Community reintegration and related factors in a Nigerian stroke sample.

Background: The goal of stroke rehabilitation has shifted from mere survival of a victim to how well a survivor can be effectively reintegrated back into the community. Objectives: The present study determined the level of satisfaction with community reintegration (CR) and related factors among Nigerian community-dwelling stroke survivors (CDSS). Methods: This was a cross-sectional survey of 71 volunteering CDSS (35 males, 36 females) from selected South-Eastern Nigerian communities. Reintegration to Normal Living Index was used to assess participants’ CR. Data was analysed using Spearman rank-order correlation, Kruskal-Wallis and Mann-Whitney U tests at p≤0.05. Results: Participants generally had deficits in CR which was either mild/moderate (52.1%) or severe (47.9%). Scores in the CR domains of distance mobility, performance of daily activities, recreational activities and family roles were particularly low (median scores ≤ 4). CR was significantly correlated with and influenced by age (r=-0.35; p=0.00) and presence/absence of diabetes mellitus (u=3.56.50; p=0.01), pre- (k=6.13; p=0.05) and post-stroke employment (k=18.26; p=0.00) status, type of assistive mobility device being used (AMD) (k=25.39; p=0.00) and support from the community (k=7.15; p=0.03) respectively. Conclusion: CR was generally poor for this CDSS sample. Survivors who are older, having diabetes as co-morbidity, using AMD (particularly wheel-chair) and without employment pre- and/or post-stroke may require keener attention. Rehabilitation focus may be targeted at enhancing mobility functions, vocational and social skills.

Community satisfaction with indoor residue spraying for Malaria control in Karonga, Northern Malawi

Background The Malawi National Malaria Control Program conducted Indoor Residual Spraying (IRS) in 2010 and 2013 in selected hot districts along the valleys including Karonga, but no study has been done to measure community satisfaction levels in these areas. Aim To assess satisfaction levels of community with IRS in both rural and urban settings, in Karonga district. Methods A cross-sectional study was conducted in urban village of Mwahimba and rural village of Fundi. Qualitative and quantitative data was collected from households’ representatives through Focus Group Discussions (FGDs) using De Wets’s Schutte tool. Qualitative data was analysed using thematic analysis while numbers and percentages were generated using Microsoft excel. Results Overall level of satisfaction in Fundi was estimated at 69% while that of Mwahimba was at 60.9%. In Fundi village, 66.1 % (37) of the household representatives were satisfied while in Mwahimba village, 60.7 % (34) were satisfied with the IRS programme. Factors that led to satisfaction were minimal adverse effects of the chemical on people after spraying, killing of other insects, sprayer’ courtesy and good communication. Factors behind dissatisfaction include: short residual effect of the chemical used, over-dilution of the chemical and minimal community involvement. Conclusion Despite finding high satisfaction levels in rural village than in an urban village, overall all the villages reported low levels of satisfaction with IRS due to various factors some of which common to both villages. Karonga District Health Office needs to involve the community in the process of spraying by recruiting sprayers from the target area and also explaining the purpose of dilution and the dilution factor to community members.