SCHOOL OF MEDICINE, COLLEGE OF MEDICAL SCIENCES,

Background: Community-acquired infections (CAIs) are infections contracted outside healthcare facilities and constitute a significant source of morbidity among university students globally, particularly in environments characterized by overcrowding, shared sanitation facilities, poor ventilation, and inadequate hygiene infrastructure. In Nigeria, university halls of residence are defined by high population density and constrained living conditions, creating environments highly conducive to respiratory, gastrointestinal, skin, and vector-borne infection transmission. Despite this burden, comprehensive data on the knowledge, attitudes, hygiene practices, prevalence, treatment-seeking behaviour, and environmental determinants of community-acquired infections among hostel-resident undergraduate students in South￾South Nigeria remain scarce. Objective: This study aimed to assess the knowledge and preventive measures of students regarding community-acquired infections, ascertain their attitudes towards infections and preventive measures, determine the prevalence and types of infections experienced, and identify risk factors influencing recurrence among undergraduate students residing in the halls of residence at the University of Benin, Benin City, Edo State, Nigeria. Methods: A descriptive cross-sectional study was conducted among undergraduate students residing in the official halls of residence and affiliated hostels at the University of Benin, Ugbowo Campus, Benin City, Edo State, Nigeria. A multistage sampling technique was employed. The minimum sample size of 436 was calculated using the Cochran formula with a design effect of 2.0, based on an estimated infection prevalence of 85% and a precision of 0.05. A xvi total of 487 respondents were enrolled, yielding a 100% response rate. Data were collected using a structured, self-administered questionnaire adapted from the WHO KAP Framework (Cronbach’s α = 0.908 and 0.767 for knowledge and attitude respectively), the WHO/UNICEF JMP WASH indicators (α = 0.743 for hygiene practices), and a validated symptom-based infection history checklist for the six-month recall period. Data were entered and analysed using IBM SPSS version 27. Descriptive statistics were summarised as frequencies and percentages, while inferential analysis was conducted using chi-square tests, Fisher’s exact test, and binary logistic regression to identify predictors of infection. Statistical significance was set at p < 0.05. Results: A total of 487 undergraduate students participated, with a mean age of 21.16 ± 2.68 years; 295 (60.6%) were female and 462 (94.9%) were Christian. Almost four in five respondents (378; 77.6%) were aware of community-acquired infections. Among aware respondents, more than four-fifths (326; 86.2%) had good knowledge, with a mean composite score of 33.18 out of 40. Islamic religion (OR = 0.101; 95% CI: 0.025–0.407; p = 0.001), 100 Level (OR = 0.203; p = 0.014), 200 Level (OR = 0.244; p = 0.007), and non-medical faculty membership (OR = 0.405; p = 0.023) were significant independent negative predictors of good knowledge. Nearly nineteen in twenty respondents (461; 94.7%) held positive attitudes; Islamic religion was the only significant independent predictor (OR = 0.098; 95% CI: 0.034– 0.286; p < 0.001). About two-thirds (329; 67.6%) had good hygiene practices; Islamic religion (OR = 0.101; p < 0.001), 600 Level seniority (OR = 16.43; p = 0.009), and higher monthly allowance (OR = 1.554; p = 0.035) were significant independent predictors. The overall six-month infection prevalence was very high, with 418 (85.8%) reporting at least one infection. Respiratory tract infections were the most prevalent (87.1% of infected xvii respondents), followed by malaria (56.2%), gastrointestinal infections (48.6%), skin and soft tissue infections (32.5%), urinary tract infections (12.7%), and eye infections (6.9%). Male sex was the strongest independent predictor of lower infection odds (OR = 0.376; 95% CI: 0.207–0.681; p = 0.001), while frequent common area cleaning was the strongest independent environmental predictor (OR = 0.195; 95% CI: 0.057–0.666; p = 0.009). Among infected respondents, 368 (88.0%) sought treatment; purchasing drugs from a pharmacy was the most common action (53.3%). Good hygiene practices was the strongest independent predictor of early treatment-seeking (OR = 3.052; p = 0.009). Critical environmental deficits were documented: 80.1% reported no soap in hostel toilets, 90.1% had no access to hand sanitizer, and 72.5% described room ventilation as poor or very poor. Conclusion: The burden of community-acquired infections among undergraduate students in the University of Benin halls of residence is very high, with respiratory tract infections, malaria, and gastrointestinal infections predominating. Although awareness and positive attitudes toward prevention were near-universal, knowledge deficits among junior and non-medical students and structural deficiencies including absent soap, poor ventilation, and infrequent common area cleaning remained the dominant determinants of infection risk. Consistent with the Health Belief Model, high perceived barriers in the form of structurally deficient hostel infrastructure negated the protective potential of adequate knowledge and positive attitudes. Frequent common area cleaning was the strongest modifiable predictor of freedom from infection. University management, the Estates Department, Student Affairs Directorate, and Health Centre should implement coordinated interventions encompassing urgent hostel infrastructure upgrades, mandatory infection prevention curricula for non-medical faculties, xviii religion-sensitive health communication, and proactive student health outreach to substantially reduce the infection burden in the residential setting.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning and development. In Nigeria, ADHD remains largely underdiagnosed and poorly understood, particularly among primary school teachers who serve as frontline identifiers of the condition. Children with ADHD in Nigerian classrooms are often mislabelled as stubborn, lazy, or poorly disciplined due to low teacher awareness and inadequate training on neurodevelopmental disorders. This study assessed the knowledge, attitudes, and classroom management practices regarding ADHD among primary school teachers in the Oredo Local Government Area, Benin City, to identify gaps in understanding and the factors influencing teachers' attitudes and practices. It further explores the impact of these factors on classroom identification and support for children with ADHD. The findings from this research will help develop targeted training approaches to raise awareness, reduce stigma, and improve educational outcomes for children with ADHD in primary schools. METHODS: A descriptive cross-sectional study was conducted among 435 primary school teachers in Oredo Local Government Area, Benin City, who were selected using a multistage sampling technique. Data were collected via structured self-administered questionnaires adapted from the Knowledge of Attention Deficit Disorders Scale (KADDS), the ADHD Specific Attitudes Scale (SASA), and the Behaviour and Instructional Management Scale (BIMS). IBM SPSS version 27.0 was used for data analysis. Descriptive data were expressed as frequencies, percentages, means, and standard deviation. Associations between socio demographic factors and knowledge, attitudes, and classroom management practices were analyzed using the chi-square test and logistic regression. The level of significance was set at p <0.05 at 95% confidence interval. Results were presented in prose, tables, and bar charts. RESULTS: The mean age of respondents was 38.72 ± 8.43 years. The majority 296 (68.0%) were female, and most identified as Benin 203 (46.7%). A significant portion 384 (88.3%) were Christians, and 217 (49.9%) held Nigeria Certificate in Education as their highest qualification. Most teachers, 241 (55.4%), worked in public schools, and 165 (37.9%) had 11 to 20 years of teaching experience. Knowledge assessment revealed that only 62 (14.3%) of teachers displayed adequate knowledge of ADHD, while 296 (68.0%) had low knowledge, particularly in the domains of symptoms, diagnosis, causes, and outcomes. Regarding attitudes, 255 (58.6%) held positive attitudes toward ADHD, though only 52 (11.9%) felt capable of effectively teaching students with ADHD behaviours. Classroom management practices showed that 359 (82.5%) demonstrated high adoption of general management strategies, yet all 435 (100%) teachers reported having no access to school counsellors or special education professionals. Nearly all teachers 431 (99.1%) expressed a strong desire for more training on ADHD. Significant associations were observed between knowledge and school type (p = 0.039), attitude and age group (p = 0.025), as well as attitude and school type (p < 0.001). Teachers with education-based qualifications were 4.2 times more likely to adopt evidence-based management strategies (OR = 4.189, p < 0.001). CONCLUSION: The study demonstrated that more than two-thirds of primary school teachers had poor knowledge of ADHD, with factors such as school type, age, and qualification type playing significant roles. The study also revealed that while a slight majority held positive attitudes toward ADHD, only a small minority felt confident in teaching students with the condition. This study highlights significant gaps in teachers' knowledge and self-efficacy regarding ADHD, with important implications for classroom identification and support. Addressing these challenges through mandatory ADHD training in teacher education, in-service workshops, and deployment of school counsellors is essential to improve early identification and educational outcomes for children with ADHD in Benin City.

Background: Undergraduate students are the upcoming workforce of any country and their health is essentially linked to the social and economic development of the country. Health- seeking behaviour and health outcomes are shaped by socio-cultural beliefs, accessibility, cost and perceived quality of available health services and these affect health outcomes and indices. This study aimed at assessing the perception of, satisfaction with, major barriers to utilization, major health conditions prompting utilization of on-campus health services and factors influencing use of alternative sources of healthcare. Methods: The study was a descriptive cross-sectional study carried out among undergraduate students of University of Benin, Benin, Edo State, Nigeria. A sample size of 430 was obtained, and a multistage sampling technique was used to select respondents. A self-administered questionnaire was used to collect the data for the study after pretesting. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 25 and the level of statistical significance was set at p<0.05. Results: The mean age of respondents was 23.0 ± 3.2 years. A higher proportion, 52.8% were male, Christians (58.1%) and single (67.7%). Out of 430 respondents, 61.4% resided off-campus, 52.6% received a monthly allowance of between 50,001 to 100,000 naira and 73.5% received support from their parents. From the responses, 41.4% had received care at the health center in the past year and were most commonly by joint pain (21.9%), fever (15.7%) and headaches (11.8%). Ninety-five percent and 99.0% had a good perception of health center and were satisfied with the services provided there respectively. Common barriers to seeking health care at the center were long waiting time (37.4%), out-of-pocket payments (17.9%).