Health Facility In Abuja Research Articles

Knowledge and preventive practices against malaria among pregnant women in urban and rural public healthcare facilities in nigeria’s federal capital territory

Background: Malaria is a life-threatening parasitic disease, and pregnant women are at risk of its adverse consequences. Objectives: The study aimed to determine knowledge and preventive practices against malaria among pregnant women at urban and rural public health facilities in Abuja, Nigeria. Materials and Methods: A cross-sectional study design was used. The two-stage sampling method was used to select 520 pregnant women in 16 health facilities. A structured questionnaire was used for data collection. Data analysis was done using SPSS statistical software version 22.0, and the level of statistical significance was determined at P-value of less than 0.05. Results: The mean age of respondents was 29.6±4.6 and 27.9±4.9 years in urban and rural areas, respectively (P≤0.001). A significantly higher proportion of women in the urban area (44.2%) had good knowledge of malaria than those in the rural area (26.2%) (P < 0.001). Comparable proportions of respondents in urban (13.1%) and rural (23.1%) areas had good preventive practices against malaria (P = 0.218). The predictor of good knowledge of malaria in the urban area was using secondary health facilities for antenatal care [95% confidence interval (CI): 1.3–4.4], whereas tertiary education (95% CI=1.1–2.3) and utilizing secondary health facilities (95% CI=1.2–2.8) were predictors in the rural area. Predictors of good preventive practice included being self-employed (95% CI=1.5–11.6) and having good knowledge of malaria (95% CI=1.3–6.4) in the urban area. Conclusion: Minor proportions of respondents in the study area had good knowledge of, and good preventive practices against, malaria. There is a need for relevant authorities to enlighten women on malaria and its preventive practices and to motivate them to practice malaria prevention throughout pregnancies.

Understanding Safety Management Practices and Safety Performance amid Coronavirus (Covid-19) Pandemic among Nurses in Public Hospitals

ABSTRACT The study aims to examine the role of safety management practices and safety performance among nurses working in public hospitals amid the Coronavirus (Covid-19) pandemic in Nigeria. Self-administered questionnaires were distributed for data collection and a total of 229 nursing staff from the public health facilities in Abuja, Nigeria participated in the study. The results demonstrated that the level of safety performance was moderately high. These findings support the influence of management commitment on safety, safety training, and employees’ involvement on safety compliance. It was also found that management commitment to safety, safety training, and safety promotion policies posed significant effects on safety participation. This study provides empirical support for the assertion that safety management practices are of paramount importance in improving safety performance among nurses in public hospitals, especially during the Covid-19 Pandemic.

Knowledge, attitude and willingness to accept the RTS,S malaria vaccine among mothers in Abuja, Nigeria

Malaria constitutes a major public health challenge and Nigeria contributes hugely to the global burden. In recent times, there has been a massive scale up of all interventions for evident impact. One of the novel preventive measures being considered is the RTS,S malaria vaccine. The objective of this study was to assess mothers’ knowledge, attitude, and practices to malaria and its prevention as well as mothers’ willingness to accept the RTS,S/AS01 malaria vaccine. A cross-sectional study design was used to administer questionnaires to 180 mothers within six public secondary health facilities in Abuja, Nigeria. About 30% (36/180) of respondents were aware of malaria vaccines but only four percent (7/180) had heard of RTS,S. Young maternal age (OR, 2.4; 95% CI, 1.09-5.28; P = 0.03), self-employment (OR, 2.55; 95% CI, 1.04-6.28; P = 0.04) and formal employment (OR, 3.74; 95% CI, 1.17-11.99; P = 0.03) were associated with no prior knowledge of malaria vaccine. Ninety-one percent (163/180) had a positive attitude to malaria vaccine and 98% (176/180) were willing to allow their child(ren) to be immunized with RTS,S despite the efficacy of the vaccine, route of administration and number of doses. We concluded that knowledge of malaria preventive measures does not correlate with knowledge of RTS,S. Although willingness to accept RTS,S is high, consistent targeted messaging on RTS,S would be required to improve community knowledge and attitude prior to implementation to ensure maximum uptake.

Timeliness of Bacilli Calmette-Guérin vaccination among infants in a tertiary health facility in sub-Saharan Africa

Context: Administration of a single dose of Bacilli Calmette-Guérin (BCG) vaccine at birth is a key component of pillar one in the End Tuberculosis strategy and has been shown to be a cost effective tuberculosis preventive intervention. However, the proportion of children vaccinated at birth varies within and across countries.Objective: To determine the proportion of infants vaccinated with BCG at birth, identify factors associated and barriers to vaccination at birth.Materials and methods: A cross-sectional study carried out among infants aged 0 – 12 months attending the immunization clinic at a tertiary health facility in Abuja. Frequency tables, chi square and logistic regression were used in the statistical analysis.Results: Among 414 caregiver participants, 100%, 75.8% and 97.1% were females, with tertiary education and married, respectively. Majority (53.1%) of infants were male. Almost all (99.5%) had received BCG but only 35.3% received at birth. No association was found between receipt of BCG at birth and socio-demographic factors or maternal obstetric history. The commonest barrier to receipt at birth was the vaccine not given to infants at health facilities on birth date (p = 0.0001 OR= 14.56 CI 8.077-26.248).Conclusion: Majority of the infants had received the BCG vaccine, however, only a small proportion had received it at birth. There is an unmet need of ensuring infant vaccination with BCG occurs daily including weekends and public holidays while increasing public awareness especially through antenatal clinics. This may help reduce child mortality and morbidity from tuberculosis.

Determinants of Antiretroviral Therapy Adherence among Hiv-Infected Adolescents Attending a Tertiary Health Facility in Abuja, Nigeria

Determinants of Antiretroviral Therapy Adherence among Hiv-Infected Adolescents Attending a Tertiary Health Facility in Abuja, Nigeria

Assessment of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting Among Healthcare Workers in Selected Health Facilities in Abuja

Background : In recent years, deaths due to adverse drug reaction (ADR) have been on the increase. In order to reduce the untoward effects and to prevent deaths, reporting of ADR remains the cornerstone in improving patients safe use of drugs. Aim : This study aimed at assessing knowledge, attitude and practice of adverse drug reaction reporting amongst Medical Doctors, Pharmacists, and Nurses in selected health facilities within Abuja, Nigeria. Methods : A cross-sectional descriptive study was undertaken using questionnaire to assess knowledge attitude, and practice of reporting adverse drug reaction among the categories of healthcare workers included in the study. Results : The findings from the study showed that 99% of the study participants had knowledge about the standard definition of pharmacovigilance, majority of the study participants (58.7%) indicated that ADR reporting should be made mandatory, more than two third of the study participants (67%) had encountered cases of ADR in their practice, only a quarter of the participants (26%) had reported cases of adverse drug reaction. Conclusion: This study revealed that almost of the study participants were aware of ADR, they had sound knowledge and positive attitude towards ADR reporting but unfortunately the practice of reporting was low among healthcare professionals included for this study. Keywords: Pharmacovigilance, Adverse Drug Reaction, Knowledge, Attitude, Practice, Yellow Form DOI: 10.7176/JBAH/11-8-05 Publication date: April 30 th 2021

The Role of Incentives on the Performance of Health Workers in a Public Sector Organization in Abuja, Nigeria

The aim of the research work is to ascertain the role of incentives on the performance of health workers in some selected public sector using Abuja as a case study. Data collection was by the used of self-administered questionnaires, which were distributed to Doctors and Nurses in some selected public health facilities in Abuja. The statistical Package for Social Sciences (SPSS) software was used for data leaning and analysis. The result obtained from the analysis shows that 64.1% agreed that incentives brings job satisfaction, 51.4% agreed that non-monetary incentives promotes organizational performance , 63.3% agreed that non-monetary incentives promotes good work relationship, 53.7% agreed that non-monetary incentives reduces stress, 65.3% agreed that incentives help in the achievement of organizational goal, 58.7% agreed that incentives serve as a motivation to employees, 57.5% agreed that incentives help workers to improve skills and qualifications in line with their job and 60.2% agreed that incentives increase the level of employee’s confidence on employer. It was concluded that incentives based on terms and conditions of employment play significant role on the performance of health workers in the public sector, performance based incentives play significant role on the performance of health workers in the public sector, there is significant government attention towards incentives and performance of health care workers in the public sector and non-financial incentives play significant role on the performance of health workers in the public sector.

Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria

The disclosure of medical errors is very important in ensuring the quality of patient care and safety. However, the disclosure practices by physicians are not well documented in this setting. The objective of this study is to compare the disclosure practices as well as the motivations and barriers to disclosure of these errors among physicians in government secondary and tertiary health facilities in Abuja, Nigeria. A cross sectional survey of physicians working in six out of fourteen government hospitals was conducted. A cluster sampling technique of the hospitals as the clusters was employed to obtain the total sample size of 402 physicians, 201 for each level. A semi structured, self-administered questionnaire was used to collect quantitative data on near misses, mistakes, slips or lapses and technical errors. Data was analysed using SPSS version 15.0 and summarised as proportions. Chi-square test was used to assess associations between variables at a significance level of 5%. Also logistic regression analyses were used to determine the significant predictors of medical error occurrences and disclosures. Some 255 physicians i.e. (52.6%) from the tertiary level and 230 (47.4%) from the secondary level were interviewed. Both the tertiary and the secondary levels had very poor medical errors disclosure practices, with disclosure of errors that caused patient’s death or disability (3.9 vs. 8.3%, p=0.023); or disclosure of errors that caused discomfort or prolonged treatment to patients (33.2% vs. 21.3%, p=0.026). The major barriers to error disclosures at the tertiary and the secondary health facilities were: lack of malpractice insurance (69.4% vs. 48.2%, p=0.000); lack of policies for disclosing errors (62.4% vs. 55.4%, p=0.119); and the fear of negative patient reactions (56.7% vs. 51.3%, p=0.233). The major motivations to errors disclosure were receiving a positive feedback from the institution (65.1% vs. 56.3%, p=0.048) and the support and understanding of colleagues (50.2% vs. 48.7%, p=0.74). This study suggests poor medical errors disclosure practices. In this study setting, the development of institutional policies on disclosure will motivate physicians’ disclosure of medical errors and this should be encouraged. Such policies should include institutionally administered malpractice insurance for the physicians.

Multi-disciplinary Approach in Management of Rhino-orbito-cerebral Mucormycosis in Resource-poor Setting in Sub-saharan Africa: A Case Report

Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon acute aggressive fungal infection occurring in several immunocompromised states including diabetes which is the most common predisposing factor. In this case report we present the clinical finding, therapeutic challenges and outcome in a 44 years old male type II diabetic patient. Patient first presented to the ortorhinolaryngologist with complaints of nasal discharge, postnasal drip, cough, hyposmia, facial pains, and intermittent nasal obstruction. He had bilateral intranasal antrostomy, upon X-ray confirmation of homogenious opacity of the left maxillary antrum and mucosal thickening of the right antrum. Fungal study of the specimen revealed mucormycosis. Six months later he presented with perception of light (PL) vision in the right eye and non-perception of light (NPL) in the left eye. There was mild lid edema in the right eye. There was marked proptosis associated with external ophthalmoplegia suggestive of orbital apex syndrome. The conjunctiva was keratinized and the cornea necrotic and opaque. The left eye enucleation and nasal exploration were done. The patient objected to taking amphotericn B, the drug of choice for this condition because of his previous adverse reaction experience to the drug. Posacornazole, the second line drug could not be assessed, posing a great therapeutic challenge in the effective management of this case. The patient was later referred for neurosurgical management but was reported to have died at a tertiary health facility in Abuja.

Multi-disciplinary Approach in Management of Rhino-orbito-cerebral Mucormycosis in Resource-poor Setting in Sub-saharan Africa: A Case Report

Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon acute aggressive fungal infection occurring in several immunocompromised states including diabetes which is the most common predisposing factor. In this case report we present the clinical finding, therapeutic challenges and outcome in a 44 years old male type II diabetic patient. Patient first presented to the ortorhinolaryngologist with complaints of nasal discharge, postnasal drip, cough, hyposmia, facial pains, and intermittent nasal obstruction. He had bilateral intranasal antrostomy, upon X-ray confirmation of homogenious opacity of the left maxillary antrum and mucosal thickening of the right antrum. Fungal study of the specimen revealed mucormycosis. Six months later he presented with perception of light (PL) vision in the right eye and non-perception of light (NPL) in the left eye. There was mild lid edema in the right eye. There was marked proptosis associated with external ophthalmoplegia suggestive of orbital apex syndrome. The conjunctiva was keratinized and the cornea necrotic and opaque. The left eye enucleation and nasal exploration were done. The patient objected to taking amphotericn B, the drug of choice for this condition because of his previous adverse reaction experience to the drug. Posacornazole, the second line drug could not be assessed, posing a great therapeutic challenge in the effective management of this case. The patient was later referred for neurosurgical management but was reported to have died at a tertiary health facility in Abuja.

Multi-disciplinary Approach in Management of Rhino-orbito-cerebral Mucormycosis in Resource-poor Setting in Sub-saharan Africa: A Case Report

Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon acute aggressive fungal infection occurring in several immunocompromised states including diabetes which is the most common predisposing factor. In this case report we present the clinical finding, therapeutic challenges and outcome in a 44 years old male type II diabetic patient. Patient first presented to the ortorhinolaryngologist with complaints of nasal discharge, postnasal drip, cough, hyposmia, facial pains, and intermittent nasal obstruction. He had bilateral intranasal antrostomy, upon X-ray confirmation of homogenious opacity of the left maxillary antrum and mucosal thickening of the right antrum. Fungal study of the specimen revealed mucormycosis. Six months later he presented with perception of light (PL) vision in the right eye and non-perception of light (NPL) in the left eye. There was mild lid edema in the right eye. There was marked proptosis associated with external ophthalmoplegia suggestive of orbital apex syndrome. The conjunctiva was keratinized and the cornea necrotic and opaque. The left eye enucleation and nasal exploration were done. The patient objected to taking amphotericn B, the drug of choice for this condition because of his previous adverse reaction experience to the drug. Posacornazole, the second line drug could not be assessed, posing a great therapeutic challenge in the effective management of this case. The patient was later referred for neurosurgical management but was reported to have died at a tertiary health facility in Abuja.

Multi-disciplinary Approach in Management of Rhino-orbito-cerebral Mucormycosis in Resource-poor Setting in Sub-saharan Africa: A Case Report

Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon acute aggressive fungal infection occurring in several immunocompromised states including diabetes which is the most common predisposing factor. In this case report we present the clinical finding, therapeutic challenges and outcome in a 44 years old male type II diabetic patient. Patient first presented to the ortorhinolaryngologist with complaints of nasal discharge, postnasal drip, cough, hyposmia, facial pains, and intermittent nasal obstruction. He had bilateral intranasal antrostomy, upon X-ray confirmation of homogenious opacity of the left maxillary antrum and mucosal thickening of the right antrum. Fungal study of the specimen revealed mucormycosis. Six months later he presented with perception of light (PL) vision in the right eye and non-perception of light (NPL) in the left eye. There was mild lid edema in the right eye. There was marked proptosis associated with external ophthalmoplegia suggestive of orbital apex syndrome. The conjunctiva was keratinized and the cornea necrotic and opaque. The left eye enucleation and nasal exploration were done. The patient objected to taking amphotericn B, the drug of choice for this condition because of his previous adverse reaction experience to the drug. Posacornazole, the second line drug could not be assessed, posing a great therapeutic challenge in the effective management of this case. The patient was later referred for neurosurgical management but was reported to have died at a tertiary health facility in Abuja.

Multi-disciplinary Approach in Management of Rhino-orbito-cerebral Mucormycosis in Resource-poor Setting in Sub-saharan Africa: A Case Report

Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon acute aggressive fungal infection occurring in several immunocompromised states including diabetes which is the most common predisposing factor. In this case report we present the clinical finding, therapeutic challenges and outcome in a 44 years old male type II diabetic patient. Patient first presented to the ortorhinolaryngologist with complaints of nasal discharge, postnasal drip, cough, hyposmia, facial pains, and intermittent nasal obstruction. He had bilateral intranasal antrostomy, upon X-ray confirmation of homogenious opacity of the left maxillary antrum and mucosal thickening of the right antrum. Fungal study of the specimen revealed mucormycosis. Six months later he presented with perception of light (PL) vision in the right eye and non-perception of light (NPL) in the left eye. There was mild lid edema in the right eye. There was marked proptosis associated with external ophthalmoplegia suggestive of orbital apex syndrome. The conjunctiva was keratinized and the cornea necrotic and opaque. The left eye enucleation and nasal exploration were done. The patient objected to taking amphotericn B, the drug of choice for this condition because of his previous adverse reaction experience to the drug. Posacornazole, the second line drug could not be assessed, posing a great therapeutic challenge in the effective management of this case. The patient was later referred for neurosurgical management but was reported to have died at a tertiary health facility in Abuja.

Determinants of antiretroviral therapy adherence among HIV-infected adolescents attending a tertiary health facility in Abuja, Nigeria

Determinants of antiretroviral therapy adherence among HIV-infected adolescents attending a tertiary health facility in Abuja, Nigeria

Impacts of a pilot of community antiretroviral group initiative on HIV-positive patients in a tertiary health facility in Abuja, North Central Nigeria

Background: Decentralization, as seen in community antiretroviral group (CAG), has resulted in a significant decline in deaths from AIDS-related causes with projected further benefits in middle- and low-income countries, such as Nigeria. After 2 years of CAG implementation in our facility, this study is designed to assess its impacts on the pilot-cohort of patients, (individual and group), and the hospital facility. Materials and Methods: Pooled data from the CAG register of the pilot cohort of 84 clients, was used for the study. Review of data at entry and 2 years after was done. A questionnaire was used to obtain additional qualitative data. This was administered to all the eighty-four pilot patients and 31 caregivers. Results: There were eight locations, with 84, clients, 62 females and 22 males. The mean/standard deviation of age was 39.38 ± 9.68 years. There were significant increases in weight (kg), (from 65.94 ± 11.012 to 70.69 ± 11.465, P < 0.001), body mass index (kg/m2), (from 24.77 ± 3.879 to 26.79 ± 4.282 P < 0.001), packed cell volume (%) from (31.19 ± 5.014 to 35.64 ± 5.131, P < 0.001), CD4 (cells/mm3), (from 394.36 ± 193.094 to 563.87 ± 220.137 P < 0.001). The viral load suppression was sustained, reducing even further, from 85.06 ± 182.329 to 31.10 ± 46.648 copies/ml, P < 0.001. Retention in care and outcomes were better. Conclusions: From this pilot, the CAG model has shown promise in reducing attrition, improving quality of care, and other direct and indirect benefits, including; cardiovascular, nutritional, and socioeconomic. This has justified the scale-up of this laudable model that will further improve the quality of care given to the patients and the overall quality profile of the facility and system.

Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer

Purpose Through the Union for International Cancer Control and Pfizer Oncology SPARC MBC grant, Project PINK BLUE–Health &amp; Psychological Trust Centre implemented the Breast Cancer Navigation and Palliative Program with strategic activities focused on metastatic breast cancer with the goal of “empower[ing] women at risk of, or living with advanced breast cancer and to reduce [the] incidence of stage III or IV breast cancer.” The project established Nigeria's first patient navigation program, which trained 138 health workers and social workers across the six area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria—diagnostic centers and hospitals—in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only; however, we trained 44 patient navigators from National Hospital Abuja, Enugu, and Kebbi states who are currently working on establishing Breast Cancer Navigation and Palliative Programs in their respective states. Trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. Whereas 72 institutions have been engaged through diverse partnerships, 27 resources were produced, including videos, documents, and a palliative/navigation book for health care workers. Ten ECHO palliative care trainings were organized for nurses and pain doctors, with an additional eight in-person workshops on palliative care and patient navigation and five patient support group meetings. Seventy-two news articles were published, including for TV, radio, and in interviews. Methods The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the six area councils of Abuja. Currently, navigators in Niger State and Enugu state have also received training on patient navigation, and more patients with cancer have been tracked and observed during their cancer journeys in Nigeria. Results The program has transited to lead national advocacy at Nigeria’s parliament for the establishment of the National Institute on Cancer Research and Treatment and has also establish such initiatives as Abuja’s first cancer support group and patient-led advocacy and campaign. Several patients with metastatic breast cancer were navigated through their journey with cancer. Conclusion Patients with metastatic breast cancer need more support to live a quality life; more than just pain medication. They need someone to listen to them and caregivers who show their care and love. Patient navigation is an emerging area of oncology and there is a need to support the patient navigators so that they may devote more time to its effects. AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Runcie C.W. Chidebe Travel, Accommodations, Expenses: Jansen and Jansen Consulting or Advisory Role: Novartis Pharmaceuticals

Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer in Nigeria

Background and context: Through the UICC and Pfizer Oncology SPARC MBC grant, Project PINK BLUE - Health and Psychological Trust Centre implemented Breast Cancer Navigation and Palliative Program (BCNPP) with strategic activities focused on metastatic breast cancer with the goal “to empower women at risk of, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer”. The project established Nigeria´s first patient navigation program which trained 138 health workers and social workers across the 6 area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria (diagnostic centers and hospitals) in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only, however, we trained 44 patient navigators from National Hospital Abuja, Enugu and Kebbi states whom are currently working on establishing BCNPP programs in their respective states. The trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. While 72 institutions have been engaged through diverse partnerships, 27 resources were produced including videos, documents, and palliative/navigation book for healthcare workers; 10 ECHO palliative care training were organized for nurses and pain doctors, with additional 8 face-to-face workshops on palliative care and patient navigation and 5 patient support group meetings. Seventy-two news articles were published including TV, radio, and interviews. Aim: To empower women at risk for, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer. Strategy/Tactics: The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the 6 area councils of Abuja. Currently, Niger state and Enugu state have also been trained on patient navigation and more cancer patients have been tracked and followed up through their journey with cancer in Nigeria. Outcomes: The program has transited to lead national advocacy at Nigeria's Parliament for the establishment of National Institute on Cancer Research and Treatment and has also establish some initiatives, such as Abuja's first cancer support group and patient-led advocacy and campaign. Several metastatic breast cancer patients were navigated through their journey with cancer. What was learned: Metastatic breast cancer patient needed more support to live a quality life, they needed more than just pain drugs. They need listening ear and caregiver who would show their care and love. Patient navigation is an emerging area of oncology, hence, there is a need to support the patient navigators to devote more time for the impact.

Long-lasting insecticidal net use and asymptomatic malaria parasitaemia among household members of laboratory-confirmed malaria patients attending selected health facilities in Abuja, Nigeria, 2016: A cross-sectional survey.

IntroductionIn Nigeria, malaria remains a major burden. There is the presupposition that household members could have common exposure to malaria parasite and use of long-lasting insecticidal net (LLIN) could reduce transmission. This study was conducted to identify factors associated with asymptomatic malaria parasitaemia and LLIN use among households of confirmed malaria patients in Abuja, Nigeria.MethodsA cross-sectional survey was conducted from March to August 2016 in twelve health facilities selected from three area councils in Abuja, Nigeria. Participants were selected using multi-stage sampling technique. Overall, we recruited 602 participants from 107 households linked to 107 malaria patients attending the health facilities. Data on LLIN ownership, utilization, and house characteristics were collected using a semi-structured questionnaire. Blood samples of household members were examined for malaria parasitaemia using microscopy. Data were analyzed using descriptive statistics, Chi-square, and logistic regression (α = 0.05).ResultsMedian age of respondents was 16.5 years (Interquartile range: 23 years); 55.0% were females. Proportions of households that owned and used at least one LLIN were 44.8% and 33.6%, respectively. Parasitaemia was detected in at least one family member of 102 (95.3%) index malaria patients. Prevalence of asymptomatic malaria parasitaemia among study participants was 421/602 (69.9%). No association was found between individual LLIN use and malaria parasitaemia (odds ratio: 0.9, 95% confidence interval (95%CI): 0.6–1.3) among study participants. Having bushes around the homes was associated with having malaria parasitaemia (adjusted OR (aOR): 2.7, 95%CI: 1.7–4.2) and less use of LLIN (aOR: 0.4, 95%CI: 0.2–0.9). Living in Kwali (aOR: 0.1, 95% CI: 0.0–0.2) was associated with less use of LLIN.ConclusionHigh prevalence of asymptomatic malaria and low use of LLIN among household members of malaria patients portend the risk of intra-household common source of malaria transmission. We recommend household health education on LLIN use and environmental management. Study to explore the role of preventive treatment of household members of confirmed malaria patient in curbing transmission is suggested. Strategies promoting LLIN use need to be intensified in Kwali.

Health Care Providers Perception and Practice of HIV Disclosure to Sero-Positive Children and Adolescents in a Tertiary Health Facility in Abuja, Nigeria

Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both their health care workers and their parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.

Seroprevalence of hepatitis B and delta viruses among HIV-infected population attending anti-retroviral clinic in selected health facilities in Abuja, Nigeria

ABSTRACTIntroduction: Triple infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis D virus (HDV) is rare. There is limited data on the seroprevalence of HIV/HBV/HDV tri-infection especially in Nigeria. The aim of this study was to determine the seroprevalences of HBsAg and HDV among HIV-infected individuals attending anti-retroviral (ARV) clinics in Abuja, Nigeria.Methods: In this cohort study, blood samples were collected from 1102 (male = 450; female = 652), with age range <20 to ≥51 years (mean age = 34.0; SD = 11.5), consenting HIV-infected population attending ARV clinics at selected health facilities in Abuja, Nigeria, between April and October 2016. A well-structured questionnaire was used to capture demographic information from the respondents. Enzyme-linked immunosorbent assay (ELISA) was used to determine the seroprevalence of hepatitis B surface antigen and anti-HDV. The result was interpreted according to manufacturer’s instruction. Statistical data were analyzed using SPSS software version 21, and chi-square (χ2) test was used to determine association with P < 0.05 considered significant.Results: Overall seroprevalences of 10.3%, 7.1%, and 0.7% for HBV, HBV/HDV, and HIV/HBV/HDV, respectively, were found among the study population. The infection rate (13.3%) peaked at age range of 31–40 years for HBV (P = 0.002), 50% at <20 years for HBV/HDV (P = 0.049), and 1.5% at 31–40 years for HIV/HBV/HDV (P = 0.202). By gender, the rate was higher in males (10.9%, 10.2%, 1.1%) than females (9.8%, 4.9%, 0.5%) for HBV, HBV/HDV, and HIV/HBV/HDV infections, respectively. However, there was no significant association between infection rate and gender.Conclusion: This study has established that HBV and HDV prevalence is still high in the population studied and that the rate of triple infection is low. We advocate for more robust control measures for HBV which should be extended to HDV in HIV population through screening and vaccination.