Effective, coordinated response reduces mortality from public health events. Attention to vulnerable groups during disasters is essential. Public Health Implications. Activating an incident command system improves the outcome of disasters in resource-constrained settings.
BackgroundCholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in suspected cholera cases in Gomani, Kwali Local Government Area. NFELTP residents were deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and instituting appropriate control measures to control the outbreak.MethodsWe conducted an unmatched case-control study. We defined a cholera case as any person aged ≥5 years with acute watery diarrhea in Gomani community. We identified community controls. A total of 43 cases and 68 controls were recruited. Structured questionnaires were administered to both cases and controls. Four stool samples from case-patients and two water samples from the community water source were collected for laboratory investigation. We performed univariate and bivariate analysis using Epi-Info version 7.1.3.10.ResultsThe mean age of cases and controls was 20.3 years and 25.4 respectively (p value 0.09). Females constituted 58.1% (cases) and 51.5%(controls). The attack rate was 4.3% with a case fatality rate of 13%. Four stool (100%) specimen tested positive for Vibrio cholerae. The water source and environment were polluted by indiscriminate defecation. Compared to controls, cases were more likely to have drank from Zamani river (OR 14.2, 95% CI: 5.5–36.8) and living in households(HH) with more than 5 persons/HH (OR 5.9, 95% CI: 1.3–27.2). Good hand hygiene was found to be protective (OR 0.3, 95% CI: 0.1–0.7).ConclusionVibrio cholerae was the cause of the outbreak in Gomani. Drinking water from Zamani river, living in overcrowded HH and poor hand hygiene were significantly associated with the outbreak. We initiated hand hygiene and water treatment to control the outbreak.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6299-3) contains supplementary material, which is available to authorized users.
Background Expanding access and use of effective contraception is important in achieving universal access to reproductive healthcare services, especially in low- and middle-income countries (LMICs), such as those in sub-Saharan Africa (SSA). Shortage of trained healthcare providers is an important contributor to increased unmet need for contraception in SSA. The World Health Organization (WHO) recommends task sharing as an important strategy to improve access to sexual and reproductive healthcare services by addressing shortage of healthcare providers. This study explores the status, successes, challenges and impacts of the implementation of task sharing for family planning in five SSA countries. This evidence is aimed at promoting the implementation and scale-up of task sharing programmes in SSA countries by WHO. Methodology and findings We employed a rapid programme review (RPR) methodology to generate evidence on task sharing for family planning programmes from five SSA countries namely, Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, and Nigeria. This involved a desk review of country task sharing policy documents, implementation plans and guidelines, annual sexual and reproductive health programme reports, WHO regional meeting reports on task sharing for family planning; and information from key informants on country background, intervention packages, impact, enablers, challenges and ways forward on task sharing for family planning. The findings indicate mainly the involvement of community health workers, midwives and nurses in the task sharing programmes with training in provision of contraceptive pills and long-acting reversible contraceptives (LARC). Results indicate an increase in family planning indicators during the task shifting implementation period. For instance, injectable contraceptive use increased more than threefold within six months in Burkina Faso; contraceptive prevalence rate doubled with declines in total fertility and unmet need for contraception in Ethiopia; and uptake of LARC increased in Ghana and Nigeria. Some barriers to successful implementation include poor retention of lower cadre providers, inadequate documentation, and poor data systems. Conclusions Task sharing plays a role in increasing contraceptive uptake and holds promise in promoting universal access to family planning in the SSA region. Evidence from this RPR is helpful in elaborating country policies and scale-up of task sharing for family planning programmes.
IntroductionIn Nigeria, malaria remains a major burden. There is the presupposition that household members could have common exposure to malaria parasite and use of long-lasting insecticidal net (LLIN) could reduce transmission. This study was conducted to identify factors associated with asymptomatic malaria parasitaemia and LLIN use among households of confirmed malaria patients in Abuja, Nigeria.MethodsA cross-sectional survey was conducted from March to August 2016 in twelve health facilities selected from three area councils in Abuja, Nigeria. Participants were selected using multi-stage sampling technique. Overall, we recruited 602 participants from 107 households linked to 107 malaria patients attending the health facilities. Data on LLIN ownership, utilization, and house characteristics were collected using a semi-structured questionnaire. Blood samples of household members were examined for malaria parasitaemia using microscopy. Data were analyzed using descriptive statistics, Chi-square, and logistic regression (α = 0.05).ResultsMedian age of respondents was 16.5 years (Interquartile range: 23 years); 55.0% were females. Proportions of households that owned and used at least one LLIN were 44.8% and 33.6%, respectively. Parasitaemia was detected in at least one family member of 102 (95.3%) index malaria patients. Prevalence of asymptomatic malaria parasitaemia among study participants was 421/602 (69.9%). No association was found between individual LLIN use and malaria parasitaemia (odds ratio: 0.9, 95% confidence interval (95%CI): 0.6–1.3) among study participants. Having bushes around the homes was associated with having malaria parasitaemia (adjusted OR (aOR): 2.7, 95%CI: 1.7–4.2) and less use of LLIN (aOR: 0.4, 95%CI: 0.2–0.9). Living in Kwali (aOR: 0.1, 95% CI: 0.0–0.2) was associated with less use of LLIN.ConclusionHigh prevalence of asymptomatic malaria and low use of LLIN among household members of malaria patients portend the risk of intra-household common source of malaria transmission. We recommend household health education on LLIN use and environmental management. Study to explore the role of preventive treatment of household members of confirmed malaria patient in curbing transmission is suggested. Strategies promoting LLIN use need to be intensified in Kwali.
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