Abstract:

This project focused on the awareness and prevalence level of obesity among adolescent and adults in Ajara community, Badagry local government area of Lagos State Nigeria. The project was carried out employing a simple survey method and random sampling technique as sampling and data collection tools. Height and weight of study participants were measured to calculate their Body Mass Index (BMI). The World Health Organization (WHO) classification of obesity using BMI was then used to determine the obesity status. A simple pre tested questionnaire was also used to collate information on the awareness of obesity from the respondent. The result shows that about one tenth (13.5%) of the study population were obese, more than half (53.9%) were aware that obesity can lead to death however majorities (90.8%) have not done any test to check their obesity status. The prevalence level (13.5%) from this study is in agreement with the 12% prevalence rate reported by Nkwoka I.J, Egua M.O, et al (2014) as well as within the range of 8.1% - 22.2% defined by Chukwuonye I.I, ChukuA.et al in 2013.

 Keywords: Obesity, Prevalence, Nigeria.

References:

[1] Abubakari AR, Lauder W, Agyemang C, Jones M, Kirk A, Bhopal RS. 2008. Prevalence and time trends in obesity among adult West African populations: a meta-analysis. Obes Rev. 2008 Jul;9(4):297-311. doi: 10.1111/j.1467-789X.2007.00462.x. Epub 2008 Jan 7

[2] Chukwuonye II, Chuku A, John C, Ohagwu KA, Imoh ME, Isa SE, Ogah OS, Oviasu E. 2013. Prevalence of overweight and obesity in adult Nigerians – a systematic review Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2013:6 43–47

[3] Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The evidence report. National Institutes of Health. Obes Res 6(Suppl 2):51S–209S. 1998

[4] Cynthia L. Ogden, Margaret D. Carroll, Brian K. Kit, Katherine M. Flegal. Prevalence of Obesity Among Adults: United States, 2011–2012. NCHS Data Brief, No. 131, October 2013

[5] Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011; 377:557-67.

[6] http://en.wikipedia.org/wiki/Childhood_obesity

[7] http://www.cdc.gov/healthyyouth/obesity/facts.htm

[8] http://www.who.int/dietphysicalactivity/childhood/en/

[9] http://childdevelopmentinfo.com/child-teen-health/weight-management-healthy-kids-teens/obesity-adolescents/#ixzz3BOVF7fd9

[10] http://www.cdc.gov/obesity/data/adult.html

[11] http://frac.org/initiatives/hunger-and-obesity/what-are-the-consequences-of-adult-overweight-and-obesity/

[12] http://www.mayoclinic.org/diseases-conditions/obesity/basics/risk-factors/con-20014834

[13] http://chealth.canoe.ca/channel_condition_info_details.asp?channel_id=143&relation_id=1711&disease_id=95&page_no=2

[14] http://en.wikipedia.org/wiki/Body_mass_index

[15] http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html?s_cid=tw_ob064

[16] http://emedicine.medscape.com/article/123702-treatment

[17] HHS. The surgeon general’s vision for a healthy and fit nation. Rockville, MD: HHS, Office of the Surgeon General. 2010

[18] Liam, J. D & Gabriel, S (2009), Donaldsons’ Essential Public Health, p.181.

[19] Ogden CL, Carroll MD, Kit BK, Flegal KM 2012.  Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. Feb 1;307(5):483-90. doi: 10.1001/jama.2012.40. Epub 2012 Jan 17

[20] Peeters .A et al; Annal of internal medicine, 2003 Jan 7; 138(1):24-32

[21] Park, K (2005), Park’s textbook of preventive and social medicine, p.316

[22] Reddy SP, Resnicow K, James S, Funani IN, Kambaran NS, Omardien RG, Masuka P, Sewpaul R, Vaughan RD, Mbewu A. 2012. Rapid increases in overweight and obesity among South African adolescents: comparison of data from the South African National Youth Risk Behaviour Survey in 2002 and 2008.  Am J Public Health. 2012 Feb;102(2):262-8. doi: 10.2105/AJPH.2011.300222. Epub 2011 Nov 28.

[23] Wikipedia, the free encyclopedia: http://en.wikipedia.org/wiki/Lagos_State.

[24] Wikipedia, the free encyclopedia: http://en.wikipedia.org/wiki/Badagry

[25] Wikipedia, the free encyclopedia: http://en.wikipedia.org/wiki/obesity.

[26] www.who.int/features/factfiles/obesity/facts/en/index1.html

[27] Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C (June 1995). “Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years”. Am. J. Epidemiol.141 (12): 1128–41.

[28] www.who.int/features/factfiles/obesity/facts/en/index1.html

Abstract:

BACKGROUND: Hypertension is an important risk factor for cardiovascular disease (CVD) and has become a major global burden on public health .Obesity and weight gain has been reported in previous studies as the most important determinants of hypertension. Close link between obesity and hypertension forms part of a broader relationship between body weight and blood pressure (BP) among others.

OBJECTIVES OF THE STUDY: This call for a study to a analyse the anthropometric risk factor profile correlates of blood pressure (BP) levels in a representative sample of market women in Juaben.

MATERIALS AND METHODS: The study was carried out using questionnaire as well as direct measurement within the period of March/April, 2015.

RESULTS: The study recorded high levels of prevalence of all the selected anthropometric risk factor profiles of high blood pressure (hypertension). A prevalence rate of 74% was noted for obesity. Among other variables, the following prevalence rates were recorded: 85.1% for excess WHR, 56% for excess abdominal circumference/girth, 84% for sum of various classes of hypertension for systolic and 48% for diastolic. An analysis of correlations of anthropometric profiles of height and BMI on systolic blood pressure were significantly correlated respectively (r=.417 and r=.366, p-value at 0.01). Contrary to this, statistically insignificant correlations were observed on both systolic and diastolic blood pressures respectively for weight r=.140 and r=.183; waist circumference r=.152 and r=.096; hip circumference r=.244 and r=.105; abdominal circumference/girth r= .082 and r=-.042; heart rate r=.187 and r=.141, p-value at 0.01). Among anthropometric variables, waist to hip ratio showed statistically insignificant correlation on BMI (r=.083, p-value at 0.01) whereas weight r=.792; height r= -.405; waist circumference r=.469; abdominal circumference/girth r=.446 were statistically significant on BMI (p-value at 0.01) and hip circumference (r=.371, p-value at 0.05)

RECOMMENDATIONS: Against this, this study proposed the following recommendations for consideration; organisation of health talk on weight management practices among market women. There should be an awareness creation on hypertension prevention as well as increased advocacy on vegetable and fruits intake.

References:

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[2] Amoah, A.G.B., Owusu, K.O., Adjei, S. (2002).Diabetes in Ghana: A Community Prevalence Study in Greater Accra. Diabetes Research and Clinical Practice, 2002; 56: 197-205.

[3] Birth to Twenty Study (2002). Physical Activity and South African Children –Some Shocking Findings. March 2002. Study Updates.

[4] Canadian Fitness and Lifestyle Research Institute (1998). Physical Inactivity Crisis Of Children And Youth Continues to Worsen. February 2, 1998.

[5] Center for Disease Control and Prevention (2001). Increasing Physical Activity: A Report on Recommendations of the Task Force on Community Preventive Services. Morbidity And Mortality Weekly Report 50:1-16

[6] Chen, Y.M., Ho SC., Woo, J.L., Leung, S.S., Lam, T.H., Janus, E.D. (2001) Association between simple anthropometric indices and cardiovascular risk factors. Int J Obes Relat Metab Disord;25:1689–1697.

[7] Dalton, M., Cameron, A.J., Zimmet, P.Z. (2003). Waist circumference, waist–hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med; 254:555–563.

[8] Dekkers, J.C., Treiber, F.A., Kapuku, G., Snieder, H. (2003). Differential Influence of Family History of Hypertension and Premature Myocardial Infarction on Systolic Blood Pressure and Left Ventricular Mass Trajectories In Youth. Pediatrics 111:1387–93

[9] Fava, C., Burri, P., Almgren, P., Groop, L., Hulthen. U.L., Melander, O. (2004). Heritability of Ambulatory and Office Blood Pressure Phenotypes in Swedish Families. J. Hypertens. 22:1717–21

[10] Ferguson, T.S., Younger, N.O., Tulloch-Reid, M.K. (2008). Prevalence of prehypertension and its relationship to risk factors for cardiovascular disease in Jamaica: Analysis from a crosssectional survey. BMC Cardiovascular Disord.;8:20.

[11] Field, A.E., Coakley, E.H., Must, A. (2001). Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Int Med.;161:1581–1586.

[12] Flegal, K.M.., Carroll, M.D., Ogden, C.L., Johnson, C.L. (2002). Prevalence And Trends In Obesity Among US Adults, 1999-2000.American Medical Assoc. Must et al., 1999).

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[14] Frantz, J., Phillips, J., Amosun, S. (2003). Promotion Of Physical Activity In South African Youth - Is It The Answer to the Public Health Burden Of Chronic Disease? African Journal for Physical, Health Education, Recreation And Dance 9(2): 200-207

[15] Galderisi, M., Benjamin, E.J., Evans, J.C., D’Agostino, R.B. (1993). Impact of Heart Rate and PR Interval On Doppler Indexes Of Left Ventricular Diastolic Filling. The American Journal of Cardiology, Ncbi.Nlm.Nih.Gov

[16] Garrow, J.S. (1988). Obesity and Related Diseases. London: Churchill Livingstone; 1988. Pp. 1–16.

[17] Ghana Statistical Service (GSS). (2004). Noguchi Memorial Institute for Medical Research (NMIMR)and ORC Macro. 2004. Ghana Demographic and Health Survey, 2003. Ghana Statistical Service: Accra, Ghana, 2004.

[18] Guo, S., Roche, A., Chumlea, W., Gardner, J., Siervogel, R. (1994). The Predictive Value of Childhood Body Mass Index Values for Overweight at Age 35. American Journal of Clinical Nutrition 59: 810-819.

[19] Hajjar, I., Jane, M. K., Theodore, A. K. (2006). Hypertension: Trends in Prevalence, Incidence, and Control .Annual Review Of Public Health. Vol. 27: 465-490

[20] Han, T.S., McNeill, G., Seidell, J.C., Lean, M.E.( 1997). Predicting intra-abdominal fatness from anthropometric measures: the influence of stature. Int J Obes Relat Metab Disord.;21: 587–593.

[21] Kannel, W.B.( 2000). Risk stratification in hypertension: new insight from the Framingham study. Am J Hypertens.;13:3S–10S.

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[28] Vasan, R.S., Larson, M.G., Leip, E.P., Evans, J.C. (2001). Impact Of High-Normal Blood Pressure On The Risk Of Cardiovascular Disease. New England Journal Of Medicine. Content.Nejm.Org

[29] World Health Organization.(1998). Obesity – Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity. Geneva: World Health Organization

[30] Wolf, H.K., Tuomilehto, J., Kuulasmaa, K., Domarkiene, S., Cepaitis, Z.(1997) . WHO MONICA Project. Blood Pressure Levels in The 41 Populations of the WHO MONICA Project. J Hum Hypertens 1997; 11:733-42. [Pubmed]

Abstract:

Vesico-vaginal fistula is an abnormal hole between the urinary bladder and the vagina leading to involuntary discharge of urine into the vagina. Vesico-vaginal fistula still remains one of the main morbidities of childbirth in developing world and Ebonyi Local Government Area of Ebonyi State is a typical example.

The study was aimed at identifying those predisposing factors to VVF in women of Ebonyi local government area of Ebonyi State. It is a cross-sectional descriptive community based study and a total of 386 women of child bearing age were assessed using interviewer administered questionnaires.

The study revealed that 80% (309) of the studied population were aware of VVF. The study also revealed that the predisposing factors to VVF were influenced by one’s level of education and employment status as both variables were statistically significant. Level of education and employment status were directly proportional to one’s knowledge and inversely proportional to those predisposing factors to the development of VVF.

In conclusion, major breakthrough is still needed in order to get the women of Ebonyi Local Government Area of Ebonyi State to actually know about VVF and those predisposing factors for the development of VVF. To decrease those predisposing factors that can lead to VVF; the study suggested advocacy, health education, economic empowerment of women, girl child education and improving the socio-economic status of women as tools to bringing the desired change.

References:

[1] Calle, A. 1992 unpublished. Fistula de origenobstetrico. Quito, Ecuador.

[2] Edström, J. 1992. Indicators for women’s health in developing countries: What they reveal and conceal. Institute of Development Studies Bulletin, 23(1), 38-49.

[3] Harrison, K.A. 1985. Child-bearing, health and social priorities: A survey of 22,774 consecutive hospital births in Zaria, Northern Nigeria. British Journal of Obstetrics and Gynaecology, 92 (supplement 5), 1-117.

[4] Kabir M. Medico social problems of vesico-vaginal fistula patients in Murtala Muhammed Specialist Hospital Kano. Bioline international- Annuals of African medicine 2004; (2): 54-57.

[5] Kelly, J.1979. Vesicovaginal fistulae. British Journal of Urology, 51,208-210.

[6] Kowalewski M, Mujinja P, Janh A. Can mothers afford maternal health care costs? User costs of maternity services in rural Tanzania. African Journal of Reproductive Health, 2002, 6(1): 65-73.

[7] Murphy, M; Baba, Tukur M. 1981. Rural dwellers and health care in northern Nigeria. Social Science and Medicine, 15A, 265-271

[8] Murphy, M. 1981. Social consequences of vesico-vaginal fistula in northern Nigeria. Journal of Biosocial Science, 13, 139-150.

[9] Nigerian demographic and health survey 2008, National Population Commission, Federal Republic of Nigeria, Abuja.

[10] Ojanuga, N.O. 1992. Education: the key to preventing vesicovaginal fistula in Nigeria. World Health Forum, 13, 54-56.

[11] Past M, Jack A, Manneh K. Evaluation of the traditional birth attendant training programme in the Gambia. “In press”.

[12] Preventing Maternal Mortality Network Team; Barriers to treatment of obstetric emergencies in rural countries of West Africa. Studies in Family Planning, 1992; 23: 279-291.

[13] Reducing maternal deaths: Evidence and action. A strategy for DFID. London Department for International Development. September 2004, www.dfid.gov.uk. (Accessed 30/03/2015)

[14] Tahzib, F. 1983. Epidemiological determinants of vesico-vaginal fistulas. British Journal of Obstetrics and Gynaecology, 90, 387-391.

[15] Royston, E.; Armstrong, S. (ed.). 1989. Preventing maternal deaths. WHO, Geneva, Switzerland.

[16] Tahzib, F. 1985. Vesicovaginal fistula in Nigerian children. Lancet, 1291-1293.

[17] Thaddeus S, Maine D. Too far to walk: Maternal mortality context. Social science and Medicine, 1994, 38:1091-1110.

[18] UNFPA, New York, 2004. Proceedings of South Asia Conference for the prevention and treatment of obstetric fistula. 9-11 December 2003, Dhaka, Bangladesh.

[19] Wall LL. Dead mothers and injured wives: The social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Studies in family planning, 1998, 19 (4):341-359.

[20] WHO [World Health Organization]. 1991. Maternal mortality and morbidity: Obstetric fistula. Women’s Global Network for Reproductive Rights. 37 (Oct.-Dec.) pp. 8-9.

[21] WHO (World Health Organization). 1989. The prevention and treatment of obstetric fistulae. Report of a Technical Working Group, Geneva, 17-21 April 1989. (WHO/FHE/89.5)

Abstract:

Diarrhoea continues to be one of the major causes of dehydration in the under-five population especially in the developing countries; resulting in high infant mortality rate, particularly in sub-Saharan Africa. Diarrhoea resulting to dehydration kills more children under five years of age than malaria, AIDS, measles and tuberculosis. It is actually the second leading cause of death in children under five in the world and responsible for 1.9 million deaths per year, following pneumonia, which kills 2 million per year. As such deaths via diarrhea represent 17% of deaths among children under-five; out of a total of 11 million deaths annually. This mostly results from the consumption of contaminated food and drinking of water from doubted sources. World-wide, around 1 billion people lack access to improve water and 2.5 billion have no access to basic sanitation. The objectives of the study were:

ü  To assess the knowledge of care providers in identifying cases with dehydration in the under-fives.

ü  To assess their practices toward the adequate management of dehydration in the under-fives.

ü  To find out the difficulties encountered in its proper management.

ü  To propose practical solutions in order to curb its occurrence.

A descriptive cross-sectional design was employed, in which primary data was collected from a sample in the study population in order to collect baseline data to be a representative of the study population during the study period, in order to assess the knowledge of care providers of Mankon Medicalized Health Centre and Nkwen Medicalized Health Centre in the assessment and management of dehydration in the under-fives.

Data was collected from care-providers of both Mankon and Nkwen Medicalised Health Centres who had served in these health facilities for at least six months and who are versed with the causes of dehydration in the under-fives, its clinical manifestations and the adequate implementation of proper management.

The convenient sampling technique for this study in which all the eight (8) care providers managing clinical cases in the medical ward and the twelve (12) care providers managing clinical cases in the paediatric ward of both Mankon and Nkwen Medicalised Centres were involved in the study and questionnaire administered to them.

A structured questionnaire was designed to collect primary data from respondents. This instrument was structured as such to tailor the specific objectives of the study:

Results show that; out of the 22 respondents, 11 (50%) were Nursing Assistants (NA), 2.0 (9.09%) were State Enrolled Nurses (SEN), then 8.0 (36.36%) were State Registered Nurses (SRN) and 1.0 (4.54%) a Bachelor in Nursing Science degree (BNSc).

Six nurses have worked for between 6-12 months, 7 nurses for between 1-5 years, 3 nurses for between 5-10 years and 4 nurses for between 20 years and above. Out of the 22 Care–providers, 13 (59.09%) suggested that dehydration is excessive loss of fluid from the body, while 9.0 (40.90%) of the respondents thought that dehydration is loss of body fluids and electrolytes. However, all the 22 respondents presented similar causes and clinical pictures and state that dehydration is classified into 3 types in terms of severity.

All the 22 respondents identified 3 types of dehydration and offered specific solutions as to each of them. They equally attribute specific length of time required to manage each type of dehydration. The 22 participations also thought that to properly manage this condition, appropriate tools (urinary bag or any calibrated bowl) should be used to estimate the amount of fluid lost.

On the clinical manifestations of dehydration, 49 responses were gotten as follows, 11 (23.40%) could not distinguish signs and symptoms as to mild, moderate and severe dehydration, 12 (25.53%) stated difficulties as regard to management approaches, while 24 (51.06%) related their difficulties to mother’s compliancy.

All the respondents suggested similar causes and clinical pictures and classified it into three types. All of them above implies that with the knowledge on dehydration, nursing staff can easily reverse this condition with less fatality using specific management approach corresponding to the degree of dehydration, and prevent complications.

Health advice offered to mothers by nurses on the management approaches at home fall under four items viz: O.R.S., water and fluid, nutrition and hygiene. 18 (33.96%) provided health talks on hygiene. If faeco-oral infections should be avoided, hygienic measures must be implemented, 14 (26.41%) nurses advocated on the use of O.R.S which should be taken at home.

 Keywords: Sanitation, Diarrhoea, Dehydration, Under-fives, Oral Rehydration solution, Hypervolemia, Fluid Replacement Therapy

References:

[1] Angelucci D. Todaro A. (1993): Reversing acute dehydration Nursing.

[2] Cumberland, David A.K, Lain H. Wilson, Richard J. Leaver, Antonia B. (2009): Care of the critically ill patient in the Tropics and Sub-tropics (first edition, pp. 76, 81-83).

[3] Hillie T (2006) Nanotechnology, water, and Development. Dillon, Meridian institute.

[4] Hoxie NJ, Davis JP, Vergeront JM, Nashold RD, Blair KA (1997)

Cryptosporidiosis-associated mortality following a massive waterborne outbreak in Milwaukee, Wisconsin. Am J Public Health 87: 2032-2035.

[5] Hunter P (1997) Waterborne Diseases. Epidemiology and Ecology.

Chichester: Wiley.

[6] Kumar SG, Jayarama S (2009) Issues related to sanitation failure in India and future perspective. Indian J Occup Environ Med 13: 104.

[7] Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, et al. (1994). A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply. N Engl J Med 331: 161-167.

[8] Meinhardt PL (2010) Recognizing water borne disease and the health

effects of water pollution: American Water Works Association and Amot Ogden Medical center.

[9] Sprigge N.M., (2010): Fluids and electrolytes balance: Nursing consideration (second edition), Philadelphia: Lippincott.

[10] Pandve HT (2008) Environmental sanitation: An ignored issue in India. Indian J Occup Environ Med 12: 40.

[11] United Nation Children’s Fund (2009): Dehydration in the under-fives.

[12] World Health Organization (2003) Guidelines for Drinking water

Quality, 3rd edn.

[13] World Health Organization (2010): Integrated Management of Childhood Illness: Treat the child.

Abstract:

Each year, there is an estimated 220 million deaths caused by malaria leading to approximately one million deaths mostly among children under five years of age. There is a growing international agreement to use prevention and treatments methods that are available against malaria. The most effective method include; the use of mosquito bed nets treated with long lasting insecticide (LLINs) to avoid mosquito and to kill mosquito and spraying the inside wall of the houses with similar to kill malaria carrying mosquitoes. In 2013 an estimated 136million LLINs were delivered in endemic countries, a major increase over the 70million bed nets were funded for delivery in 2014 and suggesting an even stronger pipeline for 2015. Population access to LLINs remain below the target universal coverage and has not appreciably improved.

Malaria being a fatal disease is becoming difficult to prevent and control because of the habit of increasing resistance to the insecticides of the female anopheles mosquito.

In Cameroon, malaria remains a public health problem and responsible for 31% of consultations and 44% of hospitalization in health facilities. It is responsible for 18% of deaths occurring in Cameron .In children less than 5 years 31% of deaths are due to malaria.

The use of LLINs in Cameroon is still a problem, that is why in world malaria days from 2013-2015 the theme has been “invest in the future, defeat malaria to call attention to the effort to finish the job this 2015 calling for high level commitment to the vision of a world free of malaria”.

The general objective was to find out the factors affecting the acquisition and proper usage of LLINs as a primary preventive measure against malaria and to propose possible solutions to identified problems.

The specific objectives of the study were:

1.      To assess the community’s knowledge on malaria prevention.

2.      To assess their practical measures used in preventing malaria through the use of LLINs.

3.      To find out the proportion of the community with LLINs properly installed and utilized.

4.      To ascertain the constraints encountered by the community in its proper usage and propose possible solution to any identified problems.

A descriptive cross-sectional study was employed in which data was collected on the acquisition and proper use of LLINs in the Batibo health area.

The study population constituted of the inhabitants of Batibo health area community.

A sample of 100 respondents were randomly selected using the systematic random sampling method to represent the entire population of Batibo Health Area). Results show that on the distribution of respondents relative to whether they have LLINs; it was observed that out of the 100 respondents 62% had LLINs while 38% did not have, 12 (19.35%) of the respondents said they have never had LLINs , 28(45.26%) said LLINs are not enough while 22( 35.48%) said the one they had is bad. The reason why LLINs may not be enough maybe because of increase in household members as 46 % of the respondents have more than four members per household.

It was equally observed that out of the 38 respondents who had LLINs they were not properly used as only 10(26.5%) said they sleep under LLIN every night,8(21.0%) said when they feel cold and 20(52.6%)said they like.

Conversely, out of the 38 respondents who had LLINs 16(42.1%) said everybody in the household sleep under LLINs while 22(57.9%) said not everybody sleep under LLINs. It was observed that not everybody sleep under LLINs because 13(34.3%) of the respondents said they were old, 2(5.2%) said they do not know why and 2(5.2%) said it is because of negligence.

In conclusion, from the results obtained it was found out that; most people do not use nets because the nets are insufficient and may be because of increasing number of per household compared to the number of LLINs given per household. In the community the relationship between mosquito and malaria well known but many people are not aware of the night-biting female anopheles mosquito that transmit the malaria parasite may be contributing to the fact that many people still reluctant to use the net properly as a primary preventive measure against malaria.

The peripheral level has a great task in the implementation of the proper use of LLINs and to let the net users understand that heat production and not breathing well are minor effects to some people at the beginning of the use of LLIN but after sometime these effects will disappear.

Key words: Long lasting Insecticidal Bednets, Female anopheles mosquitoes, Malaria, Installation, Residual spraying, Prevention, Vulnerable, Under-fives

References:

[1] Adjei K, Calman PK (2011): Targeting of malaria for control and elimination.

[2] Alexander B K ,Paul Lewsein (1996): Creating a world without mosquito nature.

[3] Atkinson JA Babagare (2009): Guidance and evidence for malaria elimination.

[4] Bardaji HJ (2012): Intermittent preventive treatment of malaria in pregnant women.

[5] Barik TY (2011): Malaria vector control from past to future.

[6] BBC news (2011): Scientists has created sperm less in an effort to curb the spread of malaria.

[7] Breman M R (1995): The standard of malaria prevention advice in UK primary care.

[8] Canyon DV Hii (1997): Environmental friendly biological agent for mosquito control medical and vertinary entomology.

[9] Center for Disease control (2012): http//www.cdc.gov/malaria.

[10] Curtis et al (2000): Development and field evaluation of synthetic mosquito lure that is more attractive than humans.

[11] Enayati OZ, Peter KL (2010): The impact of pyrenoid resistance on the efficacy of insecticide treated nets against African Anopheles mosquitoes.

[12] Esther Tallah (2012): Cameroon coalition against malaria prevention: scaling up for impact in Cameron.

[13] Health Records (2014): Statistic on malaria prevalence.

[14] Iratana ST (1999): Comparism of house spraying and insecticide treated nets for malaria control.

[15] J.A.A Le Prince (2005): Control of mosquito oiling as an anti-mosquito measure Public Health report.

[16] Jennifer Carpenter (2011): Sperm-less mosquito hold promise to stop malaria.

[17] Kayfast DF, Gilbert GH (2009): Changing perspectives on malaria.

[18] Kenneth Mackay (1995): Mosquito control through vector source reduction part iii interaction 31: A comparative study of the ability of fish to catch mosquito lava.

[19] Kijchalao YJ, Lawrence TH (1988): The use of mosquito nets as blankets.

[20] Lallow NB, Franck DH (2000): Guidelines for malaria prevention in travellers Public Health England.

[21] Lengeler (2003): Insecticide treated nets and curtains for preventing malaria the Cochrane data base.

[22] Mehlhorn (2008): Preventing malaria in travellers from malaria endemic zones.

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[24] Science and Education (2014): Education and Leadership Development/defeating malaria.

[25] UN (2000): United Nation Millennium Development Goals.

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[29] WHO (2005): Combination of chemotherapy for the treatment of malaria.

[30] WHO (2006): Guideline for testing mosquito adulticide for indoor residual spraying and treatment of nets.

[31] WHO (2008): World malaria Report: Global malaria control and eradication.

[32] WHO (2009): Control to eradicate malaria.

[33] WHO (2010): Annual Funding for malaria control.

[34] WHO (2012): National malaria control program report.

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[36] WHO (2014): World malaria report on things you need to know about malaria.

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Abstract:

Introduction: Achieving universal access to HIV services requires a mixture of strategies to increase opportunities for people to know their HIV status. APIN in conjunction with civil society organization and with funding support from Global Fund (GF) and National Agency for AIDS Control (NACA) embarked on community HTC outreach campaigns in Lagos, Plateau and Oyo States of Nigeria. Community entry, advocacy and mobilization were key start up strategies. 

Methods/Approach and Result: Partnership with Civil Society Organizations with strong presence leadership roles within the communities was the main approach to a community based approach to increasing uptake of HTC services in the three (3) states of Nigeria where AIDS Prevention Initiative in Nigeria operated. Eighteen (18) LGAs, 189 communities and 154 ANC locations across three states benefited from the outreaches. 54,841(1.2% positivity rates) people among the general population and 36,061 (0.19% positivity rates) pregnant women were provided with HCT services over three weeks.

Conclusion: Alternative approaches to facility based HTC are critical to achieving universal access to HTC. Community based approach to HTC that relies on strong partnerships and collaboration with organizations that have commitments and leadership roles in the communities can improve uptake of services. It is a veritable approach for expanding access, availability and coverage of HTC services.

Keywords: Community, Partnership, Access, Uptake, eMTCT, Advocacy, Mobilization

References:

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Abstract:

Objective: To evaluate the factors leading to the prevalence and secular trends for overweight and obese among the adolescents in junior high schools.

Methods: A qualitative study review of literature was conducted on facilitating factors to the prevalence and secular trends, obesity prevention in junior high schools. Theoretical sources of information relevant to obesity (idea-based) were used. Primary, secondary and tertiary sources were used to have a broader overview of obesity. The general approach was a combination of chronological thematic and conceptual concepts. A descriptive analysis of the objectives was done

Results: The obesogenic prenatal environment or the physical form of our community play a vital role and that can also promote obesity in young people through epigenic effects

Conclusion: It was found that high-fat and energy dense diet has tremendously increased in the 21st century while most young population have increasingly lead sedentary lives. The life style of fast foods and little physical activity have increased the prevalence of obesity among school going children, adolescent and adults too. The related obesity and chronic disease risk factors have become major public health concerns. Multilevel model is related to local ecological model on the principal of preventing obesity. Therefore multilevel is a good model to prevent obesity in school. The risk regulations–health behaviour–genetic factors model approach laid a good ground for strategic prevention of obesity and evaluation of multilevel model practices, food intake, production and physical activities.

 Key words: Obesity, Junior high schools, Obesogenic prenatal environment, Multi-level model, Risk regulators-Health behaviour-Genetic factors.

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