Strategies adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in patient education on oral cancer: A Nigerian study.

BACKGROUND: The burden of oral cancer in Nigeria is increasing. Different studies have shown how public education on oral cancer have increased knowledge of oral cancer across populations, however, it is not known if these practices are adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. AIMS: To investigate the patient oral cancer education strategies adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. METHODS: This study adopted an analytical cross-sectional study design. This study surveyed practicing oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. An e-questionnaire was used for this study. The data were analyzed using the SPSS Version 20 software, and a p-value of <.05 was used to determine the level of statistical significance. RESULTS: The study's response rate was 46.6% (75/161). The 75 participants were from the six geopolitical zones in Nigeria responded to the survey questionnaire. Even though more than half (43/75, 57.3%) of the respondents have never received any training since their post-bachelor's degree qualification on the strategies that can be used in educating patients on oral cancer, majority (54/75, 72.0%) of them knew at least one education strategy; also, the most known (36/54, 66.7%) and utilized (33/54, 61.3%) strategy among those respondents who were aware of patient education strategy was health talk. Only 38.7% (29/75) of the respondents reported that health learning materials (posters, leaflets, fliers, and flipcharts) are available in their clinics, all of which were in insufficient quantities. Also, 93.3% (70/75) of the respondents opined that it is worthwhile that dental clinics/hospitals in Nigeria invest in the provision of oral cancer learning materials for patient use. Inferential statistical analysis did not reveal any significant relationship between the respondents' characteristics and their awareness and practice on patient oral cancer education strategies. CONCLUSION: This study identified that many oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria lack the needed capacity to educate their patients on oral cancer. There is a need to strengthen their capacity by giving them training on patient oral cancer education strategies, and by providing them with good quality and enough teaching aids.

Cervical cancer screening and treatment for PLWHIV: experiences from an innovative program in Nigeria.

BACKGROUND: We evaluated cervical cancer program for women living with HIV (WLHIV) to determine program screening rate, primary case finder screening accuracy and treatment and post-treatment screening rate among screen-positive patients. METHODS: A ten-month review of cervical cancer program data among WLHIV aged 15-49 years on HIV care across forty-one comprehensive ART sites, supported by APIN (a PEPFAR implementing partner) for cervical cancer screening and treatment in Nigeria, was conducted from October 2020 to July 2021. Initial screening was done using visual inspection with acetic acid (VIA) followed by a gynaecologist expert review through a program-designed software named AVIVA, as a confirmatory test. Associations were measured between the primary case finder screening accuracy and study covariates at p-value of 0.05. RESULTS: About 10,289 asymptomatic women aged 15-49 years living with HIV were screened for cervical cancer by primary case finders using VIA-based screening test. About 732 (7.1%) had a positive screening test suggestive of precancerous lesions or cervical cancer. Three hundred and fifteen (43.0%) of VIA positive women had treatment using thermal ablation and less than one-third (21.6%) of those treated came back for post-treatment screening test. Primary case finder screening sensitivity, specificity, positive predictive and negative predictive accuracy using gynaecologist review as confirmatory test were 60.8%, 71.5%, 41.7% and 84.5% respectively. Overall screening accuracy was 68.8%. CONCLUSION AND RECOMMENDATIONS: This innovative approach to cervical cancer screening among WLHIV yielded modest results in preventing program error and wastages. Wider deployment of expert-based reviews of VIA though AVIVA software might be a veritable approach to improve screening accuracy in low resource settings.

Mind the gap: Data availability, accessibility, transparency, and credibility during the COVID-19 pandemic, an international comparative appraisal.

Data transparency has played a key role in this pandemic. The aim of this paper is to map COVID-19 data availability and accessibility, and to rate their transparency and credibility in selected countries, by the source of information. This is used to identify knowledge gaps, and to analyse policy implications. The availability of a number of COVID-19 metrics (incidence, mortality, number of people tested, test positive rate, number of patients hospitalised, number of patients discharged, the proportion of population who received at least one vaccine, the proportion of population fully vaccinated) was ascertained from selected countries for the full population, and for few of stratification variables (age, sex, ethnicity, socio-economic status) and subgroups (residents in nursing homes, inmates, students, healthcare and social workers, and residents in refugee camps). Nine countries were included: Bangladesh, Indonesia, Iran, Nigeria, Turkey, Panama, Greece, the UK, and the Netherlands. All countries reported periodically most of COVID-19 metrics on the total population. Data were more frequently broken down by age, sex, and region than by ethnic group or socio-economic status. Data on COVID-19 is partially available for special groups. This exercise highlighted the importance of a transparent and detailed reporting of COVID-19 related variables. The more data is publicly available the more transparency, accountability, and democratisation of the research process is enabled, allowing a sound evidence-based analysis of the consequences of health policies.

Effects of behaviour change communication on hypertension and diabetes related knowledge, attitude and practices in Imo and Kaduna States: a quasi-experimental study.

BACKGROUND: Behaviour change communication is a proven health communication strategy among used in promoting changes in knowledge, attitudes, beliefs, and behaviours', especially for communicable diseases. Few studies have been conducted on its effectiveness for non-communicable diseases prevention and control. This study was conducted as an evaluation assessment for a non-communicable disease focused intervention implemented in Imo and Kaduna States, Nigeria. METHODS: A twelve-month long strategic behaviour change communication intervention on hypertension and diabetes was implemented in selected communities across Imo and Kaduna States, Nigeria. This study adopted a quasi-experimental design approach among adult residents aged at least 35 years to assess the effectiveness of the intervention. Data was collected at baseline (prior to implementation of the interventions) and at the endline; among study and control groups. A uniform study tool was used to collect information on awareness & lifestyle related factors for Hypertension & Diabetes. RESULTS: The awareness of hypertension was 98.9% among the respondents in the study group compared to 94.4% among the baseline respondents (χ2 = 20.276, p < 0.001). The history of blood pressure check was recorded among 86.8% of the study group compared to 79.0% of the baseline group (χ2 = 20.27, p < 0.001). In the last 6 months prior to the study, 71.9% of the study group compared to 30.6% of the baseline group (χ2 = 243.34, p = 0.002) had blood glucose check at least once. Daily alcohol consumers make up 36.8% of the baseline respondents, compared to 22.6% in the study group (χ2 = 33.84, p < 0.001) and 30.6% of those in the control group compared to the 22.6% of the study group (χ2 = 9.23, p = 0.002). The mean (± SD) knowledge score on hypertension and diabetes was 18.12 (± 8.36) among the study group compared to 11.84 (± 6.90) among the baseline group (t = 15.29, p < 0.001), and compared to 10.97 (± 8.79) among the control group (t = 13.08, p < 0.001). CONCLUSION: Significant changes in lifestyle practices, knowledge of hypertension and diabetes and risk perception was observed following the implementation of community-based behaviour change communication interventions. There is a need to increased access to health education and promotion interventions for non-communicable diseases.

Common childhood illnesses: a cross-sectional study of commodity stocking patterns and management knowledge among patent and proprietary medicine vendors in Nigeria.

BACKGROUND: The trio of commonest illnesses and causes mortality among children under five (Malaria, Pneumonia and Diarrhea) are easily treatable through timely exposure to cost effective interventions at the community level. Patent and proprietary medicine vendors (PPMVs) are a leading source of care for illnesses among under-five children in Nigeria. This study was designed to explore child health services offering, particularly commodity stocking patterns and case management knowledge for common childhood illnesses among PPMVs in Ebonyi and Kaduna States. METHODS: A descriptive cross-sectional study was conducted among PPMVs in four local government areas across Ebonyi and Kaduna States. Data was collected using semi-structured interviewer-administered questionnaires. Information was obtained on medicine and supplies, knowledge of common childhood illnesses management and referral practices. RESULTS: A total of 374 PPMVs were interviewed; the mean age was 33.7 ± 9.8 years. Among the 132 health trained respondents, 59.0% offer treatment services for sick children while 83.5% of the non-health trained respondents offer the same service. At least, 88.0% of the respondents keep stock ACTs, Amoxycilin DT, ORS and Zinc. About 38.5% reported stock-out of ACTs in the month preceding the study, 55.1% reported stock out lasting only 0 to 6 days. Only 83 (22.2%) of respondents knew the correct diagnosis of fast breathing among children aged 2 to less than 12 months old. Education and health training background were associated with a good knowledge of common childhood illnesses management (X2 = 44.88, p < 0.001; X2 = 27.14, p < 0.001). CONCLUSION: The relative constant availability of medicines and commodities for managing childhood illnesses positions PPMVs as a preferred source of care for these illnesses. There is a need to complement steady stock availability with provision of quality services by exposing PPMVs to trainings on integrated community case management of childhood illnesses and implementation of robust supervision mechanism to monitor them.

Consistent condom use and associated factors among HIV positive women of reproductive age on anti-retroviral treatment in Ogun State, Nigeria.

Introduction: consistent condom use remains an integral and essential part of comprehensive Human Immunodeficiency Virus (HIV) prevention and care programme. This study assessed consistent use of condom among HIV-positive women of reproductive age on antiretroviral treatment and its associated factors. Methods: a cross-sectional survey of 360 women living with HIV (WLHIV) receiving treatment in four APIN Public Health Initiatives, Nigeria supported President's Emergency Plan for AIDS Relief (PEPFAR) comprehensive Antiretroviral Therapy (ART) sites in Ogun State was conducted from October 2018 to March 2019. Information were collected on consistent condom use among respondents and their associated factors using a pre-tested questionnaire. Data were analysed using SPSS IBM version, with statistical significance set at 0.05. Results: the mean age of the women was 38.1 ± 5.8 years. About two-fifth (39.4%) of the respondents reported consistent use of condom. Of the 142 respondents who reported inconsistent use of condom, 51.6% and 37.5% mentioned sexual displeasure and partner's disagreement respectively as reasons for inconsistent use. Factors associated with consistent condom use were marital status (p < 0.001), respondent's occupation (p = 0.040), partner's occupation (p = 0.012) and partner's HIV status (p = 0.045). Respondents with HIV negative partners were 1.8 times more likely to use condom consistently compared to those with HIV positive partners (AOR = 1.826, CI = 1.018 - 3.274). Conclusion: this study concludes that there is poor consistent condom use among WLHIV in Ogun State. The rate is worse among the sero-concordant partners than the sero-discordant partners. More needs to be done through behaviour change communication aimed at improving consistent condom use among HIV clients.

Impact of peer education on sexual health knowledge among adolescents and young persons in two North Western states of Nigeria.

BACKGROUND: Generally, social development among young people is largely influenced by their peers. Peer education is a proven and effective approach for promoting reproductive health among young people, especially HIV/AIDS education. This study was conducted to assess the effectiveness of a peer-led education intervention in addressing sexual and reproductive health related knowledge and concerns among young people in Kaduna and Kano States, northwest Nigeria. METHODS: A pre and post-test study was conducted among 8930 young people aged 15-24 years who participated in the MTV Shuga Peer Education intervention selected from communities in Kaduna and Kano States. A baseline pre-test was conducted before the education program, and it was followed up with a post-test at the end of the five-day long peer education sessions. RESULTS: Majority of the respondents, 7846 (87.9%) were adolescents aged 15-19 years while the rest 1084 (12.1%) were young adults aged 20-24 years. A total of 6099 (68.3%) of the respondents correctly stated that condoms prevent pregnancy during the pre-test compared to 6429 (72.0%) peers during the post test. Lower abdominal pain was correctly indicated as a symptom of STI by 6282 (70.3%) and 6984 (78.2%) of the respondents at pre-test and post-test respectively. More males (58.5%) had good knowledge about condom use compared to the females, 51.9% (χ2 = 24.62, p < 0.001). while more females (79.6%) compared to 74.7% males opined that going for HIV test with their sexual partner is important to them during the pre-test (χ2 = 19.44, p≤ 0.001).However, no significant difference was observed on knowledge of condom use and opinion on going for HIV testing with sexual partner among either gender at post-test. CONCLUSION: Significant positive changes in knowledge, views and opinions regarding STIs and HIV, HIV anti-stigma and the use of condoms were observed following exposure to the peer sessions of the MTV Shuga peer education intervention. Sustained exposure and access to informative and enlightening peer education sessions over time have the potential to comprehensively improve SRH knowledge, influence positive opinion change and in turn adoption of positive behaviours among young people.

Peer education is an approach to health promotion, in which community members are supported to promote health-enhancing change among their peers. This approach is being adopted to improve access to comprehensive sexual and reproductive health information among young people. Society for Family Health implemented a peer education intervention (MTV Shuga Naija Peer Education Project) among young people aged 15­24 years in Kaduna and Kano States, Nigeria. This study presents findings on the effectiveness of peer-education in addressing myths, misconceptions and improving knowledge on sexual and reproductive health issues.The knowledge and opinion of the project beneficiaries were assessed before and after exposure to the project's interventions (the MTV Shuga drama series and peer education). Findings from both assessments were compared and the results were presented in this article. In total, 8930 persons between the age of 15­24 years were assessed. We observed that more proportion of the respondents after exposure to the project's intervention correctly identified that condom use can prevent pregnancy and that lower abdominal pain is a sign of sexually transmitted illnesses, when compared to before the intervention. Significant improvement was observed for most of other questions that the respondents were asked about.We generally observed that the peer education strategy used in this study resulted in the knowledge of HIV/AIDS, sexually transmitted illnesses, contraception, and other reproductive health issues among young people. The use of peer-to-peer education should be encouraged and consistently adopted to improve knowledge of pertinent health issues among young people.

Psychological distress and burden of care among family caregivers of patients with mental illness in a neuropsychiatric outpatient clinic in Nigeria.

BACKGROUND: The wellbeing of family caregivers of mentally ill persons has often been ignored, despite that family caregivers can be predisposed to psychiatric morbidities and burden in caring for their mentally ill family members. This study examined the levels of psychological distress and burden of care experienced by family caregivers who care for their mentally ill relatives in Edo State, Nigeria. METHODS: This study assessed psychological distress using the General Health Questionnaire (GHQ-12). Burden of care was measured using the 22-item Zarit Burden Interview (ZBI) questionnaire. Multiple linear regression was done to determine factors associated with burden of care and psychological distress, while factor analysis was used to determine the underlying forms of burden of care and psychological distress among participants. RESULTS: Caregivers studied were relatives of patients diagnosed for depression (25.1%), substance use disorder (22.2%), schizophrenia (20.2%) and bipolar affective disorder (11.1%). Approximately 15% experienced no-to-mild burden, 51.3% mild-to-moderate burden and 34.0% high-or-severe burden. Nearly halve (49.0%) of participants experienced psychological distress. Severe rate of psychological distress was observed among subjects caring for patients with schizophrenia (60.7%), epilepsy (60.0%), substance use disorder (52.2%) and depression (49.0%). High burden of care was more preponderant among caregivers of relatives with mental retardation and epilepsy (50% each) and schizophrenia (39.3%). Having a higher educational qualification and being self-employed was a predictor of psychological distress. Gender of caregiver and the diagnosis schizophrenia among relatives of caregivers predisposed to burden of care. Three factors including social and emotional dysfunction, psychological distress and cognitive dysfunction were identified as components of psychological health through factor analysis. On the burden scale, six factor components were identified as: personal strain, role strain, intolerance, patients' dependence, guilt and interference in personal life. CONCLUSION: There is a high prevalence of psychological morbidity and burden of care among family caregivers providing care for persons with mental illness.

Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study.

OBJECTIVES: This study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria. DESIGN: A descriptive cross-sectional study. SETTING: Selected communities across 14 local government areas in Imo and Kaduna states were included. PARTICIPANTS: In total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: The study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures. RESULTS: The mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks. CONCLUSIONS: Despite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.

Hypertension and Diabetes Management Practices Among Healthcare Workers in Imo and Kaduna States, Nigeria: An Exploratory Study.

INTRODUCTION: Effective management of hypertension and diabetes through accurate diagnosis and treatment can reduce the risk of complications and early deaths. This study was a descriptive cross-sectional study aimed at determining practices regarding hypertension and type 2 diabetes management among healthcare providers in Kaduna and Imo States, Nigeria. Data were collected using a semi-structured interviewer administered questionnaire consisting of questions across four major domains: 1) screening; 2) diagnosis; 3) pharmacological; and 4) non-pharmacological treatment of hypertension and diabetes. RESULTS: A total of 77 healthcare providers were interviewed and they included; 20 (26.5%) medical doctors, 25 (32.5%) nurses/midwives, 18 (23.4%) community health extension workers and 3 (3.9%) pharmacists. Almost half (46.8%) of the respondents indicated that they prioritize routine blood pressure (BP) checks among all adult patients while only 30 (39.0%) and 8 (10.4%) correctly identified the diagnostic criteria for hypertension and diabetes, respectively. Calcium chain blockers only were the most prescribed medication for treatment of hypertension across all stages of hypertension while metformin (glucophage) was stated as the preferred medication prescribed for controlling blood glucose levels among the respondents. Only 32.5% of the respondents stated that they have a means in place in their facilities to ensure that hypertension and diabetes patients adhere to follow-on visit recommendations. CONCLUSION: A significant knowledge gap was identified in the diagnosis and treatment of hypertension and diabetes among the respondents due to unavailability of properly outlined management guidelines for these conditions for the different cadres of healthcare workers in Nigeria. There is a need for the development and wide distribution of guidelines highlighting cadre-specific roles for healthcare providers in hypertension and diabetes management and standard operating procedures based on such guidelines should be available at various points of care to ensure better treatment outcomes.

Utilization rate and factors influencing the use of HIV counseling and testing services among young females: a community-based study from Nigeria.

OBJECTIVES: This study aims to explore the utilization rate and factors influencing the use of HCT services among young females in Ikorodu, Lagos State, Nigeria. METHODS: This study was a descriptive cross-sectional survey of 404 females, aged 15-24 years, residing in Ikorodu, Nigeria. Study tool was a questionnaire. Collected data was analyzed using the SPSS version 16 software. RESULTS: The mean age (±SD) of the respondents was 19.3 (±2.6) years and 90.1% were single. Only 148 (36.6%) respondents had ever utilized the HCT service, of which only 40.5% of them were adolescents. Amongst those that had ever utilized HCT services (n=148), only 60.1% of them did so within 12 months prior to the study while only 33.8% of them initiated the demand for testing themselves. According to the respondents, the top two barriers to the utilization of HCT services were: fear of discrimination (82.9%); and fear of unavailability of access to treatment (68.0%), while the top two factors that facilitates its use were: the adoption of counseling-before-testing approach in the HCT service centers (85.9%); and peoples' need for HIV status declaration prior to getting a job employment/marriage partner (85.1%). CONCLUSIONS: The study shows that utilization of HCT service remains low among the respondents. There is an urgent need to encourage the utilization of HCT services among young females in Ikorodu, Nigeria.

Knowledge, risk perception, and attitudes of Nigerian dentists toward covid-19: pilot study

COVID-19 is a highly communicable viral respiratory infectious disease with potential life-threatening capabilities. As caregivers, the healthcare practitioners are at risk of contracting disease.Aim: To explore the knowledge, risk perception, and attitudes of Nigerian dentists toward COVID-19.Material and Methods: This pilot study was a survey of 69 dentists in Nigeria using an e-questionnaire. Collected data was analysed using SPSS version 22 software. Results: The majority (62.3%) of the respondents were within the age range of 20 ­ 29 years, 50.7% were males. All of the respondents had heard of COVID-19 and the most common source of information on the disease was the social media. They all knew about the cause of COVID-19 and also that the virus can be transmitted through respiratory droplets. The majority (≥76%) of them knew about the incubation period, symptoms, and safety measures to be adopted in curbing COVID-19 transmission. They all perceived COVID-19 to be highly contagious and a potential cause of respiratory failure. Amidst other findings, they all felt that it is not safe to see a COVID-19 patient without personal protective gears. Only 4 (5.8%) agreed that HIV/AIDS is better than COVID-19 by far while only 65.2% ([29+16]/69) of them indicated that they would like to help people that are infected with COVID-19. Conclusion: This study suggests that Nigerian dentists have sufficient knowledge and high level of risk perception of COVID19. Despite this high knowledge level, some few of them are still afraid of associating with people having the disease.