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 Gastrointestinal Injuries Following Blunt Abdominal Trauma in Children.(Nigerian Journal of Clinical Practice, 2008-02-02) Chirdan, L.B.; Uba, A.F.; Chirdan, O.O.Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and at presentation over 80% had abdominal signs. Diagnosis was mainly by physical examination supported by plain abdominal x-ray in 15 children. All 19 children had laparotomy. There were a total of 23 injuries. Gastric and duodenal injuries accounted for one each. Most of the injuries were in the jejunum and ileum (10 perforations, two contusions with one mesenteric haematoma and one mesenteric tear). There was one caecal perforation and six colonic injuries, one of which was associated with intraperitoneal rectal injury. Five children had other associated injuries (three splenic injuries, one renal injury, one bladder contusion associated with long bone fractures and one severe closed head injury). Treatment included segmental resection with end to end anastomosis, wedge resection with anastomosis, exteriorizations stomas, simple excision of the perforation and closure in two layers (gastric perforation). The total mortality was four (21.1%), two of them due to associated injuries. Gastrointestinal injuries due to blunt abdominal trauma pose a management challenge. Management based on decisions from serial clinical examinations and simple tests without recourse to advance imaging techniques may suffice.Item Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre, North Central Nigeria(Annals of African Medicine, 2008-02-02) Chirdan, O.O.; Zoakah, A.I.; Ejembi, C.L.Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Jengre, North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre-intervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P = .012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P < .001), knowledge (P < .001), malaria prevention practice (P = .001), first line treatment option (P = .031) and the type of treatment given to the children with fever (P = .048). Conclusion: Health education impacted positively caregivers’ knowledge of malaria and their willingness to access antimalarial treatment when their children have fever. Malaria information should be made available to caregivers visiting child welfare clinics. Caregivers should also be integrated into malaria control activities at community level.Item Perceptions of working conditions amongst health workers in state-owned facilities in northeastern Nigeria(Annals of African Medicine, 2009-02-02) Chirdan, O.O.; Akosu, J.T.; Ejembi, C.L.; Bassi, A.P.; Zoakah, A.I.Background: The health care sector depends to a large extent on human labor. Poor worker motivation can greatly affect health outcomes and patient safety. There is little information on the health workers’ perceptions of working conditions in resource-poor settings. Method: Three state-owned facilities in each state were selected by simple random sampling technique. The selected facilities were visited on weekdays between 9 and 10 a.m. A self-administered structured questionnaire was given to all health care workers on duty in the facility at the time of visit. Results: A total of 299 questionnaires were returned. The response rate was 85.43%. Two hundred four (68.2%) workers experienced general satisfaction with their current jobs. The relationships between general job satisfaction and presence of conflict at work (P 0.001), freedom of expression (P 0.001), managerial support for staff welfare (P0.001), managerial support for staff career development (P 0.001), availability of tools and consumables in the workplace (P 0.001) and progress towards personal professional goals (P 0.001) were statistically significant. Conclusion: The level of general job satisfaction was high. Though salaries were important, presence of conflict at work, freedom of expression, managerial support for staff welfare, managerial support for staff career development, availability of tools and consumables in the workplace and progress towards personal professional goals appear to play a role in worker motivation.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.