Communities In Southwestern Nigeria Research Articles

High mortality of subjects with endemic ataxic polyneuropathy in Nigeria.

Endemic ataxic polyneuropathy, a neurological syndrome that was thought to be benign, has been shown to persist in some communities in south-western Nigeria, where it was first described in the 1950s. This study was conducted to compare mortality of cases and controls, and to determine if mortality is related to exposure to cyanide from cassava foods. Cases of endemic ataxic polyneuropathy and two groups of controls, one group living in an endemic community and the other group living in a non-endemic community, were followed for 25 months. The outcome was death from medical causes. A total of 5970 subjects, 204 cases and 5766 controls - 4000 controls in the endemic community and 1766 controls in the non-endemic community, were followed. A total of 153 subjects died, 24 cases, 115 controls in the endemic community, and 14 controls in the non-endemic community. Relative risks of death (95% CI), adjusted for age and gender, were 4.5 (2.3-8.9) for cases (P < 0.0001), but 2.6 (1.5-4.6) for controls living in the endemic community (P = 0.001). This study shows that endemic ataxic polyneuropathy decreases survival. The finding of lower risk of death in the community with higher exposure to cyanide from cassava foods indicates that mortality of endemic ataxic polyneuropathy is not associated with exposure to cyanide from cassava foods.

Prevalence and perception of nocturnal enuresis in children of a rural community in southwestern Nigeria.

Nocturnal enuresis after the fifth year of life is a distressing problem. In Nigeria, there is a dearth of information about the condition. This cross-sectional study was carried out to determine the prevalence and perception of the condition among children in Igbo-Ora, a rural community in southwestern Nigeria. Four hundred parents/guardians were interviewed and information obtained on 644 children aged 6-12 years. Overall enuresis prevalence was 17.6% (19.9% among boys and 14.9% among girls). The reported causes of nocturnal enuresis included urinary tract infection (33.5%), excessive play (27.5%) and deep sleep (25%). A majority (74.5%) of the respondents would use herbs or traditional medicine to treat enuresis, while only 6.8% of the respondents sought orthodox healthcare facilities for its management. Only 18 (25%) of the 71 parents/guardians with enuretic children had ever consulted a health worker. The misconceptions and inappropriate enuresis management methods among the parents/guardians require health education intervention.

When Neutrality is Taboo. Navigating Institutional Identity in Protracted Conflict Settings - the Nigerian Ife/Modakeke Case

AbstractThis paper explores the means by which social institutions located in African communities that are deeply and violently polarized along ethnic-related lines, navigate the institutional role and identity within such a local environment. Utilizing a case study of ethno-political conflict in the Ile-Ife and Modakeke communities of South Western Nigeria, the paper investigates how the local academy has sought to survive as a zone of diversities located in host cit(ies) with rigidly structured mythicohistories and conflicting geopolitical claims. Through this exploration of the paradox of the uneasy cohabitation of contested realities and the quest for postwar healing and rehabilitation, the paper unveils the unusual local interpretation, rejection and reconstruction of the concept of neutrality, and highlights the challenges, both philosophical and concrete, which confront the academy. The findings of the study suggest a need to cautiously, but decidedly, resituate the university as a civically engaged arena for the creative re-envisioning of diversity and cultural pluralism and ultimately for local and national conflict transformation in Nigeria.

Substance use among secondary school students in rural and urban communities in south Western Nigeria

To determine the prevalence and pattern of drug use among secondary school students in rural and urban communities in south western Nigeria. A survey of senior secondary school students for drug use using a modified form of the World Health Organisation (WHO) questionnaire for student drug use surveys after a pilot study. Rural and urban communities in two local government areas in Ilesa, Osun State in south western part of Nigeria. A total of 600 students drawn from six secondary schools. Prevalence rates of drugs use, drug use pattern by sex, class, urban/rural location of school and age of initiation into drug use. Determination of drug use prevalence rates and pattern under anonymous condition. Questionnaires of 567 respondents were analysed. Their mean age was 17.0 years (S.D +/- 1.69). The most commonly used drugs and their current prevalence rates were salicylate analgesics, 48.7%; stimulants, 20.9%; antibiotics, 16.6%; alcohol, 13.4%; hypnosedatives, 8.9% and tobacco, 3.0%. Current and lifetime use of alcohol as well as current, past and lifetime use of tobacco occurred significantly more commonly among the males. Past and lifetime use of tobacco was significantly more common in the rural school. For the majority of respondents, initiation into drug use started at a very early age (14 years or below). The majority were mild current users of the drugs, except tobacco for which the majority were daily users. Secondary school students in south western Nigeria engage in use of commonly available drugs like their counterparts elsewhere. Stringent measures should be taken to effect supply and demand reduction.

Ecological variation of intake of cassava food and dietary cyanide load in Nigerian communities.

To study the ecological variation of intake of cassava foods and dietary cyanide load. Ecological study design. Five communities in south-western Nigeria where tropical ataxic neuropathy (TAN) was described as endemic (area A), 11 communities in south-western Nigeria where TAN was described as absent (area B), and five communities in northern Nigeria (area C). Subjects were randomly sampled from selected communities. Intake of cassava foods was estimated from dietary history and dietary cyanide load was estimated from urine thiocyanate concentrations. Residual cyanogens in cassava food samples from the community markets were determined. In total, 1272 subjects from 21 communities - 238 from area A, 659 from area B and 375 from area C - were selected. Intake of cassava food per person per week was 17 meals in area A, 10 meals in area B, and one meal in area C. Geometrical mean urine thiocyanate concentrations were 73 micromol l(-1), 51 micromol l(-1) and 17 micromol l(-1) in areas A, B and C, respectively. Mean residual cyanogen content in cassava food samples was 16 mg HCN eq kg(-1) (confidence interval (CI) 13-18) in area A, and 13 mg HCN eq kg(-1) in area B (CI 11-14). This study shows that the intake of cassava foods and dietary cyanide load is high in several communities in south-western Nigeria, predominantly in communities where TAN has been reported. Dietary cyanide load in these communities appears to be determined by the combination of frequency of intake and cyanogen content of cassava foods. Measures to improve the effectiveness of removal of cyanogen from cassava roots during processing are needed in the affected communities.

Risk factors for infant mortality in a rural community in Nigeria.

In this prospective community based study, information on births and deaths was collected for five consecutive years (1993-1997) by trained village health workers (VHW) and traditional birth attendants (TBA). The main objective was to identify factors which are associated with infant deaths in a typical rural community in southwestern Nigeria with a current mid-year population of 3,308. Infant mortality rate was found to be 68.2 per 1,000 live births and is lower than the national rate but higher than the regional rate. Neonatal deaths, with a rate of 37.6 per 1,000 live births, accounted for 55.1% of all infant deaths while postneonatal deaths accounted for 44.9% of the deaths. Twelve (44.4%) of all neonatal deaths (27) occurred within 24 h of delivery while 20 (74.1%) of all neonatal deaths occurred in the first week of life and were perinatal deaths. These high perinatal rates indicate that more efficient obstetric and public health services are needed in the community. First birth order and older mothers (> 34 years) at time of death of infant were associated with significantly higher risk for mortality in this village (p = 0.004). Females were twice as likely as males to die in infancy (p = 0.011), a finding which is contrary to what is generally found; there is a need for further studies to exclude gender discrimination in this village. Significantly more neonatal deaths occurred during the rainy season than in the dry season (p = 0.018) suggesting that environmental factors play a role in neonatal deaths. In the neonatal period, the commonest cause of death was due to complications of low birth weight while in the postneonatal period it was due to infection. VHWs and TBAs are good resource persons for obtaining accurate numerical data at the grass-roots level, and the potential of using their services to collect vital but non-existent statistics should be explored. These workers also need to be trained to recognise factors that put infants at risk. Reassessment of preventive strategies already implemented for reducing infant mortality may be required in order to further reduce the infant mortality rate in this community.

Familial Expectation and Social Support for the Elderly in Yoruba Communities of South Western Nigeria

The cross-sectional study examined the major social problems confronting the elderly as well as, sources of income and priority needs of the elderly as a result of social and cultural change in var...

Knowledge and beliefs about causes, transmission, treatment and control of human onchocerciasis in rural communities in south western Nigeria

Descriptive and quantitative information on onchocerciasis transmission and control were collected using focus group discussions and structured questionnaire to determine what changes if introduced, could upset the established human–vector–parasite relationship in limiting transmission. People’s knowledge of cause of infection and transmission was very poor. Of the 1012 people interviewed, only 3% related the clinical manifestations of onchocerciasis to Simulium bites. Thirty six percent had no idea of the cause of infection while the rest attributed the clinical symptoms of the disease to many other causes. People’s knowledge of the current treatment and control measures was also poor. However an impressive knowledge of the daily and seasonal distribution of Simulium flies was observed. The study identifies the need for health education campaigns aimed at relating the clinical manifestations of onchocerciasis to Simulium bites. This could help people in taking personal protective measures and seeking appropriate treatment.

Persistence of tropical ataxic neuropathy in a Nigerian community

OBJECTIVESThe term tropical ataxic neuropathy (TAN) is currently used to describe several neurological syndromes attributed to toxiconutritional causes. However, TAN was initially proposed to describe a specific neurological syndrome seen...

Urinary schistosomiasis among schoolchildren in Ibadan, an urban community in south-western Nigeria.

The current status of urinary schistosomiasis was assessed in Ibadan, an urban community in south-western Nigeria. Of 1331 children examined for eggs of S. haematobium in their urine, 17.4% were infected. Prevalence in postprimary schoolchildren was significantly (P < 0.01) higher (22.4%) than in primary schoolchildren (12.0%). Intensity of infection based on geometric mean egg count per 10 ml of urine was also higher in postprimary (36.7 eggs/10 ml urine) than primary pupils (29.9 eggs/10 ml urine). Boys had a significantly (P < 0.01) higher infection rate (24.1%) than girls (8.5%), and the intensity of infection was also higher (P < 0.01) in males (39.0 eggs/10 ml urine) than in females (22.1 eggs/10 ml urine). The overall geometric mean intensity of infection was highest (38.8 eggs/10 ml urine) in the 11-15 years age group. 42% of infected children excreted > 50 eggs/10 ml urine. 2.2% excreted S. mansoni eggs in urine. Water contact activities were more frequent (P < 0. 01) in males (31.8%) than females (38.2%). Nine species of snails were encountered, with B. (p) globosus being the the most abundant and widespread. These results show that urinary schistosomiasis is still being actively being transmitted in Ibadan.

Outcome of two patient education methods on recruitment and compliance with Ivermectin in the treatment of onchocerciasis

Two patient education methods, Information Media (IM) and Social Network (SN), were compared to determine their relative effectiveness on recruitment and subsequent compliance behavior of people infected with onchocerciasis in respect of appointment keeping and ivermectin consumption in existing primary health care facilities in six communities in southwestern Nigeria. Two communities each were randomly assigned to the IM intervention group, two to the SN group, and two served as controls. A total of 1265 persons out of an estimated target population of 5033 infected individuals were enrolled in the study. Coverage rates were higher in the intervention communities (30.3% for SN and 29.9% for IM) than control (7.3%), but the differences between intervention groups was not significant. A drop-off was seen in attendance at the second round of ivermectin distribution. Nearly equal proportions of the intervention groups returned (43.3% for SN and 47.4% for IM), while few control patients came back for their second dose (12.3%). Factors responsible for the low turnout were thought to include the content of educational messages, mobility of community members and limited time available to collect the drugs. Cost considerations led to recommendations to maintain facility based distribution and the SN approach, with greater emphasis on mobilization to increase coverage and compliance.

Somatization symptoms among patients using primary health care facilities in a rural community in Nigeria.

The somatic presentation of psychic distress among Africans is different from that in the West, and the prevalence of somatization symptoms suggests that they could be usefully incorporated in screening instruments. This report examines the prevalence of somatization symptoms among users of health care facilities in a rural community in southwestern Nigeria. It also examines the correlation between the presence of these symptoms and scores on instruments that assess psychiatric morbidity. Over a 5-month period in 1991, 865 adults using five primary health care facilities or seeking help from voluntary village health assistants were assessed with the 28-item General Health Questionnaire and two World Health Organization instruments, the Self-Reporting Questionnaire and the Brief Disability Questionnaire. The somatization symptoms investigated included feelings of heat, peppery and crawling sensations, and numbness. About 20% of the subjects admitted experiencing at least one somatization symptom, while 8.2% fulfilled operational criteria for probable psychiatric "caseness" on the basis of somatization alone. The rate of caseness according to the General Health Questionnaire was 6.4%. The presence of any of the somatization symptoms was significantly correlated with scores on the other test instruments. There were no sex differences in the pattern of somatization. These symptoms are reliable indexes of psychic distress. In this culture, the sensitivity of standard screening instruments fashioned in the West can be improved by using these symptoms to replace the somatization symptoms contained in those instruments.

Proteinuria and haematuria as predictors of schistosomiasis in children

Examination of urine samples from 922 children from Epe and surrounding communities in south-western Nigeria indicated a 13% prevalence of Schistosoma haematobium infection. Children, 10-14 years of age, accounted for 65% of the disease prevalence. Approximately 79% of the study population was negative for proteinuria, while 52.6% of children with 30 mg% proteinuria were positive for S. haematobium infection. However, 96% and 100% of all children who, respectively, had 30 mg% and 100 mg% proteinuria, in addition to haematuria, were found to be positive for the schistosome infection. This finding indicates that the use of haematuria and proteinuria as a combined diagnostic index significantly increased the sensitivity and specificity of the individual tests. Bacteriuria was found in 8.5% of infected children, compared with 5.2% of the control group. Streptococcus faecalis and E. coli were the two bacteria isolated from the urine specimens.

The Perception of Water Quality Among Rural Communities in South-Western Nigeria: Lesson for Planners

ABSTRACT “Clean water for all” is one of the goals of the UN International Drinking Supply and Sanitation Decade 1981–90. This goal to be accomplished, requires a level of governmental investment which is difficult to reach in many developing countries. This is particularly so of Nigeria where a vast majority of rural people is yet to benefit from improved water supply and where the level of priority accorded domestic water supply is dismally low, with some states devoting just about 1% of their total capital expenditure to water supply provision. At the same time, there is evidence that the rural people in many places, aware of the advantages of good water sources and the disadvantages of bad ones, show preferences for and undertake development programmes connected with good quality water supply: this is here exemplified by three rural communities in southwestern Nigeria. Not only are these people knowledgeable about water quality and its relationship with health, they are also eager to seize any feasibl...