Research Articles in Medicine & Surgery
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Item Compliance with driver’s license laws and illegal licensing among commercial bus drivers in Lagos, Nigeria: Policy implications and evidence for action(The Nigerian Postgraduate Medical Journal, 2014-08-02) Ifeoma, P.O.; Kofoworola, A.O.; Duro, C.D.; Adebukola, A.A.Aims and Objectives To determine the level of compliance with driver’s license laws among commercial bus drivers in Lagos, Nigeria. Subjects, Materials and Methods Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities. Results Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to driver’s license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first driver’s license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work. Conclusion: Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of driver’s license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.Item Knowledge, treatment seeking and preventive practices in respect of malaria among patients with HIV attending Lagos University Teaching Hospital, Nigeria(Tanzania Journal of Health Research, 2011-10-02) Akinwumi, A.; Akinyede A.; Charles O.; Olufunsho, A.; Sunday, O.O.; Duro, C.D.; Adebimpe, A.; Ademola, Y.Abstract: The synergistic interaction between Human Immunodeficiency virus (HIV) disease and Malaria makes it mandatory for patients with HIV to respond appropriately in preventing and treating malaria. Such response will help to control the two diseases. This study assessed the knowledge of 495 patients attending the HIV clinic, in Lagos University Teaching Hospital, Nigeria. Their treatment seeking, preventive practices with regards to malaria, as well as the impact of socio – demographic / socio - economic status were assessed. Out of these patients, 245 (49.5 %) used insecticide treated bed nets; this practice was not influenced by socio – demographic or socio – economic factors. However, knowledge of the cause, knowledge of prevention of malaria, appropriate use of antimalarial drugs and seeking treatment from the right source increased with increasing level of education (p < 0.05). A greater proportion of the patients, 321 (64.9 %) utilized hospitals, pharmacy outlets or health centres when they perceived an attack of malaria. Educational intervention may result in these patients seeking treatment from the right place when an attack of malaria fever is perceived.Item Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria(Annals of African Medicine, 2013-02-02) Okafor, I.P.; Odeyemi, K.A.; Duro, C.D.Background/Objective: Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers’ knowledge of selected road safety measures, i.e. the pre requisites for driver’s license, road signs and speed limits. Materials and Methods: This was a cross sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre tested, structured, interviewer administered questionnaire and analyzed with epi info statistical software. Results: Two hundred and sixty one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver’s license and 53.8% knew the correct minimum age for obtaining driver’s license. Only 1% of the drivers had correct knowledge of the driver’s license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. Conclusion: The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledgeItem Referral System: An Assessment of Primary Health Care Centres in Plateau State, North Central Nigeria(World Journal of Research and Review (WJRR), 2018-01-02) Afolaranmi, T.O.; Hassan, Z.I.; Filibus, D.I.; Al-Mansur, U.A.; Lagi, L.A.; Kumbak, F.D.; Daboer, J.C.; Chirdan, O.O.Abstract – Background: An effective referral system ensures a close relationship between all levels of the health system and helps to ensure patients receive the best possible care close to home. There appears to be a weak link of referral system in chain of continuity of care across the levels of health care in Nigeria placing huge demands on secondary and tertiary levels of care for health care service provision. In view of this, this study was conducted to assess the level of practice of referral and factors influencing it among health workers in PHCs in Plateau state North central Nigeria. Methodology: This was a cross sectional study conducted among 228 frontline health care workers in PHCs. SPSSS version 20 was used for data analysis, adjusted odds ratio as well as 95% confidence interval were used in this study with a p-value of ≤0.05 considered statistically significant. Results: The respondents’ mean age was 38.0 ± 9 years with slight above half 116 (54.2%) having good understanding of the concept of referral and most 77.6% had referred at least a case within the last one month. Factors such as good understanding of the concept of referral (AOR = 6.2; 95% Cl = 1.4556 – 8.7991) and availability of referral system (AOR = 8.4; 95% Cl =2.1168 – 15.5450) were predictors of the practice of referral. Conclusion: This study has demonstrated the level of practice of referral among cadres of health care workers at PHCs level with significant need for improvement.Item Awareness of occupational hazards and utilization of PPE amongst welders in Jos metropolis, Nigeria(International Journal of Research in Medical Sciences, 2018-05-22) Tagurum, Y.O.; Gwomson, M.D.; Yakubu, P.M.; Igbita, J.A.; Chingle, M.P.; Chirdan, O.O.Background: Welding poses a range of both well-known and subtle hazards to health and safety. These hazards can act quickly or may show up only in the long term. They can be rapidly fatal (electric shock or exposure to cadmiumfumes) or have delayed effects (lung changes over time). This study aimed to assess the awareness of occupational hazards and utilization of PPE amongst welders in Jos metropolis. Methods: This was a descriptive, cross-sectional study involving 295 welders in Jos metropolis. An interviewer- administered questionnaire was used to collect data which was entered and analyzed using Epi-info version 3.5.4 statistical software. A probability value of p≤0.05 was considered statistically significant. Results: All the respondents were males with a mean age of 24.6±7.7 years. The study revealed that 293 (99.3%) were aware of occupational hazards in welding. In this study, goggles were the most frequently used PPE 98%, then gloves 65.4%, boots 58%, overalls 36.3%, facemask 30.6% and earplugs 12.9%. A statistically significant (p≤0.05) relationship was found between employment pattern as well as working hours per day and the use of safety devices. Conclusions: The study showed that most of the welders had fair knowledge of welding related health problems, hazards and safety devices, and utilization of safety devices was less than optimal. An educational campaign on workplace hazards, types and proper use of different personal protective devices should be instituted for welders on aregular basis by the welders association, local and state government.Item Situational analysis of Orphans and Vulnerable Children in urban and rural communities of Plateau State(Annals of African Medicine, 2015-02-02) Tagurum, Y.O.; Chirdan, O.O.; Bello, D.A.; Afolaranmi, T.O.; Hassan, Z.I.; Iyaji A.U.; Idoko, L.Background: Orphans and Vulnerable Children (OVC) are children affected by HIV and AIDS by virtue of, among others, living in a household where one or more people are ill, dying or deceased, or which fosters orphans, and children whose care givers are too ill or old to continue to care for them. They often have more health needs than their peers. This study was carried out to obtain baseline information on the needs of OVC in North-Central Nigeria as a basis for provision of relief services. Methods: A house to house cross-sectional survey of OVC recruited via a multistage sampling technique was carried out in four LGAs of Plateau State, Nigeria. The Child Status Index (CSI) tool was used to obtain information from the respondents and/or their caregivers. Vulnerability of the children was assessed using a Vulnerability Index (VI) scoring which ranged from 1-21, with 1-9 being vulnerable, 10-14 more vulnerable, and 15-21 being most vulnerable. Results: A total of 825 OVC ages ranging from 0–17 years and mean age of 9.8 ± 4.5 years were studied. 432 were males (52.4%) and 393 females (47.6%). 64.8% lived in households headed by women out of which 77.6% were widows. Six hundred and one (72.8%) household heads were farmers. Paternal orphans made up 59.8% of the respondents and 12.1% had lost both parents. Prevalence of abuse/exploitation was 17.7% and 66.7% experienced household food insecurity. Four hundred and seventy-eight (57.9%) OVC lived in households with no source of income. One hundred and fifty-one (18.3%) children (54.9% boys and 45.1% girls) had never been to school. 55.0% had minimal health problems. Majority of them (60.3%) lived in dilapidated shelter and 3.3% were living on the street. Conclusion: This survey revealed the various needs of OVC. Efforts to care, support and protect vulnerable children should not only focus on their immediate survival needs such as education, shelter and clothing, but also on long-term developmental needs that reduce children’s vulnerability such as life skills, child protection, vocational training, food security and household economic strengthening.Item Supportive supervision: An effective intervention in achieving high quality malaria case management at primary health care level in Jos, Nigeria(Annals of African Medicine, 2013-02-02) Bello, A.B.; Hassan, Z.I.; Afolaranmi T.O.; Tagurum, Y.O.; Chirdan, O.O.; Zoakah, A.IBackground: Supportive supervision is a form of supervision that promotes quality at all levels of health system by strengthening relationships within the system through prompt identification and resolution of problems among others. It is an effective intervention in improving health worker performance in low resource settings. Malaria is responsible for majority of outpatient consultations in Nigeria at all levels of care. Materials and Methods: This was a facility-based interventional study with pre and post-intervention phases conducted among two groups.The study subjects were selected through a multistage sampling technique and data collection was done using both semistructured interviewer administered questionnaire and supervisory checklist. Results: The mean knowledge scores of malaria within the intervention group showed an increase from 10.3 ± 1.4 at preintervention to 11.3 ± 1.5 at post-intervention (P < 0.0015). The proportion of respondents who correctly followed malaria management guidelines increased from 32.73% at first supervisory visit to 70.91% by the third supervisory visit (P < 0.001). An analysis of the supervisory checklist showed improvement in performance of healthcare workers with each supportive supervisory visit in most of the variables examined. Conclusions: This study has demonstrated that supportive supervision is a feasible and practicable tool in improving knowledge and practice of malaria case management among PHC workers.Item Prevalence and determinants of contraceptive use in rural Northeastern Nigeria: Results of a mixed qualitative and quantitative assessment(Wolters Kluwer - Medknow, 2016-02-02) Kana, M.A.; Tagurum Y.O.; Hassan Z.I.; Afolanranmi T.O.; Ogbeyi G.O.; Difa J.A.; Amede P.; Chirdan O.O.Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Northern Nigeria. This study aims to assess the prevalence and identify determinants of contraceptive use in a rural setting. Methods: A mixed method cross-sectional descriptive study was conducted in Gumau, a rural community of Bauchi State, Northeastern Nigeria. Quantitative data were collected using an interviewer-administered questionnaire while the qualitative data were collected using focus group discussions with selected women and their husbands, and key informant interviews with family planning service providers. Results: Family planning commodities were regularly available in the community and the prevalence of current contraceptive use was 26%. The main determinants included age <35 years (odds ratio [OR] = 3.0; confidence interval [CI] = 1.0–8.9; P = 0.028), Christian religious affiliation (OR = 2.4; CI = 1.1–4.9; P = 0.025), and spousal support (OR = 55.1; CI = 16.0–189.8; P = 0.000). The qualitative data also reinforced the crucial role of sociocultural factors, especially men in decision-making and contraceptive uptake. Conclusion: Sociodemographic factors, especially spousal support is a key determinant of contraceptive use that should be considered in the design of acceptable family planning intervention.Item Cord care among mothers of sub-urban Lewllem community of Jos South LGA, Plateau State, Nigeria(African Journal of Pharmaceutical Research & Development, 2018-02-02) Isah, H.O.; Bassi Amos Paul; Chima, G.Care of the cord is a known determinant of an infant’s well-being in neonatal life period, and when not according to standard frequently results in high prevalence of neonatal infections and complications, some fatal. This study sought to determine the practice of cord care among mothers of Lewllem Community of Jos South LGA, Plateau State, Nigeria. This was a community-based descriptive cross-sectional study among 300 women of reproductive age group 15-49 years with children less than 5 years of age. Substances commonly applied to cord of babies, reasons for cord care, respondents’ age, educational status and ANC attendance were determined. Along with tables and proportions, associations between respondents’ educational and age status and type of substances, reasons for cord care and duration for cord care with significant level at pV < 0.05 were determined. Methylated spirit (57.60%), Vaseline (39.22%), warm water salt solution (16.61%), plain warm water (9.54%) and herbs/native preparation (1.77%) were found in use with achieving the shrivel (drying) of the cord (50.33%), prevention of cord infection (28.33%), timely detachment of the cord (22.67%) and prevention of development of bad odor by cord (2.33%) as reasons for cord care. There was no statistical significant association between educational attainment and choice of the substances (pV = 0.1656), respondents’ age and reasons for cord care (pV = 0.9226), educational attainment and reasons for cord care (pV = 0.3006) and educational attainment and duration of cord care (pV = 1.0000). Presence of a health facility within study setting and 95.5% ANC attendance rate did not impact on respondents’ choices of appropriate substances and informed reasons for cord care. Quality of MCH services made available to pregnant mothers by the health facility, and skills of service providers will require review for remedial measures.Item Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria(PLoS ONE, 2015-06-18) Dele Abegunde; Nosa Orobaton; Habib Sadauki; Bassi Amos Paul; Ibrahim A. Kabo; Masduq AbdulkarimImproving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR) and infant mortality rate (IMR) are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs) 4 and 5.At baseline (2012) and then at follow-up (2013), we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA) of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS) technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic considerations need to be given to the design of strategies that address the demand for health services.