Enhancing health policymakers' information literacy knowledge and skill for policymaking on control of infectious diseases of poverty in Nigeria

Background

In Nigeria, one of the major challenges associated with evidence-to-policy link in the control of infectious diseases of poverty (IDP), is deficient information literacy knowledge and skill among policymakers. There is need for policymakers to acquire the skill to discover relevant information, accurately evaluate retrieved information and to apply it correctly.

Objectives

To use information literacy tool of International Network for Availability of Scientific Publications (INASP) to enhance policymakers'' knowledge and skill for policymaking on control of IDP in Nigeria.

Methods

Modified "before and after" intervention study design was used in which outcomes were measured on target participants both before the intervention is implemented and after. This study was conducted in Ebonyi State, south-eastern Nigeria and participants were career health policy makers. A two-day health-policy information literacy training workshop was organized to enhance participants" information literacy capacity. Topics covered included: introduction to information literacy; defining information problem; searching for information online; evaluating information; science information; knowledge sharing interviews; and training skills.

Results

A total of 52 policymakers attended the workshop. The pre-workshop mean rating (MNR) of knowledge and capacity for information literacy ranged from 2.15-2.97, while the post-workshop MNR ranged from 3.34-3.64 on 4-point scale. The percentage increase in MNR of knowledge and capacity at the end of the workshop ranged from 22.6%-55.3%.

Conclusion

The results of this study suggest that through information literacy training workshop policy makers can acquire the knowledge and skill to identify, capture and share the right kind of information in the right contexts to influence relevant action or a policy decision.     

Sexual and Relationship Benefits of a Safer Conception Intervention Among Men with HIV Who Seek to Have Children with Serodifferent Partners in Uganda

AIDS and Behavior - Many men with HIV (MWH) in Uganda desire children, yet seldom receive reproductive counseling related to HIV care. Because men are under engaged in safer conception programming,...     

Western blot-indeterminate results in Nigerian patients HIV serodiagnosis: the clinical and public health implication

The clinical and public health implication of HIV Western blot (WB) indeterminate results is yet to be appraised in sub-Saharan Africa, including Nigeria. Using HIV Tri Line Test enzyme-linked immunosorbent assay (ELISA), 1286 patients (600 males and 686 females; age range, 5-60 years) with symptoms suggestive of HIV infection were screened. A total of 1020 (79.3%, 95% confidence interval [CI] 76.8-81.5) of the patients comprising of 514 (85.7%) males and 506 (73.8%) females were HIV seropositive and the difference was statistical significantly (chi(2) = 5.72, df = 1, p < 0.05). Western blot analysis of sera from the 1020 HIV-seropositive individuals using the BIO-RAD NEW LAV-BLOT I specifying World Health Organization (WHO) interpretive criteria, confirmed the HIV serostatus of 815 (79.9%, 95% CI, 77.4-82.4) of them with 205 (20.1%, 95% CI, 17.6-22.6) individuals having indeterminate results consisting of either; 1 env +/- gag +/- pol, gag + pol, gag only or pol only. Of these, 102 (19.8%) were males and 103 (20.4%) were females. Patients aged 11-20 years old recorded the highest percentage of indeterminate results (31.7%, 95% CI, 20.2-43.2) while those aged 21-30 years recorded the least (14.2%, 95% CI, 10.6-17.8) and the difference was statistically significant (chi(2) = 15.73, df = 5, p < 0.05). Result confirmed the limitation of Western blot assays in HIV confirmatory serodiagnosis. After obtaining HIV indeterminate Western blot result, clinicians should consider the total profile for the patient, reassess risk factors for HIV infection, perform a HIV retesting at 3-month intervals for 6 months or use an alternate HIV antibody confirmatory assay and running antibody tests for other human retroviruses.     

Malaria and HIV co-infection in pregnancy in sub-Saharan Africa: impact of treatment using antimalarial and antiretroviral agents

Malaria and HIV infection represent severe public health problems in sub-Saharan Africa, and pregnant women are at increased risk because the two diseases intersect in pregnancy, causing adverse perinatal outcome. As access to antiretroviral drugs is increasing in the sub-region, and new combinations of antimalarial drugs are being implemented while more are being evaluated, there is potential for interactions between these therapies. In this report, the impact of treatment using antimalarial and antiretroviral agents in pregnant women with malaria and HIV co-infection was reviewed, using scientific publications identified through a Medline Entrez-Pubmed search with reference to sub-Saharan Africa. The safety and operational feasibility of use of antimalarial and antiretroviral agents to treat co-infected pregnant women were evaluated. Although use of these therapies was shown to improve the health of pregnant women with co-infection, low adherence, poor-quality drugs, resource scarcity, lack of infrastructure and inadequate treatment in sub-Saharan Africa continue to hamper treatment outcome. The absence of studies on interaction between antimalarials and antiretrovirals, as well as mounting evidence of treatment failure due to drug resistance and adverse drug reactions, in most parts of sub-Saharan Africa, make the establishment of new guidelines for the prevention of malaria and HIV infection during pregnancy imperative.     

Artemisinin-based combination therapy for uncomplicated malaria in sub-Saharan Africa: the efficacy, safety, resistance and policy implementation since Abuja 2000

Following increased resistance of malaria parasites to conventional drugs in the malarial regions of the world, the WHO is promoting artemisinin-based combination therapy (ACT) for treating uncomplicated malaria. The objective of this report is to review the available scientific information on the efficacy, safety, resistance and policy implementation of ACT as it relates to sub-Saharan Africa since the Abuja 2000 Roll Back Malaria initiative. To achieve this, a Medline search was performed to identify scientific publications relevant to the review. The data reviewed indicated that ACT proved very effective in the treatment of uncomplicated Plasmodium falciparum malaria in the region. ACT was shown to be effective, safe and tolerable and no resistance has been detected so far. However, the major challenges to its widespread use in the region include its high cost, low drug quality and poor healthcare delivery systems, among others. It is absolutely imperative for sub-Saharan African countries to establish an effective national antimalarial drug policy which will provide safe, effective, high-quality, accessible and affordable antimalarial drugs such as ACT to the populations at risk of malaria but, at the same time, promote rational drug use in order to delay or prevent the development of antimalarial drug resistance.     

A Qualitative Study of the Impact of HIV on Intimacy and Sexuality Among Older Childhood Sexual Abuse Survivors Living with HIV

Archives of Sexual Behavior - Childhood sexual abuse (CSA) is a traumatic event known to influence health outcomes, and the rate of CSA among people living with HIV is more than twice that of the...     

Reliability and Validity of a Life Course Passive Smoke Exposure Questionnaire in an Australian Cohort From Childhood to Adulthood

Objectives:Life course exposure to passive smoke may predict health, but there are few validated measures. We tested the reliability and validity of a retrospective life course passive smoking questionnaire. Methods:Participants from the third follow-up of the Childhood Determinants of Adult Health study (2014-2019, ages 36-49 years) retrospectively reported mother/father/other household member smoking when living at home during childhood, including duration (years) and smoking location (never/sometimes/always inside house). The severity of exposure index (SEI; sum of mother/father/other years smoked multiplied by smoking location), cumulative years of exposure (CYE; sum of mother/father/other years), and total household smokers (THS) were derived. The reliability of retrospective passive smoking reports was examined with intraclass correlation coefficients (ICCs) using household smoking reported 34 years earlier in 1985 by participants when aged 7-15 years. Construct validity was examined by correlating retrospective passive smoking with participants’ smoking in adulthood and lung function in childhood and adulthood. Results:Among 2082 participants (mean±standard deviation [SD], 45.0±2.5 years; 55.2% females), THS ranged from 0 to 5 (mean± SD, 0.9±1.0), CYE ranged from 0 to 106 (mean±SD, 10.5±13.9), and SEI ranged from 0 to 318 (mean±SD, 24.4±36.0). Retrospective measures showed moderate agreement with total household smokers reported in childhood (ICC, 0.58 to 0.62). The retrospective measures were weakly but significantly (p<0.05) correlated with participants’ smoking (r=0.13 to 0.15) and lung function (r= -0.05 to -0.06). Conclusions:The retrospective passive smoking questionnaire showed reasonable reliability and validity. This measure may be useful for epidemiological studies.     

Evaluation of the effect of an educational intervention on knowledge and adherence to HIV guidelines among frontline health workers in Alex-Ekwueme Federal University Teaching Hospital Abakaliki,Nigeria

BackgroundThe aim of this study was to appraise the implementation of the National HIV guidelines and determine the effect of an educational intervention on health worker knowledge and practice of the guidelines.MethodsA before and after study design without control was carried out using a self-administered questionnaire and key informant interviews. Data was also collected from client record cards. An educational intervention was carried out using pamphlets containing summarized information on the guideline. Data analysis was carried out using IBM-SPSS version 20.ResultResults showed that 54.5% of the respondents were males and 76% were medical doctors. Baseline knowledge level of respondents was high with 97% of respondents having good knowledge with a mean score of 3.9. This increased to 4.1 out of 5 post-intervention. All respondents had good practice of the guidelines before and after intervention with a mean score of 4.5 out of 5. Client records also showed good practice. Barriers to guideline implementation include: poor knowledge, inadequate training, guideline unavailability, poor functioning of the laboratory equipment, poor funding.ConclusionHIV guidelines are being implemented in the clinic to a large extent; however, trainings, funding and provision of the guideline in the clinics are recommended.