Callistus Adewale Akinleye

Background and ObjectivesStroke and dementia are leading causes of death and disability worldwide, requiring enhanced preventive strategies. Glucagon-like peptide-1 receptor agonists (GLP-1RA), wid...

Objective: Immunization is one of the most cost-effective public health intervention as it saves millions of lives annually from vaccine preventable deaths. About 20 per cent of under- five children; die from a vaccine-preventable disease annually hence, the need to determine the perception and the factors militating against the uptake of immunization among mothers of under-five children. The study aimed at determining the perception and uptake of childhood immunization among mothers of under-five children attending post-natal Clinics in Osogbo, South Western, Nigeria. Methods: The study was a descriptive cross-sectional study with a sample size of 320 mothers selected using a systematic sampling technique. Data was collected using a pre-tested semi-structured interviewer administered questionnaire. SPSS Version 17 was used for analysis.The level of statistical significance was set at P-values < 0.05, at the confidence interval of 95%. Results: A significant proportion of the respondents (43.8%) were within the ages 21-30 years and 76.3% of the mothers were educated up to tertiary level. Majority of the respondents, 98.8% had good perception of immunization. About 85.7% of the children were fully immunized according to national immunization schedule. However long waiting time and inability to leave the workplace have a negative effect on uptake of immunization as 41.1 % and 31.9% of the respondents attributed the reason for missing immunization clinic days to these two factors respectively. Conclusion: Reduction of the amount of time spent in the immunization clinic and enactment of enabling policy to ensure nursing mothers are permitted to take their children for immunization during working hours would go a long way to improve rate of immunization uptake of children. Keywords: Perception,Uptake, Under-five, Postnatal clinic and Immunization.

Organ transplantation program in developing countries is still significantly dwarfed. Health workers are undeniably important in the success of transplantation. To assess the knowledge and attitude of health workers toward organ donation in South-West Nigeria with a view to explaining reasons for these shortcomings. In a cross-sectional study conducted on 850 health care workers, self-administered questionnaires were used to obtain information from participants. Of 850 participants, 766 (90.1%) returned their completed questionnaires. The mean±SD age of participants was 36.7±9.2 years. Majority (93.3%) of participants had heard of organ donation; 82.5% had desirable knowledge. Only 29.5% and 39.4% would be willing to donate and counsel potential organ donors, respectively; 36.5% would consider signing organ donation cards. Only 19.4% believed that organ transplantation is often effective and 63.4% believed they were permitted by their religion to donate. Permission by religion (OR 3.5; 95% CI 2.3 to 5.3), good knowledge (OR 2.9; 95% CI 1.4 to 5.7), readiness to sign donation cards (OR 2.6; 95% CI 1.7 to 3.8), discuss organ donation (OR 2.7; 95%CI 8.0 to 63.8), and knowing somebody who had donated (OR 2.9) independently influenced willingness to donate organ. There is disparity in knowledge of organ donation and willingness to donate among health care workers. Efforts should be intensified to give comprehensive and appropriate education to health care workers about organ donation to bridge this gap.

Pre-eclampsia progressing to eclampsia is one of the major causes of maternal death in Nigeria. Since there is long term association of pre-eclampsia with cardiovascular disease, cerebrovascular disease, renal disease, short life expectancy and mortality, it is essential to obtain obstetric history for better counseling and long term monitoring. The study assessed the knowledge of health workers about the association of pre-eclampsia with future cardiovascular disease and offering any risk-reduction counseling to women with pre-eclampsia. During a training workshop, a validated questionnaire on the association between pre-eclampsia and cardiovascular risk was distributed among health care workers working at the infant welfare and family planning clinics in Osun State. Data were analysed using descriptive and inferential statistics. One hundred and forty-six out of 150 health workers approached participated in the study (response rate 97.3 %). Mean age of respondents was 35.6 ± 9.1 years. Median age of practice was 7 years, ranging from 1–40 years. They were medical doctors (60.3 %), community health workers (26.7 %) and nurses/midwives (13.0 %). Most participants had good knowledge on future cardiovascular risk of pre-eclampsia. The medical doctors had better knowledge compared to nurses/midwives and community health workers (78.4 vs. 57.9 vs. 53.8 %; p < 0.05). Below half (45.9 %) offered risk-reduction counseling. Knowledge of the cardiovascular risk factors was lower among the nurses/midwives and community health workers. Risk reduction counseling was quite low across all the health workers. There is need for continuous medical education and possible review of the training curriculum of the lower cadres of health workers.

Loiasis is currently receiving attention as a disease of public health importance because of the possibility of increased risk of developing neurologic serious adverse event following mass ivermectin treatment against onchocerciasis in individual co-infected with Onchocerca volvulus and Loa loa. Rapid assessment procedure for loiasis (RAPLOA) was conducted in 12 communities covering the 3 senatorial districts of Osun State, Nigeria. A total of 960 people were interviewed for history of eye worm using the WHO guidelines for rapid assessment. The survey confirmed the presence of loiasis in all the 12 communities with 4 in Osun East/Ife south senatorial district being at high risk with a prevalence of over 40%. Based on the RAPLOA results, communities within Osun East/Ife south senatorial district were selected for microfilaraemic assessment of L. loa and O. volvulus. A total of 1115 and 1091 individuals were screened for L. loa and O. volvulus microfilaria worms respectively. 160 (14.3%) had L. loa microfilaria detected in their blood with 8 (5.0%) individuals having L. loa loads above 8000 mf/ml. 166 (15.2%) subjects had O. volvulus microfilaria (range 4-504 mf/ml) detected in their skin snip. 30 (2.69%) subjects were co-infected with both L. loa and O. volvulus. There was a significant variation in the prevalence (2.1% to 33.3%) of onchocerciasis in the communities studied (p = 0.001). Five (41.7%) of the studied communities had a prevalence that is equal to or greater than 20%. Low prevalence of onchocerciasis and loiasis co-infection in this study suggests that loiasis may not pose a serious epidemiological threat to the continuous distribution and sustainability of ivermectin for the treatment of onchocerciasis. Evaluation of the interruption of onchocerciasis transmissions in this region using all the indicators set forth by WHO is therefore suggested. Loiasis recently emerged as a disease of public health importance because of the risk of rare severe adverse events (SAEs) associated with the rapid killing of Loa loa microfilariae in heavily parasitized individuals following ivermectin treatment. for onchocerciasis. The possibility of developing these SAEs has been slowing down the control of onchocerciasis in some endemic communities. Based on information available at the Osun State Ministry of Health, the detailed geographic distribution of L. loa in Osun State is still awaiting elucidation. The results of this study revealed an overlap in geographic distribution of loasis and onchocerciasis in many communities in Osun State. The overall Community Microfilaria Load (CMFL) for L. loa was below the threshold level of endemicity that could be associated with the risk of SAEs after ivermectin treatment. Most individuals with slightly high L. loa microfilaria are either O. volvulus microfilaria free or have very low microfilaria load. The low prevalence of co-infection of both diseases in the study area is an indication that loiasis may not pose any serious epidemiological threat to the distribution and sustainability of ivermectin in the treatment of onchocerciaisis.

INTRODUCTION: Equipping medical graduates with the competence to manage tuberculosis is not just imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. METHODS: A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms and management of tuberculosis under DOTS. RESULTS: More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6% mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9% could correctly defined what is called a new TB case and re-treatment cases according to standard guideline. CONCLUSION: The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.