Journal of Community Medicine and Primary Health Care

Utilization of Cervical Cancer Screening Services and its Predictors among Health Workers in Hospitals in the Federal Capital Territory, Nigeria

2024-04-04T10:16:58+00:00

Background: Cervical cancer (CC) ranks second as the leading cause of cancer morbidity and mortality in Nigeria, despite being preventable through screening. Female health workers (HCWs) are expected to be role models to motivate society towards Cervical Cancer Screening Service (CCSS)uptake. This study assesses the utilization of CCSS and associated factors among HCWs in three area councils of Abuja, Nigeria.

Method: A cross-sectional design aimed at assessing the utilization of CCSS by HCWs in 13 health facilities across 3 area councils in Abuja. Study participants were selected using a multi-stage sampling technique. The outcome variable was “ever used CCSS” dichotomized into a “Yes” or “No” response. Factors associated with participants' utilization of CCSS were examined using a binary logistic regression at p<0.05 level of statistical significance.

Results: Data from 350 participants (90.6%) were analyzed. Most were married women, 290 (82.9%), between the ages of 21 to 30 years, 275 (78.6%). About twothirds of the participants, (237) reported ever being screened for cervical cancer. Factors associated with CCSS utilization at the bivariate level included marital status, duration of practice, and a negative perception regarding access to cervical cancer services. Perceived access barrier to CCSS was the only strong predictor for CCSS utilization after controlling confounders [Adjusted Odd Ratio: 0.01, 95%CI: 0.01 – 0.03].

Conclusion: The perceived access barrier is a strong determinant of the CCSS utilization rate among HCWs in our study site Efforts should be made to ensure access and create awareness about service availability and accessibility among HCWs in the Federal Capital Territory.

Identifying Barriers to Utilization of Basic Emergency Obstetric and NewBorn Care Services in Jigawa State, North-western Nigeria: A Qualitative Study

2024-04-04T10:41:45+00:00

Background: Maternal mortality has remained high in northern Nigeria despite decades of effort aimed at reducing it. The number of women who deliver in Emergency Obstetric Care (EmONC) facilities is low. This study explored the barriers to utilizing Basic EmONC services in Jigawa State.

Methods: A qualitative study was conducted among mothers of children under five years through 12 Focus Group Discussions. A purposive sampling technique was used to select participants who were categorized based on age (below 35 years, 35 years and above) and prior utilization of EmONC services. Content analysis along thematic lines was done and the findings were reported in narrative form.

Results: The mean age of participants was 31 ± 6 years. The majority of participants had primary education and most were unemployed. Most of the participants identified obstetric danger signs, however, they opine that medical attention should be sought only when complications become serious. Participants in all groups unanimously said decision-making for seeking medical care rests with the husband and occasionally the mother-in-law. Barriers to seeking care identified by participants include lack of money, distance to the nearest health facility, fear of embarrassment by healthcare workers, and insecurity among others.

Conclusion: Most participants were knowledgeable of obstetric danger signs, but with low risk-perception towards obstetric complications. The Jigawa State government should engage in a robust education campaign on the need for early decision-making to seek care as well as strengthen its women empowerment programs to overcome barriers to seeking care for obstetric complications.

Management outcome of a COVID-19 Positive Child with Multiple Contacts admitted in a General Intensive Care Unit-A Case Report

2024-04-04T10:57:44+00:00

COVID-19 infection in paediatric patients is relatively low in Nigeria. The low index of suspicion made healthcare providers to be at risk of contracting the disease from this age group making prevention and contact tracing difficult. We report the management of a 9-month- old male child who had palatoplasty following a prior negative polymerase chain reaction (PCR) screening. The patient underwent palatoplasty for isolated cleft palate under general anaesthesia and endotracheal intubation. The patient was found to be desaturating significantly on admission to the recovery room and was subsequently taken back to the theatre with multiple attempts at intubation. A repeat PCR done was positive and subsequently, he was admitted into the ICU for ventilatory support. A chest radiograph taken on admission revealed features of severe bronchopneumonia and COVID-19 pneumonic changes. He was ventilated for 14 days and thereafter, was discharged home on a tracheostomy in good clinical condition. The mother of the child and 20 members of staff (23.5%) out of the 85 personnel who had close contact with the child in the course of treatment tested PCR positive. Contact tracing was difficult among those infected. They all recovered from the disease without complications. The treatment outcome in this COVID-19-positive child was good and contact tracing was effective in reducing the transmission of SARS-CoV-2 and limiting the impact of the outbreak. We hereby recommend preventive measures against the infection, vaccination and establishment of dedicated paediatric ICU for infectious diseases.

Intimate Partner Violence among Mothers of Children with Sickle Cell Disease: A Retrospective Cohort Analysis of 2018 Nigeria DHS Data

2024-04-04T11:03:58+00:00

Background: The 2018 Nigeria Demographic and Health Survey (NDHS) collected data on the experience of intimate partner violence (IPV) among women aged 15-49 years and the genotype of their children aged 6-59 months. We performed a retrospective cohort analysis to ascertain if having a child with sickle cell disease (SCD) predisposes women to IPV.

Methods: Eighty-five mothers of children living with SCD were compared with 320 mothers of children living without SCD after matching for age, number of living children, religion, place of residence and wealth index. The prevalence rates of IPV and the relative risks (RRs) of experiencing controlling behaviour, emotional, physical, sexual and any form of IPV in the 12 months preceding the survey were calculated.

Results: Compared to mothers of children without SCD, mothers of children living with SCD were not at greater risk of experiencing controlling behaviour (RR=0.90, 95% CI: 0.54–1.49), emotional violence (RR=1.09; 95% CI=0.78–1.53), physical violence (RR=0.75, 95% CI: 0.38–1.48), sexual violence (RR=0.89, 95% CI: 0.31– 2.56) or any form of IPV (RR=0.98, 95% CI: 0.71–1.37).

Conclusion: The study did not find sufficient evidence for increased risk of IPV among mothers of children living with SCD, despite the additional health, psychosocial and financial burdens associated with raising a child with the disease. Further research is needed to address the limitations of this study and to carefully investigate the relationship between having a child with SCD and the experience of IPV among women.

Pharmaceutical Promotions and Compliance with Community-Acquired Pneumonia Prescribing Guidelines by General Practitioners in Mbarara

2024-04-04T11:20:38+00:00

Background: Generic prescribing effectively reduces dispensing errors and promotes the availability, access and quality of pharmaceutical products in health facilities or pharmacies. However, in Uganda, non-compliance with treatment guidelines is prevalent, with evidence of some General Practitioners (GPs) prescribing non-essential and obsolete drugs. This study examines the role of pharmaceutical promotions in creating awareness of new medicines among GPs and the potential influence of these promotions on prescribing practices.

Methods: The study used a qualitative phenomenological research design. Key informant interviews were conducted with 33 experienced GPs from nine hospitals in Mbarara City, Uganda. The transcribed interviews were analysed using content analysis.

Results: Most GPs were male (78.79%), aged between 41-50 years (30.30%), with a work experience of 6-10 years (39.39%). All GPs had at least been exposed to pharmaceutical promotions such as free samples, visits from medical representatives, and Continuing Medical Education sessions. Most GPs had a positive outlook on these promotions, which they believed were informative, educational, and beneficial. However, the more GPs depend on pharmaceutical promotions, the less likely they are to follow the national or international guidelines for generic prescribing.

Conclusion: The study highlights the importance of ethical pharmaceutical promotion and the need for strict regulation by the National Drug Authority (NDA) to ensure that promotional activities do not compromise patient care and public health outcomes. The study recommends that GPs be more critical of the information and incentives provided during such promotions and should be trained in rational prescribing and evidence-based medicine.

Prevalence and Forms of Sexual Abuse among Female Hawkers in Sokoto State

2024-04-04T11:32:45+00:00

Background: Sexual abuse is a public health problem affecting one-third of women in their lifetime and female hawkers are especially vulnerable. This study assessed knowledge, prevalence and forms of sexual abuse among female hawkers in Sokoto metropolis.

Methods: A cross-sectional study among two hundred and forty-five female hawkers using a multistage sampling technique was conducted. A structured interviewer-administered questionnaire was used to obtain information from the study participants. Data were analyzed using IBM SPSS version 25. Continuous variables were summarized as mean and standard deviation, while categorical variables were summarized as frequencies and percentages. Inferential statistical analysis was done using chi-square test and binary logistic regression. The level of statistical significance was set at 5% (p<0.05).

Results: One hundred and twenty- three (50.2%) of the respondents were within the 10-15 age group, 223 (91.2%) were single, and 64 (26.1%), had Quranic education. Two hundred and nineteen (89.4%) and 26 (10.6%) had good and poor knowledge of sexual abuse respectively. The prevalence of sexual abuse was 24.5%; touching, verbal harassment and attempts at having intercourse were the commonest forms of sexual abuse reported. The living arrangement of parents was the only predictor of sexual abuse (aOR= 4.282; C. I= 1.344-13.643).

Conclusion: Free and compulsory education for children especially the girl child and economic empowerment of parents will discourage hawking by children thus limiting the likelihood of children being exposed to sexual exploitation.

Assessing the Job Satisfaction of Some Physicians in Rwanda and the Associated Factors

2024-04-04T11:42:03+00:00

Background: Previous studies have shown poor job satisfaction is a major reason causing physicians to leave their jobs. Poor job satisfaction among physicians can also affect patient health outcomes and discourage young students from pursuing a medical career. This study assessed the level of physician job satisfaction in Rwanda and the associated factors.

Methods: This was a descriptive cross- sectional study. An online survey was conducted to assess the level of physician job satisfaction using the Physician Worklife Survey (PWS) tool. Our sample size was 189. The tool has 41 Likert scale 5-point statements divided into ten domains. Job satisfaction was classified as low if the average survey score was less than 3. Ethical approval was obtained from the University of Global Health Equity IRB committee (Reference no: 0156).

Results: Out of 100 respondents who filled the tool, 50% reported poor job satisfaction. The four domains with the most reported poor satisfaction were related to low income (87.6%), lack of personal time (76.8%), dissatisfaction with work (75.5%), and lack of resources at the workplace (74.5%). Other causes include poor infrastructure, lack of education opportunities, and ignored physicians’ rights. Physicians who were married, specialists, had more than two years of experience and had a second job had better satisfaction levels.

Conclusion: Overall, satisfaction among physicians in Rwanda is low. The factors significantly associated with lower satisfaction were salaries, workloads, and resources. The findings suggest that addressing financial incentives, workloads, and resources may be effective in elevating physician job satisfaction in Rwanda.

Diagnostic Accuracy of Antigen-Based Rapid Test during the Fourth Wave of COVID-19 in Edo State, Nigeria

2024-04-04T12:07:25+00:00

Background: Since the use of rapid test kits for diagnosis of COVID-19, diagnostic accuracy has been of concern, particularly in resource- limited settings. This study assessed diagnostic accuracy of Abbot Panbio antigen-based rapid diagnostic test (RDT) for COVID-19 using polymerase chain reaction (PCR) as the gold standard in Edo State, Nigeria.

Methodology: We conducted a descriptive cross-sectional study during the 4th wave of the pandemic in Edo State from January 5 – February 4th, 2022. Nasopharyngeal and oropharyngeal swabs were collected from 240 consenting participants at 10 sample collection sites. The index test (RDT) and gold standard test (real-time reverse transcription PCR) were performed simultaneously. Sensitivity, specificity, predictive values, and ROC analysis were conducted on the RDT compared to RT-PCR using SPSS version 26.0 software.

Results: Thirty-six (15.0%) participants tested positive on RDT and 34 (14.2%) tested positive on PCR. RDT had a sensitivity of 73.5% (95% CI: 66.0–81.0) and specificity of 94.7% (95% CI: 91.6-97.8) with a positive predictive value of 69.4% (95% CI: 55.8-80.7), and negative predictive value of 95.6% (95% CI: 91.8-98.0). The area under the curve (AUC) of the ROC for the RDT against PCR was 84.1% (75.1% - 93.1%).

Conclusion: The diagnostic accuracy of the Panbio rapid antigen test for SARSCoV-2 was below WHO standards. However, they remain useful tools for continued surveillance of the disease. Rigorous evaluations combining the results of rapid antigen tests with other clinical information would prove useful for prompt diagnosis and surveillance of COVID-19 in Nigeria.

Willingness to Accept Ocular Surgeries by Adults in a Community of Edo State, Nigeria

2024-04-04T12:18:17+00:00

Background: The acceptance of ocular surgery by patients can be influenced by a range of factors which encompass concerns about the surgical procedure, potential complications, financial implications and more. This study assessed willingness to accept ocular surgeries among adults in an urban community in Edo State, Nigeria.

Methodology: This was a descriptive cross-sectional study carried out among 308 adult male and female respondents in Evbomore, an urban community in Edo State between January and December 2023. Data collection was done using intervieweradministered structured questionnaires and was analysed using the Statistical Package for the social sciences version 25.0.

Results: The mean age (SD) of the respondents in this study was 35 (12.7) years. Most of the respondents (84.4%) were aware that ocular surgery is a treatment option in the management of eye conditions however, willingness to accept ocular surgery as a treatment option was quite low (24.0%). Skill level (p=0.018) and educational status (p=0.024) were significant predictors of willingness to accept this surgical treatment option.

Conclusion: The findings show a low willingness to accept ocular surgeries while identified determinants include skill level and educational status. These determinants should be harnessed by health workers in planning intervention programs such as health education campaigns and the provision of subsidized services through outreaches.