George O Ugwu - Academia.edu (original) (raw)

Papers by George O Ugwu

Research paper thumbnail of An appraisal of the implementation of the national school feeding programme and its effect on enrolment and attendance in public primary schools in Southeast, Nigeria: perception of heads of schools

BMC Nutrition, Mar 2, 2023

Research paper thumbnail of Digital technology tool for routine immunization: Lessons learned from open data kit intervention and way forward

Nigerian Journal of Clinical Practice, 2023

ABSTRACT Background: Digital technology tools like open data kit (ODK) can improve the quality of... more ABSTRACT Background: Digital technology tools like open data kit (ODK) can improve the quality of routine immunization (RI) data, yet we know very little about how well it performs. Aim: This study evaluated the implementation of ODK for RI data capture and transmission. We also discussed the way forward for the uptake of ODK for RI data capture and transmission. Methods: Sixty focal persons were recruited from 60 PHCs and trained for two days on the use of ODK. The DHIS2 tools that include daily immunization register, daily vaccine utilization summary, and daily TT immunization register were loaded into ODK. The participants collected RI data and transmitted same via ODK to a secure server for 3 months. At the end of the exercise, we conducted six (ten per group) focus group discussions with them. They were interviewed to share their experiences. The implementation was evaluated using Proctor’s outcomes with a specific focus on acceptability, adoption, and appropriateness. Results: Findings show that users were satisfied with the use of ODK for RI data capture and transmission. It was reported that ODK removed the need to transport data from the facilities to the local government headquarters for entry into the DHIS2 platform. It was also learned that it reduced errors and inconsistencies commonly reported in RI data. Conclusion: Digital technologies like ODK can improve the quality of RI data in Nigeria. Policymakers and implementers must, however, consider contextual issues relating to the incentivization of staff.

Research paper thumbnail of Prevalence, outcomes, and predictors of antepartum hemorrhage due to placenta previa in Nigeria

International Journal of Medicine and Health Development, 2022

Research paper thumbnail of 6 The Value of Ultrasound in Diagnosing Acute Appendicitis

British Journal of Surgery, Sep 1, 2021

The diagnosis of acute appendicitis relies on a thorough history and examination and can often be... more The diagnosis of acute appendicitis relies on a thorough history and examination and can often be challenging. Ultrasound is widely considered to be the most appropriate first line investigation; however non-diagnostic ultrasounds are not uncommon and do lead to delays in diagnosis and/or definitive treatment by creating a need for further clinical assessment. The purpose of this study was to determine the sensitivity and specificity of ultrasound diagnosis of appendicitis in patient treated at Doncaster Royal Infirmary, and to determine the local negative appendicectomy rate. Method: This was a retrospective analysis of 99 patients undergoing appendicectomy, with a prior ultrasound abdomen within one week of the procedure being undertaken. Data was collected from review of patient's hospital medical records (discharge summaries, clinic letters, PACs). Results: 99 patient aged 8-76 years were studied. Male to female ratios was 3:1. The sensitivity and specificity of ultrasound was 16% (95% CI-7% to 29%) and 96% (95% CI-86% to 99%) respectively with PPV of 80% and NPV of 52%. The accuracy of ultrasound diagnosis was found to be 55% (95% CI 44% to 65%). The negative appendicectomy rate was 48%. Conclusions: From our study, ultrasound cannot reliably identify nor exclude appendicitis. Less than 16% of patients who had proven appendicitis (positive histology) had scans that indicated. Almost 50% of the normal/indeterminate scans were false negatives. Furthermore, 20% of positive ultrasound reports were false positives. A collaborative quality improvement project with the imaging department is planned to address these findings.

Research paper thumbnail of The Outcome of Vaginal Birth After One Previous Caesarean Section (Vbac) at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria

FACULTY of OBSTETRICS AND GYNAECOLOGY, 2011

Research paper thumbnail of Serum immunoglobulins, C-reactive protein, and trace element level in preeclamptic Nigerian subjects

Nigerian Journal of Clinical Practice, 2022

Research paper thumbnail of Childhood Routine Immunization Data in Enugu: Findings from a Quality Assessment Survey

Nigerian Journal of Clinical Practice

Background: Immunization data are critical for the effective delivery of immunization programs, h... more Background: Immunization data are critical for the effective delivery of immunization programs, health planning, and-decision-making. It can also help to identify gaps in vaccine coverage and service delivery. Immunization data quality is dependent on the quality of the collection process at individual health facilities and its transmission to an integrated system. Aim: This study set out to appraise the quality of childhood routine immunization data across the different levels of transmission in selected health facilities in Enugu, Nigeria. Materials and Methods: This was a cross-sectional, analytical study of the immunization data of two vaccine antigens in 103 health facilities across 10 local council areas offering routine immunization services in Enugu state. Accuracy, discrepancy consistency, completeness, and timeliness of the data for the year 2020, the study period, were determined using WHO data quality assessment tools. Results: This study noted that childhood routine imm...

Research paper thumbnail of Human immunodeficiency virus self-testing: Perspectives from primary healthcare workers in Enugu state, southeast Nigeria

Nigerian Journal of Medicine

IntRoductIon Human immunodeficiency virus (HIV) testing is very important in achieving the agenda... more IntRoductIon Human immunodeficiency virus (HIV) testing is very important in achieving the agenda of the United Nations Programme on HIV/acquired immunodeficiency syndrome 90:90:90 targets which aim at ensuring that 90% of people who are infected, know their HIV status and also targets 90% of those who know their status to start receiving antiretroviral therapy (ART) of which 90% of those on ART should have their viral load suppressed. [1] HIV pandemic has remained a source of worry to the human population globally and even more worrisome is the low rate of uptake of testing services. [2] About one-quarter of Nigerian youths were reported to have ever tested for HIV in Nigeria. The following factors have been shown to be barriers to HIV testing and they could be considered at the individual level, structural level, and social level. Anticipated HIV stigma and discrimination, lack of confidentiality, fear of testing outcomes partly explain this low uptake of HIV testing among people in Nigeria. [3] These barriers contribute to reduced uptake of HIV testing services [3] and has led to alternative methods that will enhance the uptake. Several studies have highlighted various modalities of HIV testing and their uptake, but research in HIV-self testing (HIVST) in Enugu is lacking. HIV testing services are the gateway to linkage to HIV treatment and prevention. Various testing Background: Stigmatization remains an intractable issue surrounding human immunodeficiency virus (HIV) management. Testing services are the gateway to treatment and prevention. HIV-self testing (HIVST) is a panacea to this stigmatization. It is a simple friendly testing technique. This study assessed issues surrounding the HIVST from the perspectives of the primary health-care workers in Enugu State. Methods: A cross-sectional study was carried out using a semi-structured interviewer-administered questionnaire. A convenience sampling of 238 respondents were sampled from the 17 local government areas of the state. Analyses were performed using IBM-SPSS version 23. Ethical approval was obtained from the Enugu State Ministry of Health. Results: The majority of the respondents were within the age of 31-50 years 84 (35.3%), predominantly females 203 (85.3%) and mainly married 191 (80.3%). Half of them had practiced for over 10 years and 145 (60.9%) had good knowledge of HIV screening. However, 23.9% understood HIVST as a testing modality approved by the World Health Organization. A handful of them, 25 (10.5%) correctly identified the 5Cs of HIV testing. Only 162 (68.1%) of the health-care workers reported stigma as the most perceived problems of the present testing modality and 146 (61.3%) expressed a preference for HIVST over previous methods. Age was found to be a determinant of good knowledge of HIVST, as being within the age group of 20-40 years has a 1.83 greater odds of good knowledge of HIVST than, 41-60 years age group (Adjusted odds ratios = 1.830; 95% confidence interval 1.081-3.099). Conclusion: Most of the Primary health-care workers in Enugu State had poor knowledge of HIVST. These workers could benefit from awareness creation and training on HIVST by public health specialists to improve their knowledge.

Research paper thumbnail of Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria

PLOS Global Public Health

Nigeria is estimated to have the largest number of children worldwide, living with chronic hepati... more Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowled...

Research paper thumbnail of Comparative Assessment of Unintended Pregnancy at Urban and Rural Hospitals in Enugu State, Nigeria

Zenodo (CERN European Organization for Nuclear Research), Nov 6, 2022

Research paper thumbnail of Physician emigration from Nigeria and the associated factors: The implication to safeguarding the Nigeria Health System

Background: Adequate Human Resources for Health is indispensable to achieving Universal Health Co... more Background: Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria, with low physician-population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms to curtail the trend and safeguard the country’s health system.Methods: Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using online Google form with link shared via WhatsApp and Telegram forums of Nigeria Medical Association and her affiliate bodies. Data was analyzed with IBM-SPSS version-25 and charts were created with Microsoft Excel Spread Sheet version 2019. Chi-square and binary logistic regression tests were done with p-value set at 0.05 for statistical significance. Results: The mean age of respondents is 37.6±7.9 years; major...

Research paper thumbnail of Determinants of use of partograph among primary healthcare workers in Enugu State, South-East Nigeria

International Journal of Medicine and Health Development, 2021

Background: World Health Organization (WHO) recommended use of partograph during childbirth to en... more Background: World Health Organization (WHO) recommended use of partograph during childbirth to ensure early identification of abnormalities and prompt referral for emergency obstetrics care. However, factors that determine use of partograph during childbirth among primary healthcare workers (PHCWs) remain inadequately documented. Objective: This study investigated the determinants of use of partograph in conduct of labor among PHCWs in Enugu, South-East Nigeria. Materials and Methods: It was a cross-sectional descriptive survey of public PHCWs in Enugu State, Nigeria. Multistage sampling technique was used to select 393 respondents. Data were collected using a structured self-administered questionnaire and analyzed with IBM-SPSS version 22. Tests of statistics were conducted using χ2 and binary logistic regression, and statistical significance was determined at P-value of < 0.05. Results: Majority (87.0%) of the respondents have good knowledge of partograph. Reported regular availability of partograph is 32.8% but regular use of it is 25.2%. Statistically significant association exists between use of partograph and reception of training on it (P=0.001), knowledge of it (P=0.001), and availability of it (P=0.001). Availability of partograph was a predictor of use of it (adjusted odds ratio (AOR)=27.129; confidence interval=14.780–49.797). Conclusion: Although there is high knowledge of partograph among PHCWs in Enugu state, there is poor usage of it. There are 27 times higher odds of using partograph when it is made available compared with when it is not. We recommend regular provision of partograph to labor ward personnel in PHCWs in Enugu state and other similar populations.

Research paper thumbnail of Nanovesicle Formulation Enhances Anti-inflammatory Property and Safe Use of Piroxicam

Pharmaceutical Nanotechnology, 2021

Background: Enhanced utilization of certain drugs may be possible through the development of alte... more Background: Enhanced utilization of certain drugs may be possible through the development of alternative delivery forms. It has been observed that NSAIDs have adverse gastrointestinal tract effects such as irritation and ulceration during anti-inflammatory therapy. This challenge may be overcome through nano topical formulations. Objective: This study aimed to explore the potentials of a transdermal nanovesicular formulation for safe and enhanced delivery of piroxicam (PRX), a poorly water-soluble NSAID. Methods: Preformulation studies were conducted using DSC and FTIR. Ethosomal nanovesicular carrier (ENVC) was prepared by thin-film deposition technique using Phospholipon® 90 H (P90H) and ethanol and then converted into gel form. The formulation was characterized using a commercial PRX gel as control. Permeation studies were conducted using rat skin and Franz diffusion cell. Samples were assayed spectrophotometrically, and the obtained data was analyzed by ANOVA using GraphPad Pris...

Research paper thumbnail of International Journal of Women’s Health 2013:5 571–582 International Journal of Women’s Health Dovepress submit your manuscript | www.dovepress.com

Research paper thumbnail of Incidence and outcome of higher order multiple pregnancies at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

International Journal of Medicine and Health Development, 2018

Background: Higher Order multiple pregnancies (HOMP) increase the demand for neonatal intensive c... more Background: Higher Order multiple pregnancies (HOMP) increase the demand for neonatal intensive care services and knowledge of local prevalences may be useful in planning neonatal intensive care. Objectives: To determine the incidence and feto-maternal outcome of higher order multiple births in university of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu, Nigeria. Methods: It was a retrospective review of all HOMP at the UNTH Ituku/Ozalla Enugu, over a ten year period from June 2006 to May 2016. Results: During the study period, there were 8207 deliveries out of which 23 were higher order multiple (HOM) births; consisting of 19 triplets and 4 quadruplets. The overall incidence of HOM births was 0.28%. This was made up of incidences of triplet and quadruplet births of 0.23% and 0.05% respectively. Ten (43.5%) of the women conceived spontaneously while 8 (34.8%) had ‘artificial reproductive technology’ and the remaining 5 (21.7%) took ovulation inducing agents. The maternal out...

Research paper thumbnail of The prevalence of stillbirths and the probable causes in low resource settings in south-east Nigeria

International Journal of Medicine and Health Development, 2022

Research paper thumbnail of Orthodox and unorthodox practices by traditional birth attendants in Nsukka area of Enugu State, Southeast Nigeria

African Journal of Medical and Health Sciences, 2021

Unskilled Traditional Birth Attendants (TBA) is prevalent in rural Nigeria due to communal cultur... more Unskilled Traditional Birth Attendants (TBA) is prevalent in rural Nigeria due to communal culture and traditions, their compassionate attitude, and non-availability of appropriate health facilities within the communities. Yet, there is no clear framework defining their roles, locations and practices. This study aimed to identify the pattern and practices of TBA in Nsukka area of Enugu State, and evaluate their roles in rural maternity services in Enugu state of Nigeria. This was a mixed method cross sectional study involving a questionnaire-based survey and Focus group discussions (FGD). Seventy-eight TBAs, were recruited for this study. Structured interviewer-administered questionnaire was used to collect quantitative data and a semi-structured discussion guide was used for the FGD – one FGD for each development center. SPSS version 25 was used for statistical analysis. Records of FGD sessions were transcribed, condensed into themes, and analyzed. A total of 78 TBAs were interview...

Research paper thumbnail of Exploring the views of Heads of Schools on School Health Services in Public Primary Schools in Enugu Metropolis, Nigeria: A Qualitative Study

Journal of Community Medicine and Primary Health Care, 2021

Background: School health services offer a great opportunity for many children to access primary ... more Background: School health services offer a great opportunity for many children to access primary health care, especially in developing countries. This study assessed the status of health services in public primary schools in Enugu Metropolis, Enugu State, Nigeria from the perspectives of the school heads.Methods: This was a qualitative study conducted among 24 public primary school head masters/mistresses in the three Local Government Areas making up Enugu metropolis. They were purposively selected from the 117 public primary schools in the metropolis. Data were collected through the use of Key Informant Interview (KII) guide, and analyzed using thematic approach.Results: Only one of the participants knew about the school health policy, while others expressed surprise at its existence. All the schools had a first aid box, but most of the boxes were not sufficiently stocked. None of the schools had a trained first aider. De-worming was carried out once in a while in all the schools. ...

Research paper thumbnail of Primary health care under one roof: Knowledge and predictors among primary health care workers in Enugu State, South East, Nigeria

Nigerian Journal of Medicine, 2020

The declaration of Alma Ata on Primary Health Care (PHC) in 1978 has been a standard for an acces... more The declaration of Alma Ata on Primary Health Care (PHC) in 1978 has been a standard for an accessible community driven and quality health care for all people and this has given rise to the health for all by the year 2000. [1] PHC connects individuals and families to their first level of contact with their national health system that can address their major health challenges. Since its establishment, there have been remarkable achievements in the major health indicators globally with life expectancy increasing by up to 10 years of what it was in 1978 and, risk of dying before age five falling by about two-thirds. [2] PHC remains a strong system and its features support the complexity and rapid transition of the world of today; its principles: health promotion, community participation, accessibility, use of appropriate technology, and inter-sectoral collaboration are appropriate to address both current and emerging challenges of health system. [2] In spite of the palpable progress in the past 40 years of PHC, there are still unaddressed health challenges for many people of the world with wide disparity between the poor and the rich, especially for those living in vulnerable situations. [3] Background: The concept of "Primary Health Care Under One Roof" (PHCUOR) is a new governance reform to improve primary health care (PHC) implementation and integration. This study aimed at assessing the level of knowledge of this concept and its predictors among PHC Workers. Materials and Methods: This was a cross-sectional descriptive study of PHC workers in Enugu State. Respondents were selected using systematic sampling method. Data were collected with self-administered questionnaire and analyzed using IBM-SPSS version 25. Level of statistical significance was set at 5% and confidence interval (CI) of 95%. Results: A total of 292 responses out of 337 questionnaires were retrieved, giving a response rate of 86.6%. Majority of the respondents were female (257, 88.0%) and greater than half were in the age range of 41-50 years (151, 51.7%). Most of the respondents had overall good knowledge of PHCUOR (210, 71.9%) but there was poor understanding of some concepts. Bivariate analysis showed that having good knowledge of PHCUOR was associated with duration of practice (χ 2 = 6.013, P = 0.018) and age (χ 2 = 4.495, P = 0.036) but on binary logistic regression, males were found to be 2.8 times more likely to have good knowledge of the concept compared to females (adjusted odds ratio = 2.763.; 95% CI = 1.022-7.469, P = 0.045). Conclusion: There was overall good knowledge of PHCUOR but the knowledge of rationale, gateway, and minimum service package (MSP) was poor. Males were approximately 2.8 times more likely to have good knowledge compared to females. Regular training of PHC workers on the concepts of PHCUOR especially the rationale, gateway, and MSP is needed to improve their knowledge and service delivery.

Research paper thumbnail of Maternal near‐miss and death associated with abortive pregnancy outcome: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey

BJOG: An International Journal of Obstetrics & Gynaecology, 2019

ObjectiveTo investigate the prevalence of life‐threatening complications related to pregnancies w... more ObjectiveTo investigate the prevalence of life‐threatening complications related to pregnancies with abortive outcome and the associated health service events and performance in Nigerian public tertiary hospitals.DesignSecondary analysis of a nationwide cross‐sectional study.SettingForty‐two tertiary hospitals.PopulationWomen admitted for pregnancy‐related complications.MethodsAll cases of severe maternal outcomes (SMO: maternal near‐miss or death) due to abortive pregnancy complications (defined as spontaneous or induced abortion, and ectopic pregnancy) were prospectively identified over 1 year using uniform identification criteria.Main outcome measuresPrevalence of SMO, mortality index (% maternal death/SMO), case fatality rate, time until death after admission, and health service performance.ResultsOf 5779 women admitted with abortive pregnancy complications, 444 (7.9%) experienced an SMO: 366 maternal near‐misses and 78 maternal deaths. Intra‐hospital maternal mortality ratio fr...

Research paper thumbnail of An appraisal of the implementation of the national school feeding programme and its effect on enrolment and attendance in public primary schools in Southeast, Nigeria: perception of heads of schools

BMC Nutrition, Mar 2, 2023

Research paper thumbnail of Digital technology tool for routine immunization: Lessons learned from open data kit intervention and way forward

Nigerian Journal of Clinical Practice, 2023

ABSTRACT Background: Digital technology tools like open data kit (ODK) can improve the quality of... more ABSTRACT Background: Digital technology tools like open data kit (ODK) can improve the quality of routine immunization (RI) data, yet we know very little about how well it performs. Aim: This study evaluated the implementation of ODK for RI data capture and transmission. We also discussed the way forward for the uptake of ODK for RI data capture and transmission. Methods: Sixty focal persons were recruited from 60 PHCs and trained for two days on the use of ODK. The DHIS2 tools that include daily immunization register, daily vaccine utilization summary, and daily TT immunization register were loaded into ODK. The participants collected RI data and transmitted same via ODK to a secure server for 3 months. At the end of the exercise, we conducted six (ten per group) focus group discussions with them. They were interviewed to share their experiences. The implementation was evaluated using Proctor’s outcomes with a specific focus on acceptability, adoption, and appropriateness. Results: Findings show that users were satisfied with the use of ODK for RI data capture and transmission. It was reported that ODK removed the need to transport data from the facilities to the local government headquarters for entry into the DHIS2 platform. It was also learned that it reduced errors and inconsistencies commonly reported in RI data. Conclusion: Digital technologies like ODK can improve the quality of RI data in Nigeria. Policymakers and implementers must, however, consider contextual issues relating to the incentivization of staff.

Research paper thumbnail of Prevalence, outcomes, and predictors of antepartum hemorrhage due to placenta previa in Nigeria

International Journal of Medicine and Health Development, 2022

Research paper thumbnail of 6 The Value of Ultrasound in Diagnosing Acute Appendicitis

British Journal of Surgery, Sep 1, 2021

The diagnosis of acute appendicitis relies on a thorough history and examination and can often be... more The diagnosis of acute appendicitis relies on a thorough history and examination and can often be challenging. Ultrasound is widely considered to be the most appropriate first line investigation; however non-diagnostic ultrasounds are not uncommon and do lead to delays in diagnosis and/or definitive treatment by creating a need for further clinical assessment. The purpose of this study was to determine the sensitivity and specificity of ultrasound diagnosis of appendicitis in patient treated at Doncaster Royal Infirmary, and to determine the local negative appendicectomy rate. Method: This was a retrospective analysis of 99 patients undergoing appendicectomy, with a prior ultrasound abdomen within one week of the procedure being undertaken. Data was collected from review of patient's hospital medical records (discharge summaries, clinic letters, PACs). Results: 99 patient aged 8-76 years were studied. Male to female ratios was 3:1. The sensitivity and specificity of ultrasound was 16% (95% CI-7% to 29%) and 96% (95% CI-86% to 99%) respectively with PPV of 80% and NPV of 52%. The accuracy of ultrasound diagnosis was found to be 55% (95% CI 44% to 65%). The negative appendicectomy rate was 48%. Conclusions: From our study, ultrasound cannot reliably identify nor exclude appendicitis. Less than 16% of patients who had proven appendicitis (positive histology) had scans that indicated. Almost 50% of the normal/indeterminate scans were false negatives. Furthermore, 20% of positive ultrasound reports were false positives. A collaborative quality improvement project with the imaging department is planned to address these findings.

Research paper thumbnail of The Outcome of Vaginal Birth After One Previous Caesarean Section (Vbac) at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria

FACULTY of OBSTETRICS AND GYNAECOLOGY, 2011

Research paper thumbnail of Serum immunoglobulins, C-reactive protein, and trace element level in preeclamptic Nigerian subjects

Nigerian Journal of Clinical Practice, 2022

Research paper thumbnail of Childhood Routine Immunization Data in Enugu: Findings from a Quality Assessment Survey

Nigerian Journal of Clinical Practice

Background: Immunization data are critical for the effective delivery of immunization programs, h... more Background: Immunization data are critical for the effective delivery of immunization programs, health planning, and-decision-making. It can also help to identify gaps in vaccine coverage and service delivery. Immunization data quality is dependent on the quality of the collection process at individual health facilities and its transmission to an integrated system. Aim: This study set out to appraise the quality of childhood routine immunization data across the different levels of transmission in selected health facilities in Enugu, Nigeria. Materials and Methods: This was a cross-sectional, analytical study of the immunization data of two vaccine antigens in 103 health facilities across 10 local council areas offering routine immunization services in Enugu state. Accuracy, discrepancy consistency, completeness, and timeliness of the data for the year 2020, the study period, were determined using WHO data quality assessment tools. Results: This study noted that childhood routine imm...

Research paper thumbnail of Human immunodeficiency virus self-testing: Perspectives from primary healthcare workers in Enugu state, southeast Nigeria

Nigerian Journal of Medicine

IntRoductIon Human immunodeficiency virus (HIV) testing is very important in achieving the agenda... more IntRoductIon Human immunodeficiency virus (HIV) testing is very important in achieving the agenda of the United Nations Programme on HIV/acquired immunodeficiency syndrome 90:90:90 targets which aim at ensuring that 90% of people who are infected, know their HIV status and also targets 90% of those who know their status to start receiving antiretroviral therapy (ART) of which 90% of those on ART should have their viral load suppressed. [1] HIV pandemic has remained a source of worry to the human population globally and even more worrisome is the low rate of uptake of testing services. [2] About one-quarter of Nigerian youths were reported to have ever tested for HIV in Nigeria. The following factors have been shown to be barriers to HIV testing and they could be considered at the individual level, structural level, and social level. Anticipated HIV stigma and discrimination, lack of confidentiality, fear of testing outcomes partly explain this low uptake of HIV testing among people in Nigeria. [3] These barriers contribute to reduced uptake of HIV testing services [3] and has led to alternative methods that will enhance the uptake. Several studies have highlighted various modalities of HIV testing and their uptake, but research in HIV-self testing (HIVST) in Enugu is lacking. HIV testing services are the gateway to linkage to HIV treatment and prevention. Various testing Background: Stigmatization remains an intractable issue surrounding human immunodeficiency virus (HIV) management. Testing services are the gateway to treatment and prevention. HIV-self testing (HIVST) is a panacea to this stigmatization. It is a simple friendly testing technique. This study assessed issues surrounding the HIVST from the perspectives of the primary health-care workers in Enugu State. Methods: A cross-sectional study was carried out using a semi-structured interviewer-administered questionnaire. A convenience sampling of 238 respondents were sampled from the 17 local government areas of the state. Analyses were performed using IBM-SPSS version 23. Ethical approval was obtained from the Enugu State Ministry of Health. Results: The majority of the respondents were within the age of 31-50 years 84 (35.3%), predominantly females 203 (85.3%) and mainly married 191 (80.3%). Half of them had practiced for over 10 years and 145 (60.9%) had good knowledge of HIV screening. However, 23.9% understood HIVST as a testing modality approved by the World Health Organization. A handful of them, 25 (10.5%) correctly identified the 5Cs of HIV testing. Only 162 (68.1%) of the health-care workers reported stigma as the most perceived problems of the present testing modality and 146 (61.3%) expressed a preference for HIVST over previous methods. Age was found to be a determinant of good knowledge of HIVST, as being within the age group of 20-40 years has a 1.83 greater odds of good knowledge of HIVST than, 41-60 years age group (Adjusted odds ratios = 1.830; 95% confidence interval 1.081-3.099). Conclusion: Most of the Primary health-care workers in Enugu State had poor knowledge of HIVST. These workers could benefit from awareness creation and training on HIVST by public health specialists to improve their knowledge.

Research paper thumbnail of Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria

PLOS Global Public Health

Nigeria is estimated to have the largest number of children worldwide, living with chronic hepati... more Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowled...

Research paper thumbnail of Comparative Assessment of Unintended Pregnancy at Urban and Rural Hospitals in Enugu State, Nigeria

Zenodo (CERN European Organization for Nuclear Research), Nov 6, 2022

Research paper thumbnail of Physician emigration from Nigeria and the associated factors: The implication to safeguarding the Nigeria Health System

Background: Adequate Human Resources for Health is indispensable to achieving Universal Health Co... more Background: Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria, with low physician-population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms to curtail the trend and safeguard the country’s health system.Methods: Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using online Google form with link shared via WhatsApp and Telegram forums of Nigeria Medical Association and her affiliate bodies. Data was analyzed with IBM-SPSS version-25 and charts were created with Microsoft Excel Spread Sheet version 2019. Chi-square and binary logistic regression tests were done with p-value set at 0.05 for statistical significance. Results: The mean age of respondents is 37.6±7.9 years; major...

Research paper thumbnail of Determinants of use of partograph among primary healthcare workers in Enugu State, South-East Nigeria

International Journal of Medicine and Health Development, 2021

Background: World Health Organization (WHO) recommended use of partograph during childbirth to en... more Background: World Health Organization (WHO) recommended use of partograph during childbirth to ensure early identification of abnormalities and prompt referral for emergency obstetrics care. However, factors that determine use of partograph during childbirth among primary healthcare workers (PHCWs) remain inadequately documented. Objective: This study investigated the determinants of use of partograph in conduct of labor among PHCWs in Enugu, South-East Nigeria. Materials and Methods: It was a cross-sectional descriptive survey of public PHCWs in Enugu State, Nigeria. Multistage sampling technique was used to select 393 respondents. Data were collected using a structured self-administered questionnaire and analyzed with IBM-SPSS version 22. Tests of statistics were conducted using χ2 and binary logistic regression, and statistical significance was determined at P-value of < 0.05. Results: Majority (87.0%) of the respondents have good knowledge of partograph. Reported regular availability of partograph is 32.8% but regular use of it is 25.2%. Statistically significant association exists between use of partograph and reception of training on it (P=0.001), knowledge of it (P=0.001), and availability of it (P=0.001). Availability of partograph was a predictor of use of it (adjusted odds ratio (AOR)=27.129; confidence interval=14.780–49.797). Conclusion: Although there is high knowledge of partograph among PHCWs in Enugu state, there is poor usage of it. There are 27 times higher odds of using partograph when it is made available compared with when it is not. We recommend regular provision of partograph to labor ward personnel in PHCWs in Enugu state and other similar populations.

Research paper thumbnail of Nanovesicle Formulation Enhances Anti-inflammatory Property and Safe Use of Piroxicam

Pharmaceutical Nanotechnology, 2021

Background: Enhanced utilization of certain drugs may be possible through the development of alte... more Background: Enhanced utilization of certain drugs may be possible through the development of alternative delivery forms. It has been observed that NSAIDs have adverse gastrointestinal tract effects such as irritation and ulceration during anti-inflammatory therapy. This challenge may be overcome through nano topical formulations. Objective: This study aimed to explore the potentials of a transdermal nanovesicular formulation for safe and enhanced delivery of piroxicam (PRX), a poorly water-soluble NSAID. Methods: Preformulation studies were conducted using DSC and FTIR. Ethosomal nanovesicular carrier (ENVC) was prepared by thin-film deposition technique using Phospholipon® 90 H (P90H) and ethanol and then converted into gel form. The formulation was characterized using a commercial PRX gel as control. Permeation studies were conducted using rat skin and Franz diffusion cell. Samples were assayed spectrophotometrically, and the obtained data was analyzed by ANOVA using GraphPad Pris...

Research paper thumbnail of International Journal of Women’s Health 2013:5 571–582 International Journal of Women’s Health Dovepress submit your manuscript | www.dovepress.com

Research paper thumbnail of Incidence and outcome of higher order multiple pregnancies at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria

International Journal of Medicine and Health Development, 2018

Background: Higher Order multiple pregnancies (HOMP) increase the demand for neonatal intensive c... more Background: Higher Order multiple pregnancies (HOMP) increase the demand for neonatal intensive care services and knowledge of local prevalences may be useful in planning neonatal intensive care. Objectives: To determine the incidence and feto-maternal outcome of higher order multiple births in university of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu, Nigeria. Methods: It was a retrospective review of all HOMP at the UNTH Ituku/Ozalla Enugu, over a ten year period from June 2006 to May 2016. Results: During the study period, there were 8207 deliveries out of which 23 were higher order multiple (HOM) births; consisting of 19 triplets and 4 quadruplets. The overall incidence of HOM births was 0.28%. This was made up of incidences of triplet and quadruplet births of 0.23% and 0.05% respectively. Ten (43.5%) of the women conceived spontaneously while 8 (34.8%) had ‘artificial reproductive technology’ and the remaining 5 (21.7%) took ovulation inducing agents. The maternal out...

Research paper thumbnail of The prevalence of stillbirths and the probable causes in low resource settings in south-east Nigeria

International Journal of Medicine and Health Development, 2022

Research paper thumbnail of Orthodox and unorthodox practices by traditional birth attendants in Nsukka area of Enugu State, Southeast Nigeria

African Journal of Medical and Health Sciences, 2021

Unskilled Traditional Birth Attendants (TBA) is prevalent in rural Nigeria due to communal cultur... more Unskilled Traditional Birth Attendants (TBA) is prevalent in rural Nigeria due to communal culture and traditions, their compassionate attitude, and non-availability of appropriate health facilities within the communities. Yet, there is no clear framework defining their roles, locations and practices. This study aimed to identify the pattern and practices of TBA in Nsukka area of Enugu State, and evaluate their roles in rural maternity services in Enugu state of Nigeria. This was a mixed method cross sectional study involving a questionnaire-based survey and Focus group discussions (FGD). Seventy-eight TBAs, were recruited for this study. Structured interviewer-administered questionnaire was used to collect quantitative data and a semi-structured discussion guide was used for the FGD – one FGD for each development center. SPSS version 25 was used for statistical analysis. Records of FGD sessions were transcribed, condensed into themes, and analyzed. A total of 78 TBAs were interview...

Research paper thumbnail of Exploring the views of Heads of Schools on School Health Services in Public Primary Schools in Enugu Metropolis, Nigeria: A Qualitative Study

Journal of Community Medicine and Primary Health Care, 2021

Background: School health services offer a great opportunity for many children to access primary ... more Background: School health services offer a great opportunity for many children to access primary health care, especially in developing countries. This study assessed the status of health services in public primary schools in Enugu Metropolis, Enugu State, Nigeria from the perspectives of the school heads.Methods: This was a qualitative study conducted among 24 public primary school head masters/mistresses in the three Local Government Areas making up Enugu metropolis. They were purposively selected from the 117 public primary schools in the metropolis. Data were collected through the use of Key Informant Interview (KII) guide, and analyzed using thematic approach.Results: Only one of the participants knew about the school health policy, while others expressed surprise at its existence. All the schools had a first aid box, but most of the boxes were not sufficiently stocked. None of the schools had a trained first aider. De-worming was carried out once in a while in all the schools. ...

Research paper thumbnail of Primary health care under one roof: Knowledge and predictors among primary health care workers in Enugu State, South East, Nigeria

Nigerian Journal of Medicine, 2020

The declaration of Alma Ata on Primary Health Care (PHC) in 1978 has been a standard for an acces... more The declaration of Alma Ata on Primary Health Care (PHC) in 1978 has been a standard for an accessible community driven and quality health care for all people and this has given rise to the health for all by the year 2000. [1] PHC connects individuals and families to their first level of contact with their national health system that can address their major health challenges. Since its establishment, there have been remarkable achievements in the major health indicators globally with life expectancy increasing by up to 10 years of what it was in 1978 and, risk of dying before age five falling by about two-thirds. [2] PHC remains a strong system and its features support the complexity and rapid transition of the world of today; its principles: health promotion, community participation, accessibility, use of appropriate technology, and inter-sectoral collaboration are appropriate to address both current and emerging challenges of health system. [2] In spite of the palpable progress in the past 40 years of PHC, there are still unaddressed health challenges for many people of the world with wide disparity between the poor and the rich, especially for those living in vulnerable situations. [3] Background: The concept of "Primary Health Care Under One Roof" (PHCUOR) is a new governance reform to improve primary health care (PHC) implementation and integration. This study aimed at assessing the level of knowledge of this concept and its predictors among PHC Workers. Materials and Methods: This was a cross-sectional descriptive study of PHC workers in Enugu State. Respondents were selected using systematic sampling method. Data were collected with self-administered questionnaire and analyzed using IBM-SPSS version 25. Level of statistical significance was set at 5% and confidence interval (CI) of 95%. Results: A total of 292 responses out of 337 questionnaires were retrieved, giving a response rate of 86.6%. Majority of the respondents were female (257, 88.0%) and greater than half were in the age range of 41-50 years (151, 51.7%). Most of the respondents had overall good knowledge of PHCUOR (210, 71.9%) but there was poor understanding of some concepts. Bivariate analysis showed that having good knowledge of PHCUOR was associated with duration of practice (χ 2 = 6.013, P = 0.018) and age (χ 2 = 4.495, P = 0.036) but on binary logistic regression, males were found to be 2.8 times more likely to have good knowledge of the concept compared to females (adjusted odds ratio = 2.763.; 95% CI = 1.022-7.469, P = 0.045). Conclusion: There was overall good knowledge of PHCUOR but the knowledge of rationale, gateway, and minimum service package (MSP) was poor. Males were approximately 2.8 times more likely to have good knowledge compared to females. Regular training of PHC workers on the concepts of PHCUOR especially the rationale, gateway, and MSP is needed to improve their knowledge and service delivery.

Research paper thumbnail of Maternal near‐miss and death associated with abortive pregnancy outcome: a secondary analysis of the Nigeria Near‐miss and Maternal Death Survey

BJOG: An International Journal of Obstetrics & Gynaecology, 2019

ObjectiveTo investigate the prevalence of life‐threatening complications related to pregnancies w... more ObjectiveTo investigate the prevalence of life‐threatening complications related to pregnancies with abortive outcome and the associated health service events and performance in Nigerian public tertiary hospitals.DesignSecondary analysis of a nationwide cross‐sectional study.SettingForty‐two tertiary hospitals.PopulationWomen admitted for pregnancy‐related complications.MethodsAll cases of severe maternal outcomes (SMO: maternal near‐miss or death) due to abortive pregnancy complications (defined as spontaneous or induced abortion, and ectopic pregnancy) were prospectively identified over 1 year using uniform identification criteria.Main outcome measuresPrevalence of SMO, mortality index (% maternal death/SMO), case fatality rate, time until death after admission, and health service performance.ResultsOf 5779 women admitted with abortive pregnancy complications, 444 (7.9%) experienced an SMO: 366 maternal near‐misses and 78 maternal deaths. Intra‐hospital maternal mortality ratio fr...