Authors:Angwara Denis Kiwara Abstract: Background: Research reports indicate that developing countries are experiencing an epidemiological transition consisting of communicable and non-communicable diseases (NCDs) driven by the Social Determinants of Health (SDHs) (1). NCDs cause 60% of deaths globally with 17% estimated increase yearly (1, 5) and are likely to be a major health problem in the twenty first century unless appropriate measures are adopted. The increasing problem of NCDs demands that Medical Education is challenged to better understand the role played by the SDHs if the vision of healthier nations is to be achieved. The SDHs implicated in the etiology of NCDs include unhealthy nutrition, low hygiene, smoking etc. The challenge begins with an analysis of how the Medical Education that is offered at the graduate level prepares graduates in understanding the role of SDH in NCDs.Objectives: To determine the time that Graduate Medical Schools’ curricula provide for subjects related to the SDHs; analyse the curricula contents to establish how they relate to the SDHs; explore how the bio medical model may influence the graduates’ understanding of SDH role in health.Methods: A review of graduate-level medical schools’ curricula in East and Central Africa was performed in November and December 2014.Results: The findings indicate that the curricula contents and teaching is Bio-medical model driven minimizing SDH contents and understanding, and their link with NCDs. Out of the total training time of graduate physicians less than 10% is provided for SDHs related courses.Conclusion: The curricula and training times provided are inadequate for graduates to fully understand SDHs and their role in NCDs. The Bio medical model addresses secondary causes of diseases-micro-organisms-and is inappropriate for the epidemiological transition evident in the twenty first century. A richer model is needed. This paper suggests an SDH and NCD driven curricula review.Keywords: University Medical education, Social Determinants of Health, Non-Communicable Diseases, Professional formation PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:MF Lubuva, GA Shayo Abstract: Objective: The aim of this study was to assess patient’s basic knowledge on their own Human Immunodeficiency viral infection care and treatment, and socio-demographic determinants of such knowledge.Methods: A cross-sectional study conducted at the Muhimbili National Hospital HIV clinic between August and September 2013 among HIV infected adults. Socio-demographic data was collected. Ten knowledge questions were used to assess patients’ basic knowledge on HIV care and treatment. Patients were considered knowledgeable if they scored 80 percent in the knowledge questions and not knowledgeable if they scored <80 percent. CTC card number 1 and 2 were used to verify information given by patients. Chi square and Fisher’s exact test were used to compare categorical variables. Determinants of the knowledge were analyzed using logistic regression. P value of 0.05 was considered statistically significant.Results: A total of 267 patients participated in the study. Majority was females (76%), age 36 years (68.5%), jobless (35.2%) and those with education below secondary level (68.1%). Generally, 57.3% (153/267) of the respondents had basic knowledge on their HIV care and treatment. Age group 18-25 years had high percentage of knowledgeable respondents (12/14, 85.7%), p=0.029, so were those with secondary and post-secondary education (36/46, 78.3%), p=0.002, those who got HIV information from multiple sources (70/91, 76.9%), p<0.001, and those with HIV infection for 8 years (60/76, 75.9%). Females were more likely to know the indications for trimethoprimsulphamethoxazole chemoprophylaxis and effects of unprotected sex while using ARV than were men, p= 0.005, and 0.004 respectively.Conclusion: Fewer patients were knowledgeable. Knowledge was influenced by young age, secondary and post-secondary education, mixed sources of HIV information and longer duration of HIV disease. Predictors of knowledge were level of education, source of HIV information and duration of HIV.Keywords: HIV care and treatment, basic HIV knowledge, socio-demographic determinants, HIV-infected patients PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Nagesh Bhat, Rupam Gupta, Swapnil Oza, Mandeepsinh Gohil, Divya Choudhary Abstract: Objective: To assess the knowledge and attitude towards preventive dentistry among dental faculties in Jammu city.Methods: A descriptive study was carried out on all the dental faculty members (n=64) of the two dental colleges in Jammu city using pretested questionnaire. The questionnaire obtained information regarding their demographic and professional attributes, preventive knowledge regarding dental caries, periodontal disease, oral cancer, malocclusion and counselling and their attitudes towards preventive dentistry. Descriptive statistics included means and standard deviations (SD) of the respondents’ knowledge and attitude scores. Chi-square test served in statistical analysis.Results: Majority of the dental faculties (84.38%) were in the category of highest knowledge scores, while 64.06% of the dental faculties were in the category of highest attitude scores. Statistically significant differences were found for dental faculties knowledge and attitude in relation to their participation in CDE programmes (P<0.05). Dental faculties knowledge showed statistically significant difference in relation to their years of experience in teaching (P<0.05). No other significant differences were found.Conclusions: The prevention orientation of the dental faculties was associated with their credentials such as participation in CDE programmes and years of experience in teaching.Keywords: Knowledge, Attitude, Dental faculties, Preventive dentistry, Prevention PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:MO Ogunkunle, OE Adewumi Abstract: Objective: To determine the eating attitude, lifestyle practices and dietary intakes of female undergraduate students of the University of Ibadan, Nigeria.Methods: The descriptive cross-sectional study used a pretested self-administered questionnaire to obtain information from 376 randomly selected female undergraduates of the University of Ibadan. Eating attitude was evaluated using the EAT-26 questionnaire, lifestyle practice was assessed using the adapted health promoting lifestyle questionnaire (HPLP II) while 24-hour dietary recall and pretested food frequency questionnaire was used to assess the dietary intakes and pattern of the participants. Data were analysed using SPSS. Mean, frequencies and percentages were used to summarize the data while the relationship between variables were evaluated using Chi square at p <0.05.Results: Mean age was 20.1(±2.4)years, weight was 57.7(±9.2)kg and Body Mass Index(BMI) was 22.1(±3.4)kg/m2. Prevalence of abnormal eating attitude among the participants is 7.4% and 56.9% had poor lifestyle practices. Intakes of energy and protein were below recommended in 83.5% and 73.2% of the participants respectively. Also, 90.6%, 92.9%, 97.6%, 84.3% and 74.0% had inadequate intake of vitamin C, folate, calcium, zinc and iron respectively and all the food groups were infrequently consumed by the majority. Participants with normal eating attitude are significantly higher than those with abnormal eating attitude (p<0.05) while those who had poor lifestyle practices are significantly higher than those with good lifestyle practices (p<0.05). There is no significant relationship between eating attitude and BMI (p>0.05) however, significant relationship exist between eating attitude and lifestyle practices (P<0.05).Conclusion: Prevalence of abnormal eating attitude and poor lifestyle practices among the participants is notable and intakes of both macro and micronutrients were below recommendations. There is need for intensive nutrition education to emphasize the importance of adequate dietary intakes and healthy lifestyle practices to promote primary prevention of non-chronic diseases among the University students.Keywords: Eating attitude, Lifestyle practice, Female undergraduates, Dietary intakes, Nigeria PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Innocent A. Semali, Vera A. Ngowi, Mary Macha Abstract: Background: Strategies to achieve the millennium agricultural development goals include increased use of pesticides to increase agricultural production in poor countries. However, the increased availability and use of such chemicals need to be paralleled with national and personal level practices to maximize safety for communities and environment.Aim and methods: The aim of this study was to determine the pesticide safety practices among rural farmers in Karatu District in Northern Tanzania. Farmers practicing horticulture farming in Mang’ola Division were interviewed about their practices during and after pesticides application.Results: The study included 148 farmers of whom 79.7% were male. A significantly high proportion (77.7%) of the farmers did not use protective gear while applying pesticides. A notable percentage ate while applying pesticides (17.6%), one out of five took fluids and about a quarter smoked cigarettes. Factors found to be significantly associated with those practices were education, marital status, reporting frequent household spraying, long duration since starting to apply pesticides and farm size (p<0.05).Conclusions: Given the lack of protective behavior, it is then very important that farmers and farm workers are reminded of the hazardous nature of pesticides and the need to have their health monitored regularly. Special educational and information strategies have to focus on those with low education, who are unmarried, working on large farms and have a high frequency of applying pesticides. To enhance sustained education and supervisions, community level surveillance and supervisors could be introduced. PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Otieno A. Sheilla, BM Wamalwa, NO Owuor, JAM Ottieno, V Ongoma Abstract: Immunization is effective in the reduction of child infant morbidity and mortality. The client factors that influence under-five child guardian compliance to the immunization schedule are interlinked based on household characteristics, socioeconomic status of the family, and maternal health practices. An incentive to motivate the mothers to prioritize their child’s health practices especially on vaccination works perfectly towards the achievement of full immunization coverage. In this paper, sampled study carried out in Weonia Location, Trans Nzoia County in March 2014 whose target population were children under the age of five years. A multinomial logistic regression model used to analyze the determinant of partial or noneimmunized. Maternal health practices and access to a motivating intervention are significant factors that ensure a parent/guardian’s compliance to their child immunization. The study recommends sustainability and diversification of incentive as well as education of the community on the essence of vaccination.Keywords: Mortality, Immunization, Vaccination, Incentive, Maternal Health PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Aishat B. Usman, David M. Dairo, Dairo Fawole Abstract: Introduction: Mother-To-Child Transmission of HIV is responsible for more than 90.0% of HIV infections in children, and breastfeeding is one of the common routes of transmission. This study therefore determined factors influencing infant feeding choices of HIV positive mothers enrolled in Prevention of Mother to Child Transmission HIV clinics in Oyo State.Methods: Four Focus Group Discussion (FGDs) sessions were conducted among forty HIV positive mothers with babies between the ages of 6weeks and one year with the aid of an FGD guide. Data was analysed using thematic approach. Findings: More than one –third of the mothers (37.5%) were between the ages of 25-29 years. More than half of the mothers (52.5%) were married in polygamous relationships and almost half of them (47.5 %) completed primary school education. Majority were traders/artisan, two third of them were earning less than ₦18000 per month. Majority of the mothers had good knowledge of infant feeding options in the context of HIV. Majority of the mothers claimed to be practicing exclusive breast feeding due to their low economic status. Fear of disclosure of HIV status and stigma has also weakened the ability of mothers to resist family pressure that encourages mixed feeding practices. Women who chose to exclusively formula feed were the civil servants who were financially capable.Conclusion: Although a high proportion of mothers practiced exclusive breastfeeding, mixed feeding is still being practiced due to family pressure. Family members’ education on safer infant feeding practices and behavioural change programmes in the context of HIV is advocated.Keywords: Infant food; Breast feeding; HIV infections/transmission PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Francis Fredrick, Tumaini V. Mhada Abstract: Introduction: Anaemia is common among HIV infected patients; causes of anaemia in these patients are multifactorial. Anemia is noted as one of important predictors of outcome in HIV infected patients. Tis study was carried out to determine the prevalence of anaemia among HIV infected children attending HIV clinic at Muhimbili National Hospital.Methods: A cross-sectional study was carried out and 240 HIV infected children attending HIV clinic at MNH were recruited. Structured questionnaire was used to obtain socio-demographic characteristics. Laboratory tests were performed for each participant to determine haemoglobin level, mean cell volume, mean corpuscular haemoglobin concentration, white blood cells and CD4 count and percent.Results: Hundred and thirty three (55.4%) of recruited participants were males, 219 (91.2%) were using antiretroviral drugs and 129 (53%) were using stavudine, lamivudine and nevirapine combination. Mean haemoglobin level was 10.9 ± 1.4 g/dl and mean CD4 was 1118.3 ± 656.1 cell/mm3 while mean CD4 percent was 31.1 ± 10 %. Prevalence of anaemia was 78.8% (189/240), anaemia was noted to be more prevalent among younger participants (<5 years) p=0.012. Participants using ART and those high CD4 percent (25%) had lower proportion of anaemic patients as compared to participants who were not using ART and those with low CD4 percent although the difference was not statistically significant.Conclusions: Prevalence of anaemia was noted to be high and was more prevalent among younger participants; there is a need to screen for anaemia in HIV infected children attending for clinic in our setting. PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:GO Obiechina, GO Ekenedo, OO Akingboola Abstract: Objective: Tuberculosis (TB) is a world-wide public health problem. Despite progress made in the treatment of the disease, TB remains a leading infectious cause of death among adults in Nigeria. Directly observed therapy short-course (DOTS) which was introduced by WHO have proved effective in TB treatment in some parts of Asia and Africa. The aim of this study was to evaluate the treatment outcome of DOTS among pulmonary TB patients in a tertiary institution in Nigeria.Methods: A retrospective study of consecutive pulmonary TB patients that attended DOTS clinic in a Nigerian tertiary institution between January 2003 and December 2010. The research instrument was hospital records. Patients’ demographics were recorded. Diagnosis and treatment were according to the World Health Organization (WHO) recommendations. Cases detected, sputum conversion and treatment outcome reports were analyzed using percentage.Results: A total of 177 pulmonary TB patients were seen during the eight-year period of this study. A male to female ratio of 1.6: 1 was observed and the 15 to 24 years age group were mostly affected (82 [46.3%]) followed by 25-34 age group (36 [32.2%]). New smear positive patients were 138 (78%) and smear negative 13 (7.3%). The sputum conversion smear positive cases were 121 (68.4%) whereas smear negative were 56 (31.6%). Out of the total number of 177 seen, 149 (84.2%) were cured. Treatment failed in 9 (5.1%) patients, 8 (4.5%) defaulted, 3 (1.7%) died before the completion of the treatment.Conclusion: The clinic was able to meet the WHO recommendation of 70% case detection and just fell short of success rate of 85%. Effort therefore should be made to screen the students’ community every session in order to identify new cases and institute prompt treatment.Keywords: Pulmonary tuberculosis, treatment outcome, directly observed therapy short course, tertiary institution, Nigeria PubDate: 2015-12-07 Issue No:Vol. 12, No. 2 (2015)
Authors:Adebayo David Oluwole, Beatrice Nyege Sampson Abstract: Introduction: Epilepsy is a chronic neurological disorder with lots of psychosocial implications that can result in low self-esteem and social inhibitions in several social activities. The uncertainty of never knowing where the seizure will occur lowers one’s self-esteem and dignity.Objective: This study, therefore, investigated effectiveness of existential technique and cognitive restructuring strategies in enhancing self-esteem of clinically diagnosed epileptic patients in Port Harcourt, Nigeria.Methods: Pre-test, post-test, control group experimental design with a 3x2x2 factorial matrix was adopted. Three groups which were; existential technique, cognitive restructuring; and control. Purposive sampling technique was used to select sixty (60) diagnosed epileptic patients between 15 and 60 years of age from three hospitals. Treatment lasted for six weeks. Self-Esteem Scale (r=0.85) was the only instrument used. Data were analyzed using ANCOVA and Duncan post hoc test.Results: There was significant mean effect of treatments on participants’ self-esteem (F(2,49) = 43.9;p<0.05, Effect size =0.82). Cognitive restructuring therapy obtained the highest adjusted post-test mean score in self-esteem (x̄ =396.44), existential technique ( x̄=383.1), the control group ( x̄= 351.28). Sex has a significant main effect on the self-esteem (F(1,49) = 11.9; p< 0.05, Effect size=0.42). Male participants obtained higher self-esteem mean score (x̄ = 372.6) than their female counterparts (=368.91). Age had a significant main effect on the self-esteem (F(1,49) = 14.6; p< 0.05,Effect size=0.5). The older epileptic participants obtained higher self-esteem mean score ( x̄= 377.0) than the young epileptic patient ( x̄= 365.9).Conclusion: Existential technique and cognitive restructuring were effective in enhancing self-esteem of clinically diagnosed epileptic patients. Counselling and clinical psychologists should endeavor to be pragmatic in addressing the self-components of epilepsy personality.Keywords: Existential technique, Cognitive restructuring, Self-esteem, Diagnosed epileptic patients PubDate: 2015-12-03 Issue No:Vol. 12, No. 2 (2015)
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