Open Access Original Research Article

State of Health Facilities in Communities Designated for Community-Based Health Insurance Scheme in Nigeria: A Case Study of Kwara and Ogun States

T. Y. Raheem, B. Adewale, A. K. Adeneye, A. Z. Musa, S. M. C. Ezeugwu, J. Yisau, E. Afocha, M. A. Sulyman, O. O. Adewoyin, M. Olayemi, O. C. Ayeni, A. O. Akinremi, K. Runsewe, M. A. Mafe, I. A. O. Ujah

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v36i130132

Background: Nigerian Government established National Health Insurance Scheme (NHIS) including Community Based Health Insurance Scheme (CBHIS) to reduce out-of-pocket health expenses of enrollees, strengthen and ensure access to quality healthcare services. The functionality of the schemes however, revolves round health facilities being able to meet the expectation of the enrollees.

Study Objectives: The study assessed the adequacy of the designated health facilities in offering quality healthcare services to the enrollees or potential enrollees under the CBHIS, and to identify likely challenges.

Study Design: This is part of a larger prospective cross-sectional study that assessed the implementation of the Community-Based Health Insurance Scheme (CBHIS) in selected local government areas of Kwara in the north central and Ogun in the South Western part of Nigeria.

Place and Duration of the Study: Health facilities of selected wards from two Local Government Areas in Kwara and Ogun States were assessed between February and May 2015.

Methods: Semi-structured questionnaires and health facility assessment checklist were used to assess services rendered, storage of drugs and the vaccines, manpower, training opportunities, available infrastructures and perceived challenges to smooth operation of health facilities designated for CBHIS.

Results: A total of twenty designated health facilities were visited and assessed (Seventeen public and three private). Services claimed to be available at the facilities included clinical, nursing, pharmaceutical and laboratory services. The assessment showed inadequacy of some critical human resources for health. Seventeen of the 20 health facilities (85%) had evidence of recent renovation while 3 (15%) had no evidence of renovation. Twelve (60%) had backup supply of electricity from generator or solar panel. Other challenges that could impede quality healthcare service delivery under the CBHIS were identified.

Conclusion: The study showed that inadequate personnel, paucity of training opportunities for health workers, poor infrastructures (lack of ambulance services, poor electricity supply and lack of portable water supply) were the main challenges impeding delivery of quality healthcare services to the CBHIS enrollees patronizing the studied facilities.

Open Access Original Research Article

Ophthalmic Problems of Adults in Rural Communities of Rivers State, Nigeria

Obi-Fortune, Nnenna, Ejimadu, Chibuike Sydney

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2019/v36i130133

Aim: To determine the ophthalmic problems and their possible causes among adults in rural communities in Rivers State.

Methods: A multistage population based random sampling study of adults in five clans of Etche Local Government Area of Rivers State. Medical history was taken and comprehensive ocular examination done on each subject. Ocular examination included visual acuity, visual field, tonometry and ophthalmoscopy. Data taken were recorded and analysed using statistical software called Minitab 11. Ethical approval was obtained from relevant authorities.

Results: Out of the 600 subjects seen in this study 276 (46.0%) were males and 324 (54.0%) females. They were all above 21 years old. Twenty six (2.4%) subjects had good vision while 8 (0.8%) were blind. The ophthalmic problems identified were Presbyopia 298 (28.0%), Refractive error 247 (23.2%), Cataract 126 (11.8%), Allergic conjunctivitis 106 (9.9%), Glaucoma 94 (8.8%), Pterygium 86 (8.1%), Bacterial conjunctivitis 35 (3.3%), Corneal opacity 32 (3.0%), Chalazion 4 (0.4%), Diabetic retinopathy 3 (0.3%) and Ptosis 1 (0.1%).  

Conclusion: The most common ophthalmic problems in this study which were dependent on gender and occupation include Presbyopia, Refractive Error, Cataract and Allergic Conjunctivitis. More females and farmers were seen in this study. The problems identified can be easily managed if well-equipped health facilities are provided by the government.

Open Access Original Research Article

Prophylactic and Curative Potency of Alchornea laxiflora Extract on Plasmodium berghei Infected Swiss Albino Mice

Omoya, Funmilola Oluyemi, Oloruntuyi, Adedayo Blessing

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/ijtdh/2019/v36i130134

Background: Malaria is one of the most important infectious diseases in Nigeria and in Africa at large as everyone is at risk of the infection.

Objectives: This study was carried out to evaluate the antiplasmodial activity of Alchornea laxiflora leaf extracts against Plasmodium berghei infected mice.

Materials and Methods: In vivo antimalarial assay on chloroquine-sensitive P. berghei-infected mice was carried out by oral administration of graded doses (200 mg/kg, 400 mg/kg and 600 mg/kg) of methanolic and chloroform extracts using chloroquine and distilled water as positive and negative control respectively. Prophylactic potential in residual infection and curative assay against established infection were tested in P. berghei-infected mice. The assay was performed using 4-day suppressive standard test.

Results: The prophylactic efficacy of methanolic and chloroform leaf extacts showed percentage chemosuppression of 72.37% and 66.32% respectively at oral dose of 600 mg/kg. The methanol leaf extract of A. laxiflora displayed the highest curative activity of percentage chemosuppression of 98.36% at oral dose of 600 mg/kg. The extracts displayed dose-dependent significant (p ≤ 0.05) antiplasmodial activity as compared to the control. Haematological analysis revealed an increase in packed cell volume, red blood cell, haemoglobin and white blood cell counts on dose-dependent manner in the treated mice compared to the negative control mice.

Conclusion: The high suppressive values obtained in this study show that the tested leaf extracts of Alchornea laxiflora might be a good alternative drug for the treatment of malaria infection in Nigeria.

Open Access Original Research Article

In vivo Antifibrotic Potential of Extracts of Acanthospermum hispidum DC. Evaluated in Wistar Rats Using Diethylnitrosamine

Jotham Yhi-Pênê N’do, Adama Hilou, Dramane Pare, Ernest Nogma Sombie, Samson Guenne, André Tibiri

International Journal of TROPICAL DISEASE & Health, Page 1-9
DOI: 10.9734/ijtdh/2019/v36i130135

Aims: Liver fibrosis is a chronic disease of the liver. This disease is a stage of passage to liver cancer. The objective of this work was to evaluate the ability of the ethanolic extract of Acanthospermum hispidum to block the progression of hepatic fibrosis induced in rats using diethylenitrosamine (DEN).

Study Design: Study of the antifibrotic potential of extracts of Acanthospermum hispidum.

Place and Duration of Study: In vivo tests were performed from September 2018 to January 2019. The animal model tests were carried out in the pet shop of the Institute for Health Sciences Research (IRSS) of Burkina Faso and in the Cytogenetics Laboratory (FSS/ISBA) of the Republic of Benin.

Methodology: The evaluation of the antifibrotic activity consisted in treating in wistar rats a liver fibrosis induced with the DEN which is a chemical agent whose effect on the liver has already been confirmed. As a result of the treatment, all animals were removed from the liver and blood. The livers were used for macroscopic and microscopic observations. Blood has been used for the evaluation of biochemical parameters in relation to fibrosis.

Results: The analysis of the results of the biochemical parameters in relation to the fibrosis showed that the ethanolic extract of Acanthospermum hispidum at the dose of 250 mg / kg made it possible to obtain an improvement of these parameters compared to the other batches of animals. These results have been confirmed by those of the anatomo-pathological studies.

Conclusion: The results of biochemical and histological analyzes revealed a capacity of Acanthospermum hispidum extracts to block the evolution of hepatic fibrosis in the rat. These results confirm the hepatoprotective potential of this medicinal plant used in traditional medicine in Burkina Faso.

Open Access Original Research Article

Epidemiologic Profile and Predictors of Fatty Liver: A Hospital-Based Study

Ola A. Mostafa, Mohammed M. Abdel Razik, Raghda N. Marzaban, Eman T. Al Sayed, Mona S. Ahmed

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/ijtdh/2019/v36i130136

Background: Non-alcoholic fatty liver is the most common cause of chronic liver disease with increasing prevalence globally.

Settings and Design: The current study is an analytical case control study; conducted in ultrasonography outpatient clinic of Cairo University Hospital.

Materials and Methods: 150 consented fatty liver cases and 564 controls were screened for fatty liver infiltration using abdominal ultrasonography. Receiver Operating Characteristics (ROC) curve analysis was performed to explore the discriminant ability of the developed model.

Results: Among cases, Age, sex and residence matching contributes 32.7%, 36% and 31.3% mild, moderate and severe degree of fatty liver respectively. Cases showed significantly higher body mass index (BMI), waist circumference (WC), total cholesterol, triglyceride, low density lipoprotein (LDL), and lower high density lipoprotein (HDL) than controls. Cases demonstrated higher prevalence of hypertension (11.3% vs 8.3% respectively), and significantly higher prevalence of diabetes (22% vs. 9.2%) (p=0.03). Severe fatty liver cases were significantly older and had significantly higher WC, BMI, significantly higher association with diabetes mellitus, significantly higher levels of total cholesterol, triglycerides and LDL than non-severe degree cases. The significant predictors of sever fatty liver were BMI, total cholesterol and LDL (P = <0.001, R2 = 0.543).

Conclusion: The developed regression equation expressed good validation and calibration. It utilizes an algorithm that can quickly and easily address patients with fatty liver. It would useful as a fast, inexpensive primary screening tool for severe fatty liver.