Open Access Original Research Article

A Preliminary Study on Enrollees Perception and Experiences of National Health Insurance Scheme in Lagos State, Nigeria

B. Adewale, A. K. Adeneye, S. M. C. Ezeugwu, E. E. Afocha, A. Z. Musa, C. A. Enwuru, J. I. Yisau, T. Y. Raheem, M. A. Sulyman, A. A. Adeiga, O. M. Olayemi, I. A. O. Ujah

International Journal of TROPICAL DISEASE & Health, Page 1-14
DOI: 10.9734/IJTDH/2016/27309

Aim: To assess enrolees’ perception and experiences on the National Health Insurance Scheme, launched in Nigeria, in 2005 and made mandatory for all Federal civil servants.

Study Design: This descriptive cross-sectional study conducted between August and September 2013 focused on civil servant enrolees of three tertiary health institutions in Lagos, South-West Nigeria.

Methodology: Three tertiary health institutions were purposively selected. Systematic sampling was employed in selecting 150 enrolees. Quantitative data were collected from each consenting selected enrolee using semi-structured questionnaire which probed into demographic characteristics, knowledge, expectations, services accessed, experiences, perceptions and, suggestions for improvement.

Results: A total of 143 enrolees (males 43.7%; females 56.3%) completed the questionnaire. Majority (97.2%) had knowledge of the scheme: easy access to affordable healthcare (40.7%), subsidized health care services (22.2%) and pooling of resources (11.1%). Subsidized treatment, quality healthcare provision and free treatment were the most mentioned expectations. Treatment and general care were the most accessed services (55.7%). One in every five enrolees (22.9%) never accessed the services and, 18% had no knowledge of complaints channels. More than half (59.8%) were dissatisfied with services accessed for reasons ranging from drug unavailability (27.8%) to poor quality of service (12.6%) and out-of-pocket payment on drugs and tests (11.4%). Majority (57%) however claimed reduction in out-of-pocket expenses. Major suggestions proffered by enrolees (53.1%) for improving the scheme covered regular monitoring, continuous availability of genuine drugs, sensitisation, prompt response to enrolees’ complaints and continuous review of the policy.

Conclusions: Regular monitoring of the scheme’s operations is expected to contribute greatly to improvement of the scheme which should minimise out-of-pocket health expenses. Continuous enlightenment is desirable with emphasis on ensuring enrolees’ satisfaction for sustainability to secure the universal health coverage target in the country.

Open Access Original Research Article

Prevalence of Nontuberculous Mycobacteria Infections in Patients Diagnosed with Pulmonary Tuberculosis in Ibadan

O. I. Falodun, O. E. Fagade, S. I. B. Cadmus

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/IJTDH/2016/28058

Introduction: Nontuberculous mycobacteria (NTM) are mycobacteria species other than the Mycobacterium tuberculosis complex (MTC); they are opportunistic pathogens and cause life threatening infections with symptoms that mimic those of tuberculosis (TB). Paradoxically, the routine diagnostic tools for TB in Nigeria cannot differentiate MTC from NTM; Hence, TB patients with NTM infections are sometimes incorrectly diagnosed as TB.

Aim: To determine the prevalence of NTM among routinely diagnosed pulmonary TB patients attending the Directly Observed Treatment Short-course (DOTS) centres in Ibadan, Nigeria.

Materials and Methods: This was a cross sectional study conducted at the Tuberculosis Research Laboratory, Department of Veterinary Public Health and Preventive Medicine, University of Ibadan. Sputum samples were collected consecutively from 319 suspected TB patients with or without human immunodeficiency virus (HIV) between January 2010 and November 2011 on clinical visits to eight DOTS centres in Ibadan. The samples were cultured on Lowenstein-Jensen medium for about 4-8 weeks after decontamination using N-acetyl-L-cystein-NaOH method. Molecular characterisation of the isolates was done using genus typing. Data obtained were analysed using STATA 12.

Results:  In all, a total of 149 isolates were obtained, 26 (17.4%) were identified as NTM; 11 (7.4%) of which were from HIV positive patients, 3 (2.0%) from non HIV patients and 12 (8.0%) unknown cases. The univariable analysis showed association between isolation of NTM and center as well as case. Subjects screened at Ade Oyo (OR=3.5; 95%CI: 1.1-11.8) showed higher likelihood of being infected with NTM.

Conclusion: The high prevalence of NTM among patients earlier diagnosed as PTP following the diagnostic algorithm used in DOTS centers in Nigeria underscores the need for nationwide studies to determine the prevalence of NTM among suspected TB patients. The integration of culture and molecular techniques to improve on the diagnostic algorithm for TB management and control in Nigeria is hereby recommended.

Open Access Original Research Article

Evaluation of Health Inequity Status of In-School Youths in Uyo Capital Territory, Nigeria

Emem Bassey Inyang, Uwemedimbuk Smart Ekanem, Anietie Mfoniso Umoren

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/IJTDH/2016/27474

In any emerging urban territory, there are bound to be opportunities and advancements that will create alteration in the social order leading to social and economic classes. The resultant variations in socioeconomic status among the households is a critical factor in shaping individual and family decisions especially in taking advantages of services that can improve the general wellbeing of the households in space and time. Furthermore, this variation can also influence the health status of households’ members across gender, generation and rurality. The study opted to ascertain this situation in a fast developing region in Niger Delta of Nigeria. Thus, this study evaluated health inequity status of urban youths in a Niger Delta region of Nigeria. Specifically, the demographic profiles of the respondents were analyzed, the pattern of health inequity indicants were ascertained and the pattern of index of health inequity status of the urban youths were assessed. The study was an expo facto research type and adopted a cross sectional survey design. Data were collected using a self-administered structured questionnaire. A sample size of 181 respondents were selected through multi-stage sampling procedure. Descriptive statistics including frequency count, percentage and composite index analyses were used to analyze the collected data. Findings show that majority of the respondent within the ages of 17 to 19 years and 86.7% were native of the study area. Of course 90.6% were depending on their parents for socioeconomic support as 68.0% resides in areas that were not totally classed as urban. With regards to health equity status, 40.9% of the respondents had low health equity status, 57.5% had average status and only 1.7% had high health equity status. The later findings buttress the fact that there is wide gap in health and socioeconomic wellbeing of the younger generation across the households and therefore improvement in the quality of child social protection and reduction in child poverty status.

Open Access Original Research Article

Studies of Urinary Schistosomiasis amongst School Age Children in Ebonyi North Senatorial District of Ebonyi State, Nigeria

S. O. Onwe, O. C. Ani, C. A. Uhuo, C. S. Onwe, O. O. Odikamnoro

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/IJTDH/2016/13138

The prevalence of urinary schistosomiasis among school age children in seven primary schools in Ebonyi North Senatorial district of Ebonyi State was investigated using standard parasitological technique. Out of 525 pupils examined, 119(22.7%) were found to be excreting ova of S. haematobium in their urine, which comprised 44 females (17.5%) and 75 males (27.5%). Children between the age of 15 -16 years recorded the highest prevalence of 35.9%. Chi square test showed that the differences among the age groups are not statistically significant. The distribution of the infection was significantly high in Hill Top Primary School Amoffia Ngbo, Ohaukwu Local Government Area with the prevalence of 55.3% when compared to other locations assayed. Children whose parents were farmers recorded the highest prevalence (26.4%) when compared to those of other occupations (p<0.05). In the same vein, children that make use of quarry pit water as their main source of water supply recorded more infection than those that use borehole and pipe-borne water. However, health awareness programmes, provision of portable water, mass chemotherapy as well as environmental measures that may reduce population density of snail intermediate host of S. haematobium will be useful in the control of urinary schistosomiasis in the study area.

Open Access Review Article

Perspectives on Hepatitis B Vaccination among Health Care Workers in Nigeria

Oluwabunmi Lara Ogunlade

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/IJTDH/2016/27450

Nigeria has been declared among the group of countries endemic for hepatitis B infection with about 20 million people infected with HBV and about five million deaths resulting from the consequences of hepatitis B infection. Hepatitis B virus (HBV) infection is a serious global health problem, with 2 billion people infected worldwide, and 350 million suffering from chronic HBV infection. It is a major occupational hazard for Health care worker (HCWs). Approximately one health care worker dies each day from hepatitis B. Thus, Hepatitis B infection remains a major occupational hazard among health care workers in Nigeria. HBV being a vaccine preventable virus, about three-quarters of health workers in developed nations are vaccinated against HBV unlike the critically low percentage obtainable in developing countries. Despite the understanding of HCWs in Nigeria of their high risk of exposure to this deadly but vaccine preventable-virus, there is Poor compliance of Health workers to hepatitis B vaccination which calls for serious attention and thus, the heart of this review.