University of Ibadan ADHL Node

RISK FACTORS ASSOCIATED WITH BREAST CANCER AMONG WOMEN IN TWO REFERRAL CENTRES IN NIGERIA

2014-07-01T00:00:00Z

RISK FACTORS ASSOCIATED WITH BREAST CANCER AMONG WOMEN IN TWO REFERRAL CENTRES IN NIGERIA EMEJI, E.K. Breast Cancer (BC) is a common cause of death among Nigerian women. Past studies suggest that diet, lifestyle and environmental pollutants are more important risk factors in the aetiology of cancers. Identifying some of these factors is vital to directing strategies for intervention in specific locations. This study was carried out to determine risk factors associated with BC among women in two referral hospitals in Nigeria. A case-control study was carried out among 266 women aged 20-80 years. Warri Central Hospital and University College Hospital were purposively selected based on their Management's approval to be part of the study. 35 and 30 cases of BC were recruited from the hospitals, respectively. For the controls, consenting women in Warri ( 111) and Ibadan (90) were enlisted from neighbouring households in the same enumeration areas as the cases. Cases and controls were matched in the ratio of 1:3 for age and duration of stay in area of residence. A semi-structured questionnaire was used to collect data on socio-demographic characteristics, family history of breast cancer, dietary pattern, nutritional status, physical activity and environmental factors. Food frequency questionnaire was used to assess high risk food intake where consumption of high calorie-containing food ≥3 times week was categorised as high and <3 times a week as low. Body mass index (kg/m2) and waist-to-hip ratio were used to determine respondent's nutritional status and abdominal fat, respectively. Physical activity was measured using WHO standard (where exercise for at least a three times per week was categorised as good while less than three times a week as poor. Frequency of exposure to automobile, generator, industrial fumes and effluents was categorised qualitatively as daily, occasional and rarely. Data were analysed using descriptive statistics, Chi-square test and logistic regression at 5% level of significance. The mean age of the respondents was 48.7±11.8 years. Family history of breast cancer was reported by 6.2% of the cases and 5.0% of controls. Dietary pattern revealed that cases (69.2%) and controls (54.7%) significantly had high risk consumption pattern for high calorie containing foods. Cases were significantly more overweight than the controls (41.5% versus 21.4%). Higher proportion of controls (58.6%) than the cases (22.9%) had high risk abdominal obesity. Significantly more controls than cases had good exercise (17.9% versus 6.2%). The odds of developing breast cancer was four times higher among women who reported daily exposure to fumes from automobiles and generators than those who were rarely exposed (OR-=4.40, CI= 1.25-15.57), seven times higher among women who reported occasional exposure to wastes from operating industries than those who were rarely exposed (OR=6.91, CI=2.87-16.66). Major risk factors for breast cancer among women in Warri and Ibadan were lack of exercise, high calorie containing food intake, environmental pollutants and nutritional status. Health education to improve knowledge of self-protection against pollutants and adoption of healthy dietary habits may reduce risk of breast cancer. A Dissertation in the Department of Epidemiology and Medical Statistics, submitted to the Faculty of Public Health, College of Medicine, University of Ibadan in partial fulfillment of the Degree of Masters of Public Health (Field Epidemiology) of the University of Ibadan

POTENTIAL BARRIERS TOWARDS REPORTING OF SUSPECTED LASSA FEVER CASES BY HEALTHCARE WORKERS IN IBADAN

2012-08-01T00:00:00Z

POTENTIAL BARRIERS TOWARDS REPORTING OF SUSPECTED LASSA FEVER CASES BY HEALTHCARE WORKERS IN IBADAN MMADUIKE, E.C. Without knowledge of disease occurrence, health officials are limited in their ability to identify sources of illness and prevent further disease in the community. There is need for healthcare workers to remain alert to endemic infectious diseases of this nature and to institute appropriate measures to promptly identify cases and report them, protect themselves and care-givers. Effective prevention and control will depend on accurate and prompt diagnosis with urgent reporting to appropriate authorities and institution of appropriate control guidelines to abort this trend. This study is designed to assess the potential barriers towards reporting of suspected Lassa fever cases by doctors and nurses in public health facilities in Ibadan. A descriptive cross-sectional study design was employed. Stratified simple random sampling was used to select a total of 238 doctors and nurses who work at the public primary (70), secondary (36) and tertiary (132) levels of public health facilities in Ibadan. A self-administered, structured questionnaire and an observational checklist which contained items on socio demographic details, knowledge of Lassa fever and it's reporting through the integrated disease surveillance and response strategy, attitude to Lassa fever reporting, factors associated with reporting practice and availability of infrastructures for reporting of the suspected cases was used to collect the data. Knowledge of Lassa fever and its' reporting was scored based on 25 and 22 questions respectively from the knowledge sections. Participants with scores ≥12 and ≥9 respectively were categorized as having good knowledge of Lassa fever and its' reporting respectively. A total of 255 questionnaires were distributed and 238 were returned completed giving a response rate of 93.0%. The mean age of the respondents was 36.5 ± 9.3years. Only 28.2% of the respondents reported an awareness of the integrated disease surveillance and response (IDSR) diagnostic criteria for Lassa lever. A little proportion (28.4% and 21.6%) of the participants had good knowledge of the disease and it's reporting through the lDSR strategy respectively. The potential barriers towards reporting of suspected Lassa fever cases identified in this study were knowledge of the disease(AOR 2.3,95% CI 1.1-4.8) , knowledge of its' reporting through the integrated disease surveillance and response (IDSR) strategy (AOR 2.2, 95% 1.0-4.8), involvement in outbreak investigations(AOR 0.2, ) 95% CI 0.1-0.5), availability of posters (AOR 3.3,95% C.I 1.4-7.9) and manuals in clinics (AOR 0.1, 95% Cl 0.1-0.3). Lack of knowledge of reporting requirement was identified as a major barrier affecting disease reporting among doctors and nurses at the three levels of health care facilities in Ibadan. The training and retraining of health workers responsible for data generation, collection and forwarding in health facilities on notifiable diseases, availability of posters and manual on these notifiable diseases in the facilities are recommended in order to improve the disease surveillance system. A Dissertation submitted to the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment for the requirement of the award of Masters of Science Degree in Epidemiology of the University of Ibadan

WEALTH STATUS AND SEXUAL PARTNERSHIP PATTERN AMONG NIGERIAN MEN: EVIDENCE FROM THE 2007 NATIONAL HIV/AIDS AND REPRODUCTIVE HEALTH SURVEY (NARHS))

2012-07-01T00:00:00Z

WEALTH STATUS AND SEXUAL PARTNERSHIP PATTERN AMONG NIGERIAN MEN: EVIDENCE FROM THE 2007 NATIONAL HIV/AIDS AND REPRODUCTIVE HEALTH SURVEY (NARHS)) OJO, M.O. Sexual behaviour in Nigeria is guided by traditional norms and values which differ among ethnic groups. However, the decline in traditional values associated with urbanization, engaging in premarital and extramarital sex have increased due to availability of commercial sex workers (CSWs) in urban and rural areas thus increasing the number of potential partners for sexual partnership. The scantly investigated notion in Nigeria and some other regions in sub-Saharan Africa (SSA) that men are biologically different from women in their need for sex is played out in their risky sexual behaviour pattern like concurrency, multiple sexual partnership and inconsistent condom use with casual partners or CSWs. This study was designed to investigate correlate and pattern of sexual partnership among Nigerian men. Data from 6165 sexually active men aged 15-64years who participated in the National HIV/AIDS and Reproductive Health Survey (NARHS) were extracted from the main data. Wealth index was computed from data on assets (household item) ownership from factor scores generated using Principal Component Analysis (PCA). Data were analyzed using Descriptive statistics and multilevel logistic regression models. Odds ratios with 95% confidence interval were obtained. There were variations in sexual partnership across location, ethnic group, region and wealth status. Respondents from urban areas were mostly in the middle-class ( 47.8%) while rural dwellers (55.6%) and men from the northern region were mostly in the poorest group. Wealth status did not influence men's multiple sexual partnership. When contextual factors was controlled for, the odds of having multiple sexual partners was 5% (OR=1.05, (95%CI=0.89-1.25) higher for men in the middle class and lower (OR=0.95, 95%CI=0. 76-1.18) for those in the poorest group compared to men in the richest group. The odds of having non-regular sexual partner was lower for men in the poorest group (OR=0.91, 95% CI=0.68-1.22) and 12% higher for men who were moderately rich (OR= 1.12, 95%CI=0.88-1.41 ). The hypothesis that wealth was associated with number and type of sexual partnership was not confirmed. The study concluded that the pattern of sexual partnership among Nigerian men varies according to individual characteristics and behavioural factors than their contextual characteristics. A Dissertation submitted in partial fulfillment of the requirement for the award of the Degree of Master of Science in Biostatistics, Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan

BREAST CANCER RISK PREVALENCE, PERCEPTIONS AND PREVENTIVE PRACTICES AMONG FEMALE HEALTH WORKERS AND MARKET WOMEN IN IBADAN, OYO STATE: A COMPARATIVE STUDY

2014-07-01T00:00:00Z

BREAST CANCER RISK PREVALENCE, PERCEPTIONS AND PREVENTIVE PRACTICES AMONG FEMALE HEALTH WORKERS AND MARKET WOMEN IN IBADAN, OYO STATE: A COMPARATIVE STUDY OLANLOYE, E.E. As the high prevalence of risk factors for breast cancer gains increasing global attention, a woman's perception of her risk of developing breast cancer plays a vital role in determining her willingness to participate in preventive measures. This study aimed to determine and compare breast cancer risk prevalence, perception and preventive practices among female health workers and market women in Ibadan, Oyo State. A comparative cross sectional study comprising of 336 consenting female health workers at the University College hospital and 342 consenting market women in Aleshinloye market in Ibadan, Oyo state was carried out. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, breast cancer awareness and knowledge, preventive practices, prevalence of breast cancer risk factors and risk perception of breast cancer. Data was analysed using descriptive statistics, Independent t-test, Chisquare test and logistic regression at p<0.05. The overall mean age of all respondents was 39.9 ±9.9 years [health workers 39.4 ±8.0 and market women 40.4 ±11.4]. The proportion of respondents among health workers and market women who were aware of SBE, CBE and mammography as breast cancer screening methods were (51.9% vs 48.1%), (51.5% vs 48.5%) and (63.9% vs 36.1%), respectively. Overall mean knowledge score of breast cancer was significantly higher among health workers (31.1 ±5.9) compared to market women (22.60±6.5), p<0.001. The proportion of health workers who perceived their risk of developing breast cancer as "not at all" or "rarely" (52.1 %) was higher than the market women (47.9%). The proportion of respondents who practised SBE was similar among both health workers and market women (58.5% vs 41.5%), whereas practice of CBE and mammography were significantly higher among health workers compared to market women [86.0% vs 14.0% and 80.8% vs 19.2% respectively). A significant association was found between risk perception and breast cancer worry in both study group (Health workers: OR=0.20, CI=0. l 0-0.4 l and market women: OR=0.05, CI=0.02-0. 10). Respondents with family history of breast cancer were five times more likely to have practised CBE than those with no family history among health workers (OR=5.24, CI=1.15-24.01) while among women, practice of CBE was associated with attendance at training programs (OR=12.00, CI=1.57-91.67). Mammography practice among health workers was significantly associated with urban location of residence (OR=0.35, CI=0.12-0.97). The high awareness and good knowledge of breast cancer and its screening methods found in this study did not translate into practice of the screening methods among the female health workers. Interventions aimed at imparting positive attitude so as to enhance practice should be directed to both health workers and market women. A Dissertation in the Department of Epidemiology and Medical Statistics submitted to the Faculty of Public Health, in partial fulfillment for the degree of Master of Science (Epidemiology and Medical Statistics) of the University of Ibadan

INFLUENCE OF SOCIAL ACTIVITY ON ELDERLY (AGED 65+) SURVIVAL IN IDIKAN, IBADAN, OYO STATE, NIGERIA

2012-06-01T00:00:00Z

INFLUENCE OF SOCIAL ACTIVITY ON ELDERLY (AGED 65+) SURVIVAL IN IDIKAN, IBADAN, OYO STATE, NIGERIA OSUNTOKUN, T.O. There was a dearth of information on the relationship between social activities and survival of Nigerians at older age. This study provides some knowledge on the influence of social activity on the longevity of some Nigerians in Oyo State. The main purpose of the study was to identify the relationship between social activities and survival of the aged (65+) in Idikan area of Ibadan, Oyo state, Nigeria, after adjusting for potential confounders. This was a retrospective study, and a secondary analysis of data generated from a larger longitudinal prospective study. The study population consisted of all the elderly persons, aged 65 years and above living in Idikan area of Ibadan, Oyo State, Nigeria who were recruited into the Ibadan-Indianapolis Dementia Research Project at the initial stage in 1992/1993. The sampling method adopted was a total sampling of the entire study population. Detailed information on the subjects' socio demographic background, life style and health history were collected at baseline in 1992/1993 with mortality follow-up of 17 years. Simple descriptive statistics were used to summarize the data and appropriate test statistics used to investigate relationship between variables. Kaplan Meier Curve and Cox regression model were used to describe and model survival from the start of the study to the end, examining the influence of the variables collected on survival and adjusting for potential confounders with p-value <-0.05 and a 95% confidence interval. SPSS 11.0 for Windows was used to run the entire analyses. The studied population size was N= 2, 485. About 9% of the population was of age 85 years and above with majority (72.1 %) between the age of 65-74 years and a male to female ratio of 1:2. A higher proportion of those who had impaired cognition, not socially active and males had died including those ever smoke and drink. The overall median survival time for the 17 years mortality fo llow up period was estimated to be 8 years with the probabi lity of surviving past it, approximately half. Kaplan Meir Curve showed that those who were not socially active presented with a poor survival than their counterpart and this was statistically significant at 5% levels. Cox regression model result showed that participation in social activities, gender, age, literacy status, presence of chronic disease(s) and cognitive status had influence on survival except for living arrangement, alcohol consumption and smoking that were not significant at p :5 0.05. The study showed that those who were socially active were almost one and a half times more likely to live longer than those who were not socially active with p-value of 0.000 and a 95% C.I of 1.358 to 1.743. Conclusion: Participation in social activity was found to be preventive measure against early death. It contributed considerably to achieving longevity and these highlights the need to consider formulating programs surrounded with social activities for elderly people in the society, aimed at promoting longer life. A Dissertation submitted in partial fulfillment of the requirements for the award of Master of Science in Medical Statistics, Department of Medical Statistics and Environmental Health, Faculty of Public Health, College of Medicine, University of Ibadan

AGE AT FIRST SEXUAL INITIATION AND HIV RISK PERCEPTION AMONG NIGERIAN YOUTHS

2012-07-01T00:00:00Z

AGE AT FIRST SEXUAL INITIATION AND HIV RISK PERCEPTION AMONG NIGERIAN YOUTHS SHITTU, R.A. Many young people do not receive adequate preparation about the dangers associated with early sexual initiation which leaves them vulnerable to coercion, abuse, exploitation, unintended pregnancy and sexually transmitted infections, including HIV/AIDS. Therefore, the aim of this study was to examine the age pattern of youth sexual initiation and its predictors among a nationally representative sample. This study was a secondary analysis of data from National HIV/AIDS and Reproductive Health Survey (NARHS). A total of 4366 records of youth aged 15-24 years were extracted. Kaplan Meier survival analysis and Log rank test was used to identify factors associated with sexual initiation, Cox proportional hazards models to identify the predictors of sexual initiation and multinomial logistic regression was used to examine youth HIV self-risk perceptions. There were 2359 (50.9%) males and 2274 (49.1 %) females with male: female ratio of 1.03: 1. The mean age of the respondents was 17 .01±2.7 yrs.The cumulative rate of sexual initiation was 76.2% at 24 years of age. The risk of sexual initiation was lower for youths in South East (HR = 0.44; 95% CI= 0.37 - 0.52, p<0.05) compared to the South South. The risk of sexual initiation was lower in male respondents (HR = 0.49; 95% C.1= 0.45 - 0.53 , p<0.05) compared with female respondents. Urban respondents (HR = 0.809; 95% C.I= 0.735 - 0.891. p<0.05) commenced sexual intercourse later than rural counterparts. A higher proportion of the respondents 2632(63.2%) perceived no risk of HIV infection, 34.1% perceived low risk and 2.6% perceived high risk. HIV risk perception was about 2 times higher among the respondent with primary level of education (OR =2.44; 95% C.I= 1.10 5.43, p<0.05) compared with those with no formal level of education. Also, the odds of high HIV risk perception is lowest in the North West (OR =0.12; 95% C.l= 0.05 - 0.30, p<0.05) and highest in the North East region (OR = 0.94; 95% C.I= 0.50 - 1.76, p<0.05) compared with South South. The odds of low HIV -risk perception reduced by 3.6%. Also, the odd of low risk perception is about 1.6 times higher among respondents with higher level of education (OR = 1.61; 95% C.I= 1.16 - 2.23, p<0.05) compared with respondents with no formal education. The North West (OR=0.42: 95% C.I 0.33 - 0.54, p<0.05) respondents were about 58.1 % less likely to perceive low HIV risk. The findings from this study showed that substantial geographical variation exists in the rate of first sexual initiation within Nigeria. Also, majority of Nigerian youths perceived themselves as having low risk for HIV infection. There is strong evidence that the risk of early intercourse was associated with respondents' sex, education attainment, residence and geopolitical zone. A Dissertation submitted to the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment for the requirement of the award of Masters of Science in Biostatistics

CORRELATES OF CONDOM USE AMONG WOMEN OF REPRODUCTIVE AGE IN NIGERIA: EVIDENCE FROM 2007 NATIONAL HIV/AIDS AND REPRODUCTIVE HEALTH SURVEY (NARHS)

2012-08-01T00:00:00Z

CORRELATES OF CONDOM USE AMONG WOMEN OF REPRODUCTIVE AGE IN NIGERIA: EVIDENCE FROM 2007 NATIONAL HIV/AIDS AND REPRODUCTIVE HEALTH SURVEY (NARHS) OLAWUWO, SIMEON In Nigeria, studies have confirmed high prevalence rates of the HIV/ AIDS pandemic among the poor, majority of who are women of childbearing age. The number of HIV-positive children is increasing, with mother-to-child transmission as the principal route of infection. Since good health is basic to human welfare and a fundamental objective of social and economic development, this study provides insight into what exposes Nigeria women to high risk of HIV. Data were collected by personal interview method using structured and semi-structured questionnaire. A sample of 5360 subjects was selected through multi-staged sampling process. The subjects are females of reproductive age (15 to 49 years old). Preminary findings showed that the prevalence of condom use was very. low with only 22.6% being ever users. Knowledge of HIV transmission was still low among the respondents; only 26.8% knew the correct ways of contracting HIV. The prevalence of ever use of condom was highest among respondents aged 20-24 years (29.1 %) and lowest among teens (11.8%). Respondents age 15-19 are 2.8 times more likely to have ever used condom compared to those who were 25 years and above (OR=2.759, 95% CI; 1.925-3.955). The odds of ever use condom was 95% lower among respondents who had their first sex before age 20 compared to those who had their sex when they were 25 years and above. It was revealed that educational attainment is negatively associated with ever use of condom. It was also shown that women in the poorest group are 44% less likely to have ever used condom while those in the middle class are 26% less likely to have ever used condom compared to those who.are in the richest group. Urban dwellers are 1.5 times more likely to have ever use condom compared to their rural counterparts. Women who are having multiple sexual partners are 2.1 times more likely to have ever used condom compared to those who do not while respondents who took alcohol are 1.3 times more likely compared to those who do not take alcohol and the odds of ever use condom was 28% higher among women with no knowledge of HIV transmission routes compared to those with accurate knowledge of HIV transmission routes. In Conclusion, the study affirmed the linkage between alcohol use, and HIV/AIDS in one hand and also between religion and risky sexual behavior on the other hand. Knowledge of HIV/ AIDS, mode of transmission and prevention is still not very high among the respondents. Also, the cultural practice of multiple sexual partners is of serious concern in both the spread and risk sustaining factor of HIV/AIDS. Efforts at combating HIV/AIDS should take cognizance of Nigerian women many of whom may be difficult to reach through media. A Project submitted in partial fulfillment of the requirement for the award of the Degree of Master of Science of Degree in Biostatistics, Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan

ASSOCIATION BETWEEN EXPERIENCE OF INTIMATE PARTNER VIOLENCE AND CONTRACTING SEXUALLY TRANSMITTED INFECTIONS AMONG CURRENTLY MARRIED WOMEN IN NIGERIA

2014-04-01T00:00:00Z

ASSOCIATION BETWEEN EXPERIENCE OF INTIMATE PARTNER VIOLENCE AND CONTRACTING SEXUALLY TRANSMITTED INFECTIONS AMONG CURRENTLY MARRIED WOMEN IN NIGERIA SIGBEKU, O.A. Intimate partner violence (IPV) is an important public health issue that occurs worldwide and is associated with adverse sexual and reproductive health outcomes including sexually transmitted infections (STis). STis have recently gained more recognition worldwide because it increases the risk for HIV infection. However, there is dearth of information on the association between IPV and STis particularly among currently married women. This study therefore aimed to determine the association between IPV and STis after controlling for significant risk factors for STis among currently married women in Nigeria. This study involved a secondary data analysis of the 2008 Nigeria Demographic and Health Survey (NDHS) dataset. This was a national survey which used a cross sectional population based study design. The primary data obtained from the survey was collected with interviewer administered questionnaires using a stratified two-stage cluster sampling technique in the selection of the respondents. Based on the random selection of one woman per sample household who responded to questions from the domestic violence module questionnaire and who were currently married, a final sample size of 18402 was obtained. Data was analyzed using SPSS version 19. Frequency tables were used to show the distribution of respondents by the variables of interest. Values were expressed as absolute numbers and percentages while appropriate diagrams were also generated. Chi-square test was done to determine associations between STI and independent variables at 5% level of significance. Thereafter, independent variables that were significant at the 10% level of significance were included in multiple logistic regression models to identify risk factors for STis. Results: The prevalence of IPV among currently married women in Nigeria was 29.3%. Majority of the women experienced emotional violence (22.1 %), 17.3% of the married women experienced physical violence while the least experienced form of violence was sexual IPV (4.4%). In addition, majority (17.6%) of the married women experienced just one type of IPV. The experience of multiple types of IPV was also demonstrated such that 8.8% of the married women experienced two types of IPV and 2.9% experienced all three types of IPV. A small proportion (7.2%) of married women had a recent history of STI with genital discharge being the most prevalent symptom. Currently married women who had tertiary education, had ever terminated a pregnancy, had ever had more than one sexual partner, had an early age at sexual debut, drank alcohol during the last sexual intercourse, and lacked autonomy in making decisions had the greatest risk of contracting STis. Logistic regression also revealed that after controlling for other covariates, currently married women who experienced any form of IPV were found to be 1.3 times more likely to report STI than currently married women who did not experience any form IPV. In addition, physical and sexual violence experienced by currently married Nigerian women remained significantly associated with history of STis. There was also a demonstrated significant association between experiencing two or three types of IPV and STis. There is a need to incorporate IPV screening and services in gynaecologic clinic settings as well as screening for STis among women who present with IPV particularly multiple forms of violence. A Thesis submitted to the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment for the requirement of the award of Masters of Science in Epidemiology and Medical Statistics

TREATMENT OUTCOME AMONG PATIENTS WITH TUBERCULOSIS AND TUBERCULOSIS CO-INFECTED WITH HIV/AIDS ON DOTS IN UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU

2012-08-01T00:00:00Z

TREATMENT OUTCOME AMONG PATIENTS WITH TUBERCULOSIS AND TUBERCULOSIS CO-INFECTED WITH HIV/AIDS ON DOTS IN UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU ANIWADA, E.C. Nigeria is ranked 10th among the world TB most burdened country with an incidence of 133/100,000, prevalence of 199/100,000 and death rate from TB dropped from 11% in 2006 to 5% in 2010. The prevalence of HIV/AIDS is 4.1 % in 2010 with HIV prevalence among adult TB cases being 27% in Nigeria. HIV pandemic has markedly increased TB incidence. There has been studies on TB treatment but very few compared those with TB alone and those coinfected with HIV. This study also aims to explore factors influencing the treatment outcomes. The study utilized data from patient with smear sputum positive, enrolled in DOTS program and have completed treatment at Chest clinic University of Nigeria Teaching Hospital, Enugu. Data was collected from their case records and hospital registers and was analysed to determine factors that influenced treatment outcome and compare outcomes among patients with TB alone and those with TB coinfected with HIV. The association of the socio-demographic factors (age, sex, occupation) as well as other factors like CD4 count, disease status, distance covered to clinic with treatment outcome was ascertained using binary logistic regression model., Level of significance was at p=0.05. A total of 437 patients who had sputum smear positive were studied out of which 66 of them were coinfected with HIV. Of the patients that tested positive for HIV, we could access CD4 count of 56 patients. Age group mostly affected by TB was 21-40years (60.7%). Mean age of patients was 35.32±14.33. Male to female ratio was 1.6: 1. Apprentices/applicants, students, artisans were mostly affected. Males had higher prevalence of TB alone (62%) and females higher TB/HIV coinfection (53%). Median CD4 count was 203 cells/mm3. Treatment outcomes included cured (73.7%), failure(1.8%), RAD(l.4%), Relapse(1.1 %). Those that had TB alone had 76% cure against those with TB/HIV coinfection 62%. There was no association between treatment outcome and age categories, sex, occupation, CD4 count, but there were associations with disease status and distance from residence to clinic. Those that had TB coinfected with HIV were 1.7(95%CI: 0.980, 3.046) less likely to be cured than those with TB alone. Those that covered distances >20km were less likely to be cured when compared with those that covered< 20km. Coinfection of TB/HIV constitutes a major threat to control of TB. HIV prevalence among TB patients and paucity of DOTS centres including poor citing of health facilities leading to distance in accessing TB care are some of the factors hampering treatment outcome. For treatment outcome to be improved HIV pandemic must be tackled and access to services addressed. A Dissertation submitted to the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment for the requirements of the award of Masters of Science in Epidemiology and Medical Statistics

AWARENESS AND UTILIZATION OF AFFORDABLE MEDICINE FACILITY MALARIA AMONG CAREGIVERS OF UNDER FIVE CHILDREN IN IBADAN NORTHWEST LOCAL GOVERNMENT AREA, OYO STATE

2013-07-01T00:00:00Z

AWARENESS AND UTILIZATION OF AFFORDABLE MEDICINE FACILITY MALARIA AMONG CAREGIVERS OF UNDER FIVE CHILDREN IN IBADAN NORTHWEST LOCAL GOVERNMENT AREA, OYO STATE OJO, TOLULOPE Access to Artemisinin Based Combination Therapy (ACTs) by most people at risk of malaria has been a challenge. A global subsidy under the initiative Affordable Medicine Facility-malarial (AMFm) was recommended to crowd out monotherapies, expand access to ACTs and therefore decrease the burden of malaria. AMFm-ACTs distribution started in Nigeria in 2011, but its use has not been documented. Hence, this study aimed at determining awareness, pattern of use, utilization and factors influencing utilization of AMFm-ACTs in Ibadan Northwest Local Government Area. The study was a cross sectional survey involving the use of cluster sampling technique to select 478 caregivers whose children had fever within two weeks prior to the survey. An interviewer administered questionnaire was used to collect information on awareness, knowledge of symptoms of malaria, sources of drugs, utilization and factors influencing utilization of AMFm- ACTs. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of the respondents was 31.0 ± 5.4 years. Many of the caregivers (60.3%) were between 25 and 34 years, (89.3%) were married, and majority (60.6%) was Christians. More than half (61.7%) of the respondents had secondary education while 55.9% were traders. Less than half of the respondents (32.2%) were of high socio-economic status. Awareness of the programme was low as only 9.1 % have heard about the programme and less than half (42.9%) have seen the antimalarial packet that has the symbol of the Affordable Medicine Facility malaria. The commonest source of information on AMFm-ACTs was through the radio (31.7%). Overall, 29.2% used AMFm-ACTs as their first line choice of anti-malarial. More than half (54.5%) cited effectiveness of the drug as the main reason for choosing it. More than half of the respondents (51.2%) bought the drug by themselves while 35% received prescription from health workers. More than half of the respondent (82.1 %) reported availability of the anti-malarial whenever they buy it. Overall (61.5%) took the correct number of tablets in relation to their age and also for the recommended days. Most of the respondents discontinued the drug before the recommended time because symptoms got better. On bivarate analysis age group, occupation, level of education, socio-economic status, knowledge of symptoms of malaria, awareness of AMFm-ACTs, availability of AMFm-ACTs and sources of drug were significantly associated with utilization of AMFm-ACTs (P<0.05). Logistic regression demonstrated that only awareness (AOR: 13; CI: 5.731-30.509) predicted the use of AMFm-ACTs. For effective utilization of AMFm-ACTs, this study provides evidence that emphasis should be placed on awareness of this drug among those at risk of malaria and also increasing sensitization on treatment failure associated with cheap antimalarials. It equally proposes that programmes should be in place to educate people on appropriate dosing for AMFm-ACTs. A Project submitted to the Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment for the requirement of the award of Masters of Science in Epidemiology and Medical Statistics