Journal of Epidemiological Society of Nigeria

Effectiveness of Behaviour Change Communication in Reducing Risk Factors for Lassa Fever Infection in Ebonyi State, Nigeria

Francis Onwe — 2024-06-26

Background: Lassa fever is a viral illness with several annual outbreaks in Nigeria, including Ebonyi State. Behaviour Change Communication has been shown to reduce the burden of communicable diseases. It is believed that its application will reduce the burden of Lassa fever in Ebonyi State. The objective of the study was to determine the effectiveness of Behaviour Change Communication in reducing the risk factors for Lassa fever infection in Ebonyi State, Nigeria.

Methods: The study design was quasi experimental and a multistage sampling technique was used. Three local government areas from the Southern Senatorial zone and two from the Northern Senatorial zone were studied as control and intervention arms respectively. An interviewer-administered questionnaire was used to collect data which was analyzed using SPSS version 20. Fisher’s exact, Z-test and McNemar Chi square test statistics were used and significance level set at P<0.05

Results: A total of 170 respondents were recruited in each arm. The Socio-demographic characteristics in both arms were comparable. There was a statistically significant difference in the composite scores of Lassa fever risk factors between the households in the two arms post intervention (P=0.012). The reduction in the Lassa fever risk factors among individual participants post intervention was also statistically significant (P=0.013). Mud house was more associated with presence of rat at home than cement house (P=0.019).

Conclusion: Behaviour Change Communication was effective in reducing Lassa fever risk factors in Ebonyi State. It is therefore recommended for use in Lassa fever control programmes.

Comparative Analysis of the Oral Hygiene of Pregnant Women Attending Urban and Rural Primary Health Care Centres in Abuja, Nigeria

Olurotimi john Majekodunmi — 2024-06-24

Background: The oral cavity is connected to the other parts of the body hence any disease in the oral cavity can eventually affect the overall health of the individual. The aim of this study was to assess the oral hygiene of women attending antenatal care clinic at Primary Health Care Centres in urban and rural areas in Abuja, Nigeria.

Methods: A cross-sectional comparative study was carried out among pregnant women attending antenatal care clinic in Primary Health Care facilities in Abuja. Participants were selected using consecutive sampling. Data were collected using a semi structured, interviewer-administered questionnaire and analyzed using Statistical Package for the Social Sciences version 23. Significance level was set at p ≤ 0.05. Chi square for proportions was used to compare the two groups.

Results: In total 201 participants were from urban areas while 206 were from rural areas. Participants were aged between 16 and 49 years and their occupations ranged from business; 131(32.2%) to job applicants; 4 (1.0%). Thirty three (16.4%) urban women and 37 (18.0%) rural women understood that poor oral hygiene can affect pregnancy (p = 0.68). Six (3.0%) of the pregnant women had visited a dentist during their current pregnancy. Twenty four (11.9%) urban and 31 (15.1%) rural women used vertical motion to clean their teeth (p =0.001). One hundred and twenty one (60.2%) urban and 156 (75.7%) rural women had good oral hygiene and the difference was statistically significant (p = 0.001).

Conclusion: The pregnant rural women had better oral hygiene than the pregnant urban women.

Comparing Cardiovascular Event risk prediction tools in Nigerians with Rheumatoid Arthritis

Courage Uhunmwangho — 2024-06-24

Background

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease with increased cardiovascular mortality. Chronic inflammation, physical inactivity, depression, stress, and side effects of drugs worsen the risk of cardiovascular diseases in RA patients. The Framingham risk calculator, which has long been used to predict cardiovascular events in the general population, is considered less accurate for RA patients as it does not account for it as an independent risk factor. The QRISK calculator and ERS-RA calculator were developed in response to these issues but have never been used by Nigerians. This study compared all three calculators to estimate the 10-year cardiovascular event risk of patients with rheumatoid arthritis attending the rheumatology clinic of Jos University Teaching Hospital.

Methods

This was a hospital-based cross-sectional study carried out between 2019 and 2022 in the rheumatology clinic of Jos University Teaching Hospital (JUTH). Eighty-five rheumatoid arthritis patients 30 years and above who met the inclusion criteria were recruited consecutively. Relevant history, physical examination and investigations were obtained. Framingham risk, QRISK3 and the ERS-RA scores were calculated for each patient. Data was analyzed using STATA version 14; a P value < 0.05 was considered significant.

Result

There were 60 females and 25 males with a mean age of 52.5±12.5, and the mean duration of RA was 2.2±0.6. The median (IQR) Framingham score was 6.3% (8.9%), while that of QRISK3 was 4.8% (10.8%). QRISK3 agreed with Framingham in 93% of the low-risk estimates, 73.3% at intermediate risk and 92.3% at high-risk estimates. The ERS-RA calculator predicted 36 (42.4%) patients to have a high 10-year CVD risk, in fair to moderate agreement with the Framingham and the QRISK calculators.

Conclusion

The RA-specific ERS-RA calculator predicted more CVD risk than the general population's QRISK3 and Framingham risk scores. We therefore recommend the ERS-RA calculator for use in our RA population.

Prevalence of Post-Traumatic Stress Disorder and associated factors among Women Living in Internally Displaced Persons Camps in Plateau North Senatorial District, Plateau State, Nigeria

N J Gotip — 2024-06-26

Background: Post-traumatic stress disorder is a large contributor to the global burden of disease and is estimated to affect almost 4% of the world’s population which are mostly children and women. The purpose of this study was to assess the prevalence of post-traumatic stress disorder and associated factors among women living in internally displaced persons camps in Plateau North Senatorial District.

Methods: A cross sectional study was carried out among 228 women living in internally displaced persons camps within Plateau North Senatorial District who were selected using a two-stage sampling technique. Data was collected using a structured interviewer administered questionnaire and Statistical Product and Service Solution software version 26.0 was used for data analysis. A p ≤ 0.05 was considered statistically significant at 95% confidence interval.

Results: The prevalence of post-traumatic stress disorder among study participants was 218 (91.6%). Avoiding the thought of a traumatic experience or situations that reminded them of such an experience; 226 (95.0%) was the most common symptom of post-traumatic stress disorder among study participants. Factors such as lack of social support (p = 0.039), relocation from usual residence (p = 0.033) and death of close a relation (p = 0.043) were significantly associated with post-traumatic stress disorder.

Conclusion: This study found that the prevalence of post-traumatic stress disorder was high among study participants. Provision of adequate social support to women living in internally displaced persons camps will help contain and reduce the incidence of post-traumatic stress disorder among them.

Impact of COVID-19 on Routine Childhood Immunization Coverage in Plateau State Nigeria: A Five-year Retrospective Study

Mark Gyang — 2024-08-31

Background: The COVID-19 pandemic disrupted ninety percent of essential health services and routine childhood vaccinations globally with low- and middle-income countries worst affected. This study sought to compare the routine childhood immunization coverage of children in Plateau State pre and post COVID-19 and the level of recovery within the study period, 2018-2022. It also sought to determine if there was a difference in coverage between rural and urban areas in the State. Methods: We conducted a secondary data analysis of Penta-3 monthly immunization coverage data of all the local government areas in Plateau State between January 2018 and December 2022. Local government areas were categorized as rural and urban. Data was analyzed using IBM Statistical Product and Service Solution (SPSS) Statistics version 25. Probability values of p < 0.05 was considered statistically significant. Results: There was a significant difference in the State immunization coverage rates pre and post COVID-19 (p = 0.001). The mean immunization coverage rate in 2022 was 10% higher than that of 2020 but this is still lower than the pre COVID-19 rate. The difference in the immunization coverage rates between rural and urban areas pre and post COVID-19 was also statistically significant (p = 0.001) with rural areas having higher immunization coverage rates. Conclusion: There is an urgent need for all stakeholders to adopt innovative patient centered, state owned, partnership based and data guided strategies in order to recover from the impact of the pandemic and to attain globally acceptable health services.

Green Synthesis and Antimicrobial Potency of Silver Nanoparticles from Ocimum gratissimum Leaf Extract on Clinical Isolates of Escherichia coli and Klebsiella Pneumoniae Isolated from Patients in a Tertiary Health Hospital, Abakaliki, Ebonyi State, Nigeria.

Ikechukwu Egwu — 2024-06-24

Background: Nanoparticles are gaining importance in research especially in the field of medicine. This study was aimed at synthesizing silver nanoparticles (AgNPs) from Ocimum gratissimum and determining their therapeutic potentials against clinical isolates of E. coli and K. pneumoniae.

Methods: AgNPs was synthesized by mixing aqueous leaf extract of O. gratissimum and 1 mM of AgNO3 at the ratio of 1:4, heated on a sand bath at 60oC for 30min and observed for colour change. The formation of AgNPs was further confirmed by studying the optical properties of the solution using a UV visible spectroscope. Antibacterial assays of the synthesized AgNPs against clinical isolates of E. coli and K. pneumoniae was assessed using agar well diffusion techniques.

Results: Aqueous leaf extract of O. gratissimum was able to synthesize AgNPs as colour changed from dark orange to dark brown. Both the ethanoic leaf extract of O. gratissimum and AgNPs showed high antibacterial activities against the isolates. However, the synthesized AgNPs using O. gratissimum leaves extract showed higher activity than the ethanoic leaf extract only. The result of the two different concentrations of AgNPs against E. coli showed that at 100μg/ml and 150μg/ml, an IZD of 20 and 21 (mm) was observed. While in K. pneumoniae isolates, an IZD of 18 and 20 (mm) was observed at 100μg/ml and 150μg/ml concentrations.

Conclusion: In-vivo and in-vitro studies to establish the most effective, efficient and safety doses for the treatment of diseases using O. gratissimum is therefore recommended.

Antibacterial Activities of Commonly Used Soaps in Nigeria against Hospital Pathogens Isolated from In-patients in a Mission Hospital in Abakaliki, Ebonyi State, Nigeria.

Ikechukwu Herbert Egwu — 2024-08-31

Background: Soaps are used daily for several purpose, especially to control microbial growth as they capable of killing or inhibiting the growth of microorganisms. This study aimed to determine the antibacterial activities of commonly used soaps against clinical isolates of E. coli, K. pneumoniae and P. aeruginosa. Methods: The isolates were analyzed and confirmed following standard microbiological procedures. Disc diffusion method was used to assess the antibacterial activities of the soaps at different concentrations of 100, 50, 25, 12.5 (mg/ml). A 6 mm Whattman paper was cut, foiled and autoclaved at 121⁰C for 15 psi to ensure sterility of the disc. Subsequently, the discs were soaked onto different concentrations of the soap extract, followed by careful placement on the surfaces of well streaked Muller-Hinton agar plates containing the test organisms and subsequently incubated over night. After overnight incubation, the inhibition zone diameter was measured using meter rule. Results: The results of the analysis confirmed 8(80%), 7(70%) and 9(90%) prevalence of E. coli, K. pneumoniae and P. aeruginosa respectively. The result of the antibacterial activities of medicated soaps, beauty soaps and toilet soaps at different concentrations against pathogenic strains of E. coli, K. pneumoniae and P. aeruginosa showed that among the medicated soaps, medisoft soap was the most lethal soap. While among the beauty and toilet soaps, extract and lux soaps respectively are the most lethal soaps against the clinical isolates. Conclusion: The soaps showed geometric decrease in its activities from higher concentration to the lowest concentration.

Relationship between Malaria Parasitaemia and Socio-demographic and Environmental Risk Factors among Under-five Children in Maiduguri, Borno State, Nigeria

Y Inuwa — 2024-08-18

Background: Plasmodium falciparum is one among other species responsible for malaria in Nigeria. This study determined the relationship between the malaria infection status of children under the age of 5 years in Maiduguri, Borno State and selected demographic and environmental factors to identify significant risk factors associated with malaria infection. Methods: A cross-sectional study design was used and blood samples were collected from all the children that met the eligibility criteria for the study and subjected to microscopy for the detection of P. falciparum parasitaemia. Additionally, a closed-ended questionnaire was administered to ascertain the risk factors associated with the infection. Data was analysed using Statistical Products and Service Solution version 20.0. Chi-square and regression analyses were used to test for association between socio-demographic and environmental risk factors, and malaria parasitaemia. A p < 0.05 was considered statistically significant at 95% confidence interval. Results: The prevalence of P. falciparum parasitaemia in under-five-year-old children was 156 (43.0%): 38.9% in males and 49.0% in females. The odds of malaria infection were high among all age groups of parents/guardians. Factors such as gender and hospitals were observed to be the predictors of malaria infection in children. Conclusion: Sociodemographic and environmental factors such as gender and hospitals respectively were the predictors of malaria infection in under 5 years children in Maiduguri, Borno State, Nigeria.

Optimisation of Instructions for the Use of COVID-19 Self-Test Kits in Abuja, Nigeria: Enhancing Usability with References from Malawi and Zimbabwe

John Bimba — 2024-08-17

Background: Self-test kits have emerged as promising tools for enhancing testing accessibility and convenience. We optimised the instructions for the use of self-test kits for Corona Virus Disease (COVID-19) testing in Nigeria, drawing from adaptations made by Malawi and Zimbabwe to ensure accurate self-testing outcomes and promote effective self-testing practices. Methods: We conducted a qualitative study employing the health literacy framework, a cognitive interview of three rounds of iterations among participants selected purposively across primary health care, patent medicine stores, and community pharmacy settings. We observed while they performed COVID-19 self-testing using modified Instruction For Use (IFU). A structured guide, which outlined the process of testing in the IFU, was used to guide the optimization process. Qualitative data were analysed using a thematic approach and proportions. Results: Twelve participants were recruited over three rounds of iterative cognitive interviews. Seventy-five percent were females, and over half had a primary and secondary education. Overall, all participants (100%) recorded usability in conducting the steps in the testing process, with a few records of misinterpretation of the images, symbols, and instructions in the IFU among participants during the self-testing process. However, all the participants interpreted their test results correctly after the first round of IFU revision. Conclusion: Despite cultural differences, the adapted optimised IFUs required only minor modifications in Nigeria to support accurate self-testing. Our results show the value of rapid evaluation of manufacturer’s IFUs using cognitive interviewing.

Assessing Burnout Among Healthcare Professionals in a private Hospital in Abuja, Nigeria: Prevalence, Patterns, and Implications.

Nubwa N Gadzama — 2024-10-20

Background: Burnout is a significant concern among healthcare professionals, with prevalence rates ranging from 25% to 75% among physicians. The COVID-19 pandemic has exacerbated psychological distress, leading to increased exhaustion, job dissatisfaction, and poor healthcare delivery. Identifying burnout types—frenetic, underchallenged, and worn-out—is crucial for effective treatment. This study aims to determine the prevalence, patterns, and implications of burnout among healthcare professionals in a private hospital in Abuja, Nigeria. Methods: A cross-sectional study was conducted at Nisa Premier Hospital in Abuja. The study included 100 healthcare professionals selected through multistage sampling. Data was collected using a pretested, adapted Burnout Clinical Subtypes Questionnaire (BCSQ-12). Statistical analysis was performed using SPSS version 26, with descriptive statistics, frequency tables, and chi-square tests employed to determine associations.

Results: The study found a high prevalence of burnout among healthcare professionals, with 85% reporting burnout. The most common burnout type was overload (71%), followed by neglect (61%) and lack of development (18%). No significant associations were found between burnout and sociodemographic or occupational characteristics. Conclusion: Burnout prevalence was high among healthcare professionals at Nisa Premier Hospital, with overload being the most common subtype. Despite no significant associations with sociodemographic or occupational factors, the findings emphasize the need for organizational health interventions. Implementing occupational health clinics for regular mental health screenings and prompt intervention is recommended to enhance health professionals overall organizational well-being and performance.