Open Access Original Research Article

Systems of Communicating Sexual and Reproductive Health Issues between Hearing Parents and Their Deaf Adolescent Children in Western Kenya

Justine Anyango Ochieng’, Harrysone Atieli, Bernard Abongo, Collins Ouma

International Journal of TROPICAL DISEASE & Health, Page 1-12
DOI: 10.9734/ijtdh/2019/v37i330164

Background: Deaf adolescent children face greater challenges in accessing information, particularly on sexual and reproductive health (SRH) than those with other forms of disability. Parents therefore represent the first source of information for such children. However, the extent of this and systems of communication used by these parents remain largely unknown. Therefore, it is against this backdrop that we sought to study systems of parents communicating SRH issues to their children.

Methods: A mixed method design was used to collect quantitative and qualitative data on the system of communication used by the sign-language illiterate parents respectively, their perceptions on such discussions and the choice of system of communication. A sample size of 384 parent-child pairs was selected using systematic probability sampling for the quantitative component of the study. For the qualitative component, respondents were recruited using a purposive convenience sampling method which though non-representative, allowed the investigator to choose participants best suited for the intended objective. The study was carried out in ten schools; randomly selected from a sample frame comprising of a list of primary and secondary schools for deaf children within the former Nyanza region of western Kenya. Data was collected using anonymized questionnaires and Focus Group Discussions (FGDs).

Results: Majority of the male parents 90 (23.4%) were in the age range of 51-60 years, while most female parents 134 (34.8%) were in the age category of 40-50 years. Nearly 70% (67%) of the children were in the age range of 15-19 years. Overall, use of picture came out as the main mode/format of communication (33%); with females using it more (23%) compared to males 12.3%. Lip-reading (children reading the lips of their parents), was principally used by male parents. 32(8.3%) parents falling within the age group 41-50 and 51-60 years felt that the information they had on SRH was inadequate. More so, in a qualitative interview, most parents were not satisfied that they had provided enough information to their children on matters of SRH due to communication barrier. Some of the emerging themes from the FGDs were: parents lack a proper approach of conveying SRH information to their deaf adolescent children, unresponsiveness/lack of interest by deaf adolescent children, wrong translation of information conveyed and insufficient time with their deaf adolescent children to pass across these messages.

Conclusion: Children with hard hearing are less likely to get adequate information on SRH than their counterparts with no hearing impairment.

Open Access Original Research Article

Malaria Preventive Practices among Under-five Children in Rivers State, Nigeria

N. I. Paul, O. Maduka, I. Chijioke-Nwauche, A. T. O. Awopeju, T. Kasso, I. L. Oboro, G. Otto, M. Ogoro, L. E. Yaguo-Ide, C. A. Nwauche

International Journal of TROPICAL DISEASE & Health, Page 1-11
DOI: 10.9734/ijtdh/2019/v37i330165

Background: Malaria is a life threatening protozoan infection and children under 5 years are one of the most vulnerable group. Good malaria preventive practices among these group is key to reducing malaria burden and its associated mortality.

Objective: The aim of the study was to assess malaria preventive practices among under-five children in Rivers State, Nigeria.

Materials and Methods: This was a cross sectional study carried out in public and private health facilities in Rivers state. Ethical approval for the study was obtained from the Research and Ethics committee of the University of Port Harcourt Teaching Hospital, while an informed written consent was obtained from the parents or caregivers of the participants. Stratified sampling method was used to select the health facilities and the subjects for the study. A pretested interviewer administered questionnaire was used to harvest relevant information on socio demographic characteristics of the subjects and informants and malaria preventive practices. Obtained data was analysed using SPSS version 22 and results are presented in prose and tables.

Results: A total of 1138 children participated in the study constituting of 613 (53.9%) male and 525(46.1%) female giving a male: female ratio of 1.2:1. Mean age of participants was 1.74±1.08 years. Mothers, accounted for majority 1012 (88.9%) of the informants. Most of the informants had tertiary degree; 605 (53.4%) and 697 (61.8%) among mothers and fathers respectively. Among the occupations of fathers, public servants, civil servants and the self-employed were more represented, constituting 242 (21.4%), 200 (17.7%) and 149 (13.2%) respectively. Traders/ business women, the self-employed and civil servants were most represented among the occupations of mothers in the study and these accounted for 444 (39.7%), 181 (16.2%) and 137 (12.3%) respectively. Malaria preventive practices included use of Insecticide-treated bed nets (ITNs), Indoor spraying of insecticide (modified IRS), use of antimalarial drugs, clearing of bushes/ disposal of containers where mosquitoes breed and use of mosquito repellent creams which constituted 605 (53.2%), 483 (42.4%), 133 (11.7%), 4 (0.4%) and 2 (0.2%) respectively; there were 512 (45.0%) children who slept under ITNs the previous night. Also, 970 (85.2%) had window nets installed in their homes.  Protective window nets was also in place in the homes of 970 (85.2%) of the study participants. Among families that practiced use of ITNs, 110 (61.8%) were from the middle social class and 62 (34.8%) were from the upper social class, while 316 (52.2%) and 276 (45.6%) were from the upper and middle social class respectively among those that practised Indoor spraying of insecticide (IRS).  

Conclusion: Use of ITNs, modified IRS and use of anti malarials were the common malaria preventive practices among under-fives in Rivers state and these methods were more practiced among the middle and upper social class. Education on the integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be intensified.

Open Access Original Research Article

Multidrug Resistant Tuberculosis in Children in Port Harcourt – A Worrisome Trend

Lucy Eberechukwu Yaguo Ide, Nsirimobu Ichendu Paul, Rosemary Ogochukwu Ugwu

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2019/v37i330166

Background: Drug-resistant tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in particular represent a major threat to the fight against tuberculosis globally. MDR-TB presents with similar features and is transmitted in the same way as drug sensitive TB but its progression is rapid and its treatment, associated drug toxicity and monitoring constitute a heavy burden to the patients and the health system. MDR-TB affect people of all age groups but very little is known about the magnitude of this problem in children.

Aims/Objectives: To determine the prevalence of multidrug resistant tuberculosis among children in Port Harcourt.

Materials and Methods: Information on Paediatric tuberculosis was retrieved from the patients’ case notes, TB registers at the directly observed treatment short course (DOTs) clinic and the Multidrug resistant tuberculosis (MDR-TB) treatment center of the University of Port Harcourt Teaching Hospital from January 2018 to June 2019. Obtained data was analysed and presented in prose and tables. 

Results: There was a total of 1,860 patients records of which 37 were Paediatrics cases giving a prevalence of Paediatric tuberculosis cases of 2.0% Out of these 37cases, four were multidrug resistant tuberculosis cases giving a prevalence of MDR-TB cases of 10.8%. There were three males and one female giving a male female ratio of 3: 1. and their ages ranged from 3months to 24months. All belonged to social class 5.  Common presentation was chronic cough, prolonged fever, weight loss and lymph node swellings. Three (75%) had no prior treatment for tuberculosis while one (25%) completed 6months of anti TB drugs. All had BCG immunization within one week of delivery. One (25%) child had extra-pulmonary TB while 3(75%) children had pulmonary tuberculosis. Xpert MTB/RIF assay for all (100%) showed MTB detected, RIF resistant detected. Three (75%) of the mothers had MDRTB and the medications for their children was based on the drug sensitivity testing (DST) of their mothers. One (25%) of the children and his mother were HIV positive and the mother had died while still on the intensive phase of second line antiTB drugs. Three (75%) had completed the intensive phase of the conventional therapy with second line antiTB drugs and are closely followed up weekly on the continuation phase while one child is still on admission.

Conclusions: The prevalence of MDR-TB in children in PH is high. All childhood TB (whether drug susceptible or drug resistant) is usually traced to an adult, thus effectively diagnosing and     treating all adults as well as a high index of suspicion in presumptive cases is required to curb MDR-TB.

Recommendations: We recommend strict use of the DOTs strategy in TB management to ensure drug adherence. Also, proper contact tracing, investigation and treatment of children of infected parents to reduce cases of MDR-TB is advocated. 

Open Access Original Research Article

Prevalence of Erectile Dysfunction and Awareness of Its Treatment in Abuja, Nigeria

S. Abu, T. Atim, N. R. Ripiye

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v37i330167

Introduction: Erectile dysfunction (ED) is the most common male sexual dysfunction all over the World. It is underestimated in developing countries including Nigeria because it is assumed not to be a life threatening condition which is associated with stigmatization and poor health seeking behavior. The Prevalence rate of ED among specific age groups has not been reported in most available local studies. This study was aimed at determining the prevalence rates of ED and the severity of ED among different age groups and patients’ awareness of its treatment.

Methods: The study was a descriptive cross-sectional hospital based survey among men aged 18 years and above seen in the outpatient clinics of University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. Self reported erectile dysfunction was obtained using proforma. The prevalence and severity of ED was obtained using International Index of Erectile Function-5 Questionnaire (IIEF-5).

Results: A total of 378 subjects were recruited for this study with age range of 18-76 years. The prevalence of ED in this study using IIEF-5 was 66.4%. The prevalence of ED was noted to increase with increasing age as ED was more prevalent (59%) among men aged 60-79 year. ED was least common among the young subjects (15.7%) and the most severe ED found among the elderly There was a positive correlation between age and ED (rho =0.306). There was statistically significance association between ED and co-morbidities with hypertension accounting for 22.5% and diabetes 16.7%. The percentage of subjects aware of treatment for ED was 39.4% and 20.4% of the subjects had sought help from doctors. Only about a quarter (26.5%) of the subjects had their sexual challenges discussed with the doctor.

Conclusion: ED is a common medical and social problem in our environment though still shrouded in secrecy. ED is more prevalent and severe among age 60-79 years. Awareness of treatment seeking behavior and the ability of the attending physicians to discuss with men about their sexual health remains quite poor in our environment.

Open Access Original Research Article

Abnormalities of Hemoglobin and Glucose-6-Phosphate-Dehydrogenase Deficiency in Children with Uncomplicated Malaria and Living in Banfora and Saponé, Two Different Malaria Setting of Burkina Faso

Emilie S. Badoum, Samuel S. Sermé, Jean B. Yaro, Sam A. Coulibaly, Désiré Kargougou, Amidou Diarra, Amidou Z. Ouédraogo, Lankoande Malik, Issa Nébié, Issiaka Soulama, Alphonse Ouédraogo, Alfred B. Tiono, Yves Traoré, Sodiomon B. Sirima, Edith C. Bougouma

International Journal of TROPICAL DISEASE & Health, Page 1-10
DOI: 10.9734/ijtdh/2019/v37i330168

Aims: The aim of this study is to assess the prevalence of hemoglobin abnormalities and G6PD deficiency and their respective influence on anemia occurring in less than five years old children with clinical P. falciparum malaria living in Burkina Faso.

Study Design: The study was a cross-sectional survey with descriptive focus conducted from December 2010 to January 2013 in Saponé health district and from May to October 2011 in Banfora health district. Clinical and laboratory data were collected. Blood smears on slides for malaria diagnosis by microscopy, hemoglobin level and filter paper for the detection of human genetic factors were performed.

Methodology: A total of 386 subjects from Saponé (131) and Banfora (255) were enrolled. DNA collected from each sample was extracted using chelex-100 method and the human genetic resistance factors background was assessed by RFLP-PCR.  Abnormal hemoglobin patients were classified as NonAA while AA was defined the normal hemoglobin.

Results: In this study, 70.98% (274/386) were classified normal hemoglobin (AA) while 29.02% (112/386) of subjects were carrying at least one abnormal (NonAA) allele: 24.35%AC, 3.63% AS, 0.78%CC and 0.26%SC. G6PD deficiency was 9.59% (37/386) among which, 4.92% for male and 4.66% in female. However, this gender difference was not statistically significant (p=1.00). 319/367 (86.92%) of the patients were anemic (59.4% with moderate anemia and 20.98% with mild anemia). The prevalence of anemia in G6PD deficient subjects was 83.33% (of which 58.33% were moderate anemia and 22.22% mild anemia). The difference between types of hemoglobin (p=0.64) in the occurrence of anemia (AA 87.64% and Non AA 85.18%) was not statistically significant.

Conclusion: This study showed that the prevalence of these genetic factors was relatively low among children with clinical falciparum malaria with high parasite density. In addition, these factors appear to have no effect on anemia.