Publications by authors named "Joseph Chukwu"

Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how community-driven initiatives have successfully improved leprosy awareness, reduced stigma, and fostered early case detection and treatment adherence. The importance of culturally sensitive, inclusive approaches in health education and stigma reduction campaigns is highlighted, emphasizing the potential for community engagement to enhance national leprosy programs and contribute to the World Health Organization's Zero Leprosy Strategy.

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Background: Neglected tropical diseases (NTDs) significantly impact the physical and mental well-being of affected individuals, particularly in Nigeria. This study aims to evaluate the effectiveness of integrating mental health services with self-care practices for individuals suffering from leprosy, Buruli ulcer (BU), and lymphatic filariasis (LF). The role of trained Healthcare Workers (HCWs) and NTD champions (NTD-Cs) will be explored to enhance health outcomes in this population.

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Article Synopsis
  • A study in Nigeria aimed to assess community knowledge and stigma surrounding leprosy, revealing a significant gap in understanding and high levels of stigma among residents.
  • Nearly half (49.4%) of the 811 survey participants had poor knowledge about leprosy, largely due to cultural beliefs and misconceptions about its transmission.
  • The findings highlight the need for targeted health education and interventions to reduce stigma and improve knowledge about leprosy in the community.
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Article Synopsis
  • The study investigates the mental health impact of skin neglected tropical diseases, specifically leprosy and Buruli ulcer, on affected individuals in Nigeria, highlighting issues related to stigma and disability.
  • A total of 635 participants were assessed using various mental health questionnaires, revealing alarming rates of mental health issues: 89.9% experienced depressive symptoms, 79.4% had anxiety disorders, and 66.1% reported poor mental wellbeing.
  • Key factors influencing poor mental health included lack of formal education, unemployment, having leprosy, and insufficient social support, highlighting the need for targeted mental health interventions for these populations.
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Background: A major challenge to TB control globally is low case detection, largely due to routine health facility-based passive case-finding employed by national TB control programs. Active case-finding is a risk-population-based screening approach that has been established to be effective in TB control. This intervention aimed to increase TB case detection in hard-to-reach areas in southern Nigeria.

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Background: In Nigeria, similar to many leprosy-endemic countries, leprosy is highly stigmatized. High levels of stigma among community members as well as internalized stigma among persons affected by leprosy often result in negative psychosocial consequences for those affected. To break this vicious cycle, it is important to conduct context-specific behavioral change activities.

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Article Synopsis
  • Yaws, caused by the Treponema pallidum subspecies pertenue bacteria, primarily affects children under 15 and was once common in Nigeria, but eradication efforts have significantly reduced its prevalence.
  • A recent study involved screening 105,015 school children in southeast Nigeria for yaws, with trained volunteers identifying 7,706 children with various skin issues.
  • Despite eight suspected yaws cases, none were confirmed, highlighting the need for ongoing community awareness and active case-finding initiatives against yaws in the region.
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This protocol describes a study in which we would assess the effect of using community lay counselors, self-help groups (SHGs), and trained frontline health workers to reduce mental disorders and improve quality of life (QOL) of persons affected by leprosy or Buruli ulcer (BU). A cluster randomized controlled study design will be employed. The study will involve persons affected by leprosy or BU.

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Background: Lymphatic filariasis (LF), Buruli ulcer (BU) and leprosy are neglected tropical diseases (NTDs) of the skin co-endemic in some communities in Nigeria. Not enough is known about the effectiveness of integrated morbidity management and disability prevention in people with these conditions. An integrated self-care intervention was carried out for people with these skin NTDs in two endemic communities of Anambra state, Nigeria.

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Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, the annual new case detection in 2019 was 202,189 globally. Measuring endemicity levels and burden in leprosy lacks a uniform approach. As a result, the assessment of leprosy endemicity or burden are not comparable over time and across countries and regions.

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This study examines the global media framing of coronavirus disease 2019(COVID-19) to understand the dominant frames and how choice of words compares in the media. Periods of health crisis such as the outbreak of coronavirus pandemic add to the enormous burden of the media in keeping people constantly informed. Extant literature suggests that when a message is released through the media, what matters most is not what is said but how it is said.

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Background: There is a dearth of experience in and evidence for cost-effective integrated community-based management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria.

Methods/principal Findings: This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria.

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Introduction: Diabetes mellitus (DM) and tuberculosis (TB) are of great public health importance globally, especially in Sub-Saharan Africa. Tuberculosis is the third cause of death among subjects with non-communicable diseases. DM increases risk of progressing from latent to active tuberculosis.

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Multidrug-resistant tuberculosis (MDR-TB) is presently a major public health threat. MDR-TB patients face diverse financial and psychosocial difficulties. Researchers conducted in-depth interviews based on interview guides with 42 participants.

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Background: Poor knowledge can influence timely care-seeking among persons with Buruli ulcer disease (BUD).

Objectives: To assess community knowledge, attitude and stigma towards persons with BUD in endemic settings of Southern Nigeria.

Methods: This was a cross-sectional survey conducted among adult community members in four States of Southern Nigeria.

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Background: In Nigeria, little is known about the development of new or additional physical disability during leprosy treatment. The objective of this study was to determine the prevalence and evaluate factors associated with worsening of physical disability during leprosy treatment in Nigeria.

Methods: This was a retrospective cohort study conducted among leprosy patients treated in six referral facilities in six States in Nigeria between January 2011 and December 2015.

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Background: Poor knowledge of health care workers may be responsible for the under-diagnosis and low notification of Buruli ulcer (BU) in high-burden settings. This study assessed health care workers' knowledge, attitude and risk perception of BU in Southern Nigeria.

Methods: We conducted a cross-sectional survey among 186 health care workers recruited from 58 health facilities in four states of Southern Nigeria.

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Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients.

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Introduction:: Mycolactones, secreted by Mycobacterium ulcerans, were previously believed to prevent super infection in Buruli ulcer lesions. However, little is known about secondary bacterial infections in these lesions. This study evaluated contaminating bacterial flora and their antibiotic susceptibility patterns in cases of previously untreated Buruli ulcer disease from three states in Southern Nigeria.

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Background: The economic burden of Buruli ulcer for patients has not been well-documented. This study assessed the costs of Buruli ulcer care to patients from the onset of illness to diagnosis and to the end of treatment.

Methods: This was a cross-sectional cost of illness study conducted among patients with Buruli ulcer in four States in Nigeria between July and September 2015.

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Background: Delayed diagnosis of Buruli ulcer can worsen clinical presentation of the disease, prolong duration of management, and impose avoidable additional costs on patients and health providers. We investigated the profile, delays in diagnosis, duration of hospitalisation, and associated factors among patients with Buruli ulcer in Nigeria.

Methods: This was a prospective cohort study of patients with Buruli ulcer who were identified from a community-based survey.

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Background: There are limited data on the performance of the use of fixed-dose combination (FDC) TB drugs when used under programmatic settings in high TB-endemic countries. We evaluated the efficacy and safety of FDC versus loose formulation (LF) TB treatment regimens for treatment of pulmonary TB (PTB) in the context of actual medical practice in prevailing conditions within programmatic settings in five sites in two high TB-burden African countries.

Methods: A two-arm, single-blind, randomized clinical trial comparing FDCs with separate LFs involving 1000 adults newly diagnosed with culture positive PTB was conducted at five sites in two African countries between 2007 and 2011.

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Background: Poor competence of clinicians may be a critical factor responsible for the under-diagnosis of childhood TB in high-burden settings. Our objective was to assess the current practices of management of childhood TB among clinicians in Nigeria.

Methods: A cross-sectional survey was conducted among clinicians recruited through a three-stage sampling technique from 76 health facilities in Southern Nigeria.

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Background: Buruli ulcer (BU), also known as Mycobacterium ulcerans disease, is the third most common mycobacterial disease worldwide. Although BU disease has been diagnosed among Nigerians in neighbouring West African countries, data on the burden of the disease in Nigeria itself are scanty. This study aimed to assess the magnitude and epidemiology of BU in the South South region of Nigeria.

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Objective/background: Tuberculosis (TB) is a major cause of morbidity and mortality in developing countries. Passive case detection in national TB programmes is associated with low case notification, especially in children. This study was undertaken to improve detection of childhood TB in resource-poor settings through intensified case-finding strategies.

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