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British Journal of Healthcare and Medical Research - Vol. 9, No. 2
Publication Date: April, 25, 2022
DOI:10.14738/jbemi.92.11931. Nwabuko, O. C., & John, R. E. (2022). Assessment of the Effectiveness of Health Education and Screening Test in Reducing Multiple
Myeloma in the Middle-Elderly Nigerians – The Rational for Proposed Study. British Journal of Healthcare and Medical Research,
9(2). 60-68.
Services for Science and Education – United Kingdom
Assessment of the Effectiveness of Health Education and
Screening Test in Reducing Multiple Myeloma in the Middle- Elderly Nigerians – The Rational for Proposed Study
Ogbonna Collins Nwabuko
Department of Haematology, University of Calabar
Calabar, Cross-River State, Nigeria
Department of Haematology, College of Health Science
Abia State University, Aba Campus, Abia State, Nigeria
Department of Haematology and Blood Transfusion
Federal Medical Centre, Umuahia, Abia State, Nigeria
Raphael Edoka John
Division of Urology, Department of Surgery
University of Port Harcourt, Port Harcourt, Rivers state, Nigeria
ABSTRACT
The developing countries including African union bear the highest global burden of
cancer. Multiple myeloma which accounts for 1-2% of all cancers globally is grossly
under-diagnosed in this part of the world. In Nigeria, it poses diagnostic dilemma to
the target population and therapeutic challenge due to late presentation of the few
newly diagnosed cases. This could be as a result of inability of the national cancer
control framework to activate the priority areas of actions on its control. This study
proposal highlights the rationale for conducting a public health education and
screening test for multiple myeloma in Nigeria and the immediate and long-term
benefits of this strategic leadership approach of reducing the burden of multiple
myeloma in the country. Scholarly articles indexed in PubMed, MedLine, Google
Scholar, African Journal Online (AJOL) databases were searched using ‘’multiple
myeloma and rational for screening’’ as medical subject headings. This paper
presented a synthesis of the reviewed articles and the expected outcomes of
possible interventions on the burden of multiple myeloma disease in Nigeria. The
study report was analysed and grouped according to the following categories:
problem statement and rationale, strategic ways education and screening for
myeloma can improve its survival outcome in Nigeria, study strengths and
weaknesses, proposed study design (Descriptive cross-sectional study design),
research methodology linked to the study designs and their pros and cons to
research question. Conclusion: This study proposal will serve as a public health
safety measure for reducing the burden of multiple myeloma in Nigeria. The
hallmark of the study outcome may be useful in strengthening the health
institutions in Nigeria to manage multiple myeloma effectively.
Keywords: Multiple myeloma (MM), Health education, Screening test, Policy-making,
Cancer, Nigeria
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Nwabuko, O. C., & John, R. E. (2022). Assessment of the Effectiveness of Health Education and Screening Test in Reducing Multiple Myeloma in the
Middle-Elderly Nigerians – The Rational for Proposed Study. British Journal of Healthcare and Medical Research, 9(2). 60-68.
URL: http://dx.doi.org/10.14738/jbemi.92.11931
PROBLEM STATEMENT AND RATIONALE
MM poses diagnostic dilemma to health care providers in Nigeria due to poor knowledge of the
clinical course of the disease. Similarly, the low level of health literacy among the sub- population target group is contributory to late presentation and late diagnosis of the disease.
The hallmark of this knowledge gap is poor case ascertainment and late commencement of
treatment. In Nigeria, it is presumed that MM accounts for 1021 out of 100,200 newly diagnosed
cancers annually.1 Unfortunately, the total number of newly diagnosed MM from previous
studies in the country is below 10% of the presumed cumulative incidence.2-4
In addition, the 5-year post-diagnosis life expectancy of less than 10% attributable to late
diagnosis and poor therapeutic interventions has placed Nigeria in a more moribund position
in the MM disease trajectory.3
This study will take a look at the knowledge, attitude (perception), and practices of health care
providers and sub-population of Nigerians at risk of having MM. The knowledge and perception
in this context defines the adaptation of the innovation ‘‘education (awareness)’’ while
‘‘practice’’ has to do with utilization of primary level of prevention, which in this case is the
screening test. Early detection of MM requires bridging the knowledge gap, attitudinal change
and increase utilization of the innovations for prevention by the different target groups.
STRATEGIC WAYS EDUCATION AND SCREENING FOR MM CAN IMPROVE ITS SURVIVAL
OUTCOME IN NIGERIA
The middle and elderly population of Nigeria contribute about 12.5% of the estimated 200
million Nigerian populace. That is to say that about 25 million Nigerians within the age range
of forty years and above (≥40 years) are at risk of MM.5 This disease is grossly under-diagnosed
in Nigeria due to weak health institutional policies, knowledge gap of the disease by the target
audiences and resource limitations.6 It is presumed that an estimated number of nine hundred
and fifty (950) cases of MM are undetected in Nigeria due to lack of health protective tools such
as surveillance and screening tests.2,7 There are many people who fall within the risk category
of MM who passed through the health institutions with their conditions (MM) misdiagnosed.4
In few cases where diagnoses were correctly made, complications have set in. The hallmark is
increased burden of MM as evidenced by high disability-adjusted life years (DALYs), low
quality-adjusted life years (QALYs) and survival intervals of people living with MM in the
country. This study will address the research question using three public health strategic
leadership approaches namely: health promotion, health prevention and health protection.
Health promotion in this context connotes awareness campaign or education of the target
audiences, who in this case are the policymakers, health care providers (HCPs) and MM sub- population target groups (i.e., the 25 million middle to elderly population at risk). It is believed
that education of the target audiences will increase their knowledge and perception towards
utilization of the right approaches to prevention.8 The mode of information dissemination in
this case include use of social media toolkits, handbills, conferences and other public health
service providers such as mass media (i.e., television and radio adverts) and social media
networks.9
The health prevention mechanisms include education of the target audiences using Health
Believe Model (HBM) behavioural theoretical elements for change evaluation.10 In this model,