Journal of Community Medicine and Primary Health Care

Case Report - Unexpected histopathological finding: a case report of Schistosoma ova in prostate adenoma

M.M. Kura , R. Ibrahim , M.M. Damina , A.I. Lawan — Fri, 20 Dec 2024 00:00:00 +0000

Background: Schistosomiasis of the gastrointestinal and urinary tracts is wellknown, yet its chronic effect on host genitalia such as the prostate is often ignored or overlooked. This report describes an incidental finding of Schistosoma ova in a prostate adenoma.

Case: A 66-year-old man from a schistosomiasis endemic area in northeastern Nigeria presented with symptoms of bladder outlet obstruction. The Prostate-specific antigen (PSA) was normal, and he had no family history of prostate cancer. Histopathology of the prostate adenoma removed at open prostatectomy had multiple foci of acute and chronic inflammation with calcified Schistosoma ova and areas of luminal abscesses, and there were no foci of malignancy. A diagnosis of prostate adenoma with schistosomiasis was made.

Conclusion: Genital schistosomiasis should be a differential diagnosis of prostate pathologies, especially in patients who live in or have recently visited schistosomiasis endemic communities.

Prevalence and predictors of HIV status disclosure by young people on HAART in selected healthcare facilities of Benue, Nigeria: A Rural-Urban Comparison

Fri, 20 Dec 2024 00:00:00 +0000

Background: Due to increased accessibility to highly active antiretroviral therapy (HAART), HIV-infected children have improved long-term outcomes, reaching adolescence and adulthood. With this comes different challenges, one of which is HIV status disclosure: from parents to children (passive disclosure) and from young people to others (active disclosure). The challenge of disclosure has been found to impact adherence to treatment and, consequently, the lives of these young people. This study aimed to determine and compare the prevalence and determinants of passive and active HIV disclosure among young people attending urban and rural health facilities in Benue State, Nigeria.

Methods: A cross-sectional study was conducted among 354 young people aged 10 – 24 years in an urban facility (Federal Medical Centre, Makurdi) and a rural facility (NKST Hospital, Gboko) using an interviewer-administered, pretested questionnaire. Data were analysed using IBM SPSS version 23. Descriptive statistics were generated and tests for association between subgroups were carried out using chi-square and Fisher’s exact test.

Results: There was a high rate of passive disclosure of HIV in both facilities (85.8% in the urban facility and 81.4% in the rural facility). Active disclosure was 41.9% and 74.5% in the urban and rural facilities respectively. Predictors of passive disclosure included duration on HAART, route of transmission, while predictor of active disclosure of HIV in both facilities was age less than 17 years.

Conclusion: HIV disclosure support through disclosure counselling should be provided to young people, especially adolescents, parents and guardians.

Predictors of cervical precancerous lesions among women attending an urban Primary Health Centre in Lagos State, Nigeria

Fri, 20 Dec 2024 00:00:00 +0000

Background: Cervical cancer remains a major public health issue in Nigeria, significantly contributing to women’s morbidity and mortality. This study aimed to identify predictors of cervical precancerous lesions among Nigerian women attending an urban Primary Health Centre (PHC) in Lagos State.

Methodology: A retrospective cross-sectional study was conducted using hospital-based data from 500 women aged 20 to 55 years who were screened for cervical cancer at an urban PHC in Lagos between June 2021 and June 2022. Information on sociodemographic factors, sexual and reproductive history, behavioural characteristics, and Visual Inspection with Acetic Acid (VIA) screening outcomes was analysed using Epi Info version 7.2.5.0.

Results: Of the 500 women screened (mean age: 37.2 years), 45 (9%) had positive VIA results. The median age of sexual debut was 22 years, and 5.7% reported a family history of cervical cancer. Prior screening uptake was low (15.3%). Significant predictors of VIA positivity included early sexual debut (<18 years) (OR=1.6; 95% CI=1.43-1.85; p < 0.001), age ≥35 years (OR=2.8; 95% CI=2.45-3.13; p < 0.001), and higher parity (OR=2.4; 95% CI=1.86-3.00; p < 0.001).

Conclusion: Advanced age, early sexual debut, and higher parity were significant predictors of VIA positivity. Targeted interventions should focus on prioritising cervical screening for older women, raising awareness about the risks of early sexual debut, and enhancing prevention efforts for women with higher parity in Lagos state.

Assessment of prostate cancer awareness and screening among men in Gombe State, Nigeria

U.N. Adamu , R. Ibrahim , A. Sunday — Fri, 20 Dec 2024 00:00:00 +0000

Background: Prostate cancer is the number one cancer among Nigerian men, and there are screening methods that can be employed for early detection and reduction of mortality. The objective of this study was to assess the level of knowledge of prostate cancer and its screening practices among men in Gombe local government.

Methods: A descriptive cross-sectional study was carried out among men aged 40 years and older. The studied community was selected using a simple random sampling technique, and a semi-structured, interviewer-administered questionnaire was used to collect data, which was analysed using SPSS version 23 at a p-value of 5%.

Results: The mean age of the respondents was 55.87±13.40 years. The findings showed that only 2.5% of the respondents had good knowledge of prostate cancer. About 37.63% of the respondents had a high level of positive perception of prostate cancer. Very few respondents (2.5%) had good screening practices. There was a
statistically significant relationship between age knowledge of prostate cancer (p-value 0.045), while level of education was found to be statistically associated with screening practice for prostate cancer (p-value 0.020).

Conclusion: The study showed that, despite poor knowledge and screening practices for prostate cancer, positive perceptions towards prostate cancer are encouraging. This calls for improving community awareness about the importance of prostate cancer screening by health authorities in Gombe State.

Substance use among undergraduate students at the University of Lagos

O.O. Ekekezie , M.K. Daramola , F.A. Olatona — Fri, 20 Dec 2024 00:00:00 +0000

Background: The increasing prevalence of substance use among young people is a major concern globally and specifically in Nigeria, with significant impacts on individuals, society, and public health. This study assessed the pattern, prevalence and factors associated with substance use among the undergraduate students at the University of Lagos.

Methods: A descriptive cross-sectional study was conducted utilizing a multistage sampling method to select 404 students from the registered full-time undergraduate students. Data was obtained using self-administered questionnaires adapted from the WHO model core questionnaire format. Descriptive, bivariate and multivariate analyses were done using IBM SPSS version 23. The level of significance was set at 5% and the confidence interval at 95%.

Results: Most respondents (48%) were between 17-20 years, with a mean age of 20.9+2.44 years, 54.5% were male and 45.5% were in 300 level. Seventy-one percent had good knowledge, 65.4% had positive attitudes towards not using substances, while the prevalence of substance use was 36.7%: 23.3%, 10.7% and 2.7% for tobacco, drugs and alcohol respectively. Energy drinks (with its significant caffeine content) were the most commonly consumed drug-containing substance (62.8%). Peer pressure was the leading reason for substance use (65.1%). Age, gender, level of education and tobacco use were predictors of drug use.

Conclusion: Knowledge and a positive attitude towards not using substances did not significantly influence practice. Smokers were more likely to use drugs. Health education is required to correct the perceived health benefits of energy drinks while peer influence can be harnessed to curb the menace.

Compliance with the COVID-19 schools’ reopening guidelines in public and private primary schools in a South-West Nigerian Town

N.E. Okoro , O.T. Afolabi , S.O. Dauda , O.O. Adesoye — Fri, 20 Dec 2024 00:00:00 +0000

Background: The COVID-19 pandemic took the world by surprise with various burdens of morbidity and mortality in different countries, including Nigeria. Consequently, schools in Osun State were shut to prevent spread of the disease. The Federal Ministries of Education and Health and the Nigeria Centre for Disease Control prepared a set of COVID-19 schools’ reopening guidelines for a safe school environment upon resumption. However, there is sparse documentation on compliance with these guidelines in primary schools nationwide.

Objective: To assess and compare the compliance of public and private primary schools in Ile-Ife with the COVID-19 schools’ reopening guidelines.

Methods: A comparative cross-sectional study with 100 (50 public and 50 private) randomly selected primary schools in Ile-Ife. The instrument was a checklist of the COVID-19 guidelines assessed in the schools by the research team. Data were analysed using SPSS version 25. Univariate analysis was used to present the compliance in the schools, while the Chi-Square test was used for comparison, and
p-values less than 0.05 were considered significant. Ethical approval was obtained accordingly.

Results: Overall, only 21 schools (21%) had good compliance, comprising six public (12%) and 15 private (30%) schools. There was a significant association between the type of school and compliance (p = 0.027).

Conclusion: Compliance with the COVID-19 guidelines was generally low, although better among the private compared to the public schools. The materials needed for the prevention and control of COVID-19 and other infections should be provided in schools at all times.

Patient delay in seeking TB diagnostic services

A.O. Akinremi , M.C. Asuzu — Fri, 20 Dec 2024 00:00:00 +0000

Background: It has been documented that a major contributory factor to the high burden and transmission of tuberculosis (TB) is delayed presentation, which could be alarmingly prolonged from two months up to 12 months reportedly. This study explored the factors responsible for patient delay in seeking TB diagnostic services.

Methods: This was a descriptive cross-sectional study undertaken at selected TB centres with large annual turnover, using a pretested interviewer-administered questionnaire. The participants were TB patients accessing treatments at major TB centres, which included primary health centres, general hospitals, tertiary, and private facilities. Ultimately, 787 patients interviewed with complete records had their data analysed.

Results: A little less than two-thirds (63.3%) of the respondents were married, with about 7.8% of them having no form of formal education. About 54.8% of respondents reported first visiting a pharmacy or drug store after the onset of TB symptoms. The mean cough duration before medical consultation was 5.85 weeks, and 38.3% of respondents had a prolonged delay before seeking care. The identified predictors of patient delay in seeking TB diagnosis were older age, HIV seropositivity, private facility, and long facility distance.

Conclusion: The prevalence of prolonged delay in accessing TB diagnostic services is still generally high. Efforts must be made towards early case detection as many complications arise with late presentation. The delay can be reduced via active wareness creation, patient education, and improved engagement of private facilities in TB services to increase access to care.

Review Article - Bibliometric analysis of clinical health and medical care research: the case of Sudan from 1991 to 2021

F. Omer , V.O. Otitolaiye — Fri, 20 Dec 2024 00:00:00 +0000

Background: The World Health Organization (WHO) identifies good health as a crucial human resource for daily life, survival, security, and prosperity. Developing nations face numerous challenges that hinder the advancement of good health and well-being. As one of the largest countries in Sub-Saharan Africa, Sudan is positioned to advance “Good Health and Well-being.” Therefore, stakeholders are examining the current status and future outlook of clinical health and medical care (CHMC) research in Sudan. This paper used a bibliometric analysis (BA) of CHMC research in Sudan to understand the current challenges, research landscape, and scientific developments.

Methodology: The PRISMA technique was used to identify, screen, and analyze 560 documents on CHMC research from 1991 to 2021 using Scopus data. BA was adopted to perform co-authorship, co-occurrence, and citation analyses using VOSViewer.

Results: Results revealed that 85.5% of the documents are research articles, although reviews, notes, and letters account for 10.2%. The most prolific authors are Peter Moszynski (United Kingdom), Ishag Adam (Saudi-Arabia), and Hashim Ghalib (United States). Khartoum University (Sudan) is the most prolific organization/affiliation. Funding analysis revealed that CHMC research is mainly financed externally by charitable and development organizations. The most active researchers in CHMC research are in Sudan, although strong collaboration exists with others abroad due to financial support, research funding, and knowledge exchange.

Conclusion: The study suggests that CHMC research in Sudan can significantly contribute to achieving the SDGs, but further research should address major social challenges and foster targeted collaborations.

Maternal occupation and child nutritional care among working-class mothers of children aged 6-24 months in Ibadan Metropolis

O.M. Ajayi, O.E, Oyewole , P.A. Agada , M.C. Asuzu — Fri, 20 Dec 2024 00:00:00 +0000

Background: Mothers' involvement in income-generating activities can limit their time on child-care practices, which may negatively affect their children's nutritional status. This study was designed to investigate the perceived effect of maternal occupation on the nutritional care of children aged 6-24 months.

Methods: This cross-sectional survey involved 392 consenting working-class mothers with children aged 6-24 months purposively selected from vaccination centres in all four Oyo State-owned secondary and tertiary health facilities within the Ibadan metropolis. Child nutritional care (CNC) was measured using five domains of care: child-feeding knowledge (CFK), child-feeding practice (CFP), child-mother interaction (CMI), hygiene practices (HP), and health-seeking behaviour (HSB). Each scale was graded as <50%= poor and ≥ 50%= good. Data were analysed using descriptive statistics, the Chi-square test, and logistic regression at p<0.05.

Results: Most (81.0%) of the mothers worked long hours daily. Trend of poor CNC was 31.1% (CFK), 23.7% (CFP), 17.9% (CMI), 25.8% (HP), and 13.0% (HSB). Traders had poorer scores but no statistical significance for the selected domains CFK (53.0%), CFP (37.0%), CMI (45.0%), HP (61.4%) and HSB (100%). Mothers who worked six hours at most daily were more likely to have good HP (OR=1.31, 95% C.I: 0.68-2.50) and good CFK (OR=1.87, 95% C.I: 1.02-3.43) compared with mothers who worked more hours daily.

Conclusion: Traders provided poor child nutrition, and mothers who worked fewer hours daily had better hygiene practices and good child-feeding knowledge. Workplace childcare health education materials can potentially improve working mothers’ childcare practices.

Occupational injuries and associated risk factors among construction workers: a cross-sectional in rural areas of Eastern India

S. Mohanty , G. Mohapatra , S. Madhusikta , M. Kar — Fri, 20 Dec 2024 00:00:00 +0000

Background: Due to the nature of their work, construction workers are always at high risk of sustaining physical injuries. This study assessed the prevalence, types of workplace injuries, and associated factors among construction workers in Bhubaneswar, Odisha, India.

Methods: The study was conducted in the Outpatient Department (OPD) at a Rural Health Training Centre (RHTC) linked to a medical college in Bhubaneswar, Odisha, India, from October 2021 to March 2022. A total of 260 workers aged 18 and older selected by systematic random sampling from various construction sites related to RHTC were interviewed. Trained field staff, guided by one of the investigators, gathered data using a questionnaire.

Results: Most participants (49.62%) were between 19 and 28 years of age, predominantly male (85%), and studied up to primary level of education (48.5%). The prevalence of injuries was 50.77 %, and the most prevalent injuries include sprains and cuts/lacerations (24.24%). Falling objects at construction sites were the most common cause of injury (40.91%). Plumbers (odds ratio of 11.11, 95% CI: 1.27-96.87) and rod binders (odds ratio of 2.67, 95% CI: 1.08-6.59) faced greater odds of sustaining injuries, while the duration of work significantly influenced the likelihood of workplace injuries.

Conclusion: Construction workers at the study place had a relatively high prevalence of external injuries. The present burden of injuries in the locality must be lessened by effective implementation of health and safety management, training construction workers, and ensuring access to appropriate personal protective equipment.