BackgroundHIV infection and AIDS are majorpublic health challenges in Nigeria, a country with one of the highest rates of new infection in sub-Saharan Africa and the second largest HIV epidemic in the world.Non-adherence to medication and defaulting from treatment are the two major challenges faced by anti-retroviral therapy (ART) programs in resource-constrained settings. This study was undertaken to determine the rate and predictors of adherence to medication and retention among people living with HIVin Enugu State, Nigeria.MethodsThis was a cross-sectionalretrospective study conducted among adults living with HIV(PLHIV) receiving ARTs in eightcomprehensive health facilities in Enugu, Nigeria. We used self-reported adherence and recorded clinic visits to assess adherence and retention, respectively. Descriptive statistics (frequencies, proportions, mean and standard deviation) and regression analysis were then conducted to identify the association between adherence, retention and demographic and health-related factors. ResultsThe mean age of respondents was 38.5±9.8 years. Predictors of good adherence to medication includedbeing male(adjusted odds ratio [AOR]:2.08; 95% confidence interval [CI]:1.12–3.85), having been on anti-retroviral medications for more than 5 years (AOR:1.92; 95% CI: 1.17–3.16), the non-consumption of alcohol(AOR: 3.67; 95% CI: 2.01–6.70),not usingtraditional medicine (AOR: 2.76; 95% CI:1.33–5.73) and having a baseline CD4count exceeding 500 cells/μl (AOR: 5.67; 95% CI: 1.32–24.32).Adequate retention was predicted by being resident in the urban area (AOR: 1.90; 95% CI: 1.17–3.06). Being away from home (41.8%) and forgetfulness (35.0%) were reported as the major reasons for missing medication.ConclusionThe rates of adherence and retention found in this study were similar to those reported forother resource-limited settings. Health education and behavioural modification interventions should be intensified to reduce the consumption of alcohol and the use of traditional medicine by people living with HIV. Identifying other factors may help to design effective strategies to ensure that people living with HIV adhere to their medications and remain in care.

No abstract

Malaria is a major health problem in Nigeria that has as high as 25% of all global cases, and 30% of deaths attributable to malaria. In 2010, World Health Organization (WHO) recommended universal confirmation of diagnosis of malaria through blood parasitological test, prior to initiation of treatment. In addition to Microscopy, Malaria Rapid diagnostic Tests (mRDTs) are blood tests for malaria. Early diagnosis of malaria ensures that the correct treatment is commenced in good time, and this subsequently improves the prognosis. The objective of this study is to assess the use of mRDTs among medical doctors working in a tertiary hospital, Southeast Nigeria. This study was conducted in Enugu State Teaching hospital, Southeast Nigeria. The study was of cross-sectional design, and conducted in October 2016 among medical doctors working in the General Outpatient, Internal Medicine, and Paediatrics departments of the Teaching hospital. Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. A total of 86 medical doctors, out of the eligible 91 in the three departments participated in the study, and were distributed as follows; 24 (27.9%) in the General Outpatient, 30 (34.9%) in the Internal Medicine, and 32 (37.2%) in the Paediatrics departments. More medical doctors in the Paediatrics department (31.3%) used mRDTs in making diagnosis of malaria, followed by Internal medicine (13.3%), then General Outpatient Department (8.3%). Malaria rapid diagnostic tests are cost-effective, and useful tools in malaria control and elimination programmes. If tangible progress on the implementation of the WHO guidelines on confirming diagnosis of malaria before treatment; and the T3: Test, Treat, Track initiative is to be made; then the government and the Management of hospitals ought to take more determined efforts aimed at educating and informing health workers, especially medical doctors on the benefits of mRDTs.

Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more accessible. The objective of this study was to assess knowledge, and perception of malaria rapid diagnostic test (mRDT), among doctors in a tertiary health facility. A descriptive, cross sectional study, conducted in October 2016, in a state University Teaching hospital, Enugu state, Nigeria. 86 doctors in the General Outpatient, Internal Medicine, and Paediatrics departments participated. 90.7% of respondents knew parasitological examination of blood is the certain method of making malaria diagnosis, 89.5% knew microscopy and RDT are methods for parasitological diagnosis, 91.9% knew mRDT is quick blood test for malaria, 54.7% knew mRDT is usually specific for one or more species of malaria, 46.5% knew mRDT detects circulating malaria parasite antigen, 29.1% knew mRDT is read 15 to 20 minutes after the test, 70.9% knew mRDT is not superior to microscopy, 79.1% knew mRDT is not 100% specific, 80.2% knew mRDT ought not be done always by Laboratory Scientists, and 66.3% knew more than one type of mRDT kit is available. On perception, 64.0% thought it was important to confirm diagnosis before commencing treatment, 90.7% perceived mRDT as being very useful, 96.5% did not perceive mRDT as endangering patients, 70.9% opinioned that presumptive diagnosis of malaria is not a better way of making diagnosis, 76.7% did not believe malaria diagnosis is always clear on listening to the patient, 90.7% did not perceive mRDT as being hazardous, 83.7% believe using mRDT can reduce the quantity of anti-malaria drugs consumed, and 94.2% opinioned that mRDT should be encouraged and promoted. Training and re-training of health workers shall greatly enhance mRDT use in implementing the WHO How to cite this paper: Ndibuagu, E.O.,

Introduction: Cigarette smoking is an established risk factor for many diseases, and according to World Health Organization, health care workers can influence positively or negatively the smoking habits of the community. Objective: The purpose of the study was to investigate the prevalence of cigarette smoking and attitudes regarding its control among healthcare workers in Enugu, SouthEast Nigeria. Methods: This cross sectional study was conducted among 369 healthcare providers randomly selected in primary, secondary and tertiary health facilities. Data were collected using a self reported questionnaire on cigarette smoking, and were analysed using SPSS Version 21, and statistical significance of association between variables was assessed using chi-square test at p < 0.05. Ethical clearance from University of Nigeria Teaching Hospital, Enugu and informed written consent was obtained from the participants. Results: Overall, 369 respondents returned the completed questionnaires. 54.2% were males, 75.9% were aged between 20 to 40 years, while their mean age was 27.5 ± 6.2 years. Overall life time prevalence of smoking among healthcare workers was 21.1% with (95% confidence interval 17.3-25.6), currently smoking was 6.5% with (95% confidence interval 5.8-7.4), while life time prevalence among physicians was 31.7% with (95% ci 28.8-33.6). The highest smoking rate was among the internists 72.7% in the physicians group. More smokers significantly agreed that the followings should be banned: cigarette sales (X 2 = 22.134, df = 6, P = 0.003), advertising cigarettes (X 2 = 42.532, df = 28, P = 0.040), cigarettes smoking in restaurants (X 2 = 42.560, df = 20, P = 0.001), and smoking in all enclosed places (X 2 = 33.257, df = 20, P = 0.025), but not statistically significant for health professionals to serve as role models (X 2 = 24.420, df = 8, P = 0.086). Conclusion: Our results showed high percentage of cigarette smoking among healthcare providers. Smoking cessation programs should be introduced among healthcare providers.