Background: Food vendors play a critical food safety role in the "farm to plate" continuum that is necessary for the prevention and control of food borne diseases and therefore, any lack of its understanding by the food vendors poses a serious challenge to food safety. Objective: To assess the knowledge, attitude and hygienic practices of food vendors in Owerri town of Imo State, Nigeria. Methods: The study was a Cross-Sectional descriptive design that used a proportionate convenience sampling technique to select 200 food vendors from the three Local Government Areas (LGAs) in Owerri town. Data were collected using a pretested semi-structured interviewer administered questionnaire. Descriptive analyses were done with frequencies and summary statistics. Chi square statistics were computed to determine significant relationships and p value was set at 0.05 significant level. Results: While a majority of the respondents had a good level of knowledge (81%) and positive attitude (71%) about food hygiene, only 37% of the respondents had a good level of hygienic practice. It was revealed that 32% and 46% of the respondents received training on food hygiene and environmental health worker inspection respectively. It was also revealed that, there were statistically significant relationships between knowledge (p = 0.001), attitude (p = 0.000), formal training on food hygiene (p = 0.000) and the level of food hygienic practices. Conclusion: The public health management of food vending services should involve the development of strategies that will equip them with the necessary knowledge and skills to provide vending services in a hygienic and safe manner.How to cite this paper: Iwu, A.C.,

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Background: Family planning is a cost-effective strategy for achieving population development. Family planning uptake is low in sub-Saharan Africa, including Nigeria. We assessed the perception, pattern of use, partner support and determinants of uptake of family planning methods among married women of reproductive age in rural communities of Ebonyi state. Methods: This is part of a baseline report of a quasi-experimental study. A total of 484 married women of reproductive age were recruited using multistage sampling method. Four focus group discussions (men and women) and pretested semi-structured interviewer-administered questionnaires were used to collect information from the participants. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20 software and thematic analysis. Chisquare test and logistic regression were carried out at 5% significance level. Results: Only 26.2% of respondents were currently using any method of family planning. The most commonly used method was the natural method (57%). Amongst those who reported using artificial methods, 32.7% used condoms, 27.3% used implant while 23.64 and 16.4% used injectables and pills respectively. Predictors of current use of any family planning method were: older age (AOR = 1.7, 95%CI = 1.01-3.00), having more than five children (AOR = 1.7, 95%CI = 1.05-2.83), minimum of secondary level of education for respondent (AOR = 3.3, CI = 1.60-6.96) and their husband/partner (AOR = 2.0, 95%CI = 1.05-3.92). Qualitative findings showed that only few families were using a method of family planning and those who did not practice family planning perceived it to interfere with God's plan for fruitfulness and to be counter-productive to household income due to decreased manpower for agricultural activities. Poor partner involvement and support for family planning was also cited as a deterrent by both male and female participants.

Background: Lassa fever is a viral hemorrhagic fever found predominantly in West Africa with the potential to cause approximately 5,000 deaths per year. However, good knowledge of the disease may reduce the infection rate. The study assessed the knowledge of Lassa fever and its determinants among traders in Izzi community Ebonyi State, Nigeria. Methods: A descriptive cross-sectional study was conducted among 248 traders selected by simple random sampling method. Data were collected from respondents who gave their informed consent using interviewer-administered semi-structured questionnaire and analyzed using Chisquare test (Fisher's exact test where appropriate) for categorical variables and binary logistic regression for predictors of the outcome variables. Statistical significance was set at p < 0.05 Results: Most of the respondents (40%) were within the age group of 21 -30 years. Majority of the Original Research Articletraders were females (64.1%), married (64.1%) and predominantly Christians (97.2%). A large proportion of the respondents (43.1%) had secondary education level, and 10.1% had no formal education. Awareness of Lassa fever was high 197 (79.4%) among the traders. The commonest source of information was radio 152 (61.3%), and only 15% of the respondents heard about Lassa fever from health workers. Overall knowledge of Lassa fever was poor: 173 (70%) of the traders had poor knowledge, and only 53 (21.4%) had excellent knowledge. Majority of the traders 160 (64.5%) ate rat's meat. Factors found to be significantly associated with knowledge of Lassa fever include gender, educational status, and consumption of rat. Predictors of adequate knowledge include male gender and completing tertiary education. Conclusion:The high level of awareness of Lassa fever in this study did not translate to adequate knowledge of the disease. The poor level of knowledge points towards a growing need to step up not just awareness of Lassa fever but also in-depth knowledge of the causes, mode of transmission and prevention of the disease through public education with special access to the female cohort.

Summary Background Indiscriminate antimicrobial use is one of the greatest contributors to antimicrobial resistance. A low level of asepsis in hospitals and inadequate laboratory support have been adduced as reasons for indiscriminate use of antimicrobials among surgical patients. At present, there are no guidelines for presumptive antibiotic use in Nigeria and sub-Saharan Africa. Aim Surgical inpatients at the study hospital were surveyed to determine the level of antimicrobial use and degree of compliance with prescription quality indicators. Methods A cross-sectional survey was conducted among all surgical inpatients in May 2019 using a standardized tool developed by the University of Antwerp to assess the point prevalence of antimicrobials. Inpatients who were admitted from 08:00 h on the day of the survey were included. Data on patients' demographics, indication for antimicrobial use, reason for antimicrobial use, stop/review date, adherence to guidelines and laboratory use were collected. The prevalence of antimicrobial use in the surgical department was estimated. Results Eighty-two inpatients were included in the survey. Of these, 97.6% were receiving at least one antimicrobial agent. Only 5.4% of the prescriptions were targeted, and 37.6% of prescriptions were for empirical treatment of infections. Approximately half (50.7%) of the patients were receiving presumptive antibiotics, and 6% were receiving prophylactic antibiotics. In total, 58.7% of prescriptions were administered parenterally, and 98.2% of patients had documentation of a stop/review date. Metronidazole ( P =32.3%, T=29.2%), ceftriaxone ( P =28.4%, T=19.8%) and ciprofloxacin ( P =14.2%, T=14.6%) were the most common antimicrobials used. Conclusions There is a high rate of antimicrobial use among surgical inpatients, and the rate of indiscriminate antimicrobial prescribing among these patients needs to be reduced. This can be achieved by developing antimicrobial guidelines for presumptive antimicrobial therapy.

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Background The rate of diagnostic testing for malaria is still very low in Nigeria despite the scale-up of malaria rapid diagnostic test (MRDT) availability, following WHO's recommendation of universal diagnostic testing in 2010. We investigated whether a social group sensitisation and education intervention (social group intervention) and a social group intervention plus health-care provider training intervention would increase the demand (use or request, or both) for MRDTs among community members in Ebonyi state, Nigeria. MethodsWe did a three-arm, parallel, open-label, stratified cluster-randomised controlled trial in Ebonyi state, Nigeria, to evaluate the effects of two interventions compared with a control. We randomly assigned geographical clusters that were accessible (close to a road that was drivable even during the rainy seasons) and had at least one eligible public primary health facility and patent medicine vendor (those that offered MRDT services) in a 1:1:1 allocation to the control arm (receiving no intervention), social group arm (receiving sensitisation and education about MRDT), or social group plus provider arm (receiving the social group intervention plus provider training in health communication about MRDT). Investigators, participants (social groups, providers, respondents), and interviewers could not be masked to group assignments. The primary outcome was the proportion of children younger than 5 years with fever or malaria-like illness, in the 2 weeks preceding a household survey, who received an MRDT, and the coprimary outcome was the same outcome but among children aged 5 years and older (ie, up to and including 17 years) and adults (excluding pregnant women). The outcomes were measured at an individual level via household surveys before the interventions and 3 months after the end of the interventions. All analyses were done using a cluster-level method on an intention-to-treat basis. This trial is registered with ISRCTN, number ISRCTN14046444. FindingsWe carried out eligibility screening and recruitment of participants (clusters, social groups, and providers) between July 2 and Sept 27, 2018. 34 clusters met the eligibility criteria and 18 were randomly selected to participate and randomly assigned to arms (six clusters per arm). A mean proportion of 40•6% (SD 14•5) of eligible children younger than 5 years in the control arm received an MRDT, versus 66•7% (11•7) in the social group arm (adjusted risk difference [aRD] 28•8%, 95% CI 21•9-35•7, p<0•0001) and 71•7% (19•8) in the social group plus provider arm (aRD 32•7%, 24•9-40•5, p<0•0001), with no significant difference between the social group arm and the social group plus provider arm. A mean proportion of 36•3% (18•5) of eligible children aged 5 years and older in the control arm received an MRDT, versus 60•7% (14•0) in the social group arm (aRD 25•6%, 16•8-34•4, p=0•0004), and 59•5% (18•3) in the social group plus provider arm (aRD 28•0%, 19•5-36•5, p=0•0002), with no significant difference between the social group arm and the soci...

Background: Health care seeking behaviour is a complex, dynamic and multidimensional process that involves a sequence of remedial actions that are influenced by the interaction between the individual, household and community with the intention of addressing perceived ill health. Objective: To determine health care seeking attitude and behaviour and the predictors of combined orthodox and traditional health care use among households in communities in Owerri, Imo State. Nigeria. Methods: A cross sectional design that used a multistage random sampling technique to select 500 participants from households in two communities in Owerri, Imo State. Data was collected using a pretested, semi structured questionnaire. Descriptive analyses were done with frequencies and summary statistics. Chi square statistics were computed to determine significant relationships and binary logistic regression was used to determine predictors of combined use. P was set at 0.05 significance level. Results: The results revealed that, while just more than half of the respondents (56.4%) had a moderate to good level of overall knowledge of health care, almost all of the respondents (96.2%) also had a moderate to good level of overall positive attitude towards seeking health care; with less than one third (29.4%) using combined orthodox and traditional health care treatments. It further revealed that, respondents who were female, traders and from households of polygamous families were significantly more likely to use