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Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.
OBJECTIVE To determine the factors affecting utilization of ITN by pregnant women in Etsako West LGA, Edo State. METHODOLOGY A descriptive cross-sectional study design was employed. Using a systematic sampling method, a total of 385 respondents were selected from all ANC facilities in the LGA following a verbally obtained consent. Tool for data collection was a semi-structured, researcher administered questionnaire. RESULT The respondents' knowledge of cause of malaria was good, as 269 (69%) had good knowledge but only 9 (2.3%) knew its effects on the foetus. Meanwhile, ownership of ITN and its use were very low, 36 (9.3%) and 31 (8.0) respectively. The main factor affecting the use of the commodity in the LGA was unavailability of ITNs. Other factors included belief of the women on the effectiveness of the commodity, level of education, marital status and family sizes ofrespondents. CONCLUSION Use of Insecticide treated bed net has been hampered by unavailability of the commodity. It is therefore recommended that efforts should be made to make the commodity available to reduce morbidity and mortality among this vulnerable group.
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BMC Public Health. 2011 ;11 :610
21801460
Koninklijk Instituut voor de Tropen (KIT)/Royal Tropical Institute, KIT Biomedical Research, AZ Amsterdam, The Netherlands. p.mens@kit.nl
BACKGROUND There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among women of child bearing age. METHODS 1105 women of child bearing age were interviewed in their households using a structured questionnaire about their knowledge of malaria in general, MIP and use of preventive measures. Thereafter, a peer education campaign was launched to raise the level of knowledge in the community. The interviews were repeated after the campaign and the responses between the pre- and post-intervention were compared. RESULTS In the pre-assessment women on average answered 64.8% of the question on malaria and its possibility to prevent malaria correctly. The peer education campaign had a significant impact in raising the level of knowledge among the women; after the campaign the respondents answered on average 73.8% of the questions correctly. Stratified analysis on pre and post assessment scores for malaria in general (68.8 & 72.9%) and MIP (61.7 & 76.3%) showed also significant increase. Uptake of bed nets was reported to be low: 11.6% CONCLUSION Peer education led to a significant increase in knowledge of malaria and its prevention but we could not asses its influence on the use of preventive measures.
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Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.
The observational/longitudinal study was undertaken in Igueben Local Government Area (LGA), Edo State, Nigeria. The objective of the study was to determine the effect of prevention on the prevalence of malaria during pregnancy. The study population comprised 4 groups viz; Group l, had 100 women protected with Insecticide Treated bed Nets (ITNs); Group 2, another 100 treated with Sulphadoxine - pyrimethamine (SP); Group 3, 100 protected with both ITN and SP, while Group 4, were 100 unprotected others who served as control. Venous blood was collected 7 days to expected date of delivery while placental blood was collected after delivery from the subjects for parasitaemia determination. Findings showed that all protective devices used were effective against malaria. Prevention used against malaria in pregnancy is a sure safe guard against maternal morbidity/mortality and should be encouraged. It is therefore, recommended that pregnant women should be health educated to appreciate the need for malaria prevention.
Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria. wagbavic@yahoo.com
OBJECTIVE To assess the effect of sanitary provision and hygiene practices on intestinal helminth burden of primary school children. MATERIALS AND METHODS The cross sectional descriptive study was undertaken in Egor Area of Benin City, Edo State, Nigeria. Using a calculated sample size of 384, participants were selected from primary schools in the study area, using a multi stage sampling method. Although, 384 pupils were expected to participate in the study only 365 provided faecal samples for examination giving a response rate of 95%. RESULTS In most of the schools surveyed, open refuse dumping,(score 1) was the prevalent practice. Portable water supply was present only in private schools within the compound,(score 4). Toilet facilities were grossly inadequate in number and without consideration for sex. Pit latrine,(score 2) was the common toilet provided in surveyed schools. Seventy seven,(21.1%) of the pupils were infected with one or more helminth ova. Pupils in public schools were more infected 72 (30.8%) than those in private schools 5 (3.8%). Helminth ova seen in examined faecal samples were A lumbricoides 61,(16.7%); followed by hookworm, 27 (7.4%); T. trichuria, 5(1.4%); S. stercoralis, 1(0.4%). Regular hand washing with soap reduced the prevalence of helminthiasis. CONCLUSION The level of sanitation observed in the schools studied was low. Consequently, more toilets, preferably the VIP type should be built to overcome the hazard of the pit latrine. Provision of portable water supply should be mandatory for all schools to ensure healthy learning environment.
Department of Community Health, School of Medicne College of Medical Sciences, Universiy of Benin, Benin City, Nigeria.
A cross sectional study to determine the knowledge of HIV/AIDS and sexual practices of adolescents was undertaken in Benin City, Nigeria. Benin City the capital of Edo State, Nigeria, has 40 government owned secondary schools comprising 6 boys, 10 girls, and 24 mixed. Out of these 3 schools were randomly selected for survey viz; Adolor (boys only), Iyoba (girls only), Army Day (mixed). The sample size for the survey was 920 while the total population for selected schools was 1692 giving a sampling ratio of 1:2. Using the systematic sampling method and class register as sampling frame every other child was selected for the study. However, only 852 students consented to participate giving a response rate of 92.6%. An overwhelming majority of the adolescents were aware of HIV/AIDS but only 16.2% knew the cause of the disease. The submission that kissing, living with infected persons and sharing their utensils could lead to infection was an indication of ignorance. Sexual intercourse was the predominant route of transmission mentioned by 60.0% while multiple sexual partners was prevalent among age group 13-15 years. Playing with sharps, frequent clean head shave with unsterilised instruments in the barbing saloon and promiscuity were some of the activities that adolescents were involved in that could lead to HIV/AIDS infection. In conclusion, the knowledge of the study population was poor and correlates with their reckless sexual practices. Prevention is the best option to the disease. Better informed youths on HIV/AIDS will enhance the principle of prevention.
Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Nigeria.
INTRODUCTION Food handlers play a major role in ensuring food safety throughout the chain of producing, processing, storage and preparation. Mishandling and disregard for hygiene measures on their part may result in food contamination and its attendant consequences. OBJECTIVES This study was designed to assess the knowledge and practice of food hygiene by food handlers in a Nigerian University Campus. METHODOLOGY A descriptive, cross-sectional study was carried out on randomly selected food handlers operating on the campus. A total of 102 respondents were interviewed and inspected using a structural questionnaire administered by researchers. RESULTS Ninety (88.2%) of the respondents were female, and there was a predominantly poor level knowledge of food hygiene. The practice of storing and reheating leftovers was low and agreed to by 15 (14.7%) of the respondents; there was a very low frequency of hand washing. Inspection of food handlers showed a low level of personal hygiene. Only 31 (30.4%) had had pre employment medical examination and only 49 (48%) had received any form of health education. CONCLUSION This study has revealed a poor knowledge and practice of food hygiene among food handlers providing food for undergraduates in a Nigerian University. It is recommended that a massive health education campaign directed at both the public and food handlers be embarked on, to enable people take necessary steps to prevent food borne diseases.
Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria. wagbatvic@yahoo.com
OBJECTIVES Illiteracy, poverty with associated poor environmental sanitation practices have been implicated in the heavy burden of helminthiasis among children. The objective of this cross-sectional survey is to determine the impact of parents' level of education on the intestinal helminthic status of children. Patients, MATERIALS AND METHODS All patients, 0-15 years totaling 1030 who visited the communicable disease clinic of the University of Benin Teaching Hospital, Benin City, from October, 2001 to March 2002 were included in this study. However, only 207 of the enlisted patients submitted faecal samples for examination and constituted the study population. Tool for data collection was structured questionnaire that was researcher administered to mother/caregivers after informed consent was obtained. Information sought in the questionnaire included sex and age of the subjects and level of education of their parents. Formol ether concentration method was used for stool examination while intensity was estimated using McMaster counting chamber technique. RESULTS Of the 207 faecal samples examined 46(22.2%) had ova of helminths while 161(77.85%) had none. More school children, 40(19.3%), than pre-school children, 6(2.9%) had helminth ova in their faecal samples and the difference was found to be statistically significant (P < 0.05). More females, 28(13.5%) than males, 18(8.7%) were infected but the difference was however not statistically significant (P > 0.05). Intestinal helminth ova seen in order of prevalence include A. lumbricoides, 23(11.1%); hookworm, 12(5.8%); T. trichiuria, 8(3.8%); Schistosoma mansoni, 2(1.0%); Strongyloides stercoralis, 1(0.5%) while multiple infection was recorded in 11(5.3%) patients. Intensity of infection was low. The difference between the means for A. lumbricoides, T. trichiuria and multiple infection by age were found to be statistically significant P < 0.001; P < 0.05; P < 0.001, respectively. Mother's level of education more than father's level of education seemed to influence the pattern of intestinal helminthiasis among the children but the association was not found to be statistically significant (P > 0.05). CONCLUSION Prevalence and intensity of infection was low probably due to periodic antihelminthic treatment offered by the health authorities. Improvement in mother's level of education brought about decrease in prevalence of intestinal helminthiasis among the children. Therefore, improvement in female education should be encouraged to reduce the incidence of communicable disease in the family.
Department of Community Health, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria. wagbavic@yahoo.com
Onchocerciasis (river blindness) is a serious public health problem with important socioeconomic consequences. The presence of onchocercal skin lesions is unsightly and has a psychosocial effect on the affected. This cross-sectional study was undertaken to assess the perception and social implication of onchocerciasis in the village of Apana in Nigeria. Apana is a rural community, hyper-endemic for onchocerciasis and currently receiving ivermectin treatment. The village is one of the ten communities of Uzairue district of Etsako West Local Government Area (LGA), Edo State, Nigeria. There are many water streams in the community which serve the domestic needs of the inhabitants but also provide the breeding sites for the vector flies of onchocerciasis. Multi-stage sampling methods were used to select the 385 respondents that participated after informed consent was obtained. A structured researcher-administered questionnaire was the tool for data collection. Of the 385 respondents that participated in the survey, 240 (62.3%) were male while 145 (37.7%) were female. The awareness of the disease among the respondents was fair. They were aware of the nuisance value of blackflies ('Uja-ini') and associated the bite with itching. The signs and symptoms of onchocerciasis were recognised as specific diseases with specific local names. They called itching and rashes 'Erhue', nodules and leopard skin 'Evbiomu-Ogui', worm in the eye 'Okogho-Ikpalo' and blindness 'Orunalo'. The attitude of the non-affected towards the affected was partially discriminatory and suspicious. The affected were socially withdrawn, probably due to the frustration of their health condition. There is a need to improve people's attitude towards the disease and improve disease awareness through appropriate health education, which will encourage the acceptance of ivermectin as adequate treatment and compliance to the treatment regimen to reduce morbidity and promote self-esteem.
Department of Community Health, Faculty of Medicine, University of Benin, Nigeria.
OBJECTIVE: To find out how much health care providers know about the transmission of malaria and the vector. DESIGN: A cross sectional study was carried out using a predesigned questionnaire which was self administered by the student to collect the necessary information for analysis. Live samples of mosquito larvae, drawn larva and adults were provided for the subjects to identify to assess their knowledge. SETTING: The University of Benin Teaching Hospital and the School of Health Technology. SUBJECTS: 254 randomly selected Community Health Officers in training at the University of Benin Teaching Hospital and the School of Health Technology in Benin City, Edo State, Nigeria. MAIN OUTCOME MEASURES: Many of the students had no knowledge of the subject. The School's authorities were encouraged to include field practicals in their curriculum to improve the students' knowledge on mosquitoes and malaria transmission. RESULTS: Only (26.8%) and (18.1%) of the subjects could identify both drawn and live larvae respectively while (25.2%) identified the adult mosquito correctly. All the respondents knew that the mosquito transmits diseases but quite a few knew the diseases transmitted included malaria (55.3%), yellow fever (16.0%) and elephantiasis (10.7%) respectively. CONCLUSION: The knowledge of the students on the biology of mosquitoes and their role as the malaria vector was poor. The education of the subject on this important endemic disease is advocated to improve the quality of life of citizens and promote the primary Health Care Programme in Nigeria.
Dept of Community Health, University of Benin, Nigeria.
Malaria is still highly prevalent in many tropical countries and this disease can only survive in areas where mosquitoes and infected human populations are high. Relevant information on the species of mosquitoes, their habitats and their population are important in planning preventative strategies in the control of malaria, hence this study. Mosquito species and their habitats were investigated in both high and low density areas of Benin City, Edo State, Nigeria. The results showed that Culex pipiens fatigans, Aedes aegypti, Aedes albopictus, Anopheles gambiae and Culex trigripes were the commonest mosquitoes found in Benin City. Among the habitats studied, containers and gutters had the highest population of mosquitoes. The serious public health implications of these various species of mosquitoes is the possibility of outbreaks of infectious diseases like yellow fever, dengue, which some of these mosquitoes are known to transmit. Malaria, though endemic, is also important because of its associated high morbidity and mortality rates. This study provides some useful information on the habitats and species of mosquitoes found in Benin City. Follow-up studies are being carried out by the authors on quantitative studies on the population of these species of mosquitoes, the dissolved elements present in the different habitats that could promote or inhibit the breeding of mosquitoes, and KAP surveys on mosquitoes and malaria among the Benin populace. It is hoped that such comprehensive data would be very useful in planning effective preventative strategies in the control of malaria in Benin City.
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J Trop Med. 2012 ;2012 :235015
23209476
Department of Epidemiology and Biostatistics, College of Public Health and Medical Sciences, Jimma University, P.O. Box 24414, Jimma, Ethiopia.
Background. Malaria remains a major cause of mortality and morbidity in the world, and particularly in sub-Saharan Africa. Objectives. The aim of this study was to determine ownership and utilization of ITNs among households with children under five in the previous night. Methods. A community based cross-sectional study was conducted in Gursum district in Eastern Ethiopia. A total of 335 households were surveyed using a pretested structured questionnaire administered though house-to-house interviews. Results. Household ownership for at least one mosquito net and use of nets were 62.4%(95% CI 57.2-67.6%) and 21.5%(95% CI 17.1-25.9%), respectively. Households who received or were told about ITN in the last 6 months were three times more likely to have used it than those who were not (OR 3.25; 95% CI 1.5-7.10). Households whose heads were engaged as a farmer (adjusted OR 0.137; 95% CI: 0.04-0.50) and housewife (OR 0.26; 95% CI: 0.08-0.82) were less likely to use ITN than those of other occupations. Conclusion. The findings indicate low ITN ownership and utilization among the households. Intensive health education and community mobilization effort should be employed to increase the possession and proper utilization of insecticide treated bed nets.
Iran J Parasitol. 2012 ;7 (3):31-7
23109959
Department of Medical Microbiology, College of Health Sciences, Igbinedion University, Okada, Edo State, Nigeria.
BACKGROUND This study aimed at determining the prevalence of malaria and anemia among children in rural community of Okada, Edo State Nigeria, as well as to assess the level of use of Insecticide treated bed nets and its impact on prevalence of malaria and anemia among study population. METHODS Thick blood films from 226 children with signs and symptoms of malaria in Okada community were stained and examined for presence of malaria parasites. Hemoglobin concentration of all children was also determined using standard method. RESULT A total of 185 (81.9%) children were infected with malaria parasite. Malaria parasitaemia was significantly affected by age (P =0.003). A significantly higher number of positive cases of malaria and anemia was observed in rainy season as compared to dry season (P<0.05). The prevalence of anemia in children was 47.3%. Malaria was a risk factor for development of anemia in children (OR=2.551; 95% CI=1.227, 5.305; P=0.015). Use of insecticide treated bed nets was recorded in 11(4.9%) of children studied, and did not significantly reduce the prevalence of malaria and anemia. However among malaria parasite infected children, its use significantly reduced the prevalence of anemia (OR=0.126; 95%CI=0.015, 1.047; P=0.031). CONCLUSION Malaria and anemia among children was high malaria intervention progammes by relevant agencies is strongly advocated.
Niger J Clin Pract. ;15 (2):220-3
22718177
Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.
Background: Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an urban area of Lagos State. Materials and Methods: A community-based, cross sectional study was carried out in Lagos State in April 2007 among three hundred and forty (340) care givers primarily responsible for child care at home. They were selected by a multi-stage sampling method using a pre-tested, interviewer-administered, structured questionnaire. Results: ITN use rate for under-fives was high (61.8%) and this was significantly determined by care giver's marital status (P < 0.001) and the number of children under five years in the household (P = 0.006). Educational level of care giver and occupation of head of the household were not significant determinants. Conclusion: There is need for health campaigns on ITNs targeted at unmarried care givers of young children. In addition, we also recommend social marketing of modern family planning methods to reduce family size, thereby increasing chances of ITN use among children less than five years to reduce malaria burden.
Ann Afr Med. 2012 Jul ;11 (3):163-8
22684135
Department of Community Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Background: Insecticide-treated bed net (ITN) is currently distributed free of charge to vulnerable groups in Nigeria, for malaria control. Consistent use of the nets is required for maximum effectiveness; but studies indicate that the nets are often jettisoned in periods of low mosquito activity and high night time temperature. The objective of this study has been to assess the use of mass distributed nets in a semi-urban community in Rivers State, south-south Nigeria, during the late dry season, when mosquito activity is at the lowest in the community. Materials and Methods: The study was carried out in Ishiodu - Emohua, using a cross-sectional study design. The data was collected using a structured, interviewer-administered questionnaire, administered to female head of households in the community, with under-five children. Results: A total of 170 respondents were studied; they had an average age of 34.3 ± 7.6 years, most were married (86.5%), and had secondary school education (68.2%). All the households owned at least one ITN, and an average of 1.7 nets, with 75.3% of the households owning two or more ITNs. Almost all the nets (99.4%) were obtained free of charge. Of the 170 households that received the nets, 71.8% had hanged the nets as at the time of the survey; 83.6% of these hanged the nets over a bed, while 10.7% used the nets as window curtain. Of the 102 ITNs that were properly deployed, only 27.5% were occupied the night before the survey, by an average of 2.5 persons, mainly under-five children (37.7%). Conclusion: The distribution of free ITNs has resulted in universal household ownership, but the use of the nets is still very poor. Proper health education is required to encourage the consistent use of the nets, even in hot night, with low mosquito activity.
Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.
BACKGROUND The World Health Organisation (WHO) guidelines for the control of malaria during pregnancy include prompt and effective case management of malaria combined with prevention of infection by insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp). Despite this the uptake is poor. OBJECTIVE To describe the malaria prevention measures utilized by these women in this environment. METHODS Information was obtained from consented pregnant and newly delivered women on their socio-demographic characteristics, knowledge and use of malaria chemoprophylaxis RESULTS One Thousand three hundred thirty (1330) pregnant and newly delivered women in 132 facilities within the Ibadan metropolis were surveyed. The mean age of the respondents was 29. 67 years (±5.21). The modes of prevention most commonly reported as being effective were the use of insecticide spray, window nets and ITN. Only 28.2% were using ITNs in the index pregnancy, and 67.2% of the women had had a drug administered for prophylactic purposes in the index pregnancy. CONCLUSION This study demonstrates awareness but poor use of control measures. Additionally, there is poor use of the recommended agent for IPT. The factors militating against the use of these preventive measures need to be urgently explored and addressed.
Eur J Med Res. 2012 May 17;17 (1):11
22594678
ABSTRACT: BACKGROUND: Malaria is currently the most important cause of death and disability in children aged under 5 years in Africa. A health education interventional study of this nature is essential in primary control of an endemic communicable disease such as malaria. This study was therefore designed to determine the effect of health education on the home management of Malaria among the caregivers of children under 5 years old in Ogun State, Nigeria. METHODS: The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi-structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational program based on a course content adapted from the national malaria control program. A total of 400 respondents were recruited into the study, with 200 each in both the experimental and control groups, and were followed up for a period of 3 months when the knowledge and uptake of insecticide treated net was reassessed. RESULTS: There was no statistically significant differences observed between the experimental and control groups in terms of sociodemographic characteristics such as age (P = 0.99), marital status (P = 0.48), religion (P = 0.1), and income (P = 0.51). The majority in both the experimental (75.0 %) and control (71.5 %) groups use arthemisinin-based combination therapy as first line home treatment drugs pre intervention. Post health education intervention, the degree of change in the knowledge of referral signs and symptoms in the experimental group was 52.8 %(P < 0.0001) while it was 0.2 % in the control group (P = 0.93). Tepid sponging improved by 45.0 %, paracetamol use by 55.3 %, and the use of herbs and other drugs were not significantly influenced in the experimental (P = 0.65 and 0.99) and control group (P = 0.89 and 0.88), respectively. Furthermore, there was a 55.7 %(P = 0.001) increase in the proportion of respondents using the correct dose of arthemisinin-based combination therapy in the home management of malaria and 23.9 %(P < 0.001) in the proportion using it for the required time. CONCLUSIONS: The study concludes that there is a shift in the home management of malaria with the use of current and effective antimalarial drugs. It also demonstrated the effect of health education on the promptness of appropriate actions taken among the respondents for early diagnosis and treatment. Early diagnosis and appropriate treatment can be guaranteed if caregivers are knowledgeable on prompt actions to be taken in the home management of malaria.
BMC Res Notes. 2012 ;5 :211
22551039
Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria. onwujekwe@yahoo.co.uk.
UNLABELLED ABSTRACT: BACKGROUND Malaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers' and consumers' perspectives. METHODS The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010. RESULTS Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p < 0.05). It was found that 50 % of private sector providers and 25 % of public sector providers prescribed chemoprophylaxis using pyrimethamine, chloroquine and proguanil to pregnant women. CONCLUSIONS There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers' knowledge and practices with regards to management of MIP.
BMC Public Health. 2012 ;12 :315
22545723
Chinyere O Mbachu,
Obinna E Onwujekwe,
Benjamin S C Uzochukwu,
Eloka Uchegbu,
Joseph Oranuba,
Amobi L Ilika
Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, and Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria. chinyere23@yahoo.com
BACKGROUND In order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups. METHODS A questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles. RESULTS It was found that 80.5% of the households had an LLIN and 64.4% of the households stated that they actually used the nets the previous night. The findings showed that 42.3% of pregnant women who had fever within the past month received ACTs, while 37.5% of children<5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1-5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women. CONCLUSIONS The free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.
Nurse/Midwife/Public Health Nurse Tutors Programme, University College Hospital, Orita-mefa, Ibadan, Nigeria. joelforfavour@yahoo.com.
UNLABELLED ABSTRACT: BACKGROUND Pregnant women are susceptible to symptomatic malaria due to invasion of the placenta by plasmodium. Malaria increases the risk of adverse pregnancy outcomes for mothers, the foetuses and newborns. The effective use of Insecticide Treated Nets (ITNs) would be of benefit to these vulnerable women. Previous studies have focused on prenatal-women but this study sought to explore the actual trend of utilization of the proven strategy across all the pregnancy stages among postpartum women in Ibadan. METHODS This cross-sectional survey utilized a validated structured questionnaire for data collection. A calculated sample of 335 postpartum women was proportionately recruited from three fee-paying facilities within Ibadan, Nigeria using a simple random sampling technique. These hospitals have high client flow for maternity cases and are known for provision of care under traditional ANC model. The data collected were analyzed using descriptive and inferential statistics by means of Statistical Package of Social Sciences (SPSS) version 15. The level of significance was set at = 0.05. RESULTS The women's age ranged between 18 and 47 years, mean age was 29.4 ± 0.8 years. Various irregularities marked the traditional model of ANC provided at the settings and no exposure to preconception care. Also, 276 (82.4%) had heard of ITNs. Antenatal clinics formed the major source of information. Low utilization and compliance rates were observed. One hundred and twenty-seven (37.9%) of the women had high knowledge of Malaria in Pregnancy (MIP) but only 70 (20.9%) demonstrated positive attitude towards the use of ITNs. Participants' educational status, family types, employment and residential areas significantly influenced ITNs utilization. CONCLUSIONS The women knew and learned about ITNs from ANC visits. Majority of the women did not own ITNs because of lack of access to free distribution. The existing traditional model of ANC was marked by irregularities and none of the women was exposed to preconception care. In addition, negative attitude in spite of increased knowledge of MIP was observed among the women. Therefore, evaluation of free distribution of ITNs is recommended. Integration of focused ANC and preconception care are advocated to promote early access to health information.
N Am J Med Sci. 2012 Jan ;4 (1):40-4
22393547
Department of Clinical Pharmacy, University of Jos, Jos, Plateau State, Nigeria.
BACKGROUND Malaria constitutes a major health problem, with children and pregnant women being the most vulnerable to its morbidity and mortality. AIM To determine the demographic factors associated with the use of insecticide-treated nets among children and pregnant women in Nigeria. MATERIALS AND METHODS The study was based on data drawn from the Nigeria Demographic and Health Survey 2008 on the use of insecticide-treated nets among women and children. The survey was conducted in 34070 households and a total of 10,724 women aged 15-49 years participated in the survey. Data were entered into Minitab version 15 and the chi-square test for independence was performed to show association between variables. RESULTS The results revealed that 49.8% of children and 44% of pregnant women present in households that owe insecticide-treated nets slept under them on the night before the survey. Sleeping under an insecticide-treated nets among children was associated with (P<0.05) the age of a child, geopolitical zone, and wealth quintile while the use of insecticide-treated nets among pregnant women was associated with the education level and wealth quintile of households. CONCLUSION The study demonstrated that some demographic factors are associated with the use of ITNs among children and pregnant women in Nigeria.
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