Abstract:

Hand washing is a basic and simple practice which has a positive impact on community health; effective hand washing is an important measure to prevent the spread of microorganisms.

The objective of this study is to assess knowledge and attitude of hand washing among school children and to provide a health education session on effective hand washing technique.

It is a quantitative cross-sectional study. The study used a sample size of 180 children studying in grade 4, 5 and 6. A self- administered questionnaire was used to collect data, 170 questionnaires were well filled and a health education session was conducted on effective hand washing technique.

The results revealed 78.2% children who reported to always wash hands after using toilet, 88.8% children who reported to always wash hands before eating. 82.3% reported to use water and soap when washing hands and 87.1 % reported that they washed in palm, between fingers and in fingernails. The study showed that the reasons of not washing hands properly are forgetfulness (46.4%), lack of water (18.2%), lack of soap (17%), being in hurry (10.5%)and lack of water and soap (7.6%). The prevalence of diarrhea in three previous months was 13.5% . More than one third of the respondents do not know the importance of hand washing and more than one quarter do not know the consequences of not washing hands properly. The over-reporting of hand washing was different of what observed before health education when only 2 among 15 children randomly chosen washed between fingers.

There is a need of health education in order to improve the knowledge of children regarding hand washing and extending the health education sessions to other schools.

References:

[1] Adewole, I, Oluwole, O & Sagay, A. (2006). Prevention of Mother-to-Child transmission of HIV: The Nigerian PMTCT Programme. AIDS in Nigeria, 1(1), 349-84.

[2] Amazoncom. (2016). Amazoncom. Retrieved 18 July, 2016, from https://www.amazon.com/Encyclopedia-African-American-Heritage-Susa...

[3] Avertorg. (2016). Avertorg. Retrieved 17 July, 2016, from http://www.avert.org/preventing-mother-child-transmission-hiv.htm.

[4] Balogun, M & Odeyemi, K. (2010). Knowledge and practice of prevention of mother-to-child transmission of HIV among traditional birth attendants in Lagos State, Nigeria. Pan Afr Med J, 5(1), 7.

[5] Coetzee D, Hilderbrand K, Boulle A, Draper B, Abdullah F and Goemaere, E. (2005). Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa. Bull World Health Organ, 83(7), 489-94.

[6] Dabis, F, Leroy, V & Castebonk, E. (2000). Prevention of Mother to Child Transmission of HIV-1 in Africa. AIDS, 14(1), 1017–1026.

[7] De cock, K. M., Fowler, M. K., Mercier, E., De Vincenzi, I., Saba, J., Hoff, E., Alnwick, D. J., Rogers, M., and Shaffer, N. (2000). Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA, 283(1), 1175–1182.

[8] Federal Ministry of Health. (2008). Technical Report on the National HIV/Syphilis Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria. NASCP Abuja: Nigeria.

[9] Joint United Nations Programme on HIV/AIDS (UNAIDS). (2011). Countdown Zero. UNAIDS. Geneva.

[10] Jurgens, R, Cohen, J & Beyrer, C. (2007). Increasing access to HIV testing and counselling while respecting human rights. HIV AIDS Policy Law Rev, 12(2-3), 63-6.

[11] Mirkuzie, A. H. (2008). Utilization of PMTCT services in Awassa town Ethiopia. Center for Internal Health, Faculty of Medicine and Dentistry, University of Bergen, Norway.

[12] National AIDS/STIs Control Programme Federal Ministry of Health. (2014). Integrated National Guidelines for HIV Prevention, Treatment and Care.

[13] Olaniyan, F.A. (2013). Spatial Inequalities in the Provision of Private Health Facilities in Oyo State. Indonesian Journal of Geography, 45(1).

[14] Owoaje, E, Omidokun, A & Ige, O. (2012). Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria. Afr J Prim Health Care Fam Med, 4(1), 32.

[15] Schmidt, C. O & Kohlmann, T. (2008). When to use the odds ratio or the relative risk? International Journal of Public Health, 53(3), 165-167.

[16] Swamy, M. (2007). UN agencies issue new guidelines for HIV testing. HIV AIDS Policy Law Rev, 12(2-3), 39-40.

[17] Unaids.org. (2016). Unaidsorg. Retrieved17July,2016, from http://data.unaids.org/pub/Report/2010/nigeria_country_progress_report_en.pdf.

[18] World Health Organization. (2007). Guidance on provider-initiated HIV testing and counseling in health facilities.

[19] WHO/UNICEF/UNAIDS. (2011). Calculated from Universal Access Country reported unpublished data.

Abstract:

Exclusive breast feeding (EBF)means that the infant receives only breast milk with no other additional foods or liquid, not even water. Breastfeeding has many health benefits for both the mother and infant.

The aim of the study was to assess factors that hide exclusive breast feeding among the mothers attending Immunization clinic in Kericho county Hospital. The target population was all the mothers with children aged 0-6 months attending immunization clinic, Kericho County Hospital. The study design was descriptive cross-sectional study. Convenience sampling was used, as quite a number of women go for immunization at the hospital. All mothers (aged 18-49 years) with children 0-6 months old visiting Kericho County Hospital immunization clinic were included in the study. Fisher et al, 1998 was used to calculate the sample size, where 40 respondents were interviewed. Data was collected by use of a questionnaire. SPSS version 20.0 was used to analyze the data, which was summarized into percentages and presented in Text, figures, tables and graphs. Odd ratio was used to calculate the Respondents relationship distribution in terms of Education level versus Knowledge on EBF and Occupation versus complementary feeding.

Majority (62.5% ) of the respondents were aged 18-27 years followed by those with 28-37 years (25% ) while in the level of education, those with secondary were 55% , tertiary 20% and primary were 25% . For marital status, 50% were married, 32% single, 10% widowed, 5% separated and 3% divorced. The distributions for religion, 95% were Christians and only 5% were Muslims. In occupation self-employed were the majority 45% followed by those without employment at 35% and the employed at 20% .

The sources of exclusive breastfeeding as quoted by the respondents were Health center 50% , friends 25% , CHW 12.5, Books 7.5% and Childs grand-Mother 5% . On the duration of EBF, those who breastfeed for 6 Months were the majority at 62.5% , 4-5 Months at 25% and 0-3 Months at 12.5% . On whether the EBF is possible with HIV infected mothers, 75% answered yes and not possible at 25% and when asked how possible it was, 62.5% said through healthcare workers advice, 32.5% through EBF only and those who did not have an idea 5% .

On terms of the age of their children, respondents with 0-3 years were 60% and 4-6 months were 40% while 42.5% had introduced other feeds such as milk, porridge, fruits, water and 57.5 had not introduced the feeds. When requested to explain their reasons to introduce others feeds, 60% said it was because of work, advice from child’s grand-mother were 22.5% and those lucking enough milk were at 17.5% .

The odd ratio suggested that salaried respondents are twice more likely to introduce complementary than the non-salaried respondents while those with primary education were 6 times more likely to lack knowledge on EBF than the salaried. Despite high level of knowledge on exclusive breastfeeding, challenges affecting its optimal uptake there’s still need to address it in community in order to bolster its uptake. There’s need to return to work by breastfeeding mothers was noted as one of barriers of exclusive breastfeeding.

The county government should make necessary legislation to create supportive work. Environment for breasting mothers who are not covered by National Maternity Policy.

References:

[1.] Aatekah Owais, Shiyam S. Tikmani, Shazia Sultana, Umber Zaman, Imran Ahmed, Salim Allana and Anita K. M. Zaidi (2010) Incidence of pneumonia, bacteremia and invasive pnuemonoccal disease in Pakistani children. Tropical medicine & International health. 15(90), pg 1029-1036.

[2.] American Academy of Pediatrics. Breasting feeding and the use of Human milk. Pediatrics Vol. 29 (3)2012.

[3.] Arun Gupta, J. P. Dadhich, and Shoba Suri. How Can Global Rates of Exclusive Breastfeeding for the First 6 Months be Enhanced? ICAN: Infant, Child, & Adolescent Nutrition. Vol. x • no. x. 2013

[4.] County government of Kericho, Kericho sub-county Hospital Health records, 2015.

[5.] Denis, C. L. (2001 )Breastfeeding initiation and duration: A 1990-2000 Literature review. WHO report, 31(1 ).

[6.] Fisher AA, Laing JE, Strocker J E (1998) Handbook for family planning, operation research design in sampling. Population Council. 40-45.

[7.] Foss, K. A. & Southwell, B. G (2006) Infant feeding and the media: the relationship between parents magazine content and breastfeeding. 1972-2000. International breastfeeding journal. 1(10)pg 1 -9

[8.] Goldman, A. S., Hopkinson, J. M., Rassin D K (2017)Benefits and risks of breastfeeding. Advances in pediatrics. Vol. 54(1 )pg. 275-304. 14

[9.] Jessri, M., Farmer, A. P., & Olson, K. (2013). Exploring middle-eastern mother’s perceptions and experiences of breastfeeding in Canada: An ethnographic study. Maternal & child nutrition.

[10.] Juana Willumsen (2013) breast feeding education or increased duration: biological, behavioral and contextual rationale. Dept of nutrition for health and development, WHO, Geneva. Accessed on 12th March, 2015.

[11.] Kosmala-Aderson, J., & Wallace, L. M (2014) Breastfeeding works: The role of employers in supporting women who wish to breastfeed and work in four organizations in England. WHO journal of public health. 28(3)pg. 183-191 .

[12.] Kenya National bureau of statistics, (2010)The Kenya national health survey 2008-2009. Nairobi Kenya

[13.] Kimani-murage, E., Wekesah, F., wanjohi, M., Muriuki., Kwobutungi, C., Norris, S., & Griffiths, P (2013) “Because most mothers are hustlers’’: Challenges of an urban poor 15 breastfeeding mothers in Nairobi slums. In Annals of Nutrition and metabolism. Vol. 63, pg 742-742. Basel, Switzerland.

[14.] Raiser, N. S., Laudermilk, M. J., West, J. L., Thompson, P. A & Thomson. C. A(2011 ) recruitment of lactating women into a randomized dietary intervention: Successful strategies and factors promoting enrollment and retention. Contemporary clinical trials. 32(4).

[15.] Rita, 2012 Accessed from

www.consultancyafrica.com/index.php?option=com_content&view=article&id=1180:knowledge-attitudes-and-practices-regarding-exclusive-breastfeeding-in-southern-africapart-2&catid=61:hiv-aids-discussion-papers&Itemid=268. Accessed on 12th March, 2015

[16.] Shazia Memon et. al, (2010)Assessment of infant feeding practices at a tertiary care hospital, Journal of Pakistani Medical Association, Vol. 60, (12)December, 1010-1015.

[17.] Tomasoni, L. R., Moche G., Declich, S., Pietra, V., Croce, F., Pignatelli, S., Castelli, F (2011 )Knowledge , altitude and practice regarding newborn feeding modalities in HIV - infected and HIV uninfected pregnant women in sub-Saharan Africa: A multicenter study. International health journal. 3(1 )pg 56-65.

[18.] UNICEF (2007)The state of the world’s children 2008. Child survival. Vol. 8, UNICEF.

[19.] Vieth, R., Bischoff-Ferreri, H., Boucher, B. J., Dawson-Hughes, B., Garland, C.F., Heaney, R. P & Zittermann, A (2007)The urgent need to recommend an intake of vitamin Dthat is effective. The American journal of clinical medicine nutrition 85(3)pg 649-650.

[20.] www.en.wikipedia.org/wiki/Breastfeeding.Assessed 6th March, 2015.

[21.] www.jica.go.jp/kenya/english/office/topics/topics100908.html.Accessed on 7th March, 2015.

[22.] WHO (2010) Guidelines on HIV and infant feeding 2010: Principles and recommendations for infant feeding in the context of HIV and a summary of evidence.

Abstract:

Background

SMEs in Nigeria serve as the catalyst for employment generation, poverty reduction and economic development. Therefore studies on occupational health services in SMEs are needed to improve the occupational health and safety services in small and medium enterprises.

Objective

To assess and compare the occupational health and safety management systems between small and medium enterprises in Asaba, Delta State, Nigeria.

Methods

The study was conducted among 62 small and medium scale enterprises in Asaba, Delta State, selected by stratified random sampling. The design was cross-sectional analytical. A structured interviewer-administered questionnaire was developed and completed for each enterprise. Data was analyzed using SPSS version 20.0 and presented using frequency tables and charts.

Results

The findings revealed that 22.6% and 9.7% of the SMEs had OHS policy and Joint Health and Safety Committee respectively. Furthermore, 74.2% reported they had Health and Safety Rules with only 41.3% having a written rule. None had a clinic, but 27.4% had a medical retainership which included a higher proportion of medium scale enterprise (77.8%) (p<0.001). Nine enterprises (33.9%) made up of a higher proportion of medium scale firms (100.0%) (p<0.001) conducted training on OHS. A higher proportion of medium enterprises (66.7%) conducted accident reporting and investigation (p<0.001).

Conclusion

There were gaps in the implementation of occupational health and safety services in majority of the enterprises with OHS-MS significantly better developed in medium enterprises. SMEDAN should ensure SMEs implement improved occupational health services, capacity building among employees on occupational health and safety management system and also, further studies on the subject matter are recommended.

References:

[1.] Asuzu MC. The development and state of health and safety in the workplace in West Africa: perspectives from Nigeria. West Afri. J Med. 1996: 15(1):36-44.

[2.] Bonita R, Beaglehole R, KjellstomT. Basic Epidemiology. Second edi. Geneva: World Health Organization; 2006.

[3.] Bull N, Riise T, Moen BE. Work-related injuries and occupational health and safety factors in smaller enterprises- a prospective study. Occupational Medicine 2002 ; 52(2):70-74.

[4.] Bradshaw LM, Curran AD, Eskin F, Fishwick D. Provision and perception of occupational health in small and medium-sized enterprises in Sheffield, UK. Occup Med. 2001; 51(1): 39-44.

[5.] Ekwujuru P (2013). MSMEs contribute 47% to Nigeria’s GDP- SMEDAN. The Vanguard Newspaper, 13th October. Available from www.vanguardngr.com.Cited 13th February, 2014.

[6.] Gallagher C, Underhill E, Rimmer M (2001). OHS Management Systems: A Review of their Effectiveness in Securing Healthy & Safe Workplaces . Available from http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/127/OHSManagementSystems_ReviewOfEffectiveness_NOHSC_2001_Arch ivePDF.pdf.Cited 1st March, 2014.

[7.] Hoshuyama T, Hino Y, Kayashima K, Morita T, Minami M, Sakuragi S, et al. Inequality in the health status of workers in small-scale enterprises. Occupational Medicine 2007;57:126–130.

[8.] Hu SC, Lee CC, Shiao JSC, Guo YL. Employers' awareness and compliance with occupational health and safety regulations in Taiwan. Occup. Med. 1998; 48(1): 17-22. 12

[9.] Isah EC, Asuzu MC, Okojie OH. Occupational health services in manufacturing industries in Nigeria. Occup Med (Lond). 1996 Oct; 46(5):333-6.

[10.] Isah EC, Okojie OH. Occupational Health Problems of Welders in Benin City, Nigeria. Journal of Biomedical Sciences 2006; 5 (1): 64-69

[11.] Kadiri IB. Small and medium scale enterprises and employment generation: The role of finance. Kuwait chapter of Arabian journal of business and management Review 2012 ;1(9):9-88.

[12.] Kawakami T. Strengthening occupational accident and disease reporting systems. African Newsletter on Occupational Health and Safety 2010; 20 (3): 47.

[13.] Kalejaiye PO. Occupational health and safety: Issues, challenges and compensation in Nigeria. Peak Journal of Public Health and Management 2013; 1 (2): 16-23.

[14.] Lentz T J, Wenzl TB. Surveillance: Small Businesses with High Fatality Rates: Assessment of Hazards and Their Prevention. Journal of Occupational and Environmental Hygiene 2006; 3(2):9-14.

[15.] Mizoue T, Higashi T, Muto T, Yoshimura T, Fukuwatari Y. Activities of an occupational health organization in Japan., in special reference to services for small- and medium-scale enterprises. Occup. Med. 1996: 46 (1): 12-16.

[16.] Matiko JM. Injury and disease reporting in Tanzania. African Newsletter on Occupational Health and Safety 2010; 20 (3): 48-50.

[17.] Okojie OH, Isah EC. Assessment of Occupational Hazards among Beauticians in Benin City. Nigerian Journal of Clinical Practice 2001 ; 4(1): 25-27.

[18.] Okojie O. System for reporting occupational diseases in Nigeria. African Newsletter on Occupational Health and Safety, 20 (3), 51-53.

[19.] Pingqing L, Fang L, Chunjing G. Occupational Health and Safety(OHS) in Small and Medium Size Enterprises (SMEs): A Primary Review. Canadian Social Science 2006 ;2(1):7-12.

[20.] Puplampu BB, Quartey SH. Key Issues on Occupational Health and Safety Practices in Ghana: A Review. International Journal of Business and Social Science. 2012 ; 3( 19): 151-156.

[21.] Small and Medium Enterprise Development Agency of Nigeria (2007). National Policy on Micro, Small and Medium Enterprises.

[21.] Shahab S. Development and Implementation of an Occupational Safety and Health Management Program for the Small- to Medium-Sized, Indigenous, Privately Owned Enterprise in Pakistan. Appl. Occup. Environ. Hyg. 1998 ; 13(12):811-816.

Abstract:

Background: The Ebola Virus Disease (EVD) outbreak was declared in Nigeria by the Federal Ministry of Health on 24th July 2014 following the arrival of a male passenger from Liberia. Aim: The study set to assess the knowledge, attitude and practices of Ebola Virus Disease among residents in Enugu, Eastern Nigeria. Primary care providers. Materials and Methods: A total 394 participants were recruited for this descriptive cross sectional study. Data was collected using structured interviewer administered questionnaire focusing on demographic characteristics, knowledge of Ebola virus disease, and infection control practices. Data analysis was carried out using SPSS version 15. Results: The results were expressed in percentages. It showed relatively low awareness (31 .0% )about EVD with the female gender predominating. The most significant source being from the television media. Conclusion: The most important tool to fight EVD is correct adequate information through various media as prevention through improved personal hygiene is key.

References:

[1.] Centers for Disease Control. (2014)Update: Filovirus infection in animal handlers. Morbidity Mortality Weekly Report. 2014; 39(13):221.

[2.] Dalgard D. W (1992). Combined Simian Hemorrhagic Fever and Ebola Virus Infection in Cynomolgus Monkeys. Laboratory Animal Science 1992; 42(2): 152-5

[3.] Georges A. J, Leroy E. M and Renaud A. A, (1999). Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues. Journal of Infectious Diseases. 1999; 179: S65-75.

[4.] Hayes C. G, Burans J. P and Ksiazek T. G (1992). Outbreak of fatal illness among captive macaques in the Philippines caused by an Ebola-related filovirus. American Journal of Tropical Medicine and Hygiene. 1992;46(6):664-671.

[5.] Heymann D. L, Weisfeld J. S and Webb P. A (1980). Ebola hemorrhagic fever: Tandala, Zaire, 1977-1978. Journal of Infectious Diseases. 1980;142(3):372-376.

[6.] Jahrling P. B, Geisbert T. W and Dalgard D. W (1990). Preliminary report: isolation of Ebola virus from monkeys imported to USA. Lancet. 1990;335(8688):502-505.

[7.] Khan A. S, Tshioko F. K and Heymann D. L, (1999). The Reemergence of Ebola Hemorrhagic Fever, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases. 1999; 179: S76-S86.

[8.] Ministry of Health Nigeria – Ebola report, 24th July 2014, Lagos[469 KB, 5 pages]

[9.] Miranda M. E, Ksiazek T. G and Retuya T. J (1999). Epidemiology of Ebola (subtype Reston) virus in the Philippines, 1996. Journal of Infectious Diseases. 1999; 179 (suppl 1 ):S115-S119.

[10.] UNICEF, FOCUS 1000, & Catholic Relief Services. (2014). Study on Public Knowledge, Attitudes, and Practices Related to EVD Prevention and Medical Care in Sierra Leone. Sierra Leone: UNICEF, FOCUS 1000 & Catholic Relief Services.

[11.] World Health Organization. Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team [1 .4 MB, 24 pages]. Bulletin of the World Health Organization. 1978;56(2):247-270. 25

[12.] World Health Organization. Ebola haemorrhagic fever in Zaire, 2000[958 KB, 24 pages]. Report of an International Convention. Bulletin of the World Health Organization. 1978; 56(2):271 -293.

[13.] World Health Organization. End of the Ebola Outbreak in the Democratic Republic of the Congo. Global Alert and Response. 17 Febuary 2009

[14.] World Health Organization. Viral haemorrhagic fever in imported monkeys [1 .2 MB, 8 pages]. Weekly Epidemiological Record. 2014;67(24):183. 26

Abstract:

In this study which looks at the impact on access to HIV care by UN Plus Kenya, the researcher interviewed 41 staff members living with HIV. The interviews took place in one of the UN Plus meetings. For those who were unavailable at the meeting/non UN Plus members, the researcher sought for appointments with individual members while keeping confidentially during the process. The literature review revealed a similarity in the outcome of viral load suppression. The data revealed some few staff members who were not doing as well as the others and who may have to be followed up for further care.

Adequate time is required to give more attention and better analysis of all the results from this study.

References:

[1.] Corey (2000).Theory and Practice of Counselling and Psychotherapy.(6th Edition). Belmont CA: Brooks/Cole

[2.] Feltham, C. and Horton, I. (2000).Handbook of Counselling and Psychotherapy. London: Sage Publications Limited.

[3.] Hart, C. (1998). Doing Literature Review. Releasing the Social Science Research Imagination. London: Sage Publications Limited.

[4.] ILO, 2001. An ILO Code of Practice on HIV and AIDS and the World of Work. Geneva: ILO.

[5.] Long‐Term Outcome of Second‐Line Antiretroviral Therapy in Resource‐Limited Settings.(3rd April, 2014). Retrieved From http://jia.sagepub.com.

[6.] Living Positively: Country Networks – Kenya.(1st April 2014).Retrieved From www.unplus.org.

[7.] Morse, J. M. (1994). Critical Issues in Qualitative Research Methods. London: Sage Publications Limited.

[8.] NASCOP. (2008). Kenya AIDS Indicator Survey KAIS. Preliminary Report. Ministry of Health, Republic of Kenya. Nairobi: NASCOP.

[9.] The Basics: What is UN Cares? ( 1st April 2014).Retrieved From www.uncares.org. www.uncares.org.

[10.] UNAIDS. (2002). Mainstreaming gender into the Kenya National HIV and AIDS strategic Plan 2000‐ 2005. Nairobi: Information Management Consultants.

[11.] UNAIDS.(2005). UN System HIV Workplace Programmes.HIV Prevention, Treatment and Care of the UN System employees and their families. UNAIDS best practice collection.

[12.] UNAIDS. (2013). UNAIDS Global Report. UNAIDS Report on the Global AIDS Epidemic.

[13.] Understanding Viral Load vs CD4 Count.(8th April 2014).Retrieved From www.health24.com.

[14.] Yin, R. K. (1984).Case Study Research: Design and Methods. Newbury Park, CA: Sage.

Abstract:

This descriptive survey study, which was carried out in Ose local government area of Ondo State, investigated the knowledge, attitude and practices of road transport workers towards the prevention of HIV/AIDS in Ose, Ondo state, Nigeria. A structured questionnaire was used as instrument. Summated scores was used to access respondents’ knowledge about HIV/AIDS, attitude towards HIV/AIDS prevention, practices towards HIV/AIDS prevention and knowledge about HIV/AIDS protective measures. Data analysis was done with SPSS version 17. Descriptive statistics of frequencies, tables, pie and bar charts were used to present the results. Chi square was used to determine the significant association between various socio-demographic characteristics and knowledge of HIV/AIDS, practice towards prevention of HIV/AIDS and knowledge of HIV/AIDS protective measures among commercial drivers.

The results of the 150 participants study revealed that many of the commercial drivers are above 30 years old (52.4%). A considerable percentage of respondents have girlfriends (27.9%), engage in extramarital sex (54.1%), and visit sex workers more than twice per week (21.4%).This study equally revealed that considerable high percentage (40%) of the respondents have poor knowledge about HIV/AIDS, while the level of education, ethnic group and number of visits to sex workers have statistically significant association with their knowledge about HIV/AIDS. It was also revealed that 100% of commercial drivers have varying degrees of poor attitude towards HIV/AIDS prevention, coupled with 93% of varying degrees of poor practice of HIV/AIDS prevention and 77% of their varying degrees of poor knowledge of HIV/AIDS protective measures. Marital status, levels of education, ethnic group and extramarital sex were found to be significantly associated with the practice of commercial drivers towards HIV/AIDS prevention. Finally, this study also discovered that level of education and occasional extramarital sex has statistically significant association with the knowledge of commercial drivers about HIV/AIDS protective measures in Ose metropolis. Helpful recommendations on how to improve the situation were made and suggestions for further research were also given.

References:

[1.] Agha S. (2000): Potential for HIV Transmission among Truck Drivers in Pakistan. AIDS 20; 14 (15); 2404-6.

[2.] Berlier W, Bourlet T, Lawrence P, Hamzeh H, Lambert C, Genin C, Verrier B, Dieu-Nosjean MC, Pozzetto B, Delezay O. (2005). “Selective sequestration of X4 isolates by human genital epithelial cells: Implication for virus tropism selection process during sexual transmission of HIV”.J Med Virol 77: 465-474

[3.] Bwayo J, Plummer F, Omari M, Mutere A, Moses S, Ndinya-Achola J,Velentgas P, Kreis J. (1994) Human immunodeficiency virus infection in long-distance truck drivers in east Africa. Arch Intern Med 27; 154 (12); 1391-6.

[4.] Bygbjerg IC. (1983). AIDS in a Danish surgeon (Zaire, 1976). Lancet; 1:925

[5.] Carvel J. W. Injection abscess. Ugandan Medical Jounal 1983, 5, 16-20

[6.] Celentano D, Bond K, Lyles C, (2000) ncvPreventive intervention to reduce sexually transmitted infections: a field trial in the Royal Army. Arch Intern Med 160: 535-540.

[7.] Centre for Disease Control uptake. (1988). Serologic testing for anti-body to HIV. MMWR; 36:883-40

[8.] Chan, D. Kim, P. (1998). HIV entry and its inhibition. Cell 93: 681-684.

[9.] Chan, DC., Fass, D., Berger, JM., Kim, PS. (1997). Core Structure of gp41 from the HIV Envelope Glycoprotein (pdf). Cell 89: 263-273.

[10.] Chaudhary S. S., Nagargoje M. M, Kubde S. S, B hardway A. K and Singh R. (2002). Article on knowledge and attitude of autorichaw drivers about HIV/AIDS and other sexually transmitted diseases by Lumenis Agra India utter Pradesh 282002.

[11.] Chaudhry M. A, Naeemm, Iqbal R, Shabbir (2005). Level of Awareness about HIV/AIDS among truck drivers and their attitude towards persons with AIDS. Gomal J. Medical Science. 3: 19-23.

[12.] Clavel F, Guetard, Brun-Vezinet F. (1986). Isolation of a new human retrovirus from West Africa patients with AIDS. Science; 233:343-6

[13.] Clevestig P, Maljkovic I, Casper C, Carlenor E, Lindgren S, Naver L, Bohlin AB, Fenyo EM, Leithner T, Ehrnst A. (2005). The X4 phenotype of HIV type 1 evolves from R5 in two children of mothers, carrying X4, and is not linked to transmission. AIDS Res Human Retroviruses 5: 371-378

[14.] Coakley, E., Petropoulos, C. J. and Whitcomb, J. M. (2005). Assessing chemokine Co-Receptor Usage in HIV. Current opinion infections disease 18: 9-15.

[15.] Cohen, D. (2001): The HIV epidemic and sustainable human development. November 26] [19 screens] Available from: URL: http://www.undp.org/hiv/publications/issues/english/issue29e.html)

[16.] Deng H, Liu R, Ellmeier W, Choe S, Unutmaz D, Burkhart M, Di Marzio P, marmon S, Sutton RE, Hill CM, Davis CB, Peiper SC, Schall TJ, Litman DR, Landau NR. (1996). Identification of a Major Co-Receptor for primary Isolates of HIV-1. Nature 381 : 661-666.

[17.] Desrosiers R.C. (1986). Origin of Human AIDS virus. Letter Nature, 319: 728.

[18.] Federal Republic of Nigeria (2012) 'Global AIDS Response Country Progress Report, Nigeria'

[19.] Feng Y, Broder CC, Kennedy PE, Berger EA. (1996). HIV-1 entry Cofactor: Functional Cdna Clonning of a seven-Transmembrane, G Protein-coupled Receptor. Science 272: 872-877.

[20.] Froland S. S., Jenum P, Lindboe C. F., Wefring K. W., Linestad P. J and Bohmer T. (1988). HIV-1 infection in Norwegian family before 1970. The Lancet 1344-1345.

[21.] Gallo R (1987). The AIDS virus. Sci Am; 256:46-56.

[22.] Gawande AV, Vasudeo ND, Zodpey SP, Khandait DW (2000) Sexually transmitted infections in long distance truck drivers. J Commun dis 32(3); 212-5.

[23.] Health International: 1997.

[24.] Hubley J. (1995). The AIDS handbook. Second Edition, London. Macmillan

[25.] Hudson, C. P. (1996). AIDS in rural Africa: a paradigm for HIV-1 prevention. International Journal of Sexually Transmitted Diseases and AIDS 7(4):236-43.

[26.] Ibe Sally N. O1, Nwoke, E. A1, Emerole, C. O1, Onyeocha, F.A1, Nwawume, I.C2, Nwaokoro, Joakin Chidozie1 (2014): Knowledge, attitude and perception of road transport workers to HIV/AIDS, STIs and condom use in southeast, Nigeria. American Journal of Science and Technology 2014; 1(2): 50-54

[27.] Interventions in developing countries.(2000) AIDS 14 (suppl 2): S68-S84.

[28.] Karen Mupemba (1999): The Zimbabwe HIV prevention program for truck drivers and commercial sex workers: a behaviour change intervention. Resistances to Behavioural Change to Reduce HIV/AIDS Infection, 1999, 133-137

[29.] Karlsson A., Parsmyr K, Aperia K, Sandstrom E, Fenyo EM, Albert J. (1994). MT-2 cell tropism of human immunodeficiency virus type 1 isolates as a marker for response to treatment and development of drug resistance. Journal of infections disease 170: 1367-1375.

[30.] Koenig R.E, Gautier T, Levy J. A. (1986). Unusual introfamilial transmission of Human immunodeficiency virus. Lancet 2: 627.

[31.] KOLATA, Gina (28 October 1987) Boy’

[32.] Lacerda R, Gravato N, McFarland W, Rutherford G, Iskrant K, Stall R, Hearst N. (1997) Truck drivers in Brazil: prevalence of HIV and other sexually transmitted diseases, risk behavior and potential for spread of infection. AIDS 11 Suppl 1:S15-9.

[33.] Lievefranses, Johannes VanDam and Peter Piot (1991), Health Policies for controlling AIDS and STIs in developing countries. Health Policy and planning 6(2) 148-156.

[34.] Maradzika, J., S. Rusakaniko and S. Siziya. (1995): A report on the AIDS KABP baseline surveycarried out among the transport workers and the commercial sex workers in Zimbabwe. University of Zimbabwe Department of Community Medicine, Harare (unpublished report).

[35.] Merson MH, Dayton JM, O'Reilly K. (2000): Effectiveness of HIV prevention

[36.] Moore JP. (1997). Coreceptors: implications for HIV pathogenesis and therapy. Science276: 51-52.

[37.] Morisky, DE, Ang, A, Sneed, CD (2002) Validating the Effects of Social Desirability on Self-Reported Condom Use Behavior among Commercial Sex Workers. AIDS Education and Prevention, 14:351-360.

[38.] Morisky, DE, Pena, M, Tiglao, TV, Liu, KY (2002): The Impact of the Work Establishment on Condom Use among Female Bar Workers in the Philippines.Health Education and Behavior, 29, 461-472.

[39.] Morisky, Donald E (2008): HIV/AIDS Prevention among The Male Population: Results of a Peer-Education Program For Taxicab and Tricycle Drivers in the Philippines. UCLA

[40.] Muciaccia B, Padula F, Vicini E, Gandini L, Lenzi A, Stefanini M. (2005). Beta-chemokine Receptors 5 and 3 are expressed on the head region of human spermatozoon. FASEB Journal 19: 2048-2050.

[41.] Mukodzani, L., K. Mupemba and J. Marck. (1999): All roads lead to Harare: the response of the Zimbabwe transport industry to HIV/AIDS. Pp. 131-138 in The Continuing African HIV/AIDS Epidemic, ed. I.O. Orubuloye, J. C. Caldwell and J.P.M. Ntozi. Canberra: Australian National University

[42.] Nahmias AJ, Weiss J, Yao X, (1959). Evidence for Human infection with HTLV-III/LAV-like virus in central Africa. Lancet; 1:1279-80

[43.] National Agency for the Control of AIDS (2010). National HIV/AIDS Strategic Plan 2010-15. 1-45.

[44.] National Institute of Health. Crystal Structure of Key HIV Protein Reveals New Prevention, Treatment Targets, June 17, 1998. Retrieved on 2014-11-10

[45.] New Era, Family Health International. An Evaluation of International Interventions Targeted to Commerical Sex Workers and Sex Clients on the Land Transportation Routes from Janapur and Birgunj to Naubise. Kathmandu: Family

[46.] Niraula S. R., JhaN, Mishra RN and Singh S. P (2003). Awareness and risk taking behaviours regarding sexually transmitted diseases among long distance drivers in a township of Dhran. Nepal Indian 34: 129-138.

[47.] Park, K. (2007). Park’s Textbook of Preventive and Social Medicine (19th Ed.). M/s Banarsidas Bhanot Publishers. Jabalpur India. 278-296.

[48.] Peter R.L. (2002). Reducing heterosexual transmission of HIV in poor countries, (Clinical review). Br. Med. J; 324:207-213.

[49.] Podhisita, C., M. J. Wawer, A. Pramualratana, U. Kanungsukkasem and R. McNamara. (1996): Multiple sexual partners and condom use among long-distance truck drivers in Thailand. Aids Education and Prevention 8, 6:490-498.

[50.] Rao KS, Pilli RD, Rao AD, Chalam PS. Sexual lifestyle of long distance lorry drivers in India: questionnaire survey. BMJ 16: 318(7177); 162-3, 1999.

[51.] Saxinger WC, Levine PHY, Dean A. (1985). Evidence for exposure to HTLV-III in Uganda before 1973. Science; 227:1036-8

[52.] Sibanda, A., J. Murombedzi and M. Tawanda. (1997). Sexual behaviour among transport workers: a study of National Employment Council for the Transport Operating Industry (NECTOI) drivers and assistants, and commercial sex workers. Tropang Consultancy Services (Pvt) Ltd, Harare (unpublished report).

[53.] Society for Family Health and Action Aid International, Nigeria, (2006). Peer Education Plus: Introduction Module for Transport Workers HIV Intervention; Heinemann Educational Books Nigeria Plc, Ibadan.

[54.] Spradley, B.W. and Allender, J.A. (1996). Community Health Nursing: Concepts and Practice (4th Ed.) Lippincott Philadelphia New York. 510-516.

[55.] Stratford D, Ellerbrock TV, Akins JK, Hall HL (2000) “Highway cowboys, old hands, and Christian truckers; risk behavior for human immunodeficiency virus infection among long-haul truckers in Florida,” Social Science and Medicine 50(5); 737-749.

[56.] Tang, J. and Kaslow, R. A. (2003). The Impact of Host Genetics on HIV Infection and Disease Progression in the Era of Highly Active Antiretroviral Therapy. AIDs 17: S51-S60.

[57.] UNDP (2006) 'Human Development Report: Beyond scarcity- Power, poverty and the global water crises.

[58.] UNDP (2013) 'Human Development Report 2013:The Rise of the South-Human Progress in a Diverse World'

[59.] United Nation AIDS (2012). ‘Global Report: Annexes'

[60.] United Nations General Assembly Session (UNGAS) on HIV/AIDS (2001): DECLARATION ON COMMITMENT ON HIV/AIDS “Global Crisis- Global Action

[61.] Wilson, D., A. Sibanda, B. Nyathi, N. Lamson and T. Sibanda. 1994. Ethnographic and quantitative research to design a community intervention among long-distance truck drivers in Zimbabwe. Pp. 99-108 in Focusing Interventions among Vulnerable Groups for HIV Infection:

[62.] Wong, K.H., Lee, S.S., Lo, Y.C. & Lo, K.K. Condom use among female commercial sex workers and male clients in Hong Kong. International Journal of STD and AIDS, 5, 287-289, 1994.

[63.] World Bank, (2009). Transport against HIV/AIDS:Synthesis of Experience and Best Practice Guidelines.

[64.] Wyatt R, Sodroski J. (1998). The HIV-1 envelope glycoproteins: fusogens, antigens, and immunogens. Science 280: 1884-1888.

[65.] Zheng, Y. H., Lovsin, N. and Peter Lin, B. M. (2005). Newly Identified host factors modulate HIV replication. Immunol. Letter 97: 225-234.

[66.] Zhu T, Wang N., Carr A, Nam DS, Moor-Jankowski R, Cooper DA, Ho DD. (1996). Genetic Characterization of human immunodeficiency virus type 1 in blood and genital secretions: evidence for viral compartmentalization and selection during sexual transmission. Journal of Virol 70: 3098-3107.

[67.] Zhu, Tuofu and Nahinias (1998). An African HIV-1 sequence from 1959 and implication for the origin of the Epidemic Nature: 391: 594-597.

Abstract:

Background: This is a study done to assess the knowledge and attitude of health care workers in Nigeria about the Middle East Respiratory Syndrome (MERS). This study became necessary because there is now exportation of the disease from Saudi Arabia, to other countries.

Methods: It is a cross-sectional study, involving 224 respondents. Descriptive statistics was used to get the characteristics, mean attitude and knowledge scores of the study participants. Chi-square test was used to determine the relationship that exists between study variables and questions on attitude. Inferential statistics, Mann-Whitney U and Kruskal Wallis tests, were used to examine differences between study variables. P values < 0.05 were considered significant. Spearman’s rho correlation was employed in the identification of the association between knowledge and attitude scores.

Results: The respondents showed a fairly good knowledge and good attitude towards MERS. There was a significant correlation between knowledge and attitude (r = 0.301, P < 0.001). Respondents showed poorest knowledge in thinking that MERS is still restricted to the Arabian Peninsula (8.5%), however, they showed good knowledge in the type of people the disease is most devastated in (87.9%). Many of the respondents demonstrated a positive attitude in the sharing of MERS related information among peers (1.39 ± 0.866) but their attitude towards their active participation in infection control is the poorest (2.49 ±1.242).

Conclusions: This study revealed that health care workers in Nigeria have fairly good knowledge and good attitude towards MERS, but demonstrated very poor knowledge and negative attitude in some areas.

References:

[1.] Chantal B. E. M. Reusken; Lilia Messadi; Ashenafi Feyisa; Hussaini Ularamu; Gert-Jan Godeke; Agom Danmarwa; Fufa Dawo; Mohamed Jemli; Simenew Melaku; David Shamaki; Yusuf Woma; Yiltawe Wungak; Endrias Zewdu Gebremedhin; Ilse Zutt, Berend-Jan Bosch; Bart L. Haagmans; Marion P. G. Koopmans. Geographic Distribution of MERS Coronavirus Among Dromedary Camels, Africa. Emerging Infectious Diseases. 2014;20(8):1370-1374.

[2.] CDC (2015, July 6^th). Middle East respiratory syndrome (MERS). Centre for Disease Control and Prevention (2015). Available at: http://www.cdc.gov/coronavirus/mers/about/index.html

[3.] Cronbach L J (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297-334.

[4.] Embarek P K, Kerkhove V. Middle East respiratory syndrome coronavirus (MERS-CoV) –current situation 3 years after the virus was first identified. Wkly Epidemiol Rec 2015 May 15;90:245–50.

[5.] Joukar F, Mansour-Ghanaei F, Soati F, Meskinkhoda P: Knowledge level and attitudes of health care professionals toward patients with hepatitis C infection. World J Gastroenterol 2012, 8:2238–2244.

[6.] Hawkes N: Camels could be the source of MERS coronavirus, research finds. BMJ 2013, 347:f5052.

[7.] Khan, M. U, Shah, S. and Fatokun, O. (2014): Knowledge and attitude of healthcare workers about middle east respiratory syndrome in multispecialty hospitals of Qassim, Saudi Arabia. BMC Public Health 2014 14:1281. doi:10.1186/1471-2458-14-1281.

[8.] Peiris JS, Chu CM, Cheng VC, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet2003;361:1767-1772 CrossRef | Web of Science | Medline

[9.] Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV, members of the infection control programme: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000, 356:1307–1312.

[10.] Raosoft (2004). Sample size calculator. Accessed on 17^th July, 2015 at: http://www.raosoft.com/samplesize.html

[11.] Rapparini C, Feijó-Barroso P, Saraceni V, Artioli-Machado A, CôrtesFernandes G (2007): Occupationally acquired infectious diseases among health care workers in Brazil: use of internet tools to improve management, prevention, and surveillance. Am J Infect Control 2007, 35:267–270.

[12.] Rahnavardi M, Rajaeinejad M, Pourmalek F, Mardani M, Holakouie-Naieni K,Dowlatshahi S (2008): Knowledge and attitude toward Crimeane Congo haemorrhagic fever in occupationally at-risk Iranian healthcare workers. J Hosp Infect 2008, 69:77–85.

[13.] Richmond JA, Dunning TL, Desmond PV (2007): Health professionals’ attitudes toward caring for people with hepatitis C. J Viral Hepat 2007, 14:624–632.

[14.] WHO. Middle East respiratory syndrome coronavirus (MERS-CoV)— Republic of Korea. Disease outbreak news (2015, May 30). Geneva: World Health Organization, 2015. http://www.who.int/csr/don/01-june-2015-merskorea/en/ (accessed July 16, 2015).

[15.] Zumla A, Perlman S, McNabb S J, Shaikh A, Heymann D L, McCloskey B, et al (2015). Middle East respiratory syndrome in the shadow of Ebola. Lancet Respir Med 2015 Feb;3(2):100–2.

Abstract:

Objectives: To describe the major characteristics of Revised National TB Control Programme notified TB cases in district Byculla, Mumbai from January 2013 through December 2013

Design: Descriptive analysis of 1024 reported TB cases extracted from the Web based case based portal of RNTCP-NIKSHAY

Setting: Twenty, Primary, secondary and tertiary health care centres across the district of Byculla, Mumbai

Population: A multivariate population of TB patients of all ages and gender with confirmed TB registered in NIKSHAY by the district of Byculla, Mumbai from January 2013 to December 2013

Main outcome measure: Microbiologically or clinically conformed TB case registered

Results

The Total TB case notification rate was found to be 213 per 1,00,000 population in the year 2013.The highest proportion, 24.8% (p<0.000) of TB cases were notified in the age group 15-24 although the peak (22.5%) for females was observed in the age group 25-34 years. Extra pulmonary TB was calculated to be 34% (p<0.000) but was disproportionately high (48%) in the females. 31% (p,0.000) of the patients sputum result was “NA”

References:

[1.] Agarwal S, Satyavada A, Kaushik S, Kumar R. Urbanization, Urban Poverty and Health of the Urban Poor: Status, Challenges and the Way Forward. 2007;36(1):121–134.

[2.] Ahsan G, Ahmed J, Singhasivanon P, et al. Gender difference in treatment seeking behaviors of tuberculosis cases in rural communities of Bangladesh. Southeast Asian J Trop Med Public Health. 2004;35(1):126–35. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15272755. Accessed April 15, 2014.

[3.] Bishnu B, Bhaduri S, Kumar AM V, et al. What are the reasons for poor uptake of HIV testing among patients with TB in an Eastern India District? Kranzer K, ed. PLoS One. 2013;8(3):e55229. doi:10.1371/journal.pone.0055229.

[4.] Borgdorff MW, Nagelkerke NJ, Dye C, Nunn P. Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection. Int J Tuberc Lung Dis. 2000;4(2):123–32. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10694090.

[5.] Colebunders R, Bastian I. REVIEW ARTICLE A review of the diagnosis and treatment of smear-negative pulmonary tuberculosis. Int J TB Lung Dis. 2000;4(March 1999):97–107. Available at: http://www.ingentaconnect.com/content/iuatld/ijtld/2000/00000004/00000002/art00003?token=005514cf2d61405847447b496e2f2a314242356b464c4833757e6f4f2858592f3f3b574f07fae6b212220.

[6.] Central TB Division. TB India 2013.pdf. New Delhi; 2013. Available at: http://tbcindia.nic.in/pdfs/TB India 2013.pdf.

[7.] Central TB Division DG of HS. TB India 2011-Annual Status report.; 2011. Available at: http://tbcindia.nic.in/pdfs/RNTCP TB India 2011.pdf.

[8.] Central TB Division DG of HS. 2012 Guidance for TB Notification in India. 2012;(July). Available at: http://tbcindia.nic.in/pdfs/GuidancetoolforTBnotificationinIndia-FINAL.pdf.

[9.] Gautham M, Binnendijk E, Koren R, Dror DM. “First we go to the small doctor”: first contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India. Indian J Med Res. 2011;134(5):627–38. doi:10.4103/0971-5916.90987.

[10.] Neyrolles O, Quintana-Murci L. Sexual inequality in tuberculosis. PLoS Med. 2009;6(12):e1000199. doi:10.1371/journal.pmed.1000199.

[11.] Programme WGT, - WHORO for S-EA. Tuberculosis control_: the DOTS strategy (Directly Observed Treatment Short-Course)_: an annotated bibliography / compiled by the Global Tuberculosis Programme and the Regional Office for South-East Asia -.1997:WHO/TB/97.228 14 p. Available at: http://apps.who.int/iris/bitstream/10665/63548/1/WHO_TB_97.228.pdf?ua=1. Accessed April 15, 2014.

[12.] Surendra K. Sharma1,*, Alladi Mohan2,*, L.S. Chauhan3,*, J. P. Narain4,*, P. Kumar5,*, D. Behera6,*, K.S. Sachdeva7,* AK, Programme for TF for I of MC in the RNTC. Contribution of medical colleges to tuberculosis control in India under the Revised National Tuberculosis Control Programme (RNTCP): Lessons learnt & challenges ahead. Indian J Med Res 137.283–294. Available at: http://icmr.nic.in/ijmr/2013/february/0205.pdf. Accessed April 15, 2014.

[13.] Tamhane A, Ambe G, Vermund SH, Kohler CL, Karande A, Sathiakumar N. Pulmonary tuberculosis in mumbai, India: factors responsible for patient and treatment delays. Int J Prev Med. 2012;3(8):569–80. Available at:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3429805&tool=pmcentrez&rendertype=abstract.Accessed April 15, 2014.

[14.] Uplekar M, Juvekar S, Morankar S, Rangan S, Nunn P. Tuberculosis patients and practitioners in private clinics in India. Int J Tuberc Lung Dis. 1998;2:324–329.

[15.] Singh D. Migration and occupation in Mumbai: issues and implications. Pap Present 35 th Int Conf …. 2005:1999–2001. Available at: http://iussp2005.princeton.edu/papers/50938. Accessed April 15, 2014.

[16.] WHO Global TB Report 2013.; 2013.

[17.] World Health Organization. Alcohol in developing societies_: a public health approach . Summary. 2002:1–27. doi:WHO Library Cataloguing-in-Publication Data.

[18.] Prasad R. Alcohol use on the rise in India. Lancet. 2009;373(9657):17–18. doi:10.1016/S0140-6736(08)61939-X.

Abstract:

Malaria remains one of the most wild spread infectious diseases of humankind, threatening approximately half the world’s population and causing debilitating illness in more than 216 million people morbidity and mortality is particularly high in sub-Saharan Africa. Malaria is prevalent throughout Cameroon with transmission being affected by climate and geography, increased drug resistance and the lack of adequate vector control measles. It accounts for 40 to 45% of medical consultations, 57% of hospitalization days and 40% of mortality among children below 5 years. The objective of this study wee to determine the proportion of patients attending Limbe Regional Hospital whose self- diagnosis of malaria is confirm with Laboratory Analysis. A questionnaire was administered to the participants in a cross-section study. The respondent’s consent was sought. Data was analyzed manually for chi square. The level of significant was set at p>0.05. in this study, 65.7% of the 105 participants successfully self diagnosed malaria. Also, 71.4% of the studied participants knew the true cause of malaria to be plasmodium parasite .The commonest signs and symptoms as mentioned by the respondent were as follows : 33(31.4%) increased by body temperature , 23(21.9%) headache ,12(11.429%)body pains .12(11.4%) sweating and 25(23.8%) gave other symptoms .The level of education attained by respondents greatly influenced their ability to self-diagnosed malaria and to know the true cause of malaria (x² calculated =14.02, x² Tabulated = 5.99, P < 0.05).Competent authorities need to intensify and implement proper health education messages on the risk factors of malaria in order to improve upon the understanding of disease in the nation.

References:

[1.] Amino R, Thiberge S, Martin B et al. quantitative imaging of Plasmodium transmission from mosquito to mammal. Nat Med. Feb (2006); 12(2): 220-224.

[2.] Aikins MK,Pickering H, Greenwood BM (1994). Attitudes to malaria, traditional practices and bed nets (mosquito nets) as vector control measures: a comparative study in five West African Countries. J.Trop. Med Hyg. 97:81-86.

[3.] Agyepong, I.A. (1992) Malaria: Ethnomedical Perceptions and Practice in an Adangbe Farming Community and Implications for Control. Social Science and Medicine, Vol. 35(2): 131-137.

[4.] Ashley M. Vaughan, Ahmed S.I. Aly, Stefan H.I Kappe. Malaria parasite pre-erythrocytic stage infection: Gliding and Hiding Cell Host Microbe. II September (2008); 4(3): 209-218.

[5.] Breman, Joel G. M. S. Alilio, and A. Mills. (2004). “Conquering the Intolerable Burden of malaria: What’s New, What’s Needed: A Summary American Journal of Tropical Medicine and Hygiene 71 (Suppl 2): 1-15.

[6.] Brain M. Greenwood, David A. Fidock, Denis E. Kyle, Stefan H.I. Kappe, Pedro L. Alonso, Frank H. Collins, Patrick E. Duffy. Malaria: progress, perils and prospects for eradication J. Clin. Invest. (2008) 118:1266-1276. Doi: 10.1172/JC133996.

[7.] Centers for Diseases control (CDC). (2006). “Schema of the life cycle of malaria. Accessed 2007 Feb 9.

[8.] Cecil textbook of medicine, XIX edn (1992). Philadelphia, USA: W.B. Saunders Co,pp. 16901692.

[9.] Carolina Barillas-Mury, Sanjeev Kumar. Plasmodium mosquito intereactions: a tale of dangerous liaisons. Cellular Microbiology (2005); 7(11):1539-1445.

[10.] Dauda Waiswa Batega. (2004). Knowledge attitudes and practices about malaria treatment and prevention in Uganda. Health Communication Partnership based at Johns Hopkins Bloomberg School of. Public Health/Centre for Communication Programs.

[11.] Dickson Shey Nsagha I, Anna Longdoh Njunda, Henri Lucien Fouamno Kamga, Jules Clement Bguedia Assob, Charles Shey Wiysonge, Sarah Mboshi Nsagha, and Alfred Kongnyu Njamnshi (2011). Knowledge and practices relating to malaria: Signs and symptoms, causes and prevention; Journal of Public Health and Epidemiology Vol. 3(6).pp. 294-300, June 2011.

[12.] Eric A. Achidi, Tobias O Apinjoh, Judith K Anchang-Kimbi, Regina N Mugri, Andre N Ngwai, and Clarisse N Yafi (2012). Severe and uncomplicated falciparum malaria in children from three regions and three ethnic groups in Cameroon: prospective study. Achidi et al. malaria Journal 2012. 11:215.

[13.] Einterz EM (2003). Perceptions of malaria transmission, presentation and management in northern Cameroon. Trans. R. Soc. Trop. Med. Hyg. 97: 51-51.

[14.] Edmondson Jane. (2001) page 24. Malaria and Poverty: Opportunities to Address Malaria through Debt Relief and Poverty Reduction Strategies; Working document prepare by Malaria Consortium.Pg.24.

[15.] Foster S(1995). Treatment of malaria outside the formal health services. J Trop.Med.Hyg. 98:29-34.

[16.] Greenberg AE, Ntumbanzondo CM, Malaria L, Howell J, Davachi F (1989). Hospital-based Surveillance of malaria-related Pediatric morbidity and mortality in Kinshasa, Zaire. WHO Bull. 67:89-196.

[17.] Global Malaria Action Plan (2011). Available at http://www.rollbackmalaria.or/gmap and http://www.rollbackmalaria.org/gmap/3-2html.

Source: Malaria Prevalence Model: I. Kleinschmidt (2001). An empirical malaria distribution map for West Africa. Tropical Medicine and International Health 6:779-786. Topographical data.

[18.] Handrickse RG; Hasan AH; Olumide LO and Akinkunmi A. (1971). Malaria in early childhood. Annals of Tropical Medicine and Parasitology (1971); 65:1-20.

[19.] Heather M Ferguson, Andrew F Read, Mosquito appetite for blood is stimulated by Plasmodium chabaudi infections in themselves and their vertebrate hosts. Malaria Journal (2004); 3:12doi: 10.1186/1475-2875-3.

[20.] Isaac Keango Nyamongo. (1998) lay people’s responses to illness: An Ethnographic study of anti-malaria behavior among the Abagusii of Southwestern Kenya.

http:/www.who.int/malaria/world_malaria_report_(2010)/en/index.html.

[21.] Ikome LE, Ndamukong KJ, Kimbi H (2002) Prevalence and case-control study of cerebral malaria in Limbe of the South West Cameroon. Afr J Health Sci 9:61-67.

[22.] Jackson, L.C. (1985) malaria in Liberian children and mothers: Biocultural Perceptions of illness Vs. clinical Evidence of Disease. Social Science and Medicine, Vol 20(12): 1281-1287.

[23.] Jake Baum, Dave Richard, Julie Heale et al. a conserved Molecular Motor Drives Cell Invasion and Gliding Motility across Malaria Life Cycle Stages and Other Apicomplexan Parasites. The Journal of Biological Chemistry. Febraury (2006); 281:5197-5208.

[24.] Kalisa, M. W. (1997). A study of malaria control policy in Hoima district (Unpublished). Ministry of Gender and Community Development, Kampala, Uganda. J. Trop Med. Hyg. 97:81-86.

[25.] Kun JF, Mission MA,Lell B, Sovric M, Knoop H, et al. (2002) New emerging Plasmodium falciparum genotypes in children during the transition phase from asymptomatic parasitemia to malaria. AM J Trop Med HYG 66:653-658.

[26.] Kimbi HK, Awah NW, Ndamukong KJ, Mbuh JV (2005) Malaria infection and its consequences in school children. East Afr Med J 83:92-97.

[27.] Kebaier C, Voza T, Vanderberg J. Kinetics of Mosquito-Injected Plasmodium Sporozoites in Mice: Fewer Sporozoites Are Injected into Sporozoite-Immunised Mice. Plos Pathog (2009); 5(4): e1000399.

[28.] Langhorne J, Ndungu FM, Sponaas A, Marsh K: Immunity to malaria: more questions than answers, Nat Immunol (2008), 9:725-732.

[29.] Laurence Floren, Michael P. Washburn, J. Dale Raine et al. a proteomic view of the Plasmodium falciparum life cycle Nature October (2002); 419:520-526.

[30.] Lucy Megumi Yamauchi, Alida Coppi, Georges Snounou, Photini Sinnis. Plasmodium sporozoites trickle out of the injection site. Cell Microbiol. 1 May (2007); 9(5):1215 – 1222.

[31.] Malanet P. Speilman A, Sachs J: (2004). The malaria gap. Am J Trop Med Hyg (2004), 71:141 146

[32.] Ministère de la Santé Publique (2007). Plan stratégie nationale de la lute contre le paludisme au Cameoun. Pp 1- 134.

[33.] Michael F Good, Denise L Doolan. Malaria’s journal through the lymph node. Nature Medicine (2007); 13:1023-1024.

[34.] Miguel Prudêncio, Ana Rodriguez, Maria M. Mota. The silent path to thousands of merozoites: the Plasmodium liver stage. Nature Reviews Microbiology (2006); 4:849-856.

[35.] Njama D, Dorsey G, et’al (2003). Urban malaria: primary caregivers’ knowledge, attitudes, practices and predicators of malaria incidence in a cohort of Uganda children. In Trop Med and Int Health. Vol 8 of No 8 pp: 685-692.

[36.] Olivier Silvie, Maria M Nota, Kai Matuschewski, Miguel Prudencio. Interactions of the malaria parasite and its mammalian host. Current Opinion in Microbiology (2008); 11:352-359.

[37.] Quakyi AI, Leke RG, Befidi-Mengue R, Tsafack M, Bomba-Nkolo D, Manga, L, Tchinda V, Njeugue E, Kouontchou S, Fogako J, Nyonglema P, Harun LT, Djokam R, Sama G, Eno A, Megnekou R, Metenou S, Ndoutse L, Same-Ekobe A, Alake G, Meli J, Ngu J, Tietche F, Lohoue J, Mvondo, J.L, Wansi E, Leke R, Folefack A, Bigoga J, Bomba-Nkolo C, Titanji V, Walker-Abbey A, Hickey AM, Johnson AH, and Taylor, DW. (2000); The Epidemiology of Plasmoium falciparum in two Cameroonian villages: Simbok and Etoa. American Journal of Tropical Medical and Hygiene. (2000); 5:222-230.

[38.] Quakyi AI; Leke RG; Befidi-Mengue R; Tsafack M; Bomba-Nkolo D; Manga, L; Tchinda V; Njeugue E; Kountchou S; Fogako J; Nyonglema P; Harun LT; Djokam R; Sama G; Eno A; Megnekou R; Metenou S; Ndoutse L; Same-Ekobe A; Alake G; Meli J; Ngu J; Tietche F; Lohoue J; Mvondo, JL; Wansi E; Leke R; Folefack A; Bigoga J; Bomba-Nkolo C; Titanji V; Walker-Abbey A; Hickey AM; Johnson AH; and Taylor DW. The epidemiology of plasmodium falciparum in two Cameroonian villages: Simbok and Etoa. American Journal of Tropical Medicine and Hygiene (2000); 5:222-230.

[39.] Roll Back Malaria Partnership. (2002). Malaria and children. World Heal Organization Accessed May 2, 2010.

[40.] Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI: The global distribution of clinical episodes of plasmodium faciparum malaria. Nature (2005) , 434:214 – 217.

[41.] Smith DC (1982). The rise and fall of typhomalaria fever. I: origin. J. Hist. Med. Allied Sci, 37:182-220.

[42.] Snow RW, Guerra CA, Abdisalan M; Myint HY, Hay SI, (2005): The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 2005, 343:214-217.

[43.] Samba E; (2001). The malaria burden and Africa. AM J Trop Med Hyg, 64 (1 – 2 Suppl): ii.Preface.

[44.] Sylvia Münter, Benedikt Sabass, Christine Selhuber-Unke et al. plasmodium sporozoite Motility is Modulated by the Turnover of Discrete Adhesion Sites Cell Host and Microbe. December (2009); 6(17):551-562.

[45.] Theresia Nkuo-Akenji, Nelson N. Ntonifor, Maize B. Ndukum. Helen K. Kimbi, Edith L. Abongwa, Armand Nkwescheu, Damain N. Anong, Michael Songmbe, Michael G. Boyo, Keneath N, Ndamukong and Vincent P.K Titanji. (2006). Environmental factors affecting malaria parasite prevalence in rural Bolifamba, South West Cameroon. TN environment (2004). 71:141 146.

[46.] United Nations Statistics Division (2011). Malaria mortality in Cameroon. Available at http:/www.indexmundi.com/Cameroon/malaria-mortality.html. Retrieved, ay 11.

[47.] World Health Organization, World Malaria report, Global malaria programme (2011). Geneva World Health Organization Publication; (2011)

[48.] World Economic Forum (2002). Global health initiative. Private sector intervention case example Chad/Cameroon oil pipeline. Using malaria control strategically to improve worker’s health and prevent project delay,pp 1 0 8.

[49.] WHO:World Malaria report, (2011). Global malaria programme. Geneva World Health Organization Publication; (2011)

[50.] World Health Organization. (2002). World Health Report Reducing Risks, Promoting Health Life.Pg 77. Geneva.

[51.] WHO World Malaria Report (2010): Available at

http//whqlibdoc.who.int/publications/2010/9789241564106_eng.pdf

Abstract:

Early and Late ANC maybe the difference between positive and and negative foetaland maternal outcomes. The study was carried out in the community of Klerksdorp in South Africa, targeting primigravidato confirm or refute the literature findings around antenatal care and expand discussion around the development of ANC with a view to make them specific and tailored to local situations. A sample of 50 being 30% of the weekly births was randomly chosen from mothers attending postnatal care around clinics in Klerksdorp. A questionnaire was administered by way of interviews. The results showed that majority of the mothers had booked late for their ANC and outcomes show statistically significant correlation with timing for their bookings. The study concludes that Klerksdorp primigravida are younger requiring suitable and properly packaged-to- age campaign programs to educate them in their comfort zones. There is significant statistical evidence linking the standard ANC tests at clinics to positive fetal and maternal outcomes. Intervention programs for late ANC mothers need be tailored informed by evidence based research to change negative associated outcomes.

References:

[1.] City of Matlosanalocal municipality-municipal profile. http://www.citysolve.co.za/hda/files/pdf/city-of-mat

[2.] Danish, N., Fawad, A., & Abbasi, N. (2010). Assessment of pregnancy outcome in primigravida: comparison between booked and un-booked patients. J Ayub Med Coll Abbottabad.

[3.] Farlex . (2012). Farlex Partner Medical Dictionary. Farlex.

[4.] Irene Figa’- Talamanca. (1980). A study of environmental and behavioural factors affecting pregnancy outcome in an Italian community. Population and Environment. Volume 3, issue 2. Pp107-124. Doi: 10.1007/BF01254151

[5.] Lincerto, O., Mothebesaone-Anoh, S., & Patricia Gomez, M. S. (2013). Opportunities fro African Newborns: Antenatal Care. WHO.

[6.] MWOL Ltd. (2013). Parents. Retrieved April 8, 2015, from Midwives online website: http://midwives.com/parents/parents1

[7.] Mary E. Cogswell, Pamela Weisberg & Catherine Spong. (2003). Cigarette Smoking, Alcohol use and Adverse Pregnancy Outcomes: Implications for Micronutrient Suplementation. The Journal of Nutrition. Vol. 133(5): 17225-17315

[8.] Nuraini E, Parker E. (2005). Improving knowledge of antenatal care (ANC) among pregnant women: a field trial in Central Java, Indonesia. Asia Pac J Public Health. 17(1): 3-8

[9.] NHS. (2015, January 8). Your Antenatal Care. Retrieved April 14, 2015, from NHS CHOICES: http://www.nhs.uk/comditions/pregnancies-and-baby/pages/antenatal­midwife-care-pregnant.aspx#Starting

[10.] NICE Guidelines (CG 6). (2008). Routine Care for the Healthy Pregnant Woman: Clinical Guideline.

[11.] Pandit, S., & Kale, D. (2011). Obestetric Outcome in Elderly Primigravida ... how did they fare? Bombay Hospital Journal.

[12.] Saxena, P., Salhan, S., Chattopadhyay, B., Kohli, M., Nandan, D., & S V, A. (2010). Obestetric and perinatal outcome of teenage and older primigravida. A retrospective analysis. Health and Population: Perspective and issues .

[13.] Shehader, A. (2000). Elderly Primigravida and pregnancy outcome. Jordan.

[14.] Seo Won Bang, Sang Sun Lee. (2009) The factors affecting pregnancy outcomes in the second trimester pregnant women. Nutr Res Pract. 3(12): 134-140. Doi: 10.4162/nrp.2009.3.2.134

[15.] Theobald C. E. Mosha & Napendaeli Philemon. (2010). Factors influencing pregnancy outcomes in Morogoro Municipality, Tanzania. Tanzania Journal of Health Research. Vol 12(14)

[16.] Ye Y, Yoshida Y, Harun-or-Rashid M, & Sakamoto J. (2010). Fcators affecting the utilization of antenatal care services among women in Kham District, Xiengkhouang province, Lao PDR. Nagoya J Med Sci. 72(1-2): 23-33

Abstract:

A number of infectious diseases remain neglected, such as the sleeping sickness and often occur in individuals who are additionally affected by HIV/AIDS and malaria, making the problem even more serious. In this article we will be discussing the clinical interactions between HIV/AIDS, malaria and trypanosomiasis infection.

The discussed patient is a 34 year old female who presented with an intermittent fever lasting approximately three months and behavioural problems persisting for one week. The patient reported unprotected sex with multiple sexual partners. She was diagnosed with HIV (WHO stage III), human African trypanosomiasis stage II and malaria with high parasitemia. The patient receives treatment for malaria and trypanosomasis but died of neurological causes.

Discussion: There is a scarcity of data regarding the coexistence of HIV/AIDS, trypanosomasis, and malaria in a specific patient. This creates a complicated situation for diagnosis and treatment.

Conclusion: Co-infections through various infectious agents are common in sub-Saharan African creating important diagnostic, therapeutic, and prognostic implications.

References:

[1.] Afro.who.int. Overview: HIV/AIDS - WHO | Regional Office for Africa [Internet]. 2015 [cited 10 August 2015]. Available from: http://www.afro.who.int/en/clusters­a-programmes/dpc/acquired-immune-deficiency-syndrome/overview.html

[2.] Blum J, Burri C, Hatz C, Kazumba L, Mangoni P, Zellweger M. Sleeping hearts: the role of the heart in sleeping sickness (human African trypanosomiasis). Tropical Medicine & International Health. 2007;12(12):1422-1432.

[3.] Blum J, Nkunku S, Burri C. Clinical description of encephalopathic syndromes and risk factors for their occurrence and outcome during melarsoprol treatment of human African trypanosomiasis. Trop Med Int Health. 2001;6(5):390-400.

[4.] Boraschi D, Abebe Alemayehu M, Aseffa A, Chiodi F, Chisi J, Del Prete G et al. Immunity against HIV/AIDS, Malaria, and Tuberculosis during Co-Infections with Neglected Infectious Diseases: Recommendations for the European Union Research Priorities. PLoS Neglected Tropical Diseases. 2008;2(6):e255.

[5.] Galactionova K, Tediosi F, de Savigny D, Smith T, Tanner M. Effective Coverage and Systems Effectiveness for Malaria Case Management in Sub-Saharan African Countries. PLOS ONE. 2015;10(5):e0127818.

[6.] Kuepfer I, Hary E, Allan M, Edielu A, Burri C, Blum J. Clinical Presentation of T. b. rhodesiense Sleeping Sickness in Second Stage Patients from Tanzania and Uganda. PLoS Negl Trop Dis. 2011;5(3):e968.

[7.] Lejon V, Ngoyi D, Ilunga M, Beelaert G, Maes I, Buscher P et al. Low Specificities of HIV Diagnostic Tests Caused by Trypanosoma brucei gambiense Sleeping Sickness. Journal of Clinical Microbiology. 2010;48(8):2836-2839.

[8.] Lumbala C, Simarro P, Cecchi G, Paone M, Franco J, Kande Betu Ku Mesu V et al. Human African trypanosomiasis in the Democratic Republic of the Congo: disease distribution and risk. International Journal of Health Geographics. 2015;14(1).

[9.] Matete G, Kajejo O. Human African Trypanosomiasis And Human Immunodeficiency Virus Co-Infection In Western Kenya. E Af Med Jrnl. 2005;82 (1).

[10.] Meda H, Doua F, Laveissière C, Miezan T, Gaens E, Brattegaard K et al. Human immunodeficiency virus infection and human African trypanosomiasis: a case-control study in Côte d'Ivoire. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1995;89(6):639-643.

[11.] Pepin J, Ethier L, Kazadi C, Milord F, Ryder R  .The impact of human immunodeficiency virus infection on the epidemiology and treatment  ofTrypanosoma brucei gambiense sleeping sickness in Nioki, Zaire. Am J Trop Med Hyg 47.1992;47(7)

[12.] Tack D, Holman R, Folkema A, Mehal J, Blanton J, Sejvar J. Trends in Encephalitis-Associated Deaths in the United States, 1999-2008. Neuroepidemiology. 2014;43(1):1-8.11.

Abstract:

Introduction :As the health care system of Malaysia improves so does the living age of the Malaysian population. A fall in the mortality rates, better living standards , good nutrition and better medical facilities all predispose to an increase in the proportion of the elderly. As the age population curve skews towards the right there is also an increase in the number of diseases affecting the elderly. The commonest being dementia.

Objective(s) : A cross-sectional study was carried out in Klinik Kesihatan Maharani, one of the largest primary health care centres in Muar. The aim of this study was to describe the frequency and distribution of dementia. To identify risk factors that correlate with dementia.

Methods : Convenience sampling was used and using the 95% confidence interval, the minimum sample size required was 307 respondents .The dependent variable was dementia . Elderly Cognitive Assesment Questionnaire (ECAQ) and the Clock Drawing Test (CDT) were the neuropsychological tests used for this study .All those who scored 6 or below for ECAQ and 3 or more for the CDT which ever was significant were referred to a psychiatrist for further assessment.

Results :There were 313 respondents who participated in this study. The overall prevalence rate of dementia was 13.4% .The prevalence rate increased by fourfold every 10 years from 5.4% (65-74 years) to 28.1% (>75 years).Higher prevalences of dementia were found in female (19.9%), no education background(30.5%),Indians (33.3%), divorce/widowed (21.1%) and those staying in old folks home(69.2%).There was not much difference between smokers as compared to non-smokers and those from urban as compared to from rural areas . 

References:

[1.] Blossom S and Carol B; Prevalence and Projections of dementia.5843- Mc Graw-Downsbow P3.

[2.] Department of Statistics Malaysia. Key statistics. http://www.statistics.gov.my

[3.] Kua EH, Ko SM. A questionnaire to screen for cognitive impairment in elderly people in developing countries. Acta Psychiatr Scand 1992;85:119-22.

[4.] Korner EA, Lauritzen L, Nilsson FM, Lolk A, Christensen P. Simple scoring of the clock drawing test for dementia. Dan Med J 59/1 2012:1-5.

[5.] Kua EH. Dementia in elderly Malays – Preliminary findings of a community survey. Singapore Med J 1993;34:26­8.

[6]. Kokmen E , Smith GE ,Petersen RC, Tangalos E, Ivnik RC.The short test of mental status. Correlations with standardized psychometric testing. Arch Neurol 1991;48 :725-8.

[7]. Lee H, Lawlor BA. State-dependent nature of the clock drawing task in geriatric depression. J AM Geriatric Soc 1995;43:796-8.

[8]. Manos PJ, Wu R. the ten point clock test:a quick screen and grading method for cognitive impairment in medical and surgical patients. Int J Psych Med 1994;24 :229-44.

[9]. Public Health Med 2011,Vol 11(2):43-48.

[10.] Rogers S I, Farlow M R, Doody R S, Mohs R, Friedhoff L T. A 24 week double-blind placebo controlled trial of donepezil in patients with Alzheimers disease. Neurology 1998; 50:136-45.

[11.] Saroja K, Khalid K, Raymond A, Hatta S, Suzy M. Prevalence of Dementia among elderly Malays in urban settlement in Malaysia.

[12.] Sano M, Ernesto C, Thomas R G, et al. A controlled trial of selegine,  alpha-tocopherol or both as treatment for alzheimers disease. N Engl J Med 1997;336: 1216-22.

[13.] Sharifah Zainiyah S Y, Gunasegaran M, Muhammad Hanif M Z, Nuramalina M, Seow H C, Bharathi V. Prevalence of cognitive impairment among the members of the national council of senior citizens Malaysia in day care centres within Klang Valley. Mal J

[14]. Sahadevan S, Saw SM, Gao W et al. Ethnic differences in Singapore’s dementia prevalence : the stroke, Parkinsons disease, Epilepsy and Dementia in Singapore. Study J AM Geriatr Soc 2008;56:2061-2068.

[15.] Tengku A H, Saroja K, Siti S A, Yadollah A M. Sociodemographic Risk Factors and Correlates of Dementia in Older Malaysians. Dement Geriatr Cogn Disorder 2010; 30 : 533-539.

[16.] World Health Organisation . The ICD 10 classification of mental and behavioural disorders: clinical description and diagnostic guidelines. Geneva : World Health Organization 1992.

[17.] World Health Organization ; www.int/dg/speeches/2012/ageing

Abstract:

There is a fast emerging “silent killer” in town. It joins the ranks of malnutrition, malaria, hypertension, diabetes, HIV/AIDS, etc. It is obesity!

It has been defined as a condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health may be impaired.

It is a lifestyle disease characterized by excessive fat accumulation in the tissues. We are eating our way to the grave as obesity and its attendant public health impact stare at us on the face not sparing the developed or developing countries. This does not come as a surprise. Globally, the epidemic is growing. It is a substantial public-health crisis in the developed world, but the prevalence is increasing rapidly in numerous developing nations worldwide

Conservative estimates suggest that as many as 250 million people are obese and about two to three times this number are overweight

References:

[1.] African journal of reproductive health( 2013 ]

[2.] Global health observatory

[3.] obesity in adult Nigerians

[4.] Socio‐demographic correlates of overweight and obesity among women of reproductive age‐2008( Matthew Okoh}

[5.] Prevalence of obesity among women attending a Nigerian primary care clinic( Ibadan]

[6.] Prevalence of overweight and and obesity and perception of healthy and desirable body size in urban Ghana.

[7.] Tropical journal of health sciences.

[8.] www.academicjournal.org

[9.] www.vanguardngr.com

[10.] www.nigeriamedj.com

[11.] www.njcponline.com

[12.] www.knoema.com

[13.] www.obesidade.info/estudos/obesity

Abstract:

Objective - To determine the attitude and behaviour of married males towards family planning uptake of their spouses in Ado-Ekiti, Nigeria.

Study design -This is a descriptive cross-sectional study design which utilized a semi-structured, self-administered, questionnaire.

Participants -Four hundred and three voluntary participants who were married males, residing within Ajilosun area of Ado-Ekiti metropolis.

Method - Across-sectional study was employed in this research to enable any desired data to be collected at one point in time using a semi-structured questionnaire administered to participants who also consented to the survey.

Results – There were 403 returned and analyzable questionnaires out of 410 questionnaires administered. The modal age group was 41 -50 years (35.0%). A total number of 23(5.7%) respondents only had primary education, 179(44.5%)secondary education, 161(39.9%)tertiary, while 40(9.9%)had no formal education. The majority of respondents, 202(50.1 %), desired to have 1 -4 children, while 121(30.0%)opted for 5-8 children. Only a smaller fraction, 38(9.4%), depends on God for the size of their family. Although most of the respondents in the study, 265(65.5%), admitted that decisions on family planning practice should be jointly reached by both spouses, 198(49.1 %)reminded their wives to use contraceptives, but only 58(14.4%) attended family planning clinics with their wives.

Conclusions – This study highlighted that a far greater number of respondents desired small sized family and also encouraged their wives to use their chosen contraceptives, but majority were not very willing to attend Family planning clinics with their spouses. Strategies to encourage married males to adequately key into family planning programmes should be devised.

References:

[1.] AQR (2011)‘Pilot Study – definition’,[Online]. Available from: http://www.aqr.org.uk/glossary/?term= pilotstudy (Accessed: 20 May 2014).

[2.] Araoye, M. (2003)Research Methodology with statistics for Health and Social Sciences. Ilorin: Nathadex publishers.

[3.] Awonuga, O., Oluwatosin, O., and Awonuga, D. (2014)Family planning behavior of male civil servants in Ibadan, South Western Nigeria, Nigerian medical practitioner, 65(1 -2),8-12).

[4.] Bunce, A., Q., Guest, G., Searing, H., Frajzyngier, V., Riwa, P., Kanama, J., and Achwal, I. (2007)Factors Affecting Vasectomy acceptability in Tanzania. International Family planning perspective, 33, 13-21 .

[5.] Duze, M., and Mohammed, I. (2006)Male knowledge, Attitudes and family Planning practices in Northern Nigeria. African J of Reproductive Health, 10:53-56.

[6.] Federal office of Statistics (1997). “The Statistical Profile of Nigerian Women 1997”. Abuja: F.

[7.] O. S. Gebrekidan, M. (2002)The role of men in fertility and family planning program in Tigray. Ethiop.j. Health dev. 16:247-255.

[8.] Green, J. and Thorogood, N. (2009)Qualitative Methods for Health Research, 2^nd ed, London: SAGE publications Ltd.

[9.] Haub, C., and Yangishila, M., (1992). “Environment and Population”. (World Population Data Sheet). Washington, DC: Population Bureau.

[10.] Medicam Report (2004)Male involvement is key to Reproductive Health, Cambodia millennium development goals Report, 2003, Cambodia: Medicam.

[11.] Mistick, S., Nacar, M., Maziciolguim, B., and Cetinkaya, F., (2003)Married Men’s Opinions and Involvement Regarding Family Planning in Rural Areas. Contraceptives, 67: 133-137.

[12.] Monjok, E., Smesny, A., Ekabua, J., and Essien, E.,(2010)Contraceptive practices in Nigeria: literature review and recommendation for future policy decisions. Open access journal of contraception, 1 ,9-22.

[13.] Neuman, L. (2000)Social Research Methods: Qualitative and Quantitative Approaches, Sydney: Allyn and Bacon.

[14.] Oladeji, D. (2008)Gender Roles and Norms: Factors Influencing Reproductive Behavior among Couples in Ibadan, Nigeria. Anthropologist, 10:133-138.

[15.] Olawepo, R., and Okedare, E., (2005)Men’s attitudes towards Family Planning in a Traditional Urban centre: An example from Illorin, Nigeria. J Social Science, 13:83-90.

[16.] Population Reference Bureau, (2002)“Demographic Profile: Women of the World 2002”. Washington, DC: PRB

[17.] Puri, A., Garg, S., and Mehra, M. (2004)Assessment of Unmet Needs for contraception inan urban Slum of Delhi. Indian J of Community Medicine, 29,139-140.

[18.] Raju, S., and Aeds, L., (2002)Men as supportive partners in reproductive health: moving from rhetoric to reality. New Delhi population council 33.

[19.] Roy, K. and Pinto, V. (2000) Women’s Perception and Provider Challenges: Inopal Final Report Population Council. New York: Inopal.

[20.] Texila American University (2014) Lecture notes on social and behavioural aspect of Public Health module, [Online]. Available at: Texila American University Online Education LMS (Accessed: 1 July 2014).

[21.] Ülker, K., Temur, I., and Gül, A. (2012)Effects of modernisation and new population policies on reproductive health in Kars, Turkey. Eur J Contracept Reprod Health Care, 17, 187-96.

[22.] WHO (2010)Emergency Contraception, dispelling the myth and misperceptions, Bulletin of the

World Health Organization, 88, 243-243.

Abstract:

Normal systolic blood pressure (SBP) is between 100 and 140mmHg while normal diastolic blood pressure (DBP) is between 60 to 100mmHg. Pulse pressure (PP) is the difference between the systolic and diastolic pressure and it falls in the range of 40 and 50mmHg.

Mean arterial pressure (MAP) is the average arterial pressure during a single cardiac cycle. It is the perfusion pressure seen by organs in the body. The normal value is between 70 and 110mmHg

A MAP that is lower than the normal value for a prolonged period of time leads to decreased oxygen supply to vital organs. It is represented as MAP = SBP + 2 (DBP)/ 3.

Blood pressure (BP) is the force which causes blood to flow through arteries to the capillaries then back to the heart via the veins. It is measured indirectly by the use of a sphygmomanometer. It is a result of interaction between cardiac output (CO), systemic vascular resistance (SVR) and blood viscosity.

Represented as BP = CO × SVR.

References:

[1.] Carreto O A, Opanil S (January 2000). “Essential hypertension. Part 1: definition and etiology”. Circulation 101 (3) 329 – 35.

[2.] Cappucio FP, Micah FB, Emmitt L, Kerry SM, Antwi S, Martin –Peprah R, et al. (2004). Prevalence, Detection, Management and Control of Hypertension in Ashanti, West Africa. Hypertension, 43(5), 1017 -1022.

[3.] Ejike CECC, Ugwu CE, Ezeanyika LUS and Olayemi AT (2008). Blood pressure patterns in relation to goegraphic area of residence: A cross sectional study of adolescent in Kogi state, Nigeria. BMC Public Health, 8(1) 411.

[4.] Hall, John E; Guyton, Arthur C. (2006). Textbook of medical physiology. St Louis, Mo: Elsevier Saunders. P 228 ISBN 0- 7216- 0240-1

[5.] Impact Ednurse (May 31, 2007). “Mean arterial pressure” impactednurse.com. Retrieved 2010 – 12 – 25

[6.] Neal B, MacMahon S, Chapman N, Blood Pressure lowering Treatment Trialists’ Collaboration. Effects of ACE Inhibitors, calcium antagonists and other blood pressure lowering drugs: results of prospectively designed overviews of randomized trials. Lancet. 2000; 356 : 1955 – 1964.

[7.] Wiredu EK, Nyame P K, Stroke related mortality at Korle Bu Teaching Hosp Accra, Ghana. East Afr Med J 2001; 78: 180 – 184.

Abstract:

This study assessed the knowledge and utilization of contraceptives as well as possible factors impeding its utilization among sexually active men in Ojuelegba Lagos, Nigeria. More than half of the men (63.1 % )had a good knowledge of contraceptives. Overall attitude showed that only few (41.5% ) had positive attitude towards the use of contraceptives, while 58.5% had negative attitude. The overall practice of contraception was 26.7%. Barriers to contraceptive utilization include; cost of buying contraceptives (21.7% ), it causes pregnancy delay (11.5% ), not easy to use. (12.9% ), conflicts with religious belief (21.2% ), family misconception (10.6% ), search for a male child (5.1 % ), wanted more babies (24.4% ), weight gain (5.5% ), permanent damage in the womb(1.8% ), don’t just like the idea (2.3% )and being unaware of contraceptives (0.5% ).

The various contraceptive methods used by the respondents include; hormonal methods (pills, implant, inject able)(11.5% ), non-hormonal methods (24% ), sterilization method (8.3% ), traditional methods(22.1 % ), condoms (30.4% ), while the remaining 13.4% mistook abortion as a family planning method.

This study showed some associated variables that influenced knowledge and practices of contraception while utilization rate was found to be very poor. A fairly good knowledge was seen, respondents’ attitude was below average, while the practices of contraception was very poor. Political will and support should be made available to ensure mass enlightenment and adequate availability of various contraceptive methods in order to encourage attitudinal change towards family planning and contraceptive utilization.

References:

[1.] Abiodun OM, Balogun OR. Sexual activity and contraceptive use among young female students of tertiary educational institution in Ilorin, Nigeria. Contraception. 2009;79:146–149.

[2.] A. I Olugbenga Bello, V. O OBOR O, M. O. Araoye and I. O. Musa Contraceptive practice among intercity drivers in an urban settlement in north central, Nigeria

[3.] Ijadunola M. Y, Ijadunola K. T, Abiona T. C, Esimai O. A, Afolabi O. T Male involvement in family planning decision making in Ile‐Ife, Osun State. (Afr J Reprod Health. 2010 Dec; 14(4 Spec no.):43-50.

[4.] International Journal of Tropical Medical. 2009, vol 4: Issue: 2, Page No: 55-58

[5.] Khan Bella M. E, Patel CMale Involvement in family planning A KABP Study of Agra District India final report population council June 1997.

[6.] Moreland, S. and S. Talbird (2006), “Achieving the Millennium Development Goals: The Contribution of Fulfilling the Unmet Need for Family Planning.”Washington, DC: Constella Futures, POLICY Project.

[7.] Singh, S., J. Darroch, M. V lass of, and J. Nadeau. Adding It Up: The Benefits of Investing in Sexual and Reproductive Health Care. New York: UNFPA, 2004

[8.] Tanzania Demographic Health Survey (1996), p 39-90, 140-168. Final report.

[9.] Teresa Castro Martı´n; Contraceptive use patterns among Spanish single youth; The European Journal of Contraception and Reproductive Health Care December 2005;10(4):219– 228.

[10.] WHO, Safe Abortion: Technical and Policy Guidance for Health Systems, World Health Organization, Geneva, Switzerland, 2nd edition, 2012,

http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf.

Abstract:

Cancer of the cervix is the second most common cancer and the second leading cause of cancer deaths in women worldwide (WHO, 2004, Schoell, Janicek, Mirhasshemi 1999). Each year an estimated 500,000 cases are newly diagnosis (WHO, 2004, schoell et .al 1999), a significant proportion of which will be in advanced stage (Guidozzi, 1999). In developing countries, it is the most commonly occurring type of cancer among women, accounting for 80% of the cases (WHO, 2004, Guidozzi, 1996). Cervical cancer is one of the most common cancers affecting U.S. women – now ranks 14 in frequency in this population (Armstrong .C, 2007). In 2007, an estimated of 11,150 women in the United States was diagnosed with cervical cancer, and an estimated 3,670 die of this disease (Armstrong .C, 2007).The lifetime risk of cervical cancer was estimated at 3.7% in the absence of cervical cancer screening (Brabin L et. al 2006).

References:

[1.] Abogunrin, A. J. (2004). Sexual behaviour, condom use, and attitudes towards HIV/AIDS among school‐going adolescents in Nigeria. Unpublished Ph.D dissertation, University of Ilorin, Ilorin.

[2.] Abraham S: Vaginal and speculum examination in medical curricula. Aust N Z J Obstet Gynaecol 1995, 35:56‐60.

[3.] Adab P. Screening for cervical cancer in Hong Kong [abstract]. Presented at the Fifth Hong Kong International Cancer Congress; 1998 Nov 10; Hong Kong

[4.] Adegoke, A. A. (2003). Adolescents in Africa: Revealing the problems of teenagers in a contemporary African society. Ibadan: Haddasah Publishing.

[5.] Adegoke, A. A. (2004).Adolescence and adolescent problems in schools. In Adeyemi Idowu, Guidance and counselling in education. Ilorin: Indemac Publishers (Nig.) Ltd.

[6.] Adekeye, O. A. (2005). Adolescents and the HIV pandemic. Ilorin Researcher: Journal of the Postgraduate Students Association, University of Ilorin. 3 (1): 23‐28.

[7.] Adekeye, O. A. (2009). HIV Voluntary Counselling and Testing for Young People: The antidote for a healthy and positive living in Nigeria. The Counsellor: 25 (1)

[8.] Adewole IF, Benedet JL, Brian TC, Fallen M. Evolving a strategic approach to cervical cancer control in Africa. Gynecologic Oncology Vol 99, Issue 3, Suppl 1, Dec 2005, pages S209‐S212.

[9.] Ajayi I. O. and Adewole I. F. (1998). Knowledge and attitude of general outpatient attendants in Nigeria to cervical cancer screening. Cent. Afr. J. Med. Vol.44, No.2:41‐43.

[10.] Akinboye, J. O. (1985). Guidance and counselling strategies for handling adolescents and youth problems, (2nd ed.), Ibadan: Claverianum Press.

[11.] Alliance for Cervical Cancer Prevention (ACCP): Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers. Seattle; 2004:24‐28.

[12.] Amazigo, U; Silva, N.; Kaufman, J. and Obikeze, D.S. (1997). Sexual activity and contraceptive knowledge and use among in‐school adolescents in Nigeria. International Family Planning Perspectives, 23, 28‐33. Retrieved on 8th May 2010 from www.popline.org/docs/1183/121448.html.

[13.] American Cancer Society, Detailed Guide: Cervical Cancer; The Centers for Disease Control and Prevention, United States Cancer Statistics: 2002 Incidence and Mortality, 2005. 69

[14.] Araoye, M. O and Fakeye, O. O. (1998). Sexuality and contraception among Nigerian adolescents and youth. African Journal of Reproductive Health. 2 (2), 11‐14. Retrieved on 5th March 2010 from www.advocatesforyouth.org/PUBLICATIONS/factsheet/fsnigeria.htl

[15.] Armstrong C. ACIP Releases Recommendations on Quadrivalent Human Papillomavirus Vaccine Am FAM Physician. May 1, 2007; 75(9); 1391‐1380.

[16.] Ayiga, N.; James, P.M. Ntozi, Ahimbisibwe, F E.; Odwee, J. and Okurut, F. N. (2000). Deaths, HIV testing and sexual behaviour change and its determinants in northern Uganda. Department of Population Studies, Makerere University, Kampala, Uganda. Retrieved on 5th May 2010 from http://htc.anu.edu.au/pdfs/resistances_ch6.pdf

[17.] Ayinde, A. E., Adewole, I. F. & Babarinsa I. A. (1998) Trends in Cervical Cancer Screening in Ibadan Nigeria. A four‐year review. W. Afr. J. Med. Vol. 17: No.1:25‐30.

[18.] Babarinsa, I. A. and Adewole, I. F. (1998). Knowledge and attitude to utilization of cervical cytology screening by female workers in a Nigerian Teaching Hospital. Nig. Med. Pract. Vol. 35; No: 48‐52.

[19.] Babarinsa, I. A.; Akang, E. E. U. & Adewole I. F. (1998) Pattern of Gynecological Malignancies at Ibadan Cancer Registry (1976‐1996). Nig. Qt. J. Med.8:103‐106.

[20.] Brabin L, Roberts SA, Farzaneh F, Kitchener HC. Future acceptance of adolescent human papillomavirus vaccination: a survey of parental attitudes. Vaccine. 2006;24:3087–94: 10.1016/j.vaccine.2006.01.04

[21.] Bulletin of the World Health Organization. Controversial new vaccine to prevent cervical cancer 2006;

[22.] Cavalli F, Hansen HH, Kaye SB. Textbook of Medical Oncology. Martin Dunitz Ltd; 1997.

[23.] Center for Biologics Evaluation, Product Approval Information – Licensing Action, June 2006. The Centers for Disease Control and Prevention, HPV Vaccine Questions and Answers, June 2006 Ibid.

[24.] Chan DW. Sex misinformation and misconceptions among Chinese medical 15 students in Hong Kong. Med Educ 1986; 20:390–8. 20. Baumrind D. The average expectable environment is not good enough: a response to Scars. Child Dev 1993; 64:1299–317.

[25.] Chirenje MZ, Rusakaniko S, Kirumbi L, Ngwall WE, Makula‐Tlebere P, Kaggwa S, Mpanju‐Shumbusho W, Makoa L: Situational analysis for cervical cancer diagnosis and treatment in East, Central and southern African 2005.

[26.] Chirenje ZM, Chipato T, Kasule J, Rusakaniko S, Gaffikin L, and Blumenthal P, Sangvi H: Visual inspection of the cervix as a primary means of cervical cancer screening: results of a pilot study. Cent Afri J Med 1999, 45:30‐33. 70

[27.] Coombes R. Life saving treatment or giant experiment? BMJ. 2007; 334:721–723: 10.1136/bmj.39164.510127.AD.

[28.] Cronje HS, Cooreman BF, Beyer E, Bam RH, Middlecote BD, and Divall PD: Screening for cervical neoplasia in a developing country utilizing cytology, cervicography and the acetic acid test. Int J Gynaecol Obstet 2001, 72:151‐7.

[29.] Cronje HS, Parham GP, Cooreman BF, de Beer A, Divall P, Bam RH: A comparison of four screening methods for cervical neoplasia in a developing country. Am J Obstet Gynecol 2003, 188:395‐400.

[30.] Dell DL, Chen H, Ahmad F, Stewart DF. Knowledge about Human Papillomavirus among adolescents. Obstet Gynecol. 2000; 96:653–6: 10.1016/S0029‐7844(00)01009‐7.

[31.] Diaz ML. Human Papilloma Virus ‐ Prevention and Treatment. Obstet Gynecol Clin North Am. June 2008; 35(2); 199‐21. NCCN Clinical Practical Guidelines in Oncology: Cervical cancer. 1st ed. 2008. Accessed June 10, 2008

[32.] Dinh TA, Rosenthal SL, Doan ED, Trang T, Pham VH, Tran BD, Tran VD, Bao Phan GA, Chu HKH, Breitkopf CR. Attitudes of Mothers in Da Nang, Vietnam toward a Human Papillomavirus Vaccine. Journal of Adolescent Health. 2007; 10:1016.

[33.] Editorial. Should HPV vaccines be mandatory for all adolescents? The Lancet. 2006;368

[34.] Editorial. Who should be vaccinated against human papillomavirus? The Lancet Infectious Diseases. 2006; 6:1: 10.1016/S1473‐3099(05)70301‐7.

[35.] Elovainio L, Nieminen P, Miller AB: Impact of cancer screening on women's health. Int J Gynaecol Obstet 1997, 58:137‐147. MacGregor JE: Screening for cervical cancer. In Contemporary Obstetrics and Gynecology. Edited by: Chamberlain G. London: Butterworth 1988:343‐356.

[36.] Ezem B. U 2007 Awareness and uptake of cervical cancer screening in Owerri, South‐ Eastern Nigeria Department of Obstetrics and Gynecology, Imo State University Teaching Hospital, Orlu, Nigeria

[37.] Fawzy FI, Coombs RH, Gerber B. Generational continuity in the use of substances: the impact of parental substance use on adolescent substance use. Addict Behavior 1983; 8:10914.

[38.] Friedman AL, Shepeard H. Exploring the knowledge, attitudes and beliefs, and communicating preferences of the general public regarding HPV: findings from CDC focus group research and implications for practice. Health Education Behaviour. 2007; 34:471–485: 10.1177/1090198106292022. 71

[39.] Gajalakshmi CK, Krishnamurthi S, Ananth R, and Shanta V: Cervical cancer screening in Tamilnadu, India: a feasibility study of training the village health nurse. Cancer causes control 1996, 7:520‐524.

[40.] Goldie SJ, Kohli M, Grima D, et al. Projected clinical benefits and cost‐effectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst 2004; 96:604–15.

[41.] Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, Zahaf T, Innis B, Naud P, De Carvalho NS, Roteli‐Martins CM, Teixeira J, Blatter MM, Korn AP, Quint W, Dubin G. GlaxoSmithKline HPV Vaccine Study Group. Efficacy of a bivalent L1 virus‐like particle vaccine in prevention of infection with human papillomavirus type 16 and 18 in young women: a randomized control trial. The Lancet. 2004; 364:1757–1765. 10.1016/S0140‐6736(04)17398‐4.

[42.] Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, et al. Efficacy of a bivalent L1 virus‐like particle vaccine in prevention of infection with human papilloma virus types 16 and 18 in young women: a randomized controlled trial. Lancet 2004, 364 (9447), 1757‐1766.

[43.] Hoch mans A, Ratzkowski E, Schrieber H. Incidence of carcinoma of cervix in Jewish women in Israel. Br J cancer 1955; 9:358 ‐ 364).

[44.] Holcomb B, Bailey JM, Crawford K, Ruffin MT. Adults knowledge and behaviors related to human papillomavirus infection. 2004; 17:26–31.

[45.] Kahn JA, Rosenthal SL, Hamann T, Bernstein DI. Attitudes about human papillomavirus vaccine in young women. Int J STD AIDS 2003; 14:300–6.

[46.] Kandel DB, Wu P. The contributions of mothers and fathers to the intergenerational transmission of cigarette smoking in adolescence. J Res Adolescent 1995; 5:225–52.

[47.] Kapiga SH, Msamanga GI, Spiegelman D, Mwakyoma H, Fawzi WW, Hunter DJ: Risk factors for squamous intraepithelial lesions among HIV‐1 seropositive women in Dares Salaam, Tanzania. Int J Gynaecol Obstet 1999, 67:87‐94.

[48.] Koutsky LA, Ault KA, Wheeler CM, Brown DR, Barr E, Alvarez FB, Chiacchierini LM, Jansen KU. A controlled trial of a human papillomavirus type 16 vaccine. The New England Journal of Medicine. 2002; 347:1645–51. 10.1056/NEJMoa020586.

[49.] Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N England J Med 2002; 347:1645–51.

[50.] Lehtinen M, Apter D, Dubin G, Kosunen EL, Kyha‐Osterlund L, Lunnas T, Luostarinen T, Niemi L, Palmroth J, Petaja T, Rekonen S, Salmivesi S, Siitari‐Mattlia M, Svartsjo S, 72 Tuomivaara L, Viikki M, Pukkala E, Paavonen J. Enrolment of 22,000 adolescent women to cancer registry follow up for long term human papillomavirus vaccine efficacy: guarding against guesses. International journal of STD and AIDS. 2006; 17:517–521. 10.1258/095646206778145550.

[51.] Leroy V, Ladner J, DeClercq A, Meheus A, Nyiraziraje M, Karita E, Dabis F: Cervical dysplasia and HIV type 1 infection in African pregnant women: a cross sectional study, Kigali, Rwanda. The Pregnancy and HIV Study Group (EGE). Sex Transm Infect 1999, 75:103‐106.

[52.] Lo B. HPV vaccine and adolescents' sexual activity. BMJ. 2006; 332:1106–1107. 10.1136/bmj.332.7550.1106.

[53.] Lowndes CM, Gill OM. Cervical cancer, human papilloma virus and vaccination. BMJ. 2005; 331:915–916: 10.1136/bmj.331.7522.915.

[54.] Lowndes CM. Editorial review: Vaccines for cervical cancer. Epidemiology Infect. 2006; 134:1–12. 10.1017/S0950268805005728.

[55.] Maggwa BN, Hunter DJ, Mbugua S, Tukei P, Mati JK: The relationship between HIV infection and cervical intraepithelial neoplasia among women attending two family planning clinics in Nairobi, Kenya. 16. AIDS 1993, 7:733‐738.

[56.] Mahlck CG, Jonsson H, Lenner P: Pap smears screening and changes in cervical cancer mortality in Sweden. Int J Gynaecol Obstet 1994, 44:267‐272.

[57.] Marlow LAV, Waller J, Wardle J. Parental attitudes to pre‐pubertal HPV vaccination. Vaccine. 2007; 25:1945–1952. 10.1016/j.vaccine.2007.01.059.

[58.] Martin D. Health Reporter: Daily Mail. National Newspaper, UK. p. 11. Saturday May 5, 2007. [59.] Mati JK, Mbugua S, Wanderi P: Cervical cancer in Kenya: prospects for early detection at primary level. Int J Gynaecol Obstet 1994, 47:261‐267.

[60.] McIntyre P. Finding the viral link: the story of Harald Zur Hausen. Cancer World. 2005.

[61.] Megan E. Roberts, BA Meg Gerrard, PhD, Rachel Reimer, PhD, Frederick X. Gibbons Mother‐Daughter Communication and Human Papillomavirus Vaccine Uptake by College Students (Published online April 12, 2010PEDIATRICS (doi:10.1542/peds.2009‐ 2888)

[62.] Merck, Merck to Create New Patient Assistance Program for Vaccines, May 26, 200663. Merck, Merck Vaccine Patient Assistance Program, September 2006. 73

[64.] Mirembe F: The changing pattern of carcinoma cervix in Uganda. In Proceedings of the Scientific Conference of the Association of Obstetricians of Uganda: International Conference Centre, Kampala, Uganda, 22–23 Jan., 1993. Association of Obstetrician and Gynecologists Uganda (AOGU); 1993:54‐61.

[65.] Mmiro FA: Gynecology and oncology in Africa. J Obstet Gynaecol E Centr Afr 1987, 6:66‐68.

[66.] Morris M, Tortollero‐Luna G, Malpica A, et al.: Cervical intraepithelial neoplasia and cervical cancer. Obstet Gynecol Clin North Am 1996, 23:347‐410.

[67.] National Vaccine Information Center, State Exemptions, June 2006. Ibid.Sprigg, P. July 15, 2006.

[68.] Noakes K, Yarwood J, Salisbury D. Parental response to the introduction of a vaccine against human papilloma virus. Hum Vaccin. 2006; 2:243–8.

[69.] Ogilvie GS, Remple VP, Marra F, McNeil SA, Naus M, Pielak KL, Ehlen TG, Dobson SR, Money DM, Patrick DM. Parental intention to have daughters receive the human papillomavirus vaccine. CMAJ. 177:1506–12. 2007 Dec 4.

[70.] Olamijulo J, Duncan ID: Is cervical cytology screening of teenagers worthwhile? BrGynaecol Obstet 1995, 102:515‐516.

[71.] Olshen E, Woods ER, Austin SB, Luskin M, Bauchner H. Parental acceptance of the human papillomavirus vaccine. Journal of Adolescent Health. 2005; 36:124. 10.1016/j.jadohealth.2004.11.062.

[72.] Parkin D. M. (2000) Personal Communication, IARC .Planning Appropriate Cervical Cancer Programs. 2nd Edition 2000 Program for Appropriate Technology in Health (PATH).

[73.] Parkin DM, Ferlay J, Hamdi‐Cherif M, Sitas F, Thomas JO, Wabinga H, Whelan SL: Cancer in Africa, epidemiology and prevention. In IARC Scientific Publication, No 153. IARC Press Lyon, France; 2003:167‐179. 268–275.

[74.] Peckham, Pinedo, Veronesi Oxford textbook of Oncology sections 8–20. Vol. 2. Oxford: Oxford University press; 1995.

[75.] Poland GA, Jacobson RM, Koutsky LA, Tamms GM, Railkar R, Smith JF, Bryan JT, Cavanaugh PF, Jansen KU, Barr E. Immunogenicity and reactogenicity of a novel vaccine for human papillomavirus 16: a 2‐year randomized controlled clinical trial. Mayo clinic proceedings. 2005;80:601–61074

[76.] Poland GA, Jacobson RM, Koutsky LA, Tamms GM, Railkar R, Smith JF, Bryan JT, Cavanaugh PF, Jansen KU, Barr E. Immunogenicity and reactogenicity of a novel vaccine for human papillomavirus 16: a 2‐year randomized controlled clinical trial. Mayo clinic proceedings. 2005; 80:601–610.

[77.] Pro‐Family, Pro‐Vaccine—But Keep It Voluntary, washingtonpost.com. The Centers for Disease Control and Prevention, Vaccines for Children (VFC) Program, July 19, 2006.

[78.] Raley, J.C., K.A. Follow will, G.D. Zimet, et al. September–December 2004. Gynecologists' Attitudes Regarding Human Papilloma Virus Vaccination: A Survey of Fellows of the American College of Obstetricians

[79.] Riedese l JM, Rosenthal SL, Zimet GD, Bernstein DI, Huang B, Lan D, Kahn JA. Family physicians' attitudes about HPV vaccines. Journal of Adolescent Health. 2005; 36:124– 125. 10.1016/j.jadohealth.2004.11.063.

[80.] Rimal RN. Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors. Health Education Behaviors 2003; 30:10–28.

[81.] Rose M. Official social classifications in the UK. Guildford: University of Surrey; 1998.

[82.] Ryder AG, Alden LE, Paulhus DL. Is acculturation one‐dimensional or bi dimensional? A head‐to‐head comparison in the prediction of personality, self‐identity, and adjustment. J Pers Soc Psychol 2000; 79(1):49–65.

[83.] Southern African countries Bulletin of the World Health Organization 2001, 79:127‐132.

[84.] Steinbrook R. The Potential of Human Papilllomavirus Vaccines. NEJM. 2006; 354:1109– 1112. 10.1056/NEJMp058305.

[85.] The Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices (ACIP), June 2006.

[86.] The Centers for Disease Control and Prevention, HPV and HPV Vaccine – Information for Healthcare Providers, June 2006.

[87.] The Centers for Disease Control and Prevention, HPV Vaccine Questions and Answers, June 2006.

[88.] The Office of Minority Health, Eliminate Disparities in Cancer Screening & Management, June 30, 2006. The Centers for Disease Control and Prevention, CDC Press Briefing: ACIP Recommends HPV Vaccination, June 29, 2006.

[89.] Villa LL, Costa RL, Petta CA, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus‐like particle vaccine in young women: a randomised 75 double‐blind placebo‐controlled multicentre phase II efficacy trial. Lancet Oncol 2005; 6:271–8.

[90.] Waller Marlow L, Wardle J. Public awareness that HPV is a risk factor for cervical cancer. Br J Cancer. 2007; 97:691–94: 10.1038/sj.bjc.6603927.

[91.] Woodhall SC, Lehtinen M, Verho T, Huhtala H, Hokkanen M, Kosunen E. Anticipated Acceptance of HPV Vaccination at the Baseline of Implementation: A Survey of Parental and Adolescent Knowledge and Attitudes in Finland. Journal of Adolescent Health. 2007; 40:466–469. 10.1016/j.jadohealth.2007.01.005.

[92.] World Health Organization (WHO). Primary Prevention of Cervical Cancer. WHO, Geneva, October 3‐November 2, CAN/85.1 (1985).

[93.] World Health Organization, Comprehensive Cervical Cancer Control: A Guide to Essential Practice, 2006.

[94.] Zach S, Netz Y. Like mother like child: three generations’ patterns of exercise behavior. Fam Syst Health 2007; 25:419–34.

[95.] Zimet GD, Liddon N, Rosenthal SL, Lazcano‐Ponce E, Allen B. Psychosocial aspects of vaccine acceptability. Vaccine. 2006;24: S201–209. 10.1016/j.vaccine.2006.06.017. 11. 2006 Canadian statistics [homepage on the Internet]. 2008. Available at: http://www12.statcan.ca/english/census06/

Abstract:

Objective:

Low back pain (LBP) incidence among metal workers is relatively high. This study assessed the sexual habits relationship to LBP among metal workers in Owerri, South-eastern Nigeria.

Study design

A prospective cases-control study design

Methods:

A surveillance exercise was carried out. A simple random sampling was used to select 50 cases and matched to 50 non-cases from identified cases and noncases. Frequency matching was done. Data analysis was carried out using descriptive and inferential statistics of 2 x 2 contingency table.

Results:

Sexual habits such as having multiple sex partners (OR = 0.26, CI = 0.35 – 1.25; p < 0.04), higher sex frequency (OR = 0.73, CI = 0.16 – 3.46; p <0.05), married (OR=1.00, CI=0.446-2.242, p>0.58) were not significantly associated with LBP.

Conclusion:

There was no association between higher sex frequency per week, having multiple sex partners or not, married or not married and occurrence of lowback pain. However, the need for further study to determine how well metal workers manage their sexual life and their health was stated, as all sampled metal workers engaged in sexual activities irrespective of their marital status.

References:

[1.] .Aggarwal N, Anand T, Kishore J, Ingle GK. (2013): Low back pain and associated risk factors among undergraduate students of a medical college in Delhi. Educ Health (Abingdon); 26:103_8.

[2.] .Ambler N, de C W, Amanda C., Hill P, Gunary R, Cratchley GD. (2001): Sexual difficulties of Chronic Pain Patients. Clinical Journal of Pain; 17( 2): 138-145

[3.] .Ayeni GO, Morakinyo MO, Olaniyi O, Onigbinde AT, Ayeni OA (2014): Prevalence and Relationship between Analgesic and Alcohol Consumption, Smoking Habit and Occurrence of Lowback Pain amongst Craftsmen in a South-East Nigerian Community. American Journal of Health Research. Special Issue: Supplementary Prescribing in Nigeria: A Needy Concept to Promote Clinical Physiotherapy Practice; 2(1): 45-49.

[4.] .Bener A, Alwash R, Gaber T, and Lovasz G. (2003): Obesity and low back pain. Collegium Antropologicum, 27(1): 95–104.

[5.] .Craft RM., Mogil JS., and. Aloisi AM (2004): “Sex differences in pain and analgesia: the role of gonadal hormones,” European Journal of Pain; 8(5):397–411.

[6.] .Croft PR and Rigby AS (19994): “Socioeconomic influences on back problems in the community in Britain,” Journal of Epidemiology and Community Health, 48(2):166–170.

[7.] .Fillingim RB, King C.D, Ribeiro-Dasilva CM, Rahim-illiams B, Riley III JL (2009): Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings . Journal of pain; 10 (5):447–485.

[8.] .Hakala P, Rimpelä A, Salminen J.J, Virtanen S.M, and Rimpelä M (2002): “Back, neck, and shoulder pain in Finnish adolescents: national cross sectional surveys,” British Medical Journal: 325(7367):743–745.

[9.] .Harreby M, Kjer J, Hesselsøe G, and Neergaard K. (1986): “Epidemiological aspects and risk factors for low back pain in 38-year-old men and women: a 25-year prospective cohort study of 640 school children,” European Spine Journal; 5(5): 312–318.

[10.] .Horst (2015): New research shows spinal surgery improves sexual function, reduces low back pain. American Academy of Orthopaedic Surgeons; March 24, 2015.

[11.] .Knox J, Orchowski J, Scher DL, Owens BD, Burks R, and Belmont PJ (2011): The incidence of low back pain in active duty United States military service members. Spine, 36(18):1492–1500.

[12.] .Louw Q.A, Morris L.D, and Grimmer-Somers K (2007): The prevalence of low back pain in Africa: a systematic review. BMC Musculoskeletal Disorders; 8: 105.

[13.] .McBeth J and Jones K (2007): Epidemiology of chronic musculoskeletal pain. Best Practice and Research, 21(3):403–425.

[14.] .Meerding W.J, IJzelenberg W, Koopmanschap M.A, Severens J.L, and Burdorf A (2005): Health problems lead to considerable productivity loss at work among workers with high physical load jobs. Journal of Clinical Epidemiology, 58(5):517–523.

[15.] .Mielenz T.J, Devellis R.F, Battie M.C, and Carey T.S. (2011): Stop using the modified work APGAR to measure job satisfaction. Pain Research and Treatment, vol. 2011, Article ID 406235, 8 pp.

[16.] .Müller C.F, Monrad T, Biering-Sørensen F, Darre E, Deis A, and Kryger P. (1999): The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble: a 15-year follow-up study of risk indicators for selfreported sick-listing caused by low back trouble. Spine 24(15):1562–1570.

[17.] .Nicholas M.K, Linton S.J, Watson P.J, Main C.J., and Decade of the Flags Working Group (2011): Early identification and management of psychological risk factors (“yellow flags”) in patients with low back pain: a reappraisal. Physical Therapy, 91(5):737–753.

[18.] .Ouédraogo D.D, Ouédraogo V, Ouédraogo L.T. et al (2010): Prevalence and factors associated with low back pain among hospital staff in Ouagadougou (Burkina Faso). Médecine Tropicale, 70(3):277–280.

[19.] .Pincus T, Vlaeyen JW, Kendall NA, Von Korff MR, Kalauokalani D.A, and Reis S (2002): Cognitive-behavioral therapy and psychosocial factors in low back pain: directions for the future. Spine, 27(5):E133–E138.

[20.] .Schmidt CO and Kohlmann T. (2005): What do we know about the symptoms of back pain? pidemiological results on prevalence, incidence, progression and risk factors. Z Orthop Ihre Grenzgeb; 143: 292_8.

[21.] .Schneider S, Randoll D, and Buchner M. (2006): Why do women have back pain more than men? A representative prevalence study in the Federal Republic of Germany. Clinical Journal of Pain, 22(8):738–747.

[22.] .Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, and Viikari-Juntura E. (2010): The association between obesity and low back pain: a meta-analysis. American Journal of Epidemiology, 171(2):135–154.

[23.] .Shiri R, Solovieva S, Husgafvel-Pursiainen K. et al (2008): The association between obesity and the prevalence of low back pain in young adults: the cardiovascular risk in young finns study. American Journal of Epidemiology, 167(9):1110–1119.

[24.] .Strine T. W. and Hootman J. M. (2007): US national prevalence and correlates of low back and neck pain among adults. Arthritis Care and Research, 57(4): 656–665.

[25.] .Webb R, Brammah T, Lunt M, Urwin M, Allison T, and Symmons D. (2003): Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine, 28(11):1195–1202.

[26.] .Wijnhoven H.A.H., de Vet H.C.W, and Picavet H.S.J. (2006): Prevalence of musculoskeletal disorders is systematically higher in women than in men. Clinical Journal of Pain, 22(8):717–724.

Abstract:

The target of a healthcare system is to employ healthcare, social and other resources to meet people’s health needs within a given area (Kerleau and Pelletier-Fleury 2002). Ideally, a healthcare system should encompass everyone, from the person who is ill and in need of care to the paramedic who brings the person to a hospital, from the nurses who attend to the sick person to the doctors who diagnose the patient, from the pharmacist who dispenses drugs for the patients ‘use to the surgeon who performs surgery on the patient (Wei et al. 2007). In many countries, the health care system also includes the insurance agencies (social or private) and insurers make decisions based on the type and extent of care to be administered. Large differences in healthcare systems exist between countries. These variations are even more evident between developed nations for example United States of America and developing nations like Nigeria. This paper compares the quality management structures and processes commonly found in United States healthcare organizations with that of Nigeria’s healthcare organizations. According to Varkey (2010), the Institute of Medicine (IOM)defines quality of care as the degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge. The Agency for Health Research and Quality (AHRQ) also describes quality of care as doing the right thing at the right time for the right individual to get the best possible results (Varkey, 2010 p.1).Avedis Donabedian created the structure, the process, and the outcome paradigm for assessing quality in healthcare that had profound influence than The is often thought of as the modern founder and leader of the quality field (Varkey, 2010; Graham, 1995). This paper will base the comparison between the quality of United States healthcare organizations and Nigeria’s healthcare organizations on the Donabedian model. According to Graham (1995), the structure denotes the attributes of the settings in which care occur this include the attributes of material resources (such as facilities, equipment, and money), of human resources (such as the number and qualifications of personnel), and of organizational structure (such as medical staff organization, methods of peer review, and methods of reimbursement). The process is what is actually done in giving and receiving care which include patient’s activities in seeking care and carrying it out as well as the practitioner’s activities in making a diagnosis and recommending or implementing treatment. Outcome denotes the effects of care on the health status of patients and populations.

References:

[1.] Agency for Health Care Research and Quality. (2011, March). 2011 Report to congress: National strategy for quality improvement in health care. Retrieved form http://www.ahrq.gov/workingforquality/nqs/nqs2011 annlrpt.htm

[2.] Aigbokan, B. E. (2000). Poverty, growth, and inequality in Nigeria. A case study. Retrieved from http://unpan1.un.org/intradoc/groups/public/documents/IDEP/UNPA003895.pdf

[3.] Boslaugh, S.E. (2013). Health care systems around the world: A comparative guide. Los Angeles: SAGE Publication, Inc.

[4.] Docteur, E., & Berenson, R. A. (2009). How does the quality of U.S. health care compare internationally. Retrieved from http://www.urban.org/sites/default/files/alfresco/publication-pdfs/411947-How-Does-the-Quality-of-U-S-Health-Care-Compare-Internationally-.PDF

[5.] Graham, N. O. (1995). Quality in health care: Theory, application, and evolution. Maryland: Aspen Publishers.

[6.] Ibitoye, A., &Adeleke, I. A. (2008). Does national health insurance promote access to quality health care? Evidence from Nigeria. The Geneva Papers, 33, 219-233. doi:10.1057/gpp.2008.6

[7.] Kerleau, M., & Pelletier-Fleury, N. (2002). Restructuring of the healthcare system and the diffusion of telemedicine. European Journal of Health Economics. 3(3)

[8.] National Committee for Quality Assurance. (n.d).The essential guide to health care quality. Retrieved from

http://www.ncqa.org/Portals/0/Publications/Resource%20Library/NCQA_Primer_web.pdf

[9.] PLoS Medicine. (2005). How do Nigeria’s health care personnel treat patients with HIV/AIDS? PLoS Med. 2(8), 257.

[10.] Shi, L., & Singh, D.A. (2015). Delivering health care in America: A systems approach. Burlington, MA: Jones & Bartlett Learning.

[11.] Society for Quality in Health Care in Nigeria. (2014). SQHN In- country survey report. Retrieved from http://www.hanshep.org/member-area/programmes/healthcare-qualityself-regulating-body-in-nigeria/feb-2014-survey-report-on-quality-management-innigeria.pdf

[12.] Varkey, P. (2010). Medial quality management: Theory and practice. Sudbury, MA: Jones & Bartlett Learning.

[13.] Wei, F., Polsa, P., Spens, K., & Antai, I. (2007, June 2-5). A comparison of health systems in Finland, The people’s republic of China, and Nigeria. The International Society of Marketing and Development and the Macro-marketing Society Joint Conference.

[14.] Zeitz, P.S., Salami, G. C., Burnham, G., Goings, S. A. J., Tijani, K., & Morrow, R .H. (1993). Quality assurance management methods applied to a local-level primary health care system in rural Nigeria. International Journal of Health Planning and Management, 8(3), 235-244. doi: 10.1002/hpm.4740080307

Abstract:

Background: Exercise is also known as physical activity. In simple terms exercise is any movement that works your body at a greater intensity than your usual level of daily activity. Exercise raises your heart rate and works your muscles and is most commonly undertaken to achieve the aim of physical fitness. It offers major health benefits and counselling for it should be integrated into the medical consultation.

Objectives: To estimate the prevalence of physical activity habits among doctors in School of medicine / faculty of medical sciences . Also, to identify the reasons for engagement in physical exercise among the study population and the reasons for not engaging in physical activity. Besides that , to determine whether physicians in the study encourage their patients to be physically active through their advice and lifestyle , and whether they encourage to study sport medicine in medical colleges.

Method : A cross-sectional study was carried out among doctors who are in contact and lecturers of the school of medicine/faculty of medical sciences/university of sulaimani. The questionnaire were collected by visiting their hospitals , departments or branches from March 1^st till April 1^st and was a self-administered questionnaire and verbal consent was taken .The doctors absolutely voluntarily participated in the study, and obtained information was coded and anonymous. The data of this study was entered and analyzed by using Statistical Package for Social Science (SPSS) version 21.0 software program .

Result : In this study the collected data are 91 , in which 64.8% are male and 25.2% are female , and age ranges 29 – 63 , with highest response between 35 – 44 age group , and BMI ranged from<18 to >30 with the highest response from over-weighted group, and among specialty the highest response were among surgeons.

The prevalence of physical activity assessed as 53.8% and with no significant associations between physical activity with age, gender, marital status and BMI but only specialty shows significant association of 80.8% of surgeons. There is close prevalence of physical activity between male and female of 52.5% and 56.25% respectively, and highest prevalence for age are among 45 and above, and normal and obese BMI groups are of highest in engaging in physical activities and overall 59.2% do exercise regularly. The most common motivator is improving health 38.8% , and most cited barriers are being busy with family (37.4%) and being too tired (35.2%).91.2% recommend studying sport medicine in medical colleges , and 97.7 counsel their patients for exercising.

Conclusion : Doctors shows good engagement in physical activities. Prevalence of exercise is not related to gender, age ,BMI, marital status but only associated with specialty. Male and female show close prevalence of engagement in physical activities. The regularity of exercise among doctors is not maintained as expected. Most doctors recommend studying Sport medicine in medical colleges. The most common motivator among doctors is improving health , and being busy with family and being tired are the most cited barrier . Being a doctor has affect in not participating in physical activities by many ways. Most doctors counsel their patients about exercise.

References:

[1.] Al-Shahri M Z, Al-Almaei SM.(1998). Promotion of physical exercise by primary health care physicians in Riyadh City. Saudi Med J; 19:67-69. Riyadh.

[2.] Buman, M. P. and King, A. C., (2010), "Exercise as a Treatment to Enhance Sleep", American Journal of Lifestyle Medicine.

[3.] Dr James O’Keefe, 2012,” Excess exercise hurts the heart” . Saint Luke’s Hospital of Kansas City. U.S.

[4.] de Vos, N., Singh, N., Ross, D., Stavrinos, T., et al. 2005. Optimal Load for Increasing Muscle Power During Explosive Resistance Training in Older Adults. The Journals of Gerontology, 60A(5), 638–647.

[5.] "Exercise and Physical Fitness." MedlinePlus.

http://www.nlm.nih.gov/medlineplus/exerciseandphysicalfitness.html. accessed on 4th , march , 2013 at 5:00 p.m.

[6.] Frank Lloyd, Wright Blvd . Scottsdale .

http://www.personalpowertraining.net/Articles/history_of_exercise.htm accessed on 22th Feb. 2013 at 7:30 P.M.

[7.] Hu., F., Manson, J., Stampfer, M., Graham, C., et al. (2001). Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. The New England Journal of Medicine, 345(11), 790–797.

[8.] Hensrud DD, Sprafka J M, Connett J, Leon AS. (1992), Physical activity in Minnesota physicians , Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota.

[9.] Joris Aertsens, Bas de Geus, Grégory Vandenbulcke, Bart Degraeuwe, Steven Broekx, Leo De Nocker, Inge Liekens, Inge Mayeres, Romain Meeusen, Isabelle Thomas, Rudi Torfs, Hanny Willems, Luc Int Panis (2010). "Commuting by bike in Belgium, the costs of minor accidents". Accident Analysis and Prevention 42 (6): 2149–2157.

[10.] Jacobs, L; Nawrot, Tim S; De Geus, Bas; Meeusen, Romain; Degraeuwe, Bart; Bernard, Alfred; Sughis, Muhammad; Nemery, Benoit et al. (Oct 2010). "Subclinical responses in healthy cyclists briefly exposed to traffic-related air pollution". Environmental Health 9 (64): 64.

[11.] Julia Berry; Anne Bradley; Hillery Magness. "Amenorrhea". The Female Athlete Triad. University of Oregon, Department of Human Physiology.

[12.] Kuper, Simon, (2009), "The man who invented exercise". Financial Times. http://www.ft.com/cms/s/2/e6ff90ea-9da2-11de-9f4a-00144feabdc0.html accessed on 23th Feb. 2013 at 6:20 P.M.

[13.] Leon Hammer, (2011). Stopping Long-Term Strenuous Exercise Suddenly: An Epidemic Treated with Chinese Herbal Medicine, Chinese Medicine Times - Volume 6 Issue 1. China.

[14.] Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport, 63, 60-66.

[15.] Medifast Exercise Guide. 2007: Medifast, Inc. Owings Mills, Maryland.

 http://www.medifastmedia.com/med/docs/exercise_guide.pdf accessed on 28^th Feb 2013 at 11:50 P.M.

[16.] Mayo Foundation for Medical Education and Research (MFMER) , July 23, 2011.

http://www.mayoclinic.com/health/exercise/HQ01676/NSECTIONGROUP=2 accessed on 1^st March, 2013 at 10:40 P.M.

[17.] O'Connor, D., Crowe, M., Spinks, W. 2005. Effects of static stretching on leg capacity during cycling. Turin, 46(1), 52–56.

[18.] Paul H. Gaertner; Whitmer B. Firor, ; Lindsay Edouard,(1991) , Physical inactivity among physicians in Saskatoon , Saskatoon/Canada.

[19.] Robin B. Kanarek, Kristen E. D'Anci, Nicole Jurdak, Wendy Foulds Mathes, (2009). Running and addiction. Behavioral Neuroscience, Vol 123(4), 905-912 .U.S.

[20.] Stefan S. du Plessis, (2011), Division of Medical Physiology, Stellenbosch University, Tygerberg, South Africa , Science Journal 3, 105-113.

[21.] Stampfer, M. J.; Hu, F. B.; Manson, J. E.; Rimm, E. B.; Willett, W. C. (2000). "Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle". New England Journal of Medicine 343 (1): 16–22.

[22.] Shilan Othman, Luna Ako, Kazhaw Mohammed, Shilan Ali,(2012), “Prevalence of exercise among students of School of medicine”, university of Sulaimani, Kurdistan/Iraq.

[23.] Samia Bahram, Basim Abbas, Jalal Kamal, Ebtisam Fakhro, (June 2003) , Leisure -Time Physical Activity Habits Among Bahraini Physicians, Vol.25, No. 2, Bahrain Medical Bulleti.

[24.] Suija et al.,(2010).Physical activity of Estonian family doctors and their counselling for a healthy lifestyle, Department of Polyclinic and Family Medicine, University of Tartu, Tartu, Estonia.

[25.] Wilmore, J., Knuttgen, H. 2003. Aerobic Exercise and Endurance Improving Fitness for Health Benefits. The Physician and Sports medicine, 31(5).

[25.] Zubia Veqar , M Ejaz Hussain ,(2012), Sleep quality improvement and Exercise , Centre for physiotherapy and rehabilitation sciences , New Delhi / India.

Abstract:

The impact of health insurance show positive effects on access and utilization but, it is difficult to generalize the impact as the enrollment has not been as wide spread as planned. Still, given the available literature, we do expect to find an average but not wide spread impact on access and utilization of health care this will improve when the State Governments and the informal sector is integrated in the scheme.

References:

[1.] Amsterdam Institute for International Development (AIID).A Short-Term Impact Evaluation Of The Health Insurance Fund Program In Central Kwara State, Nigeria- Final Draft (March, 2013)

[2.] Arogundade.M.A. The role of Health Maintenance Organizations in the Nigerian National Health Insurance Scheme

[3.] Mc Keon, Kimberley. September 2009. Financing and Business Development Needs of Private Health Care Providers in Nigeria: Market Research Report. Bethesda, MD: Banking on Health, Abt Associates Inc.

[4.] Obiajulu Nnamuchi. The Nigerian Social Health Insurance System and the Challenges of Access to Health Care: An Antidote or a White Elephant? Beazley Institute for Health 15 Law & Policy, Loyola University Chicago School of Law Medicine and Law Journal, Vol. 28, No. 1, pp. 125-166, 2009

Abstract:

Prolonged sitting and sedentary behavior comprises a major part of the modern lifestyle: at work, leisure (watching television, Internet) and commuting/traveling, and this has been implicated in the prevalence of overweight and obesity. The study sought to assess the degree of knowledge of a population of non‐governmental staff in AkwaIbom state Nigeria on the health effects of overweight and obesity. A questionnaire was administered through direct interview to fifty (n‐50) staff in FHI360 AkwaIbom state office, Nigeria who gave verbal consent (Non‐Health Personnel (n=23), Laboratory Personnel (n=8), Doctor (n=15), and Pharmacist (n=4).82% of respondents have an appreciable knowledge of the health effects of overweight/obesity, 95.5% the causes, while 74.5% are aware that BMI (body Mass Index) can be used as a monitoring tool for overweight/obesity, however, only a total 42.8% of respondents knew their BMI. There is therefore an urgent need to create an avenue in form of health fare for the study population to determine their BMI and improve their lifestyle/health seeking behavior to avoid the adverse health effects of overweight/obesity. 

References:

[1.] Akarolo‐Anthony SN, Willett WC, Spiegelman D, and Adebamowo CA (2014). Obesity epidemic hasemerged among Nigerians.BMC Public Health, 14:455

http://www.biomedcentral.com/1471‐2458/14/455

[2.] Allison KC, Ahima RS, O'Reardon JP, Dinges DF, Sharma V, Cummings DE, et al. (2005): Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. J Clin Endocrinol Metab.; 90:6214–6217.

[3.] Basu S, M cKee M , Galea G, Stuckler D. (201 3): Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross‐national analysis of 75 countries. Am J Public Health 1 03(1 1 ):2071 -7

[4.] Dhingra R, Sullivan L, Jacques PF, et al (2007) . Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle aged adults in the community. Circulation; 116:480‐488

[5.] Dietz WH Jr, Gortmaker SL. (1985): Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics; 75(5):807–812.

[6.] Ebbeling, Cara B.(2014) Sugar‐sweetened beverages and body weight. Current Opinion in Lipidology: Volume 25 ‐ Issue 1 ‐ p 1‐7

[7.] French SA, Jeffery RW, Forster JL, McGovern PG, Kelder SH, Baxter JE. (1994): Predictors of weight change over two years among a population of working adults: the Healthy Worker Project. Int J Obes Relat Metab Disord.; 18:145‐154. French SA, Harnack L, Jeffery RW. (2000): Fast food restaurant use among women in the Pound of Prevention study: dietary, behavioral and demographic correlates. Int J Obes Relat Metab Disord.;24:1353‐1359

[8.] Joshua A. Bell &Mark Hamer&G. David Batty &Archana Singh‐Manoux&Séverine Sabia & Mika Kivimaki (2014): Combined effect of physical activity and leisure time sitting on long‐term risk of incident obesity and metabolic risk factor clustering. Springerlink.com

[9.] Kant AK, Graubard BI. (2006): Secular trends in patterns of self‐reported food consumption of adult Americans: NHANES 1971–1975 to NHANES 1999–2002. Am J Clin Nutr 84(5): 1215–1223.

[10.] Kelly T, Yang W, Chen CS, Reynolds K, He J(2008): Global burden of obesity in 2005 and projections to 2030. Int J Obes, 32:1431–1437.

[11.] Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair‐Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker‐Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan‐Hancock C, Bucello C, et al: A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013, 380:2224–2260.

[12.] Omran A (2001). The epidemiologic transition. A theory of the Epidemiology of population change. Bull World Health Organ. 79(2):161‐170.

[13.] Ono T, Guthold R, Strong K (2005; 2012: WHO Global Comparable Estimates: Global Infobasdata for saving lives. https://apps.who.int/infobase/Index.aspx.

[14.] Popkin BM, Adair LS, Ng SW (2012): Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev, 70:3–21.

[15.] Prentice AM, Jebb SA. (1995): Obesity in Britain: gluttony or sloth? BMJ 12; 311(7002):437– 439.

[16.] Reddy K and Yusuf S (1998). Emerging epidemic of cardiovascular disease in developing countries. Circulation. 97(6):596‐601.

[17.] RC Boston, PJ Moate, KC Allison, JD Lundgren, Stunkard AJ.(2008): Modeling circadian rhythms of food intake by means of parametric deconvolution: results from studies of the night eating syndrome. Am J ClinNutr.; 87:1672–1677.

[18.] Shiyovich A1, Shlyakhover V, Katz A. (2013): Sitting and cardiovascular morbidity and mortality, Harefuah; 152(1):43‐8, 58, 57.

[19.] Sanjay Basu, Martin McKee, Gauden Galea, and David Stuckler,(201 3) Relationship of Soft Drink Consumption to Global Overweight, Obesity, and Diabetes: A Cross-National Analysis of 75 Countries. American Journal of Public Health: Vol. 103, No. 11, pp. 2071-2077.

[20.] WHO: Fact sheet on Obesity 2010; 2012. http://www.who.int/topics/obesity/en/.

Abstract:

This study is a retrospective study design to examine the outcome of babies born to HIV-positive mothers in Specialist Hospital Yola, Adamawa state, Nigeria. The total population of women who tested HIV-positive and accessed antenatal care, intra-natal care and post natal care and were enrolled for PMTCT at Specialist Hospital, Yola between January 2013 and December 2013 and infants below 24 months .

The objective of this study is to determine the number of the exposed infants that received PCR service using DBS as compared with the total number of positive pregnant mothers and also to identify the gaps with the view to correcting them

Total ANC attendee was forty thousand three hundred and Seventy four (40,374) pregnant women of which Eleven thousand three hundred (11,300) received counseled, tested and received results for HIV. Two hundred and Nineteen (219) 1.9% tested were reported positive. This makes up 1.9% of the population tested. The HIV testing among HIV-exposed

Infants within the health care facility were (133) 60.7%. The prevalence of HIV infection among

HIV-exposed infants who were tested by HIV-1 DNA PCR method was (8) 8.4%. 95 (71%) of the total DBS sample collected had their results. 38 (28.6%) of the infants never received their result.

The facility had intermittent supply of commodities for EID of HIV, trained human resources, system of identification of HIV-exposed infants. Early HIV testing during

Pregnancy, PMTCT ARV prophylaxis, disclosure of HIV status, enrollment to care and treatment, frequent attendance to EID services, co-trimoxazole prophylaxis and exclusive breast feeding was found to be significant predictors for testing of HIV-exposed infants.

References:

[1.] (n.d.). Retrieved April 7, 2014, from www.poz.com/arcchives/2008_march_2168

[2.] Aledort JE, R. A. (2006). Reducing the burden of HIV/AIDS in Infants: the contribution of improved diagnostics. Nature, 444 suppl 1. 19-21.

[3.] Assembly, U. G. (2011). Political declaration on HIV and AIDS: Intensifying our efforts to eliminate HIV and AIDS. Geneva: UNAIDS.

[4.] Cassol S, S. T. (December 1992). Stability of dried blood spot specimens for detection of human immunodeficiency virus DNA by polymerase chain reaction. J. Clin. Microbiol.30 (12), 3039-42.

[5.] Chou R, H. L. (2005). Screeening for HIV: a review of evidence for the U.S Preventive Service Task Force. Annals of Internal Medicine143(1), 55-73.

[6.] Ciaranello AL, P. J.-A. (2011). Early infant HIV-1 diagnosis programs in resource-limited settings: opportunities. BMC Med.

[7.] Douek DC, R. M. (2009). Emerging Concepts in the Immunopathogenesis. Annu. Rev.Med 60, 471-84.

[8.] en wikipedia.org/wiki/infection

[9.] en wikipedia.org/wiki/Dried_Blood_Spot

[10.] Generalized epidemic in sub Saharan Africa. Journal of international development 13(4) 451-466

[11.] HIVand AIDS. Geneva: UNAIDS

[12.] Hassan AS, S. E. (2012). .Dynamics and constraints of early. AIDS and Behavior. 16(1), 5-12.

[13.] Kumaranayake L, W. C. (2001). Resource allocation and priority setting of HIV/AIDS interventions: addressing the generalized epidemic in sub-saharan Africa. Journal of international Development 13(4), 451-466.

[14.] Muhimbili University of Health and Allied Science by JG Gamaliel 2012

[15.] Nuwagaba H.B., S. W. (2010). Introducing a multi-site program for early diagnosis of HIV. BMC Pediatr.

[16.] Parker SP, C. W. (September 1999). The use of the dried blood spot sample in epidemiological studies. J. clin. pathol.52 (9), 633-9.

[17.] Post exposure prophylaxis against human immunodeficiency virus. American Family Physician 82(2):161-6

[18.] RA, W. (1993). How does HIV cause AIDS ? Science 260(5112), 1273-9.

[19.] Stability of Dry Blood Spot specimen for detection of human immunodeficiency virus DNA by polymerase chain reaction. J.clin.microbiol.30 (12):3039-42

[20.] Schools-wikipaedia.org/wp/h/hiv.htm

[21.] S, K. (2004). Patient inforation: Blood donation and transfusion. uptodate.

[22.] Tolle MA, S. H. (July 15, 2010). Post exposure prophylaxis against human immunodeficiency virus. American Family Physician 82 (2), 161-6.

[23.] Wikipedia Dry Blood Spot, 3/27/14

[24.] www.Pathfinder’s.org , early infant diagnosis

[25.] www.emtct-1qtt.org : utilization of HIV and AIDS -mother to child transmission

[26.] www.Independent.org/ Delusions of power by Robert Higgs

[27.] www.update.com

[28.] www.plosone.org

[29.] www.scirp.org/journal/paper download. J. Purushottam, 2012

[30.] www.youtube.com question/index?qid

[31.] www.intergayhiv.com/Humanimmunodeficiencyvirus-hiv

[32.] www.Ihaveachronicdisease.com/hivaids

[33.] www.POZ.COM/archives/2008_mar_2168.shtml

[34.] www.andrenaingram.org/always-to-contract-hiv

[35.] www.palneetclinic.com/index

[36.] www.sanfordburnham.org

Abstract:

OBJECTIVE: To prepare a report on the application of Geographic Information Systems for the selection of suitable sites/locations for health facilities establishment.

METHOD: Information provided, concerning the application of Geographic information systems in the field of Health care.

CONCLUSION: The potentials and capabilities of Geographic information systems in planning and decision making is widely known as an experimental tool but its real world application is yet to be realised. Geographic information systems can be used effectively as tool for decision making in relation to optimum gainful utilization of available medical resource in various areas.

References:

[1.] Abdul, K.A.M. (2001).Application of GIS in Health Care Facilities Planning. Jedda: Saudi Arabia.

[2.] Balraqui, N. (1997).Demographic Changes in Jeddah. Jeddah: Unpublished Phd. Thesis.

[3.] Birkin, M., Clarke, G., Clarke, M. & Wilson, A. (1996). Intelligent GIS. Cambridge: Geo‐Information Int.

[4.] Brown, P., Hirschfield, A. & Batey (1991). Applications of Geodermographic Methods in the Analysis of Health Condition Incidence Data. Papers in Regional Science. 70 (1), 329‐344.

[5.] Davis, B. (1996).Geographic Information Systems, A Visual Approach. USA: Onward Press Camiro.

[6.] Environment Systems Research Institute (1997). Getting To Know Arcview. Cambrige: Geoinformation Int.

[7.] Environmental Systems Research Institute (1999). Enterprise GIS In Health and Social Agencies. An ESRI White Paper. 1 (1), 5‐8.

[8.] Forbers, H. & Todd, P. (1995). Review of Cancer Services. Liverpool: University Of Liverpool.

[9.] Gatrell, A. & Senior, M. (1991). Health and Health Care Application in Information System Principles and Application. United Kingdom: John Willy & Sons.

[10.] Gilbert, E.W. (1958). John Snow’s Cholera Map. United Kingdom: York University.

[11.] Hirschfield, A., Brown, P. & Bundred, P. (1995).The Spatial Analysis of Community Health Services. Journal of International Research Society. 46 (1), 147‐159.

[12.] Johnes, A. & Bentham, G. (1995). Emergency Medical Service Accessibility and Come from Road Traffic Accidents. Public Health. 109(2), 169‐177.

[13.] Kosoko, S.O.A. (2003). Site Selection through Design User Interface. Federal School Of Surveying, Oyo.

[14.] Kufoniyi, O. (1998). Database Design and Creation on Ezigbo. C.U. (Ed). (3), 52‐55.

[15.] Nicol, J.(1991). Geographic Information System within the Healths, the Scope for Implementations. Planning Outlook. 34(1), 37‐42.

[16.] Obafemi, O. (2003). Land Subdivision Basics. Ibadan: Pent House Publications.

[17.] Perry, M.& Gesler, A. (2006). Analyzing Theme, Space and Time. ACM International Symposium on Geographic Information Systems. 147‐154.

[18.] Pindiga, A.M. (2001). Application of GIS in Site Selection for an additional Public Hospital in Bauchi Metropolis. Federal School of Surveying Oyo. Unpublished PGD. GIS Project.

[19.] Sowton, S. (1991). Development of GIS related activities at the ordinance survey. A paper presented at the survey coordination and advisory board on Survey Training and conference: Markudi, Benue State.

[20.] Sumi, S. (2006).GIS Application in Health Care Facility. Kirkee Cantt: Bhosle Nagar.

[21.] Transer, F., Hosegood, V., Benze, J. & Solarch, G. (2001). New Approaches to Spatially Analze Primary Health Care Usage in Rural South Africa. Tropical Medicine and Informational Health Journal. 6 (1) 2‐5.

[22.] Wigley, N. (1991). Market‐Based Systems of Health Care Provision. The NHS Bill and Geographical Information System, Environment and Planning. (23), 5‐8.

[23.] Wikipedia, the Free Encyclopedia. (2015). www.wikipedia.com. Retrieved at 4.00pm on 10/08/2015.

[24.] World Bank. (1993).World development report. New York: Oxford University Press.

[25.] World Health Organization Report (2000). Why do Health Systems Matter? WHO. 

Abstract:

Introduction. Child survival remains one of the most important public health challenges in Ghana. The promotion of community-based child health interventions is among the key strategies to improve child survival. The primary goal of the study was therefore to assess the potential of community-based primary health care interventions on child survival in Yendi Municipality. Method. The study was a community-based cross sectional study. The study employed multi-stage random cluster sampling procedure to select households and villages in Yendi district. Both quantitative and qualitative methods were used to collect data from the study target population which included the caregivers, the community based agent and community health officers. Results. The study established high level of caregivers’ knowledge on prevention of diarrhea, and malaria. It revealed similarities in some knowledge and practice and showed significant difference in some home based care of children. It also noted significant association between caregivers’ health seeking behavior and presence or availability of health facility. Conclusion. The finding concluded that there was general improvement in the health and survival of children less than five years of age. This was however, better in communities with health facility. Hence community-based primary health care have a positive effects on child survival.

References:

[1.] Abhay, B.M., Dohare, S., AND Gitte, S.V., (2012). Child health: Understanding the home care practices in some illnesses among Under-five children in IMNCI implemented rural area. International Journal of Biological & Medical Research, 3(5): 1251-1254

[2.] Ahmad, O.B., Lopez, A.D., Inoue, M. (2000). The decline in child mortality: Reapraisal Bulletin WHO 78: 1175-1191

[3.] American Public Health Association (2009). Report to the Expert Review Panel, Community- Based Primary Health Care Working Group, International Health Section, American Public Health Association. Retrieved on 25/11/2011 from

http://www.apha.org/membergroups/sections/aphasections/intlhealth/cbphcw

[4.] Anaman, K.A. (2003). Research Methods in Applied Economics and Other Social Sciences. Bandar Seri Begawan: Brunei Press, Sendirian Berhad

[5.] Black R. E., Morris S. S., Bryce J. (2003). Where and why are 10 million children dying every year? The lancent, 361:2226–34.

[6.] Breman J.G, Egan A, Keusch G. T. (2001). The intolerable burden of malaria: a new look at the numbers. American Journal of Tropical Medicine Hygiene. 64 (Suppl 1):iv–vii.

[7.] Bryc EJ, Arifeen S., Pariyo G., Lanata C., Gwatkin D, Habicht J.P. (2003). Reducing child mortality: Can public health deliver? The Lancet; 362:159-64.

[8.] Cooper, D. R. & Schindler, P. S. (2001). Business Research Methods, New York: McGraw-Hill Company

[9.] Daily GraphiC(2012). Reducing child mortality by 2015 is off track. Daily Graphic, Wednesday, November 21, 2012.

[10.] Darmstadt, G. L., Bhutta, Z. A., Cousens, S., Adam, T., Walker, N. & De Bernis, L. (2005). Evidence-based, cost-effective interventions: How many newborn babies can we save? Lancet, 365, 977 – 988

[11.] Easterby-Smith, M., Thorpe, R. & Lowe, A. (2002). Management Research: An Introduction (2nd ed), London: Sage publications

[12.] Ghana Statistical Service & Ghana Health Service (2008). Ghana Demographic and Health Survey, Accra: Ghana ICF Macro Calverton, Maryland, U.S.A.

[13.] Ghana Statistical Service & Ghana Health Service, (2009). Ghana Maternal Health Survey. Calverton Maryland: GSS, GHS, and Macro International, Inc.

[14.] Glanz K, Lewis FM, Rimer BK. (2002). "Health Behavior and Health Education" ISBN 0787957151

[15.] Jones, G., Steketee, R. W., Black, R. E., Bhutta, Z. A. & Morris, S. S. (2003). How many child deaths can we prevent this year? Lancet, 362, 65-71.

[16.] King, R., Mann, V., & Boone, P. D., (2010). Knowledge and reported practice of men and women on metal and child health in rural Guinea Bissau: a cross sectional survey. Bio Med Central public health publication; 1471- 2458/10: 319

[17.] Kumekpor, T. K. B. (2002). Research methods and Techniques of social Research. Accra: Son Life Press and Services: p132

[18.] Mclennan, J. D. (2000). Prevention of Diarrhoea in a Poor District of Santo Domingo, Dominican Republic: Practices, Knowledge, and Barriers. Center for health and Population Research, Journal of Health and Nutrition, 18(1):15-22

[19.] MOH & GHS, (2010). Home management of malaria, Acute Respiratory Infection, and Diarrhea in Ghana: Participants’ Training Manual, Accra: NMCP, GHS

[21.] Perry, H. & Freeman, P. (2009). A Review of the Evidence: How Effective Is Community-Based Primary Health Care in Improving the Health of Children? Summary Findings

[22.] Perry, H., Berggren, W., Berggren, G., Dowell, D., Menager, H., Bottex, E., Dortonne, J. R., Philippe, F. & Cayemittes, M. (2007a). Long-term reductions in mortality among children under age 5 in rural Haiti: effects of a comprehensive health system in an impoverished setting. American Journal of Public Health, 97, 240-6.

[23.] Perry, H., Freeman, P., Rassekh, B. & Gupta, S. (2009a). How cost-effective is community-based primary health care in improving child health? World Health Organ, 84, 949-

[24.] Perry, H., Northrup, R., Bryant, J., Berggren, W. & Berggren, G., (2009b). The cost-effectiveness of a long-term comprehensive primary health care program in reducing under-5 mortality: findings from rural Haiti. Document submitted for publication

[25.] Phillips, J. F., Bawah, A. A. & Binka, F. N. (2006), Accelerating reproductive and child health program, impact with community-based services: the Navrongo experiment in Ghana. Bulletin of the world health organization; 84, 949-55.

[26.] Rutherford E. M., Dockertyy, J. D, Jasseh, M., Howie, S.R.C., Herbison, P., Jeffries, D.J. Leach, M., Stevens, W, Mulholland, K, Adegbola R.A., Hill, P. C, (2009). Access to health care and mortality of children under 5 years of age in the Gambia: a case-control study. Bulletin of WHO; 87:216-224.

[27.] Saunders, M., Lewis, P & Thornhill, A., (2007). Research Methods for Business Students (4th edn)Harlow: Pearson Education Limited.

[28.] Schellenberg JA, Victora CG, Mushi A, De Savigny D, Schellenberg D, Mshinda H, Bryce J. (2003). Tanzania Integrated Management of Childhood Illness MCE Baseline Household Survey Study Group. Inequities among the very poor: health care for children in rural southern Tanzania. Lancet.; 361:561–6

[29.] Seyal, T. & Hanif, A. (2009). Knowledge, Attitude and Practices of the Mothers and Doctors Regarding Feeding, Oral Rehydration Solution (ORS)and Use of Drugs in Children during Acute Diarrhea. ANNALS, vol 15. No. 1: 38-41

[30.] UNICEF (2008a). State of the World’s Children 2008, New York, NY: United Nations Children’s Fund. Oxford University Press

[31.] UNITED NATIONS (2000). Resolution 55/2 adopted by the General Assembly: United Nations Millennium Declaration

[32.] Varkevisser C. M., Pathmanathan I. &, Brownlee A. (2003). Designing and Conducting Health Systems Reseach Projects: Health System Research Training Serirs. Vol II part 1, Ottawa: IDRCand WHO.

[33.] WHO & UNICEF (1978). Alma Ata Declaration, USSR, December 6-12, 1978. Geneva, Switzerland: World Health Organization. Primary Health Care, Report on the International Conference on Primary Health Care.

[34.] WHO (2006). Multicenter Growth Reference Study Group, WHO child growth standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization

[35.] WHO Regional office for Africa, (2010). Ghana Factsheets of Health Statistics 2010. Retrieved from: ghndp.org/childmedicines or http://childmedicines.ghndp.org 13:32

[36.] WHO, (2005). The World health report: make every mother and child count. Geneva, Switzerland: World Health Organization.

[37.] Yendi District Health MANagement Team (2010). Annual performance review, Yendi Municipal Health Directorate

[38.] Yendi District Health Management Team (2011). Annual performance review: 2011 programme of work, Yendi: Municipal Health Directorate 43

Abstract:

Background: Health facility delivery is an important factor in reducing deaths arising from complications of pregnancy. Despite the importance of prenatal care the extent of its contribution to hospital based delivery has not yet been evaluated in Nigeria. This study aimed to estimate the extent of the contribution of pre-natal care to hospital delivery in Nigeria.

Methods: Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were utilized. The 2013 NDHS was conducted in all the states of Nigeria including the Federal Capital Territory (FCT). The study population comprised of 31 ,828 women of reproductive age (15-49 years) who were asked questions from the delivery module. The primary data for the survey were collected by visiting households and conducting face-to-face interviews and with the use of questionnaires to obtain information. Data was analysed using SPSS version 21 .

Result: The mean age of mother was 29.4 years ± 7 standard deviation. The prevalence of health facility based delivery in 2013 was 35.8% . Prenatal care was received by 13477(66%). Among Nigeria women 34.6% felt delivering their babies in the hospital was not important. Among those who received pre-natal care 7350(54.6%) delivered in the health facilities compared to 289(4.2%) health facility delivery among those who did not receive pre-natal care. (p<0.001). Those who received pre-natal care were 12 times more likely to deliver in the health facility (95% CI= 10.56-14.42) p<0.001 . In those who had prenatal care 53% reduction in home delivery occurred.

Conclusion: To increase health facility delivery in Nigeria efforts to encourage the use of antenatal care services are pertinent.

References:

[1.] Abebe, F., Berhane, Y. & Girma, B. (2012) Factors associated with home delivery in Bahirdar, Ethiopia: A case control study. BMC Res Notes, 5.

[2.] Ahmed, S., Creanga, A., Gillespie, D. & Tsui, A. (2010) Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS ONE [Electronic Resource], 5.

[3.] Doctor, H. (2011) Intergenerational differences in antenatal care and supervised deliveries in Nigeria. Health Place, 17, 480‐489.

[4.] Emelumadu, O., Onyeonoro, U., Ukegbu, A., Ezeama, N., Ifeadike, C. & Okezie, O. K. (2014) Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria. Niger Med J, 55, 148‐155.

[5.] Faye, A., Niane, M. & Ba, I. (2011) Home birth in women who have given birth at least once in a health facility: contributory factors in a developing country. Acta Obstet Gynecol Scand, 90, 1239‐43.

[6.] Federal Republic of Nigeria (2008) Mid ‐Point Assessment of the Millennium Development Goals in Nigeria 2000 ‐2007. Abuja: The Office of the Senior Special Assistant to the President on the MDGs.

[7.] Franny, A. (2013) Gulu women’s economic development and globalization http://www.globalgiving.org/pfil/9326/Quaterly_Report_April__June_2013.pdf.

[8.] Gabrysch, S., Cousens, S., Cox, J. & Campbell, O. (2011) The influence of distance and level of care on delivery place in rural Zambia: a study of linked national data in a geographic information system. PLoS Medicine, 8.

[9.] Galaa, S. & Daare, K. (2008) Understanding barriers to maternal child health services utilization in northern Ghana. Journal of Social Development in Africa, 23, 127‐155.

[10.] Harvey, S., Blandon, Y., McCaw‐Binns, A., Sandino, I., Urbina, L. & Rodriguez, C., et al. (2007) Are skilled birth attendants really skilled? A measurement method, some disturbing results and a potential way forward. Bull World Health Organ, 85, 783‐790.

[11.] Idris, S., Gwarzo, U. & Shehu, A. (2006) Determinants of place of delivery among women in a semiurban settlement in Zaria, northern Nigeria. Ann Afr Med., 5, 68‐72.

[12.] Idris, S., Sambo, M. & Ibrahim, M. (2013) Barriers to utilisation of maternal health services in a semiurban community in northern Nigeria: the clients’ perspective. Nigerian Medical Journal, 54, 27‐32.

[13.] Ilesanmi, O., Ige, O. & Adebayo, A. (2013) The Role of Antenatal Care in Pregnancy Outcome: A Comparative Study in South Western Nigeria Article from the 13th world congress on Public Health April 23‐27, 2012‐Addis Ababa (Ethiopia). Medimond International Proceedings, 23‐ 26.

[14.] Khalid, S., Daniel, W. & Lale, S. (2006) WHO analysis of causes of maternal death: a systemic review. The Lancet Maternal Survival Series, 367, 1066‐1074.

[15.] Lawn, J., Cousens, S. & Zupan, J. (2005) Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet, 365, 891‐900.

[16.] Lozano, R., Wang, H., Foreman, K., Rajaratnam, J., Naghavi, M. & Marcus, J., et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet, 378, 1139‐1165.

[17.] Mengesha, Z., Biks, G., Ayele, T., Tessema, G. & Koye, D. (2013) Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study. BMC Public Health, 13.

[18.] Montagu, D., Yamey, G., Visconti, A., Harding, A. & Yoong, J. (2011) Where do poor women in developing countries give birth? A multi‐country analysis of demographic and health survey data. PLoS One, 6.

[19.] Moore, B., Alex‐Hart, B. & George, I. (2011) Utilization of health care services by pregnant mothers during delivery: a community based study in Nigeria. East Afr J Public Health, 8, 49‐51.

[20.] Mpembeni, R., Killewo, J., Leshabari, M., Massawe, S., Jahn, A., Mushi, D. & Mwakipa, H. (2007) Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG‐5 targets. BMC Pregnancy Childbirth, 7.

[21.] National Population Commission (NPC) [Nigeria] & Macro, I. C. F. (eds.) 2009. Nigeria Demographic and Health Survey 2008, Abuja, Nigeria: National Population Commission and ICF Macro.

[22.] National Population Commission (NPC) [Nigeria] and ICF International (2014) Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.

[23.] Osubor, K., Fatusi, A. & Chiwuzie, J. (2006) Maternal health‐seeking behavior and associated factors in a rural Nigerian community. Matern Child Health J, 10, 159‐6.

[24.] Rajaratnam, J., Marcus, J., Flaxman, A., Wang, H., Levin‐Rector, A. & Dwyer, L., et al. (2010) Neonatal, post‐neonatal, childhood, and under‐5 mortality for 187 countries, 1970‐2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet, 375, 1988‐ 2000.

[25.] Rockers, P., Wilson, M., Mbaruku, G. & Kruk, M. (2009) Source of antenatal care influences facility delivery in rural Tanzania: a population‐based study. Matern Child Health J 13, 879‐85.

[26.] Stephenson, R., Baschieri, A., Clements, S., Hennink, M. & Madise, N. (2006) Contextual influences on the use of health facilities for childbirth in Africa. Am J Pub Health, 96, 84‐93.

[27.] United Nations Population Fund. 2015. Sub‐Saharan Africa’s maternal death rate down 41 percent. 201 http://africa.unfpa.org/public/cache/offence/news/pid/10767. Accessed 05 May 2015. [Online].

[28.] Wang, W., Alva, S., Wang, S. & Fort, A. (2011) Levels and Trends in the Use of Maternal Health Services in Developing Countries. DHS Comparative Reports No. 26. Calverton, Maryland: ICF Macro.

[29.] Woldemicael, G. (2010) Do women with higher autonomy seek more maternal health care? Evidence from Eritrea and Ethiopia. Health Care Women Int 31, 599‐620.

[30.] Yanagisawa, S., Oum, S. & Wakai, S. (2006) Determinants of skilled birth attendance in rural Cambodia. Trop Med Int Health, 11, 238‐251. 

Abstract:

The study was a comparison between the haematological profile parameters of Human Immunodeficiency Virus (HIV) positive patients who developed a cardiac event and those who did not. The aim was to assess the possibility of using haematological parameters as predictors of the risk of developing a cardiovascular event in a Botswana HIV positive cohort. Elevated white blood cell (WBC) count, neutrophil (NEUT), CD8 T cell count (CD8) and decreased lymphocyte (LYMPH), CD4 T cell count (CD4) and CD4/CD8 ratio have been associated with cardiovascular risk. Whether this association is present in an HIV positive cohort in Botswana is uncertain. Differences in the haematological parameters of HIV positive patients who developed a cardiac event and of those who did not were compared at 3 different time points using the Mann Whitney U Test. A total of 9 cases and 34 controls were studied. At baseline, cases had higher WBC counts with a mean rank of 25.86 compared to controls (16.04) with p value of 0.012. NEUT mean rank of 24.58 for cases was higher than 13.23 for controls (p=0.002). At 6 months into study and at occurrence of event, the differences were not statistically significant. Study shows that at baseline, WBC and NEUT are higher for patients likely to develop a cardiac event hence can be a potential risk predictor.

References:

[1.] Abu-Zeid, H. A., & Chapman, J. M. (1977). Hemoglobin level and ischemic heart disease: relationship to known risk factors. Prev Med, 6(1), 120–129. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/850674

[2.] AIDS.gov. (n.d.). Just Diagnosed with HIV/AIDS:Overview: Chronic Manageable Disease. Retrieved from Retrieved from https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/overview/chronic-manageable-disease/

[3.] Anogeianaki, A., Angelucci, D., Cianchetti, E., D’Alessandro, M., Maccauro, G., Saggini, A., … Shaik-Dasthagirisaheb, Y. B. (2011). Atherosclerosis: a classic inflammatory disease. Int J Immunopathol Pharmacol, 24(4), 817–825. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22230389

[4.] Bhatt, D. L., Chew, D. P., Lincoff, A. M., Simoons, M. L., Harrington, R. A., Ommen, S. R., … Topol, E. J. (2003). Effect of revascularization on mortality associated with an elevated white blood cell count in acute coronary syndromes. Am J Cardiol, 92(2), 136–140. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12860213

[5.] Burr, M. L., Holliday, R. M., Fehily, A. M., & Whitehead, P. J. (1992). Haematological prognostic indices after myocardial infarction: evidence from the diet and reinfarction trial (DART). Eur Heart J, 13(2), 166–170. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1313369

[6.] Cannon, C. P., McCabe, C. H., Wilcox, R. G., Bentley, J. H., & Braunwald, E. (2001). Association of white blood cell count with increased mortality in acute myocardial infarction and unstable angina pectoris. OPUS-TIMI 16 Investigators. Am J Cardiol, 87(5), 636–9, A10. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11230853

[7.] Carter, C., McGee, D., Reed, D., Yano, K., & Stemmermann, G. (1983). Hematocrit and the risk of coronary heart disease: the Honolulu Heart Program. Am Heart J, 105(4), 674–679. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/6837420

[8.] Cerrato, E., Calcagno, A., D’Ascenzo, F., Biondi-Zoccai, G., Mancone, M., Grosso Marra, W., … Gaita, F. (2015). Cardiovascular disease in HIV patients: from bench to bedside and backwards. Open Heart, 2(1), e000174. http://doi.org/10.1136/openhrt-2014-000174

[9.] Deeks, S. G., Lewin, S. R., & Havlir, D. V. (2013). The end of AIDS: HIV infection as a chronic disease. Lancet, 382(9903), 1525–1533. http://doi.org/10.1016/S0140-6736(13)61809-7

[10.] Deeks, S. G., & Phillips, A. N. (2009). HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. BMJ, 338, a3172. http://doi.org/10.1136/bmj.a3172

[11.] Dragu, R., Khoury, S., Huri, S., Zuckerman, R., Suleiman, M., Mutlak, D., … Aronson, D. (2008). Predictive value of white blood cell subtypes for long-term outcome following myocardial infarction. Atherosclerosis, 196(1), 405–12. http://doi.org/10.1016/j.atherosclerosis.2006.11.022

[12.] Eriksson, E. E., Xie, X., Werr, J., Thoren, P., & Lindbom, L. (2001). Importance of primary capture and L-selectin-dependent secondary capture in leukocyte accumulation in inflammation and atherosclerosis in vivo. J Exp Med, 194(2), 205–218. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11457895

[13.] Ernst, E. (1987). Leukocytes and the Risk of Ischemic Diseases. JAMA: The Journal of the American Medical Association, 257(17), 2318. http://doi.org/10.1001/jama.1987.03390170074031

[14.] Farahani, M., Vable, A., Lebelonyane, R., Seipone, K., Anderson, M., Avalos, A., … Marlink, R. (2014). Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis. The Lancet Global Health, 2(1), e44–e50. Retrieved from http://linkinghub.elsevier.com/retrieve/pii/S2214109X13701499

[15.] Freiberg, M. S., Chang, C.-C. H., Kuller, L. H., Skanderson, M., Lowy, E., Kraemer, K. L., … Justice, A. C. (2013). HIV infection and the risk of acute myocardial infarction. JAMA Internal Medicine, 173(8), 614–22. http://doi.org/10.1001/jamainternmed.2013.3728

[16.] Frostegard, J. (2013). Immunity, atherosclerosis and cardiovascular disease. BMC Medicine, 11(1), 117. Retrieved from http://www.biomedcentral.com/1741-7015/11/117

[17.] Fuster, V. (1994). Lewis A. Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology [published erratum appears in Circulation 1995 Jan 1;91(1):256]. Circulation, 90(4), 2126–2146. http://doi.org/10.1161/01.CIR.90.4.2126

[18.] Gebo, K. A. (2006). HIV and aging: implications for patient management. Drugs Aging, 23(11), 897–913. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17109568

[19.] Grzybowski, M., Welch, R. D., Parsons, L., Ndumele, C. E., Chen, E., Zalenski, R., & Barron, H. V. (2004). The Association between White Blood Cell Count and Acute Myocardial Infarction In-hospital Mortality: Findings from the National Registry of Myocardial Infarction. Academic Emergency Medicine, 11(10), 1049–1060. http://doi.org/10.1197/j.aem.2004.06.005

[20.] Hansson, G. K. M. D. P. (2005). MECHANISMS OF DISEASE: Inflammation, Atherosclerosis, and Coronary Artery Disease. N Engl J Med, 352(16), 1685–1695. Retrieved from http://search.proquest.com/docview/223931318?accountid=15083

[21.] Harmon, M. (2014a). Excel Master Series Blog: Mann-Whitney U Test in 12 Steps in Excel as 2-Sample Pooled t-Test Nonparametric Alternative in Excel 2010 and Excel 2013. Retrieved September 24, 2015, from http://blog.excelmasterseries.com/2014/05/mann-whitney-u-test-as-2-sample-pooled.html

[22.] Harmon, M. (2014b). Excel Master Series Blog: Sign Test As a 1-Sample t-Test Alternative in Excel 2010 and Excel 2013. Retrieved September 25, 2015, from http://blog.excelmasterseries.com/2014/05/sign-test-as-1-sample-t-test.html

[23.] Haumer, M., Amighi, J., Exner, M., Mlekusch, W., Sabeti, S., Schlager, O., … Schillinger, M. (2005). Association of neutrophils and future cardiovascular events in patients with peripheral artery disease. Journal of Vascular Surgery, 41(4), 610–7. http://doi.org/10.1016/j.jvs.2005.01.013

[24.] Health, M. of (Ed.). (2002). Botswana Guidelines on Antiretroviral Treatment. Gaborone, Botswana.

[25.] Health, M. of (Ed.). (2005). Botswana Guidelines on Antiretroviral Treatment. Gaborone, Botswana.

[26.] Hoffman, M., Blum, A., Baruch, R., Kaplan, E., & Benjamin, M. (2004). Leukocytes and coronary heart disease. Atherosclerosis, 172(1), 1–6. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14709350

[27.] Horne, B. D., Anderson, J. L., John, J. M., Weaver, A., Bair, T. L., Jensen, K. R., … Muhlestein, J. B. (2005). Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol, 45(10), 1638–1643. http://doi.org/10.1016/j.jacc.2005.02.054

[28.] Hotchkiss, J. W., & Leyland, A. H. (2011). The relationship between body size and mortality in the linked Scottish Health Surveys: cross-sectional surveys with follow-up. International Journal of Obesity (2005), 35(6), 838–51. http://doi.org/10.1038/ijo.2010.207

[29.] Hyde, J. (2004). Retrospective Cohort Study Strengths and Weaknesses. Retrieved from http://ocw.tufts.edu/Content/1/lecturenotes/194039/194062

[30.] Jonasson, L., Holm, J., Skalli, O., Bondjers, G., & Hansson, G. K. (1986). Regional accumulations of T cells, macrophages, and smooth muscle cells in the human atherosclerotic plaque. Arteriosclerosis, Thrombosis, and Vascular Biology, 6(2), 131–138. http://doi.org/10.1161/01.atv.6.2.131

[31.] Kovanen, P. T., Kaartinen, M., & Paavonen, T. (1995). Infiltrates of Activated Mast Cells at the Site of Coronary Atheromatous Erosion or Rupture in Myocardial Infarction. Circulation, 92(5), 1084–1088. http://doi.org/10.1161/01.cir.92.5.1084

[32.] Lang, S., Mary-Krause, M., Simon, A., Partisani, M., Gilquin, J., Cotte, L., … Costagliola, D. (2012). HIV replication and immune status are independent predictors of the risk of myocardial infarction in HIV-infected individuals. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 55(4), 600–7. http://doi.org/10.1093/cid/cis489

[33.] Langston, R. D., Presley, R., Flanders, W. D., & McClellan, W. M. (2003). Renal insufficiency and anemia are independent risk factors for death among patients with acute myocardial infarction. Kidney Int, 64(4), 1398–1405. http://doi.org/10.1046/j.1523-1755.2003.00200.x

[34.] Ledergerber, B., Egger, M., Opravil, M., Telenti, A., Hirschel, B., Battegay, M., … Weber, R. (1999). Clinical progression and virological failure on highly active antiretroviral therapy in HIV-1 patients: a prospective cohort study. Lancet, 353(9156), 863–868. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=1645441&site=ehost-live

[35.] Libby, P. (1995). Molecular bases of the acute coronary syndromes. Circulation, 91(11), 2844–2850. http://doi.org/10.1161/01.CIR.91.11.2844

[36.] Libby, P. (2002). Inflammation in atherosclerosis. Nature, 420(6917), 868–74. http://doi.org/10.1038/nature01323

[37.] Libby, P. (2003). Vascular biology of atherosclerosis: overview and state of the art. The American Journal of Cardiology, 91(3A), 3A–6A. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12645637

[38.] Lowe, G. D., Lee, A. J., Rumley, A., Price, J. F., & Fowkes, F. G. (1997). Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study. Br J Haematol, 96(1), 168–173. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9012704

[39.] Madjid, M., & Fatemi, O. (2013). Components of the complete blood count as risk predictors for coronary heart disease: in-depth review and update. Tex Heart Inst J, 40(1), 17–29. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23467296

[40.] Martinez, E., Milinkovic, A., Buira, E., de Lazzari, E., Leon, A., Larrousse, M., … Gatell, J. M. (2007). Incidence and causes of death in HIV-infected persons receiving highly active antiretroviral therapy compared with estimates for the general population of similar age and from the same geographical area. HIV Med, 8(4), 251–258. http://doi.org/10.1111/j.1468-1293.2007.00468.x

[41.] Massberg, S., Brand, K., Grüner, S., Page, S., Müller, E., Müller, I., … Gawaz, M. (2002). A Critical Role of Platelet Adhesion in the Initiation of Atherosclerotic Lesion Formation. The Journal of Experimental Medicine, 196(7), 887–896. http://doi.org/10.1084/jem.20012044

[42.] Menon, V., Lessard, D., Yarzebski, J., Furman, M. I., Gore, J. M., & Goldberg, R. J. (2003). Leukocytosis and adverse hospital outcomes after acute myocardial infarction. Am J Cardiol, 92(4), 368–372. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12914863

[43.] Montaner, J. S., Wood, E., Kerr, T., Lima, V., Barrios, R., Shannon, K., … Hogg, R. (2010). Expanded highly active antiretroviral therapy coverage among HIV-positive drug users to improve individual and public health outcomes. J Acquir Immune Defic Syndr, 55 Suppl 1, S5–9. http://doi.org/10.1097/QAI.0b013e3181f9c1f0

[44.] Mueller, C., Neumann, F. J., Perruchoud, A. P., & Buettner, H. J. (2003). White blood cell count and long term mortality after non-ST elevation acute coronary syndrome treated with very early revascularisation. Heart, 89(4), 389–392. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12639865

[45.] Mussini, C., Lorenzini, P., Cozzi-Lepri, A., Lapadula, G., Marchetti, G., Nicastri, E., … Monforte, A. d’Arminio. (2015). CD4/CD8 ratio normalisation and non-AIDS-related events in individuals with HIV who achieve viral load suppression with antiretroviral therapy: an observational cohort study. The Lancet HIV. http://doi.org/10.1016/S2352-3018(15)00006-5

[46.] Olivares, R., Ducimetiere, P., & Claude, J. R. (1993). Monocyte count: a risk factor for coronary heart disease? Am J Epidemiol, 137(1), 49–53. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8434572

[47.] Oluwatosin A. Badejo, Chung-Chou Chang, et al. (2015). CD8+ T-Cells Count in Acute Myocardial Infarction in HIV Disease in a Predominantly Male Cohort. BioMed Research International, 2015, 5. http://doi.org/10.1155/2015/246870

[48.] Ommen, S. R., Gibbons, R. J., Hodge, D. O., & Thomson, S. P. (1997). Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. The American Journal of Cardiology, 79(6), 812–4. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9070569

[49.] Palella Jr., F. J., Baker, R. K., Moorman, A. C., Chmiel, J. S., Wood, K. C., Brooks, J. T., & Holmberg, S. D. (2006). Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr, 43(1), 27–34. http://doi.org/10.1097/01.qai.0000233310.90484.16

[50.] Panos, G., Samonis, G., Alexiou, V. G., Kavarnou, G. A., Charatsis, G., & Falagas, M. E. (2008). Mortality and morbidity of HIV infected patients receiving HAART: a cohort study. Curr HIV Res, 6(3), 257–260. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18473789

[51.] Prentice, R. L., Szatrowski, T. P., Fujikura, T., Kato, H., Mason, M. W., & Hamilton, H. H. (1982). Leukocyte counts and coronary heart disease in a Japanese cohort. Am J Epidemiol, 116(3), 496–509. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7124717

[52.] Puddu, P. E., Lanti, M., Menotti, A., Mancini, M., Zanchetti, A., Cirillo, M., & Angeletti, M. (2002). Red blood cell count in short-term prediction of cardiovascular disease incidence in the Gubbio population study. Acta Cardiol, 57(3), 177–185. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12088175

[53.] Ross, R. (1999). Atherosclerosis--an inflammatory disease. The New England Journal of Medicine, 340(2), 115–26. http://doi.org/10.1056/NEJM199901143400207

[54.] Sabatine, M. S., Morrow, D. A., Cannon, C. P., Murphy, S. A., Demopoulos, L. A., DiBattiste, P. M., … Gibson, C. M. (2002). Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a TACTICS-TIMI 18 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservati. J Am Coll Cardiol, 40(10), 1761–1768. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12446059

[55.] Stary, H. C., Chandler, A. B., Dinsmore, R. E., Fuster, V., Glagov, S., Insull, W., … Wissler, R. W. (1995). A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis: A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation, 92(5), 1355–1374. http://doi.org/10.1161/01.cir.92.5.1355

[56.] Teague, A. (n.d.). HIV: Now a manageable chronic disease. Retrieved from Retrieved from www.pharmacytimes.com/publications/issue/2007/2007.../2007-03-6317

[57.] Triant, V. A., Lee, H., Hadigan, C., & Grinspoon, S. K. (2007). Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. The Journal of Clinical Endocrinology and Metabolism, 92(7), 2506–12. http://doi.org/10.1210/jc.2006-2190

[58.] Turner, S. J., Ketch, T. R., Gandhi, S. K., & Sane, D. C. (2008). Routine hematologic clinical tests as prognostic markers in patients with acute coronary syndromes. Am Heart J, 155(5), 806–816. http://doi.org/10.1016/j.ahj.2007.11.037

[59.] Turner, S. J., Ketch, T. R., Gandhi, S. K., & Sane, D. C. (2008). Routine hematologic clinical tests as prognostic markers in patients with acute coronary syndromes. American Heart Journal, 155(5), 806–16. http://doi.org/10.1016/j.ahj.2007.11.037

[60.] Wester, C. W., Bussmann, H., Koethe, J., Moffat, C., Vermund, S., Essex, M., & Marlink, R. G. (2009). Adult combination antiretroviral therapy in sub-Saharan Africa: lessons from Botswana and future challenges. HIV Ther, 3(5), 501–526. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20161344

[61.] Wester, C. W., Kim, S., Bussmann, H., Avalos, A., Ndwapi, N., Peter, T. F., … Marlink, R. (2005). Initial response to highly active antiretroviral therapy in HIV-1C-infected adults in a public sector treatment program in Botswana. J Acquir Immune Defic Syndr, 40(3), 336–343. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16249709

[62.] Wester, C. W., Koethe, J. R., Shepherd, B. E., Stinnette, S. E., Rebeiro, P. F., Kipp, A. M., … Marlink, R. G. (2011). Non-AIDS-defining events among HIV-1-infected adults receiving combination antiretroviral therapy in resource-replete versus resource-limited urban setting. AIDS, 25(12), 1471–1479. http://doi.org/10.1097/QAD.0b013e328347f9d4

[63.] Wester, C. W., Thomas, A. M., Bussmann, H., Moyo, S., Makhema, J. M., Gaolathe, T., … Marlink, R. G. (2010). Non-nucleoside reverse transcriptase inhibitor outcomes among combination antiretroviral therapy-treated adults in Botswana. AIDS, 24 Suppl 1, S27–36. http://doi.org/10.1097/01.aids.0000366080.91192.55

[64.] Whitlock, G., Lewington, S., Sherliker, P., Clarke, R., Emberson, J., Halsey, J., … Peto, R. (2009). Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet, 373(9669), 1083–96. http://doi.org/10.1016/S0140-6736(09)60318-4

[65.] Zalokar, J. B., Richard, J. L., & Claude, J. R. (1981). Leukocyte count, smoking, and myocardial infarction. The New England Journal of Medicine, 304(8), 465–8. http://doi.org/10.1056/NEJM198102193040806

[66.] Zouridakis, E. G., Garcia-Moll, X., & Kaski, J. C. (2000). Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol, 86(4), 449–451. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10946041

Abstract:

BACKGROUND: Even though the Ghana Community-based Health Planning and Services (CHPS) initiative for scaling up service delivery is in place, the level of neonatal mortality remains high. OBJECTIVES: This study was designed to understand the current maternal antenatal performance and its effects on the birth weight of infants and selected new born care practices: Early initiation of breast-feeding; pre-lacteal feeding; Bathing of newborn after birth; Cord care; and Giving of water. METHODS: This community-based cross sectional survey combines both qualitative and quantitative data collection on a sample of 240 mothers and their babies; who were delivered in the community. RESULTS: A total of 81.7% (196) of the women begun seeking Antenatal Care (ANC) during the first trimester of pregnancy and 91.7% (220) attended ANC sessions four or more times. Application of inappropriate substances to the umbilical cord was 79.2% (190). Most women, 96.3% (231), gave colostrum to their babies. Women who gave birth to normal weight babies were about two times more likely to have attended ANC as early as in the second trimester compared to women who did not give birth to normal weight babies (OR=1.69, CI: 0.740--3.867); P=0.213. Mothers who initiated ANC in the first trimester gave colostrum to their newborn infants compared to those in the second and third trimesters (OR=6.28, X²=13.44, P=0.037). CONCLUSION: The study could not establish that early initiation of ANC in the first or second trimesters and maternal age at first delivery was independent predictors of the selected newborn care practices

References:

[1.] Abhulimhen-Iyoha BI, Ibadin MO (2012). Determinants of cord care practices among mothers in Benin City, Edo State, Nigeria. Niger J Clin Pract. 2012 Apr-Jun;15(2):210-3. doi: 10.4103/1119-3077.97320. PubMed PMID: 22718175.

[2.] Barnett S, Azad K, Barua S, Mridha M, Abrar M, Rego A, Khan A, Flatman D, Costello A. (2006) Maternal and newborn-care practices during pregnancy, childbirth, and the postnatal period: a comparison in three rural districts in Bangladesh. J Health Popul Nutr. 2006 Dec;24(4):394-402. PubMed PMID: 17591336; PubMed Central PMCID: PMC3001143.

[3.] Bawku West District Annual Health Report (2014). Annual Health Report of the Bawku West District Health Directorate.

[4.] Bergstrom A, Byaruhanga R, Okong P. (2005). The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: a randomized, controlled trial. Acta Paediatr 2005, 94(10):1462–1467.

[5.] Dey I. (1993). Qualitative Data Analysis. Routledge, 11 New Fetter Lane, London EC4P 4EE 1993, 285 pp, ISBN 0-415-05851-1 (hbk). Dec. 2008

[6.] Gary LD, Bhutta ZA, Cousens S, Taghreed A, Neff Walker, Luc de Bernis, Team ftLNSS (2005). Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005, 365:977–988

[7.] Ghana Statistical Service (2011). Ghana Multiple Indicator Cluster Survey with an Enhanced Malaria Module and Biomarker, 2011, Final Report. Accra, Ghana.

[8.] Gilani I, Kayani ZA (2014). Household practices of mothers regarding neonatal care in rural &amp; urban settings of the capital district of Azad Jammu &amp; Kashmir. Rural Remote Health. 2014;14:2503. Epub 2014 Apr 5. PubMed PMID: 24702463

[9.] Hall, Carl T. (2002). "Study speeds up biological clocks / Fertility rates dip after women hit 27". The San Francisco Chronicle..

[10.] Lawn, J. M. Brian, and R. R. Susan (2001). The Healthy Newborn: A Reference Manual for Program Managers, CARE-CDC Health Initiative Atlanta, 2001.

[11.] Mahama, S. Mariam I. (2014). Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana. Hindawi Publishing Corporation International Journal of Population Research Volume 2014, Article ID 404387, 10 pages http://dx.doi.org/10.1155/2014/404387

[12.] Mangwi Ayiasi R, Kasasa S, Criel B, Garimoi Orach C, Kolsteren P. (2014). Is antenatal care preparing mothers to care for their newborns? A community-based cross-sectional study among lactating women in Masindi, Uganda. BMC Pregnancy Childbirth. 2014 Mar 25;14:114. doi: 10.1186/1471-2393-14-114. PubMed PMID: 24667001; PubMed Central PMCID: PMC3987096.

[13.] Marah A. (2011). Assessing Household Practices That Influence Neonatal Survival in the Asante-Akim North District of Ashanti Region-Ghana, Kwame Nkrumah University Science and Technology, Kumasi, Ghana, 2011.

[14.] Neupane S, Nwaru BI (2014). Impact of prenatal care utilization on infant care practices in Nepal: a national representative cross-sectional survey. Eur J Pediatr. 2014 Jan;173(1):99-109. doi: 10.1007/s00431-013-2136-y. Epub 2013 Aug 14. PubMed PMID: 23942747

[15.] Under-Five Child Health Policy (2007-2015). Ministry of Health (MOH), Ghana

Abstract:

This descriptive cross-sectional study assessed various hygiene practices among 250 Babcock University cafeteria workers, and the hygienic condition of the working environment. Most of the respondents, 126 (50.4%) were ever married, females 146 (58.4%), Christians 208 (83.2%) and of the Yoruba ethnic group, 128 (51.2%). Result findings revealed that 226(90.4%) respondents had good knowledge of food hygiene, and 206(82.4%) knew that protective wears reduce the risk of food contamination and accidents in the cafeteria. However, 167(66.8%) of the respondents were not aware that virus causes food contamination. Only 83(33.2%) of the respondents indicated that they clean their working environment two times a day while 41(16.4%) of the respondents clean once a day meaning majority of the respondents, 126 (51.4%) do not clean regularly resulting in a questionable working environment. Findings also show that only 60 (24%) respondents use personal protective equipment (PPE) any time they are in the cafeteria while 104 (41.6%) make use of PPE when preparing and serving food. Bi-variate (Chi-square test statistics) analysis revealed significant relationships between attitude and age (p= 0.05); hygiene level of working environment and tribe (p=0.008); level of hygiene practices versus marital status (p=0.035) and tribe (p=0.001); level of use of PPE versus marital status (p=0.006) and knowledge of respondents (p=0.001). The study concluded that though workers in Babcock University cafeteria have satisfactory level of knowledge and good attitude towards food hygiene practices, their level of environmental hygiene practices are not adequate. Recommendations include training programs to re-orientate the workers on proper environmental hygiene practices and daily work environment inspections.

References:

[1.] Abhay, B.M. (2010). Health Status and Personal Hygiene among Food Handlers Working at Food Establishment around a Rural Teaching Hospital in Wardha District of Maharashtra, India. Global Journal of Health Science; 2(2): 190-206

[2.] Aimee, S., Pragle, M.S., Anna, K., James, C. (2007). Food Workers’ Perspectives on Handwashing Behaviors and Barriers in the Restaurant Environment. Journal of Environmental Health Volume; 69(10): 27-32

[3.] Angelillo, F., Viggiani, N. M. A., Greco, R. M., & Rito, D. (2001). HACCP and food hygiene in hospital: knowledge, attitudes, and practices of food-services staff in Calabria, Italy. Infection Control and Hospital Epidemiology, 22(6):1-7

[4.] Barro, N., Bello, A.R., Itsiembou, Y., Savadogo, A., Ouattara, C.A., Nikiema, A.P (2007). Street-Vended Foods Improvement: Contamination Mechanisms and Application of Food Safety Objective Strategy: Critical Review. Pakistan Journal of Nutrition; 6 (1): 1-10.

[5.] Ehizibolo, D.O., Chukwu, C.O., Chukwu, I.D., Muhammad, M.J., and Olabode, A.O. (2007). Occurrence of Food borne Bacteria Pathogen in Smoked fish at Retail Level in Jos, Nigeria. Nigerian Veterinary Journal; 28(1):21-26.

[6.] Gashaw I, Stiller S, Boing C, Kimmig R, Winterhager E. Premenstrual regulation of the pro-angiogenic factor CYR61 in human endometrium. Endocrinology. 2008:149:2261-2269

[7.] Green, L.R., C.A. Selman, V. Radke, D. Ripley, J.C. Mack, D.W. Reimann, T. Stigger, M. Mostinger, and L. Bushnell. 2006. Food worker hand washing practices: an EHS-Net observation study. Journal of Food Protection. 69(10):2417-23

[8.] Ifenkwe, G.E. (2012). Food safety regulations: reducing the risk of food-borne diseases in rural communities of Abia state, Nigeria. Agricultural Science Research Journals; 2(7): 384-389.

[9.] Maizun, M.Z., Nyi, N.N. (2002). Sociodemographic Characteristics of Food Handlers and Their Knowledge, Attitude and Practice towards Food Sanitation: A Preliminary Report. Southeast Asian J Trop Med Public Health; 33(2):410-417

[10.] Mulugeta, K and Bayeh, A. (2012). The Sanitary Conditions of Food Service Establishments and Food Safety Knowledge and Practices of Food Handlers in Bahir Dar Town. Ethiopian Journal of Health Science; 22(1): 27–35.

[11.] Murat, B., Azmi, S.E., Gokhan, K. (2006). The Evaluation of Food Hygiene Knowledge, Attitude and Practices of Food Handlers in Food Businesses in Turkey. Journal of food control; 17: 317-322.

[12.] Nevin, S., Faith, T. (2010). Perceptions of Hygiene among Staff Working in Food Companies. Research Journal of Medical Sciences;4(3):231-237.

[13.] Oranusi, S., Galadima, M., Umoh, V.J. and Nwanze, P.I. (2007). Food safety evaluation in boarding schools in Zaria, Nigeria, using the HACCP system Scientific Research and Essay; 2(10): 426-433.

[14.] Orefi, A. (2012) Food Security in Nigeria and South Africa: Policies and Challenges. J Hum Ecol, 38(1): 31-35.

[15.] Siow, O., Norrakiah, A.S. (2011). Assessment of Knowledge, Attitudes and Practices (KAP) Among Food Handlers at Residential Colleges and Canteen Regarding Food Safety. Sains Malaysian; 40(4):403–410.

[16.] William, G.K., Bekker, J.L. and Onyango, R.O. (2012). An Assessment of Knowledge, Attitudes and Practices of Food Handlers in Food Kiosks In Relation To Food Hygiene in Eldoret, Kenya. International Journal of Current Research; 4(04):127-138.

Abstract:

This study is a retrospective description of the phenomenon of malnutrition in the district of Guidam Roumdji in the Maradi Region of Niger Republic, and a quantitative as well as qualitative analysis of the impact of a malnutrition program ran by the international medical organization Medicines Sans Frontieres within the same area and timeframe. Niger republic is an Islamic country in the Sahel region of West Africa with a prolonged history of famine and nutritional crisis over the past 25 years. From January to December 2012, a population of 2987 cured children aged 6-59 months and without sex differentiation was discharged from the ambulatory therapeutic feeding center. A sample of 520 of them was used to estimate the average weight gain (AWG) and average length of stay (ALS), the two most important indicators of program success. Observations included a cure rate of over 86.9%, 0.8% death rate, 4.5% default, 3.8% transfer and 4.0% non-respondents. Results also revealed an AWG of 6.4 g/kg/day and an ALS of 33.14 days and both were far above expectations thus confirming the effectiveness of the program. Using a z-test under 5% significance rate and considering a one tail side confidence interval, the sample AWG and ALS were found not to be significantly different from their population counterpart, thus in support of an effective program performance at the population level. A further qualitative analysis of the causes of defaulting implicate the low societal status occupied by the women leading to the conclusion that women empowerment in Niger will help improve compliance to treatment and maximize the overall outcome of such program. In conclusion achieving prevention lies on empowering the women while curative treatment is the responsibility of the well-established medical programs ran under government scrutiny.

References:

[1.] BLÖSSNER, 2005, Malnutrition Quantifying the health impact at the national and local level. Environmental Burden of Diseases Series, No 12

[2.] © Douglas Harper 2015, etymonline.com, © 2001-2005 Douglas Harper, Custom Logo Design

[3.] Golden, 2002, History of Food and Nutrition In Emergency Relief , The Development of the concept of malnutrition, Michael H.N. Golden

[4.] Harper Collins 2004 , Collins English Dictionary , Harper Collins 2004

[5.] Harris & Drimmie, 2012, Toward an integrated approach for addressing malnutrition in Zambia , IFPRI ( International food policy research institute) Discussion paper 01200 August 2012

[6.] Houghton Miffin Company, 2005, The American Heritage ® New Dictionary of cultural literacy, Third edition. Houghton Miffin Company , 2005

[7.] Potts & Gidi & Campbell & Zureich , 2011 , Niger : Too little, Too late. Malcom Potts, Virginia Gidi, Martha Campbell and Sarah Zureick, International Perspectives on Sexual and Reproductive health , Volume 37, Number 2, June 2011.

[8.] Potts & Gidi & Campbell & Zureich , as cited by Turner 2011, Niger : Too little, Too late. Malcom Potts, Virginia Gidi, Martha Campbell and Sarah Zureick, International Perspectives on Sexual and Reproductive health , Volume 37, Number 2, June 2011.

[9.] © Random House. Inc 2015 “Malnutrition”. Dictionary.com Unabridged , Random House , Inc, 2015

[10.] UNICEF , 2010 , Facts for life , 4th edition UNICEF

[11.] Young, 2012, Food and development, Abingdon, Oxon : Routledge .

Bibliography

[1.] American Heritage ® Stedman’s medical dictionary

[2.] Collins English dictionary

[3.] https://www.easycalculation.com/statistics/standard-deviation.php

[4.] http://in-silico.net/tools/statistics/ztest

[5.] How to weigh and measure children: Assessing the Nutritional Status of Young Children, United Nations, 1986

[6.] Institut National de la statistique. Le Niger en chiffres 2011 p. 24

[7.] MSF Data base CRENAS-Guidam Roumdji 2012

[8.] MSF ATFC Nutritional guide

[9.] <Niger: Too Little, Too Late> is an article by Malcolm Potts, Virginia Gidi, Martha Campbell and Sarah Zureick.

[10.] Online etymology dictionary, © 2010 Douglas Harper

[11.] ©Random House, Inc.20153

[12.] Towards an integrated approach for addressing malnutrition in Zambia4>, Joddy Harris and Scott Drimie

[13.] Young, E.M. 2012. Food and development

Abstract:

Condom Use among HIV infected clients seeking care at Rimuka Integrated HIV and Tuberculosis Site, Kadoma, Zimbabwe 2015. Daniel Chirundu, Brian Shawarira, Rumbidzai Kazingizi, Pamela Nyaradzai Magande

Introduction. Inconsistent use of condoms among HIV the infected during vaginal sex is a cause of concern. Its can lead to STI, unwanted pregnancies and infection with resistant strains of HIV. A study done in Kadoma revealed that among the respondents 35% had not used condoms during their last sexual encounter. It is against this background that we investigated factors associated with condom use among HIV clients seeking care .

Methodology. We used an analytical cross sectional study design. The study population were HIV infected clients seeking care at Rimuka Clinic. A sample size of 150 respondents were conveniently recruited. Data were captured using a pretested administered questionnaire. Data were analysed using EpiInfo 7 statistical software. Written informed consent was obtained from respondents.

Results. We interviewed 150 respondents. The prevalence of consistent condom use in the 3 months prior to the study was 52% among females and 37% among males. Factors positively associated with condom use were partners positive feelings on condom OR=7 p<0.05 . Factors negatively associated with condom use were being gainfully employed OR= 0.4 p<0.05; perception that condoms reduce sexual pleasure OR=0.2 p<0.05; thinking that there is no need for a condom in a long term union, OR = 0.29 p=0.02, no need for condom if HIV positive OR=0.11 p=0.01; perceptions that condoms are for use by prostitutes OR=0.23 p=0.04.

Conclusion: Correct consistent condom use should be encouraged among the HIV infected.

References:

[1.] Ballah Akawu Denue et. al. (2014). Evaluation of Condom Use and Associated Factors among Adult HIV Clients in Maiduguri, North Eastern Nigeria: A Comparative Cross Sectional Study. World Journal of AIDS, 2014, 4, 169-177

[2.] Callegari L et. al. (2008). Consistent condom use in married Zimbabwean women after a condom intervention. Sex Transm Dis. 2008 Jun;35(6):624-30. doi: 10.1097/OLQ.0b013e31816b3208.

[3.] Daniel Chirundu (2014). HRQL Among HIV Infected at Rimuka- Capstone 2014 In press

[4.] Delgado Hurtado et. al. (2011). Knowledge of HIV transmission and condom use among HIV-positive heterosexual men and women in Guatemala. Journal of the International AIDS Society 2011, 14:58

[5.] Dessie Y, et. al. (2011). Risky sexual practices and related factors among ART attendees in Addis Ababa public hospitals, Ethiopia: a cross-sectional study. BMC Public Health. 2011;11:422.

[6.] Elmes J et. al. (2014). The price of sex: condom use and the determinants of the price of sex among female sex workers in eastern Zimbabwe. J Infect Dis. 2014 Dec 1;210 Suppl 2:S569-78. doi: 10.1093/infdis/jiu493

[7.] Gregson S et. al. (2006). HIV decline associated with behavior change in eastern Zimbabwe. Science. 2006 Feb 3;311(5761):664-6

[8.] Heidi W. Reynolds (2012). The Measurement of Condom Use in Four Countries in East and Southern Africa. AIDS Behav. 2012 May; 16(4): 1044–1053. doi: 10.1007/s10461-012-0146-9

[9.] Joshua O. Akinyemi, et. al. (2010). Condom use among antiretroviral therapy patients in Ibadan, Nigeria. J Infect Dev Ctries 2010; 4(8):495-502.

[10.] Julia Cordero Coma et. al. (2014). HIV prevention and marriage: Peer group effects on condom use acceptability in rural Kenya. SOCIAL Science & Medicine 116:169– 177 September 2014

[11.] Kefyalew Addis Alene et. al. (2014). Consistent condom use among sexually active HIV-positive women in Amhara region, Ethiopia. Open Access Journal of Contraception 2014:5 85–90

[12.] Mary E. Randolph et. al. (2007). Sexual Pleasure and Condom Use. Arch Sex Behav. 2007 Dec; 36(6): 844–848. 17. S A Rizwan et. al. (2014). Correlates of Intention to Use Condom among Male Migrant Factory Workers in Northern India. J Clin Diagn Res. 2014 Aug; 8(8): JC05– JC08

[13.] Pedraza MA et. al.(1999). Heterosexual transmission of HIV-1 is associated with high plasma viral load levels and a positive viral isolation in the infected partner. J Acquir Immune Defic Syndr. 1999 Jun 1;21(2):120-5

[14.] Stolte IG et.al. (2001). Increase in sexually transmitted infections among homosexual men in Amsterdam in relation to HAART. Sex Transm Infect 77: 184 – 186.

[15.] Yalew et. al. (2012). Patterns of condom use and associated factors among adult HIV positive clients in North Western Ethiopia: a comparative cross sectional study. BMC Public Health 2012, 12:308

[16.] Zewdneh Shewamene et. al. (2015). Consistent condom use in HIV/AIDS patients receiving Antiretroviral therapy in northwestern Ethiopia: Implication to reduce transmission and multiple infections. HIV/AIDS – Research and Palliative Care 2015:7 119–124)

Abstract:

Analysis of the Kadoma General Hospital Cervical Cancer Screening Program Dataset, 2014-2015

Pamela N. Magande, Daniel Chirundu, Notion Gombe, More Mungati, Donewell Bangure, Mufuta Tshimanga

Introduction: Early diagnosis of cervical cancer results in successful treatment. Visual Inspection with acetic Acid and Cervicography (VIAC) is an effective method of cervical cancer screening being used in Zimbabwe. In Kadoma screening started in 2014, 2506 clients had been screened in July 2015. Factors associated with VIAC positivity were determined since VIAC positivity was low, 3%.

Materials and methods: An analytical cross sectional study based on secondary dataset analysis was conducted in 2015. All the 2506 clients were included. The data was exported from an electronic database into Epi Info 7TM (CDC. 2014). Frequencies and means were generated using this software. Bivariate analysis and multilogistic regression were also performed.

Results: Among the clients who were screened, 81% were married. The median age was 39.7 years (Q1 =31; Q3=47). The median number of children was two (Q1 =2; Q3 =4). Early sexual debut, <16 years (POR=2.37(1.47-3.83), p value<0.05), being single (POR=1.92(1.21-3.12), p value=0.005), being HIV positive (POR=3.87(2.40-6.23), p< 0.05), history of STI (POR=1.83(1.05-3.15), p=0.03), (POR=2.79(1.17-6.65), p value=0.015) were significant risk factors. The significant protective factor was having one sexual partner (POR=0.45(0.29-0.70), p value<0.05). The independent risk factor was being HIV positive (aOR=4.16(2.56-6.77), p value <0.05). The independent protective factors were delaying sexual debut, aOR=0.53 (0.32-0.87), p value =0.012 and regular condom use aOR=0.28 (0.086-0.92), p value=0.036.

Conclusion: VIAC should be routine care for the HIV positive. Efforts should be intensified to promote delaying sexual debut and prevent STIs.

References:

[1.] Ajah LO, Chigbu CO, Ozumba BC, Oguanuo TC, Ezeonu PO,(2015) Is there any association between hormonal contraceptives and cervical neoplasia in a poor Nigerian setting?, Dove Press Journal, , OncoTargets and Therapy, 8, 1887–1892.

[2.] Basu PS, Sankaranarayanan R, Mandal R, Roy C, Das P, Choudhury D,et.al.; (2003)Visual inspection with acetic acid and cytology in the early detection of cervical neoplasia in Kolkata, India. Calcutta Cervical Cancer Early Detection Group, International Journal of Gynecological Cancer, 13(5): 626-32.

[3.] Brown B, Bristow C, Iñiguez R.I, Magis-Rodriguez C, Silverman J.G, Meckel-Parker K, et. al, (2015)Prevalence And Risk Factors Of Cervical Abnormalities Among Female Sex Workers In Mexico, International Papillomavirus Conference. Lisbon, Portugal, .

[4.] Biswas LN, Manna B, Maiti PK, Sengupta S, (1997)Sexual risk factors for cervical cancer among rural Indian women: a case-control study, Int J Epidemiol. 26(3):491-5.

[5.] Betram CC, (2004) Evidence for practice: oral contraception and risk of cervical cancer, J Am Acad Nurse Pract. 16(10):455-61.

[6.] Coker A, McCann MS, Hulka BS,Walton LA, (1992) Oral contraceptive use and cervical intraepithelial neoplasia , J Clin Epidemiol;45(10):1111-8.

[7.] Chokunonga E, Borok M.Z, Chirenje Z.M, Nyakabau A.M, Zimbabwe Cancer Registry, 2010, 14

[8.] Franceschi S, Dal Maso L, Arniani S, Crosignani P, Vercelli M, Simonato ,et al (1998),Risk factors for cancer other than Kaposi’s sarcoma in persons with AIDS in Italy. Cancer and AIDS Registry Linkage Study, Br J Cancer 78:966–970

[9.] Global Cancer Facts & Figures, : American Cancer Society; 2011, 2nd Edition, page 1,24

[10.] Gunguwo T.(2006) Zimbabwe Manual for Cervical cancer screening, Ministry of Health and Child Welfare Zimbabwe (MOHCW) and UNFPA, , 12-24

[11.] Gedefaw A, Astatkie A, Tessema GA, (2013)The Prevalence of Precancerous Cervical Cancer Lesion among HIV-Infected Women in Southern Ethiopia: A Cross-Sectional Study, PLoS ONE ,8(12)

[12.] Holmes RS, Hawes SE, Touré P, Dem A, Feng Q, Weiss NS et. al, (2009),HIV Infection as a Risk Factor for Cervical Cancer and Cervical Intraepithelial Neoplasia in Senegal, Cancer Epidemiol Biomarkers Prev , 18; 2442

[13.] Huchko MJ, Leslie H,Sneden J, Maloba M, Abdulrahim N, Bukusi EA and Cohen CR, (2014), Risk factors for cervical precancer detection among previously unscreened HIV-infected women in Western Kenya, International Journal of Cancer; 134(3): 740–745

[14.] International Agency for Research against Cancer, GLOBOCAN 2012, Estimated Cancer Incidence, Mortality and Prevalence in 2012, http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx Accessed 25 August 2015

[15.] Key Informant Dr Madzima, Director Family Health Services, Ministry of Health and Child Care, Zimbabwe

[16.] Leck I, Sibary K, Wakefield J,(1978) Incidence of cervical cancer by marital status, J Epidemiol Community Health, 32(2): 108–110.

[17.] Likes W, Itano J, (2003)Human papillomavirus and cervical cancer: not just a sexually transmitted disease, Clin J Oncol Nurs, 7(3):271-6

[18.] Memiah P, Mbuthia W,Kiiru G, Agbor S, Odhiambo F,Ojoo S,3 and Biadgilign S,(2012) Prevalence and Risk Factors Associated with Precancerous Cervical Cancer Lesions among HIV-Infected Women in Resource-Limited Settings, , AIDS Research and Treatment, 7

[19.] Makuza JD, Nsanzimana S, Muhimpundu MA, Pace LE, Ntaganira J, Riedel DJ, Prevalence and risk factors for cervical cancer and pre-cancerous lesions in Rwanda, The Pan African Medical Journal;22:26

[20.] Murthy NS, Mathew A,(2000) Risk factors for pre-cancerous lesions of the cervix. Eur J Cancer Prev. 9 (1):5-14.

[21.] Sankaranarayanan R, Wesley R, Somanathan T, Dhakad N, Shyamalakumary B, Amma NS, Parkin DM, Nair MK(1998), Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursors, Cancer. ;83(10):2150-6.

[22.] Schiffman M, Wentzensen N, Wacholder S, Kinney W, Gage JC, Castle P. (2011)Human Papillomavirus Testing in the Prevention of Cervical Cancer, Oxford University Press, .

[23.] Sellors J, Lewis K, Kidula N, Muhombe K, Tsu V, Herdman C (2003) Screening and Management of Pre-Cancerous Lesions To Prevent Cervical Cancer in Low-Resource Settings, Asian Pacific Journal of Cancer Prevention, Volume 4, 3:277-280

[24.] Vere M, Shambira G,(2013) Risk Factors for Cervical Pre-cancer Lesions among Women Attending Cervical Cancer Screening Clinics in Harare, University of Zimbabwe, , unpublished.

[25.] World Health Organisation News, WHO supports introduction of HPV vaccine in Zimbabwe, http://www.afro.who.int/en/zimbabwe/press-materials/item/6992-who-supports-introduction-of-hpv-vaccine-in-zimbabwe.html. Accessed 27 August 2015

[26.] World Health Organisation, (2006)International Agency for Research against Cancer Handbook Cancer Prevention, Volume 10 Cervix Cancer Screenings ,59-109

[27.] Wiley DJ, Douglas J, Beutner K, Cox T, Fife K, Moscicki AB,et. al. (2002), External Genital Warts: Diagnosis, Treatment, and Prevention, Clin Infect Dis, 35 (Supplement 2): S210-S224

[28.] Zondervan KT, Carpenter LM, Painter R and Vessey MP,(1996) Oral contraceptives and cervical cancer -further findings from the Oxford Family Planning Association contraceptive study, British Journal of Cancer, 73, 1291-1297

[29.] Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International.( 2012) Zimbabwe Demographic and Health Survey 2010-11. Calverton, Maryland: ZIMSTAT and ICF International Inc.

Abstract:

One hundred and fifty six (156) stool samples were analyzed using selective cultural methods for the isolation of Vibrio species. They were from epidemic areas namely; Jos (Plateau State), Argungu (Kebbi State), Kwali and Gwagwa (Abuja) and Suleja (Niger State) all in Northern Nigeria. 123 (78.8%) were males and 33 (21.1%) females.

Eight of these samples were positive for Vibrio cholera with the distribution as follows; Jos – 2, Argungu – 5 and Kwali – 1.

Serotyping showed that all were of the Ogawa serotype.

Antibiotic sensitivity pattern showed that all eight (100%) samples were sensitive to Ceftazidime, Cefuroxime Axetil, Gentamycin, Sparfloxacin and Tetracycline, 5 (62.5%) sensitive to Erythromycin and 4 (50%) sensitive to Chloramphenicol. The antibiotics that all the isolates were resistant to were Ampicillin, Cloxacillin, Streptomycin and Penicillin.

The study showed that Vibrio cholerae is one of the causes of gastroenteritis epidemics in Northern Nigeria.

References:

[1.] Arora DR, Arora B (2008): Texbook of Microbiology, 3^rd Edition

[2.] Chander, Kaitsha J. Gupta N, Melita M, Singla Anitarksh N, Sarkar BL. (2001): Epidemiology and antibiograms of Vibrio cholera isolates from a tertiary care hospital in Chandigarih, North. India, Indian J Med 613-617.

[3.] Chow KH, Yuen KY, Yam WC. (2008): Detection of RTX Toxin Gene in Vibrocholerae by PCR. Journal of Clinical Microbiology P.2594-2597.

[4.] Constantinde M, Murtugudde GCR, Sapino MRP, Nizan A, Brown CW, Busalacchi AJ, Yunus M, Nair GB, Lanata CF, Calkins J, Manna B. Rajendran K, Bhattacharya MK, Huq A, Sack RB, Colwell. (2008): Environmental Signatures associated with Cholera Epidemics. Proc. Natl AcadSci, USA 105:17676-17681.

[5.] Cruickshank R, Duguid JP, Marmion BP, Swan RHA. (1977): Medical Microbiology 20^th Edition.

[6.] David BM. (2008): CTX Prophages in classical biotype Vibrio cholera Functional phage genes but dysfunctional phage genomes. Journal of Bacteriology 182:6992-6998.

[7.] Honda T, Finkelstein RA. (2000): Purification and Characterization of a haemolysin produed by Vibrocholerae.

[8.] Janda JM. (1998): Microbiology and Microbial infection by Topley and Wilson, volume 2 published by Arnold Great Britain.

[9.] John A, Ndon, SundeMilldo, William Wherenberg B (1992): Journal of clinical Microbiology.P.2730-2732.

[10.] Kiiru JN, Saiduum, Goddens BM, Wamae NC, Butaye, P, Kariuki SM. (2009). Characterization of Vibrio cholerae01 strain carrying an SXT/R391-like element from Cholera outbreaks in Kenya. BMC Microbiology P.1278.

[11.] Linda B, Adams and Ronald J Seibeling . (2008): Baton Rouge, Louisina. 70803.

[12.] Lopez AL, Clement JD, Dean J, Jodar I. (2008): Cholera vaccines for the developing world .Human Vaccine 4(1): 165-169.

[13.] LizarragaPariida ML, Quilci M. (2009): Molecular Analysis of Vibrio cholera 01 and Clinical strain, including new non Toxigenic variant isolated in Mexico during the Cholera epidemic years. J Clinical Microbiology 47 (33): 1364-1371.

[14.] McCathy SA. (2009): Toxigenic Vibrio cholera and Cargo ships entering Gulf of Mexico Lancet 339:624-625.

[15.] Mohammed HF, Mhatu FS, Lyamuya EF. (2005): Susceptibility of Salmonella, shigella and Vibrio cholera 01 to Antimicrobial Agents. Medical Journal 14-17.

[16.] MSNBC, 16 Nov. 2010; Cholera Epidemic death toll rises to 352.

[17.] Muhammad Alid Akond, Saidul A, Hassan SMR, Sarder Nasir Uddin, Momena Shirin. (2008): Antibiotic Resistance of Vibrio cholera from poultry sorces of Dhaka, Bangladesh; Advances in Biological Research. 2(3-4): 60-67. ISSN 1992-0062@Dosi Publications.

[18.] News 24, 24, Jan. 2009; 381 new Cholera cases in Mpumalanga.

[19.] Nguyen BM. (2009): Cholera outbreak caused by an altered Vibrio cholera 01 EI Tor Biotype strain producing classical cholera Toxin B in Vietnam. J. Clincial Microbiology. 47 (5): 1568-1571.

[20.] Osei FB, Duker A.A (2008): Shifting Prevaelnce of Major Diarrhoeal pathogens in patients seeking Hospital care during floods in Dhaka, Bangladesh. I Am J.Trop Med Hyg.79(95): 708-714.

[21.] Roy J.Almeida, Hickman-Breinner FW, Evangeline G. Sowers, Nancy D. Pulu Farmer III, Wacksmith IK. (2008): Comparisons of a latex agglutination assay and an enyme linked immunosorbent assay for detecting Cholera Toxin. Journal of Clinical Microbiology.P128-130.

[22.] Sack DA, Tacker CO, Cohem MB. (2008): Validation of a volunteer model of Cholera with Frozen Bacterias the challenge. Infect Immun 66:1968-72.

[23.] Sack DA, Sack RB. Cholera.Lancet. (2004): 363:223-233.

[24.] SaiduAlam, Sarder Nasir, Uddin Momena Shirin, Hassan SMR. (2008): Antibiotic Resistance of Vibrio cholera from poultry sources of Dhaka, Bangladesh. Advances in BiologialResearch 2 (3-4): 60-67; 753-851.

[25.] Saka Zaki R, Albert MJ. (2008): Bacteriology of Vibrio and related organisms in cholera. Medial book company, p. 37-54.

[26.] Shukla Das, RumpaSaha, Iqbal R Kaur. Trends of Antibiotic Resistance of Vibrio cholera strains. J.Med 127:478-482.

[27.] Siddique AK, Nur GB, Sack RB. (2004): cholera Lancet. 365:223-225.

[28.] Smith AM, Sooka A, Ismail H, Nadan S, Crisp N, Weewink E, Keedy KH, (2007): Analyusis of Vibrio cholera isolates from Northern province of South Africa. P 151-154.

[29.] Teruyo Ito, Shogo Kuwahara, Takeshi Yokota. (2009): Automatic and Manual latex Agglutination Tests for measurement of cholera Toxin and Heat Labile.

[30.] Urassa WK, Mhardo YB, Mhalu FS, Mhonja SJ. (2000): Antimicroial susceptibility pattern of Vibrio cholera 01 strain during two cholera outbreaks in Dares Salaam, Tanzania.

[31.] World Health Organization, Cholera in Zimbabwe: Epidemiological Bulletin Number 16, Week 13 (22-28 March, 2009). WHO Zimbabwe Daily Cholera Update, 16 April 2009.

[32.] Yechezkel Kashi, Yael Darun Poleg, Lyora A. Cohen, HananGanez, Yoav Y. Broza, HanohGoldsmidt, Elinor Malul, Lea Valinsky, Larisa Lerner, MeiraBroza. (2006): Vibrio cholera strain typing and phylogeny study based on simple sequence repeats.

Abstract:

This project intends to critically examine the effect of Government Health Policies, with a particular reference to the policies that have direct bearing on primary Health Care Delivery.

It would also consider the impact of these policies on the duties of a Nurse, the economic condition and socio-cultural beliefs of a community.

The study would attempt to address the negative perception by some communities that rejected immunization against some infectious disease e.g. poliomyelitis, measles Diphtheria, tuberculosis etc.Also rejected by some communities was the program on family planning.  e.g. use of condoms, child spacing etc.

The project would also carefully look at the effect of the role of a Nurse using the appropriate method of information, education and Communication in addressing the aforementioned challenges.

In the end, an evaluation would be carried out with a view to measuring the impact of pre and post government policies, the Nurses role using communication as a tool.

References:

[1.] Revised National Health Policy, 2004

[2.] Road map for accelerating the attainment of the MDGs related

[3.] Reproductive Health in Refugee situations: an inter-agency field manual. www.unfpa.org Primary Health Care Development Agency (PHCDA) Act degree 29 of 1992.

[4.] UN millennium development Goals

[5.] UNFPA Reproductive Health in Refugee situation;

Abstract:

Background: Malaria has been noted as world’s most important tropical parasitic disease that has killed millions of children mostly in developing countries of the World. The attendant problems associated with malaria prevention and treatment in most African countries had substantially increased the yearly rates of infant illness and child death. Therefore, this prospective study focused on the prevalence of malaria among children in different areas in Nigeria. Thick and thin films were made and stained using parasitological standard procedures. Structured questionnaire were also distributed to ascertain their state of health before recruiting them into the study.  Overall 30% of Male and 15.7% of female were respectively positive to malaria diagnosis while 35.7% and 18.6% male and female were negative respectively. High rate of 87.5%, 88.9% and 100% of toddlers, infant and school children respectively had fever while 9.4% and 8.0% toddlers and pre-school children suffer convulsion respectively. Malaria parasite was found in 77.8% infants, 65.6% toddlers, 60% pre-school and 75% school children but total of 34.3% of all the children had no parasite. Symptoms observed among the children indicate a very high percentage of 88.9% infant showing fever while all the school age of 6 to 10 years age shows feverish symptoms due to malaria infection.

Conclusion: The prevalence of malaria among children observed in this study shows increasing burden of malaria in the early years of many children. Aggressive and strategic intervention shall be needed to curtail and prevent unforeseen death rate of many vulnerable children.

Background: Malaria has been noted as world’s most important tropical parasitic disease that has killed more people than any other communicable disease (1). It has remains one of the most prevalent diseases in the World with an estimated 300-500 million cases annually of which 90% occurs in Africa (1). The increasing burden of malaria among children in sub-Saharan Africa has now constituted a leading cause of high mortality due to poverty in this region and poor environmental hygiene which serve as major risk factor. This is because sub-Sahara African region has the greatest number of people exposed to malaria transmission, greatest burden of malaria morbidity and mortality in the world (2). The problems associated with malaria treatment in Africa had substantially increased the rates of illness and death mostly among children (3,4). It is estimated that more than one million children living in Africa die yearly from direct and indirect effects of malaria infection (5). This make malaria a major public health problem and leading cause of premature death in tropical and subtropical countries among children (6).

Moreover, the attendant problems associated with malaria treatment in most Africa countries had substantially increased the yearly rates of infant illness and death (3,7).  With regards to children aged between 1 and 3 years of age, malaria attack episode usually last for 5 to 15 days and often incapacitate the victim with several symptom which include frequent vomiting, convulsion and progressive difficult breathing.

In respect to this, many households had to spend enormous amount on lives, medical cost and drugs. The daily labour cost coupled with cost of treatment and high mortality associated with the disease make malaria one of the main factors retarding development in Africa. Despite huge loss of economic resources, public health, productivity and life span had been adversely affected subjecting many people to abject poverty (8), mostly in hyper-endemic areas in Nigeria (9).

Malaria is a known infection caused by the parasite Plasmodium, of which P. falciparum and P. vivax are the most common but mixed infections with two or more of the Plasmodium species are common. P. falciparum is responsible for most severe, often fatal forms of malaria disease in tropical region (10). Nigeria accounted for more than 25% of the malaria disease burden in Africa, and this has significantly contributed to death of million in a year, which mostly consist of children and pregnant women (11).Despite all efforts to provide several preventive methods; malaria related deaths accounts for up to 11% of maternal mortality, 25% of infant mortality and 30% of under five mortality, resulting in about 300,000 childhood death annually (12). The vast majority of deaths occur among children below five years of age and pregnant women (13), especially in remote rural areas with poor access to health. Therefore, this prospective study focused on the prevalence of malaria among children in different areas in Nigeria

References:

[1.] ANGYO, L. A., PAM, C .D. and SZLACHETBA, R. (1996). Clinical patterns and outcome in children with acute severe Plasmodium falciparum malaria at Jos University Teaching Hospital Nigeria. East Africa Medical Journal 73(12): 823 – 826.

[2.] ANI, OGONNA CHRISTIANA (2004). Endemicity of malaria among primary school children in Ebonyi State, Nigeria Animal Research International (2004) 1(3): 155 – 159 155

[3.] Adeyemo, A. A., Olumese, P. E, Amodu, O. K. and Gbadesin N, R. A. (1999). Correlates of Hepatomegaly and Splenomegaly among Healthy School children in malaria – endemic village. Nigerian Journal of Paediatrics, 26(1): 1 – 3.

[4.] ADEMOWO, O. G. FALUSI, A. G. and MEWOYEKA, O. O. (1995). Prevalence of asymptomatic parasitaemia in an urban and rural community in south- western Nigeria. Central African Medicine, 41: 18 – 21.

[5.] CHEESBROUGH; M (1998); District Laboratory. Practice in Tropical Countries. Examination of blood for malaria parasites. Cambridge University press, Edinburgh, United Kingdom.: 239 - 242.

[6.] Cheesbrough M. (2000). District Laboratory practice manual in Tropical Countries pt 2  Malaria Diagnosis, New Perspectives. Geneva, World Health Organization. WHO/CDS/RBM/2000.- - - - 13

[7.] DAVID, A. (2000). Roll Back Malaria: What are the prospects? Bulletin of the World Health Organization, 78(12): 1377 – 1385.

[8.] FAWOLE, O.I. & ONADEKO M.O. (2001). Knowledge and Management of Malaria in Under Five Children by Primary Health Care Workers in Ibadan South East Local Government Area. Nigeria. Post Graduate Medical Journal 8 (1): 1-

[9.] Jagannathan Prasanna,  Mary K Muhindo, Abel Kakuru, Emmanuel Arinaitwe, Bryan Greenhouse, Jordan Tappero, Philip J Rosenthal, Frank Kaharuza, Moses R Kamya and Grant Dorsey (2010). Increasing incidences of malaria in children despite insecticide-treated bed nets and prompt anti-malarial therapy in Tororo, Uganda. Malaria Journal 2012, 11:435

[10.] OFOVWE, E G. and EREGIE C. O. (2001). Manifestations of severe falciparum malaria in children aged 6 month to 5 years in Benin City, Nigeria. The Resident Doctor, 5 (1): 16 – 20.

[11.] Philips, R. S.(2011) Current status of malaria and potential for control. Clinical Microbiology Revision 14: 208 – 226.

[12.] PETER, B. B., MARYON, M. E. and SYLVIA, M. (2000). Combination therapy for malaria in Africa. Bulletin of the World Health Organization, 78(12): 1377 – 1386.

[13.] SALAKO, L. A and AJAYI, F. O, SOWUNMI, A, WALKER, O. (1990). Malaria in Nigeria: a revisit. American Journal of Tropical Medicine and Parasitology.

[14.] Salako, L. A and Ajayi, F. O, Somumi, A, Walker, O. (1990). Malaria in Nigeria: a revisit. American Journal of Tropical Medicine and Parasitology, 84: 2 – 11.

[15.] TARIMO, D. S., URASSA, D. P. and MSAMANGA, G. I. (1998). Caretakers’ perception of Clinical Manifestations of Childhood malaria in holo - endemic rural communities in Tanzania. East African Medical Journal, 75(2): 93 – 98.

[16.] WHO (1996). World Malaria Situation in 1993, Part 1.World Health Organization. Weekly Epidemiological Record, 71: 17 – 22.

[17.] World Health Organization (2005) World Malaria Report. Geneva.

[18.] World Health Organization (2012) Roll back malaria partnership, WHO focus in Nigeria. Progress and impact series. Community Report. 4: 58

Abstract:

Labour and delivery is the end of pregnancy and beginning of new life. Antenatal care plays an important role to achieve a successful labour and delivery process. Regular antenatal classes help in the physical and mental preparation of women and help them relax during those last months. Antenatal care ensures maternal fetal health wellbeing and also prepares women physically fit for labour, delivery and the postpartum period.¹

Nighty four percent of women access antenatal services in Swaziland at least once and seventy one percent of pregnant women deliver in health facility. ii A majority of the country’s population is young. According to Swaziland’s latest census report (2007), 52% of the 1.1 million people are under the age of 20 and those aged 10 –24 years constitute 37% of the population (39% male and 36% female)². In addition, adolescents comprise of 37% of the country’s population among which 25% of 33, 000 deliveries areadolescents. 27% of antenatal care (ANC) clients who live with HIV areadolescents³.

Maternal mortality is still high in Swaziland where we lose a significant number pregnant women, it accounts to 320/100 000 live births.⁴ Female adolescents account for a significant proportion of maternal deaths, which are largely due to preventable causes like malnutrition, infections and hemorrhage coupled with inadequate health care negligence and supportive services, particularly in the rural areas. Unsafe abortions contribute significantly to maternal morbidity and mortality among adolescents.

The Ministry of health through the Sexual and Reproductive Health Unit has adopted

References:

[1.] Central Statistical Office. Swaziland Population and Housing Census, Mbabane, Swaziland. 2007.

[2.] http://drsimran.expertscolumn.com/article/why-antenatal-care-important-during-pregnancy. Abstracted October 15, 2015 at 08.10hrs.

[3.] http://www.indexmundi.com/swaziland/maternal_mortality_rate.html. Abstracted October 15, 2015 at 08.18 Hrs.

[4.] Swaziland. Ministry of Health. National Sexual Reproductive Health and Rights Strategic Plan 2014 – 2018. Mbabane. 2015, p10-11.

[5.] Swaziland. Ministry of Health. 11th National HIV sero-surveillance among women attending antenatal care services. Mbabane: Printpak. 2010

Abstract:

Stress is commonly defined as a non specific response of the body to any demand or change. Both mind and body plays an interactive role in the stress process. Medical education being a highly stressful course among the other professional courses makes the students to face a lot of stress than the other student population. This study emphasis mainly on the various causative factors of stress among the under graduate (UG) medical students and its changing modality in the past two consecutive years. For this study 100 UG 2^nd yr medical students were selected randomly and research was done.

Each student was given a questionnaire for the assessment of stress levels and from their response various levels of stress were brought and also the major factors responsible for their stress process.

From this study it was also found out that stress phase was increasing every year and there is a need for the adaptation of various methods and facilities to control their stress process.

References:

Abstract:

One of the major challenges mitigating against the success of the HIV program in Nigeria, particularly in Taraba state, the state under study, was the incidence of community terrorism and clashes between the TIV farmers and Fulani herdsman that happened across certain communities where healthcare facilities were located that offered HIV program. This article will analyze the HIV program in Taraba state and how community terrorism and clashes has contributed to poor quality of care received by HIV patients and led to the dearth of healthcare workers, such as doctors, Pharmacists, nurses, laboratory scientists, record staffs etc and consequently contributed to the high prevalence of HIV in the state. 

References:

[1.] Dolberg OT, Barkai G, Leor A, Rapoport H, Bloch M, Schreiber S. Injured civilian survivors of suicide bomb attacks: from partial PTSD to recovery or to traumatisation. Where is the turning point? World J Biol Psychiatry 2010; 11: 344-51.

[2.] Gillespie K, Duffy M, Hackmann A, Clark DM. Community based cognitive therapy in the treatment of posttraumatic stress disorder following the Omagh bomb. Behav Res Ther 2002; 40: 345-57.

[3.] Husain N, Creed F, Tomenson B. Depression and social stress in Pakistan. Psychol Med 2000; 30: 395-402.

[4.] Innovations in Civic Participants. (Online) (Cited 2011 March 30) . Avaiable from URL: www.icicp.org/ht/d/sp/d/sp/a/GetDocumentAction/i/4801.

[5.] Mumford DB, Tareen IA, Bajwa MA, Bhatti MR, Karim R.The translation and evaluation of an Urdu version of the Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1991; 83: 81-5.

[6.] (Online) (Cited 2011 March 22). Available from URL: http://enwikipedia.org/wiki/list_of_terrorist_incidents_in_Pakistan_since_2001. [link not found]

[7.] Reference for factor loading cut-off. (Online) (Cited 2013 Sep 2). Available from URL: http://spssx-discussion.1045642.n5.nabble.com/Reference-for-factor-loading-cut-off-td1087452.html.

[8.] Schindel-Allon I, Aderka IM, Shahar G, Stein M, Gilboa-Schechtman E. Longitudinal associations between post-traumatic distress and depressive symptoms following a traumatic event: a test of three models. Psychol Med 2010; 40: 1669-78.

[9.] What Is Terrorism? (Online) (Cited 2013 Sep 2). Available from URL: http://www.journalofamericanhistory.org/teaching/2011_06/sources/day1ex3_fbi_definitions.htm

[10.] Yehuda R, Hyman SE. The impact of terrorism on brain and behavior: what we know and what we need to know Neuropsychopharmacology 2005; 30: 1773-80.

Abstract:

Background: There are high reported cases of pentavalent 3 vaccines dropout and low immunization coverage in Miga local government area (LGA), Jigawa State, Nigeria. This study aims to evaluate the determinants of the low immunization coverage in children aged 12-23 months in order to formulate/recommend public health interventions to revitalize the routine immunization activities in the Local government area.

Method: This is a cross-sectional study (using the WHO cluster sampling technique) conducted among 390 care givers who have eligible children between 12-23 months old using structured free tested questioner on routine immunization activities to find out the determining factors responsible for the low immunization coverage and high dropout rate of pentavalent vaccines. A stratified sampling method was used to select 30 clusters from 186 settlements. The Data collected was analyzed using the excel spread sheet and determinants responsible for the low coverage were identified.

Results: After differential analysis of the data collected, 5 factors were identified: maternal education, mass media exposure, community education and awareness campaign on routine immunization all other factors that prevented child from visiting health clinic such as not trusting vaccine by the parent, permission not granted by the husband, cost of transportation to the clinic ,non execution of planned outreaches by the health workers as major determinants responsible for wide gap in routine immunization coverage in the local government area.

Conclusion: Low immunization coverage has debilitating consequences on the lives of the children. To improve the immunization uptake, it is recommended that health education/promotion programs that focus on meeting the needs of the caregivers of the eligible children as well as continual social support should be developed and be part of the LGA’s holistic public health/promotion program to save the underserved children.

References:

[1.] Annual Program Activity and progress implementation report 2013 pg28-29 by NPHCDA.

[2.] Adeyinka, D.A., Oladimeji, O., Adeyinka, F.E., &Aimakhu, C. (2009). Uptake Of Childhood Immunization Among Mothers Of Under-Five In Southwestern Nigeria. The Internet Journal of Epidemiology, 7.doi: DOI: 10.5580/f4 Antai, D. (2009). Faith and child survival: the role of religion in childhood immunization in Nigeria. Journal of Biosocial Science, 41(01), 57-76

[3.] Babalola, S. (2009). Determinants of the Uptake of the Full Dose of Diphtheria-Pertussis Tetanus Vaccines (DPT3) in Northern Nigeria: A Multilevel Analysis. Maternal Child Health Journal 13, 550-558. Centre for Disease control and prevention (CDC) (2010).

[4.] Burton A, Monasch R, Lautenbach B, et al. WHO and UNICEF estimates of national infant immunization coverage: methods and processes. Bull World Health Organ 2009;87:535–41.

[5.] CDC. Global routine vaccination coverage, 2010. MMWR Morb Mortal Wkly Rep 2011;60:1520–2.

[6.] Federal Ministry of Health, National Primary Health Care Development Agency. Comprehensive EPI Multi-Year Plan 2009 - 2014

[7.] GHO Global Health Observatory Data 2015 http://www.who.int/gho/publications/world_health_statistics/2015/en/

[8.] Improving Routing Immunization in Northern Nigeria Apr,2013(PRRIN –MNCH) report.

[9.] Jennifer B. Harris, PhD1, 2, Marta Gacic-Dobo, MSc3, Rudolf Eggers, MD3, David W. Brown, DSc 4, Samir V. Sodha, “MDI 1 Global Immunization Division, Center for Global Health, CDC; 2 Epidemic Intelligence Service, CDC; 3 Department of Immunization, Vaccines and Biological, World Health Organization; 4 Division of Data, Research and Policy, United Nations Children's Fund (Corresponding author: Jennifer Harris, jbharris@cdc.gov, 404-639-4498) NOV 2014

[10.] LilianChepkemoi Maina1,&, Simon Karanja1, Janeth Kombich2 1Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University of agriculture and Technology. P.O.BOX 62000-00200 Nairobi, Kenya, 2Kabianga University College, P.O. Box 2030, 20200, Kericho, Kenya 2012.

[11.] Miga LGA WHO facilitators November 2014 IPDs report.

[12.] Nath B, Singh J V, Awasthi S, Bhushan V, Kumar V, Singh S K. A study on determinants of immunization coverage among 12-23 months old children in urban slums of Lucknow district, India. Indian J Med Sci2007;61:598-606 http://www.indianjmedsci.org/text.asp?2007/61/11/598/37046

[13.] National Primary Health Care Development Agency. National Immunization Coverage Survey; 2003

[14.] PRRIN Jigawa state exit Data presentations 2014.

[15.] Research advisors sample size time table 2006 Google web site (http://research.advisors.com)

[16.] SaheedGidado, ,Kabir Sabit and 10 Others Determinants of routine immunization coverage in Bungudu, Zamfara State, Northern Nigeria, May 2010

[17.] Salako AA, Oluwole AF. An Appraisal of Immunization in Nigeria: Towards Improving Coverage. Nigerian Hospital Practice. 2009;3(3-4)

[18.] SMOH (State Ministry of Health ) Jigawa State Task force on immunization presentation Jan 2015

[19.] Tagbo, B.N., Eke, C.B., Omotowo, B.I., Onwuasigwe, C.N., Onyeka, E.B. and Mildred, U.O. (2014) Vaccination Coverage and Its Determinants in Children Aged 11 - 23 Months in an Urban District of Nigeria. World Journal of Vaccines, 4, 175-183. http://dx.doi.org/10.4236/wjv.2014.44020

[20.] Vanguard Nigeria news paper 26^th June , 2012 www.vanguardngr.com/.../new.pentavalent2012

[21.] www.who.int/mediacentre/factsheets/fs378 Cached Fact sheet from WHO on immunization coverage: provides key facts and information about recommended vaccines, key challenges and WHO response.(2015)

[22.] World Health Organization. Expanded Programmed on Immunization: Routine Immunization Schedule in Nigeria. 2009 www.int.org

[23.] WHO immunization coverage Cluster Survey Reference Manual, Department of Immunization Vaccines And Biological http//www.who.int/vaccines.documents. (WHO_IVB_04.23.pdf) 2005

[24.] WHO Jigawa State Task force on immunization presentation Jan 2015

[25.] Wikipedia the free encyclopedia Jigawa State 2015 https//en.m,Wikipedia.Jigawa_state

[26.] WHO Regional office for Africa web site /news Nigeria launches penta vaccines www.afro.who.int/.../nigeria/.../4735 June 2012

Abstract:

Introduction: Measles is the main cause of childhood morbidity and mortality and highly prevalent worldwide. Over the last 15 years there has been a general decline in all the reported Vaccine Preventable Diseases in India but the decline in measles incidence is far below the expected level. WHO targets measles next to polio for eradication.

Objectives: 1) To determine the immunization coverage in measles in Kanyakumari district and 2) To identify the factors associated with Drop outs.

Methodology: This is a community based cross sectional study conducted in whole Kanyakumari district in Tamilnadu, India from June 2012 to May 2013 with 210 children in the age group between 12 and 23 completed months selected by 30 x 7 cluster sampling method. Structured pre tested Questionnaire was used to collect data. 

Results:  Mean age of the children was 18.1 ± 3.1 (SD) months. Out of 210 children, 171 children (81.4%) were immunized for measles vaccination. 64.9% vaccinated in Government facility and  35.1% of children in private setup. Forgetfulness due to longer timegap between OPV/DPT 3^rd Dose and Measles vaccine was the most common factor for drop out constituting 25.6%.  Area of Residence, Marital Status of the parents, Total Income, Distance and the Availability of Immunisation card are the significantly associated with Dropouts. 

Conclusion: The prevalence of dropout is 18.6%. Forgetfulness, Area of residence, Marital status and Income of parents, Distance, Availability of immunization card were the significant factors associated with Drop outs.

References:

[1.] Abhishek Kumar, S.K. Mohanty. (2009). Understanding the Factors Associated with slow Progress in Childhood Immunisation in India. Paper Submitted in XXVI IUSSP International Population Conference in Marrakech, Morocco. 2009.

[2.] Akhalesh Kumar Shakya, Vibha Shukla, Harjeet Singh Maan, Tapan N Dhole. (2012). Identification of different lineages of measles virus strains circulating in Uttar Pradesh, No rth India. Virology Journal, 9:237  DOI:10.1186/1743-422X-9-237.

[3.] Bhagyalaxmi A, Kedia G, Rawal VS. (2007). Study of incidence of measles and vaccination coverage in Ahmedabad urban slums. Indian J Public Health 2007;51(1):52-53.

[4.] DLHS 2007-08. District Level household and Facility Survey 2007-08. Fact Sheets India. Ministry of Health and Damily Welfare, Nirman Bhavan, New Delhi 110011.

[5.] Freeman PA, Thomason JA, Bukenya GB, (1992). Factors affecting the use of immunization among urban settlement dwellers in Papua New Guinea. PNG Med J. 1992 Sep; 35(3) : 179-85.

[6.] Gregory A. Poland, Robert M Jacobson. (2012). The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines? Vaccine Jan 5, 2012; 30(2): 103–104.

[7.] Hussen Mohammed, Alemayehu Atomsa. (2013). Assessment of Child Immunization Coverage and Associated Factors in Oromia Regional State, Eastern Ethiopia. Science, Technology and Arts Research Journal .Jan-Mar 2013,2(1): 36-41.

[8.] Kishore J. (2011). Reproductive and Child Health Program –II. In: J. Kishore (Editor), National Health Programs of India, 9th Edition. Century Publishers, New Delhi, 2011: 155-160.

[9.] National Rural health Mission 2014. Disease Alerts /Outbreaks Reported and Responded to by the States / UTs through IDSP 22nd week 2014. Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi -110011. Available at: http://www.idsp.nic.in/idsp/IDSP/rcntobrk.pdf Accessed on 02 June 2014.

[10.] Niyi Awofeso, Anu Rammohan, Kazi Iqbal. (2013). Age-appropriate vaccination against measles and DPT-3 in India – closing the gaps. BMC Public Health, 13:358  DOI:10.1186/1471-2458-13-358.

[11.] Owino LO, Irimu G, Olenja J, Meme JS. (2009). Factors influencing immunization coverage in Mathare Valley, Nairobi, East Afr Med J. 2009 Jul; 86(7) 322-9.

[12.] Pushpa Narayan. (2011). TN moms to get cash for vaccines. The Times of India (Chennai Edition), Aug 1, 2011. Availabel at http://timesofindia.indiatimes.com/city/chennai/TN-moms-to-get-cash-for-vaccines/articleshow/9438314.cms Accessed on 20 Feb 2014.

[13.] Rajesh Vaidhya. (2009). Measles. In: RajVir Bhalwar, Chief Editor, Text Book of Public Health and Community Medicine, First Edition, New Delhi, AFMC, 2009: 1089-92.

[14.] Rup Kumar Phukan, Manash Pratim Barman, Jagadish Mahanta. (2009). Factors Associated with Immunization coverage of children in Assam, India : Over the first year of life. Journal of Tropical Pediatrics. Volume, 55, Issue 4 : Pp. 249 – 252.

[15.] Singh P, Yadav R.J. (2000). Immunization status of children of India. Indian Pediatrics; 37: 1194–1199.

[16.] Surender N Gupta, Naveen Gupta. (2009). Two highly immunized hilly areas versus double measles outbreak investigations in district Kangra, Himachal Pradesh, India, in 2006. Public Health Research; 1(1): 14-20.

[17.] UNICEF - Coverage Evaluation Survey 2009: National Fact Sheet. Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi – 110011.

[18.] VK Desai, SJ Kapadia, Pradeep Kumar, Siddharth Nirupam. (2003). Study of Measles Incidence and Vaccination Coverage in Slums of Surat City. Indian Journal of Community Medicine Vol. XXVIII, No.1, Jan.-Mar., 2003. 10-14.

[19.] World Health Organization. (2014). Fact Sheet – Measles, Fact sheet N°286, Updated February 2014. Available at: http://who.int/mediacentre /factsheets/fs286/en/ accessed on 23 March 2015. 

Abstract:

Performance Based Financing (PBF) increasingly has been accepted by many Countries in Africa seeking to reform their health system as a way forward. Though PBF is not a magic bullet, reformers believe that its adaptation to respond to specific program issues can improve the quantity and quality of some targeted services produced by motivated health workers in low income countries.

References:

Abstract:

Introduction: Primary health care, though supposed to be the bedrock of the country`s health care policy, is catering for less than 20% of the potential beneficiaries. This study is aimed at looking at the current status in primary health care services in rural communities in Nigeria, the gaps in services and possible ways to address them.

Methods: Secondary data was obtained from results of search for the National health policy review report 2008, National health and demographic survey, Millennium Development Goal, World and Africa report 2014 and UNDP 2014 report for Nigeria.

Results: Nigeria is still short of 2015 Primary Health Care targets with under 5 mortality rate at 94 deaths per 1000 live birth in 2012, maternal mortality at 350 maternal deaths per 100,000 live births and TB burden still at 5.0 per 100,000 in 2012. Challenges include amongst others poor financing, poor strategy and inter-sectorial collaboration.

Conclusion: Increase in government funding with good strategy and inter-sectorial collaboration while involving community will help in reducing the present gaps in primary health services.

References:

[1.] Abdulraheem, I.S., Olapipo, A.R. and Amodu, M.O. (2012). Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. J. Pub. Health Epidem.;4(1):5-13.

[2.] Federal Ministry of Health (2008). National Health policy, Nigerian National Health Bill.

[3.] Federal Republic of Nigeria (2013), national health and demographic survey

[4.] Gupta MD, Gauri, V, Khemani S (2004). Decentralized Delivery of Primary Health Services in Nigeria: Survey Evidence from the States of Lagos and Kogi, Washington: The World Bank.

[5.] Hag C. et al (2009). Primary health care: past, present and future. Global health education consortium and collaborating partners.

[6.] Magawa, R. (2012). Primary Health Care Implementation: A brief review. Available from: http://www.consultancyafrica.com/index. Accessed 22/5/14.

[7.] Millennium development goals report 2014; assessing progress in Africa towards the MDGs- analysis of common African position on the post-2015 development agenda.

[8.] Nigeria millennium development goals report 2014.

[9.] Obionu. C.N. (2007). Primary Health Care for Developing Countries. 2nd ed. Enugu: Delta Publications.

[10.] United Nations global millennium development goals report 2014.

[11.] WHO 1978 World Health Organization-United Nations Children Fund (WHO-UNICEF) (1978). Declaration of Alma-Ata.

Abstract:

This research work was aimed at assessing the awareness and perceived effect of noise pollution among students of tertiary institution in Osun State. Questionnaire was administered to 125 respondents in this descriptive cross sectional study. The degree of exposure was assessed using three questions- intensity of noise relative to that of busy traffic; need to raise voice at the location and raising volume of music gadget after leaving the site. Knowledge of common effect noise was also assessed.

There was moderate level of awareness of effect of noise pollution among the participants, 58.4% of the respondents. The common sources of noise pollution were peoples’ conversation, generator and traffic congestion. Despite this level of awareness of noise pollution, awareness of existence of noise regulatory law is very low. Only 24% of the respondents were aware of the law. 

References:

[1.] Aluko, E., & Nna, V. (2015). Impact of noise on human cardiovascular system. International Journal of Tropical Disease and health, 6(2), 35- 43.

[2.] Ana, R., Shendel, D., Brown, G., & Sridar, M. (2009). Assessment of noise and associated health impacts at selected secondary schools in Ibadan, Nigeria. Journal of Environmental and Public Health, 2009.

[3.] Awosusi, A. O., & Akindutire, I. O. (2014). Percieved health effect of environmental noise pollution on the inhabitant of Ado Ekiti metropolis, Ekiti State Nigeria. Journal of Biology Agriculture and Healthcare, 4(26), 106- 113.

[4.] Bulunuz, N. (2014). Noise Pollution in Turkish elementary schools: Evaluation of noise pollution awareness and sensitivity tranning. International Journal of Environmental and science Education, 9, 215- 234.

[5.] Committee, S. P. W. Noise pollution and abatement act of 1972. (S. Rep. No. 1160).

[6.] Essandoh, P. K., Armah, F. A., Afrifa, E. K., & Pappoe, A. N. (2011). Determination of ambient noise levels and perception of residents in Halls at the University of Cape Coast, Ghana. Environment and Natural Resources Research, 1(1), 181- 188.

[7.] Farzana, S. Z., Nuri, A. H., Biswas, B., & Das, A. (2014). A study on noise pollution of stone crusher machine at Jaflong, Sylhet Paper presented at the Proceedings of 5th International Conference on Environmental Aspect of Bangladesh, Bangladesh

[8.] Lisa, G., & Louis, H. (2007). Noise Pollution: A Mordern Plague. Southern Medical Journal, 100, 287-

294.

[9.] Onuigbo, L. N., Onuoha, J. C., & Ugwuanyi, L. T. (2013). Noise induced hearing loss among social studies education students in tertiary institutions in Enugu State, Nigeria: Awareness and safety issues. International Journal of Current Research.

[10.] Osun, S. o. (2014). The Omoluabis Retrieved 15/10/15, 2015, from www.osunstate.gov.ng/aboutosun/the-people

[11.] Park, K. (2009). Preventive and Social Medicine. India: M/s Banarsidas Bhanot.

[12.] Shield, B. M., & Dockrell, J. E. (2003). The effect of noise on children at school: A review. Journal of Building Acoustics, 10(2), 97- 106.

[13.] Understanding noise pollution. Retrieved 09/10/2015, from http://www.conserve-energyfuture.com/cause-and-effect-of-noise-pollution.php

Abstract:

The Kingdom of Lesotho is situated in the south eastern region of Southern Africa, covering an area of 30,355 km² and is entirely surrounded by South Africa. Lesotho’s geographical formation is characterized by high mountains and deep valleys, and it is the only country in the world to have all its entire territory located at more than 1,000 meters above sea level. More than 75 % of Lesotho is mountainous, with only 25 % considered lowland. The lowest point is 1,388 meters rising to almost 3,500 meters in the Maloti mountain range which forms the border with South Africa to the north east and south west. Seventy five percent of the Lesotho population life in rural areas, with no social services and poor road infrastructure, as postulated by Tanga, 2014.

References:

[1.] Jacob G, Aeron-Thomas A, Astrop A. Estimating road fatalities. TRL Report 445. Growthrone. Transport Research Laboratory (2000)

[2.] Kopits E, Cropper M. Why have traffic fatalities declined in industrialized countries? Implications for pedestrians and vehicle occupants; U.S. EPA – National Center for Environmental Economics; World Bank Policy Research Working Paper 3678, August 2005

[3.] McManus W. The economics of road safety: an international perspective. UMTRI-2007-23: October, 2007

[4.] NHS Health Scotland. Evidence summary: Public health interventions to prevent unintentional injuries among the under 15s; NHS Health Scotland, 2012

[5.] Pius T, Ramakatsa L, Monaheng C, Maotobo T, Sumbulu A. The Impact of Improved Road Infrastructure on the Livelihoods of Rural Residents in Lesotho: The Case of Phamong. Department of Social Work and Social Development, University of Fort Hare; Stud Tribes Tribals, 12(2): 209-218 (2014)

[6.] Robyn N, Adnan A. H, David B, Margie P. Unintentional Injuries; Chapter 39

[7.] www.https://epirev.oxfordjournals.org/content/32/1/110.full

Abstract:

Obstructive sleep apnea is common under‐diagnosed disease associated with high incidence of cardiovascular disease and death there is a strong association between OSA and obesity, almost 70% of patients with OSA are obese. As Obesity and fat deposits may affect compliance of upper airway walls and lead to narrowing of luminal area, which increase the airway collapse

OSA is also there is strong relation between OSA and increased risk of type 2 diabetes by different mechanisms, like intermittent hypoxia, sleep disturbance and immune activation may affect this association. Which play important role in the pathogenesis

Central obesity, increase level of insulin and resistance are associated with high risk of OSA, some researches shown a high prevalence of T2DM and pre‐diabetes in obese patient with OSA, which indicate cause glucose intolerance may cause by OSA.

Study aimed to assess whether extremely obese people who have T2DM and preDM have higher odds of OSA than their counterparts with normal glucose tolerance.

References:

[1.] Type 2 diabetes and pre‐diabetes are associated with obstructive sleep apnea in extremely obese subjects Jan Magnus Fredheim 12*, Jan Rollheim1, Torbjørn Omland3, Dag Hofsø1, Jo Røislien

[2.] Type 2 diabetes and pre‐diabetes are associated with obstructive sleep apnea in extremely obese subjects: a cross‐sectional study. Fredheim JM1, Rollheim J, Omland T, Hofsø D, Røislien J, Vegsgaard K, Hjelmesæth J

[3.] Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S: The occurrence of sleep‐disordered breathing among middle‐aged adults

Abstract:

Millennium Development Goals (MDGs) are 8 international goals that were officially established following the millennium summit of the United Nations in 2000. Using Nigeria as a case study, there has been massive strides in attaining goals 1 to 6 while there has not been visible improvements in attaining goals 7 and 8. It is imperative for focus to shift to the rural areas where there is a higher demand for provision of basic healthcare and environmental infrastructure if these targets are to be met by 2015. Most importantly, the issues of poverty, universal basic education and health, and provision of safe drinking water will go a long way to improving the quality of life of over 160 million Nigerians.

References:

[1.] Abani, C., Igbuzor, O. and Moru, J. (2005),Attaining the Millennium Development Goals in Nigeria: Indicative Progress and a Call for Action. In Moru, J. (Ed), Another Nigeria is Possible: Proceedings of the First Nigeria Social Forum. Abuja, Nigeria Social Forum.

[2.] Federal Ministry of Agriculture and Rural Development (2012). Agricultural transformation agenda: execution and delivery for 2012 by Honorable Minister of Agriculture and Rural Development. Abuja: Federal Ministry of Agriculture and Rural Development.

[3.] Federal Republic of Nigeria (FRN) (2010),The MDGDRG funded Midwives Service Scheme: concept, process and progress. Abuja: National Primary Health Care Development Agency.

[4.] List of goals, targets, and indicators. Available at http://siteresources.worldbank.org

[5.] National Agency for the Control of HIV/AIDS (2011).Factsheet 2011: update on the HIV/AIDS epidemic and response in Nigeria. Abuja: National Agency for the Control of HIV/AIDS.

[6.] National Bureau of Statistics (NBS) (2009). Profile of Women and Men in Nigeria. Available at:

www.nigerianstat.gov.ng.

[7.] National Gender Policy (2008). Retrieved from

http://nascp.gov.ng/demo/wpcontent/uploads/2014/02/National-Gender-Policy-Strategic-Framework-2008-MWASD.pdf

[8.] National Population Commission (NPC), National Malaria Control Programme (NMCP) and ICF International (2012)Nigeria Malaria Indicator Survey (2010). Abuja: NPC, NMCP and IF International

[9.] Nigeria MDG Report (2010). Available at

http://www.mdgs.gov.ng/index.php/downloads/category/1-mdgs-general#

[10.] Nigeria meets MDG 1 (n.d). Available at

http://www.fao.org/countryprofiles/newsarticle/en/c/202569/

[11.] Obaji, C.N. (2005).Nigeria's experience with girls' education and linkages with action with adult female literacy to impact on poverty alleviation. Paper presented at the United Nations girls' education initiative, technical consultation, Beijing, China, 26–27 November. Available at:

http://www.ungei.org/beijing/nigeria _opening.html.

[12.] OSSAP-MDGs (2010).Nigeria Millennium Development Goals (MDGs) countdown strategy2010 to 2015: achieving the MDGs. Abuja: OSSAPMDGs.

[13.] UNDP Nigeria MDG Report (2013). Retrieved from

http://www.ng.undp.org/content/dam/nigeria/docs/MDGs/UNDP_NG_MDGsReport2013.pdf

Abstract:

This article review critically appraises the article ‘Influences of Hospitals Structure on Malpractice Claim Costs’ in the Academy of Health Care Management Journal. The article was written by Young, C.C. and Williams, D. R. of the Mississippi State University and Appalachian State University respectively in Florida, United States of America, USA. No background information was given about the authors of this article as to their position or discipline in their respective universities. This study which was conducted in the State of Florida, USA, sought to examine the structural factors affecting the total amount of malpractice claims costs by hospitals. The article was published online in portable document format (pdf) and used in-text references throughout the article in a way that unraveled the authors thought pattern which flowed seamlessly and brought about a clear view of the topic under discuss: what they hoped to achieve and how to go about it in a way that made reading interesting. This review will first summarize the article. Secondly, it will briefly analyze the effectiveness of the article’s structure, investigating how the information is set out, vocabulary and how easily the reader can access it. Thirdly, the review will critique the article, evaluating its authority, currency, accuracy, objectivity and coverage. The review will also analyze the tables and figures before finally judging the article’s accessibility and credibility. Overall it will determine if the article was well written, clear and relevant.

References:

[1.] Agency for Healthcare Research and Quality. (2004). 2004 National Healthcare Quality Report (No. AHRQ Publication No. 05-0013). Rockville, MD: Agency for Healthcare Research and Quality; U.S. Department of Health and Human Services.

[2.] Allison, J., Kiefe, C., Weissman, N., Person, S., Rousculp, M., Canto, J., et al. (2000).Relationship of hospital teaching status with quality of care and mortality for Medicare patients with acute MI. JAMA, 284(10), 1256.

[3.] American Hospital Association. (2006). Chartbook 2006 Available from http://www.aha.org/aha_app/trendwatch/archive.jsp

[4.] Anderson, G., Hussey, P., Frogner, B., &  Waters, H. (2005).Health spending in the United States and the rest of the industrialized world. Health Affairs, 24(4), 903.

[5.] Barney, J., Wright, M., & Ketchen, D. (2001). The resource-based view of the firm: Ten years after 1991. Journal of Management, 27(6), 625-642.

[6.] Barney, J. B. (1991). Firm resources and sustainable competitive advantage. Journal of Management, 17(1), 99-120.

[7.] Berwick, D. M., Calkins, D. R., McCannon, C. J., & Hackbarth, A. D. (2006). The 100 000 Lives Campaign: Setting a Goal and a Deadline for Improving Health Care Quality. JAMA, 295(3), 324-327.

[8.] Congressional Budget Office.(2006). Medical Malpractice Tort Limits and Health Care Spending. Retrieved from http://www.cbo.gov/ftpdocs/71xx/doc7174/04-28-MedicalMalpractice.pdf.

[9.] Congressional Budget Office. (2009). CBO Correspondence to Senator Orrin G. Hatch; analysis of the effects of proposals to limit costs related to medical malpractice. Retrieved 02/26/2010, 2010, from https://www.cbo.gov/ftpdocs/106xx/doc10641/10-09-Tort_Reform.pdf

[10.] Danzon, P. M. (1994). Tort Reform: The Case of Medical Malpractice. Oxford Review of Economic Policy, 10(1),84.

[11.] Davis, J. H., Schoorman, F. D., &  Donaldson, L. (1997).Toward a Stewardship Theory of Management. Academy of Management Review, 22(1), 20-47.

[12.] Dlugacz, Y. (2006). Measuring Health Care: Using Quality Data for Operational, Financial, and Clinical Improvement: Jossey-bass

[13.] Donabedian, A. (1966). Evaluating the Quality of Medical Care. Milbank Memorial Fund Quarterly(44), 166-203.

[14.] Donabedian, A. (1988). Quality and Cost: Choices and Responsibility. Inquiry, 25(1), 90-99.

[15.] Fahy, J., & Smithee, A. (1999). Strategic Marketing and the Resource Based View of the Firm. Academy of Marketing Science Review(10), 1-19.

[16.] Hair, J., Anderson, R., Tatham, R., &  Black, W. (1998).Multivariate analysis. Englewood: Prentice Hall International.

[17.] Hansen, G. S., & Wernerfelt, B. (1989). Determinants of Firm Performance: The Relative Importance of Economic and Organizational Factors. Strategic Management Journal, 10(5), 399.

[18.] Health Grades.(2004). Patient Safety in American Hospitals. Lakewood, CO.

[19.] Hitt, M. A., Bierman, L., Shimizu, K., & Kochhar, K. (2001). Direct and moderating effects of human capital on strategy and performance in professional service firms: A resource-based perspective. Academy of Management Journal, 44, 13-28.

[20.] Hoopes, D., Madsen, T., &  Walker, G. (2003). Guest editors' introduction to the special issue: why is there are source-based view? Toward a theory of competitive heterogeneity. Strategic Management Journal, 24(10), 889-902.

[21.] Hyman, D. A., &  Silver, C. M. (2004). The Poor State of Health Care Quality in the U.S.: Is Malpractice Liability Part of the Problem or Part of the Solution? Unpublished manuscript

Abstract:

Obesity has become one of the major global problems, its emergence has created a lot of headaches griping the whole continent, (Africa) and yet on the rise, there are 120,000 death related to obesity in United States in 2010, according to WHO, Overweight and Obesity related conditions are the second leading of preventable death after tobacco smoking, It is also listed that obese children are more likely to stay obese into adulthood and more likely to die from any non communicable disease before the age of 55 than their thinner counterpart.

References:

[1.] Abidoye RO, Izunwa RD, Akinkuade FO, Abidoye GO. Interrelationships between lifestyle and diabetes mellitus, overweight, obesity and hypertension in Nigeria. Nutrition Health 2003; 16:203-13.

[2.] National Task Force on the Prevention and Treatment of Obesity, Overweight and Health Risk. Arch Intern Med 2000; 160:898-904.

[3.] OBESITY: Societal Impression of Good Life, Galleria Health and Lifestyle, Nigeria

[4.] Obesity An underestimated ‘silent killer’ - Vanguard News

[5.] Obesity in adult Nigerians: A study of its pattern and common primary co-morbidities in a rural Mission General Hospital in Imo state, south-eastern Nigeria

[6.] Obesity And Health : A Review A Case Study By Ogbu C E And Ogbu C S, Nigeria

[7.] Physical Activity: A Key for the Preclusion of Obesity in Children Obesity and Public Health, Texila American University

[8.] The Teen Years Explained: A Guide to Healthy Adolescent Development Obesity: Nutrition and Exercise

Abstract:

Pakistan is a state of four provinces, Punjab, Sindh, Khyberpakhtunkhawa and Baluchistan and it contains four federal territories, Islamabad, FATA (Federally administered tribal areas), AJK (Azaad Jamu and Kashmir) and Gilgat Balitistan. Pakistan’s neighbor countries are India, China, Iran and Afghanistan.

With an estimated more than 180 million population, Pakistan is the sixth biggest country in the world and second largest Muslim country after Indonesia, with life expectancy of 65 years with literacy rate of 49 percent (63 male and 36 female) and HDI (Human development Index) ranks of Pakistan is 141 of 182 and considered as an under developed country.

The despite of 33 of its 67 years under military rule the situation of security in the country is complex with multiple overlapping threats from bordering countries like Afghanistan and India. This increase in the magnitude of its natural disasters like floods, earthquake and droughts and whole situation explains Pakistan as a disaster-prone country. Some unseen disasters like Mega flood in 2010 (20 million affected and destroyed two million homes, 514 health facilities destroyed, almost a size of England land inundated), 2011 and 2012 heavy monsoon rains, 2013 and 2014 military operations against terrorism in the areas near to Afghan border left millions homeless (Around four million IDPs and refugees, including 2005 earthquake) and 2014 floods in KPK and Punjab are a real issue with the limited resources of state which are prioritized to address emergencies.

The Health indicators were poor before the floods and terrorism, counter war as MMR 230 (190-280) per 100000 live births and 89 per 1000 live births in under five children.  The flood dragged population further down on the socioeconomic Quintiles and these disasters worsened their life style and left a high impact on public health of the people. High Global acute malnutrition rates, stunting rates, psychiatric shocks due to frequent and ongoing terrorist attacks and displacement had affected the population, prone to the disasters. This situation clearly hurdles country to show standard and required progress on millennium development goals.

References:

[1.] ++ An article by Sardar Sikandar Shaheen from daily times, on Pakistan lost Rs 8,264 billion in ‘war on terror’

http://www.dailytimes.com.pk/national/03-Jun-2014/pakistan-lost-rs-8-264-billion-in-war-on-terror

[2.] +Floods in Pakistan- a public health crisis by Haiderwadaich, Anita KM Zaidi and Kavita Patel, Bull World Health Organ. Mar 1, 2011; 89(3):  236–237.doi:  10.2471/BLT.10.083386

[3.] Impact of Afghan war on economy of Pakistan. Annexure III of economic survey of 2013 and 2014 Pakistan.

http://finance.gov.pk/survey/chapters_14/Annex_3.pdf

[4.] *** Government of Pakistan, Economic survey 2010-11, Report

http://www.finance.gov.pk/survey/chapter_11/Special%20Section_1.pdf

[5.] * Ministry of planning, development and reforms commission Pakistan report 2013 on “Pakistan Millennium development goals.”

http://www.undp.org/content/dam/pakistan/docs/MDGs/MDG2013Report/UNDP-Report13.pdf

[6.] ** Planning commission, planning and development division Government of Pakistan. “National nutrition survey 2011” survey report.

http://pakresponse.info/LinkClick.aspx?fileticket=Ao4s-rwdFVI%3D&tabid=117&mid=752

Abstract:

This review is critically reviewing the article ‘who am I? Where am I? Experiences of young women in a slum in Islamabad, Pakistan’ in the journal ‘Bio Med central Public health’. During this review, firstly the above mentioned article will be summarized. Secondly the article’s format, structure and the matters of readers understanding and access will be briefly analyzed. Thirdly this review will critique the article based on its authority, current approach, accuracy/validity, objectivity and coverage. It is said that “a critical review of a journal article is an evaluation of an article's strengths, weaknesses and validity” (H.T.Coutts). Furthermore this review will also analyze the graphs, tables utilized to present different results. Along with the above mentioned components the article will also be reviewed for its accessibility and credibility of the publishing journal. 

References:

[1.] Article Review/Critique, University of the Fraser Valley writing center, Retrieved on 10th May, 2014 from http://www.ufv.ca/media/assets/writing-centre/Article+review+and+critique.pdf

[2.] Coutts. H.T, Critical Reviews of Journal Articles; University of Alberta, Retrieved on 10th May 2014 from http://wwwbcf.usc.edu/~genzuk/Reviews_Journal_Articles.pdf

[3.] Metzger. M.J, Making Sense of Credibility on the Web: Models for Evaluating Online Information and Recommendations for Future Research:, University of California Press

Abstract:

Introduction

There is increasing recognition of the importance of clients of FSW as bridge group to HIV transmission. However, there is paucity of evidence that establishes the HIV vulnerabilities or risk among clients in India. The current analysis examines the changes in risk behaviors (condom use), prevalence of HIV and STIs, and the factors associated with condom use behaviors among clients of sex workers in three Indian states using data from a large scale cross-sectional bio-behavioural survey.

Methods

Data were derived from two rounds of integrated behavioural and biological assessments (IBBA) conducted among clients in the years 2006 and 2009 in Andhra Pradesh, Tamil Nadu and Maharashtra, India. Eligible clients for the survey included men aged 18 years or older who had bought sex from a FSW at least once in the previous month.Two stage probability sampling was used and time location clusters sampling was applied. Consented participants completed structured interviews to collect behavioural data and provided blood and urine samples for HIV, Neisseria gonorrhea, Chlamydia trachomatis, and syphilis testing.

Results

Samples of 4,821 and 4,803 clients were covered in IBBA rounds 1 and 2, respectively. The majority of the clients were literate, ever married and worked as a laborer in two consecutive rounds. Over three fourth of clients had first paid sex before age 25 years. Clients of FSWs had a higher level of condom use during last sex act (AOR-2.5, 95% CI 1.9-3.3) and consistent condom use (AOR-3.1, 95% CI-2.1-3.9) with occasional FSWs during Round 2, compared with Round 1. Clients 24 years or younger (AOR=4.2; 95% CI: 2.9-6.2) were most likely to have reported consistent condom use with FSWs when compared with clients 40 years or older. Clients who reported having sex with other men, were less likely to report consistent condom use (AOR=0.63; 95% CI: 0.4-0.8) with FSWs. Clients who had exposure to messages on STIs or condom use through media advertising were significantly more likely to report consistent condom use with FSWs (AOR=1.6; 95% CI: 1.1-2.3). Logistic regression analysis of factors associated with having an STI indicates that clients having sex with another man have significantly higher likely hood of having an STI (9.1% versus 6.6%; AOR=1.8; 95% CI: 1.1 – 2.9).

Conclusion

The findings strongly suggest improvements in condom use among the bridge population, which is also confirmed by the non-increase in HIV and STI prevalence. Exposure to media messages on STIs and condom have shown to positively influence condom use. These findings have programmatic implications, in that it increases understanding about the sub-populations of bridge populations more at risk and who need to be reached with more tailored interventions.

References:

[1.] National AIDS Control Organisation MoHFW, Government of India. Annual Report 2006. 2007.

[2.] Kumar R JP, Arora P, Dhingra N, Rao S HIV-1 trends, risk factors and growth in India. 2005.

[3.] Nagelkerke NJD JP, de Vlas SJ, Korenromp EL, Moses S, et al. Modelling HIV/AIDS epidemics in Botswana and India: impact of interventions to prevent transmission. Bull World Health Organ 2002;80(2):89-96.

[4.] Venkataramana CB SP. Extent and speed of spread of HIV infection in India through the commercial sex networks: a perspective. Trop Med Int Health 2001;6(12):1040–1061.

[5.] National AIDS Control Organisation MoHaFW, Government of India. 2006. New DelhiNational Behavioural Surveillance Survey (BSS)-Female Sex Workers (FSWs) and their Clients.

[6.] Subramanian T, Gupte MD, Paranjape RS, et al. HIV, sexually transmitted infections and sexual behaviour of male clients of female sex workers in Andhra Pradesh, Tamil Nadu and Maharashtra, India: results of a cross-sectional survey. AIDS. . 20081222 DCOM- 20090220 2008 22 ( 5):S69-79. .

[7.] Michelle F. Gaffey SV, Neeraj Dhingra, Ajay Khera, Rajesh Kumar, Paul Arora, Nico Nagelkerke, Prabhat Jha. Male Use of Female Sex Work in India: A Nationally Representative Behavioural Survey. PLoS ONE. 2011;6(7).

[8.] Ruxrungtham K BT, Phanuphak P HIV/AIDS in Asia. Lancet. 2004;364(9428):69-82.

[9.] Saidel T, Adhikary R, Mainkar M, et al. Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges. AIDS (London, England). 2008;22:S17-S34 10.1097/1001.aids.0000343761.0000377702.0000343704.

[10.] Saidel T LV, Salyuk T, Emmanuel F, Morineau G, Lyerla R. . Applying current methods in size estimation for high risk groups in the context of concentrated epidemics: Lessons learned. jHASE 2010:1-24.

[11.] Boerma JT, Weir SS. Integrating demographic and epidemiological approaches to research on HIV/AIDS: the proximate-determinants framework. J Infect Dis. Feb 1 2005;191 Suppl 1:S61-67.

[12.] Organization NAC. Natinal behavioral surveillance survey among general population. 2006.

[13.] Lipovsek V, Mukherjee A, Navin D, Marjara P, Sharma A, Roy KP. Increases in self-reported consistent condom use among male clients of female sex workers following exposure to an integrated behaviour change programme in four states in southern India. Sexually transmitted infections. 2010;86(1):038497.

[14.] Shaw S, Deering K, Reza-Paul S, et al. Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study. BMC public health. 2011;11(Suppl 6):S4.

[15.] Phillips AE, Lowndes CM, Boily MC, et al. Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic. Sexually Transmitted Infections. June 1, 2010 2010;86(3):187-192.

[16.] Hernandez AL, Lindan CP, Mathur M, et al. Sexual behavior among men who have sex with women, men, and Hijras in Mumbai, India--multiple sexual risks. AIDS Behav. Jul 2006;10(4 Suppl):S5-16.

[17.] Rajatashuvra Adhikary AG, Satya Ranjan Lenka, Prabuddhagopal Goswami, Lakshmi Ramakrishnan, Bitra George, Mandar K. Mainkar, S. Thilakavathi,, Paranjape GNVBRR. Decline in unprotected sex & sexually transmitted infections (STIs) among female sex workers from repeated behavioural & biological surveys in three southern States of India. The Indian journal of medical research. 2012;136:5-13.

[18.] Ramesh BM, Moses S, Washington R, et al. Determinants of HIV prevalence among female sex workers in four south Indian states: analysis of cross-sectional surveys in twenty-three districts. AIDS (London, England). 2008;22(5).

[19.] Mainkar M, Pardeshi D, Dale J, et al. Targeted interventions of the Avahan program and their association with intermediate outcomes among female sex workers in Maharashtra, India. BMC public health. 2011;11(Suppl 6):S2.

[20.] Rachakulla HK, Kodavalla V, Rajkumar H, et al. Condom use and prevalence of syphilis and HIV among female sex workers in Andhra Pradesh, India - following a large-scale HIV prevention intervention. BMC public health. 2011;11(Suppl 6):S1.

[21.] Suryawanshi D, Bhatnagar T, Deshpande S, Zhou W, Singh P, Collumbien M. Diversity among Clients of Female Sex Workers in India: Comparing Risk Profiles and Intervention Impact by Site of Solicitation. Implications for the Vulnerability of Less Visible Female Sex Workers. PloS one. 2013;8(9):e73470.

[22.] Michael D Sweat JD, Caitlin Kennedy, Virginia Tedrow & Kevin O'Reilly Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990–2010. Bulletin of the World Health Organization 2012;90:613-622A.

[23.] Piot B, Mukherjee A, Navin D, et al. Lot quality assurance sampling for monitoring coverage and quality of a targeted condom social marketing programme in traditional and non-traditional outlets in India. Sexually transmitted infections. February 1, 2010 2010;86(Suppl 1):i56-i61.

[24.] Gomes do Espirito Santo ME, Etheredge GD. Male clients of brothel prostitutes as a bridge for HIV infection between high risk and low risk groups of women in Senegal. Sexually transmitted infections. 2005;81(4):342-344.

[25.] Vuylsteke BL, Ghys PD, Traore M, et al. HIV prevalence and risk behavior among clients of female sex workers in Abidjan, Cote d'Ivoire. AIDS (London, England). 2003;17(11):1691-1694.

[26.] Espirito Santo ME, Etheredge GD. How to reach clients of female sex workers: a survey by surprise in brothels in Dakar, Senegal. Bull World Health Organ. 2002;80(9):709-713.

Abstract:

Cryptococcal Meningitis (CM) is a central nervous system infection caused by a fungus. A large majority of cases are caused by Cryptococcus neoformans var. neoformans. The fungus C. neoformans is found in soil that contains bird droppings, particularly pigeon excreta, all over the world. Cryptococcusneoformans var. gatti, on the other hand, is found primarily in tropical and subtropical regions trees, most commonly eucalyptus trees. It grows in the debris around the trees’ bases. Cryptococcal meningitis usually occurs in people who have a compromised immune system and is a rare occurrence in someone who has a normal immune system. Of the two fungi, Cryptococcalgattii is the one more likely to infect someone with a normal immune system.The incidence of infections caused by C.neoformans has risen markedly over the past 20 years as a result of the HIV/AIDS epidemic and increasing use of immunosuppressive therapies. Cryptococcal meningitis is a common opportunistic infection and an AIDS-defining illness in patients with late-stage HIV infection, particularly in Southeast Asia and Southern and East Africa. It is widely considered as the most common life-threatening AIDS related fungal infection. Cryptococcal meningitis has been estimated at about 70 to 90% worldwide in AIDS patients with mortalities of between 50% to 70% in Sub-Saharan Africa. [2,3,4] Mortality from HIV-associated cryptococcal meningitis remains high (13–33%), even in developed countries, because of the inadequacy of current antifungal drugs and combinations, and the complication of raised intracranial pressure.[2,7,8]In the cases presented, the findings were so non-specific that the diagnosis was highly dependent on the CSF findings. Based on the characteristics of the presenting signs and symptoms, Cryptococcal meningitis should always be included in the differential diagnosis of chronic or subacute meningoencephalitis, since clinical features are not specific.