Noise levels and hearing impairment in an urban community in Ibadan,Southwest Nigeria

Aim  The study sought to measure the noise levels in an urban community and assess the hearing levels of persons working within the community. Subjects and methods  Noise levels were measured in selected locations in Ibadan, southwest Nigeria, using a sound level meter CEL 269 (CEL Instruments UK Ltd.). Measurements were done between the hours of 08:00 and 15:00. Audiometric screening was done on 51 persons working within the community to determine the occurrence of hearing impairment. Results  The noisiest locations were workshops using machines such as saw mills, 95–102 dBA; carpentry tools, 87–101 dBA; printing presses, 85–88 dBA; and grain mills, 88–105 dBA. Music shops also constituted a nuisance with noise levels of 89–99 dBA. Roadside noise levels on major road junctions were 86–90 dBA and 61–65 dBA on side streets. Noise levels in designated markets ranged from 65–69 dBA and 61–81 dBA in street markets. Within residential areas, noise levels ranged from 39–41 dBA in low-density areas to 55–59 dBA in high-density areas. Audiometric screening showed that 28 participants (55%) had normal hearing. Mild and moderate hearing impairment was recorded among 17(33%) and 6 (11.7%) participants, respectively. Of the 23 who were hearing impaired, 10 had bilateral impairment. The prevalence of hearing impairment increased with age from 14% in the 2nd decade to 75% in the 5th decade. Conclusion  Noise levels in several areas of the city exceed WHO guideline values and constitute a public health hazard to residents and street workers. There is a need for regulation and control of the social and economic activities that generate noise. This may reduce the occurrence of hearing impairment and other adverse health outcomes in the general population.     

The pathology of schistosomiasis in Ibadan, Nigeria with special reference to the appendix, brain, pancreas and genital organs.

Examination of 499 autopsies in Ibadan revealed S. haematobium infection in 98. Digest and histopathologic data were recorded for 88 of these cases (54 males and 34 females). The intensity of schistosomal infection was classified as mild, moderate, or severe on the basis of the egg load per gram of bladder tissue. The majority of cases (64%) demonstrated mild infection. Although the frequency of infection increased with age in males, the intensity decreased significnatly after age 40. Changes induced in the appendix, brain, pancreas, and genital organs by schistosomal infection were directly related to the intensity of the infection. The digest and histologic methods, respectively, indicated the following frequencies of infection: appendix, 37% and 24%; pancreas, 17% and 0; brain, 0.01% and O. The paucity of ova recovered from the brain in this study contradicts previous findings. In terms of male genital organs, the seminal vesicles showed the greatest frequency and intensity of infection, followed by the prostate, testes, and epididymis. Despite high ova loads, lesions were noted histologically in only 7 of 54 seminal vesicle sections. Digest studies on the prostate noted ova in 31.5% of cases, but ova were noted histologically in only 8 sections. With regard to the testes, ova were detected in only 6 digests and no lesions were found histologically. The epididymis was the least affected male organ. Infection in the cervix and vagina had frequencies of 41% and 40%, respectively, but the intensity of infection was greater in the vagina. The ova load was never heavy in the cervix. Digests in the ovaries were positive in 31%, but no ova were seen histologically. The ovary is considered to be more severely affected in S. mansoni infection. Digests were positive in only 11% of cases for the fallopian tubes and 20% of cases for the uterus, and no lesions were noted histologically in either organ. Schistosomiasis is an uncommon cause of ectopic pregnancy. Lesions have been identified in the myometrium, and menorrhagia, spontaneous abortion, and premature labor have been attributed to infection. Overall, these data suggest that schistosomiasis is rarely a cause of male or female infertility, at least in West Africa.     

Isotope renography and urinary schistosomiasis: a study in a Gambian community

A transportable apparatus for isotope renography, which allowed deconvolution analysis, was used to study the prevalence and prognosis of abnormalities associated with urinary schistosomiasis. Before carrying out studies in a heavily infected community, observations were made in a non-endemic area to allow derivation of criteria for abnormality. Comparison of the findings in the two areas showed that changes suggesting urinary tract obstruction were more common in the endemic area in subjects between nine and 45 years but not in older subjects. Measurements of effective renal plasma flow showed renal function was impaired in the endemic area in subjects older than 17 years but not in younger subjects. In the endemic area the results of renography were unrelated to the urinary egg count of the subjects examined, but there was an improvement in the abnormal renograms in a group of subjects aged between nine and 20 years who were re-examined a year after treatment with metrifonate. Follow-up data about 316 subjects was obtained two years after renography. Nine subjects had died, including four of the five subjects with abnormalities suggesting both obstruction and over-all loss of renal function. These findings, which are comparable to the results of similar studies using radiological techniques, suggest urinary schistosomiasis may be a significant cause of mortality in adults in intensely infected communities.     

Sociocultural practices influencing under five nutritional status in an urban community in Osun State, Nigeria

Three hundred and forty four preschool children from Ilare district of Ife Central Local Government Area of Osun State, Nigeria were assessed for nutritional status using selected and sensitive anthropometric techniques. The sociocultural practices of the parents were also examined. Approximately 53.8% and 54.7% of the children were identified to be malnourished and stunted respectively. The socioeconomic situation of the family was identified to have a significant influence on the child's nutritional status. Female children were observed not to be as adequately nourished as their male counterparts. However parity and food taboo had no significant influence on the child's nutritional status. The need for improvement in the socioeconomic status of the family and education of the community on the importance of female nutrition are discussed.     

Participatory action research in youth programming: A theory in use

Participatory Action Research (PAR) is a kind of research that involves participants in the research process and produces knowledge that is useful to service providers, program participants, and other professionals. This article describes an example of PAR conducted by a youth-adult team to evaluate a youth conference based on the philosophy of “youth empowerment.” How participants were included in shaping the research and how researchers collaborated with participants and staff of the program are examined, as well as the specific ways in which the evaluation produced knowledge that was used in the program. This research was made possible by the Massachusetts Department of Public Health and Prevention Support Services of the Medical Foundation, Boston.     

An evaluation of contraceptive knowledge and practice in an urban community in Benin City in Nigeria

Cultural and religious objections to family planning among Nigeria's Catholics and Moslems have comprised a serious obstacle to sex education efforts. This study compared contraceptive knowledge and practices among 2 random samples in Benin City: students at an urban female teachers training college and mothers of children brought to an urban health center. All of the 260 women surveyed at the health center were married; among the 175 teachers in training, 104 (59%) were married, 68 (39%) were single, and 3 (1%) were divorced. The contraceptive prevalence rate was 20% among mothers attending the child health center compared with 53% among student teachers (72% among married teachers and 38% among single teachers). Among future teachers, contraceptive awareness was higher among single women (49%) than married women (39%). The predominant forms of contraception used by teacher trainees were the pill (22%), condom (18%), rhythm (13%), the IUD (115), Depo-Provera injections (115), and abstinence (8%). The major sources of contraceptive awareness reported by these women were boyfriend (18%), sister (16%), nurse (14%), friend (13%), and television (13%). 29% of the teachers in training indicated they themselves had made the decision to use contraception, while 43% cited the influence of husband or boyfriend and 19% were motivated by medical personnel.     

Intimate partner violence: prevalence and perceptions of married men in Ibadan, Nigeria

In sub-Saharan Africa rates of intimate partner violence (IPV) are high. Thus, identifying reasons for abuse is crucial in ensuring women's health. Hence, mens perception of IPV was assessed, and prevalence of abuse determined. Survey of 820 married men from six urban communities in Ibadan was done using interviewer administered questionnaire. Four focus group discussions were conducted. Lifetime prevalence of perpetration of physical abuse was 25.1%, while psychological violence was 44.4%. Two hundred and forty (29.3%) had ever perpetrated sexual violence and 23.2% economic violence. At least one of these forms of violence had been perpetrated by 44.1% of the respondents. "Being rude" (66.4%) and "insufficient care of the children" (54.3%) were common justifications for IPV. Motive of the abuse were "to make partner responsible" (60.3%) and "to obtain respect" (59.9%). Predictors of perpetrating violence were being in polygamous unions (OR 1.83, 95% CI: 1.11-3.03), consuming alcohol (AOR 1.67; 95% CI: 1.10-2.53), and being Moslem (AOR = 1.87, 95% CI: 1.21-2.910). Men with inadequate knowledge and negative attitudes had greater likelihood of perpetrating IPV (AOR = 2.11, 95% CI: 1.37-3.26 and AOR = 2.09, 95% CI: 1.33-3.27). IPV was also associated with young age. Premarital counseling on how to resolve conflict without resulting to violence and early education of boys on violence to women is recommended.     

Studies on schistosomiasis in the Niger Delta: Schistosoma intercalatum in the urban city of Port Harcourt, Nigeria

Ova of S. intercalatum have been found in the urban city of Port Harcourt in the Niger Delta area of Nigeria, following examination of stool and urine samples from 1,709 persons (5-15 years of age) resident in various parts of the city. The ova occurred only in urine, with prevalence ranging from 1.0% to 9.8% with an overall prevalence of 5.7%. The intensity of the infection was low. Most infected individuals had counts of less than 500 ova in total bladder content. There was no significant difference in either the prevalence or intensity of the infection among the sexes (Male; prevalence 6.1%, intensity 527.3 vs Female; prevalence 5.4%, intensity 500.9). No case of infection with either S. haematobium or S. mansoni was encountered in the study. Malacological surveys in the gutters, creeks, streams and stagnant waterbodies within the city showed the presence of Lymnaea natalensis, Bulinus forskalii, Pila ovata, Melanoides tuberculata, Physa sp., Lanistes ovum and Segmentorbis sp. B. forskalii is indicated as the probable vector of S. intercalatum in the city. The growing problem of urban schistosomiasis in tropical Africa is discussed. Further studies on urban transmission and epidemiology of schistosomiasis in the Niger Delta area of Nigeria is also indicated.     

��Salmonella hirschfeldii�� in poultry and man in Ibadan, Nigeria

During an epidemiological study of salmonellosis in free-range village poultry, “Salmonella hirschfeldii” (invalid) was isolated from four birds in a village on the outskirts of the city of Ibadan, Nigeria. This is the first report of an isolation of “S. hirschfeldii” in poultry in Nigeria. The same organism was found in an adult male in the village. The simultaneous isolation of this serotype from poultry and man is significant because of the complex epidemiological pattern of salmonella infections in the tropical environment. It was not possible to determine whether the infection was transmitted from the poultry to the villager or vice versa.     

Participatory testing and reporting in an environmental-justice community of Worcester,Massachusetts: a pilot project

Background

Despite indoor home environments being where people spend most time, involving residents in testing those environments has been very limited, especially in marginalized communities. We piloted participatory testing and reporting that combined relatively simple tests with actionable reporting to empower residents in Main South/Piedmont neighborhoods of Worcester, Massachusetts. We answered: 1) How do we design and implement the approach for neighborhood and household environments using participatory methods? 2) What do pilot tests reveal? 3) How does our experience inform testing practice?

Methods

The approach was designed and implemented with community partners using community-based participatory research. Residents and researchers tested fourteen homes for: lead in dust indoors, soil outdoors, paint indoors and drinking water; radon in basement air; PM2.5 in indoor air; mold spores in indoor/outdoor air; and drinking water quality. Monitoring of neighborhood particulates by residents and researchers used real-time data to stimulate dialogue.

Results

Given the newness of our partnership and unforeseen conflicts, we achieved moderate-high success overall based on process and outcome criteria: methods, test results, reporting, lessons learned. The conflict burden we experienced may be attributable less to generic university-community differences in interests/culture, and more to territoriality and interpersonal issues. Lead-in-paint touch-swab results were poor proxies for lead-in-dust. Of eight units tested in summer, three had very high lead-in-dust (>1000 μ g/ft²), six exceeded at least one USEPA standard for lead-in-dust and/or soil. Tap water tests showed no significant exposures. Monitoring of neighborhood particulates raised awareness of environmental health risks, especially asthma.

Conclusions

Timely reporting back home-toxics' results to residents is ethical but it must be empowering. Future work should fund the active participation of a few motivated residents as representatives of the target population. Although difficult and demanding in time and effort, the approach can educate residents and inform exposure assessment. It should be considered as a core ingredient of comprehensive household toxics' testing, and has potential to improve participant retention and the overall positive impact of long-term environmental health research efforts.

     

Fostering an Internet-based work group in community health through action research

In this article, we describe an action research study to foster an Internet-based work group as part of a two-year community health research training program in Alberta, Canada. The objectives of our study were to incorporate Internet-based technology into the program, establish a distributed work group over time, and reflect on the lessons learned. The participants represented seventeen health regions. There were thirty-five instructors and expert resource persons (varied over time), two training coordinators, four support staff, a program coordinator, two action researchers, and two independent consultants. The data collected included program documents, phone interviews, online surveys, meeting notes, online discussions, computer usage log, site visits, keystroke entry logs, help desk logs, and program evaluation reports. Content analysis was conducted with NUD*IST to identify concepts and themes from the data. Our findings suggest that role clarification, facilitative support, network linkages, and workplace learning are important aspects of fostering Internet-based work groups in a health setting, where members strive to establish themselves, seek meaning in their work, support each other, and add value to their organizations.     

Changing an urban community through health research: a South African case study

This article reflects on a positive example of health research translation. Research conducted in a disadvantaged urban community in Johannesburg by the World Health Organization Collaborating Centre for Urban Health as part of the Health Environment and Development study led to a number of community-led health promotion initiatives. Using the Research and Policy in International Development framework for analyzing the links between research and practice, the process and outcomes that have transformed local approaches to health are reviewed. Lessons learned may prove useful to others seeking to use health research to influence local approaches to health.