at charcoal sites, the dose-response relationship between site-based exposure levels to air pollutants and prevalence of respiratory symptoms among charcoal workers, and the measures these workers employ to safeguard their health. DESIGN: Cross-sectional but comparative design SETTING: Charcoal production kiln sites in Sapele, Delta State, Nigeria. PARTICIPANTS: Overall 296 charcoal workers and age-matched, sex-matched and height-matched non-exposed traders (comparison group). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the prevalence of respiratory symptoms among charcoal workers while secondary outcomes included lung function indices as well as hazard control practices among charcoal workers. RESULTS: Majority (83.3%) of the sites had PM10 and PM2.5 values five times higher than the WHO standard. Charcoal workers were more likely to have respiratory symptoms; wheeze was statistically significant after adjusting for confounders, (OR 4.22; CI 1.37 to 12.99). The dose-response relationship between site-based exposure levels to air pollutants and the prevalence of respiratory symptoms among charcoal workers was statistically significant for all symptoms except chest tightness (p=0.167). Mean forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were considerably lower among workers with differences of -0.22 (-0.42 to -0.05) L and -0.52 (-0.76 to -0.29) L, respectively, whereas FEV1/FVC ratio and peak expiratory flow rate were higher among workers with mean differences of 5.68 (3.59-8.82)% and 0.31 (-23.70 to 24.43) L/min, respectively; but the mean difference was significant only for the FEV1/FVC ratio. Charcoal workers had poor hazard control practices; only 3.4% reportedly used personal protective equipment. CONCLUSION: Air pollutants at kiln sites were higher than WHO standards. Despite the significantly higher prevalence of wheeze, chest tightness and chronic cough among charcoal workers, their hazard control practices were inadequate. Charcoal workers should adopt appropriate hazard control practices, and use improved devices which emit minimal pollutants.

Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities

Background: Health care-associated infection remains a significant hazard for hospitalized patients. Hand hygiene is a fundamental action for ensuring patient safety. Objective: To promote adoption of World Health Organization Hand Hygiene Guidelines to enhance compliance among doctors and nurses and improve patient safety. Methods: The study design was a cross sectional intervention in a Federal Teaching Hospital South-eastern Nigeria. Interventions involved training/education; introduction of hand rub; and hand hygiene reminders. The impact of interventions and hand hygiene compliance were evaluated using World Health Organization direct observation technique. Results: The post-intervention hand hygiene compliance rate was 65.3%. Hand hygiene indications showed highest compliance rate ‘after body fluid exposure' (75.3%) and ‘after touching a patient' (73.6%) while the least compliance rate was recorded ‘before touching a patient' (58.0%). Hand hygiene compliance rate was significantly higher among nurses (72.9%) compared to doctors (59.7%) (χ2 = 23.8, p < 0.05). Hand hygiene indication with significantly higher compliance rate was “before clean/aseptic procedure” (84.4%) (χ2 = 80.74, p < 0.05). Out of the 815 hand hygiene practices recorded 550 (67.5%) were hand rub action. Conclusions: hand hygiene campaigns using the World Health Organization tools and methodology can be successfully executed in a tertiary health facility of a low-income setting with far reaching improvements in compliance. .

Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities.

BACKGROUND: Health care-associated infection remains a significant hazard for hospitalized patients. Hand hygiene is a fundamental action for ensuring patient safety. OBJECTIVE: To promote adoption of World Health Organization Hand Hygiene Guidelines to enhance compliance among doctors and nurses and improve patient safety. METHODS: The study design was a cross sectional intervention in a Federal Teaching Hospital South-eastern Nigeria. Interventions involved training/education; introduction of hand rub; and hand hygiene reminders. The impact of interventions and hand hygiene compliance were evaluated using World Health Organization direct observation technique. RESULTS: The post-intervention hand hygiene compliance rate was 65.3%. Hand hygiene indications showed highest compliance rate 'after body fluid exposure' (75.3%) and 'after touching a patient' (73.6%) while the least compliance rate was recorded 'before touching a patient' (58.0%). Hand hygiene compliance rate was significantly higher among nurses (72.9%) compared to doctors (59.7%) (χ(2)=23.8, p<0.05). Hand hygiene indication with significantly higher compliance rate was "before clean/aseptic procedure" (84.4%) (χ(2)=80.74, p<0.05). Out of the 815 hand hygiene practices recorded 550 (67.5%) were hand rub action. CONCLUSIONS: hand hygiene campaigns using the World Health Organization tools and methodology can be successfully executed in a tertiary health facility of a low-income setting with far reaching improvements in compliance.

Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers and stakeholders perspective and involvement.

INTRODUCTION: Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. METHODS: A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). RESULTS: Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. CONCLUSION: Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.

Assessment of the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South Eastern Nigeria.

BACKGROUND: Nigeria has one of the worst maternal and child health indices globally. AIMS: The objective of this study was to assess the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South East Nigeria. SUBJECTS AND METHOD: This was a cross-sectional descriptive study of pregnant women selected by systematic random sampling. The study instrument was a pre-tested semi-structured interviewer-administered questionnaire. RESULT: The age range of the women in the study was 16-43 years. The mean age was 25.3 ± 1.3 years. According to the scoring system used, about one-fourth of the women (26%) had a high risk pregnancy while about a tenth (9.1%) had very high risk pregnancy. The vast majority of the women with at-risk pregnancies registered for antenatal care late: 58.9 % registered for antenatal care in the second trimester and 37.0 % registered for antenatal care in the third trimester of pregnancy. Of the women with an at-risk pregnancy, 79.5% had their last delivery at home and 67.1 % of them preferred to deliver at home in their current pregnancies. CONCLUSION: This study revealed that a substantial proportion of rural women with at-risk pregnancies go through their pregnancy period without significant modern antenatal care. The local government health department should intensify efforts through health enlightenment campaigns to educate rural pregnant women of the benefits of utilizing modern antenatal care services.