Uptake of hepatitis B vaccination and its determinants among health care workers in a tertiary health facility in Enugu, South-East, Nigeria.

BACKGROUND: Hepatitis B vaccination is the most effective method of prevention for hepatitis B virus infection. It is a major public health problem in Nigeria, and health workers are at increased risk. This study determined the uptake of hepatitis B vaccination and assessed its determinants among health care workers (HCWs). METHODS: A hospital-based cross-sectional study was conducted between July and August, 2016 using self-administered structured questionnaires among 3132 HCWs in University of Nigeria Teaching Hospital, Enugu, South-East, Nigeria. Data was analysed using SPSS version 22. Binary logistic regression analysis was used to identify factors that influenced uptake of vaccination. Ethical clearance was obtained from the Research Ethics Committee of the health facility. RESULTS: The uptake of hepatitis B vaccination was 14.2% (n = 445). The number of doses received were: 3 doses (218/3132, 48.9%), 2 doses (71/3132, 16.0%), and one dose (156/3132, 35.1%). The reasons for non-uptake of vaccination included: cost of vaccine 48 (10.8%), 'did not believe they could be infected' 28 (6.6%), long vaccination schedule, and lack of time 150 (35.1%). The Odds for uptake of hepatitis B vaccination were 22% lower among nurses compared to doctors (AOR = 0.78, 95% CI = 0.54-0.98, P = 0.037). It increased with increasing age (AOR = 1.30, 95% CI = 1.08-1.59, P <  0.001), increasing duration of work in the hospital (AOR = 1.19, 95% CI = 1.09-1.32, P = 0.032), and was about twice higher among those that had tertiary education than others that had less education (AOR = 1.96, 95 CI = 0.76-5.07, P = 0.164). CONCLUSIONS: The uptake of hepatitis B vaccination was low among HCWs in Enugu, Nigeria. Age, staff category, and duration of work in the hospital, were independently associated with hepatitis B vaccination. Provision of adequate hepatitis B surface antigen screening facilities and vaccination sites where the cost of vaccination is subsidized for all HCWs is recommended.

Determinants of patterns of maternal and child health service utilization in a rural community in south eastern Nigeria.

BACKGROUND: Women and children constitute a large proportion of any population. They are the most vulnerable to morbidity and mortality especially in developing countries. In many situations the problem of poor maternal and child health stems from the poor use of available services even when they are not of optimum quality. This study seeks to describe the patterns of utilization of Maternal and Child health (MCH) services in a rural area of Enugu State, and identify factors that are associated with and responsible for determining them. METHODS: The study used a cross sectional analytic design. Pretested semi structured questionnaires were administered by interviewers to 602 women from a rural community in Enugu state, South east Nigeria. Two focus group discussions (FGDs) involving 8-10 men/ women each were conducted to identify factors affecting service utilization. Chi square analysis was done to identify factors associated with Maternal and Child Health services utilization. Logistic regression was used to identify determinants of utilization patterns. N vivo software was used to analyze findings of the FGDs. RESULTS: The study revealed that increasing age, educational level, monthly income, number of children and occupation of both women and their husbands were associated with increased MCH service utilization. Average monthly income (OR: 1.317, p = 0.048, CI: 0.073-0.986) and number of children (OR: 1.196, p < 0.01,CI: 1.563-7.000) were determinants of increased use of child care services while educational level (OR: 0.495, p < 0.001, CI: 1.244-2.164) and age (OR: 0.115, p < 0.001, CI: 0.838-0.948) determined better use of delivery and family planning services respectively. CONCLUSIONS: Improved use of MCH services is related to socio economic challenges women face such as illiteracy and low income. Furthermore, the way health facilities and their staff are perceived by rural women affect how they use some of these services and should be considered in programs which seek to reduce maternal and child mortality. Behavioral change programs with high local content need to be implemented within rural areas especially among younger, illiterate women .

Human rabies: still a neglected preventable disease in Nigeria.

BACKGROUND/OBJECTIVES: Adequate surveillance and monitoring of dog bite incidents are veritable tools in the determination of the epidemiology of human rabies infections. There is a paucity of data with regards to rabies in Nigeria. Hence, this study was aimed at describing the pattern and outcomes of dog bites and rabies infections among patients presenting to University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. SUBJECTS AND METHODS: This was a 10-year (January 1, 2004 to December 31, 2013) observational retrospective study. Case definition of rabies was based on ICD 10 criteria, while relevant clinical data were retrieved from individual folders of registered victims using a semi-structured questionnaire. Data were analyzed using SPSS version 17.0 while the level of statistical significance was set at P < 0.05. RESULTS: A total of 149 cases of dog bites were reported during the period under review, of which 6 (4.0%) had confirmed rabies. Ninety-six (64.4%) cases presented more than 24 h after the bites. Majority of the offending dogs were stray dogs 86 (57.7%), which attacked their victims unprovoked, in 54.6% of cases. Furthermore, most of the bites were from dogs with unknown history of rabies vaccination 72 (52.3%), while the case fatality rate was 100%. CONCLUSIONS: All the cases of rabies reported were as a result of bites from stray dogs with unknown history of rabies vaccinations, and the outcome was 100% fatality in all cases. Efforts should be made to create and strengthen awareness campaigns on control of rabies infections through responsible dog ownership including their regular vaccinations as well as provision and use of prompt postexposure prophylaxis in human cases of dog bites at all levels of health care.