Department of Medicine & Surgery
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Item Substance Abuse and its Prevalence Among Secondary School Adolescents in Kagoro, Kaduna State, Nigeria(World Journal of Research and Review (WJRR), 2017-07-02) Bassi, A.P.; Ogundeko, T.O.; Ramyil, M.S.C.; Abisoye-Ogunniyan, A.; Ogbole, E.A.; Thilza, S.A.; SuleUredo’, O.; Ante, E.B.; Baba, A.I.; Chimbuoyim, I.N.Despite the existing scanty data on patterns of drug abuse in specific groups in the Nigerian communities due to the tendency of changing patterns in illicit drug use with various alarming reports on same points to the need to constantly update information on the use of drugs among Nigerian adolescents. This was a cross sectional, descriptive study on the prevalence of substance use amongst adolescents. A total number of 400 Senior Secondary Schools 1,2,3 students from two selected schools in Kagoro Chiefdom of Kaura local government area in Kaduna State (Nigeria) were randomly administered with a pre-coded four sections (socio-demographic information, drug awareness and use, attitude of the students to drug abuse and practice of substance abuse). Out of a total of 400 respondents, which males constituted 75% and females 25% of substance users. 89.20% were aware of substance use and 10.80 % were not aware. Substances used were alcohol (52.58%), analgesics (33.7%), marijuana (2.59%), cigarette (1.72%), glue/solution (0.86%) and other local substances (8.62%) respectively. Family setting of respondents taking substance (66.6%:5.95%:27.4%) from monogamous, polygamous and extended families respectively. Factors responsible for engagement in substance use was curiosity 38.10%, peer pressure 19.05%, depression 7.14%, energy for work 4.76%, home problems 1.19%, festivities aura 11.90% beliefs 5.96%, others 11.90%. 58.3% of respondents were introduced to substance use by friends, while 25% were introduced by their family members. Curiosity and peer pressure which is a characteristic of this age group are the major reasons for indulgence in substance use as well the ease at obtaining substances. Family also plays a role.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, 2014-09-03) Okafor, I.P.; Odeyemi, K.A.; Dolapo, D.C.; Adegbola, 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 The Impact of Integrated Community Case Management of Childhood Diseases Interventions to Prevent Malaria Fever in Children Less than Five Years Old in Bauchi State of Nigeria(PLOS ONE, 2016-02-02) Abegunde, D.; Orobaton, N.; Bassi, A.P.; Oguntunde, O.; Bamidele, M.; Abdulkrim, M.; Nwizugbe, E.Background Malaria accounts for about 300,000 childhood deaths and 30% of under-five year old mor-tality in Nigeria annually. We assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. We explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria. Methods A cross-sectional case-controlled, interventional study, which sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, was conducted from 2013 to 2015. Difference-in-differences and logistic regression analyses were performed to estimate the impact attributable to the interventions: integrated community case management of childhood illness which introduced trained pub- lic and private sector health providers and the possession of nets on the prevalence of fever. Results Two-week prevalence of fever among under-fives declined from 56.6% at pre-intervention to 42.5% at post-intervention. Fever-prevention fraction attributable to nets was statistically significant (OR = 0.217, 95% CI: 0.08–0.33). Children in the intervention group had signifi- cantly fewer incidence of fever than children in the control group had (OR = 0.765, 95% CI:0.67–0.87). Although being in the intervention group significantly provided 23.5% protection against fever (95% CI: 0.13–0.33), the post-intervention likelihood of fever was also signifi-cantly less than at pre-intervention (OR = 0.57, 95% CI: 0.50–0.65). The intervention protec-tion fraction against fever was statistically significant at 43.4% (OR = 0.434, 95% CI: 0.36– 0.50). Logistic regression showed that the odds of fever were lower in households with nets (OR = 0.72, 95% CI: 0.60–0.88), among children whose mothers had higher education, in the post-intervention period (OR = 0.39, 95% CI: 0.33–0.46) and in the intervention group (OR = 0.52, 95% CI: 0.48–0.66). The odds of fever increased with higher socio-economic status of households (17.9%-19.5%). Difference-in-differences showed that the interven-tions significantly reduced occurrence of fever in the intervention group (OR = 1.70, 95% CI:1.36–2.14). Conclusion The interventions were effective in reducing the prevalence and the likelihood of childhood malaria fever. Taken to scale, these can significantly reduce the burden of malaria fever in the under-five year old children.Item Reducing the burden of diarrhea among children under five years old: lessons learned from oral rehydration therapy corner program implementation in Northern Nigeria(BioMed Central, 2015-02-02) Charyeva, Z.; Cannon, M.; Oguntunde, O.; Garba, A.M.; Sambisa, W.; Bassi, A.P.; Ibrahim, M.A.; Danladi, S.E.; Lawal, N.Background: In Nigeria, diarrhea remains one of the leading causes of death among children under five years old. Oral Rehydration Therapy (ORT) corners were introduced to health facilities in Bauchi and Sokoto states to serve as points of treatment for sick children and equip caregivers with necessary skills in case management of diarrhea and diarrhea prevention. Objectives: The operations research study examined the effect of facility-based ORT corners on caregivers’ knowledge and skills in management of simple and moderate diarrhea at home, as well as caregivers’ and service providers’ perceived facilitators and barriers to utilization and delivering of ORT corner services. It also examined whether ORT activities were conducted according to the established protocols. Methods: This quantitative study relied on multiple sources of information to provide a complete picture of the current status of ORT corner services, namely surveys with ORT corner providers (N = 21), health facility providers(N = 23) and caregivers (N = 229), as well as a review of service statistics and health facility observations. Frequency distribution and binary analysis were conducted. Results: The study revealed that ORT corner users were more knowledgeable in diarrhea prevention and managementand demonstrated better skills for managing diarrhea at home than ORT corner non-users. However, the percentage of knowledgeable ORT users is not optimal, and providers need to continue to work toward improving such knowledge. ORT corner providers identified a lack of supplies as the major barrier for providing services. Furthermore, the study revealed a lack of information, education and communication materials, supportive supervision, and protocols and guidelines for delivering ORT corner services, as well as inadequate documentation of services provided at ORT corners. Recommendations: Recommendations for ORT corners program planners and implementers include ensuring all ORT corners have oral rehydration salt (ORS) packages and salt, sugar, and zinc tablets in stock, a secured commodity supply chain to avoid stockouts, and adequate policies and procedures in place.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 (P 0.001), 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 Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey(BioMed Central, 2017-02-02) Abegunde, D.; Orobaton, N.; Beal, K.; Bassi, A.P.; Bamidele, M.; Akomolafe, T.; Ohanyido, F.; Umar-Farouk, O.; Danladi, S.Background: Neonatal infections caused by unsafe umbilical cord practices account for the majority of neonatal deaths in Nigeria. We examined the trends in umbilical cord care practices between 2012 and 2015 that coincided with the introduction of chlorhexidine digluconate 7.1% gel in Bauchi and Sokoto States. Methods: We obtained data from three rounds of lot quality assurance samples (LQAS) surveys conducted in 2012, 2013 and 2015. Households were randomly sampled in each round that totaled 1140 and 1311 households in Bauchi and Sokoto States respectively. Mothers responded to questions on cord care practices in the last delivery. Coverage estimates of practice indicators were obtained for each survey period. Local Government Area (LGA) estimates for each indicator were obtained with α ≤ 5%, and β ≤20% statistical errors and aggregated to State-level estimates with finite sample correction relative to the LGA population. Results: Over 75 and 80% of deliveries in Bauchi and Sokoto States respectively took place at home. The proportion of deliveries in public facilities reported by mothers ranged from 19% in 2012 to 22.4% in 2015 in Bauchi State and from 12.9 to 13.2% in 2015 in Sokoto State. Approximately 50% of deliveries in Bauchi and more than 80% in Sokoto States were assisted by traditional birth attendants (TBAs) or relatives and friends, with little change in the survey periods. InBauchi and in Sokoto States, over 75% and over 80% of newborn cords were cut with razor blades underscoring the pervasive role of the TBAs in the immediate postpartum period. Use of chlorhexidine digluconate 7.1% gel for cord dressing significantly increased to the highest level in 2015 in both States. Health workers who attended deliveries in health facilities switched from methylated spirit to chlorhexidine. There were no observable changes in cord care practices among the TBAs. Conclusion: Unsafe umbilical cord care practices remained prevalent in Bauchi and Sokoto States of Nigeria, although a recent introduction of chlorhexidine digluconate 7.1% gel positively changed the cord care practices toward safer practices among public health providers. TBAs, friends and relatives played the strongest immediate postpartum roles and mostly retained the unsafe cord care practices such as use of ash, cow dung and hot compress. We recommend that existing TBAs are retrained and refocused to forge stronger links between communities and the primary health centers to increase mothers’ access to skilled birth attendants.Item Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study(Malaria Journal, 2014-02-02) Millar, K.R.; McCutcheon, J.; Coakley, E.H.; Brieger, W.; Ibrahim, M.A.; Mohammed, Z.; Bassi, A.P.; Sambisa, W.Background: Despite recent improvements in malaria prevention strategies, malaria case management remains aweakness in Northern Nigeria, which is underserved and suffers the country’s highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria’s National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity. Methods: A cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment. Results: Overall, 76.7% of children were brought to treatment—45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7–59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months. Conclusions: Northern Nigeria’s coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.Item Sero-prevalence of hepatitis B surface antigen among primary school pupils in rural Hawal valley, Borno State, Nigeria(Journal of Community Medicine and Primary Health Care, 2005-02-02) Bukbuk, D.N.; Bassi, A.P.; Mangoro, Z.M.Background and objective: Hepatitis B virus infection is a major public health problem worldwide and in Africa. In the northeastern part of Nigeria. Information on the prevalence of HBV infection in rural communities is scarce. This study was carried out to determine the sero-prevalence of hepatitis B surface antigen amongst primary school pupils in a rural setting in northeastern Nigeria. Methods: Hepatitis B surface antigen was tested for in 150 apparently healthy children in two primary schools in two rural communities situated in the Hawal valley area in Borno State, North East zone of Nigeria using an Enzyme Linked Immunosorbent Assay technique. Results: The overall sero-positivity of Hepatitis B surface antigen (HBsAg) in the pupils was 44.7% (95% C.I: 36.6 53.0). The prevalence of HBsAg was found to increase with age, rising from 40.6% in children aged 10-11 years to 75% in children aged above 13 years. The sero-prevalence is (47.2%, (95% C.I: 37.5 57.1) among males while among the females it was slightly lower 38.1 % (95 C.I: 23.6 54.4%). The differences in the HbsAg sero-prevalence by age, sex and location were not statistically significant. Conclusion: The high prevalence of HBsAg in the two primary school children provides evidence for an urgent mass immunization for children on entry to the schools.Item Bacterial and antibiotic susceptibility pattern of urinary tract infection isolated from asymptomatic and symptomatic diabetic patients attending tertiary hospital in Jos, Nigeria(Trends in Medicine, 2017-02-02) Anejo-Okopi, J.A.; Okojokwu, O.J.; Ramyi, S.A.; Bakwet, P.B.; Okechalu. J.; Agada, G.; Bassi, A.P.; Adeniyi, S.D.Urinary tract infection (UTI) is an infection caused by the presence and growth of microorganisms in the urinary tract. In most cases empirical antimicrobial treatment is usually initiated before the laboratory results are made available; hence the need for antibiotic susceptibility test to enhance management of UTI. The study was designed to determine the bacterial profile and antibiotic susceptibility pattern of urinary tract bacteria isolated from symptomatic and asymptomatic diabetic patients at Bingham University Teaching Hospital Jos. 100 mid-stream urine samples (app. 20 mls) were aseptically collected into sterile containers after informed consent of diabetic patients of ages 20 years and above were analyzed at Central Diagnostic Laboratory NVRI Vom. The isolates were identified using standard bacteriological techniques after been cultured on MacConkey and CLED agars. Antibiotic sensitivity testing was done in accordance with NCCLS disc diffusion methods. The results were then analyzed using chi square test. Of the 100 urine samples, different bacterial uropathogens were isolated, with a prevalence of 40%. The bacteria isolates were; Coagulase negative Staphylococci (CNS) (37.5%), Escherichia coli (24%), Klebsiella pneumoniae (12.5%), Staphylococcus aureus (15%) and Streptococcus spp (10%). Esherichia coli and Klebsiella pneumoniae were highly resistant to most antibiotics used, while coagulase negative staphylococci, Staphylococcus aureus and Streptococcus spp were highly sensitive to most antibiotics used in this study. Self-medication including antibiotics is clearly a major culprit. Behavioral Change Communication to all stake holders is increased to cover all radio and TV stations in the state. In addition, investigations (routine microscopy, culture and sensitivity of urine) be completed before treatment is commenced in order to mitigate acquisition and spread of drug resistance by bacteria.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.