Community acceptance,satisfaction, and support for case management of malaria of various degrees in selected rural communities in Ibadan,Oyo-State

ObjectivesThis study aimed to assess communities'' perception and adoption of the evidenced-based malaria diagnosis and case management intervention targeted at under-five children. The effectiveness of trained Volunteer Community Health Workers (VCHWs) to diagnose malaria among under-five children using rapid diagnostic testing kit, provide treatment using Artemisinin Combination Therapy and rectal Artesunate were assessed.DesignA qualitative evaluation study was conducted in October 2015.SettingCommunities in the 6 rural wards in Ona-Ara Local Government Area, Oyo State Nigeria.ParticipantsCaregivers of under-five children, community-based frontline health workers, and community leaders selected using purposively sampling.MethodsNine Focus Group Discussions and 15 Key Informant Interviews were conducted using a pre-tested guide. Data were subjected to thematic analysis.ResultsIt was disclosed that VCHWs promoted people''s access to prompt and appropriate malaria treatment. The communities accepted the VCHWs; the reasons given for this included the following: effectiveness of VCHWs in case management of malaria; good inter-personal relationship with caregivers; and the positive health outcomes associated with services provided by them. In addition, community members expressed satisfaction with the VCHWs and provided them with all the support needed to function throughout the malaria case management intervention. The VCHWs considered the support as a great source of encouragement.ConclusionsThe use of VCHWs to treat malaria was adjudged to be effective and considered acceptable to the communities. The adoption of the intervention and its integration into the primary health system by the government is advocated for in medically underserved rural communities.FundingThis work was supported by UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID: A80550 [Nigeria] through funds made available by the European Commission (FP7) for research to improve community access to health interventions in Africa.     

Hypolipidemic effect of Telfairia occidentalis (fluted pumpkin) in rats fed a cholesterol-rich diet

Telfairia occidentalis (fluted pumpkin) is one of the commonly consumed leafy vegetables in Nigeria. In order to justify its inclusion in herbal preparations in African traditional medicine, the possible hypolipidemic effect of this vegetable was investigated in rats fed a cholesterol-rich diet. The ability of Questran, a hypolipidemic drug, to attenuate hypercholesterolemia was also examined. Rats were fed with either a basal diet containing cholic acid (0.2%) or a supplemented diet with T. occidentalis at the 3% and 6% levels. Oral administration of cholesterol for 9 consecutive weeks resulted in a significant increase (P < .001) in the relative weight of the heart of cholesterol-fed rats. However, supplemented diets significantly (P < .001) ameliorated the cholesterol-induced enlargement of the heart. Rats fed on supplemented diets had a dose-dependent reduction in plasma and postmitochondrial supernatant fraction (PMF) cholesterol levels. In particular, supplemented diets containing 3% and 6% T. occidentalis decreased plasma and PMF cholesterol levels by 20% and 30% and by 30% and 45%, respectively. A similar decrease in plasma and PMF cholesterol levels was obtained in Questran-treated hypercholesterolemic rats. Furthermore, 3% and 6% T. occidentalis-supplemented diets significantly (P < .05) decreased the cholesterol-induced increase in plasma and PMF low-density lipoprotein (LDL) cholesterol levels by 24% and 48% and by 28% and 52%, respectively. In contrast, there was no significant difference (P > .05) in plasma and PMF triglyceride levels of rats fed on supplemented diets when compared with cholesterol-fed rats. There were significant decreases (P < .05) in lipid peroxidation levels in rats fed on the supplemented diets. Specifically, 3% and 6% T. occidentalis-supplemented diets decreased plasma and PMF lipid peroxidation by 24% and 20% and by 42% and 21%, respectively. This study demonstrates that T. occidentalis may be a useful therapy for hypercholesterolemia through reducing oxidative stress and cholesterol levels.     

Utilization of Long-Acting Reversible Contraceptive (LARC) Methods in a tertiary hospital in southwestern Nigeria: A Mixed Methods Study

Background/PurposeThere is an increasing trend in the utilization of long-acting reversible contraceptive (LARC) methods globally. The study assessed the utilization of LARC methods and its determinants in a tertiary hospital, southwestern Nigeria using a mixed method study.MethodsA cross-sectional study of women attending the Family Planning Clinic of the tertiary hospital was conducted between November 1, 2018 and October 31, 2019 using both quantitative and qualitative methods. Quantitative data was collected using structured questionnaire while in-depth interviewer topic guide was used to obtain qualitative data from the respondents. The quantitative and qualitative data obtained from the respondents were analyzed using SPSS version 22 and open code version 3.6.2, respectively, and the determinants of utilization of LARC methods were identified using multivariate regression model.ResultsThe current utilization rate of LARC methods was 65.6% and implants accounted for 75% of LARC used. Higher education (p = 0.035), more than 3 living children (p = 0.030), previous use of LARC (p = 0.028), good knowledge (p = 0.025) and positive attitude of the women about LARC (p = 0.026) were significant determinants of utilization among the women. Limiting size of family was the commonest reason among LARC users, while partner disapproval, fear of procedure and side effects were reasons given by non-users.ConclusionsThe utilization rate of LARC methods are high, and this should be sustained through improved information dissemination, education of women and involvement of male partners in reproductive health matters including family planning.     

Maternal perspectives on gestational weight gain: Critical information on developing weight control interventions

Background:

Our aim was to demonstrate what women reported being counselled about weight gain in pregnancy, their perceptions of inappropriate gestational weight gain (GWG), and plans for weight gain in pregnancy.

Materials and Methods:

A cross-sectional survey of perceptions of prenatal attendees about inappropriate GWG was conducted at the prenatal clinic of a referral tertiary health facility in south western, Nigeria, between January 1, 2013 and June 30, 2013. Primary outcomes were the perceptions of women about risks involved with inappropriate weight gain and the proportion of women who self-reported being counselled at all on GWG, and had the right knowledge of risk(s) involved with inappropriate weight gain during pregnancy.

Results:

Of the 348 women who completed the survey, approximately four-fifths (82.8%) reported GWG being discussed at all by health care provider. Fewer women (29.3%) believed there were maternal risks with excess weight gain compared to inadequate weight gain (34.8%). With respect to perception of risks of inappropriate weight gain to infants, 23.65 and 18.4%, respectively, believed there were infant risks with excess and inadequate GWG. Overweight women [OR 0.39 (95% CI 0.16-0.98)] and those who received GWG information from more than one type of health care provider [OR 4.71 (95% CI 1.64-13.78)] had significant increased rate of correct knowledge of risks involved with inappropriate GWG.

Conclusion:

The lack of awareness of risks involved with inappropriate GWG by over half of respondents underscores the need for improvement in educational intervention on GWG in our environment.     

Identification and comparison of the volatile constituents of fresh and dried leaves of Spondias mombin found in North-central Nigeria: in vitro evaluation of their cytotoxic and antioxidant activities

Context: Various studies have shown that the leaf extracts of Spondias mombin Linn (Anacardiaceae) possess pharmacological properties such as antioxidant and antiviral effects. However, no biological activity from its essential oil has been reported in literature.

Objective: To analyse the chemical constituents, cytotoxic activity and antioxidant capability of the essential oils from fresh and dried leaves of S. mombin.

Materials and methods: Hydrodistillation using Clevenger-type apparatus was employed to obtain the essential oil. Oil analysis was performed using an HP 6890 Gas Chromatograph coupled with an HP 5973 Mass Selective Detector. The cytotoxicity bioassay was carried out using the brine shrimp lethality test (10,000–0.01?μg/mL). Additionally, the reactive oxygen species scavenging potential of the two S. mombin oils (1000–200?μg/mL) were investigated using a hydroxyl radical scavenging and ferric iron reducing system.

Results: Chemical analysis of essential oils from S. mombin revealed the presence of 41 compounds, with predominance of monoterpenoids, sesquiterpenoids and non-terpenoids derivatives. In both fractions, the principal component was β-caryophellene (27.9–30.9%), followed by γ-cadinene (9.7–12.3%). There was an increase in the oxygenated monoterpenoid contents and a concomitant decrease in the amounts of sesquiterpenoids hydrocarbons observed on drying the leaves. The oil obtained from the fresh leaves was more active than that obtained from dried leaves, with LC₅₀ values (from the brine shrimp lethality assay) of 0.01 and 4.78?μg/mL, respectively. The two oils (from fresh and dried leaves) at 1.0?mg/mL scavenged hydroxyl radical by 83% and 99.8%, respectively. Moreover, they reduced ferric ion significantly and compared favourably with vitamin C.

Conclusions: Essential oil derived from the leaves of S. mombin could hold promise for future application in the treatment of cancer-related diseases.     

Cesarean section on maternal request: the viewpoint of expectant women

Purpose

To determine the women’s perception and factors influencing willingness to have cesarean section on maternal request (CSMR) in the absence of medical or obstetric indication.

Methods

A cross-sectional questionnaire-based survey of 752 antenatal clinic attendees at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti. Pre-tested questionnaires were used to elicit information on socio-demographic and obstetric variables, awareness and perspective of CSMR and the willingness to request CS without physician’s recommendation. Frequency tables were generated and univariate and multivariate logistic regression were used to determine factors that influenced CSMR using SPSS software version 16.0.

Results

Forty-eight (6.4 %) of the respondents reported willingness to request CS. The most common motivations for the request were fear of losing the baby during labor, delay in conception and fear of labor pains. Analysis by simple logistic regression and multiple regression showed age, parity and educational status were not significantly related to the decision for CSMR.

Conclusion

CSMR is an evolving entity in obstetrics practice in the developing countries. Delay in conception, fear of labor pain and loss of baby during labor appear to be strong motivations.