Introduction: Burden of Malaria in pregnancy (MIP) is still high despite availability of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance, but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with preventative services for malaria during pregnancy delivered at antenatal clinics (ANC) in Anambra State Nigeria.Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using multistage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall, 62.2% were satisfied with quality of preventive services for malaria during pregnancy. However, 64.8% and 57.8% were dissatisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the respondents (88.73%) had poor knowledge of malaria preventive services during pregnancy. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare. Conclusion: A fair proportion of respondents were satisfied with the preventive services for malaria during pregnancy provided even though most were dissatisfied with the cost of assessing care and interpersonal relationship with health workers. Uninterrupted availability of long lasting insecticide treated bed nets and intermittent preventive treatment for malaria at all health facilities, subsidized cost of malaria-related commodities, and incentives for good customer satisfaction ratings may remediate the described barriers to seeking preventative care for malaria during pregnancy.

Introduction: Burden of Malaria in pregnancy (MIP) is still high despite availability of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with preventative services for malaria during pregnancy delivered at antenatal clinics (ANC) in Anambra State Nigeria.Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of preventive services for malaria during pregnancy. However, 64.8% and 57.8% were dissatisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of malaria preventive services during pregnancy. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare. Conclusion: A fair proportion of respondents were satisfied with the preventive services for malaria during pregnancy provided even though most were dissatisfied with the cost of assessing care and interpersonal relationship with health workers. Uninterrupted availability of LLIN and IPT at all health facilities, subsidized cost of malaria-related commodities, and incentives for good customer satisfaction ratings may remediate the described barriers to seeking preventative care for malaria during pregnancy

Background: Burden of Malaria in pregnancy (MIP) is still high despite deployment of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with malaria in pregnancy services delivered at antenatal clinics (ANC) in Anambra State Nigeria. Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables. Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of MIP preventive services, but 64.8% and 57.8% were not satisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of MIP preventive services. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare domain. Conclusion: A fair proportion of respondents were satisfied with the MIP services provided even though most were unsatisfied with the cost of assessing care and interpersonal relationship with health workers. To achieve satisfaction with services, the state government should subsidize the cost of services and encourage HWs to build good relationships with their clients especially at public secondary health facilities.

Background: Histoplasmosis is a systemic fungal infection caused by Histoplasma Capsularum. It has a worldwide distribution, with a predominant prevalence in tropical and temperate zones. It is considered an important public health problem, especially in patients with acquired immunodeficiency virus (HIV), in which poor prognosis and high mortality are evident. The objective of this study is to analyze epidemiological data and complications associated to histoplasmosis, aiming at better promotion and prevention of it.Methods & Materials: Cross-sectional, retrospective and analytical study of 27 patients diagnosed with histoplasmosis during hospitalization at Hospital Couto Maia (HCM) in Salvador, Bahia, Brazil, from 2012 to 2014. The diagnosis of histoplasmosis was confirmed by visualization of the fungus by direct research, histopathological evidence at any site, isolation of the fungus in culture medium and/or tests of specific serological reactions. The medical records were reviewed, and age, color, sex, origin, marital status, histoplasmosis classification, deaths, survival time and types of infectious complications were analyzed.Results: The majority of the patients came from Salvador (59.2%). The mean age was 42.3 years, with 51.8% being less than 40 years old, predominantly male (74%), single (70.3%) and brown (74%); 66.6% presented the disseminated form of the disease, 22.2% had acute pulmonary disease and 11.1% were ignored. The most frequent infectious complications were: AIDS (92.5%), candidiasis (44.4%), sepsis (40.7%), toxoplasmosis (22.2%), cryptococcosis (14.8%), syphilis (7.4%), hepatitis B (11.1%), HTLV (7.4%), urinary tract infection (7.4%), community acquired pneumonia (7.4%), pneumocystosis and tuberculosis (7.4%). Of the deaths (66.6%), 94.4% had AIDS and 5.5% were not diagnosed with AIDS. The mean survival time of patients with histoplasmosis was 68.9 days, with AIDS patients 71.8 days and in the non-AIDS patient 20 days. Conclusion:Patients with histoplasmosis, admitted to HCM, presented the following characteristics: young adults, male sex, single, brown, disseminated form of the disease, with multiple and concomitant opportunistic infections, presenting high mortality in patients with AIDS with low time of survival.

Background: Burden of Malaria in pregnancy (MIP) is still high despite availability of proven cost-effective interventions. Considerable progress has been made on improving antenatal attendance but MIP preventive services utilization remains low. Factors responsible for this include dissatisfaction with the services provided. We assessed clients’ satisfaction with preventative services for malaria during pregnancy delivered at antenatal clinics (ANC) in Anambra State Nigeria.Method: We conducted a cross-sectional study among 284 pregnant women attending ANC using a three-stage sampling technique. Pre-tested semi-structured interviewer-administered questionnaire was used to collect information on socio-demographics, knowledge of malaria in pregnancy services and satisfaction with services. Responses to questions on satisfaction was on a 5-point Likert scale. A cut off of ≥75% of composite score was used to classify respondents as satisfied. For knowledge, every correct answer was scored 1 and incorrect 0; ≥75% of the composite score was graded as good knowledge. Chi square and logistic regression were used to test for association between client satisfaction and independent variables.Results: The mean age of participants is 28 years±4.4 years. Overall 62.2% were satisfied with quality of preventive services for malaria during pregnancy. However, 64.8% and 57.8% were dissatisfied with cost of healthcare and interpersonal relationship with the health workers (HWs). Majority of the of respondents (88.73%) had poor knowledge of malaria preventive services during pregnancy. Type of facility (Adjusted odds ratio [aOR] = 2.11; 95%CI: 1.20-3.71) and knowledge (aOR: 0.41; 95%CI: 0.18 – 0.90) were independently associated with satisfaction with interpersonal relationship respectively. Type of facility (aOR: 0.47; 95%CI: 0.27-0.80) and employment status (aOR: 3.07; 95%CI: 1.39 -6.74) were also independently associated with satisfaction with cost of healthcare.Conclusion: A fair proportion of respondents were satisfied with the preventive services for malaria during pregnancy provided even though most were dissatisfied with the cost of assessing care and interpersonal relationship with health workers. Uninterrupted availability of LLIN and IPT at all health facilities, subsidized cost of malaria-related commodities, and incentives for good customer satisfaction ratings may remediate the described barriers to seeking preventative care for malaria during pregnancy.