Transcript COMPREHENSIVE HEALTH SCREENING

YOU
AND YOUR
HEALTH
7/17/2015
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PRESENTED
@
Christ Life Church,
Olubadan Estate, Ibadan
Sunday 28th February 2010
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by
Dr Olugbenga Bejide
M.B.,B.S.,M.B.A.,M.P.H.,F.N.I.M.
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TODAY
………..is the day
the Lord has made
We shall rejoice and
be glad in Him
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COVERAGE
• INTRODUCTION
• HEALTHY LIFESTYLE TIPS
• COMPREHENSIVE HEALTH SCREENING
•
•
•
•
•
CANCER SCREENING
THE MENACE OF NOISE
HEALTH INSURANCE
HIV/AIDS
SUMMARY AND CONCLUSION
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YOUTH
•Defining
YOUTH
•Describing YOUTH
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HEALTH
• Defining
HEALTH
• Describing HEALTH
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DEFINITION OF HEALTH
……the state of physical, mental and
social well-being and not just the
absence of disease or infirmity…………
(WHO, 1948)
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SUCCESS
• PLAN
PURPOSEFULLY
• PREPARE PRAYERFULLY
• PROCEED
• PURSUE
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POSITIVELY
PERSISTENTLY
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PERSONAL VISION
STATEMENT
Please state yours
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PERSONAL MISSION
STATEMENT
Please state yours
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ROLE OF ATTITUDE
Its your
ATTITUDE
rather than your
APTITUDE
that determines your
ALTITUDE
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in life
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KEYNOTES IN NIGERIA
•
•
•
•
The most religious in the world
The happiest people in the world
The most populous African country
Houses the highest number of sicklers
in the entire world
• Houses the highest number of multiple
pregnancies in the world
• Has the highest number of PLWHA
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SCRIPTURAL HIGHLIGHTS
• Hosea 4: 6
My people perish for lack of knowledge
• Proverbs 23: 7
As a man thinketh, so he is
• Ecclesiastes 1: 18
He that increaseth knowledge
increaseth sorrow
• Ecclesiastes 3: 1-8
To everything there is a season,
and a time to every purpose under the heaven
• Matthews 25:14-30
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The parable of the talent
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SCRIPTURAL HIGHLIGHTS(2)
• Exodus 23:20
Behold I send an angel before thee to keep
thee in the way and to bring thee into the place I have prepared
• Exodus 23 :25
and I will take sickness away from
their midst
• Luke 1:37
For with God nothing shall be impossible
• Numbers 21: 1-9
• Revelations 22:11
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The story of the serpent of brass
He that is filthy, …
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SOME
HEALTHY
LIFESTYLE
TIPS
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HEALTH TIPS(1)
• A healthy day is spent thus: 1/3 work,
1/3 sleep and 1/3 recreation
• Please note that you are what you eat
• Eat and drink moderately
• Take plenty of vegetables and fruits
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HEALTH TIPS (2)
• Eat beans and bean products regularly
• Avoid junk food items
• Avoid red meat, fresh fish and dairy products
• Skip dinner if you can or make it very light
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HEALTH TIPS (3)
• Avoid eating in between meals
• Avoid additional salt or sugar
• Please note that the slimmer you are,
the healthier(aim at right weight for height)
• Regular dedicated physical exercise vital
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HEALTH TIPS(4)
• Take at least 8 glasses of water/day
• Note that LOW ALCOHOL INTAKE is
healthier than NO ALCOHOL INTAKE
• Avoid smoking in any form
• Avoid unprescribed drugs
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HEALTH TIPS(5)
• Always use correct lifting techniques
to avoid musculo-skeletal disorders
• Always use your seat belt while driving
• Avoid casual sex
• Periodic health assessment/check-up vital
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COMPREHENSIVE
HEALTH SCREENING
aka
PERIODIC HEALTH ASSESSMENT
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NOTE
Your health is your
greatest
ASSET
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NOTE
Sometimes you don’t
appreciate what you
have until you lose it!
e.g. sleep
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PREVENTIVE MAINTENANCE
.......of machines including
vehicles, generators,
air-conditioner units
and even computers
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WHEREAS
Man is the most complex
MACHINE
in the entire world!
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LIFE SPAN:nature & nurture
• Japan
• Denmark
• USA
• Nigeria
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GENERAL GUIDE FOR CHECK-UPS
< 30 years
Once
30 - 40 years
Once in 5 years
40 - 50 years
Once in 2 years
50 - 60 years
Every year
60 - 70 years
Every six months
> 70 years Every three months
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MEDICAL CHECK CLASSES
•
•
•
•
•
A
B
C
D
E
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Advanced
Basic
Classical
Diamond
Elementary
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CLASS E
• General Physical Examination
• Weight, Height (BMI), Blood Pressure, Pulse,
• Visual Acuity
• FBC + FBS
+ FU
• ABO Blood Grouping + Haemoglobin Genotype
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CLASS D
•
•
•
•
•
Class E
+
Hepatitis B Screening
Hepatitis C Screening
Retroviral Screening
Faecal Occult Blood
H. pylori
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CLASS C
•
•
•
•
Class D
+
Chest Xray
Fundoscopy
Lipid Profile
Liver Function Tests
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CLASS B
Class C
+
• Electrocardiograph (ECG)
• Abdominal Ultrasound
• Renal Function Tests
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CLASS A
Class B
+
• PSA/Pap’s Smear
• ENT
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STEPS
(1)
• 1
Preparatory Chat
• 2
Health Questionnaire
• 3
Visit to the Nurse (Class E/D)
• 4
Visit to external laboratories (Class C/B)
• 5
Visit to specialists (Class C/B/A)
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STEPS (2)
• 6
Collation of results
• 7
Compilation of results
• 8
Discussion with clients
• 9
Follow up visits
• 10
Seeking Spouse cooperation
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MEDICAL REPORT
• Comprehensive Medical Report
• Highlighting key positive findings
• Summary and Conclusion
• Medical advice
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METABOLIC SYNDROME
• Total Cholesterol
• Trigylicerides
• FBS
Fasting Blood Sugar
• BMI
Body Mass Index
• AC
Abdominal Circumference
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BENEFITS
• Health Score Card
• Preventive Maintenance
• Taking Responsibility for Your Health
• Improved Quality of Life
• Lifestyle Modification
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REMEMBER
God’s promise:
…....I will take sickness
away from thy midst
Exodus 23:25
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CANCER
SCREENING
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What Is Cancer?
Cancer is the
name given
to a large
number of
diseases
Breast Cancer
BREAST CANCER
Breast Structure
Breast Cancer Facts
MC female cancer,
worldwide & Nigeria

Leading cause of female
cancer deaths in Nigeria

Incidence  with age

All women are at risk

Breast Cancer Risk Factors
that cannot be changed
Age
Family/Personal
History
Race
Treatment with
DES
GENDER - All
women are
at risk
Reproductive
History
Menstrual
History
Radiation
Genetic
Factors
Breast Cancer Risk Factors
that can be controlled
Obesity
All
women are
at risk
Exercise
Breastfeeding
Alcohol
Hormone
Replacement
Therapy
Not having
children
Birth Control
Pills
A Good Breast Health Plan
1.
2.
3.
Mammograms
Clinical Breast
Examination
(CBE)
Self Awareness
(Monthly Self
Exams) (BSE)
A Good Breast Health Plan
1.
2.
3.
Mammograms
Clinical Breast
Examination
(CBE)
Self Awareness
(Monthly Self
Exams) (BSE)
Mammography
Average-size lump found by woman practicing occasional
breast self-exam (BSE)
Average-size lump found by woman practicing regular
breast self-exam (BSE)
Average-size lump found by first mammogram
Average-size lump found by getting regular
mammograms
BREAST SELF
EXAMINATIONS
Warning Signs
Warning signs and symptoms:





Painless lump or thickening
Thickening or swelling that persist
Nipple pain or retraction
Breast skin irritation or dimpling
Spontaneous discharge
Early breast cancer
may not have symptoms.
American Cancer Society
Screening Recommendations
 Annual mammograms, starting
at age 40
 Clinical breast exams
every year starting at age 40
– every 3 years for women age
20-39
–
 Self-breast exams monthly,
starting at age 20
Nutrition Guidelines
Eat
a variety of healthful
foods, with an emphasis on
plant sources.
Adopt a physically active
lifestyle.
Maintain a healthful weight
throughout life.
If you drink alcoholic
beverages, limit
consumptions.
Cervical Cancer
CERVICAL CANCER
What Is The Cervix [Ser-vix]?
• The cervix is one of
the female genital
organs
• Other female organs
include the:
– Vulva [vul-vah]
– Vagina [ve-juynah]
– Uterus [yoo-tuhris]
– Fallopian tubes
[fuh-loh-pee-an
toobs]
Cervical Cancer Facts
• 2nd commonest female
cancer in Nigeria
• 2nd MCC of cancer deaths
• The easiest female cancer
to prevent through
screening
What Causes Cervical Cancer?
Human Papillomavirus (HPV)
▪ Genital HPV is a virus that is spread by sex
• You could have been infected with HPV years
ago but only recently had it found on a test
• There are many different types of HPV
• Certain “high-risk” HPV types can cause cell
changes and cervical cancer
Early Cell Changes
How Common Is HPV?
• Most men and women who have
had sex have been exposed to
HPV
• Most sexually active women (at
least 80%) have been exposed to
HPV by age 50
Who Is At Higher Risk For HPV?
• Anyone who has had more
than one sex partner
• Anyone whose sex partner(s)
has had more than one sex
partner
Does HPV = Cancer?
• No! Most people get HPV infection,
but very few get cervical cancer
• In most cases, HPV infection goes
away on its own
• Sometimes, the HPV infection does
not go away after many years. This
type is called “persistent”. It can
lead to cervical cancer
How Do I Know If I Have HPV?
• Abnormal Pap smear results are
often a sign of HPV
What Is A Pap Smear?
• Cells are collected from the surface of
your cervix by a doctor
• These cells are then checked under a
microscope for any abnormalities
• If abnormal (or precancerous) cells are
found, they can be treated before they
turn into cancer
• Cervical cancer can be found in the
Early Cell Changes
Normal cervical cells
Precancer cells
Who Is At Risk For Cervical
Cancer?
• Women who do not have Pap
tests
• Women who do not follow up
with testing or treatment after
an abnormal Pap test, as told
by their health care provider
• Women who have persistent
HPV
• Women who smoke
Who Is At Risk For Cervical Cancer?
• Women with immune problems
• HIV
• Transplanted organs
• Steroid medications
• Chemotherapy
• Women whose mothers took the
drug, DES
How Do I  My Risk Of Cervical
Ca?
• Get regular Pap tests and follow up, if
necessary
• Abstain till marriage and choose a
spouse who has had no or few prior sex
partners.
• Be faithful in marriage.
• Do not smoke cigarettes
• Keep a healthy diet and lifestyle
• (Condom use)
What Will A Pap Smear Tell Me?
That The Cells In Your Cervix Are…
• Normal
• Abnormal:
– Minor Cell Changes Of Unknown
Importance, Possibly Unrelated To
Precancer
– Minor Cell Changes
– Moderate Cell Changes
How Often Do I Need A Pap
Smear?
• First Pap
– No more than 3 years after you first have
sex
– No later than age 21
• Subsequently
– Every year until age 30
– After age 30, if you have had only normal
results, you may have them every 2 to 3
years (after talking with your health care
Why Do I Need To Keep Getting
Tested?
• Just like mammogram screening, Pap testing is
not a one-time test
• The test is not perfect
• New changes (abnormalities) can occur after you
get tested, even if you have not had new partners
• It could take many years for changes to develop
or to be noticed
• Your risk changes if you have new partners, or if
your partner has other partners
What Can I Do To Make My
Pap Smear As Accurate As
Possible?
• Schedule your Pap smear when you are
not having a menstrual period
• Do not have sex for 2 days before the
test
• Do not douche for 2 days before the test
• Do not use tampons, birth control
foams, jellies, or other vaginal creams
and drugs for 2 days before the test.
What Can I Do To Make My
Pap Smear As Accurate As
Possible?
• Schedule your Pap smear when you are
not having a menstrual period
• Do not have sex for 2 days before the
test
• Do not douche for 2 days before the test
• Do not use tampons, birth control
foams, jellies, or other vaginal creams
and drugs for 2 days before the test.
What Should I Expect When I
Have a Pap Smear?
What Should I Expect When I
Have a Pap Smear?
Follow-Up For Pap Smear
Results
• You can call or re-visit your doctor
for your results.
• If you have an abnormal result, it is
extremely important to show up for
follow-up appointments and get the
recommended testing
• Even after a normal Pap test, it is
still important to report any
symptoms of abnormal vaginal
bleeding, discharge, or pain to
PROSTATE CANCER
PROSTATE GLAND
What Is The Prostate Gland?
•Part of the male
reproductive system
•Makes a fluid that
mixes with sperm and
other fluids during
ejaculation.
•A normal prostate is
about the size of a
walnut.
Prostate Cancer Facts
• 5th MC cancer worldwide
• MC cancer in men in Nigeria (11%)
• Risk factors
– Age (>50)
– Race (Blacks)
– Family history
– High fat diet/obesity
• Many tumours are only histologically
Possible Symptoms of Prostate
Cancer
• Call your doctor if you have any of
these symptoms:
– Difficulty starting to urinate
– Less force to the stream of urine
– Dribbling after you finish urinating
– Frequent urination
– Blood or pus in the urine
– Pain or burning feeling while urinating
Prostate Cancer Screening
• Screening tests for prostate
cancer
– Prostate Specific Antigen
•
•
•
•
•
Blood test
<4 ng/ml Normal
>10ng/ml High
4-10ng/ml Intermediate
Also  in BPH & Prostatitis
– Digital Rectal Exam
Prostate Cancer Screening
• Insufficient evidence from studies abroad
to recommend routine prostate screening
• Many studies failed to show improvement
in mortality or morbidity from screening
• Recent data that treatment of early
detected ca (other than discovered by
screening) decreases mortality
• However, no evidence that screening
THE MENACE OF
NOISE
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HEARING CONSERVATION PROGRAMME :
LOCAL STUDIES
• Agodi Motor Park, Agodi Gate
• Ayons Musical Centre, Sanngo
• Dupsy Grinders Shop, Bodija Market
84
OTHER POTENTIALS
•
•
•
•
•
•
•
Noisy musical neighbours
Car stereo
Office music
Religious noise to the Lord!!
Market cacophony
Ear phones/hand-free sets
Airport environment
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PRESBYACUSIS
• …..means natural progressive age-related
loss of hearing commencing
from the
age of 40
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NOISE LEVELS
• < 85 decibels over 8 hours
• Sound level meter
• Personal dosimeter
• Noise survey
• Noise map
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CONTROLS
• Engineering
• Administrative
• Epidemiological
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DEVICES
• Encasement/glass panels
• Ear muffs
• Ear plugs
-standard
--
customised
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INTERVENTION
• Drugs e.g. vitamin supplements,
nasal drops
• Hearing aids
• Surgery(ENT)
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PREVENTION
`
is however
better
than
CURE!!
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INSURING
YOUR HEALTH
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THE PEOPLE SAY:
HEALTH
is
WEALTH
WHO says:
….the state of physical, mental and
social well being and not just the
absence of disease or infirmity!
(WHO 1948)
NOTE
Your health is
your greatest
ASSET
WHAT DO THESE HAVE IN
COMMON?
AIR
SLEEP
HEALTH
HEALTH CARE
is no longer
a pay as you go affair
HEALTH CARE FINANCING
OPTIONS
•
•
•
•
•
•
•
Relations
Community
Government (federal, state, local)
Employer
Personal (out-of-pocket)
Trade by barter
Health insurance
HEALTH INSURANCE
• National Health Insurance
Scheme (NHIS)
• Health Maintenance
Organisations (HMO) e.g. Total
Health Trust(THT), Hygeia
CAPITATION SCHEME
•
•
•
•
•
•
•
Pre-paid
Per head (capitus)
Option of choice and transfer
ID Badges provided
ID badges usable anywhere in the network
Different Categories
No age barrier
CATEGORIES
• Standard plan
• Silver plan
• Gold plan
MEDICAL EXCLUSIONS(I)
•
•
•
•
•
•
•
Evacuation
Intensive care treatment
Optical care
Cytotoxic drugs
Radiotherapy
Plastic/cosmetic surgery
Transplant surgery
MEDICAL EXCLUSIONS(II)
•
•
•
•
•
•
•
Prostheses
Specific treatment of HIV/AIDS
Infertility
Advanced radiology e.g. CT scan, MRI, etc
Overseas treatment
Dental care
Embalment and autopsy
THE TAKE HOME
ENSURE
Your health
By
INSURING
Your health
TODAY
HIV/AIDS
CURRENTLY THE
GREATEST PANDEMIC OF
MANKIND
MORE DEVASTATING THAN
ALL THE WARS COMBINED
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ABC OF HIV PREVENTION
• A
ABSTINENCE
• B
BE FAITHFUL
• C CORRECT CONSISTENT CONDOM
USE
106
ATM OF HIV PREVENTION
• A
abstinence
• T
till
• M
marriage
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HIGH RISK TARGET GROUPS
• Long distance truck drivers
• Employees who live far apart from
their families
• Employees in Sales Division
• Employees involved in promotional
activities
• Health Care Workers
108
2008 National HIV SeroPrevalence Sentinel Survey
Among the Antenatal Clinic
Attendees
Preliminary Findings
Be nue
10.6
Nas ar aw a
10.0
FCT
9.9
Ak w a Ibom
9.7
Cr os s Rive r
8.0
Rive r s
7.3
Baye ls a
7.2
Kaduna
7.0
Adam aw a
6.8
Nige r
6.2
Sok oto
6.0
Enugu
5.8
State
Anam br a
5.6
Edo
5.2
Tar aba
5.2
Lagos
5.1
Kogi
5.1
Abia
5.0
Im o
4.6
Gom be
4.0
De lta
3.7
Bauchi
3.1
Ke bbi
2.9
Ebonyi
2.8
Yobe
2.7
Plate au
2.6
Kats ina
2.6
Ondo
2.4
Kano
2.2
Oyo
2.2
Zam far a
2.1
Bor no
2.0
Kw ar a
1.8
Ogun
1.7
Jigaw a
Os un
Ek iti
0.0
1.6
1.2
1.0
2.0
4.0
6.0
Prevalence (% )
8.0
10.0
12.0
HIV prevalence by zone
8
7.0
Prevalence (%)
7
6
5.4
4.6
5
3.7
4
3
2
4.0
2.4
2
1
0
SW
NW
SE
NE
ZONE
NC
SS
NATIONAL
HIV Prevalence by age group
5.6
6
5
Prevalence (%)
4.9
4.6
4.1
4
3.3
2.9
3
2
1
0
15-19
20 - 24
25-29
30-34
Age Group (Years)
35-39
40-44
National HIV Prevalence Trend 1991 – 2008
7.0
6.0
5.8
5.4
5.0
5.0
Prevalence (%)
4.5
4.0
4.4
4.6
3.8
3.0
2.0
1.8
1.0
0.0
1991
1993
1995/96
1999
2001
Year
2003
2005
2008
Summary of findings
• Overall HIV Prevalence was 4.6% .
• Prevalence range: 1.0% in Ekiti to 10.6% in
Benue
• All states and FCT had prevalence greater
than 1%
• 17 states and FCT had prevalence greater
than 5%
• In 7 of the states and FCT the prevalence
was 7% and above; 4 of the states were from
the SS, 2 and FCT from NC and 1 from the
NW geo-political zones
Summary of findings cont.
• Bwari in FCT had the highest site prevalence of
22.0% while the least (0.0%) was recorded in
Igbara Odo (Ekiti), Ganawuri (Plateau), Taura
(Jigawa) and Tudun wada (Kano State)
• The prevalence was higher among those with
primary and secondary level education and least
among those with Qur’anic only
• There was a declining HIV prevalence trends
among women aged 15-24yrs from 2001-2008
• 5 states showed a declining HIV prevalence trend
from 2001-2008 while one showed an increasing
trend.
• About 3 million PLWH out of which 833,000 require
RECAP
• INTRODUCTION
• HEALTHY LIFESTYLE TIPS
• COMPREHENSIVE HEALTH SCREENING
•
•
•
•
•
CANCER SCREENING
THE MENACE OF NOISE
HEALTH INSURANCE
HIV/AIDS
SUMMARY AND CONCLUSION
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SUMMARY
We all need to
take ownership
of our health
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CONCLUSION
Are you ready
to take
ownership of
your health?
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THANK
YOU!
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QUESTIONS
AND
ANSWERS
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