Abstract:

OBJECTIVES

To ascertain the level of knowledge about malaria, its prevention, and control; to determine the relationship between knowledge acquisition and malaria disease; and to determine malaria treatment preference with regards to what and where malaria treatment(s) are received in the community.

METHODS

This cross sectional study used semi-structured questionnaires to gather information from participants in Ukwuani Local Government Area of Nigeria. Trained interviewers used direct one-on-one interviews. Collected data were analysed using Statistical Package for Social Sciences (SPSS) version 21.

RESULTS

From a total of 262 participants, 100 (38.17%) respondents didn’t actually know what malaria is, 85 (32.44%) didn’t really know the cause of malaria, and only 109 (41.6%) participants practice some form of malaria prevention and control. A logistic regression analysis of malaria incidence in the last four weeks as the dependent variable, and levels of educational qualification as the independent variable gave a significance of <0.05. Out of the total 46 respondents who got infected with malaria disease in the last four weeks, 21 (45.65%) did not attend any health facility, but opted for self medication.

CONCLUSION

The level of knowledge about malaria, its prevention, and control can be improved on through well planned consistent health promotion.

KEYWORDS

Knowledge and attitude, malaria, prevention and control, Nigeria.

References:

1.      Abate A, Degarege A, Erko B. Community knowledge, attitude and practice about malaria in a low endemic setting of Shewa Robit Town, northeastern Ethiopia. BMC Public Health 2013; 13: 312.

2.      Adeneye AK, Jegede AS, Mafu MA, Nwokocha EE. A pilot study to evaluate malaria control strategies in Ogun State, Nigeria. World Health Popul. 2007; 9(2):83-94.

3.      Ahmed SM, Haque R, Haque U, Hossain A. Knowledge on the transmission, prevention and treatment of malaria among two endemic populations of Bangladesh and their health-seeking behaviour. Malar J 2009; 8: 173.

4.      Beier JC, Keating J, Githure JI, Macdonald MB, Impoinvil DE, Novak RJ. Integrated vector management for malaria control. Malar J. 2008 Dec 11; 7 Suppl 1:S4.

5.      Crawley J, Chu C, Mtove G, Nosten F. Malaria in children. Lancet 2010; 375: 1468-81.

6.      Delta State, 2014. http://www.deltastate.com.ng/Local-Government/ukwuani-local-government.html Accessed 1/5/14.

7.      Fairhurst RM, Wellems TE. Plasmodium species (Malaria). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009: chap 275.

8.      Jeffrey P. Attitudes and Perceptions. In: Borkowski N ed. Organizational Behaviour in Health Care. Jones and Bartlett Publishers. 2014: Chapter 3, pp. 43-76. http://healthadmin.jbpub.com/Borkowski/chapter3.pdf. Accessed 3/05/14.

9.      Kimbi HK, Nkesa SB, Ndamukong-Nyanga JL, Sumbele IUN, Atashili J, Atanga MBS. Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District, Cameroon. BMC Public Health 2014; 14: 883.

10.  Khumbulani WH, Musawenkosi LHM, Simon K, Dayanandan G, Rajendra M. Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: A country earmarked for malaria elimination. Malar J 2009, 8: 29.

11.  Lawrence CE, Croft AM. Do mosquito coils prevent malaria: a systematic review of trials. J Travel Med 2004; 11(2): 92-96.

12.  Legesse M, Deressa W. Community awareness about malaria, its treatment and mosquito vector in rural highlands of central Ethiopia. Ethiop J Health Dev. 2009; 23(1): 40-47.

13.  Lora LS, Abanish R, Mohamed IB, Mrigendra PS, Jordan T, Blair JW, Katherine MJ, Kojo YA, Neeru S, Davidson HH. Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in eastern India. Am J Trop Med Hyg 2010; 82(6): 1010–1016.

14.  Nadjm B, Amos B, Mtove G, Ostermann J, Chonya S, Wangai H, et al., WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study. BMJ 2010; 340: c1350.

15.  National Center for Biotechnology Information: Malaria http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001646/ Accessed 1/5/14.

16.  Okell LC, Drakeley CJ, Ghani AC, Bousema T, Sutherland CJ. Reduction of transmission from malaria patients by artemisinin combination therapies: a pooled analysis of six randomized trials. Malar J 2008; 7: 125.

17.  Okoli C, Enna M. A cross-sectional study on knowledge of, attitudes towards and practice of malaria prevention. South Afr J Infect Dis 2014; 29(1): 37-42.

18.  Okwundu CI, Nagpal S, Musekiwa A, Sinclair D. Home‐ or community‐based programmes for treating malaria. Cochrane Database Syst Rev 2013, Issue 5.

19.  Olorunfemi EA. Impact of health education intervention on malaria prevention practices among nursing mothers in rural communities in Nigeria. Niger Med J. 2013 Mar-Apr; 54(2): 115–122.

20.  Pluess B, Tanser FC, Lengeler C, Sharp BL. Indoor residual spraying for preventing malaria. Cochrane Database Syst Rev 2010, Issue 4.

21.  Salwa MEAE, El-Amin ER, Hayder AG, Abd El-Karim AEF. Knowledge, practices and perceptions which affect acquiring malaria in man-made malarious area in Khartoum State, Sudan. Sudanese J Public Health 2009, 4(1):199–209. UNICEF. 2014.

22.  Vontas J, Moore S, Kleinschmidt I, Ranson H, Lindsay S, Lengeler C, Hamon N, McLean T, Hemingway J. Framework for rapid assessment and adoption of new vector control tools. Trends Parasitol. 2014; 30(4):191-204.

23.  World Health Organization (2003): The solid facts: social determinants of health. Geneva: World Health Organization.

24.  World Health Organization (2008), Commission on Social Determinants of Health. Closing the Gap in a Generation: Health equity through action on the social determinants of health. Geneva: World Health Organization.

25.  World Health Organization (2010), Guidelines for the treatment of malaria. 2010, Second edn, World Health Organization.

26.  World Health Organization (2013), World malaria report 2013. Geneva: World Health Organization.

27.  World Health Organization (2014), http://www.who.int/mediacentre/factsheets/fs094/en/ Accessed 1/5/14.

28.  Yoel L, Arthorn, Arjen, et al., 2011. Bull World Health Organ. 2011; 89: 504-512.

Abstract:

Maternal mortality rates are still alarmingly high in Sub-Saharan Africa. Skilled delivery care during childbirth is the most critical intervention for improving maternal health. Despite the importance of skilled delivery services, performance of skilled delivery care is still low in the Bongo District. The researcher, being an indigene of this district, and a professional nurse, observed that skilled birth care during pregnancy, labour and childbirth has been low within the Bongo community and its environs. The study aimed at determining the barriers to utilisation of skilled birth care services provided by healthcare professional from the perspective of mothers in the Bongo District of Upper East Region of Ghana. A descriptive study with cross-sectional design of 610 mothers, selected through simple random sampling technique was conducted. Data were collected using a structured interviewer-administered questionnaire, and analysed using SPSS statistics. The study identified women’s age; education; marital status; religion; husband’s education; parity and health insurance status as the socio-demographic characteristics of women that were significantly associated with utilisation or non-utilisation of skilled delivery services. The study also identified lack of money to pay for transportation and cost of treatment; poor quality of services and poor attitudes of health personnel; availability and influence of TBAs; long distance and lack of means of transportation; and cultural reasons as the major barriers to the utilisation of skilled delivery services. The recommendations emerging from the study reinforce the importance of skilled attendants’ awareness regarding attitude, and the need for development of interpersonal communication skills into education and training that women are treated with respect, understanding and dignity. It is also recommended that midwives and other skilled attendants in deprived areas should reorient their caring practices to more culturally appropriate and evidenced- based maternity care. Further research on women’s experiences of care received, and health care delivery in rural areas is needed.

References:

1.      Abor, P. A., Abekah-Nkrumah, G., Sakyi, K., Adjasi, C.K.D and Abor, J. (2011). “The socio-economic determinants of maternal health care utilisation in Ghana”, International Journal of Social Economics, 38 (7), 628-648

2.      Addai, I. (2000). “Determinants of use of maternal-child health services in rural Ghana”, Journal of Biosocial Science 32(1):1-15.

3.      Adetunji, J.A. (1994). Infant mortality in Nigeria: effects of place of birth, mother’s education and region of residence, Harvard Center for Population and Development Studies, Cambridge, Massachusetts, USA

4.      Adetunji, J. A., (1991). “Response of Parents to Five Killer Diseases among Children in a Yoruba community, Nigeria”, Social Science & Medicine 32(12):1379-1387.

5.      Adjei, M. (2008). “Factors contributing to Low Utilization of Skilled Delivery in Ahafo – Ano South District Ashanti Region”, West African Journal of Medicine, 14(13) 22-38.

6.      Amankwa, B. (2008). “To Assess the Determinants of Skilled Birth Attendance in Bolgatanga Municipality”, Maternal Child Health Journal, 12(23): 43-51

7.      Andersen, R.M. and Newman, J.F. (1973). “Social and individual determinants of medical care utilisation in the United States”, Milbank Memorial Quarterly, 51: 95-124.

8.      Andersen, R.M. (1995). “Revisiting the behavioural model and access to medical care: does it matter?” Journal of Health and Social Behaviour, 36(1): 1-10.

9.      Bongo Health Directorate (2010). District Annual Health Report. Bongo, Ghana

10.  Buor, D. (2004a). “Determinants of utilization of health services by women in rural and urban areas in Ghana”, Geo Journal, 61: 89-102.

11.  Carlough, M. and McCall, M. (2005), “Skilled birth attendance; what does it mean and how can it be measured? A clinical skills assessment of MCH workers in Nepal”, Int Journal of Gynecology and Obstetrics, 89: 200-208.

12.  Chakraborty, N., Islam, M.A., Chowdhury, R.I. and Bari, W. (2001). “Utilisation of postnatal care in Bangladesh: evidence from a longitudinal study”, Health and Social Care in the Community, 10 (6), 492-502.

13.  Gage, A.J. (2007). “Barriers to the utilization of maternal health care in rural Mali”, Social Science and Medicine, 65 (8), 1666-82.

14.  Ghana Statistical Service (2012). Multiple Indicator Cluster Survey 2011. Accra. Government Press.

15.  Ghana Health Service Annual Report (2007). Reproductive and Child Health Unit, Public Health Unit, Ghana

16.  Ghana Statistical Service, Ghana Health Service, and ICF Macro (2009). Ghana Demographic and Health Survey 2008: Key Findings. Maryland: ICF Macro.

17.  Mills, S. and Bertrand, J. (2005). “Use of health professionals for obstetric care in Northern Ghana”; Stud Fam Plann, 36(1):45-56.

18.  Mrisho, M., Schellenberg, A.J., Mushi, K.A., Obrist B. and Schellenberg, D. (2007). “Factors affecting home delivery in rural Tanzania”. Tropical Medicine and International Health 4, 927-944.

19.  Nketiah, E.A. (2009). “Expectant mothers and the demand for institutional delivery: Do household income and access to health information matter? Some insight from Ghana”. European Journal of Social Sciences, 2 (8):3-8.

20.  Obeng J.B. (2008). “Factors Influencing the Utilization of Skilled Delivery Services in the Offinso South District of Ghana”, Maternal Child Health Journal, 14(23): 67-89.

21.  Owusu, J.D. (2007). “Factors contributing to low utilisation of maternal health services in Kumasi”. Accra. Available at: http://web.knust.edu.gh/downloads/newsletter1

22.  Sepehri, A., Sarma, S., Simpson, W. and Moshiri, S. (2008). “How important are individual, household and commune characteristics in explaining utilisation of maternal health services in Vietnam?” Soc Sci Med, 67(6):1009-17.

23.  Stanton C, Lawn J.E, Rahman H, Wilczynska‐Ketende K, Hill K. (2006). “Stillbirth rates: delivering estimates in 190 countries”. Lancet; 367(9521):1487‐94.

24.  Stephenson, R. and Tsui, O. A. (2002). “Contextual influences on reproductive health service use in Uttar Pradesh, India”, Studies in Family Planning, 33(4): 309 –321.

25.  Thaddeus, S. and Maine, D. (1994). “Too far to walk: maternal mortality in context”, Social Science and Medicine 38(8): 1091-1110.

26.  UNFPA (2004). In good hands: progress report from the field. Available online www.UNFPA.Org (accessed 1/10/2011)

27.  WHO, UNICEF, UNFPA and the World Bank (2014). Trends in Maternal Mortality: 1990 to 2013, WHO, Geneva, Available online http://whqlibdoc.who.int/publications/2012/9789241503631_eng.pdf Accessed: April 10, 2014

28.  WHO (2010). Progress Report 2010 on Maternal and reproductive health, Available at http://www.who.int/reproductivehealth/publications/family/en/ (accessed http://www.who.int/gho/maternal_health/en/index.html.(accessed on 20th April, 2012)

29.  WHO, UNICEF, UNFPA, World Bank (2010).Trends in Maternal Mortality: 1990 to 2008. Available online at http://whqlibdoc.who.int/publications/2011/9789241500265_eng.pdf prenatal use in the Philippines, Social Science & Medicine, 24(11), 927-944.

30.  WHO (2009).World Health Statistics 2009. Geneva: Available at http://www.who.int/gho/maternal_health/countries/en/index.html acessed on 5th June, 2012)

31.  WHO (2008). Proportion of birth attended by a skilled health worker; 2008 updates. Retrieved from http://www.who.int/reproductivehealth/...health/2008_skilled_attendant (accessed on 4th May, 2011)

32.  WHO, (2007). Skilled Attendant Updates: Available at: http://www.who.int/reproductive health data.html Accessed on 10/09/2011.

33.  WHO (2005). The World Health Report 2005: Make every mother and child count. World Health Organization, Geneva. Switzerland

34.  WHO (1994). Coverage of maternal care: a listing of availability of information. Geneva: http://www.who.int/maternal_child_adolescent/countries/gha_rev.pdf. (accessed on 10th November, 2011).

35.  Yakong, V. (2014). Ethnographic Perspective on Rural Women’s Reproductive Health Decisions in Ghana: The Cultural Influences of Gender Relations, Kinship and Belief System: Doctoral Thesis, the College of Graduate Studies University of British Columbia Okanagan.

Abstract:

OBJECTIVE

To determine prevalence and severity of dental caries using WHO methods by age, gender and educational levels and compare actual DMFT scores to self-reported scores.

METHOD

Cross-sectional study was conducted using face-to-face interviews and oral examinations in La Esquina community, Province Maria Trinidad Sanchez, Dominican Republic (DR) among 104 adult participants. Caries experience was determined using DMFT scores.

RESULTS

Prevalence of caries was high with 94.2% of participants affected by it. Mean DMFT index (11.95±9.67) for participants having ≤ 8 years of school education was significantly higher than the mean score (6.69±4.39) for people with >8 years of education (F=9.3; p<0.01). Likewise, mean DMFT score for age group ≥55 years was significantly higher than for younger age categories (F=5.87; p<0.01). Caries severity was found to be statistically significant by age groups (χ² =17.42, p=.002) with more proportion of participants ≥ 55 years having DMFT score≥14. Actual mean DMFT score was 4.51 higher than mean self-reported score (9.51 versus 5.08) (Spearman r=.27; p= .01).

CONCLUSIONS

This study provides preliminary data on caries prevalence and identifies unmet treatment needs in rural DR. While caries experience among adults increased significantly both by age and educational levels, caries severity increased significantly with age alone.

References:

1.      Astroth, J., Berg, R., Berkey, D., McDowell, J., & Hamman, R. (1998). Dental caries prevalence and treatment need in Chiriqui Province, Panama. International Dental Journal, 48, 203-209.

2.      Becker, T., Levin, L., Shochat, T., & Einy, S. (2007, May). How much does the DMFT index underestimate the need for restorative care? Journal of Dental Education, 71(5).

3.       Dominican Republic Population Mid-2014. (2014). Retrieved from Population Reference Bureau: http://www.prb.org/DataFinder/Geography/Data.aspx?loc=329

4.      Dowsett, S. A., Archila, L., & Kowolik, M. J. (2001). Oral health status of an indigenous adult population of Central America. Community Dental Health, 18, 162-166.

5.      Estupiñán-Day, S. (2005). Promoting oral health: the use of salt fluoridation to prevent dental caries. Washington D C: Pan American Health Organization.

6.      Fadnes, L. T., Taube, A., & Tylleskär, T. (2008). How to identify information bias due to self-reporting in epidemiological research. 7.

7.      Guiglia, R., Musciotto, A., Compilato, D., Procaccini, M., Russo, L. L., Ciavarella, D., … Campisi, G. (2010). Aging and Oral Health: Effects in Hard and Soft tissues. Current Pharmaceutical Design, 16(6), 619-630.

8.      Hobdell, M., Peterson, P. E., Clarkson, J., & Johnson, N. (2003). Global goals for oral health 2020. International Dental Journal, 5, 285-288.

9.      Milner, T. A. (1998). The salt industry of the Dominican Republic- An Assessment. Pan American Health Organization.

10.  (2005). Opportunity and strategy for improving general health in the Americas through Critical advancements in Oral Health, The way forward 2005-2015. Washington DC: Pan American Health Organization. Retrieved from World Health Organization.

11.  Oral Health Surveys. Basic methods (Third ed.). (1987). Geneva: World Health Organization.

12.   PAHO Basic Health Indicator Data Base. (n.d.). Retrieved from World Health Organization: http://www1.paho.org/english/dd/ais/cp_214.htm

13.   Peterson, P. E. (2003). The World Oral Health Report. Retrieved from World Health Organization: http://www.who.int/oral_health/media/en/orh_report03_en.pdf?ua=1

14.  Peterson, P. E., & Baez, R. J. (2013). Oral Health Surveys. Basic Methods (Fifth ed.). France: World Health Organization.

15.  Peterson, P. E., & Yamamoto, T. (2005). Improving the oral health of older people: the approach of the WHO Global Oral Health Programme. Community Dentistry and Oral Epidemiology, 33, 81-92.

16.  Peterson, P. E., Bourgeois, D., Ogawa, H., Estupinan-Day, S., & Ndiaye, C. (2005). The global burden of oral diseases and risks to oral health. Bulletin of the World Health Organization, 83, 661-669.

17.  Smith, A. C., & Lang, W. P. (1993). CPITN, DMFT, and treatment requirements in a Nicaraguan population. Community Dental Oral Epidemiology, 21, 190-193.

18.  Tisone, C. (2004). The relationship between family health care practices and child growth in the Dominican Republic, Thesis. Indiana University, Department of Anthropology.

Abstract:

Effective communication activity is an essential type of program action in support of Polio eradication initiatives (PEI), and routine immunization. Communication activity includes: Social mobilization, Advocacy, and behavioral change communication aspired to improve immunization services and use of those services. Other key components of effective immunization services include: Vaccine procurement for service delivery, cold chain, logistics and capacity building for health workers to provide high quality immunization service and to conduct surveillance on vaccine preventable disease to monitor disease circulation in the country to guide immunization Polio eradication initiative (PEI) was launched in May 1989 by world health Assembly (WHA) resolve to eradicate poliomyelitis from the word by the year 200 using the following strategies;

References:

1.      Communication hand book for routine Immunization, WHO

2.      Communication guideline for Immunization, August 2013

3.      Communication for Polio Eradication and routine Immunization, WHO, 2002

4.      Global Immunization Data July 2014

5.      Polio eradication and end game strategy plan (2013-2018), by WHO, UNICEF, and CDC

Abstract:

INTRODUCTION

Urinary Tract Infection (UTI) is a significant health problem worldwide, affecting all ages and both sexes. Hence, the need for determination of microorganisms causing urinary tract infection (UTI) and their in-vitro susceptibility test is of paramount important to improve service delivery to patients. With this background, a retrospective study was carried out from July 2013 to December 2013 at National Hospital Abuja (NHA).

OBJECTIVE

This study is planned to determine the prevalence of urinary tract infection (UTI) among different sexes and age groups as well as the predominant bacterial pathogens and their sensitivity to antibiotics so as to guide empirical antibiotic therapy. This is aimed at providing improved patient care and management.

MATERIALS AND METHODS

A total of 2640 urine samples from patients attending both inpatient and Outpatient departments of NHA were included in this study. Data of all patients who had positive urine culture between July 2013 and December 2013 were systematically and retrospectively collected from the Laboratory register of the Medical Microbiology and Parasitology Department. Demographic data of these selected individuals’ patient, sex, marital status, pathogens isolated and their antimicrobial sensitivity pattern were collated and analyse. These urine samples were earlier subjected to culture and sensitivity test with the use of standard bacteriological techniques as described by American Society for Microbiology (ASM).

RESULTS

Twenty five percent of the total urine samples (2640) showed significant bacterial growth. Ten different bacterial species were isolated. Among these, Escherichia coli (49.5%) was significantly the most predominant one (P<0.05) followed by Staphylococcus aureus (14.9%), Klebsiella spp (11.8%), Enterococcus faecalis (8.9%), Pseudomonas aeruginosa (4.4%), Proteus spp (3.3%) and others. Majority of Gram-negative bacteria showed susceptibility towards Ciprofloxacin, Gentamicin, and Amikacin. The age group with highest frequency of UTIs was 21–30 years with females predominating in all the age groups except in less than 1 and above 60 years (Fig. 7). The results showed that married women are more likely to be affected than their single or widowed counterparts while the reverse was the case in males (Fig. 8).

CONCLUSION

This outcome of this study shows that there is need for more work in this area be to consistently determine the changing pattern of microbial uropathogens and their antimicrobial profiles.

References:

1.      Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing, 17th informational supplement. Wayne, PA: CLSI.2007; M100-S17.

2.      Chattopadhya AK and Mandal AK. Microbes associated with urinary tract infection in Burdwan, West Bengal. Ind J physiology and Allied Science 1993; 47:67-72.

3.      Cheesbrough, M. District Laboratory Practice in Tropical Countries. Part 2. Cambridge University Press: Cambridge, UK. 2002; 105-112.

4.      De Francesco, M.A., R. Guiseppe, P. Laura, N. Ricardo and M. Nino. Urinary tract infection in Brescia, Italy: Etiology of Uropathogens and antimicrobial resistance of common uropathogens Med. Sci Monit., 2007; 13:136-144.

5.      El-Sweih N, Jamal W, Rotimi VO. Spectrum and antibiotic resistance of uropathogens isolated from hospital and community patients with urinary tract infections in two large hospitals in Kuwait. Med. Principl. pract. 2008; 14: 401-407.

6.      Esko E and Renkonen OV. Comparative in vitro activity of Norfloxacin and 7 other antimicrobial agents against clinical isolates from urinary tract infection. Scand J Infect Dis 1985; 17:95-8.

7.      Forbes BA, Sahm DF and Weissfeld AS. Bailey and Scott’s Diagnostic Microbiology (11th ed). USA: Mosby 2002.

8.      Foster, R.T., Sr. “Uncomplicated Urinary Tract Infection in Women”. Obstet Gynecol Clin., North Am. 2008; 35(2):235-48.

9.      Fowler JE. Urinary tract infections in women. Urol. Clin. North Am. 1986; 13: 673-676

10.  Fowler, J.E. “Urinary Tract Infection in Women”. J. of Urol. Clin. of North Am. 1996; 11:67-68.

11.  Foxman B, Barlow R, D’Arcy H, et al. Urinary tract infection: Self-reported incidence and associated costs. Ann Epidemiol 2000; 10:509–15.

12.  Gluisier MPC. Urinary tract infection and pyelonephritis. In: Medical Microbiology and Infectious Diseases, Braude AIP, Sander WB (ed.), WB Comp. Philadelphia 1991; pp. 1172-1183.

13.  Gupta K. Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Int. J. Antimicrob. Agents. 2001; 135: 41-50

14.  Henry D. Isenberg. Clinical Microbiology Procedures Handbook (2nd ed). Washington, D.C.: ASM press 2004.

15.  Karki A, Tiwari BR and Pradhan SB. Study on Bacteria isolated from Urinary tract infection and their sensitivity pattern. J Nep Med Assoc 2004; 43:200-3.

16.  Kunin CM. Urinary tract infections in females. Clin. Infect. Dis. 1994; 18: 1-12.

17.  Kolawale AS, Kolawale OM, Kandaki-Olukemi YT, Babatunde SK, Durowade KA, Kplawale CF. Prevalence of urinary tract infections among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. Int. J. Med. Med. Sci. 2009; 1(5):163-167

18.  Leegard, T.M., D.A. Caugant, L.O. Froholm and E.A. Hoiby, Apparent difference in antimicrobial susceptibility as a consequence of national guidelines. Clin Microbiol Infect., 2000; 6:290

19.  Levitt PN. Analysis of pathogens isolated from urinary tract infection in Barbados. West Indi Med J 1993; 42:72-6.

20.  Lin, K. and K. Fajardo. “US Preventive Services Task Force. Screening for Asymptomatic Bacteriuria in Adults”. Ann. Intern. Med. 2008; 149 (1): 20-4.

21.  Mbata TI. Prevalence and antibiogram of UTIs among prison inmates in Nigeria. Int. J. Microbiol. 2007; 3(2): 6-12.

22.  Mulugeta, K and A. Bayeh. Prevalence and antibiogram of bacterial isolates from urinary tract infections at Dessie Health research Laboratory, Ethiopia. Asian Pac. J Trop Biomed., 2014; 4(2):164-168

23.  Nicolle, L.E. “Uncomplicated Urinary Tract Infection in Adults Including Uncomplicated Pyelonephritis”. J. of Urol. Clin. of North Am. 2008; 35(1): 1-12.

24.  Norrby, S.R. “Approach to the Patient with Urinary Tract Infection”. In: Goldman L, Ausiello, D, eds. Ceil Medicine 23rd ed. Philadephia, PA. 2007; p.306.

25.  Obi CL, Tarupiwa A and Simango C. Scope of urinary pathogens isolated in the public health bacteriology laboratory. Harare: Antibiotic susceptibility patterns of isolates and incidence of haemolytic bacteria. Central African J Med 1996; 42: 244-9.

26.  Okada K, Usui Y and Wananabe R. Statistic studies on bacteria isolated from urinary tract infection (Report 6: Isolation rate and drug sensitivity from 1988 through 1989). Acta Urol Japonica 1994; 40:175-85

27.  Onuh, S.O., O.U.J. Umeora, G.O. Igberase, M.E. Azikem and E.E. Okpere. Microbiological Isolates and sensitivity pattern of Urinary tract infection in pregnancy in Benin city, Ebonyi Medical Journal., 2006; 5(2): 48-52.

28.  Pokhrel BM. A handbook of clinical microbiology (1st ed). Kathmandu: Gorakhnath desktop and printers 2004.

29.  Talukder MAS. Sensitivity pattern of positive urine culture in a Teaching Hospital. Ban Ren J 1987; 6:49-52.

30.  Simon, H. et. al. Urinary Tract Infections. http://www.reutershealth.com/wellconnected Accessed on 2001; 23/8/2008

Abstract:

OBJECTIVE

This study is planned to determine the effectiveness of AFB smears microscopy training and refresher training on the performance of TB laboratory personnel working in the Nigerian Military Hospital.

BACKGROUND

With an estimated 9.4 million new cases globally, tuberculosis (TB) continues to be a major public health concern¹. Eighty percent of all cases worldwide occur in 22 high-burdens, mainly resource-poor settings of which Nigeria ranked 13th. This devastating impact of tuberculosis on vulnerable populations is also driven by its deadly synergy with HIV. Therefore, building capacity and enhancing universal access to rapid and accurate laboratory diagnostics are necessary to control TB and HIV-TB co-infections in resource-limited countries². In low income countries (Nigeria inclusive), Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment³. In order to have efficient and reliable AFB microscopy centres, it is very necessary to have continuous refresher training for laboratory professionals and strong External Quality Assessment (EQA) system. However, very little data exists as to the effect of in-service training on performance of laboratory personnel in Nigeria.

METHODS

A cross-sectional retrospective study was conducted to appraise theoretical and practical performance of TB Laboratory personnel drawn from various Nigerian Military hospitals supported by the joint partnership of Nigerian Ministry of Defence (NMOD)/United States Department of Defense Walter Reed Program-Nigeria (USDOD WRPN), before and after AFB microscopy training. Theoretical assessment was based on standard questions while practical assessment was based on smear reading of 10 standard slides. Data generated from four (4) rounds of a five days AFB Smear Microscopy training at NTBLTC, Zaria, Kaduna State, Nigeria between 2011 and 2013 was retrospectively collated and analyzed using SPSS 16.0 statistical software.

RESULT

The pre-training mean score of the theoretical knowledge and practical skills were 64.3% and 64.5%, respectively. The post training mean scores were 83.6% and 85.3% for theoretical knowledge and practical skills, respectively. The increase in mean score of both theoretical and practical assessment was statistically significant (p<0.0001). Post training mean score of theoretical knowledge was higher among diploma holders trainees than the BSc degree counter parts (p=0.001). The mean scores on practice before and after training were dependent on participation in previous AFB microscopy trainings (p<0.0001). Proportions of participants with both major and minor errors were found to decrease after they were trained. Trainees who have had previous training were found to commit less error than those who have never participated in previous training (p<0.0001).

CONCLUSIONS

This study established that training improved theoretical and practical performance of Medical Laboratory personnel. Training and continuous training irrespective of lab professional’s qualification, service status and service year and sustainable EQA are highly recommended to ensure quality of AFB microscopy services in all NMOD/USDOD supported health facilities across the country.

References:

1.      Arslan S, Ozdemir L, Demirel Y, Akkurt I: The validity of diagnostic methods in predicting pulmonary tuberculosis. Afr J Microbiol Res 2010, 4:613–617.

2.      CJ Mundy, AD Harries, A Banerjee, FM Salaniponi, CF Gilks, SB Squire. Quality assessment of sputum transportation, smear preparation and AFB microscopy in a rural district in Malawi. Int J Tuberc Lung Dis 2002; 6: 47-54.

3.      International Union against Tuberculosis and Lung Disease: Sputum examination for tuberculosis by direct microscopy in Low income countries. Technical guide. 5th edition. Paris, France: IUATLD; 2000.

4.      Kumar TA, Shyni S, Shiju S, Nagmoti M, Balasangameswara V, Kumar P: Awareness of ‘external quality assessment’ network for AFB sputum smear microscopy & drug sensitivity testing for M.tuberculosis among post-graduate medical students. Natl Tuberc Inst Bull 2005, 41:109–117.

5.      Martinez-Guarneros A, Balandrano-Campos S, Solano-Ceh MA, Gonzalez- Dominguez F, Lipman HB, Ridderhof JC, Flisser A: Implementation of proficiency testing in conjuction with a rechecking system for external quality assurance in tuberculosis laboratories in Mexico. Int J Tuberc Lung Dis 2003, 7:516–521.

6.      Rieder HL, Chonde TM, Myking H, Urbanczik R, Laszlo A, Kim SJ, Deun AV, Trébucq A: The public health service national tuberculosis reference laboratory and the national laboratory network: minimum requirements, role and operation in a Low-income country. Paris, France: International Union Against Tuberculosis and Lung Disease; 1998. ISBN 2-9504238-7-6.

7.      Selvakumar N, Kumar V, Gopi PG, Sivagamasundari S, Prabhakaran E, Vasanthan S, Narayanan PR: Proficiency to read sputum AFB smears by senior tuberculosis laboratory supervisors under training at a reference laboratory in India. Indian J Tuberc 2005, 52:11–14.

8.      Van Rie A, Fitzgerald D, Kabuya G, Van Deun A, Tabala M, Jarret N, Behets F, Bahati E: Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings. J Clin Microbiol 2008, 46:897–901.

9.      World Health Organization (WHO), Association of Public Health Laboratory (APHL), center for Disease Control (CDC), International Union Against Tuberculosis and Lung Disease: External quality assessments for AFB smear microscopy. Washington DC: Association of Public Health Laboratories; 2002.

10.  WHO October 2013 (GTB number C7): www.who.int/tb/challenges/mdr

11.  WHO 2013; HIV Associated TB Facts; http://www.who.int/tb/challenges/hiv/

12.  WHO 2013; Tuberculosis Diagnostics: www.who.int/tb

13.  WHO 2012; Nigeria Tuberculosis Profile; www.who.int/tb/data.

14.  World Health Organization: Laboratory services in tuberculosis control: Organization and management, Part I WHO/TB/98258 1998. Geneva, Switzerland: WHO; 1998.

Abstract:

Global polio eradication initiative launched in Pakistan in 1988 with collaborative efforts of WHO, UNICEFF, Rotary and other allied. With all endeavors, Pakistan is still having high number of cases in the world which is 80% of total. Total 306 polio cases reported in Pakistan in 2014 and 19 cases reported till 20 March in 2015

Pakistan is among one of the three endemic countries. Efforts for eradication started in 1994. The world Health Organization reported that Lahore, Rawalpindi, Peshawar and Karachi have indigenous circulation of poliomyelitis virus as environmental samples came out positive number of times in 2014.

References:

1.      A. Hussain; B. Kolachi; Yasmin Memon; Muhammad A. Kazi; Shankar L. Rathi (2009). “Quality Assessment and Impact of Parent Literacy on National Immunization Days Campaign in District Jamshoro Sindh-Pakistan”. Biomedica (Pak Biomedical Research Society) 25 (1): 24–27. Retrieved 25 May 2012.

2.      “Bin Laden death: ‘CIA doctor’ accused of treason”. BBC News. 6 October 2011. Retrieved 8 October 2011.

3.      Centers for Disease Control and Prevention (CDC) (2006). “Update on vaccine-derived polioviruses”. MMWR Morb Mortal Wkly Rep 55 (40): 1093–7. PMID 17035927.

4.      to: ^{a b} “Explainer: Why Polio Remains Endemic In Afghanistan, Pakistan, And Nigeria”. Radio Free Europe. 20 December 2012. Retrieved 18 March 2015.

5.      to: ^{a b c} Heidi Larson (27 May 2012). “The CIA’s fake vaccination drive has damaged the battle against polio”. The Guardian. Retrieved 3 June 2012.

6.      to: ^{a b} Imran Ali Teepu (26 February 2012). “WHO rejects polio rumours”. Dawn. Retrieved 3 June 2012.

7.      Imran Ali Teepu (2 March 2012). “American NGOs assail CIA over fake polio drive”. Dawn. Retrieved 27 May 2012.

8.      to: ^{a b} Kounteya Sinha (15 May 2012). “WHO to declare polio global health emergency”. The Times of India. Retrieved 3 June 2012.

9.      Orla Guerin (24 May 2012). “‘Emergency plan’ to eradicate polio launched”. BBC News. Retrieved 27 May 2012.

10.  “Polio virus found in Lahore, Rawalpindi, Peshawar”. Dunya News. 27 May 2012. Retrieved 27 May 2012.

11.  “Polio True Stories”. Country Programme Human Interest Stories. UNICEF. Retrieved 27 May 2012.

12.  “Pakistan’s fight against polio clashes with battle against Taliban”. The National. 20 January 2015. Retrieved 18 March 2015.

13.  “Polio: Arrest warrants for parents reduce cases of vaccination refusal”. DAWN. 6 March 2015. Retrieved 18 March 2015.

14.  Silver, Cary, ed. (May 2001). “Pakistani Rotarians help immunize 27 million children in NIDs”. The Rotarian (Rotarian International): 54. ISBN: S5LQ-BE8-DD3Q. Retrieved 28 May 2012.

15.  Svea Closser (16 August 2010). Chasing Polio in Pakistan: Why the World’s Largest Public Health Initiative May Fail. Vanderbilt University Press. pp. 40–41. ISBN 978-0826517098. Retrieved 27 May 2012.

16.  Saeed Shah (2 March 2012). “CIA tactics to trap Bin Laden linked with polio crisis, say aid groups”. The Guardian. Retrieved 27 May 2012.

17.   “Third Plenary Session”. 1994 Proceedings: Eighty-Fifth Annual Convention of Rotary International. Taipei: Rotary International. 15 June 1994. p. 38. Retrieved 26 May 2012.