Mycolactones, secreted by Mycobacterium ulcerans, were previously believed to prevent super infection in Buruli ulcer lesions. However, little is known about secondary bacterial infections in these ...lesions. This study evaluated contaminating bacterial flora and their antibiotic susceptibility patterns in cases of previously untreated Buruli ulcer disease from three states in Southern Nigeria.
A prospective analysis was conducted between January and June of 2015 using wound swabs from eligible patients with Buruli ulcer disease, confirmed by quantitative-polymerase chain reaction, with active ulcers. Microbiological analyses including isolation of bacteria, species identification of isolates, and drug susceptibility tests were performed.
Of 51 patients, 27 (52.9%) were female. One or more bacterial species of clinical importance was isolated from each patient. A total of 17 different microbial species were isolated; 76.4% were Gram-negative and 23.6% were Gram-positive isolates. The most common bacterial species detected was Staphylococcus aureus (24%), followed by Aeromonas hydrophila (13%), Pseudomonas aeruginosa (13%), and Klebsiella pneumoniae (11%). Drug susceptibility tests showed a particularly high frequency of resistance to commonly used antimicrobials in Nigeria for Staphylococcus aureus.
Super bacterial infections occur in Buruli ulcer lesions in Nigeria, and these infections are associated with high rates of resistance to commonly used antibiotics in the country.
A Delphi Exercise was undertaken with two objectives: (1) To ascertain whether operational definitions for WHO Disability Grading could be formulated by consensus. (2) To develop a set of simple ...guidelines based on those definitions for the guidance of health workers. Fifteen people with general expertise in prevention of disability due to leprosy were invited to participate as Delphi panel members, twelve responded positively. Eight issues that commonly cause confusion provided foci for the exercise. Operational definitions aimed at resolving those issues were developed by consensus. Simple guidelines for health workers, based on those definitions were also created and supported by consensus. This paper presents the process followed and the outcomes gained from the endeavour.
Poor knowledge can influence timely care-seeking among persons with Buruli ulcer disease (BUD).
To assess community knowledge, attitude and stigma towards persons with BUD in endemic settings of ...Southern Nigeria.
This was a cross-sectional survey conducted among adult community members in four States of Southern Nigeria. A semi-structured interviewer-administered questionnaire was administered to all participants.
Of 491 adults who completed the survey, 315 (64.2%) belonged to the ≤40 years age group, 257 (52.3%) were males and 415 (84.5%) had some formal education. The overall mean (SD) knowledge score was 5.5±2.3 (maximum 10). Only 172 (35.0%) of the participants had a good knowledge of BUD. A total of 327 (66.6%) considered BUD as a very serious illness. Also, there was a high-level of stigma against BUD patients; 372 (75.8%) of the participants felt compassion for and desire to help them, 77 (15.7%) felt compassion but tended to stay away from them, and 53 (10.8%) feared them because they may infect them with the disease. Having a formal education and ethnicity were independent predictors of good knowledge of BUD.
There is poor community knowledge of BUD in endemic settings of Southern Nigeria which influenced the attitude and perceptions of community members towards persons with BUD.
Purpose
– In 2007, Nigeria commenced a nationwide behavioural change communication (BCC) intervention to increase uptake of tuberculosis (TB) care services. The purpose of this paper is to evaluate ...the effect of TB BCC intervention on knowledge and perception of TB in Enugu state, southeast Nigeria.
Design/methodology/approach
– This is a cross-sectional study carried out in December 2009 in which a total of 1,200 respondents (620 males and 580 females) from six local government areas (three urban and three rural), selected by multi-stage sampling technique were interviewed using a semi-structured questionnaire.
Findings
– The survey showed that most of the respondents had access to radio and about half to television. Access to media was significantly higher in urban areas than rural areas. Radio and community were the commonest sources of information of TB. The majority of the respondents were aware of that there was a message, however, ability to recall the content of the message varied. Significant association was observed between knowledge of the health education message and knowledge of TB transmission, that TB is curable and of appropriate care-seeking behaviour. Access to this media health education intervention was determined by age, gender, educational status, literacy, religion and access to media.
Practical implications
– The study showed that TB BCC is associated with high-level awareness of TB disease and appropriate care-seeking behaviour. Socio-demographic characteristics and locality were found to influence access to mass media communication. Therefore, consideration should be given to the appropriateness of medium of communication in the design of TB BCC. However, there is need to combine it with other strategies to reach the disadvantaged population.
Originality/value
– This study is the first population-based survey to ascertain access to TB-related BCC intervention and its effect on knowledge and care-seeking behaviour of this study population.
Objectives: The Participation Scale (P-Scale) has been shown to be a valid and reliable scale for measuring participation restriction in people affected by leprosy. Until, now there has been no ...translation of the scale in Igbo. This study set out to produce a valid translation of the P-Scale in Igbo. Design: The research design was a cross-sectional survey. Forty (40) subjects were chosen by purposive sampling. Data were analysed using Cronbach's Alpha and factor analyses. Result: Reliability analysis conducted using the Cronbach Alpha reliability test revealed that the overall reliability Alpha of the scale is 0-91. Firstly, most of the scale items showed a correlation coefficient of at least 0-3 with at least one other item on the scale, which suggests reasonable factorability. Secondly, the Kaiser-Meyer-OLkin measure of sampling adequacy was 0-77, and Bartlett's test of sphericity was significant (chi square (190) = 473-93, P < 0-001). Finally, the communalities were all above 0-5 confirming that each item shared some common variance with other items. Conclusion: It can be concluded that this Igbo translation of the Participation Scale is reliable and valid for use among the Igbo speaking group in Nigeria. Keywords: Participation Scale, Psychometric, Leprosy, Igbo
Leprosy or Hansen's disease is an infectious disease affecting skin and peripheral nerves. The World Health Organization (WHO) Recent Report reveals Africa as having 20,599 new cases, America 36, ...178, Eastern Asia 166,445, Western pacific 5,400; totally up to 232,875 new cases. Nigeria as at 2012 had 3,805 new cases. Nerve dysfunction can lead to severe impairments, such as wounds, clawing and shortening of digits, and visual impairments that are often indicated as WHO Grade 2 disabilities. The Screening Activity Limitation Safety Awareness (SALSA) scale however, was developed to-measure self-reported activity limitation in people affected by peripheral neuropathy, and has been translated into several languages world-wide, including two of the three major indigenous languages in Nigeria (i.e. Yoruba and Hausa), leaving the Igbo language yet to be translated. This resulted in the present study, in which the scale was translated into Igbo and the psychometric properties also established to help in data collection and to promote research among the Igbo speaking people living with disabilities from Hansen's disease.
The research design was a cross-sectional survey, facility based with 70% RFT and 30% on MDT. Data were analysed using Cronbach's alpha and factor analyses.
A quantitative exploration of participants' characteristics revealed that of the 40 respondents that participated in the study; 87.5% of them were predominantly from a rural population; 42.5% were males and 57.5% females. Their ages ranged between 15 and 64 years; 55% were uneducated; while 45% were educated. The SALSA Scale was interviewer-administered to the participants. Reliability analysis conducted on the data revealed high Cronbach's alpha co-efficient of 0.93 - 0.94 for the entire items on the scale. Firstly, most of the scale items correlated at least 0.3 with at least one other item on the scale, Secondly, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.71, Bartlett's test of sphericity was significant (Χ2 (190) = 482.63, P < 0.001). Finally, the communalities were all above 0.3. The principal factor analysis of the scale revealed a five factor scale, having fulfilled all the necessary conditions.
It can be concluded that the Igbo version of SALSA is reliable and valid for use among the Igbo speaking group in Nigeria.
Yaws is a disease caused by the bacteria Treponema pallidum subspecies pertenue, which is most commonly seen among children below 15 years. In the twentieth century yaws was endemic in Nigeria but ...eradication strategies markedly reduced the disease burden. Currently there is minimal data on the ongoing transmission of yaws in Nigeria, despite reports of confirmed yaws cases in neighbouring West African countries.
We conducted both community and school-based active yaws case search among school-aged children in southeast Nigeria. Children were screened by trained community volunteers. Suspected yaws cases were clinically reviewed and tested using rapid diagnostic serological tests.
Between February and May 2021, up to 28 trained community volunteers screened a total of 105,015 school children for yaws. Overall, 7,706 children with various skin lesions were identified. Eight (8) suspected cases of yaws were reported, reviewed and screened, but none was confirmed using rapid diagnostic tests. The four most common skin conditions identified were scabies (39%), papular urticaria (29%), tinea corporis (14%) and tinea capitis (12%).
No case of yaws was confirmed in this large population of children in south-east Nigeria. Continuous community awareness and yaws case finding activities have been recommended across Nigeria.
Coping with a relative with a learning disability could be a stressful experience for family members. The present study is aimed at exploring the coping strategies adopted by families in trying to ...make meaning of their situation.
A qualitative study design using focus group discussions (FGDs) was adopted. Ten FGD sessions were held with family members of persons with a learning disability.
Findings revealed patterns of family coping to include problem-focused, emotion-focused, and spiritual/religious-focused. Also, coping responses to a learning disability varied based on the level of information available to families about the condition of their relative. In some cases, interspousal relationship was strained due to stress.
It was recommended that families of persons with a learning disability need social support and professional help from social workers to facilitate the adoption of more positive-oriented coping strategies by family members.
There is a dearth of experience in and evidence for cost-effective integrated community-based management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the ...knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria.
This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria. The survey was completed by 353 community members (61.8% female) and 15 health care workers (100.0% female). A total of 52 individuals participated in six FGDs. Of the community members, 236 (66.9%) had heard or seen a case of leprosy; 324 (91.8%) and 131 (37.5%) had heard or seen a case of Buruli ulcer and lymphatic filariasis, respectively. Again, 213 (60.3%) of the respondents reported that the diseases were caused by witchcraft or curse. As regards prevention, 241 (68.3%) suggested avoiding handshake with affected persons. Up to 223 (63.2%) of respondents strongly agreed to the seriousness of skin NTDs in their community. Meanwhile, 272 (77.1%) of the respondents believed that the transmission of these skin NTDs can be prevented. Furthermore, 324 (91.7%) desired active community engagement for control of skin NTDs. Regarding community care seeking practices, 197 (55.8%) would first visit the health centre/hospital, followed by 91 (25.8%) traditional healer/herbalist and 35 (9.9%) pharmacy/patent medicine vendor if they develop a skin NTD. Overall, 332 (94.1%) of respondents expressed interest in being taught self-care practices for skin NTDs. Out of 15 healthcare workers, 13 (86.7%) were able to correctly diagnose two of these skin NTDs and 10 (66.7%) would encourage patients to practice self-care. Prominent themes in the FGDs were belief in witchcraft and herbal remedies; as well as the occurrence of physical, social and economic distress.
Our study helped quantify the information gaps that need to be addressed in order to create demand for integrated skin NTDs services in an endemic setting in Nigeria. Individual, structural and socioeconomic challenges to access and delivery of services were identified. Community and health care workers' empowerment and engagement through outreach and regular training, respectively may alleviate these challenges.
PDF
